MPT Operating Partnership 10-K 1 Mar 23 2022 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($) shares in Millions, $ in Billions	12 Months Ended
	Dec. 31, 2022	Feb. 17, 2023	Jun. 30, 2022
Document Information [Line Items]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2022
Document Fiscal Year Focus	2022
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		598.3
Entity Public Float			$ 9.1
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 25, 2023 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, 2022
Document Fiscal Year Focus	2022
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, 2022	Dec. 31, 2021
Real estate assets
Land	$ 1,948,216	$ 1,961,478
Buildings and improvements	10,352,308	10,581,992
Construction in progress	167,420	101,439
Intangible lease assets	1,394,471	1,417,813
Investment in financing leases	1,691,323	2,053,327
Real estate held for sale	0	1,096,505
Mortgage loans	364,101	213,211
Gross investment in real estate assets	15,917,839	17,425,765
Accumulated depreciation	(1,008,340)	(853,879)
Accumulated amortization	(184,972)	(139,221)
Net investment in real estate assets	14,724,527	16,432,665
Cash and cash equivalents	235,668	459,227
Interest and rent receivables	167,035	56,229
Straight-line rent receivables	787,166	728,522
Investments in unconsolidated real estate joint ventures	1,497,903	1,152,927
Investments in unconsolidated operating entities	1,444,872	1,289,434
Other loans	227,839	67,317
Other assets	572,990	333,480
Total Assets	19,658,000	20,519,801
Liabilities
Debt, net	10,268,412	11,282,770
Accounts payable and accrued expenses	621,324	607,792
Deferred revenue	27,727	25,563
Obligations to tenants and other lease liabilities	146,130	158,005
Total Liabilities	11,063,593	12,074,130
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 - 597,476 shares at December 31, 2022 and 596,748 shares at December 31, 2021	597	597
Additional paid-in capital	8,535,140	8,564,009
Retained earnings (deficit)	116,285	(87,691)
Accumulated other comprehensive loss	(59,184)	(36,727)
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital)	8,592,838	8,440,188
Non-controlling interests	1,569	5,483
Total Equity / Capital	8,594,407	8,445,671
Total Liabilities and Equity / Capital	19,658,000	20,519,801
MPT Operating Partnership, L.P. [Member]
Real estate assets
Land	1,948,216	1,961,478
Buildings and improvements	10,352,308	10,581,992
Construction in progress	167,420	101,439
Intangible lease assets	1,394,471	1,417,813
Investment in financing leases	1,691,323	2,053,327
Real estate held for sale		1,096,505
Mortgage loans	364,101	213,211
Gross investment in real estate assets	15,917,839	17,425,765
Accumulated depreciation	(1,008,340)	(853,879)
Accumulated amortization	(184,972)	(139,221)
Net investment in real estate assets	14,724,527	16,432,665
Cash and cash equivalents	235,668	459,227
Interest and rent receivables	167,035	56,229
Straight-line rent receivables	787,166	728,522
Investments in unconsolidated real estate joint ventures	1,497,903	1,152,927
Investments in unconsolidated operating entities	1,444,872	1,289,434
Other loans	227,839	67,317
Other assets	572,990	333,480
Total Assets	19,658,000	20,519,801
Liabilities
Debt, net	10,268,412	11,282,770
Accounts payable and accrued expenses	444,354	430,908
Deferred revenue	27,727	25,563
Obligations to tenants and other lease liabilities	146,130	158,005
Payable due to Medical Properties Trust, Inc.	176,580	176,494
Total Liabilities	11,063,203	12,073,740
Commitments and Contingencies
Equity / Capital
General partner - issued and outstanding - 5976 units at December 31, 2022 and 5,968 units at December 31, 2021	86,599	84,847
Limited Partners - issued and outstanding - 591,500 units at December 31, 2022 and 590,780 units at December 31, 2021	8,565,813	8,392,458
Accumulated other comprehensive loss	(59,184)	(36,727)
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital)	8,593,228	8,440,578
Non-controlling interests	1,569	5,483
Total Equity / Capital	8,594,797	8,446,061
Total Liabilities and Equity / Capital	$ 19,658,000	$ 20,519,801

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Dec. 31, 2022	Dec. 31, 2021
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	597,476,000	596,748,000
Common stock, shares outstanding	597,476,000	596,748,000
General Partner [Member] | MPT Operating Partnership, L.P. [Member]
General partner, units issued	5,976,000	5,968,000
General partner, units outstanding	5,976,000	5,968,000
Common Units | MPT Operating Partnership, L.P. [Member]
Limited Partners, units issued	591,500,000	590,780,000
Limited Partners, units outstanding	591,500,000	590,780,000

Consolidated Statements of Net

Consolidated Statements of Net Income - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Revenues
Rent billed	$ 968,874	$ 931,942	$ 741,311
Straight-line rent	204,159	241,433	158,881
Income from financing leases	203,580	202,599	206,550
Interest and other income	166,238	168,695	142,496
Total revenues	1,542,851	1,544,669	1,249,238
Expenses
Interest	359,036	367,393	328,728
Real estate depreciation and amortization	332,977	321,249	264,245
Property-related	45,697	39,098	24,890
General and administrative	160,494	145,638	131,663
Total expenses	898,204	873,378	749,526
Other income (expense)
Gain (loss) on sale of real estate	536,755	52,471	(2,833)
Real estate and other impairment charges, net	(268,375)	(39,411)	(19,006)
Earnings from equity interests	40,800	28,488	20,417
Debt refinancing and unutilized financing costs	(9,452)	(27,650)	(28,180)
Other (including fair value adjustments on securities)	15,344	45,699	(6,782)
Total other income (expense)	315,072	59,597	(36,384)
Income before income tax	959,719	730,888	463,328
Income tax expense	(55,900)	(73,948)	(31,056)
Net income	903,819	656,940	432,272
Net income attributable to non-controlling interests	(1,222)	(919)	(822)
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 902,597	$ 656,021	$ 431,450
Earnings per common share (units) basic
Net income attributable to MPT common stockholders (Operating Partnership partners), basic	$ 1.50	$ 1.11	$ 0.81
Earnings per common share (units) diluted
Net income attributable to MPT common stockholders (Operating Partnership partners), diluted	$ 1.50	$ 1.11	$ 0.81
Weighted average shares (units) outstanding basic	598,634	588,817	529,239
Weighted average shares (units) outstanding diluted	598,837	590,139	530,461
MPT Operating Partnership, L.P. [Member]
Revenues
Rent billed	$ 968,874	$ 931,942	$ 741,311
Straight-line rent	204,159	241,433	158,881
Income from financing leases	203,580	202,599	206,550
Interest and other income	166,238	168,695	142,496
Total revenues	1,542,851	1,544,669	1,249,238
Expenses
Interest	359,036	367,393	328,728
Real estate depreciation and amortization	332,977	321,249	264,245
Property-related	45,697	39,098	24,890
General and administrative	160,494	145,638	131,663
Total expenses	898,204	873,378	749,526
Other income (expense)
Gain (loss) on sale of real estate	536,755	52,471	(2,833)
Real estate and other impairment charges, net	(268,375)	(39,411)	(19,006)
Earnings from equity interests	40,800	28,488	20,417
Debt refinancing and unutilized financing costs	(9,452)	(27,650)	(28,180)
Other (including fair value adjustments on securities)	15,344	45,699	(6,782)
Total other income (expense)	315,072	59,597	(36,384)
Income before income tax	959,719	730,888	463,328
Income tax expense	(55,900)	(73,948)	(31,056)
Net income	903,819	656,940	432,272
Net income attributable to non-controlling interests	(1,222)	(919)	(822)
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 902,597	$ 656,021	$ 431,450
Earnings per common share (units) basic
Net income attributable to MPT common stockholders (Operating Partnership partners), basic	$ 1.50	$ 1.11	$ 0.81
Earnings per common share (units) diluted
Net income attributable to MPT common stockholders (Operating Partnership partners), diluted	$ 1.50	$ 1.11	$ 0.81
Weighted average shares (units) outstanding basic	598,634	588,817	529,239
Weighted average shares (units) outstanding diluted	598,837	590,139	530,461

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Net income	$ 903,819	$ 656,940	$ 432,272
Other comprehensive income:
Unrealized gain (loss) on interest rate swaps, net of tax	100,550	52,288	(33,091)
Foreign currency translation (loss) gain	(123,007)	(37,691)	44,672
Total comprehensive income	881,362	671,537	443,853
Comprehensive income attributable to non-controlling interests	(1,222)	(919)	(822)
Comprehensive income attributable to MPT common stockholders (Operating Partnership Partners)	880,140	670,618	443,031
MPT Operating Partnership, L.P. [Member]
Net income	903,819	656,940	432,272
Other comprehensive income:
Unrealized gain (loss) on interest rate swaps, net of tax	100,550	52,288	(33,091)
Foreign currency translation (loss) gain	(123,007)	(37,691)	44,672
Total comprehensive income	881,362	671,537	443,853
Comprehensive income attributable to non-controlling interests	(1,222)	(919)	(822)
Comprehensive income attributable to MPT common stockholders (Operating Partnership Partners)	$ 880,140	$ 670,618	$ 443,031

Consolidated Statements of Equi

Consolidated Statements of Equity / Capital - USD ($) shares 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]	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, 2019	$ 7,028,154,000	$ 7,028,544,000	$ 70,939,000				$ 518,000	$ 7,020,403,000		$ 7,007,422,000	$ 83,012,000		$ (62,905,000)	$ (62,905,000)	$ 107,000	$ 107,000
Beginning balance (Accounting Standards Update 2016-13) at Dec. 31, 2019					$ (8,399,000)	$ (84,000)			$ (8,315,000)
Beginning balance (in shares) at Dec. 31, 2019			5,176				517,456	512,280									232
Net income	432,272,000	432,272,000	$ 4,315,000					$ 427,135,000			431,450,000				822,000	822,000
Unrealized gain (loss) on interest rate swaps, net of tax	(33,091,000)	(33,091,000)											(33,091,000)	(33,091,000)
Foreign currency translation gain (loss)	44,672,000	44,672,000											44,672,000	44,672,000
Stock (Unit) vesting and amortization of stock-based compensation	47,154,000	47,154,000	$ 472,000				$ 2,000	$ 46,682,000		47,152,000
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)			29				2,893	2,864
Sale of non-controlling interests	5,097,000	5,097,000													5,097,000	5,097,000
Redemption of MOP units	(4,928,000)	(4,928,000)						$ (4,928,000)		(4,928,000)
Redemption of common units (shares)								(232)
Conversion of LTIP units to common units (shares)								232									(232)
Distributions to non-controlling interests, net	(701,000)	(701,000)													(701,000)	(701,000)
Proceeds from offering (net of offering costs)	411,101,000	411,101,000	$ 4,111,000				$ 21,000	$ 406,990,000		411,080,000
Proceeds from offering (net of offering costs) (shares)			209				21,004	20,795
Dividends (Distributions) declared	(577,474,000)	(577,474,000)	$ (5,776,000)					$ (571,698,000)			(577,474,000)
Ending balance at Dec. 31, 2020	7,343,857,000	7,344,247,000	$ 73,977,000				$ 541,000	$ 7,316,269,000		7,460,726,000	(71,411,000)		(51,324,000)	(51,324,000)	5,325,000	5,325,000
Ending balance (Accounting Standards Update 2016-02) at Dec. 31, 2020				$ (8,399,000)								$ (8,399,000)
Ending balance (in shares) at Dec. 31, 2020			5,414				541,353	535,939
Net income	656,940,000	656,940,000	$ 6,560,000					$ 649,461,000			656,021,000				919,000	919,000
Unrealized gain (loss) on interest rate swaps, net of tax	52,288,000	52,288,000											52,288,000	52,288,000
Foreign currency translation gain (loss)	(37,691,000)	(37,691,000)											(37,691,000)	(37,691,000)
Stock (Unit) vesting and amortization of stock-based compensation	52,110,000	52,110,000	$ 521,000				$ 3,000	$ 51,589,000		52,107,000
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)			23				2,332	2,309
Distributions to non-controlling interests, net	(761,000)	(761,000)													(761,000)	(761,000)
Proceeds from offering (net of offering costs)	1,051,229,000	1,051,229,000	$ 10,512,000				$ 53,000	$ 1,040,717,000		1,051,176,000
Proceeds from offering (net of offering costs) (shares)			531				53,063	52,532
Dividends (Distributions) declared	(672,301,000)	(672,301,000)	$ (6,723,000)					$ (665,578,000)			(672,301,000)
Ending balance at Dec. 31, 2021	8,445,671,000	8,446,061,000	$ 84,847,000				$ 597,000	$ 8,392,458,000		8,564,009,000	(87,691,000)		(36,727,000)	(36,727,000)	5,483,000	5,483,000
Ending balance (in shares) at Dec. 31, 2021			5,968				596,748	590,780
Net income	903,819,000	903,819,000	$ 9,026,000					$ 893,571,000			902,597,000				1,222,000	1,222,000
Unrealized gain (loss) on interest rate swaps, net of tax	100,550,000	100,550,000											100,550,000	100,550,000
Foreign currency translation gain (loss)	(123,007,000)	(123,007,000)											(123,007,000)	(123,007,000)
Stock (Unit) vesting and amortization of stock-based compensation	49,421,000	49,421,000	$ 494,000				$ 3,000	$ 48,927,000		49,418,000
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)			37				3,675	3,638
Stock (Unit) vesting - satisfaction of tax withholding	(29,922,000)	(29,922,000)	$ (299,000)				$ (1,000)	$ (29,623,000)		(29,921,000)
Stock (Unit) vesting - satisfaction of tax withholding (shares)			(13)				(1,302)	(1,289)
Repurchase of units	(17,940,000)	(17,940,000)	$ (179,000)				$ (2,000)	$ (17,761,000)		(17,938,000)
Repurchase of units (shares)			(16)				(1,645)	(1,629)
Acquisition of non-controlling interest	(35,022,000)	(35,022,000)	$ (304,000)					$ (30,124,000)		(30,428,000)					(4,594,000)	(4,594,000)
Redemption of MOP units		0
Issuance of non-controlling interest	1,054,000	1,054,000													1,054,000	1,054,000
Distributions to non-controlling interests, net	(1,596,000)	(1,596,000)													(1,596,000)	(1,596,000)
Dividends (Distributions) declared	(698,621,000)	(698,621,000)	(6,986,000)					(691,635,000)			(698,621,000)
Ending balance at Dec. 31, 2022	$ 8,594,407,000	$ 8,594,797,000	$ 86,599,000				$ 597,000	$ 8,565,813,000		$ 8,535,140,000	$ 116,285,000		$ (59,184,000)	$ (59,184,000)	$ 1,569,000	$ 1,569,000
Ending balance (in shares) at Dec. 31, 2022			5,976				597,476	591,500

Consolidated Statements of Eq_2

Consolidated Statements of Equity / Capital (Parenthetical) - $ / shares	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Dividends (Distributions) declared per common share / unit	$ 1.16	$ 1.12	$ 1.08
MPT Operating Partnership, L.P. [Member]
Dividends (Distributions) declared per common share / unit	1.16	1.12		$ 1.08
MPT Operating Partnership, L.P. [Member] | General Partner [Member]
Dividends (Distributions) declared per common share / unit	1.16	1.12		1.08
Common Par Value [Member] | MPT Operating Partnership, L.P. [Member] | Limited Partner [Member]
Dividends (Distributions) declared per common share / unit	$ 1.16	$ 1.12		$ 1.08

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Operating activities
Net income	$ 903,819	$ 656,940	$ 432,272
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	345,577	333,781	275,953
Amortization of deferred financing costs and debt discount	17,045	16,856	13,099
Straight-line rent revenue and other	(282,504)	(288,717)	(226,906)
Stock / (Unit)-based compensation expense	49,421	52,110	47,154
(Gain) loss from sale of real estate	(536,755)	(52,471)	2,833
Real estate and other impairment charges	268,375	39,411	19,006
Write-off of unbilled rent and other	34,605	7,213	26,415
Debt refinancing and unutilized financing costs	9,452	27,650	28,180
Gain on sale of equity investments		(40,945)
Tax rate and other changes	10,697	34,796	9,295
Pre-acquisition rent collected - Circle Transaction			(35,020)
Other adjustments	6,108	11,913	8,134
Changes in:
Interest and rent receivables	(116,420)	(23,867)	(2,438)
Other assets	(4,029)	(4,375)	18,264
Accounts payable and accrued expenses	33,576	54,058	(18,424)
Deferred revenue	43	(12,697)	19,819
Net cash provided by operating activities	739,010	811,656	617,636
Investing activities
Cash paid for acquisitions and other related investments	(1,332,962)	(5,350,239)	(4,249,180)
Net proceeds from sale of real estate	2,185,574	246,468	94,177
Principal received on loans receivable	53,322	1,595,708	1,306,187
Investment in loans receivable	(207,542)	(58,932)	(62,651)
Construction in progress and other	(109,237)	(67,725)	(68,350)
Proceeds from sale and return of equity investment	14,295	65,546	69,224
Capital additions and other investments, net	(207,394)	(289,239)	(36,180)
Net cash provided by (used for) investing activities	396,056	(3,858,413)	(2,946,773)
Financing activities
Proceeds from term debt, net of discount	128,536	3,407,535	2,215,950
Payments of term debt	(869,606)	(1,390,994)	(800,000)
Revolving credit facilities, net	203,576	559,985	162,633
Dividends / Distribution paid	(698,535)	(643,473)	(567,969)
Lease deposits and other obligations to tenants	(5,020)	17,815	21,706
Proceeds from sale of common shares, net of offering costs		1,051,229	411,101
Repurchase of common stock / unit	(17,940)
Stock / Unit vesting - satisfaction of tax withholdings	(29,922)
Payment of debt refinancing, deferred financing costs and other financing activities	(53,612)	(54,489)	(42,347)
Net cash (used for) provided by financing activities	(1,342,523)	2,947,608	1,401,074
Decrease in cash, cash equivalents, and restricted cash for the year	(207,457)	(99,149)	(928,063)
Effect of exchange rate changes	(12,887)	4,662	16,441
Cash, cash equivalents, and restricted cash at beginning of year	461,882	556,369	1,467,991
Cash, cash equivalents, and restricted cash at end of year	241,538	461,882	556,369
Interest paid, including capitalized interest of $6,454 in 2022, $3,289 in 2021, and $3,030 in 2020	353,838	326,406	309,920
Supplemental schedule of non-cash financing activities:
Dividends declared, unpaid	176,580	176,494	147,666
Cash, cash equivalents, and restricted cash are comprised of the following:
Cash and cash equivalents at beginning of period	459,227	549,884	1,462,286
Restricted cash, included in Other assets at beginning 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 beginning of year	$ 241,538	$ 461,882	$ 556,369
Cash and cash equivalents at end of period	235,668	459,227	549,884
Restricted cash, included in Other assets at end of period	$ 5,870	$ 2,655	$ 6,485
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	$ 241,538	$ 461,882	$ 556,369
MPT Operating Partnership, L.P. [Member]
Operating activities
Net income	903,819	656,940	432,272
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	345,577	333,781	275,953
Amortization of deferred financing costs and debt discount	17,045	16,856	13,099
Straight-line rent revenue and other	(282,504)	(288,717)	(226,906)
Stock / (Unit)-based compensation expense	49,421	52,110	47,154
(Gain) loss from sale of real estate	(536,755)	(52,471)	2,833
Real estate and other impairment charges	268,375	39,411	19,006
Write-off of unbilled rent and other	34,605	7,213	26,415
Debt refinancing and unutilized financing costs	9,452	27,650	28,180
Gain on sale of equity investments		(40,945)
Tax rate and other changes	10,697	34,796	9,295
Pre-acquisition rent collected - Circle Transaction			(35,020)
Other adjustments	6,108	11,913	8,134
Changes in:
Interest and rent receivables	(116,420)	(23,867)	(2,438)
Other assets	(4,029)	(4,375)	18,264
Accounts payable and accrued expenses	33,576	54,058	(18,424)
Deferred revenue	43	(12,697)	19,819
Net cash provided by operating activities	739,010	811,656	617,636
Investing activities
Cash paid for acquisitions and other related investments	(1,332,962)	(5,350,239)	(4,249,180)
Net proceeds from sale of real estate	2,185,574	246,468	94,177
Principal received on loans receivable	53,322	1,595,708	1,306,187
Investment in loans receivable	(207,542)	(58,932)	(62,651)
Construction in progress and other	(109,237)	(67,725)	(68,350)
Proceeds from sale and return of equity investment	14,295	65,546	69,224
Capital additions and other investments, net	(207,394)	(289,239)	(36,180)
Net cash provided by (used for) investing activities	396,056	(3,858,413)	(2,946,773)
Financing activities
Proceeds from term debt, net of discount	128,536	3,407,535	2,215,950
Payments of term debt	(869,606)	(1,390,994)	(800,000)
Revolving credit facilities, net	203,576	559,985	162,633
Dividends / Distribution paid	(698,535)	(643,473)	(567,969)
Lease deposits and other obligations to tenants	(5,020)	17,815	21,706
Proceeds from sale of units, net of offering costs		1,051,229	411,101
Repurchase of common stock / unit	(17,940)
Stock / Unit vesting - satisfaction of tax withholdings	(29,922)
Payment of debt refinancing, deferred financing costs and other financing activities	(53,612)	(54,489)	(42,347)
Net cash (used for) provided by financing activities	(1,342,523)	2,947,608	1,401,074
Decrease in cash, cash equivalents, and restricted cash for the year	(207,457)	(99,149)	(928,063)
Effect of exchange rate changes	(12,887)	4,662	16,441
Cash, cash equivalents, and restricted cash at beginning of year	461,882	556,369	1,467,991
Cash, cash equivalents, and restricted cash at end of year	241,538	461,882	556,369
Interest paid, including capitalized interest of $6,454 in 2022, $3,289 in 2021, and $3,030 in 2020	353,838	326,406	309,920
Supplemental schedule of non-cash financing activities:
Dividends declared, unpaid	176,580	176,494	147,666
Cash, cash equivalents, and restricted cash are comprised of the following:
Cash and cash equivalents at beginning of period	459,227	549,884	1,462,286
Restricted cash, included in Other assets at beginning 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 beginning of year	$ 241,538	$ 461,882	$ 556,369
Cash and cash equivalents at end of period	235,668	459,227	549,884
Restricted cash, included in Other assets at end of period	$ 5,870	$ 2,655	$ 6,485
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	$ 241,538	$ 461,882	$ 556,369

Consolidated Statements of Ca_2

Consolidated Statements of Cash Flows (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Interest paid, capitalized	$ 6,454	$ 3,289	$ 3,030
MPT Operating Partnership, L.P. [Member]
Interest paid, capitalized	$ 6,454	$ 3,289	$ 3,030

Organization

Organization	12 Months Ended
	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization	1. Orga nization 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 substantially 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 are generally not subject to United States (“U.S.”) federal income tax on our REIT taxable income, provided that we continue to qualify as a REIT and our distributions to our stockholders equal or exceed such 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 facilities, long-term acute care hospitals, and freestanding ER/urgent care facilities. We also make mortgage loans to healthcare operators collateralized by their real estate. In addition, we may make noncontrolling investments in our tenants, from time-to-time, typically in conjunction with larger real estate transactions with the tenant, which may enhance our overall return and provide for certain minority rights and protections. 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, 2022 , we have investments in 444 facilities in 31 states in the U.S., in seven 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, 2022
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Signific ant 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 at December 31, 2022 are reasonable and supportable based on the information available (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). 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, 2022, we had loans and/or equity investments in certain variable interest entities approximating $ 633 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. This includes the five investments in unconsolidated real estate joint ventures at December 31, 2022. 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 ventures with Primotop Holdings S.à.r.l. ("Primotop") and Macquarie Asset Management ("MAM") (for which we handle the accounting of), we have elected to record our share of such investee’s earnings or losses on a lag basis (not to exceed three months). 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, when collectability of the lease payments is deemed probable, 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, is 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, 2022 are as follows: Buildings and improvements 39.0 years Lease intangibles 26.8 years Leasehold improvements 14.4 years Furniture, equipment, and other 9.8 years Credit Losses: Losses from Rent Receivables: For all leases, we continuously monitor the performance of our existing tenants including, but not limited to: admission levels and surgery/procedure volumes by type; current operating margins; ratio of our tenant's operating margins both to facility rent and to facility rent plus other fixed costs; trends in revenue, cash collections, patient mix; and the effect of evolving healthcare regulations, adverse economic and political conditions, such as rising inflation and interest rates, and other events ongoing on a tenant's profitability and liquidity. Losses from Operating Lease Receivables: We utilize the information above along with the tenant’s payment and default history in evaluating (on a property-by-property basis) whether or not a provision for losses on outstanding billed rent and/or straight-line rent receivables is needed. A provision for losses on rent receivables (including straight-line rent receivables) is ultimately recorded when it becomes probable that the receivable will not be collected in full. The provision is an amount which reduces the receivable to its estimated net realizable value based on a determination of the eventual amounts to be collected either from the debtor or from existing collateral, if any. Losses on Financing Lease Receivables: We apply a forward-looking “expected credit loss” model to all of our financing receivables, including financing leases and loans. To do this, we have grouped our financial instruments into two primary pools of similar credit risk: secured and unsecured. The secured instruments include our investments in financing receivables as all are secured by the underlying real estate, among other collateral. Within the two primary pools, we further grouped our instruments into sub-pools based on several tenant/borrower characteristics, including years of experience in the healthcare industry and in a particular market or region and overall capitalization. We then determined a credit loss percentage per pool based on our history over a period of time that closely matches the remaining terms of the financial instruments being analyzed and adjusted as needed for current trends or unusual circumstances. We have applied these credit loss percentages to the book value of the related instruments to establish a credit loss reserve on our financing lease receivables and such credit loss reserve (including the underlying assumptions) is reviewed and adjusted quarterly. If a financing receivable is under performing and is deemed uncollectible based on the lessee’s overall financial condition, we will adjust the credit loss reserve based on the fair value of the underlying collateral. We made the accounting policy election to exclude interest receivables from the credit loss reserve model. Instead, 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 consist of mortgage loans, working capital loans, and other loans. Mortgage loans are collateralized by interests in real property. Working capital and other loans are typically collateralized by interests in receivables and corporate and individual guarantees. We record loans at cost. Like our financing lease receivables, we establish credit loss reserves on all outstanding loans based on historical credit losses of similar instruments. Such credit loss reserves, including the underlying assumptions, are reviewed and adjusted quarterly. If a loan’s performance worsens and foreclosure is deemed probable for our collateral-based loans (after considering the borrower’s overall financial condition as described above for leases), we will adjust the allowance for expected credit losses based on the current fair value of such collateral at the time the loan is deemed uncollectible. If the loan is not collateralized, the loan will be reserved for/written-off once it is determined that such loan is no longer collectible. Interest receivables on loans are excluded from the forward looking credit loss reserve model; however, we assess their collectability similar to how we assess collectability for interest receivables on financing leases described above. The following table summarizes our credit loss reserves (in thousands): December 31, 2022 December 31, 2021 Balance at beginning of the year $ 48,527 $ 8,726 Provision (recovery) for credit loss, net 99,009 41,710 Expected credit loss reserve related to financial instruments sold, ( 26,390 ) ( 1,909 ) Balance at end of year $ 121,146 $ 48,527 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. 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, which was amended during the second quarter of 2022. 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 third-party 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 (expense) 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. F

Real Estate and Other Activitie

Real Estate and Other Activities	12 Months Ended
	Dec. 31, 2022
Real Estate [Abstract]
Real Estate and Other Activities	3. Real Esta te and Other Activities New Investments For the years ended December 31, 2022, 2021, and 2020, we acquired or invested in the following net assets (in thousands): 2022 2021 2020 Land and land improvements $ 135,301 $ 642,312 $ 365,281 Buildings 487,698 2,381,654 2,547,313 Intangible lease assets — subject to amortization 21.3 years in 2022, 34.5 years in 2021, and 27.5 years in 2020) 45,394 262,385 642,699 Investment in financing leases — — 114,797 Mortgage loans(1)(2) 159,735 1,113,300 176,840 Investments in unconsolidated real estate joint ventures 399,456 — 233,593 Investments in unconsolidated operating entities 131,105 1,033,096 205,000 Other loans — — 103,195 Other assets — — 1,328 Liabilities assumed ( 25,727 ) ( 82,508 ) ( 140,866 ) $ 1,332,962 $ 5,350,239 $ 4,249,180 Loans repaid(1) — ( 1,103,410 ) ( 834,743 ) Total net assets acquired $ 1,332,962 $ 4,246,829 $ 3,414,437 (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 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. (2) In the 2022 second quarter, we increased our mortgage loan to Prospect Medical Holdings, Inc. ("Prospect") that was originated in 2019 and that is secured by a first lien on a California hospital. The loan bears interest at a current market rate plus a component of additional interest upon repayment. 2022 Activity Macquarie Transaction On March 14, 2022, we completed a transaction with Macquarie Asset Management (“MAM”), an unrelated party, to form a partnership (the “Macquarie Transaction”), pursuant to which we contributed eight Massachusetts-based general acute care hospitals that are leased to Steward, and a fund managed by MAM acquired, for cash consideration, a 50 % interest in the partnership. The transaction valued the portfolio at approximately $ 1.7 billion, and we recognized a gain on sale of real estate of approximately $ 600 million from this transaction, partially offset by the write-off of unbilled straight-line rent receivables. The partnership raised nonrecourse secured debt of 55 % of asset value, and we received proceeds, including from the secured debt, of approximately $ 1.3 billion. We obtained a 50 % interest in the real estate partnership valued at approximately $ 400 million (included in the "Investments in unconsolidated real estate joint ventures" line of our consolidated balance sheets), which is being accounted for under the equity method of accounting. In connection with this transaction, we separated the eight Massachusetts-based facilities into a separate master lease with terms generally identical to the other master lease, and the initial fixed lease term of both master leases were extended to 2041 . Other Transactions On December 9, 2022, we acquired six behavioral health facilities in the United Kingdom for £ 233 million ($ 286 million), plus customary tax and other transaction costs. These hospitals are leased to Priory pursuant to separate long-term leases with inflation-based escalators. As part of this transaction, the third-party seller of the real estate provided £ 105 million of seller financing - see Note 4 for further details on this debt. On March 11, 2022, we acquired four general acute care hospitals in Finland for € 178 million ($ 194 million). These hospitals are leased to Pihlajalinna pursuant to a long-term lease with annual inflation-based escalators. We acquired these facilities by the share purchase of real estate holding entities that included deferred income tax and other liabilities of approximately $ 26 million. On February 16, 2022, we agreed to participate in an existing syndicated term loan with a term of six years originated on behalf of Priory. We funded £ 96.5 million towards a £ 100 million participation level, reflecting a 3.5 % discount. The loan carries a variable rate that was 8.3 % at December 31, 2022. Other investments in 2022 included the acquisition of six general acute care facilities and the origination of a CHF 60 million mortgage loan to Infracore SA ("Infracore"). Of the assets acquired, three were general acute care facilities located throughout Spain, acquired on April 29, 2022 for € 27 million, and leased to GenesisCare pursuant to a long-term lease with annual inflation-based escalators. In addition, two general acute care facilities, one in Arizona and the other in Florida, were acquired on April 18 and 25, 2022, respectively, for approximately $ 80 million and leased to Steward pursuant to an already existing master lease agreement with annual inflation-based escalators. The other general acute care facility, located in Colombia, was acquired on July 29, 2022 for $ 26 million and leased to Fundación Cardiovascular de Colombia pursuant to a long-term lease with inflation-based escalators. 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. 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 ("IMED") 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 a master lease, with annual inflation-based escalators. 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 System, LLC ("Pipeline") 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 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 held by 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”), as part of a share purchase in which we also inherited certain net deferred income tax and other liabilities and £ 27.6 million of unearned rent revenue. 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 renewal options and improve the annual inflation-based escalators. These 30 leases are cross-defaulted and guaranteed by Circle. 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. These five facilities, with an approximate $ 115 million total investment, are 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 a 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 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. Development Activities 2022 Activity During 2022, we agreed to finance the development of five new projects. One of these development projects is a behavioral health facility in McKinney, Texas with a total budget of approximately $ 35 million. This facility will be leased to Springstone pursuant to the existing long-term master lease. The second development project is an inpatient rehabilitation facility in Cayce, South Carolina with a total budget of approximately $ 22 million. This facility will be leased to Ernest pursuant to an existing long-term master lease. In addition, we agreed to finance the development of and lease three general acute care facilities located throughout Spain for a total commitment of approximately € 120 million. These facilities will be leased to our existing tenant, IMED, under a long-term master lease agreement. During the 2022 first quarter, we completed construction and began recording rental income on an inpatient rehabilitation facility located in Bakersfield, California. This facility commenced rent on March 1, 2022 and is being leased to Ernest pursuant to an existing long-term master lease. 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. After initial delays with a change in the general contractor, physical construction has begun with an updated expected completion date of the first quarter of 2026. This facility will be leased to Steward pursuant to an existing long-term master lease. 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 pursuant to an existing long-term master lease. During 2020, we completed construction on two general acute care facilities and one inpatient rehabilitation facility and began recognizing revenue on these properties immediately thereafter. See table below for a status summary of our current development projects (in thousands): Property Commitment Costs Estimated Rent Ernest (Stockton, California) $ 47,700 $ 45,739 1Q 2023 IMED (Spain) 50,411 13,037 2Q 2023 Ernest (South Carolina) 22,400 7,541 2Q 2023 IMED (Spain) 45,408 33,801 3Q 2023 Springstone (Texas) 34,600 1,962 1Q 2024 IMED (Spain) 36,734 8,320 3Q 2024 Steward (Texas) 169,408 57,020 1Q 2026 $ 406,661 $ 167,420 Disposals 2022 Activity On March 14, 2022, we completed the previously described partnership with MAM, in which we sold the real estate of eight Massachusetts-based general acute care hospitals, with a fair value of approximately $ 1.7 billion. See "New Investments" in this Note 3 for further details on this transaction. During 2022, we also completed the sale of 15 other facilities (including 11 properties sold on September 1, 2022 related to the Prime repurchase option for proceeds of $ 366 million) and five ancillary properties for total proceeds of approximately $ 522 million and recognized a gain on real estate of approximately $ 100 million, along with a $ 42 million write-off of straight-line rent receivables due to the early termination of certain properties' expected lease terms. Summary of Operations for Disposed Assets in 2022 The properties sold during 2022 do not meet the definition of discontinued operations. However, the following represents the operating results from these properties for the periods presented (in thousands): For the Year Ended December 31, 2022 2021 2020 Revenues(1) $ 17,831 $ 180,549 $ 174,362 Real estate depreciation and amortization(2) ( 4,683 ) ( 28,579 ) ( 38,059 ) Property-related expenses ( 1,588 ) ( 5,065 ) ( 12,509 ) Other income(3) 536,813 181 1,228 Income from real estate dispositions, net $ 548,373 $ 147,086 $ 125,022 (1) Includes approximately $ 42 million of straight-line rent and other write-offs associated with the non-Macquarie disposal transactions for the year ended December 31, 2022. (2) Lower in 2022 as we stopped depreciating the properties making up the Macquarie Transaction once deemed held for sale in September 2021. (3) Includes $ 536.8 million of gains (net of $ 125 million write-off of straight-line rent receivables related to the Macquarie Transaction) for the year ended December 31, 2022. 2021 Activity 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. Intangible Assets At December 31, 2022 and 2021 , our intangible lease assets were $ 1.4 billion ($ 1.2 billion, net of accumulated amortization) and $ 1.4 billion ($ 1.3 billion, net of accumulated amortization), respectively. We recorded amortization expense related to intangible lease assets of $ 55.9 million, $ 56.0 million, and $ 42.4 million in 2022, 2021, and 2020, respectively, and expect to recognize amortization expense from existing lease intangible assets as follows (amounts in thousands): For the Year Ended December 31: 2023 $ 56,740 2024 56,683 2025 56,535 2026 56,266 2027 55,932 As of December 31, 2022 , capitalized lease intangibles have a weighted-average remaining life of 23.7 years. Leasing Operations (Lessor) We acquire and develop healthcare facilities and lease the facilities to healthcare operating companies. The initial fixed lease terms of these infrastructure-type assets are typically 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 indices 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 initial investment. For three properties with a carrying value of approximately $ 110 million at December 31, 2022, 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 our assets are being maintained properly and in compliance with the terms of our 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, 2022 (amounts in thousands): Total Under Total Under Total 2023 $ 984,353 $ 161,079 $ 1,145,432 2024 1,001,456 164,357 1,165,813 2025 1,016,367 167,701 1,184,068 2026 1,031,717 171,112 1,202,829 2027 1,048,409 174,591 1,223,000 Thereafter 25,851,987 4,376,304 30,228,291 $ 30,934,289 $ 5,215,144 $ 36,149,433 For all of our properties subject to lease, we are the legal owner of the property and the tenant's right to use and possess such property is guided by the terms of a lease. At December 31, 2022 , we account for all of these leases as operating leases, except where GAAP requires alternative classification, including leases on 13 Ernest facilities and three Prime facilities that are accounted for as DFLs and leases on 13 of our Prospect facilities and five of our Ernest facilities that 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, 2022 As of December 31, 2021 Minimum lease payments receivable $ 880,253 $ 1,183,855 Estimated unguaranteed residual values 203,818 203,818 Less: Unearned income and allowance for credit loss ( 731,915 ) ( 918,584 ) Net investment in direct financing leases 352,156 469,089 Other financing leases (net of allowance for credit loss) 1,339,167 1,584,238 Total investment in financing leases $ 1,691,323 $ 2,053,327 The decrease in total investment in financing leases during 2022 is primarily related to financing leases associated with two properties sold on September 1, 2022 associated with the Prime repurchase transaction, along with the impairment associated with our Prospect properties, as discussed further below. COVID-19 Rent Deferrals Due to the COVID-19 pandemic and its impact on our tenants’ business, we agreed to defer collection of a certain amount of rent for a few tenants. Pursuant to our agreements with these tenants, we expect repayments of previously deferred rent to continue, with the remaining outstanding deferred rent balance of approximately $ 14.6 million as of December 31, 2022, to be paid over specified periods in the future with interest. Prospect Medical Holdings In August 2019, we invested in a portfolio of 14 acute care hospitals in three states (California, Pennsylvania, and Connecticut) operated by Prospect for a combined purchase price of approximately $ 1.5 billion. In addition, we originated a $ 112.9 million term loan secured by a parent guaranty. In the 2022 second quarter, we funded an additional $ 100 million towards the existing mortgage loan that is secured by a first lien on a California hospital. Prospect (like other healthcare systems around the world) struggled through the COVID-19 pandemic, starting in early 2020 and continuing through much of the 2022 first quarter with the impact from the Omicron variant. Although admissions, surgeries, and ER visits are back above pre-COVID levels at their California and Connecticut properties, Prospect’s four Pennsylvania facilities are still trailing. Now with the impact of higher labor and other costs due to inflation, Prospect has experienced a decline in cash flows during 2022. Prospect has been working through various restructuring plans to manage their cash flow. Some of these plans have made it to the binding commitment stage, including the expected sale of their Connecticut properties to Yale New Haven Health ("Yale") announced in October 2022, while others have not. Until the 2022 fourth quarter, Prospect was current on its rent and interest obligations under the various agreements. However, with rent and interest now past due and certain of Prospect’s restructuring plans yet to be finalized, we recorded an approximate $ 280 million impairment charge in the 2022 fourth quarter, as shown in "Real estate and other impairment charges, net" on the consolidated statements of net income. As part of this charge, we reduced the carrying value of the underperforming Pennsylvania properties by approximately $ 170 million (to approximately $ 250 million) and reserved all non-cash rent for a total of $ 112 million. We expect to record rent on our Prospect leases on a cash basis for the foreseeable future. At December 31, 2022, we believe our remaining investment in the Prospect real estate and other assets are fully recoverable, but no assurances can be given that we will not have any further impairments in future periods. Pipeline Health System On October 2, 2022, Pipeline filed for reorganization relief under Chapter 11 protection of the United States Bankruptcy Code in the Southern District of Texas, while keeping its hospitals open to continue providing care to the communities served. On February 6, 2023, Pipeline emerged from bankruptcy. Per the bankruptcy settlement, Pipeline's current lease of our California assets remains in place, and we were repaid on February 7, 2023 for all rent that was outstanding at December 31, 2022, along with what was due for January and February 2023. We have agreed to defer $ 5.6 million, or approximately 30 %, of rent in 2023 to be paid in 2024 with interest. We also agreed to provide approximately $ 11 million in capital funding for Pipeline to complete their behavioral facility addition to the Coast Plaza Hospital, which will result in increased rent to us upon completion. As of December 31, 2022, assets leased to Pipeline represent 1 % of our total assets, which we believe are fully recoverable at this time. However, no assurances can be given that we will not have any write-offs or impairments in future periods. Watsonville Community Hospital 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 the COVID-19 pandemic. During this time, we increased the loan in an effort to support the operator of this facility, allowing it to continue to serve the community's needs. 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 of approximately $ 40 million against the estimated uncollectible portion of the loan and wrote off approximately $ 2.5 million of billed and straight-line rent receivables. On February 23, 2022, the bankruptcy court approved the bid by Pajaro Valley Healthcare District Corporation ("Pajaro") to purchase the operations of the Watsonville Community Hospital and lease the real estate from us. On August 31, 2022, Pajaro completed this purchase of the operations of the Watsonville Community Hospital. As a result of this transaction, we were repaid approximately $ 32 million of the loans previously provided to the hospital. This loan repayment resulted in a net credit loss recovery of approximately $ 15 million in 2022 and reflected in the "Real estate and other impairment charges, net" line of the consolidated statements of net income. To date, Pajaro has been current on its monthly rental payments to us. Other Leasing Activities 2022 Activity At September 30, 2022 , 99 % of our properties are occupied by tenants, leaving five properties as vacant, representing less than 0.3 % of total assets. We are in various stages of either releasing or selling these vacant properties, for one of which we received and recorded a significant termination fee in 2019. 2021 Activity On December 23, 2021, Lifepoint Health, Inc. ("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. Investments in Unconsolidated Entities Investments in Unconsolidated Real Estate Joint Ventures Our primary business strategy is to acquire real estate and lease to providers of healthcare services. Typically, we directly own 100 % of such investment. However, from time-to-time, we will co-invest with other investors that share a similar view that hospital real estate is a necessary infrastructure-type asset in communities. In these types of investments, we will own undivided interests of less than 100 % of the real estate and share control over the assets through unconsolidated real estate joint ventures. The underlying real estate and leases in these unconsolidated real estate joint ventures are structured similarly and carry a similar risk profile to the rest of our real estate portfolio. The following is a summary of our investments in unconsolidated real estate joint ventures by operator (amounts in thousands): Operator Ownership Percentage As of December 31, 2022 As of December 31, 2021 MEDIAN 50 % $ 482,735 $ 517,648 Swiss Medical Network 70 % 454,083 476,193 Steward (Macquarie Transaction) 50 % 417,701 — Policlinico di Monza 50 % 86,245 95,468 HM Hospitales 45 % 57,139 63,618 Total $ 1,497,903 $ 1,152,927 For the increase in our investments in unconsolidated real estate joint ventures since December 31, 2021, see "New Investments" section in this same Note 3 for a discussion of the Macquarie Transaction. Investments in Unconsolidated Operating Entities Our investments in unconsolidated operating entities are noncontrolling investments that are typically made in conjunction with larger real estate transactions in which the operators are vetted as part of our overall underwriting process. In many cases, we would not be able to acquire the larger real estate portfolio without such investments in operators. These investments also offer the opportunity to enhance our overall return and provide for certain minority rights and protections. The following is a summary of our investments in unconsolidated operating entities (amounts in thousands): Operator As of December 31, As of December 31, Steward (loan investment) $ 362,831 $ 360,164 International joint venture 231,402 219,387 Springstone 200,827 187,450 Priory 156,575 42,315 Swiss Medical Network 157,145 159,208 Steward (equity investment) 125,862 139,000 Prospect 112,777 112,283 Aevis Victoria SA ("Aevis") 72,904 61,271 Aspris Children's Services ("Aspris") 16,023 8,356 Caremax 8,526 — Total $ 1,444,872 $ 1,289,434 The increase during 2022 is primarily due to our investment in the Priory syndicated term loan as described under "New Investments" in this Note 3 . In the 2022 fourth quarter, Steward sold its managed care business to Caremax and received shares of Caremax plus cash, along with the potential for additional stock contingent on performance. As part of this transaction, we received a dividend of Caremax shares that are marked to fair value each period. Pursuant to our approximate 5 % stake in Aevis and other investments marked to fair value, we recorded a $ 2.3 million favorable non-cash fair value adjustment during 2022 as shown in the "Other (including fair value adjustments on securities)" line of the consolidated statements of net income; whereas, this was an $ 8.2 million favorable non-cash fair value adjustment in 2021. We also earned approximately $ 4 million of dividend income from our Switzerland investments during 2022. Pursuant to our existing 9.9 % equity interest in Steward, we received an $ 11 million cash distribution during 2021, which was accounted for as a return of capital. Other Investment Activities In the 2022 second quarter, we l

Debt

Debt	12 Months Ended
	Dec. 31, 2022
Debt Disclosure [Abstract]
Debt	4. Debt The following is a summary of debt (dollar amounts in thousands): As of December 31, As of December 31, Revolving credit facility(A) $ 929,584 $ 730,000 Interim credit facility — 869,606 Term loan 200,000 200,000 British pound sterling term loan due 2024(B) 126,690 — British pound sterling term loan due 2025(B) 845,810 947,240 Australian term loan facility(B) 817,560 871,560 2.550 % Senior Unsecured Notes due 2023(B) 483,320 541,280 3.325 % Senior Unsecured Notes due 2025(B) 535,250 568,500 0.993 % Senior Unsecured Notes due 2026(B) 535,250 568,500 2.500 % Senior Unsecured Notes due 2026(B) 604,150 676,600 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) 724,980 811,920 4.625 % Senior Unsecured Notes due 2029 900,000 900,000 3.375 % Senior Unsecured Notes due 2030(B) 422,905 473,620 3.500 % Senior Unsecured Notes due 2031 1,300,000 1,300,000 $ 10,325,499 $ 11,358,826 Debt issue costs and discount, net ( 57,087 ) ( 76,056 ) $ 10,268,412 $ 11,282,770 (a) Includes £ 90 million of GBP-denominated borrowings and € 253 million of Euro-denominated borrowings that reflect the exchange rate at December 31, 2022 . (b) Non-U.S. dollar denominated debt that reflects the exchange rate at period-end. As of December 31, 2022, 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): 2023 $ 483,320 2024 944,250 2025 1,381,060 2026 2,568,984 2027 1,600,000 Thereafter 3,347,885 Total $ 10,325,499 Credit Facility On May 6, 2022, we increased the amount of our unsecured credit facility ("Credit Facility") by $ 500 million by exercising the accordion feature. In addition, our revolver and U.S. dollar term loan were modified with Secured Overnight Financing Rate as a replacement reference rate to U.S. dollar LIBOR. Currently, our Credit Facility includes a $ 1.8 billion unsecured revolving loan facility and a $ 200 million unsecured term loan facility. On June 29, 2022, we amended our Credit Facility. The amendment extended the maturity date of our revolving facility to June 30, 2026 with our option to extend for an additional 12 months. The maturity date of our $ 200 million unsecured term loan facility was extended to June 30, 2027 . Additionally, we may request incremental term loan and/or revolving loan commitments in an aggregate amount not to exceed $ 1 billion. In addition, the amendment improved interest rate spreads for both facilities. Under the amended Credit Facility and at our election, loans may be made as either ABR Loans or Term Benchmark Loans. The applicable margin for term loans that are ABR Loans is adjustable on a sliding scale from 0.00 % to 0.70 % based on current credit rating. The applicable margin for term loans that are Term Benchmark Loans is adjustable on a sliding scale from 0.875 % to 1.70 % based on current credit rating. The applicable margin for revolving loans that are ABR Loans is adjustable on a sliding scale from 0.00 % to 0.50 % based on current credit rating. The applicable margin for revolving loans that are Term Benchmark Loans or RFR Loans, as defined in the Credit Facility agreement, is adjustable on a sliding scale from 0.80 % to 1.50 % based on current credit rating. The facility fee is adjustable on a sliding scale from 0.125 % to 0.30 % (currently 0.25 %) based on current credit rating and is payable on the revolving loan facility. At December 31, 2022 , we had $ 929.6 million outstanding on the revolving credit facility, whereas, we had $ 730.0 million outstanding on our revolving credit facility at December 31, 2021. At December 31, 2022 and 2021, our availability under our revolving credit facility was $ 0.9 billion and $ 0.6 billion, respectively. The weighted-average interest rate on the revolving facility was 3.8 % and 1.3 % during 2022 and 2021, respectively. At December 31, 2022 and 2021 , the interest rate in effect on our term loan was 5.70 % and 1.56 %, 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 proceeds from 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. 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. On March 15, 2022 , we paid off and terminated the July 2021 Interim Credit Facility with proceeds from the Macquarie Transaction as more fully described in Note 3 to the consolidated financial statements. Non-U.S. Term Loans British Pound Sterling Term Loan due 2024 On December 9, 2022, we entered into a £ 105 million unsecured sterling-denominated term loan, of which we used to partially fund the Priory acquisition on the same date. This term loan matures on December 9, 2024 , and has a fixed interest rate of 5.250 %. British Pound Sterling Term Loan due 2025 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 %. Interest Rate Swaps At December 31, 2022, we had a derivative asset of approximately $ 93.2 million related to the combination of the sterling-denominated term loan interest rate swap and the Australian dollar term loan interest rate swap. 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. Derivative assets are included in “Other assets” while, the derivative liabilities are 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, 2022 (par value amounts in thousands): Offering Maturity Date Par Value % of Par 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 We may repurchase, redeem, or refinance senior unsecured notes from time-to-time. We may purchase senior notes for cash through open market purchases, privately negotiated transactions, or a tender offer. In some cases, 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. Redemptions and repurchases of debt, if any, will depend on prevailing market conditions, our liquidity requirements, contractual restrictions, and other factors. Debt Refinancing and Unutilized Financing Costs 2022 In 2022, we incurred approximately $ 9.5 million of debt refinancing costs. These costs were incurred as a result of the payoff of our July 2021 Interim Credit Facility with proceeds from the Macquarie Transaction on March 14, 2022, along with the amendment of our Credit Facility on June 29, 2022 . 2021 With the termination of our January 2021 Interim Credit Facility and other debt activity, 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). 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, 2022 , 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, 2022 , we were in compliance with all such financial and operating covenants.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Income Taxes	5. Inco me 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 REIT 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 REIT 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 REIT 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. 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, 2022 2021 2020 Current income tax (expense) benefit: Domestic $ 1,111 $ ( 1,559 ) $ 63 Foreign ( 27,751 ) ( 18,964 ) ( 10,203 ) ( 26,640 ) ( 20,523 ) ( 10,140 ) Deferred income tax (expense) benefit: Domestic ( 15,628 ) 6,915 ( 10,680 ) Foreign ( 13,632 ) ( 60,340 ) ( 10,236 ) ( 29,260 ) ( 53,425 ) ( 20,916 ) Income tax (expense) $ ( 55,900 ) $ ( 73,948 ) $ ( 31,056 ) 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, 2022, 2021, and 2020 is as follows (in thousands): For the Years Ended December 31, 2022 2021 2020 Income before income tax $ 959,719 $ 730,888 $ 463,328 Income tax (expense) at the U.S. statutory federal rate ( 21 % in 2022, 2021, and 2020) ( 201,541 ) ( 153,486 ) ( 97,299 ) Decrease (increase) in income tax resulting from: Foreign rate differential 1,826 2,742 2,160 State income taxes, net of federal benefit ( 1,886 ) — 970 U.S. earnings not subject to federal income tax 165,705 132,266 82,921 Equity investments — — 380 Change in valuation allowance ( 11,281 ) ( 10,040 ) ( 8,514 ) Statutory tax rate change ( 941 ) ( 43,924 ) ( 9,471 ) Interest disallowance ( 1,737 ) ( 646 ) — Other items, net ( 6,045 ) ( 860 ) ( 2,203 ) Total income tax (expense) $ ( 55,900 ) $ ( 73,948 ) $ ( 31,056 ) In 2022, we incurred approximately $ 5 million of income tax expense from the credit loss recovery on loans made to the Watsonville Community Hospital; whereas, in 2021, we recorded an approximate $ 10 million income tax benefit related to the initial loan impairment, as more fully described in Note 3 to Item 8 of this Annual Report on Form 10-K. 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. The foreign provision for income taxes is based on foreign profit before income taxes of $ 159.6 million, $ 164.0 million, and $ 62.1 million in 2022, 2021, and 2020, respectively. The domestic provision for income taxes is based on income (loss) before income taxes of $ 10.8 million in 2022 , $( 29.7 ) million in 2021 , and $ 6.4 million in 2020 from our TRS entities. At December 31, 2022 and 2021, components of our deferred tax assets and liabilities were as follows (in thousands): 2022 2021 Deferred tax assets: Operating loss and interest deduction carry forwards $ 175,922 $ 197,876 Other 15,218 1,815 Total deferred tax assets 191,140 199,691 Valuation allowance ( 71,499 ) ( 61,747 ) Total net deferred tax assets $ 119,641 $ 137,944 Deferred tax liabilities: Property and equipment $ ( 294,181 ) $ ( 320,546 ) Net unbilled revenue ( 63,324 ) ( 43,366 ) Partnership investments ( 26,268 ) ( 15,963 ) Other ( 27,153 ) ( 3,836 ) Total deferred tax liabilities ( 410,926 ) ( 383,711 ) Net deferred tax asset (liability) $ ( 291,285 ) $ ( 245,767 ) At December 31, 2022, we had net NOL and other tax attribute carryforwards as follows (in thousands): U.S. Foreign Gross NOL carryforwards $ 148,900 $ 633,682 Tax-effected NOL carryforwards $ 24,013 $ 151,909 Valuation allowance ( 13,864 ) ( 57,635 ) Net deferred tax asset - NOL carryforwards $ 10,149 $ 94,274 Expiration periods 2024 - 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 2022, a valuation allowance of $ 9.8 million has been recorded against a portion of our 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 REIT taxable income in 2022, 2021, and 2020. 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, Per share: 2022 2021 2020 Ordinary dividend (1) $ 0.4703 $ 0.7646 $ 0.6030 Long-term capital gain (2) 0.6797 0.1654 — Return of capital — 0.1800 0.4670 Total $ 1.1500 $ 1.1100 $ 1.0700 (1) For the years ended December 31, 2022, 2021, and 2020, includes Section 199A dividends of 0.4703 , 0.7646 , and 0.6030 , respectively. (2) For the years ended December 31, 2022, 2021, and 2020, includes Unrecaptured Section 1250 gains of 0.2574 , 0.0583 , and 0.0000 , respectively. 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, 2022
Earnings Per Share [Abstract]
Earnings Per Share/Unit	6. Earnings P er 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, 2022 2021 2020 Numerator: Net income $ 903,819 $ 656,940 $ 432,272 Non-controlling interests’ share in earnings ( 1,222 ) ( 919 ) ( 822 ) Participating securities’ share in earnings ( 1,602 ) ( 2,161 ) ( 2,105 ) Net income, less participating securities’ share in $ 900,995 $ 653,860 $ 429,345 Denominator: Basic weighted-average common shares 598,634 588,817 529,239 Dilutive potential common shares 203 1,322 1,222 Diluted weighted-average common shares 598,837 590,139 530,461 MPT Operating Partnership, L.P. Our earnings per unit were calculated based on the following (amounts in thousands): For the Years Ended December 31, 2022 2021 2020 Numerator: Net income $ 903,819 $ 656,940 $ 432,272 Non-controlling interests’ share in earnings ( 1,222 ) ( 919 ) ( 822 ) Participating securities’ share in earnings ( 1,602 ) ( 2,161 ) ( 2,105 ) Net income, less participating securities’ share in $ 900,995 $ 653,860 $ 429,345 Denominator: Basic weighted-average units 598,634 588,817 529,239 Dilutive potential units 203 1,322 1,222 Diluted weighted-average units 598,837 590,139 530,461

Stock Awards

Stock Awards	12 Months Ended
	Dec. 31, 2022
Share-Based Payment Arrangement [Abstract]
Stock Awards	7. Stoc k Awards Stock Awards During the second quarter of 2022, we amended the 2019 Equity Incentive Plan (the "Equity Incentive Plan"), which authorizes the issuance of common stock options, restricted stock, restricted stock units, deferred stock units, stock appreciation rights, performance units, and awards of interests in our Operating Partnership. Our Equity Incentive Plan is administered by the Compensation Committee of the Board of Directors. Among other things, the recent amendment increased the number of shares of common stock registered and reserved for stock awards by 16 million to 28.9 million. As of December 31, 2022 , 19.3 million shares remain available for future stock awards. The Equity Incentive Plan contains a limit of 5 million shares as the maximum number of shares of common stock that may be awarded to an individual in any fiscal year. Awards under the Equity Incentive Plan are subject to forfeiture due to termination of employment prior to vesting and/or from not achieving the respective performance/market conditions. In the event of a change in control, outstanding and unvested options will immediately vest, unless otherwise provided in the participant’s award or employment agreement, and restricted stock, restricted stock units, deferred stock units, and other stock-based awards will vest if so provided in the participant’s award agreement. The term of the awards is set by the Compensation Committee, though Incentive Stock Options may not have terms of more than ten years . Forfeited awards (along with shares withheld for payroll tax withholding purposes) are returned to the Equity Incentive Plan and are then available to be re-issued as future awards. For each share of common stock issued by Medical Properties Trust, Inc. pursuant to its Equity Incentive Plan, the Operating Partnership issues a corresponding number of Operating Partnership units. 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 2022, 2021, and 2020 , 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 ). Dividends are generally paid on these awards prior to vesting. Performance-Based Awards In 2022, 2021, and 2020, 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 2022, 2021, and 2020 , 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 period with the opportunity to earn a portion of the award earlier. More or less shares than the target number of shares are available to be earned based on our performance compared to the set thresholds. At the end of each of the performance periods, any earned shares during such period will vest on January 1 of the following calendar year. The performance thresholds for 2022, 2021, and 2020 awards were based on funds from operations growth, EBITDA, and acquisitions. 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 2022, 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. The following summarizes stock-based award activity in 2022 and 2021 (which includes awards granted in 2022, 2021, 2020, and any applicable prior years), respectively: For the Year Ended December 31, 2022: Vesting Based Vesting Based on Shares Weighted-Average Shares Weighted-Average Nonvested awards at beginning of the year 922,954 $ 20.26 5,477,536 $ 15.86 Awarded 659,393 $ 21.18 1,828,971 $ 18.45 Vested ( 750,854 ) $ 20.25 ( 2,924,722 ) $ 13.87 Forfeited ( 21,010 ) $ 20.06 ( 32,704 ) $ 19.17 Nonvested awards at end of year 810,483 $ 21.02 4,349,081 $ 18.26 For the Year Ended December 31, 2021: Vesting Based Vesting Based on Shares Weighted-Average Shares Weighted-Average 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 The value of stock-based awards is charged to compensation expense over the service periods. For the years ended December 31, 2022, 2021, and 2020 , we recorded $ 49.4 million, $ 52.1 million, and $ 47.2 million, respectively, of non-cash compensation expense. The remaining unrecognized cost from stock-based awards at December 31, 2022 , is $ 47.1 million, which will be recognized over a weighted-average period of 1.2 years. Stock-based awards that vested in 2022, 2021, and 2020 , had a value of $ 82.6 million, $ 49.9 million, and $ 58.9 million, respectively.

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2022
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	8. Commitments and Contingencies Commitments On October 5, 2022, we entered into definitive agreements to sell three Prospect facilities located in Connecticut to Yale for approximately $ 457 million. This transaction is expected to close in 2023 subject to certain regulatory approvals and the completion of Yale's acquisition of the hospital operations from Prospect. No assurances can be given that this transaction will be consummated as described or at all. 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, 2022
Equity [Abstract]
Common Stock/Partner's Capital	9. Common Stock/ Partner’s Capital Medical Properties Trust, Inc. 2022 Activity On October 9, 2022, the board of directors of the Company authorized a stock repurchase program (the "Stock Repurchase Program") for up to $ 500 million of common stock, par value $ 0.001 per share. In 2022, we repurchased 1.6 million shares for a total of $ 17.9 million. The Stock Repurchase Program expires on October 10, 2023 . 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. MPT Operating Partnership, L.P. At December 31, 2022 , 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. No LTIP units exist at December 31, 2022. For each share of common stock issued/repurchased by Medical Properties Trust, Inc., the Operating Partnership issues/repurchases a corresponding number of operating partnership units.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	12 Months Ended
	Dec. 31, 2022
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	10. Fair Value of F inancial 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, 2022 December 31, 2021 Asset (Liability) Book Fair Book Fair Interest and rent receivables $ 167,035 $ 163,101 $ 56,229 $ 56,564 Loans(1) 1,405,615 (2) 1,360,113 991,609 (2) 991,954 Debt, net ( 10,268,412 ) ( 8,697,042 ) ( 11,282,770 ) ( 11,526,388 ) (1) Excludes the acquisition loan and mortgage loan made in October 2021 for our Springstone investment and the acquisition loan made in May 2020 related to our investment in the international joint venture, along with the related subsequent investment in the real estate of three hospitals in Colombia, as these assets are accounted for under the fair value option method, as noted below. (2) Includes $ 223.8 million and $ 70.1 million of mortgage loans, a $ 315.9 million and $ 335.6 million shareholder loan included in investments in unconsolidated real estate joint ventures, $ 640.4 million and $ 521.4 million of loans that are part of our investments in unconsolidated operating entities, and $ 225.5 million and $ 64.5 million of other loans at December 31, 2022 and 2021, respectively. 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, 2022 and 2021, the amounts recorded under the fair value option method were as follows (in thousands): As of December 31, 2022 As of December 31, 2021 Asset (Liability) Fair Value Original Fair Value Original Asset Type Classification Mortgage loans $ 140,260 $ 140,260 $ 143,068 $ 143,068 Mortgage loans Equity investment and other loans 434,609 441,943 409,638 409,638 Investments in unconsolidated 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, while also considering the value of the underlying collateral of each loan. 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 investments as Level 3, as we use certain unobservable inputs to the valuation methodology that are significant to the fair value measurement, and the valuations require management judgment due to absence of quoted market prices. For the cash flow models, 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”). In regards to the underlying projections used in the discounted cash flow model, such projections are provided by the investees. 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. In 2022, we recorded an unfavorable fair value adjustment of approximately $ 7 million to our investments, as shown in "Other (including fair value adjustments on securities)" in our consolidated statements of net income. No fair value adjustment was recorded in 2021. The DLOM on our Springstone investment was 40 % at December 31, 2022. 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 + 100 basis points $ ( 43 ) - 100 basis points 43 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. In these cases, fair value may be 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 , or for our real estate, including for the impairment analysis on our Prospect Pennsylvania real estate in 2022, we may use a market approach using level 2 inputs, whereby we will divide the expected net operating income (i.e. rent revenue less expenses, if any) of the facility by a market capitalization rate.

Leases (Lessee)

Leases (Lessee)	12 Months Ended
	Dec. 31, 2022
Leases [Abstract]
Leases (Lessee)	11. Lease s (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 2022 2021 Operating lease cost (1) (2) $ 12,175 $ 10,694 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 ( 4,485 ) ( 4,466 ) Total lease cost $ 7,869 $ 6,407 (1) Includes short-term leases. (2) $ 5.7 million and $ 6.3 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2022 and 2021, 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, 2022 are as follows (amounts in thousands): Operating Leases Finance Leases Amounts To Net 2023 $ 8,742 $ 129 $ ( 4,416 ) $ 4,455 2024 8,880 130 ( 4,272 ) 4,738 2025 8,289 131 ( 4,328 ) 4,092 2026 7,884 133 ( 4,021 ) 3,996 2027 7,873 134 ( 3,730 ) 4,277 Thereafter 235,940 4,516 ( 65,320 ) 175,136 (1) Total undiscounted minimum lease payments $ 277,608 $ 5,173 $ ( 86,087 ) $ 196,694 Less: interest ( 176,016 ) ( 3,235 ) Present value of lease liabilities $ 101,592 $ 1,938 (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 December 31, December 31, Right of use assets: Operating leases - real estate Land $ 63,553 $ 68,616 Finance leases - real estate Land 1,734 1,785 Total real estate right of use assets $ 65,287 $ 70,401 Operating leases - corporate Other assets 26,225 7,458 Total right of use assets $ 91,512 $ 77,859 Lease liabilities: Operating leases Obligations to tenants and $ 101,592 $ 85,217 Financing leases Obligations to tenants and 1,938 1,937 Total lease liabilities $ 103,530 $ 87,154 Weighted-average remaining lease term: Operating leases 33.2 40.6 Finance leases 33.9 34.9 Weighted-average discount rate: Operating leases 6.1 % 6.4 % Finance leases 6.6 % 6.6 % The following is supplemental cash flow information (in thousands): For the Years Ended December 31, 2022 2021 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows used for operating leases $ 7,169 $ 7,330 Operating cash flows used for finance leases 128 126 Non-cash activities - Right-of-use assets obtained in exchange for lease Operating leases 23,066 1,120

Other Assets

Other Assets	12 Months Ended
	Dec. 31, 2022
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Other Assets	12. Othe r Assets The following is a summary of our other assets on our consolidated balance sheets (in thousands): As of December 31, 2022 2021 Debt issue costs, net(1) $ 12,036 $ 5,488 Other corporate assets 256,438 231,731 Prepaids and other assets 304,516 96,261 Total other assets $ 572,990 $ 333,480 (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), non-tenant receivables, derivative assets, and lease inducements made to tenants, among other items. Prepaids and other assets are higher in 2022 due to an approximate $ 80 million increase in derivative assets (associated with our interest rate swaps) and recovery receivables associated with flood damage of our Norwood facility, among other things.

Subsequent Events

Subsequent Events	12 Months Ended
	Dec. 31, 2022
Subsequent Events [Abstract]
Subsequent Events	13. Subsequent Events On February 7, 2023, a subsidiary of Lifepoint acquired a majority interest in Springstone (the "Lifepoint Transaction") based on an enterprise value of $ 250 million. We received approximately $ 205 million in full satisfaction of our initial acquisition loan to Springstone, including accrued interest. We also retained our minority equity interest in the operations of Springstone and will continue to own and lease Springstone's behavioral hospitals. As part of the Lifepoint Transaction, Lifepoint agreed to extend its current lease with us on eight existing general acute care hospitals by five years to 2041 . On February 15, 2023, we agreed to lease five general acute care facilities located in Utah currently leased to Steward to Catholic Health Initiatives Colorado ("CHIC"), a wholly owned subsidiary of CommonSpirit Health, subsequent to CHIC's pending acquisition of the Utah hospital business currently operated by Steward. Centura Health will manage the facilities for CHIC. The consummation of this transaction, which is subject to regulatory approval, is expected in 2023. The initial 15 year lease with CHIC for these Utah assets (approximately 5.5 % of our total assets at December 31, 2022) will generate an initial cash yield of 7.8 %, bump annually by 3 %, and include repurchase options at the greater of fair value or our gross investment.

Schedule II_ Valuation and Qual

Schedule II: Valuation and Qualifying Accounts	12 Months Ended
	Dec. 31, 2022
SEC Schedule, 12-09, 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, 2022 Additions Deductions Year Ended December 31, Balance at Charged Charged to Net Balance at (In thousands) 2022 $ 154,161 $ 294,861 (2) $ — $ ( 55,965 ) (3) $ 393,057 2021 $ 146,637 $ 69,131 (4) $ 7,340 (5) $ ( 68,947 ) (6) $ 154,161 2020 $ 109,803 $ 58,044 (7) $ 22,944 (8) $ ( 44,154 ) (9) $ 146,637 (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 $ 170.6 million increase to real estate impairment reserves, $ 0.5 million increase in accounts receivable and other reserves, $ 114.0 million increase in credit loss reserves on financing-type receivables, and a $ 9.8 million increase in valuation allowance to reserve against our net deferred tax assets in 2022. (3) Includes a $ 2.9 million decrease in real estate impairment reserves related to disposals in 2022, a $ 11.7 million decrease in accounts receivable and other reserves, a net credit loss recovery of approximately $ 15 million on the Watsonville loans, and a $ 26.4 million decrease of credit loss reserves related to financial instruments sold, repaid, or satisfied in 2022. (4) 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. (5) 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. (6) 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. (7) 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. (8) 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. (9) 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.

SCHEDULE III - REAL ESTATE INVE

SCHEDULE III - REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION	12 Months Ended
	Dec. 31, 2022
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]
SCHEDULE III - REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION	SCHEDULE III — REAL ESTATE INVEST MENTS AND ACCUMULATED DEPRECIATION December 31, 2022 Initial Costs Additions Subsequent Cost at December 31, 2022(1) Accumulated Life on Location Type of Property Land Buildings Improve- Carrying Land Buildings Total Depreciation Encum- Date of Date computed (Dollar amounts in thousands) Aberdeen, UK Acute care general hospital $ 4,036 $ 95,595 $ — $ — $ 4,036 $ 95,595 $ 99,631 $ 7,194 $ — 1985 January 9, 2020 40 Algeciras, Spain Acute care general hospital 505 7,973 — — 505 7,973 8,478 146 — 1997 April 29, 2022 40 Altoona, WI Acute care general hospital — 29,062 — — — 29,062 29,062 6,055 — 2014 August 31, 2014 40 Altrincham, UK Behavioral health facility 13,899 23,895 — — 13,899 23,895 37,794 61 — 1890 , 2014 December 9, 2022 40 Alvin, TX Freestanding ER 105 4,087 — — 105 4,087 4,192 871 — 2014 March 19, 2014 40 Arnold, UK Behavioral health facility 453 9,412 — — 453 9,412 9,865 387 — 2008 June 25, 2021 40 Ashtead, UK Acute care general hospital 35,840 67,195 — — 35,840 67,195 103,035 5,852 — 1981 August 16, 2019 40 Aurora, CO Freestanding ER 2,845 4,812 — — 2,845 4,812 7,657 872 — 2015 September 17, 2015 40 Austin, TX Freestanding ER 3,665 4,200 — — 3,665 4,200 7,865 642 — 2017 March 2, 2017 40 Avondale, AZ Behavioral health facility 5,383 64,650 — — 5,383 64,650 70,033 2,050 — 2016 October 19, 2021 40 Ayr, UK Behavioral health facility 16,125 46,178 — — 16,125 46,178 62,303 1,768 — 2004 June 25, 2021 40 Bad Salzuflen, Germany Rehabilitation hospital 10,186 25,777 — — 10,186 25,777 35,963 3,573 — 1974 , 2016 November 30, 2017 40 Bad Salzuflen, Germany Rehabilitation hospital 6,922 22,669 — — 6,922 22,669 29,591 2,992 — 1989 , 2016 November 30, 2017 40 Bad Oeynhausen, Germany Rehabilitation hospital 1,092 2,669 — — 1,092 2,669 3,761 379 — 1973 , 2010 November 30, 2017 40 Bakersfield, CA Rehabilitation hospital 2,178 45,253 — — 2,178 45,253 47,431 930 — 2022 May 15, 2020 40 Basingstoke, UK Acute care general hospital 12,264 47,635 — — 12,264 47,635 59,899 3,609 — 1984 January 9, 2020 40 Bassenheim, Germany Rehabilitation hospital 1,095 5,129 — — 1,095 5,129 6,224 557 — 1887 , 1983 February 9, 2019 39 Bath, UK Acute care general hospital 1,432 29,685 — — 1,432 29,685 31,117 6,308 — 2008 , 2009 July 1, 2014 40 Bath, UK Acute care general hospital 6,827 12,389 — — 6,827 12,389 19,216 965 — 1992 January 9, 2020 40 Beckenham, UK Acute care general hospital 5,184 19,882 — — 5,184 19,882 25,066 1,501 — 1981 January 9, 2020 40 Bedford, UK Acute care general hospital 1,462 7,122 — — 1,462 7,122 8,584 544 — 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 9,999 — 1984 April 1, 2008 42 Big Spring, TX Acute care general hospital 1,655 21,254 815 — 1,655 22,069 23,724 2,296 — 1973 April 12, 2019 41 Birmingham, UK Acute care general hospital 7,952 40,068 — — 7,952 40,068 48,020 2,504 — 2017 April 3, 2017 40 Birmingham, UK Acute care general hospital 9,360 89,090 — — 9,360 89,090 98,450 6,751 — 1982 January 9, 2020 40 Birmingham, UK Rehabilitation hospital — 16,477 — — — 16,477 16,477 1,030 — 2018 June 29, 2020 40 Birmingham, UK Behavioral health facility 391 18,188 — — 391 18,188 18,579 731 — 1900 , 1984 , 2016 June 25, 2021 40 Blackburn, UK Acute care general hospital 2,526 48,405 — — 2,526 48,405 50,931 3,652 — 1957 January 9, 2020 40 Blackburn, UK Behavioral health facility 19,010 51,573 — — 19,010 51,573 70,583 2,120 — 1930 June 25, 2021 40 Blue Springs, MO Acute care general hospital 4,347 23,494 — — 4,347 23,494 27,841 4,886 — 1980 February 13, 2015 40 Boardman, OH Long term acute care hospital 79 275 — — 79 275 354 26 — 2008 August 30, 2019 40 Boise, ID Long term acute care hospital 1,558 11,027 — — 1,558 11,027 12,585 1,094 — 2008 February 29, 2012 50 Bolton, UK Acute care general hospital 1,504 42,267 — — 1,504 42,267 43,771 3,181 — 1989 January 9, 2020 40 Boonton Township, NJ Behavioral health facility 6,712 17,031 — — 6,712 17,031 23,743 1,033 — 1952 , 1971 - 1978 September 30, 2015 40 Initial Costs Additions Subsequent Cost at December 31, 2022(1) Accumulated Life on Location Type of Property Land Buildings Improve- Carrying Land Buildings Total Depreciation Encum- Date of Date computed (Dollar amounts in thousands) Bossier City, LA Long term acute care hospital 900 17,818 944 — 900 18,762 19,662 6,692 — 1982 April 1, 2008 40 Bowling Green, KY Rehabilitation hospital 3,486 56,296 3,550 — 3,486 59,846 63,332 5,255 — 1992 August 30, 2019 40 Braunfels, Germany Acute care general hospital 2,109 13,138 — — 2,109 13,138 15,247 2,490 — 1977 June 30, 2015 40 Bristol, UK Behavioral health facility 4,466 35,485 — — 4,466 35,485 39,951 79 — 1790 , 2014 December 9, 2022 40 Bromley, UK Behavioral health facility 6,856 14,731 — — 6,856 14,731 21,587 614 — 1714 , 1830 , 2021 June 25, 2021 40 Broomfield, CO Freestanding ER 825 3,895 — — 825 3,895 4,720 828 — 2014 July 3, 2014 40 Bundoora, Australia Acute care general hospital 6,510 60,125 3,935 — 6,510 64,060 70,570 6,090 — 1979 June 7, 2019 37 Bury, UK Behavioral health facility 8,076 18,404 — — 8,076 18,404 26,480 796 — 2003 June 25, 2021 40 Bussage, UK Behavioral health facility 8,058 3,562 — — 8,058 3,562 11,620 149 — 1970 June 25, 2021 40 Cadiz, Spain Acute care general hospital 290 6,593 — — 290 6,593 6,883 118 — 2000 April 29, 2022 40 Campbelltown, Australia Acute care general hospital 1,037 51,364 312 — 1,037 51,676 52,713 4,621 — 2007 June 7, 2019 40 Canterbury, UK Acute care general hospital 8,718 26,185 — — 8,718 26,185 34,903 1,980 — 1982 January 9, 2020 40 Carmarthen, UK Acute care general hospital 864 24,274 — — 864 24,274 25,138 1,839 — 1990 January 9, 2020 40 Carrollton, TX Behavioral health facility 4,941 52,227 — — 4,941 52,227 57,168 1,663 — 2012 October 19, 2021 40 Casper, WY Rehabilitation hospital 1,734 — — — 1,734 — 1,734 — — 2012 February 29, 2012 — Caterham, UK Acute care general hospital 10,015 19,785 — — 10,015 19,785 29,800 1,748 — 1982 August 16, 2019 40 Chandler, AZ Freestanding ER 3,567 4,783 — — 3,567 4,783 8,350 917 — 2015 April 24, 2015 40 Chandler, AZ Freestanding ER 750 3,853 — — 750 3,853 4,603 698 — 2015 October 7, 2015 40 Cheadle, UK Acute care general hospital 29,362 154,668 — — 29,362 154,668 184,030 11,673 — 1981 January 9, 2020 40 Cheadle, UK Behavioral health facility 28,297 89,982 — — 28,297 89,982 118,279 3,652 — 1994 July 8, 2020 40 Cheraw, SC Acute care general hospital 657 19,576 — — 657 19,576 20,233 12,409 — 1982 April 1, 2008 42 Clarksville, TX Rehabilitation hospital 2,460 25,540 — — 2,460 25,540 28,000 1,420 — 2019 December 17, 2020 39 Cologne, Germany Acute care general hospital 4,292 14,512 — — 4,292 14,512 18,804 2,031 — 2001 August 7, 2020 40 Colorado Springs, CO Freestanding ER 600 4,231 — — 600 4,231 4,831 908 — 2014 June 5, 2014 40 Columbus, OH Behavioral health facility 2,101 44,218 — — 2,101 44,218 46,319 1,422 — 2017 October 19, 2021 40 Commerce City, TX Freestanding ER 707 4,248 — — 707 4,248 4,955 858 — 2014 December 11, 2014 40 Conroe, TX Behavioral health facility 3,855 38,892 — — 3,855 38,892 42,747 1,278 — 2018 October 19, 2021 40 Converse, TX Freestanding ER 750 4,423 — — 750 4,423 5,173 857 — 2015 April 10, 2015 40 Coral Gables, FL Acute care general hospital 26,215 84,584 — — 26,215 84,584 110,799 3,104 — 1959 August 1, 2021 40 Crown Point, IN Long term acute care hospital 302 528 — — 302 528 830 56 — 2008 August 30, 2019 40 Croydon, UK Acute care general hospital 9,437 39,583 — — 9,437 39,583 49,020 3,007 — 1981 January 9, 2020 40 Dahlen, Germany Rehabilitation hospital 1,303 10,996 — — 1,303 10,996 12,299 730 — 1993 , 2006 August 28, 2018 40 Dallas, TX Long term acute care hospital 1,421 13,536 — — 1,421 13,536 14,957 5,527 — 2006 September 5, 2006 40 Darlington, UK Acute care general hospital 1,981 33,995 — — 1,981 33,995 35,976 2,106 — 2001 August 7, 2020 40 Darlington, UK Behavioral health facility 20,165 45,806 — — 20,165 45,806 65,971 2,012 — 1935 , 2018 , 2020 June 25, 2021 40 Darlington, UK Behavioral health facility 4,962 25,007 — — 4,962 25,007 29,969 988 — 1960 , 1990 June 25, 2021 40 Denver, CO Freestanding ER 1,257 4,276 — — 1,257 4,276 5,533 811 — 2015 June 8, 2015 40 Denville, NJ Acute care general hospital 15,709 55,772 — — 15,709 55,772 71,481 3,308 — 1953 , 1969 - 2008 September 30, 2015 40 Detroit, MI Long term acute care hospital 1,220 8,323 — — 1,220 8,323 9,543 3,099 — 1956 May 22, 2008 40 Diss, UK Behavioral health facility 2,762 9,849 — — 2,762 9,849 12,611 453 — 1840 (2) June 25, 2021 40 Dorchester, UK Acute care general hospital 512 29,746 — — 512 29,746 30,258 2,242 — 1981 January 9, 2020 40 Dormagen, Germany Rehabilitation hospital 1,852 5,477 — — 1,852 5,477 7,329 631 — 1993 , 2006 August 28, 2018 40 Dover, NJ Acute care general hospital 3,865 8,693 — — 3,865 8,693 12,558 549 — 1925 , 1927 - 2008 September 30, 2015 40 Initial Costs Additions Subsequent Cost at December 31, 2022(1) Accumulated Life on Location Type of Property Land Buildings Improve- Carrying Land Buildings Total Depreciation Encum- Date of Date computed (Dollar amounts in thousands) Droitwich, UK Acute care general hospital 72 14,520 — — 72 14,520 14,592 1,103 — 1984 January 9, 2020 40 Dublin, OH Behavioral health facility 5,118 69,346 — — 5,118 69,346 74,464 2,185 — 2012 October 19, 2021 40 El Paso, TX Rehabilitation hospital 4,268 21,345 — — 4,268 21,345 25,613 1,240 — 2018 December 17, 2020 38 Englewood, CO Behavioral health facility 3,369 65,480 — — 3,369 65,480 68,849 2,081 — 2017 October 19, 2021 40 Essex, UK Behavioral health facility 4,406 41,011 — — 4,406 41,011 45,417 91 — 1790 , 1992 , 2014 December 9, 2022 40 Euxton, UK Acute care general hospital 4,382 33,750 — — 4,382 33,750 38,132 3,026 — 1981 August 16, 2019 40 Firestone, TX Freestanding ER 495 3,963 — — 495 3,963 4,458 850 — 2014 June 6, 2014 40 Flagstaff, AZ Rehabilitation hospital 3,049 22,464 — — 3,049 22,464 25,513 2,714 — 2016 August 23, 2016 40 Florence, AZ Acute care general hospital 900 28,462 105 — 900 28,567 29,467 7,674 — 2012 February 7, 2012 40 Floridablanca, Colombia Acute care general hospital 651 20,392 — — 651 20,392 21,043 214 — 1997 July 29, 2022 40 Folsom, CA Long term acute care hospital 3,291 21,293 — — 3,291 21,293 24,584 2,106 — 2009 August 30, 2019 40 Fort Worth, TX Behavioral health facility 3,406 34,627 — — 3,406 34,627 38,033 1,131 — 2014 October 19, 2021 40 Fountain, CO Freestanding ER 1,508 4,131 — — 1,508 4,131 5,639 869 — 2014 July 31, 2014 40 Fresno, CA Rehabilitation hospital 5,507 70,473 — — 5,507 70,473 75,980 6,329 — 1991 August 30, 2019 40 Frome, UK Behavioral health facility 2,748 16,652 — — 2,748 16,652 19,400 705 — 1980 June 25, 2021 40 Frome, UK Behavioral health facility 10,340 10,166 — — 10,340 10,166 20,506 567 — 1700 , 2015 , 2017 June 25, 2021 40 Gardena, CA Acute care general hospital 14,010 65,282 — — 14,010 65,282 79,292 2,646 — 1966 July 6, 2021 40 Georgetown, TX Behavioral health facility 4,569 22,858 1,062 — 4,569 23,920 28,489 741 — 2014 October 19, 2021 40 Gilbert, AZ Freestanding ER 1,517 4,661 — — 1,517 4,661 6,178 864 — 2015 July 22, 2015 40 Gilbert, AZ Behavioral health facility 4,790 45,076 — — 4,790 45,076 49,866 1,408 — 2020 October 19, 2021 40 Glasgow, UK Acute care general hospital 6,114 124,874 — — 6,114 124,874 130,988 9,392 — 1983 January 9, 2020 40 Glasgow, UK Behavioral health facility 1,355 14,824 — — 1,355 14,824 16,179 603 — 1900 , 1980 June 25, 2021 40 Glen Waverly, Australia Rehabilitation hospital 29,641 22,296 — — 29,641 22,296 51,937 2,848 — 1972 June 7, 2019 32 Glendale, AZ Freestanding ER 1,144 6,087 — — 1,144 6,087 7,231 938 — 2016 October 21, 2016 40 Glendale, AZ Freestanding ER 1,193 4,046 — — 1,193 4,046 5,239 767 — 2015 June 5, 2015 40 Gloucester, UK Acute care general hospital 5,296 58,249 — — 5,296 58,249 63,545 5,142 — 1990 August 16, 2019 40 Godalming, UK Behavioral health facility 8,880 18,014 — — 8,880 18,014 26,894 783 — 1796 , 2007 June 25, 2021 40 Goodyear, AZ Freestanding ER 1,800 4,713 — — 1,800 4,713 6,513 795 — 2016 April 4, 2016 40 Great Missenden, UK Acute care general hospital 11,171 99,814 — — 11,171 99,814 110,985 7,545 — 1981 January 9, 2020 40 Grefath, Germany Rehabilitation hospital 1,164 2,937 — — 1,164 2,937 4,101 346 — 1886 , 1983 August 28, 2018 40 Guildford, UK Acute care general hospital 6,531 34,573 — — 6,531 34,573 41,104 2,616 — 1989 January 9, 2020 40 Halsall, UK Acute care general hospital 1,912 29,573 — — 1,912 29,573 31,485 2,618 — 1986 August 16, 2019 40 Harrow, UK Acute care general hospital 36,448 38,358 — — 36,448 38,358 74,806 2,917 — 1980 January 9, 2020 40 Hartsville, SC Acute care general hospital 2,050 43,970 — — 2,050 43,970 46,020 9,332 — 1999 August 31, 2015 34 Hassocks, UK Behavioral health facility 5,205 27,215 — — 5,205 27,215 32,420 1,255 — 1998 June 25, 2021 40 Hastings, PA Acute care general hospital 603 8,834 — — 603 8,834 9,437 1,090 — 1924 December 17, 2019 30 Hausman, TX Acute care general hospital 1,500 8,957 — — 1,500 8,957 10,457 2,183 — 2013 March 1, 2013 40 Heidelberg, Germany Rehabilitation hospital 6,049 34,547 — — 6,049 34,547 40,596 5,644 — 1885 , 1991 June 22, 2016 40 Helotes, TX Freestanding ER 1,900 5,115 — — 1,900 5,115 7,015 874 — 2016 March 10, 2016 40 Helsinki, Finland Acute care general hospital 3,962 65,927 — — 3,962 65,927 69,889 1,384 — 1992 , 2013 March 11, 2022 40 Hemel Hempstead, UK Behavioral health facility 11,854 5,983 — — 11,854 5,983 17,837 313 — 1901 , 1990 June 25, 2021 40 Hialeah, FL Acute care general hospital 18,802 107,783 — — 18,802 107,783 126,585 4,043 — 1950 August 1, 2021 40 Hialeah, FL Acute care general hospital 75,339 222,271 75,494 — 75,339 297,765 373,104 8,995 — 1969 August 1, 2021 40 Highland Hills, OH Behavioral health facility 3,148 43,891 — — 3,148 43,891 47,039 1,412 — 2015 October 19, 2021 40 Initial Costs Additions Subsequent Cost at December 31, 2022(1) Accumulated Life on Location Type of Property Land Buildings Improve- Carrying Land Buildings Total Depreciation Encum- Date of Date computed (Dollar amounts in thousands) Highland Village, TX Freestanding ER 3,218 1,551 — — 3,218 1,551 4,769 445 — 2015 September 22, 2015 40 Highlands Ranch, CO Freestanding ER 4,200 4,779 — — 4,200 4,779 8,979 767 — 2016 July 25, 2016 40 Hill County, TX Acute care general hospital 1,120 17,882 503 — 1,120 18,385 19,505 14,833 — 1980 September 17, 2010 15 Hinckley, UK Behavioral health facility 2,340 15,949 — — 2,340 15,949 18,289 648 — 1892 , 2007 June 25, 2021 40 Hook, UK Behavioral health facility 5,140 9,790 — — 5,140 9,790 14,930 432 — 1980 June 25, 2021 40 Hoover, AL Freestanding ER — 7,581 — — — 7,581 7,581 1,697 — 2015 May 1, 2015 34 Hoover, AL Freestanding ER — 1,034 296 — — 1,330 1,330 268 — 2015 May 1, 2015 34 Hope, AR Acute care general hospital 1,651 3,359 2,733 — 1,651 6,092 7,743 1,146 — 1984 - 2001 September 29, 2017 41 Hot Springs, AR Acute care general hospital 5,622 59,432 21,221 — 5,622 80,653 86,275 15,232 — 1985 August 31, 2015 40 Houston, TX Acute care general hospital 28,687 104,028 78,415 — 28,687 182,443 211,130 12,756 — 1940 - 1950 September 29, 2017 41 Houston, TX Freestanding ER 950 3,996 — — 950 3,996 4,946 624 — 2016 September 26, 2016 40 Houston, TX Behavioral health facility 6,063 19,881 2,565 — 6,063 22,446 28,509 1,122 — 2020 October 25, 2019 40 Houston, TX Acute care general hospital 3,274 27,324 32,499 — 3,274 59,823 63,097 19,503 — 1960 August 10, 2007 40 Huntington Park, CA Acute care general hospital 3,132 5,002 — — 3,132 5,002 8,134 231 — 1967 July 6, 2021 40 Huntington Park, CA Acute care general hospital 3,935 6,103 — — 3,935 6,103 10,038 276 — 1960 - 1969 July 6, 2021 40 Idaho Falls, ID Acute care general hospital 1,822 37,467 15,921 — 1,822 53,388 55,210 16,455 — 2002 April 1, 2008 40 Idaho Falls, ID Acute care general hospital 1,880 107,608 — — 1,880 107,608 109,488 7,835 — 2020 December 19, 2017 40 Johnstown, PA Acute care general hospital 8,877 247,158 — — 8,877 247,158 256,035 25,076 — 1924 December 17, 2019 30 Kansas City, KS Acute care general hospital 2,351 13,665 — — 2,351 13,665 16,016 1,059 — 2017 June 10, 2019 50 Kansas City, MO Acute care general hospital 10,497 64,419 — — 10,497 64,419 74,916 12,996 — 1978 February 13, 2015 40 Katy, TX Freestanding ER 1,556 4,174 — — 1,556 4,174 5,730 652 — 2016 October 10, 2016 40 Katy, TX Freestanding ER 2,147 3,873 — — 2,147 3,873 6,020 694 — 2015 October 21, 2015 40 Kingswood, Australia Acute care general hospital 23,216 75,501 11,829 — 23,216 87,330 110,546 6,888 — 2000 June 7, 2019 40 Kuopio, Finland Acute care general hospital 1,269 42,401 — — 1,269 42,401 43,670 920 — 2017 March 11, 2022 29 Lafayette, IN Rehabilitation hospital 800 14,968 ( 25 ) — 800 14,943 15,743 3,694 — 2013 February 1, 2013 40 Lafayette, IN Behavioral health facility 2,829 10,795 — — 2,829 10,795 13,624 421 — 2012 October 19, 2021 40 Lander, WY Acute care general hospital 761 42,849 — — 761 42,849 43,610 3,434 — 1983 December 17, 2019 40 Lauderdale Lakes, FL Acute care general hospital 10,657 150,313 — — 10,657 150,313 160,970 6,038 — 1975 August 1, 2021 40 Lawton, OK Acute care general hospital 3,944 63,031 — — 3,944 63,031 66,975 5,077 — 1985 December 17, 2019 40 Layton, UT Acute care general hospital 14,360 370,154 5,481 — 14,360 375,635 389,995 22,737 — 1976 - 2010 September 29, 2017 40 League City, TX Freestanding ER 1,297 3,901 — — 1,297 3,901 5,198 731 — 2015 June 19, 2015 40 Leawood, KS Acute care general hospital 2,513 13,938 — — 2,513 13,938 16,451 1,073 — 2017 June 10, 2019 50 Leeds, UK Behavioral health facility 2,163 9,037 — — 2,163 9,037 11,200 379 — 1990 June 25, 2021 40 Lehi, UT Acute care general hospital 13,368 29,950 1,676 — 13,368 31,626 44,994 4,738 — 2015 September 29, 2017 45 Lewiston, ID Acute care general hospital 5,389 75,435 — — 5,389 75,435 80,824 14,455 — 1922 May 1, 2017 40 Little Elm, TX Freestanding ER 1,241 3,491 — — 1,241 3,491 4,732 790 — 2013 December 1, 2013 40 Liverpool, Australia Acute care general hospital 13,022 40,532 196 — 13,022 40,728 53,750 4,879 — 1975 June 7, 2019 30 London, UK Acute care general hospital 8,772 57,899 — — 8,772 57,899 66,671 4,357 — 1984 January 9, 2020 40 London, UK Behavioral health facility 34,421 49,182 — — 34,421 49,182 83,603 110 — 1811 , 2014 December 9, 2022 40 London, UK Acute care general hospital 3,117 3,937 — — 3,117 3,937 7,054 300 — 1987 January 9, 2020 40 London, UK Behavioral health facility 27,463 14,237 — — 27,463 14,237 41,700 36 — 1790 , 1992 , 2014 December 9, 2022 40 London, UK Acute care general hospital 11,817 77,130 — — 11,817 77,130 88,947 5,790 — 1977 January 9, 2020 40 London, UK Behavioral health facility 5,848 14,858 — — 5,848 14,858 20,706 613 — 1900 , 1960 June 25, 2021 40 Initial Costs Additions Subsequent Cost at December 31, 2022(1) Accumulated Life on Location Type of Property Land Buildings Improve- Carrying Land Buildings Total Depreciation Encum- Date of Date computed (Dollar amounts in thousands) London, UK Behavioral health facility 13,107 6,464 — — 13,107 6,464 19,571 277 — 1992 June 25, 2021 40 Longmont, CO Freestanding ER 1,773 4,181 — — 1,773 4,181 5,954 723 — 2016 February 10, 2016 40 Los Angeles, CA Acute care general hospital 12,562 40,164 — — 12,562 40,164 52,726 1,556 — 1972 July 6, 2021 40 Lubbock, TX Rehabilitation hospital 1,376 28,292 3,648 — 1,376 31,940 33,316 5,906 — 2008 June 16, 2015 40 Lynwood, CA Acute care general hospital 30,116 148,527 — — 30,116 148,527 178,643 9,018 — 1940 , 1989 - 2000 August 13, 2020 40 Malaga, SP Acute care general hospital 726 11,364 — — 726 11,364 12,090 193 — 2018 April 29, 2022 40 Mandeville, LA Freestanding ER 2,800 5,370 — — 2,800 5,370 8,170 828 — 2016 October 28, 2016 40 Marrero, LA Freestanding ER 1,584 5,801 — — 1,584 5,801 7,385 943 — 2016 July 15, 2016 40 McKinney, TX Freestanding ER 2,614 4,060 — — 2,614 4,060 6,674 1,012 — 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 16,630 — 1996 August 31, 2015 41 Melbourne, FL Acute care general hospital 5,642 17,087 21,818 — 5,642 38,905 44,547 4,054 — 2002 May 1, 2017 42 Melton Mowbray, UK Behavioral health facility 5,411 15,169 — — 5,411 15,169 20,580 651 — 1990 June 25, 2021 40 Mesa, AZ Acute care general hospital 6,534 100,042 4,135 — 6,534 104,177 110,711 24,726 — 2007 September 26, 2013 40 Mesa, AZ Acute care general hospital 2,604 16,400 — — 2,604 16,400 19,004 283 — 2019 April 18, 2022 40 Meyersdale, PA Acute care general hospital 390 4,280 — — 390 4,280 4,670 548 — 1960 December 17, 2019 30 Miami, FL Acute care general hospital 44,400 107,203 — — 44,400 107,203 151,603 4,744 — 1955 August 1, 2021 40 Miami, FL Acute care general hospital 20,430 33,881 10,364 — 20,430 44,245 64,675 593 — 1958 , 1962 , 1988 , 2016 April 25, 2022 40 Milton Keynes, UK Acute care general hospital 4,979 34,035 — — 4,979 34,035 39,014 2,570 — 1983 January 9, 2020 40 Monmouth, UK Behavioral health facility 14,717 10,964 — — 14,717 10,964 25,681 556 — 2017 June 25, 2021 40 Montclair, NJ Acute care general hospital 7,900 99,640 577 — 8,477 99,640 108,117 22,329 — 1920 - 2000 April 1, 2014 40 Mount Pleasant, SC Long term acute care hospital 597 2,198 — — 597 2,198 2,795 213 — 2012 August 30, 2019 40 New Braunfels, TX Rehabilitation hospital 1,853 10,622 — — 1,853 10,622 12,475 574 — 2011 February 29, 2012 40 New Orleans, LA Freestanding ER 2,850 6,125 — — 2,850 6,125 8,975 957 — 2016 September 23, 2016 40 Newark, NJ Acute care general hospital 32,957 24,553 — — 32,957 24,553 57,510 1,381 — 1919 , 1920 - 2003 May 2, 2016 40 Newburgh, IN Behavioral health facility 1,215 7,212 — — 1,215 7,212 8,427 254 — 2010 October 19, 2021 40 Northland, MO Long term acute care hospital 834 17,182 — — 834 17,182 18,016 5,119 — 2007 February 14, 2011 40 Norwalk, CA Acute care general hospital 2,811 5,940 — — 2,811 5,940 8,751 278 — 1959 , 1995 July 6, 2021 40 Norwalk, CA Acute care general hospital 7,946 30,465 — — 7,946 30,465 38,411 1,221 — 1958 - 1978 July 6, 2021 40 Norwood, MA Acute care general hospital 6,373 — 69,916 — 6,373 69,916 76,289 — — 1926 - 2001 June 27, 2018 46 Nottingham, UK Acute care general hospital 4,700 43,612 — — 4,700 43,612 48,312 3,317 — 1983 January 9, 2020 40 Nottingham, UK Behavioral health facility 9,502 8,504 — — 9,502 8,504 18,006 419 — 2000 June 25, 2021 40 Nottingham, UK Behavioral health facility 9,643 3,081 — — 9,643 3,081 12,724 129 — 1980 June 25, 2021 40 Odessa, TX Acute care general hospital 6,217 123,518 16,600 — 6,217 140,118 146,335 16,927 — 1973 - 2004 September 29, 2017 41 Ogden, UT Rehabilitation hospital 1,759 16,414 — — 1,759 16,414 18,173 3,614 — 2014 March 1, 2014 40 Oklahoma City, OK Behavioral health facility 3,641 3,047 — — 3,641 3,047 6,688 181 — 2017 October 19, 2021 40 Olathe, KS Behavioral health facility 5,966 55,745 — — 5,966 55,745 61,711 1,818 — 2015 October 19, 2021 40 Olathe, KS Acute care general hospital 3,485 14,484 — — 3,485 14,484 17,969 1,127 — 2018 June 10, 2019 50 Orpington, UK Acute care general hospital 9,811 40,540 — — 9,811 40,540 50,351 3,069 — 1987 January 9, 2020 40 Ottumwa, IA Acute care general hospital 2,377 48,697 — — 2,377 48,697 51,074 5,434 — 1950 December 17, 2019 30 Oulu, Finland Acute care general hospital 3,076 43,939 — — 3,076 43,939 47,015 965 — 2017 March 11, 2022 40 Overland Park, KS Acute care general hospital 2,974 14,405 — — 2,974 14,405 17,379 1,127 — 2017 June 10, 2019 50 Overland Park, KS Acute care general hospital 3,191 14,263 — — 3,191 14,263 17,454 1,172 — 2019 June 10, 2019 50 Overlook, TX Acute care general hospital 2,452 9,666 7 — 2,452 9,673 12,125 2,383 — 2012 February 1, 2013 40 Palestine, TX Acute care general hospital 1,848 95,257 — — 1,848 95,257 97,105 7,489 — 1988 December 17, 2019 40 Parker, CO Freestanding ER 1,300 4,448 — — 1,300 4,448 5,748 797 — 2015 November 6, 2015 40 Initial Costs Additions Subsequent Cost at December 31, 2022(1) Accumulated Life on Location Type of Property Land Buildings Improve- Carrying Land Buildings Total Depreciation Encum- Date of Date computed (Dollar amounts in thousands) Pasco, WA Acute care general hospital 2,594 13,195 — — 2,594 13,195 15,789 1,953 — 1920 August 31, 2018 30 Pearland, TX Freestanding ER 1,075 3,577 — — 1,075 3,577 4,652 745 — 2014 September 8, 2014 40 Perth, Australia Acute care general hospital 99,659 35,321 2,165 — 99,659 37,486 137,145 4,456 — 1965 June 7, 2019 30 Petersburg, VA Rehabilitation hospital 1,302 9,121 — — 1,302 9,121 10,423 3,306 — 2006 July 1, 2008 40 Phoenix, AZ Behavioral health facility 2,396 26,521 2,985 — 2,396 29,506 31,902 4,062 — 1979 September 29, 2017 42 Phoenix, AZ Acute care general hospital 12,695 73,773 4,499 — 12,695 78,272 90,967 10,931 — 1968 - 1976 September 29, 2017 43 Phoenix, AZ Acute care general hospital 5,576 45,782 — — 5,576 45,782 51,358 6,772 — 2017 February 10, 2017 40 Phoenix, AZ Freestanding ER 1,132 5,052 — — 1,132 5,052 6,184 726 — 2017 April 13, 2017 40 Plano, TX Freestanding ER 4,204 2,492 — — 4,204 2,492 6,696 494 — 2016 September 30, 2016 40 Poole, UK Acute care general hospital 2,206 36,429 — — 2,206 36,429 38,635 3,538 — 1996 April 3, 2019 40 Poplar Bluff, MO Acute care general hospital 2,659 38,694 — — 2,659 38,694 41,353 14,217 — 1980 April 22, 2008 40 Port Arthur, TX Acute care general hospital 12,972 78,051 6,877 — 12,972 84,928 97,900 18,823 — 2005 September 26, 2013 40 Port Huron, MI Acute care general hospital 2,531 14,252 — — 2,531 14,252 16,783 3,408 — 1953 , 1973 - 1983 December 31, 2015 30 Post Falls, ID Rehabilitation hospital 417 12,175 1,905 — 767 13,730 14,497 3,099 — 2013 December 31, 2013 40 Preston, UK Behavioral health facility 8,296 24,677 — — 8,296 24,677 32,973 991 — 1850 , 2018 , 2021 June 25, 2021 40 Princes Risborough, UK Acute care general hospital 4,425 — — — 4,425 — 4,425 — — N/A January 9, 2020 40 Raleigh, NC Behavioral health facility 3,469 27,514 — — 3,469 27,514 30,983 952 — 2018 October 19, 2021 40 Reading, UK Acute care general hospital 33,024 43,823 — — 33,024 43,823 76,847 3,816 — 1990 August 16, 2019 40 Reading, UK Acute care general hospital 24,672 79,057 — — 24,672 79,057 103,729 4,028 — 2012 December 18, 2020 40 Remscheid, Germany Rehabilitation hospital 1,017 2,451 — — 1,017 2,451 3,468 282 — 1951 , 1983 August 28, 2018 40 Richmond, TX Behavioral health facility 5,380 6,155 736 — 5,380 6,891 12,271 254 — 2014 October 19, 2021 40 Richmond, VA Long term acute care hospital 1,299 10,071 — — 1,299 10,071 11,370 1,087 — 1989 August 30, 2019 40 Ringwood, Australia Acute care general hospital 4,038 18,125 — — 4,038 18,125 22,163 1,912 — 1973 June 7, 2019 35 Riverton, WY Acute care general hospital 1,163 29,647 — — 1,163 29,647 30,810 2,756 — 1983 December 17, 2019 36 Roaring Springs, PA Acute care general hospital 1,446 9,549 — — 1,446 9,549 10,995 1,216 — 1924 December 17, 2019 30 Rochdale, MA Long term acute care hospital 654 3,368 — — 654 3,368 4,022 329 — 1989 August 30, 2019 40 Rochdale, MA Acute care general hospital 67 344 — — 67 344 411 34 — 1989 August 30, 2019 40 Rochdale, UK Acute care general hospital 3,395 38,679 — — 3,395 38,679 42,074 2,927 — 1965 January 9, 2020 40 Rockledge, FL Acute care general hospital 13,919 23,282 8,338 — 13,919 31,620 45,539 5,521 — 1950 , 1970 May 1, 2017 42 Roeland Park, KS Acute care general hospital 1,569 15,103 — — 1,569 15,103 16,672 1,152 — 2018 June 10, 2019 50 Romford, UK Behavioral health facility 5,082 8,319 — — 5,082 8,319 13,401 394 — 1980 June 25, 2021 40 Rosenberg, TX Freestanding ER 1,270 4,505 — — 1,270 4,505 5,775 788 — 2016 January 15, 2016 40 Rowley, UK Acute care general hospital 2,760 17,370 — — 2,760 17,370 20,130 1,585 — 1986 August 16, 2019 40 Royston, UK Behavioral health facility 6,391 19,028 — — 6,391 19,028 25,419 899 — 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 14,618 — 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 4,701 — 1978 - 2002 September 29, 2017 41 San Antonio, TX Freestanding ER 3,120 4,801 — — 3,120 4,801 7,921 730 — 2016 December 9, 2016 40 San Antonio, TX Freestanding ER 351 3,952 — — 351 3,952 4,303 863 — 2014 January 1, 2014 40 San Antonio, TX Acute care general hospital 2,248 5,880 — — 2,248 5,880 8,128 1,494 — 2012 October 2, 2012 40 San Antonio, TX Freestanding ER 2,412 4,253 — — 2,412 4,253 6,665 656 — 2016 October 27, 2016 40 San Bernardino, CA Acute care general hospital 2,209 37,498 — — 2,209 37,498 39,707 3,415 — 1993 August 30, 2019 40 Initial Costs Additions Subsequent Cost at December 31, 2022(1) Accumulated Life on which Location Type of Property Land Buildings Improve- Carrying Land Buildings Total Depreciation Encum- Date of Date Acquired computed (Dollar amounts in thousands) Santa Maria de Feira, PT Acute care general hospital 1,804 17,299 — — 1,804 17,299 19,103 531 — 2015 October 21, 2021 40 Sebastian, FL Acute care general hospital 5,733 49,136 56,430 — 5,733 105,566 111,299 11,126 — 1974 May 1, 2017 41 Sharon, PA Acute care general hospital 6,179 9,066 5,428 — 6,179 14,494 20,673 3,091 — 1950 - 1980 May 1, 2017 41 Shawnee, KS Acute care general hospital 3,076 14,945 — — 3,076 14,945 18,021 1,328 — 2018 June 10, 2019 50 Sheffield, UK Acute care general hospital 6,277 42,344 — — 6,277 42,344 48,621 3,223 — 2008 January 9, 2020 40 Sherman, TX Acute care general hospital 3,363 10,932 — — 3,363 10,932 14,295 3,940 — 1913 , 1960 - 2010 October 31, 2014 40 Southampton, UK Behavioral health facility 6,116 17,961 — — 6,116 17,961 24,077 835 — 1820 , 1985 June 25, 2021 40 Spartanburg, SC Rehabilitation hospital 1,135 15,717 — — 1,135 15,717 16,852 3,685 — 2013 August 1, 2013 40 St. Albans Park, Australia Acute care general hospital 2,562 20,786 10,700 — 2,562 31,486 34,048 2,420 — 1985 June 7, 2019 40 Stirling, UK Acute care general hospital 1,001 18,517 — — 1,001 18,517 19,518 726 — 1992 July 6, 2021 40 Stockton, CA Rehabilitation hospital 2,841 — — — 2,841 — 2,841 — — 2021 November 23, 2020 40 Strathpine, Australia Acute care general hospital 2,755 34,489 — — 2,755 34,489 37,244 3,177 — 1985 June 7, 2019 40 Sunnybank, Australia Acute care general hospital 5,982 42,915 — — 5,982 42,915 48,897 4,580 — 1979 June 7, 2019 34 Surrey, UK Behavioral health facility 14,280 8,741 — — 14,280 8,741 23,021 25 — 1950 , 2014 December 9, 2022 40 Sussex, NJ Acute care general hospital 477 2,097 — — 477 2,097 2,574 130 — 1920 September 30, 2015 40 Swindon, UK Acute care general hospital 5,056 56,730 — — 5,056 56,730 61,786 4,280 — 1984 January 9, 2020 40 Tadley, UK Behavioral health facility 19,853 18,090 — — 19,853 18,090 37,943 891 — 2020 June 25, 2021 40 Tempe, AZ Acute care general hospital 6,050 10,986 5,084 — 6,050 16,070 22,120 2,410 — 1940 September 29, 2017 41 Texarkana, TX Acute care general hospital 14,562 — — — 14,562 — 14,562 — — 2017 September 29, 2017 - The Woodlands, TX Freestanding ER 2,005 4,524 — — 2,005 4,524 6,529 764 — 2016 March 28, 2016 40 Thornton, CO Freestanding ER 1,350 4,259 — — 1,350 4,259 5,609 887 — 2014 August 29, 2014 40 Toledo, OH Rehabilitation hospital 1,150 17,740 — — 1,150 17,740 18,890 2,994 — 2016 April 1, 2016 40 Tomball, TX Long term acute care hospital 1,299 23,982 — — 1,299 23,982 25,281 7,195 — 2005 December 21, 2010 40 Torquay, UK Acute care general hospital 2,829 33,923 — — 2,829 33,923 36,752 2,915 — 1981 August 16, 2019 40 Turku, Finland Acute care general hospital 1,171 57,048 — — 1,171 57,048 58,219 1,206 — 2018 March 11, 2022 40 Usk, UK Behavioral health facility 1,641 21,072 — — 1,641 21,072 22,713 838 — 1770 , 1850 , 1980 June 25, 2021 40 Valencia, SP Acute care general hospital 10,791 67,447 — — 10,791 67,447 78,238 2,106 — 2017 December 2, 2021 40 Viseu, Portugal Acute care general hospital 2,458 28,010 — — 2,458 28,010 30,468 2,422 — 2016 November 28, 2019 37 Wantirna, Australia Acute care general hospital 25,595 202,892 24,129 — 25,595 227,021 252,616 18,529 — 1984 June 7, 2019 40 Warren, OH Acute care general hospital 5,385 47,588 10,486 — 5,385 58,074 63,459 9,460 — 1982 May 1, 2017 41 Warren, OH Rehabilitation hospital 2,417 15,857 1,737 — 2,417 17,594 20,011 3,150 — 1922 - 2000 May 1, 2017 46 Watsonville, CA Acute care general hospital 16,488 17,800 — — 16,488 17,800 34,288 2,126 — 1983 September 30, 2019 39 Webster, TX Long term acute care hospital 663 33,751 — — 663 33,751 34,414 10,126 — 2

SCHEDULE IV - MORTGAGE LOANS ON

SCHEDULE IV - MORTGAGE LOANS ON REAL ESTATE	12 Months Ended
	Dec. 31, 2022
SEC Schedule, 12-29, Real Estate Companies, Investment in 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, 2022 Column A Column B Column C Column D Column E Column F Column G(1) Column H Description Interest Final Periodic Payment Prior Face Carrying Principal (Dollar amounts in thousands) Long-term first mortgage loan: Payable in monthly Colombia(4) 8.95 % 2035 (2 ) $ 117,360 $ 117,360 (3 ) Vibra 11.50 % 2024 (2 ) 7,986 7,986 (3 ) Prospect 7.96 % 2034 (2 ) 151,267 151,267 (3 ) Springstone 7.00 % 2041 (2 ) 22,900 22,900 (3 ) Infracore 4.20 % 2023 (2 ) 64,907 64,907 (3 ) $ 364,420 $ 364,420 (5 ) (1) The aggregate cost for federal income tax purposes is $ 364.4 million. (2) There were no prior liens on loans as of December 31, 2022. (3) Mortgage loans were not delinquent with respect to principal or interest, other than for two months of interest on the Prospect loan. (4) Mortgage loans covering three properties. (5) Excludes allowance for credit loss of $ 0.3 million at December 31, 2022. Changes in mortgage loans (excluding allowance for credit loss) for the years ended December 31, 2022, 2021, and 2020 are summarized as follows: Year Ended December 31, 2022 2021 2020 (Dollar amounts in thousands) Balance at beginning of year $ 213,320 $ 248,335 $ 1,274,995 Additions during year: New mortgage loans and additional advances on 177,924 1,128,695 (6) 193,590 Exchange rate fluctuations ( 15,824 ) ( 3,640 ) 9,785 375,420 1,373,390 1,478,370 Deductions during year: Collection of principal ( 11,000 ) ( 1,160,070 ) (6) ( 1,230,035 ) (7) ( 11,000 ) ( 1,160,070 ) ( 1,230,035 ) Balance at end of year $ 364,420 $ 213,320 $ 248,335 (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 to Item 8 of this Annual Report on Form 10-K.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2022
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 at December 31, 2022 are reasonable and supportable based on the information available (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). 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, 2022, we had loans and/or equity investments in certain variable interest entities approximating $ 633 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. This includes the five investments in unconsolidated real estate joint ventures at December 31, 2022. 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 ventures with Primotop Holdings S.à.r.l. ("Primotop") and Macquarie Asset Management ("MAM") (for which we handle the accounting of), we have elected to record our share of such investee’s earnings or losses on a lag basis (not to exceed three months). 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, when collectability of the lease payments is deemed probable, 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, is 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, 2022 are as follows: Buildings and improvements 39.0 years Lease intangibles 26.8 years Leasehold improvements 14.4 years Furniture, equipment, and other 9.8 years
Losses from Rent Receivables	Credit Losses: Losses from Rent Receivables: For all leases, we continuously monitor the performance of our existing tenants including, but not limited to: admission levels and surgery/procedure volumes by type; current operating margins; ratio of our tenant's operating margins both to facility rent and to facility rent plus other fixed costs; trends in revenue, cash collections, patient mix; and the effect of evolving healthcare regulations, adverse economic and political conditions, such as rising inflation and interest rates, and other events ongoing on a tenant's profitability and liquidity. Losses from Operating Lease Receivables: We utilize the information above along with the tenant’s payment and default history in evaluating (on a property-by-property basis) whether or not a provision for losses on outstanding billed rent and/or straight-line rent receivables is needed. A provision for losses on rent receivables (including straight-line rent receivables) is ultimately recorded when it becomes probable that the receivable will not be collected in full. The provision is an amount which reduces the receivable to its estimated net realizable value based on a determination of the eventual amounts to be collected either from the debtor or from existing collateral, if any. Losses on Financing Lease Receivables: We apply a forward-looking “expected credit loss” model to all of our financing receivables, including financing leases and loans. To do this, we have grouped our financial instruments into two primary pools of similar credit risk: secured and unsecured. The secured instruments include our investments in financing receivables as all are secured by the underlying real estate, among other collateral. Within the two primary pools, we further grouped our instruments into sub-pools based on several tenant/borrower characteristics, including years of experience in the healthcare industry and in a particular market or region and overall capitalization. We then determined a credit loss percentage per pool based on our history over a period of time that closely matches the remaining terms of the financial instruments being analyzed and adjusted as needed for current trends or unusual circumstances. We have applied these credit loss percentages to the book value of the related instruments to establish a credit loss reserve on our financing lease receivables and such credit loss reserve (including the underlying assumptions) is reviewed and adjusted quarterly. If a financing receivable is under performing and is deemed uncollectible based on the lessee’s overall financial condition, we will adjust the credit loss reserve based on the fair value of the underlying collateral. We made the accounting policy election to exclude interest receivables from the credit loss reserve model. Instead, 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 : Loans consist of mortgage loans, working capital loans, and other loans. Mortgage loans are collateralized by interests in real property. Working capital and other loans are typically collateralized by interests in receivables and corporate and individual guarantees. We record loans at cost. Like our financing lease receivables, we establish credit loss reserves on all outstanding loans based on historical credit losses of similar instruments. Such credit loss reserves, including the underlying assumptions, are reviewed and adjusted quarterly. If a loan’s performance worsens and foreclosure is deemed probable for our collateral-based loans (after considering the borrower’s overall financial condition as described above for leases), we will adjust the allowance for expected credit losses based on the current fair value of such collateral at the time the loan is deemed uncollectible. If the loan is not collateralized, the loan will be reserved for/written-off once it is determined that such loan is no longer collectible. Interest receivables on loans are excluded from the forward looking credit loss reserve model; however, we assess their collectability similar to how we assess collectability for interest receivables on financing leases described above. The following table summarizes our credit loss reserves (in thousands): December 31, 2022 December 31, 2021 Balance at beginning of the year $ 48,527 $ 8,726 Provision (recovery) for credit loss, net 99,009 41,710 Expected credit loss reserve related to financial instruments sold, ( 26,390 ) ( 1,909 ) Balance at end of year $ 121,146 $ 48,527
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. 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, which was amended during the second quarter of 2022. 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 third-party 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 (expense) 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 Health Opco, 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 exist at December 31, 2022 .
Leases (Lessee)	Leases (Lessee) Pursuant to ASU 2016-02, we are required to apply a dual approach, classifying leases (in which we are the lessee) as either financing or operating leases based on the principle of whether or not the lease is effectively a financed purchase. 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. For the year ended December 31, 2021, $ 39.4 million has been reclassified from "Other (including fair value adjustments on securities)" to "Real estate and other impairment charges, net" in our consolidated statements of Net Income. There is no impact to net income.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2022
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, 2022 are as follows: Buildings and improvements 39.0 years Lease intangibles 26.8 years Leasehold improvements 14.4 years Furniture, equipment, and other 9.8 years
Summary of Credit Loss Reserves	The following table summarizes our credit loss reserves (in thousands): December 31, 2022 December 31, 2021 Balance at beginning of the year $ 48,527 $ 8,726 Provision (recovery) for credit loss, net 99,009 41,710 Expected credit loss reserve related to financial instruments sold, ( 26,390 ) ( 1,909 ) Balance at end of year $ 121,146 $ 48,527

Real Estate and Other Activit_2

Real Estate and Other Activities (Tables)	12 Months Ended
	Dec. 31, 2022
Real Estate [Abstract]
Net Assets Acquired	For the years ended December 31, 2022, 2021, and 2020, we acquired or invested in the following net assets (in thousands): 2022 2021 2020 Land and land improvements $ 135,301 $ 642,312 $ 365,281 Buildings 487,698 2,381,654 2,547,313 Intangible lease assets — subject to amortization 21.3 years in 2022, 34.5 years in 2021, and 27.5 years in 2020) 45,394 262,385 642,699 Investment in financing leases — — 114,797 Mortgage loans(1)(2) 159,735 1,113,300 176,840 Investments in unconsolidated real estate joint ventures 399,456 — 233,593 Investments in unconsolidated operating entities 131,105 1,033,096 205,000 Other loans — — 103,195 Other assets — — 1,328 Liabilities assumed ( 25,727 ) ( 82,508 ) ( 140,866 ) $ 1,332,962 $ 5,350,239 $ 4,249,180 Loans repaid(1) — ( 1,103,410 ) ( 834,743 ) Total net assets acquired $ 1,332,962 $ 4,246,829 $ 3,414,437 (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 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. (2) In the 2022 second quarter, we increased our mortgage loan to Prospect Medical Holdings, Inc. ("Prospect") that was originated in 2019 and that is secured by a first lien on a California hospital. The loan bears interest at a current market rate plus a component of additional interest upon repayment.
Summary of Status on Current Development Projects	See table below for a status summary of our current development projects (in thousands): Property Commitment Costs Estimated Rent Ernest (Stockton, California) $ 47,700 $ 45,739 1Q 2023 IMED (Spain) 50,411 13,037 2Q 2023 Ernest (South Carolina) 22,400 7,541 2Q 2023 IMED (Spain) 45,408 33,801 3Q 2023 Springstone (Texas) 34,600 1,962 1Q 2024 IMED (Spain) 36,734 8,320 3Q 2024 Steward (Texas) 169,408 57,020 1Q 2026 $ 406,661 $ 167,420
Summary of Operating Results from Properties	The properties sold during 2022 do not meet the definition of discontinued operations. However, the following represents the operating results from these properties for the periods presented (in thousands): For the Year Ended December 31, 2022 2021 2020 Revenues(1) $ 17,831 $ 180,549 $ 174,362 Real estate depreciation and amortization(2) ( 4,683 ) ( 28,579 ) ( 38,059 ) Property-related expenses ( 1,588 ) ( 5,065 ) ( 12,509 ) Other income(3) 536,813 181 1,228 Income from real estate dispositions, net $ 548,373 $ 147,086 $ 125,022 (1) Includes approximately $ 42 million of straight-line rent and other write-offs associated with the non-Macquarie disposal transactions for the year ended December 31, 2022. (2) Lower in 2022 as we stopped depreciating the properties making up the Macquarie Transaction once deemed held for sale in September 2021. (3) Includes $ 536.8 million of gains (net of $ 125 million write-off of straight-line rent receivables related to the Macquarie Transaction) for the year ended December 31, 2022.
Amortization Expense from Existing Lease Intangible Assets	We recorded amortization expense related to intangible lease assets of $ 55.9 million, $ 56.0 million, and $ 42.4 million in 2022, 2021, and 2020, respectively, and expect to recognize amortization expense from existing lease intangible assets as follows (amounts in thousands): For the Year Ended December 31: 2023 $ 56,740 2024 56,683 2025 56,535 2026 56,266 2027 55,932
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, 2022 (amounts in thousands): Total Under Total Under Total 2023 $ 984,353 $ 161,079 $ 1,145,432 2024 1,001,456 164,357 1,165,813 2025 1,016,367 167,701 1,184,068 2026 1,031,717 171,112 1,202,829 2027 1,048,409 174,591 1,223,000 Thereafter 25,851,987 4,376,304 30,228,291 $ 30,934,289 $ 5,215,144 $ 36,149,433
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, 2022 As of December 31, 2021 Minimum lease payments receivable $ 880,253 $ 1,183,855 Estimated unguaranteed residual values 203,818 203,818 Less: Unearned income and allowance for credit loss ( 731,915 ) ( 918,584 ) Net investment in direct financing leases 352,156 469,089 Other financing leases (net of allowance for credit loss) 1,339,167 1,584,238 Total investment in financing leases $ 1,691,323 $ 2,053,327
Summary of Investments in Unconsolidated Operating Entities	The following is a summary of our investments in unconsolidated real estate joint ventures by operator (amounts in thousands): Operator Ownership Percentage As of December 31, 2022 As of December 31, 2021 MEDIAN 50 % $ 482,735 $ 517,648 Swiss Medical Network 70 % 454,083 476,193 Steward (Macquarie Transaction) 50 % 417,701 — Policlinico di Monza 50 % 86,245 95,468 HM Hospitales 45 % 57,139 63,618 Total $ 1,497,903 $ 1,152,927 The following is a summary of our investments in unconsolidated operating entities (amounts in thousands): Operator As of December 31, As of December 31, Steward (loan investment) $ 362,831 $ 360,164 International joint venture 231,402 219,387 Springstone 200,827 187,450 Priory 156,575 42,315 Swiss Medical Network 157,145 159,208 Steward (equity investment) 125,862 139,000 Prospect 112,777 112,283 Aevis Victoria SA ("Aevis") 72,904 61,271 Aspris Children's Services ("Aspris") 16,023 8,356 Caremax 8,526 — Total $ 1,444,872 $ 1,289,434

Debt (Tables)

Debt (Tables)	12 Months Ended
	Dec. 31, 2022
Debt Disclosure [Abstract]
Summary of Debt	The following is a summary of debt (dollar amounts in thousands): As of December 31, As of December 31, Revolving credit facility(A) $ 929,584 $ 730,000 Interim credit facility — 869,606 Term loan 200,000 200,000 British pound sterling term loan due 2024(B) 126,690 — British pound sterling term loan due 2025(B) 845,810 947,240 Australian term loan facility(B) 817,560 871,560 2.550 % Senior Unsecured Notes due 2023(B) 483,320 541,280 3.325 % Senior Unsecured Notes due 2025(B) 535,250 568,500 0.993 % Senior Unsecured Notes due 2026(B) 535,250 568,500 2.500 % Senior Unsecured Notes due 2026(B) 604,150 676,600 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) 724,980 811,920 4.625 % Senior Unsecured Notes due 2029 900,000 900,000 3.375 % Senior Unsecured Notes due 2030(B) 422,905 473,620 3.500 % Senior Unsecured Notes due 2031 1,300,000 1,300,000 $ 10,325,499 $ 11,358,826 Debt issue costs and discount, net ( 57,087 ) ( 76,056 ) $ 10,268,412 $ 11,282,770 (a) Includes £ 90 million of GBP-denominated borrowings and € 253 million of Euro-denominated borrowings that reflect the exchange rate at December 31, 2022 . (b) Non-U.S. dollar denominated debt that reflects the exchange rate at period-end.
Principal Payments Due on Debt	As of December 31, 2022, 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): 2023 $ 483,320 2024 944,250 2025 1,381,060 2026 2,568,984 2027 1,600,000 Thereafter 3,347,885 Total $ 10,325,499
Basic Terms of Senior Unsecured Notes	The following are the basic terms of our senior unsecured notes at December 31, 2022 (par value amounts in thousands): Offering Maturity Date Par Value % of Par 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, 2022
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, 2022 2021 2020 Current income tax (expense) benefit: Domestic $ 1,111 $ ( 1,559 ) $ 63 Foreign ( 27,751 ) ( 18,964 ) ( 10,203 ) ( 26,640 ) ( 20,523 ) ( 10,140 ) Deferred income tax (expense) benefit: Domestic ( 15,628 ) 6,915 ( 10,680 ) Foreign ( 13,632 ) ( 60,340 ) ( 10,236 ) ( 29,260 ) ( 53,425 ) ( 20,916 ) Income tax (expense) $ ( 55,900 ) $ ( 73,948 ) $ ( 31,056 )
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, 2022, 2021, and 2020 is as follows (in thousands): For the Years Ended December 31, 2022 2021 2020 Income before income tax $ 959,719 $ 730,888 $ 463,328 Income tax (expense) at the U.S. statutory federal rate ( 21 % in 2022, 2021, and 2020) ( 201,541 ) ( 153,486 ) ( 97,299 ) Decrease (increase) in income tax resulting from: Foreign rate differential 1,826 2,742 2,160 State income taxes, net of federal benefit ( 1,886 ) — 970 U.S. earnings not subject to federal income tax 165,705 132,266 82,921 Equity investments — — 380 Change in valuation allowance ( 11,281 ) ( 10,040 ) ( 8,514 ) Statutory tax rate change ( 941 ) ( 43,924 ) ( 9,471 ) Interest disallowance ( 1,737 ) ( 646 ) — Other items, net ( 6,045 ) ( 860 ) ( 2,203 ) Total income tax (expense) $ ( 55,900 ) $ ( 73,948 ) $ ( 31,056 )
Schedule of Deferred Tax Assets and Liabilities	At December 31, 2022 and 2021, components of our deferred tax assets and liabilities were as follows (in thousands): 2022 2021 Deferred tax assets: Operating loss and interest deduction carry forwards $ 175,922 $ 197,876 Other 15,218 1,815 Total deferred tax assets 191,140 199,691 Valuation allowance ( 71,499 ) ( 61,747 ) Total net deferred tax assets $ 119,641 $ 137,944 Deferred tax liabilities: Property and equipment $ ( 294,181 ) $ ( 320,546 ) Net unbilled revenue ( 63,324 ) ( 43,366 ) Partnership investments ( 26,268 ) ( 15,963 ) Other ( 27,153 ) ( 3,836 ) Total deferred tax liabilities ( 410,926 ) ( 383,711 ) Net deferred tax asset (liability) $ ( 291,285 ) $ ( 245,767 )
Schedule of Net NOL and Other Tax Attribute Carryforwards	At December 31, 2022, we had net NOL and other tax attribute carryforwards as follows (in thousands): U.S. Foreign Gross NOL carryforwards $ 148,900 $ 633,682 Tax-effected NOL carryforwards $ 24,013 $ 151,909 Valuation allowance ( 13,864 ) ( 57,635 ) Net deferred tax asset - NOL carryforwards $ 10,149 $ 94,274 Expiration periods 2024 - 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, Per share: 2022 2021 2020 Ordinary dividend (1) $ 0.4703 $ 0.7646 $ 0.6030 Long-term capital gain (2) 0.6797 0.1654 — Return of capital — 0.1800 0.4670 Total $ 1.1500 $ 1.1100 $ 1.0700 (1) For the years ended December 31, 2022, 2021, and 2020, includes Section 199A dividends of 0.4703 , 0.7646 , and 0.6030 , respectively. (2) For the years ended December 31, 2022, 2021, and 2020, includes Unrecaptured Section 1250 gains of 0.2574 , 0.0583 , and 0.0000 , respectively.

Earnings Per Share_Unit (Tables

Earnings Per Share/Unit (Tables)	12 Months Ended
	Dec. 31, 2022
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, 2022 2021 2020 Numerator: Net income $ 903,819 $ 656,940 $ 432,272 Non-controlling interests’ share in earnings ( 1,222 ) ( 919 ) ( 822 ) Participating securities’ share in earnings ( 1,602 ) ( 2,161 ) ( 2,105 ) Net income, less participating securities’ share in $ 900,995 $ 653,860 $ 429,345 Denominator: Basic weighted-average common shares 598,634 588,817 529,239 Dilutive potential common shares 203 1,322 1,222 Diluted weighted-average common shares 598,837 590,139 530,461 MPT Operating Partnership, L.P. Our earnings per unit were calculated based on the following (amounts in thousands): For the Years Ended December 31, 2022 2021 2020 Numerator: Net income $ 903,819 $ 656,940 $ 432,272 Non-controlling interests’ share in earnings ( 1,222 ) ( 919 ) ( 822 ) Participating securities’ share in earnings ( 1,602 ) ( 2,161 ) ( 2,105 ) Net income, less participating securities’ share in $ 900,995 $ 653,860 $ 429,345 Denominator: Basic weighted-average units 598,634 588,817 529,239 Dilutive potential units 203 1,322 1,222 Diluted weighted-average units 598,837 590,139 530,461

Stock Awards (Tables)

Stock Awards (Tables)	12 Months Ended
	Dec. 31, 2022
Share-Based Payment Arrangement [Abstract]
Stock-based Award Activity	The following summarizes stock-based award activity in 2022 and 2021 (which includes awards granted in 2022, 2021, 2020, and any applicable prior years), respectively: For the Year Ended December 31, 2022: Vesting Based Vesting Based on Shares Weighted-Average Shares Weighted-Average Nonvested awards at beginning of the year 922,954 $ 20.26 5,477,536 $ 15.86 Awarded 659,393 $ 21.18 1,828,971 $ 18.45 Vested ( 750,854 ) $ 20.25 ( 2,924,722 ) $ 13.87 Forfeited ( 21,010 ) $ 20.06 ( 32,704 ) $ 19.17 Nonvested awards at end of year 810,483 $ 21.02 4,349,081 $ 18.26 For the Year Ended December 31, 2021: Vesting Based Vesting Based on Shares Weighted-Average Shares Weighted-Average 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

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	12 Months Ended
	Dec. 31, 2022
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, 2022 December 31, 2021 Asset (Liability) Book Fair Book Fair Interest and rent receivables $ 167,035 $ 163,101 $ 56,229 $ 56,564 Loans(1) 1,405,615 (2) 1,360,113 991,609 (2) 991,954 Debt, net ( 10,268,412 ) ( 8,697,042 ) ( 11,282,770 ) ( 11,526,388 ) (1) Excludes the acquisition loan and mortgage loan made in October 2021 for our Springstone investment and the acquisition loan made in May 2020 related to our investment in the international joint venture, along with the related subsequent investment in the real estate of three hospitals in Colombia, as these assets are accounted for under the fair value option method, as noted below. (2) Includes $ 223.8 million and $ 70.1 million of mortgage loans, a $ 315.9 million and $ 335.6 million shareholder loan included in investments in unconsolidated real estate joint ventures, $ 640.4 million and $ 521.4 million of loans that are part of our investments in unconsolidated operating entities, and $ 225.5 million and $ 64.5 million of other loans at December 31, 2022 and 2021, respectively.
Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis	At December 31, 2022 and 2021, the amounts recorded under the fair value option method were as follows (in thousands): As of December 31, 2022 As of December 31, 2021 Asset (Liability) Fair Value Original Fair Value Original Asset Type Classification Mortgage loans $ 140,260 $ 140,260 $ 143,068 $ 143,068 Mortgage loans Equity investment and other loans 434,609 441,943 409,638 409,638 Investments in unconsolidated
Schedule of Effects of Movement in DLOM by Sensitivity Analysis by Using Basis Point Variations	The DLOM on our Springstone investment was 40 % at December 31, 2022. 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 + 100 basis points $ ( 43 ) - 100 basis points 43

Leases (Lessee) (Tables)

Leases (Lessee) (Tables)	12 Months Ended
	Dec. 31, 2022
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 2022 2021 Operating lease cost (1) (2) $ 12,175 $ 10,694 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 ( 4,485 ) ( 4,466 ) Total lease cost $ 7,869 $ 6,407 (1) Includes short-term leases. (2) $ 5.7 million and $ 6.3 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2022 and 2021, 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, 2022 are as follows (amounts in thousands): Operating Leases Finance Leases Amounts To Net 2023 $ 8,742 $ 129 $ ( 4,416 ) $ 4,455 2024 8,880 130 ( 4,272 ) 4,738 2025 8,289 131 ( 4,328 ) 4,092 2026 7,884 133 ( 4,021 ) 3,996 2027 7,873 134 ( 3,730 ) 4,277 Thereafter 235,940 4,516 ( 65,320 ) 175,136 (1) Total undiscounted minimum lease payments $ 277,608 $ 5,173 $ ( 86,087 ) $ 196,694 Less: interest ( 176,016 ) ( 3,235 ) Present value of lease liabilities $ 101,592 $ 1,938 (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 December 31, December 31, Right of use assets: Operating leases - real estate Land $ 63,553 $ 68,616 Finance leases - real estate Land 1,734 1,785 Total real estate right of use assets $ 65,287 $ 70,401 Operating leases - corporate Other assets 26,225 7,458 Total right of use assets $ 91,512 $ 77,859 Lease liabilities: Operating leases Obligations to tenants and $ 101,592 $ 85,217 Financing leases Obligations to tenants and 1,938 1,937 Total lease liabilities $ 103,530 $ 87,154 Weighted-average remaining lease term: Operating leases 33.2 40.6 Finance leases 33.9 34.9 Weighted-average discount rate: Operating leases 6.1 % 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, 2022 2021 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows used for operating leases $ 7,169 $ 7,330 Operating cash flows used for finance leases 128 126 Non-cash activities - Right-of-use assets obtained in exchange for lease Operating leases 23,066 1,120

Other Assets (Tables)

Other Assets (Tables)	12 Months Ended
	Dec. 31, 2022
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, 2022 2021 Debt issue costs, net(1) $ 12,036 $ 5,488 Other corporate assets 256,438 231,731 Prepaids and other assets 304,516 96,261 Total other assets $ 572,990 $ 333,480 (1) Relates to our revolving credit facility

Organization - Additional Infor

Organization - Additional Information (Detail)	Dec. 31, 2022 Facility State Country
Business Acquisition [Line Items]
Number of facilities | Facility	444
Number of states | State	31
Europe [Member]
Business Acquisition [Line Items]
Number of countries	7
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 Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Significant Accounting Policies [Line Items]
Threshold ownership percentage for inter company balances and transactions elimination	100%
Loans and/or equity investments in variable interest entities	$ 633,000
Expected lease-up periods for estimating lost rentals, in months	6 months
Percentage of ordinary taxable income to be distributed for real estate investment trust qualification	90%	90%	90%
Number of years of federal income tax at corporate rates on failure to qualify as REIT	4 years
Real estate and other impairment charges	$ 268,375	$ 39,411	$ 19,006
Net income	$ 903,819	$ 656,940	$ 432,272
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, 2022
Buildings and improvements [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	39 years
Lease Intangibles [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	26 years 9 months 18 days
Leasehold improvements [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	14 years 4 months 24 days
Furniture, equipment and other [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	9 years 9 months 18 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, 2022	Dec. 31, 2021
Accounting Policies [Abstract]
Balance at beginning of the year	$ 48,527	$ 8,726
Provision (recovery) for credit loss, net	99,009	41,710
Expected credit loss reserve related to financial instruments sold, repaid, or satisfied	(26,390)	(1,909)
Balance at end of year	$ 121,146	$ 48,527

Real Estate and Other Activit_3

Real Estate and Other Activities - Net Assets Acquired (Detail) - USD ($) $ in Thousands		Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Business Acquisition [Line Items]
Total assets acquired		$ 1,332,962	$ 5,350,239	$ 4,249,180
Liabilities assumed		(25,727)	(82,508)	(140,866)
Loans repaid	[1]		(1,103,410)	(834,743)
Total net assets acquired		1,332,962	4,246,829	3,414,437
Land and Land Improvements [Member]
Business Acquisition [Line Items]
Total assets acquired		135,301	642,312	365,281
Building [Member]
Business Acquisition [Line Items]
Total assets acquired		487,698	2,381,654	2,547,313
Intangible Lease Assets [Member]
Business Acquisition [Line Items]
Total assets acquired		45,394	262,385	642,699
Mortgage Loans [Member]
Business Acquisition [Line Items]
Total assets acquired	[1],[2]	159,735	1,113,300	176,840
Investments in Financing Leases [Member]
Business Acquisition [Line Items]
Total assets acquired				114,797
Equity Investments [Member]
Business Acquisition [Line Items]
Total assets acquired				1,328
Other Loans and Assets [Member]
Business Acquisition [Line Items]
Total assets acquired				103,195
Real Estate Investments Unconsolidated Real Estate And Other Joint Ventures [Member]
Business Acquisition [Line Items]
Total assets acquired		399,456		233,593
Investments In Unconsolidated Operating Entities [Member]
Business Acquisition [Line Items]
Total assets acquired		$ 131,105	$ 1,033,096	$ 205,000
[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 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. In the 2022 second quarter, we increased our mortgage loan to Prospect Medical Holdings, Inc. ("Prospect") that was originated in 2019 and that is secured by a first lien on a California hospital. The loan bears interest at a current market rate plus a component of additional interest upon repayment.

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, 2022	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($) Hospital	Dec. 31, 2019 USD ($) Hospital	Jun. 30, 2021 Property	Mar. 31, 2021 GBP (£)
Business Acquisition [Line Items]
Weighted-average useful life of acquired intangible lease assets (in years)		23 years 8 months 12 days
Loans repaid	[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]
Loans repaid					$ 100,000
Mortgage Loans [Member] | Priory Group [Member]
Business Acquisition [Line Items]
Loans repaid | £							£ 800
Mortgage Loans [Member] | Steward Health Care System LLC [Member]
Business Acquisition [Line Items]
Loans repaid				$ 740,000
Intangible Lease Assets [Member]
Business Acquisition [Line Items]
Weighted-average useful life of acquired intangible lease assets (in years)		21 years 3 months 18 days	34 years 6 months	27 years 6 months
[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 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 - 2022 Activity - Additional Information) (Detail) $ in Thousands, € in Millions, £ in Millions, SFr in Millions

3 Months Ended

12 Months Ended

Dec. 09, 2022 USD ($) Facility

Dec. 09, 2022 GBP (£) Facility

Jul. 29, 2022 USD ($)

Apr. 29, 2022 EUR (€) Facility

Apr. 25, 2022 USD ($) Facility

Apr. 18, 2022 Facility

Mar. 14, 2022 USD ($) Facility

Mar. 11, 2022 USD ($) Facility

Mar. 11, 2022 EUR (€) Facility

Feb. 16, 2022 GBP (£)

Dec. 29, 2020 CHF (SFr)

Dec. 31, 2021 USD ($)

Dec. 31, 2022 USD ($) Facility

Dec. 31, 2022 CHF (SFr) Facility

Dec. 31, 2021 USD ($)

Dec. 31, 2020 USD ($)

Business Acquisition [Line Items]

Investments in unconsolidated real estate joint ventures

$ 1,152,927

$ 1,497,903

$ 1,152,927

Gain (loss) on real estate dispositions

(40,000)

52,500

$ (2,800)

Mortgage loan

177,924

1,128,695

193,590

Deferred income tax liabilities and other liabilities, incurred

$ 26,000

Acquisition loan

$ 5,350,239

$ 1,332,962

$ 5,350,239

$ 4,249,180

Syndicated Term Loan [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | £

£ 96.5

Acquisition loan | £

£ 100

Loan term

6 years

Percentage of discount on investment

3.50%

Variable interest rate

8.30%

General Acute Care Hospitals [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Facility

2

6

6

Purchase price of acquisition

$ 80,000

Infracore [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | SFr

SFr 206.5

Mortgage loan | SFr

SFr 60

Massachusetts-based General Acute Care Hospitals [Member]

Business Acquisition [Line Items]

Proceeds from expected secured debt

$ 1,300,000

Gain (loss) on real estate dispositions

$ 600,000

Nonrecourse secured debt percentage of asset value

55%

Number of facilities acquired | Facility

8

Purchase price of acquisition

$ 1,700,000

Lease extension expiration year

2041

United Kingdom [Member] | Behavioral Health Facilities [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Facility

6

6

Purchase price of acquisition

$ 286,000

£ 233

Real estate financing by third party seller | £

£ 105

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

Business Acquisition [Line Items]

Number of facilities acquired | Facility

4

4

Purchase price of acquisition

$ 194,000

€ 178

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

Business Acquisition [Line Items]

Number of facilities acquired | Facility

3

3

3

Purchase price of acquisition | €

€ 27

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

Business Acquisition [Line Items]

Number of facilities acquired | Facility

1

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

Business Acquisition [Line Items]

Purchase price of acquisition

$ 26,000

Corporate Joint Venture [Member]

Business Acquisition [Line Items]

Investments in unconsolidated real estate joint ventures

$ 400,000

Real Estate Partnership [Member]

Business Acquisition [Line Items]

Percentage of equity investment

50%

Macquarie Asset Management [Member] | Massachusetts-based General Acute Care Hospitals [Member]

Business Acquisition [Line Items]

Percentage of equity investment

50%

Real Estate and Other Activit_6

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

12 Months Ended

Apr. 25, 2022 USD ($) Facility

Mar. 14, 2022 USD ($) Facility

Dec. 02, 2021 EUR (€)

Oct. 21, 2021 EUR (€)

Oct. 19, 2021 USD ($)

Aug. 01, 2021 USD ($) Hospital

Jul. 06, 2021 USD ($) Hospital

Jul. 06, 2021 GBP (£) Hospital

Jun. 25, 2021 GBP (£) Property

Jan. 19, 2021 GBP (£)

Nov. 25, 2020 GBP (£)

Dec. 31, 2022 Facility

Dec. 31, 2021 Hospital

Dec. 31, 2020 Hospital

Mar. 11, 2022 USD ($)

Jun. 30, 2021 Property

Apr. 16, 2021 CHF (SFr)

Jan. 08, 2021 USD ($)

Business Acquisition [Line Items]

Deferred income tax liabilities and other liabilities, incurred

$ 26

General Acute Care Hospitals [Member]

Business Acquisition [Line Items]

Purchase price of acquisition

$ 80

Number of facilities acquired | Facility

2

6

Swiss Medical Network [Member]

Business Acquisition [Line Items]

Equity investment | SFr

SFr 145

Massachusetts Based General Acute Care Hospitals [Member]

Business Acquisition [Line Items]

Purchase price of acquisition

$ 1,700

Nonrecourse Secured Debt Percentage Of Asset Value

55%

Number of facilities acquired | Facility

8

Lease extension expiration year

2041

Acute Care Hospital [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

2

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

Business Acquisition [Line Items]

Purchase price of acquisition | £

£ 50

Portugal [Member] | Acute Care Hospital [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | €

€ 17.8

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

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

Business Acquisition [Line Items]

Purchase price of acquisition | €

€ 46

Ownership interest

50%

Priory Group [Member]

Business Acquisition [Line Items]

Number of real estate assets acquired | Property

35

Deferred income tax liabilities and other liabilities, incurred | £

£ 47.1

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

Business Acquisition [Line Items]

Number of real estate assets acquired | Property

35

Payment for acquisition | £

£ 800

Purchase price of acquisition loan | £

£ 250

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

Business Acquisition [Line Items]

Purchase price of acquisition | £

£ 800

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

Business Acquisition [Line Items]

Ownership interest

9.90%

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]

Number of facilities acquired | Hospital

2

Other loan to affiliates

$ 335

Real Estate and Other Activit_7

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

12 Months Ended

Dec. 29, 2020 CHF (SFr)

Dec. 18, 2020 GBP (£) Hospital

Dec. 17, 2020 USD ($) Hospital

Nov. 25, 2020 GBP (£)

Nov. 17, 2020 USD ($) Hospital

Aug. 13, 2020 USD ($)

Aug. 07, 2020 GBP (£) Hospital

Aug. 05, 2020 EUR (€)

Jul. 08, 2020 USD ($) Hospital

Jun. 16, 2020 RenewalOption

Jan. 08, 2020 GBP (£) Hospital

Dec. 31, 2022 USD ($) Hospital

Dec. 31, 2021 USD ($) Hospital

Dec. 31, 2020 USD ($) Hospital Facility

Jun. 24, 2020 CHF (SFr)

May 13, 2020 USD ($)

Business Acquisition [Line Items]

Term of lease extension, years

5 years

Acquisition loan | $

$ 1,332,962

$ 5,350,239

$ 4,249,180

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%

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

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

2

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

30

Purchase price of acquisition | £

£ 1,500

Unearned rent revenue | £

£ 27.6

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

1

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

3

Purchase price of acquisition | $

$ 135,000

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

Business Acquisition [Line Items]

Number of facilities acquired

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

3

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

Business Acquisition [Line Items]

Number of facilities acquired

3

Purchase price of acquisition | €

€ 12.5

Inpatient Rehabilitation Hospital [Member] | Texas [Member]

Business Acquisition [Line Items]

Number of facilities acquired

1

Inpatient Rehabilitation Hospital [Member] | Indiana [Member]

Business Acquisition [Line Items]

Number of facilities acquired

1

Private Acute Care Hospital [Member]

Business Acquisition [Line Items]

Number of facilities acquired

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_8

Real Estate and Other Activities - Development Activities - Additional Information (Detail) $ in Thousands, € in Millions			3 Months Ended	12 Months Ended
	Apr. 29, 2022 Facility	Apr. 25, 2022 Facility	Jun. 30, 2020 Hospital	Dec. 31, 2022 USD ($) NewProject Facility	Dec. 31, 2021 USD ($) Hospital	Dec. 31, 2020 Hospital	Dec. 31, 2019 Hospital	Dec. 31, 2022 EUR (€)	Nov. 23, 2020 USD ($)
Business Acquisition [Line Items]
Number of development of new projects | NewProject				5
Total commitment | $				$ 406,661
Acute Care Hospital [Member]
Business Acquisition [Line Items]
Number of facilities acquired					2
Acute Care Hospital [Member] | Cayce, South Carolina [member]
Business Acquisition [Line Items]
Number of facilities acquired						1
Inpatient Rehabilitation Hospital [Member] | Cayce, South Carolina [member]
Business Acquisition [Line Items]
Number of facilities acquired						3
Ernest [Member]
Business Acquisition [Line Items]
Number of facilities acquired							4
Ernest [Member] | Cayce, South Carolina [member]
Business Acquisition [Line Items]
Total commitment | $				$ 22,400
General Acute Care Hospitals [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Facility		2		6
General Acute Care Hospitals [Member] | Spain [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Facility	3			3
Total commitment | €								€ 120
Springstone [Member] | McKinney, Texas [Member]
Business Acquisition [Line Items]
Total commitment | $				$ 35,000
Development Activities [Member] | Acute Care Hospital [Member]
Business Acquisition [Line Items]
Number of facilities acquired			2
Development Activities [Member] | Inpatient Rehabilitation Hospital [Member]
Business Acquisition [Line Items]
Number of facilities acquired			1
Development Activities [Member] | Ernest [Member]
Business Acquisition [Line Items]
Total commitment | $									$ 47,700
Development Activities [Member] | Steward [Member]
Business Acquisition [Line Items]
Total commitment | $					$ 169,400

Real Estate and Other Activit_9

Real Estate and Other Activities - Development Activities - Summary of Status on Current Development Projects (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2022 USD ($)
Business Acquisition [Line Items]
Commitment	$ 406,661
Costs Incurred as of December 31, 2022	167,420
Steward [Member] | Texas [Member]
Business Acquisition [Line Items]
Commitment	169,408
Costs Incurred as of December 31, 2022	$ 57,020
Estimated Rent Commencement Date	1Q 2026
Ernest [Member] | California [Member]
Business Acquisition [Line Items]
Commitment	$ 47,700
Costs Incurred as of December 31, 2022	$ 45,739
Estimated Rent Commencement Date	1Q 2023
Ernest [Member] | South Carolina [Member]
Business Acquisition [Line Items]
Commitment	$ 22,400
Costs Incurred as of December 31, 2022	$ 7,541
Estimated Rent Commencement Date	2Q 2023
IMED [Member] | Spain [Member]
Business Acquisition [Line Items]
Commitment	$ 50,411
Costs Incurred as of December 31, 2022	$ 13,037
Estimated Rent Commencement Date	2Q 2023
IMED [Member] | Spain [Member]
Business Acquisition [Line Items]
Commitment	$ 45,408
Costs Incurred as of December 31, 2022	$ 33,801
Estimated Rent Commencement Date	3Q 2023
IMED [Member] | Spain [Member]
Business Acquisition [Line Items]
Commitment	$ 36,734
Costs Incurred as of December 31, 2022	$ 8,320
Estimated Rent Commencement Date	3Q 2024
Springstone [Member] | Texas [Member]
Business Acquisition [Line Items]
Commitment	$ 34,600
Costs Incurred as of December 31, 2022	$ 1,962
Estimated Rent Commencement Date	1Q 2024

Real Estate and Other Activi_10

Real Estate and Other Activities - Disposals - Additional Information (Detail) $ in Thousands		3 Months Ended	12 Months Ended
	Mar. 14, 2022 USD ($) Facility	Dec. 31, 2021 USD ($)	Dec. 31, 2022 USD ($) Property Facility	Dec. 31, 2021 USD ($) Facility	Dec. 31, 2020 USD ($) Facility Hospital Property
Business Acquisition [Line Items]
Number of facilities sold | Facility			15	16	9
Number of properties sold | Property					6
Proceeds from sale of facilities		$ 54,500	$ 522,000	$ 246,000	$ 94
Number of ancillary properties sold | Facility			5
Gain (loss) on real estate dispositions		$ (40,000)		$ 52,500	$ (2,800)
Straight-line rent write-offs			$ 42
Steward Health Care System LLC [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Hospital					2
Massachusetts-based General Acute Care Hospitals [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Facility	8
Purchase price of acquisition	$ 1,700,000
Gain (loss) on real estate dispositions	$ 600,000
Proceeds from expected secured debt			$ 1,300,000
Prime Healthcare Services, Inc. Facilities [Member]
Business Acquisition [Line Items]
Number of properties sold | Property			11
Proceeds from sale of facilities			$ 366,000
Prime [Member]
Business Acquisition [Line Items]
Gain (loss) on real estate dispositions			$ 100,000

Real Estate and Other Activi_11

Real Estate and Other Activities - Summary of Operating Results from Properties Sold (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Business Acquisition [Line Items]
Revenues	$ 1,542,851	$ 1,544,669	$ 1,249,238
Real estate depreciation and amortization	(332,977)	(321,249)	(264,245)
Other income	15,344	45,699	(6,782)
Disposal Group, Not Discontinued Operations [Member]
Business Acquisition [Line Items]
Revenues	17,831	180,549	174,362
Real estate depreciation and amortization	(4,683)	(28,579)	(38,059)
Property-related expenses	(1,588)	(5,065)	(12,509)
Other income	536,813	181	1,228
Income from real estate dispositions, net	$ 548,373	$ 147,086	$ 125,022

Real Estate and Other Activi_12

Real Estate and Other Activities - Summary of Operating Results from Properties Sold (Parenthetical) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021
Business Acquisition [Line Items]
Straight-line rent write-offs	$ 42
Gains		$ 40,945
Disposal Group, Not Discontinued Operations [Member]
Business Acquisition [Line Items]
Straight-line rent write-offs	42,000
Massachusetts-based General Acute Care Hospitals [Member]
Business Acquisition [Line Items]
Straight-line rent write-offs	125,000
Massachusetts-based General Acute Care Hospitals [Member] | Disposal Group, Not Discontinued Operations [Member]
Business Acquisition [Line Items]
Gains	$ 536,800

Real Estate and Other Activi_13

Real Estate and Other Activities - Other Disposal Transactions - Additional Information (Detail) $ in Thousands	3 Months Ended	12 Months Ended
	Dec. 31, 2021 USD ($) Operator	Dec. 31, 2022 USD ($) Facility	Dec. 31, 2021 USD ($) Operator Facility	Dec. 31, 2020 USD ($) Facility Property
Business Acquisition [Line Items]
Number of operations sold | Operator	3		3
Proceeds from sale of facilities	$ 54,500	$ 522,000	$ 246,000	$ 94
Gain (loss) on real estate dispositions	$ (40,000)		$ 52,500	$ (2,800)
Number of facilities sold | Facility		15	16	9
Number of properties sold | Property				6

Real Estate and Other Activi_14

Real Estate and Other Activities - Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Business Combinations [Abstract]
Intangible lease assets	$ 1,394,471	$ 1,417,813
Accumulated amortization, net	1,200,000	1,300,000
Amortization expense related to intangible lease assets	$ 55,900	$ 56,000	$ 42,400
Capitalized lease intangibles, weighted average life (in years)	23 years 8 months 12 days

Real Estate and Other Activi_15

Real Estate and Other Activities - Amortization Expense from Existing Lease Intangible Assets (Detail) $ in Thousands	Dec. 31, 2022 USD ($)
Business Combinations [Abstract]
2023	$ 56,740
2024	56,683
2025	56,535
2026	56,266
2027	$ 55,932

Real Estate and Other Activi_16

Real Estate and Other Activities - Leasing Operations (Lessor) - Additional Information (Detail) $ in Millions		12 Months Ended
	Sep. 01, 2022 Property	Dec. 31, 2022 USD ($) Property Lease
Lessor Lease Description [Line Items]
Lease renewal term		5 years
Annual rent escalations		99%
Carrying value of lease requiring residual value guarantee | $		$ 110
Number of properties | Property		3
Number of properties sold associated with financing leases | Property	2
Minimum [Member]
Lessor Lease Description [Line Items]
Term of lease		15 years
Ernest [Member]
Lessor Lease Description [Line Items]
Number of direct financing leases		13
Number of financing leases		5
Prime Healthcare Services, Inc. Facilities [Member]
Lessor Lease Description [Line Items]
Number of direct financing leases		3
Prospect [Member]
Lessor Lease Description [Line Items]
Number of financing leases		13

Real Estate and Other Activi_17

Real Estate and Other Activities - Summary of Total Future Minimum Lease Payments to be Received (Detail) $ in Thousands	Dec. 31, 2022 USD ($)
Lessor Lease Description [Line Items]
2023	$ 1,145,432
2024	1,165,813
2025	1,184,068
2026	1,202,829
2027	1,223,000
Thereafter	30,228,291
Future minimum lease payments to be received	36,149,433
Operating Leases [Member]
Lessor Lease Description [Line Items]
2023	984,353
2024	1,001,456
2025	1,016,367
2026	1,031,717
2027	1,048,409
Thereafter	25,851,987
Future minimum lease payments to be received	30,934,289
Financing Leases [Member]
Lessor Lease Description [Line Items]
2023	161,079
2024	164,357
2025	167,701
2026	171,112
2027	174,591
Thereafter	4,376,304
Future minimum lease payments to be received	$ 5,215,144

Real Estate and Other Activi_18

Real Estate and Other Activities - Components of Total Investment in Financing Leases (Detail) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Direct Financing Lease Net Investment In Leases [Abstract]
Minimum lease payments receivable	$ 880,253	$ 1,183,855
Estimated unguaranteed residual values	203,818	203,818
Less: Unearned income and allowance for credit loss	(731,915)	(918,584)
Net investment in direct financing leases	352,156	469,089
Other financing leases (net of allowance for credit loss)	1,339,167	1,584,238
Total investment in financing leases	$ 1,691,323	$ 2,053,327

Real Estate and Other Activi_19

Real Estate and Other Activities - Rent Deferrals - Additional Information (Detail) $ in Millions	Dec. 31, 2022 USD ($)
Business Acquisition [Line Items]
Remaining outstanding deferred rent to be received	$ 14.6

Real Estate and Other Activi_20

Real Estate and Other Activities - Prospect Medical Holdings Additional Information (Detail) $ in Thousands		1 Months Ended	3 Months Ended
		Aug. 31, 2019 USD ($) Hospital	Dec. 31, 2022 USD ($)	Jun. 30, 2022 USD ($)	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)
Business Acquisition [Line Items]
Additional mortgage loan			$ 1,332,962		$ 5,350,239	$ 4,249,180
Carrying value of lease requiring residual value guarantee			110,000
Mortgage Loans [Member]
Business Acquisition [Line Items]
Additional mortgage loan	[1],[2]		159,735		$ 1,113,300	$ 176,840
Prospect [Member]
Business Acquisition [Line Items]
Purchase price of acquisition		$ 1,500,000
Term loan		$ 112,900
Impairment charge			280,000
Prospect [Member] | Pennsylvania
Business Acquisition [Line Items]
Carrying value of lease requiring residual value guarantee			170,000
Non-cash rent			112,000
Prospect [Member] | Pennsylvania | Maximum [Member]
Business Acquisition [Line Items]
Carrying value of lease requiring residual value guarantee			$ 250,000
Prospect [Member] | Mortgage Loans [Member]
Business Acquisition [Line Items]
Additional mortgage loan				$ 100,000
Acute Care Campus [Member] | Prospect [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Hospital		14
[1] In the 2022 second quarter, we increased our mortgage loan to Prospect Medical Holdings, Inc. ("Prospect") that was originated in 2019 and that is secured by a first lien on a California hospital. The loan bears interest at a current market rate plus a component of additional interest upon repayment. 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 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 Activi_21

Real Estate and Other Activities - Pipeline Health System - Additional Information (Detail) - Pipeline Health System [Member] - USD ($) $ in Millions		12 Months Ended
	Feb. 07, 2023	Dec. 31, 2022
Subsequent Event [Member]
Business Acquisition [Line Items]
Cash rent	$ 5.6
Percentage of defered rent	30%
Capital funding	$ 11
Customer Concentration Risk [Member] | Total Gross Assets [Member]
Business Acquisition [Line Items]
Percentage of total assets		1%

Real Estate and Other Activi_22

Real Estate and Other Activities - Watsonville Community Hospital - Additional Information (Detail) - USD ($) $ in Thousands			12 Months Ended
		Sep. 30, 2019	Dec. 31, 2022	Aug. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Business Acquisition [Line Items]
Loans repaid	[1]				$ 1,103,410	$ 834,743
Halsen Healthcare [Member]
Business Acquisition [Line Items]
Credit loss reserve			$ 40,000
Halsen Healthcare [Member] | Maximum [Member]
Business Acquisition [Line Items]
Write off of billed and straight-line rent receivables			2,500
Watsonville, California [Member]
Business Acquisition [Line Items]
Provision (recovery) for credit loss			15,000
Watsonville, California [Member] | Halsen Healthcare [Member]
Business Acquisition [Line Items]
Loans repaid				$ 32,000
Provision (recovery) for credit loss			$ 15,000
Acute Care Hospital [Member] | Watsonville, California [Member]
Business Acquisition [Line Items]
Funded for interim mortgage loan		$ 40,000
[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 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 Activi_23

Real Estate and Other Activities - Other Leasing Activities - Additional Information (Detail) $ in Millions		3 Months Ended	9 Months Ended
	Jul. 24, 2020 USD ($) Property	Sep. 30, 2020 USD ($)	Sep. 30, 2022 Property	Dec. 23, 2021 Property
Business Acquisition [Line Items]
Percentage of properties occupied by tenants			99%
Number of properties vacant			5
Minimum [Member]
Business Acquisition [Line Items]
Percentage of vacant on leased property			0.30%
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_24

Real Estate and Other Activities - Investments in Unconsolidated Real Estate Joint Ventures - Additional Information (Details) - Investments in Unconsolidated Real Estate Joint Ventures [Member]	Dec. 31, 2022
Business Acquisition [Line Items]
Percentage of equity investment	100%
Maximum [Member]
Business Acquisition [Line Items]
Percentage of equity investment	100%

Real Estate and Other Activi_25

Real Estate and Other Activities - Summary of Investments in Unconsolidated Real Estate Joint Ventures by Operator (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated real estate joint ventures	$ 1,497,903	$ 1,152,927
Median [Member]
Schedule of Equity Method Investments [Line Items]
Ownership interest	50%
Investments in unconsolidated real estate joint ventures	$ 482,735	517,648
Swiss Medical Network [Member]
Schedule of Equity Method Investments [Line Items]
Ownership interest	70%
Investments in unconsolidated real estate joint ventures	$ 454,083	476,193
Steward (Macquarie Transaction) [Member]
Schedule of Equity Method Investments [Line Items]
Ownership interest	50%
Investments in unconsolidated real estate joint ventures	$ 417,701
Policlinico di Monza [Member]
Schedule of Equity Method Investments [Line Items]
Ownership interest	50%
Investments in unconsolidated real estate joint ventures	$ 86,245	95,468
HM Hospital [Member]
Schedule of Equity Method Investments [Line Items]
Ownership interest	45%
Investments in unconsolidated real estate joint ventures	$ 57,139	$ 63,618

Real Estate and Other Activi_26

Real Estate and Other Activities - Summary of Investments in Unconsolidated Operating Entities (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	$ 1,444,872	$ 1,289,434
Steward Loan Investment [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	362,831	360,164
International Joint Venture [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	231,402	219,387
Springstone [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	200,827	187,450
Priory [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	156,575	42,315
Swiss Medical Network [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	157,145	159,208
Steward Equity Investment [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	125,862	139,000
Prospect [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	112,777	112,283
Aevis Victoria SA [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	72,904	61,271
Aspris Children's Services [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	16,023	$ 8,356
Caremax [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	$ 8,526

Real Estate and Other Activi_27

Real Estate and Other Activities - Investments in Unconsolidated Operating Entities - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Jan. 08, 2021
Business Acquisition [Line Items]
Distribution on equity investment		$ 11,000,000
Steward Health Care System LLC [Member] | Affiliates of Steward Health Care System L L C [Member]
Business Acquisition [Line Items]
Passive equity interest			9.90%
Aevis Victoria SA [Member]
Business Acquisition [Line Items]
Ownership interest in joint venture under the cost method	5%
COVID-19 Pandemic [Member]
Business Acquisition [Line Items]
Favorable non-cash fair value adjustment on investment		$ 8,200,000
Dividend income	$ 4,000,000
COVID-19 Pandemic [Member] | Other [Member]
Business Acquisition [Line Items]
Favorable non-cash fair value adjustment on investment	$ 2,300

Real Estate and Other Activi_28

Real Estate and Other Activities - Other Investment Activities - Additional Information (Detail) - Steward Health Care System LLC [Member] $ in Millions	3 Months Ended
	Jun. 30, 2022 USD ($)
Business Acquisition [Line Items]
Secured loan amount	$ 150
Secured loan period	5 years

Real Estate and Other Activi_29

Real Estate and Other Activities - Concentration of Credit Risks and Related Party Transactions - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Related Party Transactions [Member]
Business Acquisition [Line Items]
Lease and interest revenue earned from tenants	$ 135.5	$ 63.9	$ 29.8
Total Gross Assets [Member] | Geographic Concentration [Member] | U.S. [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	61%	64%
Total Gross Assets [Member] | Geographic Concentration [Member] | Europe [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	33%	30%
Total Gross Assets [Member] | Geographic Concentration [Member] | Australia [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	5%	5%
Total Gross Assets [Member] | Geographic Concentration [Member] | South America [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	1%	1%
Revenue [Member] | Customer Concentration Risk [Member] | General Acute Care Hospital And Healthcare System
Business Acquisition [Line Items]
Percentage of concentration risk	76%	81%
Revenue [Member] | Customer Concentration Risk [Member] | Behavioral health facilities
Business Acquisition [Line Items]
Percentage of concentration risk		8%
Revenue [Member] | Customer Concentration Risk [Member] | Rehabilitation Hospital
Business Acquisition [Line Items]
Percentage of concentration risk	13%	7%
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%
Revenue [Member] | Customer Concentration Risk [Member] | Long Term Acute Care Hospital
Business Acquisition [Line Items]
Percentage of concentration risk	7%
Revenue [Member] | Customer Concentration Risk [Member] | Maximum [Member] | Freestanding ER/Urgent Care and Long-Term Acute Care Facilities [Member]
Business Acquisition [Line Items]
Percentage of concentration risk		4%
Revenue [Member] | Operator Concentration Risk [Member] | Steward Health Care System LLC [Member] | Minimum [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	10%
Revenue [Member] | Operator Concentration Risk [Member] | Circle [Member] | Minimum [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	10%
Revenue [Member] | Operator Concentration Risk [Member] | Prospect [Member] | Minimum [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	10%
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%	2.70%

Debt - Summary of Debt (Detail)

Debt - Summary of Debt (Detail) - USD ($) $ in Thousands		Dec. 31, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Debt		$ 10,325,499	$ 11,358,826
Debt issue costs and discount, net		(57,087)	(76,056)
Debt, net		10,268,412	11,282,770
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Debt	[1]	929,584	730,000
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] | Australia [Member]
Debt Instrument [Line Items]
Debt	[2]	817,560	871,560
Term loan due 2024 | British Pound Sterling [Member]
Debt Instrument [Line Items]
Debt	[2]	126,690
Term loan due 2025 | British Pound Sterling [Member]
Debt Instrument [Line Items]
Debt	[2]	845,810	947,240
2.550% Senior Unsecured Notes due 2023 [Member]
Debt Instrument [Line Items]
Debt	[2]	483,320	541,280
3.325% Senior Unsecured Notes Due 2025 [Member]
Debt Instrument [Line Items]
Debt	[2]	535,250	568,500
0.993% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Debt	[2]	535,250	568,500
2.500% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Debt	[2]	604,150	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]	724,980	811,920
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]	422,905	473,620
3.500% Senior Unsecured Notes Due 2031 [Member]
Debt Instrument [Line Items]
Debt		$ 1,300,000	$ 1,300,000
[1] Includes £ 90 million of GBP-denominated borrowings and € 253 million of Euro-denominated borrowings that reflect the exchange rate at December 31, 2022 . 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, £ in Millions		Dec. 31, 2022 USD ($)	Dec. 31, 2022 GBP (£)	Dec. 31, 2022 EUR (€)	Dec. 31, 2021 USD ($)	Dec. 31, 2020
Debt Instrument [Line Items]
Debt		$ 10,325,499			$ 11,358,826
GBP-denominated Borrowings [Member]
Debt Instrument [Line Items]
Debt | £			£ 90
EURO-denominated Borrowings [Member]
Debt Instrument [Line Items]
Debt | €				€ 253
2.550% Senior Unsecured Notes due 2023 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		2.55%	2.55%	2.55%	2.55%
Debt	[1]	$ 483,320			$ 541,280
3.325% Senior Unsecured Notes Due 2025 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		3.325%	3.325%	3.325%	3.325%
Debt	[1]	$ 535,250			$ 568,500
0.993% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		0.993%	0.993%	0.993%	0.993%
Debt	[1]	$ 535,250			$ 568,500
2.500% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		2.50%	2.50%	2.50%	2.50%
Debt	[1]	$ 604,150			$ 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%	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%	5%	5%	5%
Debt		$ 1,400,000			$ 1,400,000
3.692% Senior Unsecured Notes due 2028 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		3.692%	3.692%	3.692%	3.692%
Debt	[1]	$ 724,980			$ 811,920
4.625% Senior Unsecured Notes Due 2029 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		4.625%	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		3.375%	3.375%	3.375%	3.375%
Debt	[1]	$ 422,905			$ 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%	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, 2022	Dec. 31, 2021
Debt Disclosure [Abstract]
2023	$ 483,320
2024	944,250
2025	1,381,060
2026	2,568,984
2027	1,600,000
Thereafter	3,347,885
Total	$ 10,325,499	$ 11,358,826

Debt - Credit Facility - Additi

Debt - Credit Facility - Additional Information (Detail) - USD ($) $ in Millions			12 Months Ended
	Jun. 29, 2022	May 06, 2022	Dec. 31, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Commitment fee			0.25%
Minimum [Member]
Debt Instrument [Line Items]
Commitment fee	0.125%
Maximum [Member]
Debt Instrument [Line Items]
Commitment fee	0.30%
Alternate Base Rate [Member] | Minimum [Member]
Debt Instrument [Line Items]
Applicable margin for term loan	0%
Applicable margin for revolving loans	0%
Alternate Base Rate [Member] | Maximum [Member]
Debt Instrument [Line Items]
Applicable margin for term loan	0.70%
Applicable margin for revolving loans	0.50%
Term Benchmark Loans or RFR Loans [Member] | Minimum [Member]
Debt Instrument [Line Items]
Applicable margin for revolving loans	0.80%
Term Benchmark Loans or RFR Loans [Member] | Maximum [Member]
Debt Instrument [Line Items]
Applicable margin for revolving loans	1.50%
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Increase in revolving credit facility		$ 500
Debt instrument amendment extended maturity date description			The amendment extended the maturity date of our revolving facility to June 30, 2026 with our option to extend for an additional 12 months.
Unsecured Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Amount of senior unsecured debt		1,800
Debt instrument maturity date	Jun. 30, 2026
Credit facilities, amount outstanding			$ 929.6	$ 730
Line of credit facility, Borrowing capacity			$ 900	$ 600
Maximum incremental credit facility	$ 1,000
Credit facilities, weighted average interest rate			3.80%	1.30%
Term Loan [Member]
Debt Instrument [Line Items]
Amount of senior unsecured debt	$ 200	$ 200
Debt instrument maturity date	Jun. 30, 2027
Interest rate at end of period			5.70%	1.56%
Term Loan [Member] | Term Benchmark Loans [Member] | Minimum [Member]
Debt Instrument [Line Items]
Applicable margin for term loan	0.875%
Term Loan [Member] | Term Benchmark Loans [Member] | Maximum [Member]
Debt Instrument [Line Items]
Applicable margin for term loan	1.70%

Debt - Interim Credit Facility

Debt - Interim Credit Facility - Additional Information (Detail) £ in Millions	Jan. 15, 2021 USD ($)	Dec. 31, 2022	Dec. 31, 2021	Jan. 15, 2021 GBP (£)
2.500% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		2.50%	2.50%
3.375% Senior Unsecured Notes Due 2030 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		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%

Debt - July 2021 Interim Credit

Debt - July 2021 Interim Credit Facility - Additional Information (Detail) - Interim Credit Facility [Member] £ in Millions		12 Months Ended
	Jan. 15, 2021 USD ($)	Dec. 31, 2022	Dec. 31, 2021 USD ($)	Jul. 27, 2021 USD ($)	Jan. 15, 2021 GBP (£)
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
Barclays Bank PLC [Member]
Debt Instrument [Line Items]
Line of credit facility, Borrowing capacity				$ 1,000,000,000
Line of credit			$ 869,600,000
Line of credit, terminated date		Mar. 15, 2022

Debt - British Pound Sterling T

Debt - British Pound Sterling Term Loan - Additional Information (Detail) - British Pound Sterling [Member] - GBP (£)	Dec. 09, 2022	Mar. 04, 2020	Jan. 06, 2020	Dec. 31, 2022
Term loan due 2024
Debt Instrument [Line Items]
Line of Credit Facility, Maximum Borrowing Capacity	£ 105,000,000
Debt instrument maturity date	Dec. 09, 2024
Senior unsecured notes, interest rate	5.25%
Term loan due 2025 | Bank of America, N.A
Debt Instrument [Line Items]
Line of Credit Facility, Maximum Borrowing Capacity			£ 700,000,000
Debt instrument maturity date			Jan. 15, 2025
Debt instrument effective date		Mar. 06, 2020
Effective interest rate		0.70%
Senior unsecured notes, interest rate				1.95%
Term loan due 2025 | Bank of America, N.A | Minimum [Member]
Debt Instrument [Line Items]
Applicable margin adjustable based on pricing grid, percentage			0.85%
Term loan due 2025 | Bank of America, N.A | Maximum [Member]
Debt Instrument [Line Items]
Applicable margin adjustable based on pricing grid, percentage			1.65%
Term loan due 2025 | Bank of America, N.A | Credit Rating
Debt Instrument [Line Items]
Variable interest rate				1.25%

Debt - Australian Term Loan - A

Debt - Australian Term Loan - Additional Information (Detail) - Term Loan [Member] - Bank of America, N.A - Australia [Member] - USD ($)	Jun. 27, 2019	May 23, 2019
Debt Instrument [Line Items]
Line of credit facility, Borrowing capacity		$ 1,200,000,000
Debt instrument maturity date		May 23, 2024
Debt instrument effective date	Jul. 03, 2019
Effective interest rate	1.20%
Reference rate	0%
Senior unsecured notes, interest rate	2.45%
Credit Rating
Debt Instrument [Line Items]
Variable interest rate	1.25%
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%

Debt - Interest Rate Swaps - Ad

Debt - Interest Rate Swaps - Additional Information (Detail) - USD ($) $ in Millions	Dec. 31, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Derivative asset	$ 93.2	$ 12.4
Derivative Asset, Statement of Financial Position [Extensible Enumeration]	Other Assets	Other Assets
Derivative liability		$ 4.2
Derivative Liability, Statement of Financial Position [Extensible Enumeration]		Accounts Payable and Accrued Liabilities

Debt - Basic Terms of Senior Un

Debt - Basic Terms of Senior Unsecured Notes (Details) - 12 months ended Dec. 31, 2022	GBP (£)	EUR (€)	USD ($)
2.550% Senior Unsecured Notes due 2023 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Dec. 05, 2019
Debt instrument maturity date	Dec. 05, 2023
Par Value | £	£ 400,000,000
% of Par Value	100%
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%
Interest Payment Frequency	Annually
0.993% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Oct. 06, 2021
Debt instrument maturity date	Oct. 15, 2026
Par Value | €		€ 500,000,000
% of Par Value	100%
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. 01, 2026
Par Value | $			$ 500,000,000
% of Par Value	100%
Interest Payment Frequency	Semi-annually
5.000% Senior Unsecured Notes Due 2027 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Sep. 07, 2017
Debt instrument maturity date	Oct. 15, 2027
Par Value | $			1,400,000,000
% of Par Value	100%
Interest Payment Frequency	Semi-annually
3.692% Senior Unsecured Notes due 2028 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Dec. 05, 2019
Debt instrument maturity date	Jun. 05, 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. 01, 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. 04, 2020
Debt instrument maturity date	Mar. 15, 2031
Par Value | $			$ 1,300,000,000
% of Par Value	100%
Interest Payment Frequency	Semi-annually

Debt - Senior Unsecured Notes -

Debt - Senior Unsecured Notes - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2022
Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest	101%

Debt - Additional Information (

Debt - Additional Information (Detail) € in Millions, $ in Millions	12 Months Ended
	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)	Dec. 31, 2021 EUR (€)	Dec. 31, 2020 USD ($)
0.993% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	0.993%	0.993%	0.993%
Senior unsecured notes, maturity year		2026	2026
Debt instrument maturity date	Oct. 15, 2026
4.000% Senior Unsecured Notes Due 2022 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		4%	4%
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
3.500% Senior Unsecured Notes Due 2031 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	3.50%	3.50%	3.50%	3.50%
Senior unsecured notes, maturity year				2031
Debt instrument maturity date	Mar. 15, 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
Waterland Private Equity Fund VII C.V. [Member] | Interim Credit Facility [Member]
Debt Instrument [Line Items]
Debt refinancing costs	$ 9.5	$ 7.3
Debt instrument maturity date	Jun. 29, 2022

Debt - Covenants - Additional I

Debt - Covenants - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2022
Debt Disclosure [Abstract]
Percentage of dividends which could be paid from adjusted operating funds	95%
Percentage of dividends which could be paid from operation funds	95%
Maximum percentage of total unencumbered assets	150%

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($)		3 Months Ended		12 Months Ended
	Apr. 01, 2023	Sep. 30, 2022	Jun. 30, 2021	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Taxes [Line Items]
Percentage of ordinary taxable income to be distributed for real estate investment trust qualification				90%	90%	90%
Percentage of taxable income to be distributed for federal income tax assumption				100%
Amount of foreign income (loss) before income taxes				$ 159,600,000	$ 164,000,000	$ 62,100,000
Amount of domestic income (loss) before income taxes				10,800,000	(29,700,000)	6,400,000
Income tax expense (benefit)		$ 5,000,000		$ 55,900,000	73,948,000	$ 31,056,000
Income tax benefit related to the initial loan impairment					$ 10,000,000
Income tax at the US statutory federal rate				21%	21%	21%
Valuation allowance not expected to be realized				$ 9,800,000
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%
Deferred tax liabilities, one time adjustment			$ 43,000,000
United Kingdom [Member] | Forecast [Member]
Income Taxes [Line Items]
Income tax at the US statutory federal rate	25%

Income Taxes - Schedule of Inco

Income Taxes - Schedule of Income Tax (Expense) Benefit (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Sep. 30, 2022	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Current income tax (expense) benefit:
Domestic		$ 1,111	$ (1,559)	$ 63
Foreign		(27,751)	(18,964)	(10,203)
Total income tax expense		(26,640)	(20,523)	(10,140)
Deferred income tax (expense) benefit:
Domestic		(15,628)	6,915	(10,680)
Foreign		(13,632)	(60,340)	(10,236)
Total income tax expense		(29,260)	(53,425)	(20,916)
Income tax (expense)	$ (5,000)	$ (55,900)	$ (73,948)	$ (31,056)

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	3 Months Ended	12 Months Ended
	Sep. 30, 2022	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Tax Disclosure [Abstract]
Income before income tax		$ 959,719	$ 730,888	$ 463,328
Income tax (expense) at the U.S. statutory federal rate (21% in 2022, 2021, and 2020)		(201,541)	(153,486)	(97,299)
Decrease (increase) in income tax resulting from:
Foreign rate differential		1,826	2,742	2,160
State income taxes, net of federal benefit		(1,886)		970
U.S. earnings not subject to federal income tax		165,705	132,266	82,921
Equity investments				380
Change in valuation allowance		(11,281)	(10,040)	(8,514)
Statutory tax rate change		(941)	(43,924)	(9,471)
Interest disallowance		(1,737)	(646)
Other items, net		(6,045)	(860)	(2,203)
Income tax (expense)	$ (5,000)	$ (55,900)	$ (73,948)	$ (31,056)

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, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Tax Disclosure [Abstract]
Income tax at the US statutory federal rate	21%	21%	21%

Income Taxes - Schedule of Defe

Income Taxes - Schedule of Deferred Tax Assets and liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Operating loss and interest deduction carry forwards	$ 175,922	$ 197,876
Other	15,218	1,815
Total deferred tax assets	191,140	199,691
Valuation allowance	(71,499)	(61,747)
Total net deferred tax assets	119,641	137,944
Property and equipment	(294,181)	(320,546)
Net unbilled revenue	(63,324)	(43,366)
Partnership investments	(26,268)	(15,963)
Other	(27,153)	(3,836)
Total deferred tax liabilities	(410,926)	(383,711)
Net deferred tax asset (liability)	$ (291,285)	$ (245,767)

Income Taxes - Schedule of Net

Income Taxes - Schedule of Net NOL and Other Tax Attribute Carryforwards (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2022 USD ($)
U.S. [Member]
Income Taxes [Line Items]
Gross NOL carryforwards	$ 148,900
Tax-effected NOL carryforwards	24,013
Valuation allowance	(13,864)
Net deferred tax asset - NOL carryforwards	$ 10,149
Expiration periods	2024
Expiration periods	indefinite
Foreign [Member]
Income Taxes [Line Items]
Gross NOL carryforwards	$ 633,682
Tax-effected NOL carryforwards	151,909
Valuation allowance	(57,635)
Net deferred tax asset - NOL carryforwards	$ 94,274
Expiration periods	indefinite

Income Taxes - Schedule of Per

Income Taxes - Schedule of Per Share Distributions to Stockholders (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Tax Disclosure [Abstract]
Common share distribution	$ 1.1500	$ 1.1100	$ 1.0700
Ordinary dividend	0.4703	0.7646	0.6030
Long-term capital gain	0.6797	0.1654
Return of capital		0.1800	0.4670
Total	$ 1.1500	$ 1.1100	$ 1.0700

Income Taxes - Schedule of Pe_2

Income Taxes - Schedule of Per Share Distributions to Stockholders (Parenthetical) (Details) - $ / shares	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Tax Disclosure [Abstract]
Section 199A Dividends	$ 0.4703	$ 0.7646	$ 0.6030
Unrecaptured Sec. 1250 gain	$ 0.2574	$ 0.0583	$ 0

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, 2022	Dec. 31, 2021	Dec. 31, 2020
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Net income	$ 903,819	$ 656,940	$ 432,272
Non-controlling interests’ share in earnings	(1,222)	(919)	(822)
Participating securities’ share in earnings	(1,602)	(2,161)	(2,105)
Net income, less participating securities’ share in earnings	$ 900,995	$ 653,860	$ 429,345
Basic weighted-average common shares	598,634	588,817	529,239
Dilutive potential common shares	203	1,322	1,222
Diluted weighted-average common shares	598,837	590,139	530,461
MPT Operating Partnership, L.P. [Member]
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Net income	$ 903,819	$ 656,940	$ 432,272
Non-controlling interests’ share in earnings	(1,222)	(919)	(822)
Participating securities’ share in earnings	(1,602)	(2,161)	(2,105)
Net income, less participating securities’ share in earnings	$ 900,995	$ 653,860	$ 429,345
Basic weighted-average common shares	598,634	588,817	529,239
Dilutive potential common shares	203	1,322	1,222
Diluted weighted-average common shares	598,837	590,139	530,461

Stock Awards - Additional Infor

Stock Awards - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Jun. 30, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock / (Unit)-based compensation expense	$ 49,421	$ 52,110	$ 47,154
Stock-based compensation expense, unrecognized cost	$ 47,100
Stock-based compensation expense, unrecognized cost, reorganization period (in years)	1 year 2 months 12 days
Stock-based awards, fair value	$ 82,600	$ 49,900	$ 58,900
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	28,900,000			16,000,000
Common stock remaining for future stock awards transferred to the equity incentive plan	19,300,000
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, 2022	Dec. 31, 2021
Vesting Based on Service [Member]
Employee Restricted Equity Awards Vesting Activity [Line Items]
Nonvested awards at beginning of the year, Shares	922,954	1,057,054
Awarded, Shares	659,393	651,113
Vested, Shares	(750,854)	(781,076)
Forfeited, Shares	(21,010)	(4,137)
Nonvested awards at end of year, Shares	810,483	922,954
Nonvested awards at beginning of the year, Weighted Average Value at Award Date	$ 20.26	$ 18.79
Awarded, Weighted Average Value at Award Date	21.18	20.83
Vested, Weighted Average Value at Award Date	20.25	18.77
Forfeited, Weighted Average Value at Award Date	20.06	18.69
Nonvested awards at end of year, Weighted Average Value at Award Date	$ 21.02	$ 20.26
Vesting Based on Market/Performance Conditions [Member]
Employee Restricted Equity Awards Vesting Activity [Line Items]
Nonvested awards at beginning of the year, Shares	5,477,536	5,086,983
Awarded, Shares	1,828,971	1,957,802
Vested, Shares	(2,924,722)	(1,551,482)
Forfeited, Shares	(32,704)	(15,767)
Nonvested awards at end of year, Shares	4,349,081	5,477,536
Nonvested awards at beginning of the year, Weighted Average Value at Award Date	$ 15.86	$ 14.41
Awarded, Weighted Average Value at Award Date	18.45	17.94
Vested, Weighted Average Value at Award Date	13.87	13.73
Forfeited, Weighted Average Value at Award Date	19.17	16.72
Nonvested awards at end of year, Weighted Average Value at Award Date	$ 18.26	$ 15.86

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Detail) $ in Thousands		3 Months Ended	12 Months Ended
	Oct. 05, 2022 USD ($) Facility	Dec. 31, 2021 USD ($)	Dec. 31, 2022 USD ($) Facility	Dec. 31, 2021 USD ($) Facility	Dec. 31, 2020 USD ($) Facility
Commitment And Contingencies [Line Items]
Number of facilities sold | Facility			15	16	9
Expected cash proceeds on transaction close | $		$ 54,500	$ 522,000	$ 246,000	$ 94
Prospect [Member] | Connecticut [Member]
Commitment And Contingencies [Line Items]
Number of facilities sold | Facility	3
Expected cash proceeds on transaction close | $	$ 457,000

Common Stock_Partners' Capital

Common Stock/Partners' Capital - Additional Information (Detail) - USD ($)				12 Months Ended
	Oct. 09, 2022	Jan. 11, 2021	Dec. 28, 2020	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Class Of Stock [Line Items]
Common stock, shares issued				597,476,000	596,748,000
Proceeds from sale of common shares / units, net of offering costs					$ 1,051,229,000	$ 411,101,000
Shares issued price per share	$ 0.001
Stock repurchase, Value				$ 17,940,000
Stock repurchase program expiration date	Oct. 10, 2023
Redemption of common units						4,928,000
Maximum [Member]
Class Of Stock [Line Items]
Stock repurchase program, authorized amount	$ 500,000,000
MPT Operating Partnership, L.P. [Member]
Class Of Stock [Line Items]
Stock repurchase, Value				17,940,000
Redemption of common units			$ 4,900,000	$ 0		$ 4,928,000
MPT Operating Partnership, L.P. [Member] | Medical Properties Trust, LLC. [Member]
Class Of Stock [Line Items]
Percentage of ownership of general partner				100%
MPT Operating Partnership, L.P. [Member] | MPT TRS, Inc [Member]
Class Of Stock [Line Items]
Percentage of ownership of general partner				100%
MPT Operating Partnership, L.P. [Member] | Operating Partnership [Member]
Class Of Stock [Line Items]
Percentage of ownership limited partner				100%
Common Units [Member]
Class Of Stock [Line Items]
Number of share sold					53,063,000	21,004,000
Stock repurchase, Shares				1,645,000
Stock repurchase, Value				$ 2,000
Common Units [Member] | MPT Operating Partnership, L.P. [Member] | Limited Partner [Member]
Class Of Stock [Line Items]
Number of share sold					52,532,000	20,795,000
Stock repurchase, Shares				1,629,000
Stock repurchase, Value				$ 17,761,000
Conversion of LTIP units to common units			232,000			232,000
Redemption of common units						$ 4,928,000
Public Offering [Member]
Class Of Stock [Line Items]
Common stock, shares issued		36,800,000
Proceeds from sale of common shares / units, net of offering costs		$ 711,000,000
At-the-Market Equity Offering Program [Member]
Class Of Stock [Line Items]
Proceeds from sale of common shares / units, net of offering costs					$ 340,000,000
At-the-Market Equity Offering Program [Member] | Common Units [Member]
Class Of Stock [Line Items]
Number of share sold					16,300,000	21,000,000

Fair Value of Financial Instr_3

Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Detail) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Fair Value Disclosures [Abstract]
Interest and rent receivables, Book value	$ 167,035	$ 56,229
Loans, Book value	1,405,615	991,609
Debt, net Book value	(10,268,412)	(11,282,770)
Interest and rent receivables, Fair value	163,101	56,564
Loans, Fair value	1,360,113	991,954
Debt, net Fair value	$ (8,697,042)	$ (11,526,388)

Fair Value of Financial Instr_4

Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Parenthetical) (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2022 USD ($) Health_Center	Dec. 31, 2021 USD ($)
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Mortgage loans	$ 364,101	$ 213,211
Investments in unconsolidated real estate joint ventures	1,497,903	1,152,927
Investments in unconsolidated operating entities	1,444,872	1,289,434
Shareholder Loan [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Mortgage loans	223,800	70,100
Investments in unconsolidated real estate joint ventures	315,900	335,600
Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Investments in unconsolidated operating entities	640,400	521,400
Other loans	$ 225,500	$ 64,500
Fair Value, Recurring | Colombia [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Number of facilities acquired | Health_Center	3
Fair Value, Recurring | Acquisition Loans [Member] | Colombia [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Number of facilities acquired | Health_Center	3

Fair Value of Financial Instr_5

Fair Value of Financial Instruments - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2022 USD ($) Health_Center	Dec. 31, 2021 USD ($)
Springstone Inc. and International Joint Venture [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Discount for lack of marketability percentage on Springstone equity investment	40%
Equity investments unrealized gain/loss | $	$ 7,000,000	$ 0
Fair Value, Recurring | Colombia [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Number of facilities acquired | Health_Center	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, 2022	Dec. 31, 2021
Mortgage Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	$ 140,260	$ 143,068
Original Cost	140,260	143,068
Equity Method Investment and Other Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	434,609	409,638
Original Cost	$ 441,943	$ 409,638

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, 2022 USD ($)
+ 100 Basis Points [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Estimated Increase (Decrease) in Fair Value	$ (43)
- 100 Basis Points [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Estimated Increase (Decrease) in Fair Value	$ 43

Leases (Lessee) - Summary of Le

Leases (Lessee) - Summary of Lease Expense (Detail) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2022	Dec. 31, 2021
Lessee Lease Description [Line Items]
Operating lease cost	[1],[2]	$ 12,175	$ 10,694
Finance lease cost:
Total lease cost		7,869	6,407
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		$ (4,485)	$ (4,466)
[1] $ 5.7 million and $ 6.3 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2022 and 2021, respectively. 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, 2022	Dec. 31, 2021
Lessee Lease Description [Line Items]
Operating lease cost	[1],[2]	$ 12,175	$ 10,694
Property-related [Member]
Lessee Lease Description [Line Items]
Operating lease cost		$ 5,700	$ 6,300
[1] $ 5.7 million and $ 6.3 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2022 and 2021, respectively. 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, 2022	Dec. 31, 2021
Leases [Abstract]
Operating Leases, 2023		$ 8,742
Operating Leases, 2024		8,880
Operating Leases, 2025		8,289
Operating Leases, 2026		7,884
Operating Leases, 2027		7,873
Operating Leases, Thereafter		235,940
Operating Leases, Total undiscounted minimum lease payments		277,608
Operating Leases, Less: interest		(176,016)
Operating Leases, Present value of lease liabilities		101,592	$ 85,217
Finance Leases, 2023		129
Finance Leases, 2024		130
Finance Leases, 2025		131
Finance Leases, 2026		133
Finance Leases, 2027		134
Finance Leases, Thereafter		4,516
Finance Leases, Total undiscounted minimum lease payments		5,173
Finance Leases, Less: interest		(3,235)
Finance Leases, Present value of lease liabilities		1,938	$ 1,937
Amounts To Be Received From Subleases, 2023		(4,416)
Amounts To Be Received From Subleases, 2024		(4,272)
Amounts To Be Received From Subleases, 2025		(4,328)
Amounts To Be Received From Subleases, 2026		(4,021)
Amounts To Be Received From Subleases, 2027		(3,730)
Amounts To Be Received From Subleases, Thereafter		(65,320)
Amounts To Be Received From Subleases, Total undiscounted minimum lease payments		(86,087)
Net Payments, 2023		4,455
Net Payments, 2024		4,738
Net Payments, 2025		4,092
Net Payments, 2026		3,996
Net Payments, 2027		4,277
Net Payments, Thereafter	[1]	175,136
Net Payments, Total undiscounted minimum lease payments		$ 196,694
[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, 2022	Dec. 31, 2021
Right of use assets:
Finance leases	$ 1,734	$ 1,785
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List]	Land	Land
Total real estate right of use assets	$ 65,287	$ 70,401
Total right of use assets	91,512	77,859
Lease liabilities:
Operating leases	$ 101,592	$ 85,217
Operating Lease, Liability, Statement of Financial Position [Extensible Enumeration]	us-gaap:OtherLiabilities	us-gaap:OtherLiabilities
Financing leases	$ 1,938	$ 1,937
Finance Lease, Liability, Statement of Financial Position [Extensible Enumeration]	us-gaap:OtherLiabilities	us-gaap:OtherLiabilities
Total lease liabilities	$ 103,530	$ 87,154
Weighted-average remaining lease term:
Operating leases	33 years 2 months 12 days	40 years 7 months 6 days
Finance leases	33 years 10 months 24 days	34 years 10 months 24 days
Weighted-average discount rate:
Operating leases	6.10%	6.40%
Finance leases	6.60%	6.60%
Corporate [Member]
Right of use assets:
Operating leases	$ 26,225	$ 7,458
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	Other Assets	Other Assets
Real Estate [Member]
Right of use assets:
Operating leases	$ 63,553	$ 68,616
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	Land	Land

Leases (Lessee) - Summary of _3

Leases (Lessee) - Summary of Supplemental Cash Flow Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows used for operating leases	$ 7,169	$ 7,330
Operating cash flows used for finance leases	128	126
Non-cash activities - Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$ 23,066	$ 1,120	$ 13,800

Other Assets - Summary of Other

Other Assets - Summary of Other Assets on our Condensed Consolidated Balance Sheets (Detail) - USD ($) $ in Thousands		Dec. 31, 2022	Dec. 31, 2021
Other Assets [Abstract]
Debt issue costs, net	[1]	$ 12,036	$ 5,488
Other corporate assets		256,438	231,731
Prepaids and other assets		304,516	96,261
Total other assets		$ 572,990	$ 333,480
[1] Relates to our revolving credit facility

Other Assets - Additional Infor

Other Assets - Additional Information (Detail) $ in Millions	12 Months Ended
	Dec. 31, 2022 USD ($)
Other Assets [Abstract]
Increase in derivative assets	$ 80

Subsequent Events - Additional

Subsequent Events - Additional Information (Detail) $ in Thousands				12 Months Ended
	Feb. 15, 2023 Facility	Feb. 07, 2023 USD ($) Facility	Apr. 25, 2022 USD ($) Facility	Dec. 31, 2022 USD ($) Facility	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)
Subsequent Event [Line Items]
Acquisition loan				$ 1,332,962	$ 5,350,239	$ 4,249,180
Catholic Health Initiatives Colorado [Member] | Utah [Member]
Subsequent Event [Line Items]
Percentage of total assets				5.50%
General Acute Care Hospitals [Member]
Subsequent Event [Line Items]
Number of facilities acquired | Facility			2	6
Purchase price of acquisition			$ 80,000
Subsequent Event [Member] | Catholic Health Initiatives Colorado [Member] | Utah [Member]
Subsequent Event [Line Items]
Initial lease term	15 years
Percentage of initial cash yield	7.80%
Percentage of annually operating lease	3%
Subsequent Event [Member] | General Acute Care Hospitals [Member] | Catholic Health Initiatives Colorado [Member] | Utah [Member]
Subsequent Event [Line Items]
Number of leased facilities | Facility	5
Subsequent Event [Member] | Springstone Health Opco, LLC [Member]
Subsequent Event [Line Items]
Acquisition loan		$ 205,000
Purchase price of acquisition		$ 250,000
Subsequent Event [Member] | Springstone Health Opco, LLC [Member] | General Acute Care Hospitals [Member]
Subsequent Event [Line Items]
Number of facilities acquired | Facility		8
Lease extension expiration term		5 years
Lease extension expiration year		2041

Schedule II - Schedule of Valua

Schedule II - Schedule of Valuation and Qualifying Accounts (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]
Balance at Beginning of Year	$ 154,161	$ 146,637	$ 109,803
Additions, Charged Against Operations	294,861	69,131	58,044
Addition, Charged to Other Accounts		7,340	22,944
Deductions, Net Recoveries/Write-offs	(55,965)	(68,947)	(44,154)
Balance at End of Year	$ 393,057	$ 154,161	$ 146,637

Schedule II - Schedule of Val_2

Schedule II - Schedule of Valuation and Qualifying Accounts (Parenthetical) (Detail) - USD ($) $ in Thousands		12 Months Ended
	Jan. 08, 2020	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Jan. 01, 2020
Increase in real estate impairment reserves		$ 170,600		$ 19,000
Equity investment impairments reserve related to disposals			$ 6,000
Increase in accounts receivable and other reserves		500	8,000	23,900
Decrease in accounts receivable and other reserves		11,700	38,700
Increase (decrease) in valuation allowances				800
Tax valuation allowances recorded as part of purchase price allocation			7,340	22,944
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		(2,900)	(22,400)	(40,500)
Credit loss recovery related to loan paydowns			1,900	2,900
Increase in credit loss reserves on financing-type receivables		114,000	41,700	3,300
Decrease in credit loss reserves on financing-type receivables		26,400
Watsonville, California [Member]
Provision (recovery) for credit loss		15,000
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		$ 9,800	$ 20,000	$ 11,900

Schedule III - Real Estate In_2

Schedule III - Real Estate Investments and Accumulated Depreciation (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021		Dec. 31, 2020	Dec. 31, 2019
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Initial costs, land	$ 1,946,737
Initial costs, buildings	9,772,121
Additions subsequent to acquisition, Improvements	581,666
Land at cost	1,948,216
Buildings at cost	10,352,308
Total at cost	12,300,524	$ 13,628,749	[1]	$ 10,749,707	$ 7,312,486
Accumulated Depreciation	$ 1,008,340	$ 853,879
Princes Risborough, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,425
Land at cost	4,425
Total at cost	4,425
Encumbrances	$ 0
Date Acquired	Jan. 09, 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	$ 35,840
Initial costs, buildings	67,195
Land at cost	35,840
Buildings at cost	67,195
Total at cost	103,035
Accumulated Depreciation	5,852
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	$ 5,184
Initial costs, buildings	19,882
Land at cost	5,184
Buildings at cost	19,882
Total at cost	25,066
Accumulated Depreciation	1,501
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Jan. 09, 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	$ 29,362
Initial costs, buildings	154,668
Land at cost	29,362
Buildings at cost	154,668
Total at cost	184,030
Accumulated Depreciation	11,673
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Croydon, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 9,437
Initial costs, buildings	39,583
Land at cost	9,437
Buildings at cost	39,583
Total at cost	49,020
Accumulated Depreciation	3,007
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Jan. 09, 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	$ 512
Initial costs, buildings	29,746
Land at cost	512
Buildings at cost	29,746
Total at cost	30,258
Accumulated Depreciation	2,242
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Jan. 09, 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	$ 4,382
Initial costs, buildings	33,750
Land at cost	4,382
Buildings at cost	33,750
Total at cost	38,132
Accumulated Depreciation	3,026
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	$ 11,171
Initial costs, buildings	99,814
Land at cost	11,171
Buildings at cost	99,814
Total at cost	110,985
Accumulated Depreciation	7,545
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Jan. 09, 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	$ 2,829
Initial costs, buildings	33,923
Land at cost	2,829
Buildings at cost	33,923
Total at cost	36,752
Accumulated Depreciation	2,915
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] | Arnold, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 453
Initial costs, buildings	9,412
Land at cost	453
Buildings at cost	9,412
Total at cost	9,865
Accumulated Depreciation	387
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] | Bath, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,432
Initial costs, buildings	29,685
Land at cost	1,432
Buildings at cost	29,685
Total at cost	31,117
Accumulated Depreciation	6,308
Encumbrances	$ 0
Date of Construction	2008
Date Acquired	Jul. 01, 2014
Life on which depreciation in latest income statements is computed (Years)	40 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	26
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] | 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	1,094
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] | 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	56
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	3,308
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	549
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	5,906
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	$ 6,277
Initial costs, buildings	42,344
Land at cost	6,277
Buildings at cost	42,344
Total at cost	48,621
Accumulated Depreciation	3,223
Encumbrances	$ 0
Date of Construction	2008
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1811 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 34,421
Initial costs, buildings	49,182
Land at cost	34,421
Buildings at cost	49,182
Total at cost	83,603
Accumulated Depreciation	110
Encumbrances	$ 0
Date of Construction	1811
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1890 [Member] | Altrincham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 13,899
Initial costs, buildings	23,895
Land at cost	13,899
Buildings at cost	23,895
Total at cost	37,794
Accumulated Depreciation	61
Encumbrances	$ 0
Date of Construction	1890
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1790 [Member] | Bristol, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 4,466
Initial costs, buildings	35,485
Land at cost	4,466
Buildings at cost	35,485
Total at cost	39,951
Accumulated Depreciation	79
Encumbrances	$ 0
Date of Construction	1790
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1790 [Member] | Essex, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 4,406
Initial costs, buildings	41,011
Land at cost	4,406
Buildings at cost	41,011
Total at cost	45,417
Accumulated Depreciation	91
Encumbrances	$ 0
Date of Construction	1790
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1790 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 27,463
Initial costs, buildings	14,237
Land at cost	27,463
Buildings at cost	14,237
Total at cost	41,700
Accumulated Depreciation	36
Encumbrances	$ 0
Date of Construction	1790
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Altoona, WI [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, buildings	$ 29,062
Buildings at cost	29,062
Total at cost	29,062
Accumulated Depreciation	6,055
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Aug. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Altrincham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 13,899
Initial costs, buildings	23,895
Land at cost	13,899
Buildings at cost	23,895
Total at cost	37,794
Accumulated Depreciation	61
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Alvin, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 105
Initial costs, buildings	4,087
Land at cost	105
Buildings at cost	4,087
Total at cost	4,192
Accumulated Depreciation	871
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Mar. 19, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Bristol, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 4,466
Initial costs, buildings	35,485
Land at cost	4,466
Buildings at cost	35,485
Total at cost	39,951
Accumulated Depreciation	79
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Broomfield, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 825
Initial costs, buildings	3,895
Land at cost	825
Buildings at cost	3,895
Total at cost	4,720
Accumulated Depreciation	828
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jul. 03, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Commerce City, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 707
Initial costs, buildings	4,248
Land at cost	707
Buildings at cost	4,248
Total at cost	4,955
Accumulated Depreciation	858
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Dec. 11, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | 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	908
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jun. 05, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Essex, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 4,406
Initial costs, buildings	41,011
Land at cost	4,406
Buildings at cost	41,011
Total at cost	45,417
Accumulated Depreciation	91
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Firestone, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 495
Initial costs, buildings	3,963
Land at cost	495
Buildings at cost	3,963
Total at cost	4,458
Accumulated Depreciation	850
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jun. 06, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Fort Worth, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 3,406
Initial costs, buildings	34,627
Land at cost	3,406
Buildings at cost	34,627
Total at cost	38,033
Accumulated Depreciation	1,131
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Fountain, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,508
Initial costs, buildings	4,131
Land at cost	1,508
Buildings at cost	4,131
Total at cost	5,639
Accumulated Depreciation	869
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jul. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | 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	22,858
Additions subsequent to acquisition, Improvements	1,062
Land at cost	4,569
Buildings at cost	23,920
Total at cost	28,489
Accumulated Depreciation	741
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 27,463
Initial costs, buildings	14,237
Land at cost	27,463
Buildings at cost	14,237
Total at cost	41,700
Accumulated Depreciation	36
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 34,421
Initial costs, buildings	49,182
Land at cost	34,421
Buildings at cost	49,182
Total at cost	83,603
Accumulated Depreciation	110
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Ogden, UT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,759
Initial costs, buildings	16,414
Land at cost	1,759
Buildings at cost	16,414
Total at cost	18,173
Accumulated Depreciation	3,614
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Mar. 01, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Pearland, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,075
Initial costs, buildings	3,577
Land at cost	1,075
Buildings at cost	3,577
Total at cost	4,652
Accumulated Depreciation	745
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Sep. 08, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 351
Initial costs, buildings	3,952
Land at cost	351
Buildings at cost	3,952
Total at cost	4,303
Accumulated Depreciation	863
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jan. 01, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Richmond, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,380
Initial costs, buildings	6,155
Additions subsequent to acquisition, Improvements	736
Land at cost	5,380
Buildings at cost	6,891
Total at cost	12,271
Accumulated Depreciation	254
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Surrey, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 14,280
Initial costs, buildings	8,741
Land at cost	14,280
Buildings at cost	8,741
Total at cost	23,021
Accumulated Depreciation	25
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Thornton, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,350
Initial costs, buildings	4,259
Land at cost	1,350
Buildings at cost	4,259
Total at cost	5,609
Accumulated Depreciation	887
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	$ 1,095
Initial costs, buildings	5,129
Land at cost	1,095
Buildings at cost	5,129
Total at cost	6,224
Accumulated Depreciation	557
Encumbrances	$ 0
Date of Construction	1887
Date Acquired	Feb. 09, 2019
Life on which depreciation in latest income statements is computed (Years)	39 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	$ 10,186
Initial costs, buildings	25,777
Land at cost	10,186
Buildings at cost	25,777
Total at cost	35,963
Accumulated Depreciation	3,573
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] | 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	56,430
Land at cost	5,733
Buildings at cost	105,566
Total at cost	111,299
Accumulated Depreciation	11,126
Encumbrances	$ 0
Date of Construction	1974
Date Acquired	May 01, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
2017 [Member] | Austin, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 3,665
Initial costs, buildings	4,200
Land at cost	3,665
Buildings at cost	4,200
Total at cost	7,865
Accumulated Depreciation	642
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Mar. 02, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Birmingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,952
Initial costs, buildings	40,068
Land at cost	7,952
Buildings at cost	40,068
Total at cost	48,020
Accumulated Depreciation	2,504
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Apr. 03, 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	44,218
Land at cost	2,101
Buildings at cost	44,218
Total at cost	46,319
Accumulated Depreciation	1,422
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	65,480
Land at cost	3,369
Buildings at cost	65,480
Total at cost	68,849
Accumulated Depreciation	2,081
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	$ 10,340
Initial costs, buildings	10,166
Land at cost	10,340
Buildings at cost	10,166
Total at cost	20,506
Accumulated Depreciation	567
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	1,059
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] | Kuopio, Finland [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,269
Initial costs, buildings	42,401
Land at cost	1,269
Buildings at cost	42,401
Total at cost	43,670
Accumulated Depreciation	920
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Mar. 11, 2022
Life on which depreciation in latest income statements is computed (Years)	29 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	1,073
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] | Oulu, Finland [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	43,939
Land at cost	3,076
Buildings at cost	43,939
Total at cost	47,015
Accumulated Depreciation	965
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Mar. 11, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Overland Park, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,974
Initial costs, buildings	14,405
Land at cost	2,974
Buildings at cost	14,405
Total at cost	17,379
Accumulated Depreciation	1,127
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	$ 14,717
Initial costs, buildings	10,964
Land at cost	14,717
Buildings at cost	10,964
Total at cost	25,681
Accumulated Depreciation	556
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	3,047
Land at cost	3,641
Buildings at cost	3,047
Total at cost	6,688
Accumulated Depreciation	181
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, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,576
Initial costs, buildings	45,782
Land at cost	5,576
Buildings at cost	45,782
Total at cost	51,358
Accumulated Depreciation	6,772
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	726
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
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	$ 10,791
Initial costs, buildings	67,447
Land at cost	10,791
Buildings at cost	67,447
Total at cost	78,238
Accumulated Depreciation	2,106
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Dec. 02, 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	64,650
Land at cost	5,383
Buildings at cost	64,650
Total at cost	70,033
Accumulated Depreciation	2,050
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] | Bad Salzuflen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 10,186
Initial costs, buildings	25,777
Land at cost	10,186
Buildings at cost	25,777
Total at cost	35,963
Accumulated Depreciation	3,573
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, land	$ 391
Initial costs, buildings	18,188
Land at cost	391
Buildings at cost	18,188
Total at cost	18,579
Accumulated Depreciation	731
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] | 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	795
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Apr. 04, 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	2,714
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	874
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] | Glendale,AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,144
Initial costs, buildings	6,087
Land at cost	1,144
Buildings at cost	6,087
Total at cost	7,231
Accumulated Depreciation	938
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	624
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	767
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	$ 1,556
Initial costs, buildings	4,174
Land at cost	1,556
Buildings at cost	4,174
Total at cost	5,730
Accumulated Depreciation	652
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] | Longmont, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,773
Initial costs, buildings	4,181
Land at cost	1,773
Buildings at cost	4,181
Total at cost	5,954
Accumulated Depreciation	723
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Feb. 10, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Mandeville, LA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,800
Initial costs, buildings	5,370
Land at cost	2,800
Buildings at cost	5,370
Total at cost	8,170
Accumulated Depreciation	828
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Oct. 28, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Marrero, LA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,584
Initial costs, buildings	5,801
Land at cost	1,584
Buildings at cost	5,801
Total at cost	7,385
Accumulated Depreciation	943
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] | Miami, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 20,430
Initial costs, buildings	33,881
Additions subsequent to acquisition, Improvements	10,364
Land at cost	20,430
Buildings at cost	44,245
Total at cost	64,675
Accumulated Depreciation	593
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Apr. 25, 2022
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	957
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	$ 3,120
Initial costs, buildings	4,801
Land at cost	3,120
Buildings at cost	4,801
Total at cost	7,921
Accumulated Depreciation	730
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Dec. 09, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Plano, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 4,204
Initial costs, buildings	2,492
Land at cost	4,204
Buildings at cost	2,492
Total at cost	6,696
Accumulated Depreciation	494
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	$ 1,270
Initial costs, buildings	4,505
Land at cost	1,270
Buildings at cost	4,505
Total at cost	5,775
Accumulated Depreciation	788
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	$ 2,412
Initial costs, buildings	4,253
Land at cost	2,412
Buildings at cost	4,253
Total at cost	6,665
Accumulated Depreciation	656
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	$ 2,005
Initial costs, buildings	4,524
Land at cost	2,005
Buildings at cost	4,524
Total at cost	6,529
Accumulated Depreciation	764
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	$ 1,150
Initial costs, buildings	17,740
Land at cost	1,150
Buildings at cost	17,740
Total at cost	18,890
Accumulated Depreciation	2,994
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Apr. 01, 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	$ 2,458
Initial costs, buildings	28,010
Land at cost	2,458
Buildings at cost	28,010
Total at cost	30,468
Accumulated Depreciation	2,422
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	$ 6,922
Initial costs, buildings	22,669
Land at cost	6,922
Buildings at cost	22,669
Total at cost	29,591
Accumulated Depreciation	2,992
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	$ 1,504
Initial costs, buildings	42,267
Land at cost	1,504
Buildings at cost	42,267
Total at cost	43,771
Accumulated Depreciation	3,181
Encumbrances	$ 0
Date of Construction	1989
Date Acquired	Jan. 09, 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	$ 6,531
Initial costs, buildings	34,573
Land at cost	6,531
Buildings at cost	34,573
Total at cost	41,104
Accumulated Depreciation	2,616
Encumbrances	$ 0
Date of Construction	1989
Date Acquired	Jan. 09, 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	9,018
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	$ 1,299
Initial costs, buildings	10,071
Land at cost	1,299
Buildings at cost	10,071
Total at cost	11,370
Accumulated Depreciation	1,087
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	329
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	34
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	$ 16,125
Initial costs, buildings	46,178
Land at cost	16,125
Buildings at cost	46,178
Total at cost	62,303
Accumulated Depreciation	1,768
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	$ 6,217
Initial costs, buildings	123,518
Additions subsequent to acquisition, Improvements	16,600
Land at cost	6,217
Buildings at cost	140,118
Total at cost	146,335
Accumulated Depreciation	16,927
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, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 663
Initial costs, buildings	33,751
Land at cost	663
Buildings at cost	33,751
Total at cost	34,414
Accumulated Depreciation	10,126
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	$ 1,092
Initial costs, buildings	2,669
Land at cost	1,092
Buildings at cost	2,669
Total at cost	3,761
Accumulated Depreciation	379
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	815
Land at cost	1,655
Buildings at cost	22,069
Total at cost	23,724
Accumulated Depreciation	2,296
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	$ 6,217
Initial costs, buildings	123,518
Additions subsequent to acquisition, Improvements	16,600
Land at cost	6,217
Buildings at cost	140,118
Total at cost	146,335
Accumulated Depreciation	16,927
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	3,408
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	$ 4,038
Initial costs, buildings	18,125
Land at cost	4,038
Buildings at cost	18,125
Total at cost	22,163
Accumulated Depreciation	1,912
Encumbrances	$ 0
Date of Construction	1973
Date Acquired	Jun. 07, 2019
Life on which depreciation in latest income statements is computed (Years)	35 years
2015 [Member] | Aurora, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,845
Initial costs, buildings	4,812
Land at cost	2,845
Buildings at cost	4,812
Total at cost	7,657
Accumulated Depreciation	872
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	$ 3,567
Initial costs, buildings	4,783
Land at cost	3,567
Buildings at cost	4,783
Total at cost	8,350
Accumulated Depreciation	917
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] | 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	857
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	$ 1,257
Initial costs, buildings	4,276
Land at cost	1,257
Buildings at cost	4,276
Total at cost	5,533
Accumulated Depreciation	811
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Jun. 08, 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	$ 10,340
Initial costs, buildings	10,166
Land at cost	10,340
Buildings at cost	10,166
Total at cost	20,506
Accumulated Depreciation	567
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	864
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] | Glendale,AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,193
Initial costs, buildings	4,046
Land at cost	1,193
Buildings at cost	4,046
Total at cost	5,239
Accumulated Depreciation	767
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Jun. 05, 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	43,891
Land at cost	3,148
Buildings at cost	43,891
Total at cost	47,039
Accumulated Depreciation	1,412
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 TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 3,218
Initial costs, buildings	1,551
Land at cost	3,218
Buildings at cost	1,551
Total at cost	4,769
Accumulated Depreciation	445
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Sep. 22, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Hoover, AL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 7,581
Buildings at cost	7,581
Total at cost	7,581
Accumulated Depreciation	1,697
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	May 01, 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	$ 2,147
Initial costs, buildings	3,873
Land at cost	2,147
Buildings at cost	3,873
Total at cost	6,020
Accumulated Depreciation	694
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	$ 13,368
Initial costs, buildings	29,950
Additions subsequent to acquisition, Improvements	1,676
Land at cost	13,368
Buildings at cost	31,626
Total at cost	44,994
Accumulated Depreciation	4,738
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	$ 1,297
Initial costs, buildings	3,901
Land at cost	1,297
Buildings at cost	3,901
Total at cost	5,198
Accumulated Depreciation	731
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] | McKinney, Texas [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,614
Initial costs, buildings	4,060
Land at cost	2,614
Buildings at cost	4,060
Total at cost	6,674
Accumulated Depreciation	1,012
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	55,745
Land at cost	5,966
Buildings at cost	55,745
Total at cost	61,711
Accumulated Depreciation	1,818
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] | 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	797
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Nov. 06, 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	$ 1,804
Initial costs, buildings	17,299
Land at cost	1,804
Buildings at cost	17,299
Total at cost	19,103
Accumulated Depreciation	531
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Oct. 21, 2021
Life on which depreciation in latest income statements is computed (Years)	40 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	$ 8,058
Initial costs, buildings	3,562
Land at cost	8,058
Buildings at cost	3,562
Total at cost	11,620
Accumulated Depreciation	149
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	8,338
Land at cost	13,919
Buildings at cost	31,620
Total at cost	45,539
Accumulated Depreciation	5,521
Encumbrances	$ 0
Date of Construction	1970
Date Acquired	May 01, 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	$ 6,391
Initial costs, buildings	19,028
Land at cost	6,391
Buildings at cost	19,028
Total at cost	25,419
Accumulated Depreciation	899
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	$ 6,827
Initial costs, buildings	12,389
Land at cost	6,827
Buildings at cost	12,389
Total at cost	19,216
Accumulated Depreciation	965
Encumbrances	$ 0
Date of Construction	1992
Date Acquired	Jan. 09, 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
Additions subsequent to acquisition, Improvements	3,550
Land at cost	3,486
Buildings at cost	59,846
Total at cost	63,332
Accumulated Depreciation	5,255
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] | Essex, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 4,406
Initial costs, buildings	41,011
Land at cost	4,406
Buildings at cost	41,011
Total at cost	45,417
Accumulated Depreciation	91
Encumbrances	$ 0
Date of Construction	1992
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1992 [Member] | Helsinki, Finland [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,962
Initial costs, buildings	65,927
Land at cost	3,962
Buildings at cost	65,927
Total at cost	69,889
Accumulated Depreciation	1,384
Encumbrances	$ 0
Date of Construction	1992
Date Acquired	Mar. 11, 2022
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	$ 27,463
Initial costs, buildings	14,237
Land at cost	27,463
Buildings at cost	14,237
Total at cost	41,700
Accumulated Depreciation	36
Encumbrances	$ 0
Date of Construction	1992
Date Acquired	Dec. 09, 2022
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	$ 1,001
Initial costs, buildings	18,517
Land at cost	1,001
Buildings at cost	18,517
Total at cost	19,518
Accumulated Depreciation	726
Encumbrances	$ 0
Date of Construction	1992
Date Acquired	Jul. 06, 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	18,374
Land at cost	1,019
Buildings at cost	18,374
Total at cost	19,393
Accumulated Depreciation	6,774
Encumbrances	$ 0
Date of Construction	1992
Date Acquired	Apr. 04, 2008
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	$ 13,107
Initial costs, buildings	6,464
Land at cost	13,107
Buildings at cost	6,464
Total at cost	19,571
Accumulated Depreciation	277
Encumbrances	$ 0
Date of Construction	1992
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 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	$ 12,264
Initial costs, buildings	47,635
Land at cost	12,264
Buildings at cost	47,635
Total at cost	59,899
Accumulated Depreciation	3,609
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Jan. 09, 2020
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	9,999
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Apr. 01, 2008
Life on which depreciation in latest income statements is computed (Years)	42 years
1984 [Member] | Birmingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 391
Initial costs, buildings	18,188
Land at cost	391
Buildings at cost	18,188
Total at cost	18,579
Accumulated Depreciation	731
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] | Droitwich, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 72
Initial costs, buildings	14,520
Land at cost	72
Buildings at cost	14,520
Total at cost	14,592
Accumulated Depreciation	1,103
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1984 [Member] | Hope, AR [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,651
Initial costs, buildings	3,359
Additions subsequent to acquisition, Improvements	2,733
Land at cost	1,651
Buildings at cost	6,092
Total at cost	7,743
Accumulated Depreciation	1,146
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	$ 8,772
Initial costs, buildings	57,899
Land at cost	8,772
Buildings at cost	57,899
Total at cost	66,671
Accumulated Depreciation	4,357
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Jan. 09, 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	$ 5,056
Initial costs, buildings	56,730
Land at cost	5,056
Buildings at cost	56,730
Total at cost	61,786
Accumulated Depreciation	4,280
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Jan. 09, 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	$ 25,595
Initial costs, buildings	202,892
Additions subsequent to acquisition, Improvements	24,129
Land at cost	25,595
Buildings at cost	227,021
Total at cost	252,616
Accumulated Depreciation	18,529
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Jun. 07, 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	4,886
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	$ 2,748
Initial costs, buildings	16,652
Land at cost	2,748
Buildings at cost	16,652
Total at cost	19,400
Accumulated Depreciation	705
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	$ 1,355
Initial costs, buildings	14,824
Land at cost	1,355
Buildings at cost	14,824
Total at cost	16,179
Accumulated Depreciation	603
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	$ 36,448
Initial costs, buildings	38,358
Land at cost	36,448
Buildings at cost	38,358
Total at cost	74,806
Accumulated Depreciation	2,917
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Jan. 09, 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	503
Land at cost	1,120
Buildings at cost	18,385
Total at cost	19,505
Accumulated Depreciation	14,833
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	$ 5,140
Initial costs, buildings	9,790
Land at cost	5,140
Buildings at cost	9,790
Total at cost	14,930
Accumulated Depreciation	432
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	$ 9,643
Initial costs, buildings	3,081
Land at cost	9,643
Buildings at cost	3,081
Total at cost	12,724
Accumulated Depreciation	129
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	38,694
Land at cost	2,659
Buildings at cost	38,694
Total at cost	41,353
Accumulated Depreciation	14,217
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	$ 5,082
Initial costs, buildings	8,319
Land at cost	5,082
Buildings at cost	8,319
Total at cost	13,401
Accumulated Depreciation	394
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	3,091
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	May 01, 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	$ 1,641
Initial costs, buildings	21,072
Land at cost	1,641
Buildings at cost	21,072
Total at cost	22,713
Accumulated Depreciation	838
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	$ 5,260
Initial costs, buildings	58,314
Additions subsequent to acquisition, Improvements	6,644
Land at cost	5,260
Buildings at cost	64,958
Total at cost	70,218
Accumulated Depreciation	22,415
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	$ 20,534
Initial costs, buildings	68,118
Land at cost	20,534
Buildings at cost	68,118
Total at cost	88,652
Accumulated Depreciation	2,699
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 hours
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	$ 4,036
Initial costs, buildings	95,595
Land at cost	4,036
Buildings at cost	95,595
Total at cost	99,631
Accumulated Depreciation	7,194
Encumbrances	$ 0
Date of Construction	1985
Date Acquired	Jan. 09, 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	$ 5,622
Initial costs, buildings	59,432
Additions subsequent to acquisition, Improvements	21,221
Land at cost	5,622
Buildings at cost	80,653
Total at cost	86,275
Accumulated Depreciation	15,232
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	5,077
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	$ 6,116
Initial costs, buildings	17,961
Land at cost	6,116
Buildings at cost	17,961
Total at cost	24,077
Accumulated Depreciation	835
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	$ 2,562
Initial costs, buildings	20,786
Additions subsequent to acquisition, Improvements	10,700
Land at cost	2,562
Buildings at cost	31,486
Total at cost	34,048
Accumulated Depreciation	2,420
Encumbrances	$ 0
Date of Construction	1985
Date Acquired	Jun. 07, 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	$ 2,755
Initial costs, buildings	34,489
Land at cost	2,755
Buildings at cost	34,489
Total at cost	37,244
Accumulated Depreciation	3,177
Encumbrances	$ 0
Date of Construction	1985
Date Acquired	Jun. 07, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1997 [Member] | Algeciras, Spain [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 505
Initial costs, buildings	7,973
Land at cost	505
Buildings at cost	7,973
Total at cost	8,478
Accumulated Depreciation	146
Encumbrances	$ 0
Date of Construction	1997
Date Acquired	Apr. 29, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1997 [Member] | Floridablanca, Colombia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 651
Initial costs, buildings	20,392
Land at cost	651
Buildings at cost	20,392
Total at cost	21,043
Accumulated Depreciation	214
Encumbrances	$ 0
Date of Construction	1997
Date Acquired	Jul. 29, 2022
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	$ 1,462
Initial costs, buildings	7,122
Land at cost	1,462
Buildings at cost	7,122
Total at cost	8,584
Accumulated Depreciation	544
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Jan. 09, 2020
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	$ 9,360
Initial costs, buildings	89,090
Land at cost	9,360
Buildings at cost	89,090
Total at cost	98,450
Accumulated Depreciation	6,751
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Jan. 09, 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	6,692
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Apr. 01, 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	12,409
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Apr. 01, 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	$ 10,015
Initial costs, buildings	19,785
Land at cost	10,015
Buildings at cost	19,785
Total at cost	29,800
Accumulated Depreciation	1,748
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	$ 8,718
Initial costs, buildings	26,185
Land at cost	8,718
Buildings at cost	26,185
Total at cost	34,903
Accumulated Depreciation	1,980
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Jan. 09, 2020
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	9,460
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	May 01, 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	$ 16,477
Buildings at cost	16,477
Total at cost	16,477
Accumulated Depreciation	1,030
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	38,892
Land at cost	3,855
Buildings at cost	38,892
Total at cost	42,747
Accumulated Depreciation	1,278
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] | Darlington, United Kingdom [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 20,165
Initial costs, buildings	45,806
Land at cost	20,165
Buildings at cost	45,806
Total at cost	65,971
Accumulated Depreciation	2,012
Encumbrances	$ 0
Date Acquired	Jun. 25, 2021
2018 [Member] | Darlington UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Date of Construction	2018
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	1,240
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] | Malaga, SP [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 726
Initial costs, buildings	11,364
Land at cost	726
Buildings at cost	11,364
Total at cost	12,090
Accumulated Depreciation	193
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Apr. 29, 2022
Life on which depreciation in latest income statements is computed (Years)	40 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	1,127
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	$ 8,296
Initial costs, buildings	24,677
Land at cost	8,296
Buildings at cost	24,677
Total at cost	32,973
Accumulated Depreciation	991
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	27,514
Land at cost	3,469
Buildings at cost	27,514
Total at cost	30,983
Accumulated Depreciation	952
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	1,152
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	1,328
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] | Turku, Finland [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,171
Initial costs, buildings	57,048
Land at cost	1,171
Buildings at cost	57,048
Total at cost	58,219
Accumulated Depreciation	1,206
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Mar. 11, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1900 [Member] | Birmingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 391
Initial costs, buildings	18,188
Land at cost	391
Buildings at cost	18,188
Total at cost	18,579
Accumulated Depreciation	731
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] | Glasgow, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Date of Construction	1900
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]
Date of Construction	1900
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	$ 29,641
Initial costs, buildings	22,296
Land at cost	29,641
Buildings at cost	22,296
Total at cost	51,937
Accumulated Depreciation	2,848
Encumbrances	$ 0
Date of Construction	1972
Date Acquired	Jun. 07, 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	1,556
Encumbrances	$ 0
Date of Construction	1972
Date Acquired	Jul. 06, 2021
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	$ 2,526
Initial costs, buildings	48,405
Land at cost	2,526
Buildings at cost	48,405
Total at cost	50,931
Accumulated Depreciation	3,652
Encumbrances	$ 0
Date of Construction	1957
Date Acquired	Jan. 09, 2020
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	$ 1,421
Initial costs, buildings	13,536
Land at cost	1,421
Buildings at cost	13,536
Total at cost	14,957
Accumulated Depreciation	5,527
Encumbrances	$ 0
Date of Construction	2006
Date Acquired	Sep. 05, 2006
Life on which depreciation in latest income statements is computed (Years)	40 years
2006 [Member] | Dahlen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,303
Initial costs, buildings	10,996
Land at cost	1,303
Buildings at cost	10,996
Total at cost	12,299
Accumulated Depreciation	730
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] | Dormagen Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,852
Initial costs, buildings	5,477
Land at cost	1,852
Buildings at cost	5,477
Total at cost	7,329
Accumulated Depreciation	631
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, VA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,302
Initial costs, buildings	9,121
Land at cost	1,302
Buildings at cost	9,121
Total at cost	10,423
Accumulated Depreciation	3,306
Encumbrances	$ 0
Date of Construction	2006
Date Acquired	Jul. 01, 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	$ 19,010
Initial costs, buildings	51,573
Land at cost	19,010
Buildings at cost	51,573
Total at cost	70,583
Accumulated Depreciation	2,120
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	1,033
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	$ 1,432
Initial costs, buildings	29,685
Land at cost	1,432
Buildings at cost	29,685
Total at cost	31,117
Accumulated Depreciation	6,308
Encumbrances	$ 0
Date of Construction	2009
Date Acquired	Jul. 01, 2014
Life on which depreciation in latest income statements is computed (Years)	40 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	2,106
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	$ 1,095
Initial costs, buildings	5,129
Land at cost	1,095
Buildings at cost	5,129
Total at cost	6,224
Accumulated Depreciation	557
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Feb. 09, 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	$ 6,114
Initial costs, buildings	124,874
Land at cost	6,114
Buildings at cost	124,874
Total at cost	130,988
Accumulated Depreciation	9,392
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Jan. 09, 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	$ 1,164
Initial costs, buildings	2,937
Land at cost	1,164
Buildings at cost	2,937
Total at cost	4,101
Accumulated Depreciation	346
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	3,434
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	$ 4,700
Initial costs, buildings	43,612
Land at cost	4,700
Buildings at cost	43,612
Total at cost	48,312
Accumulated Depreciation	3,317
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Jan. 09, 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	$ 4,979
Initial costs, buildings	34,035
Land at cost	4,979
Buildings at cost	34,035
Total at cost	39,014
Accumulated Depreciation	2,570
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Jan. 09, 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	3,408
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	$ 1,017
Initial costs, buildings	2,451
Land at cost	1,017
Buildings at cost	2,451
Total at cost	3,468
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] | 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	2,756
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	2,126
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	4,078
Land at cost	16,897
Buildings at cost	237,334
Total at cost	254,231
Accumulated Depreciation	16,101
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	$ 6,922
Initial costs, buildings	22,669
Land at cost	6,922
Buildings at cost	22,669
Total at cost	29,591
Accumulated Depreciation	2,992
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Nov. 30, 2017
2010 [Member] | Bad Oeynhausen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,092
Initial costs, buildings	2,669
Land at cost	1,092
Buildings at cost	2,669
Total at cost	3,761
Accumulated Depreciation	379
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] | 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	5,481
Land at cost	14,360
Buildings at cost	375,635
Total at cost	389,995
Accumulated Depreciation	22,737
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	7,212
Land at cost	1,215
Buildings at cost	7,212
Total at cost	8,427
Accumulated Depreciation	254
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	3,940
Encumbrances	$ 0
Date of Construction	2010
Date Acquired	Oct. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2022 [Member] | Bakersfield, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,178
Initial costs, buildings	45,253
Land at cost	2,178
Buildings at cost	45,253
Total at cost	47,431
Accumulated Depreciation	930
Encumbrances	$ 0
Date of Construction	2022
Date Acquired	May 15, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1922 [Member] | Lewiston, ID [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,389
Initial costs, buildings	75,435
Land at cost	5,389
Buildings at cost	75,435
Total at cost	80,824
Accumulated Depreciation	14,455
Encumbrances	$ 0
Date of Construction	1922
Date Acquired	May 01, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
1922 [Member] | Warren, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,417
Initial costs, buildings	15,857
Additions subsequent to acquisition, Improvements	1,737
Land at cost	2,417
Buildings at cost	17,594
Total at cost	20,011
Accumulated Depreciation	3,150
Encumbrances	$ 0
Date of Construction	1922
Date Acquired	May 01, 2017
Life on which depreciation in latest income statements is computed (Years)	46 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	2,183
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Mar. 01, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2013 [Member] | Helsinki, Finland [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,962
Initial costs, buildings	65,927
Land at cost	3,962
Buildings at cost	65,927
Total at cost	69,889
Accumulated Depreciation	1,384
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Mar. 11, 2022
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	3,694
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Feb. 01, 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	790
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Dec. 01, 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	3,099
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	3,685
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Aug. 01, 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	61,338
Land at cost	3,670
Buildings at cost	61,338
Total at cost	65,008
Accumulated Depreciation	1,976
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	1,033
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] | 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	1,033
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, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,695
Initial costs, buildings	73,773
Additions subsequent to acquisition, Improvements	4,499
Land at cost	12,695
Buildings at cost	78,272
Total at cost	90,967
Accumulated Depreciation	10,931
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	$ 1,037
Initial costs, buildings	51,364
Additions subsequent to acquisition, Improvements	312
Land at cost	1,037
Buildings at cost	51,676
Total at cost	52,713
Accumulated Depreciation	4,621
Encumbrances	$ 0
Date of Construction	2007
Date Acquired	Jun. 07, 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	$ 8,880
Initial costs, buildings	18,014
Land at cost	8,880
Buildings at cost	18,014
Total at cost	26,894
Accumulated Depreciation	783
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	$ 2,340
Initial costs, buildings	15,949
Land at cost	2,340
Buildings at cost	15,949
Total at cost	18,289
Accumulated Depreciation	648
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	5,119
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	4,135
Land at cost	6,534
Buildings at cost	104,177
Total at cost	110,711
Accumulated Depreciation	24,726
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 [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	698
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Oct. 07, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Hoover, AL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 1,034
Additions subsequent to acquisition, Improvements	296
Buildings at cost	1,330
Total at cost	1,330
Accumulated Depreciation	268
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	May 01, 2015
Life on which depreciation in latest income statements is computed (Years)	34 years
1978 [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Date of Construction	1978
Date Acquired	Jul. 06, 2021
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	12,996
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] | Norwalk, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,946
Initial costs, buildings	30,465
Land at cost	7,946
Buildings at cost	30,465
Total at cost	38,411
Accumulated Depreciation	1,221
Encumbrances	$ 0
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	4,701
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 [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,109
Initial costs, buildings	13,138
Land at cost	2,109
Buildings at cost	13,138
Total at cost	15,247
Accumulated Depreciation	2,490
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	$ 11,817
Initial costs, buildings	77,130
Land at cost	11,817
Buildings at cost	77,130
Total at cost	88,947
Accumulated Depreciation	5,790
Encumbrances	$ 0
Date of Construction	1977
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 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	$ 99,659
Initial costs, buildings	35,321
Additions subsequent to acquisition, Improvements	2,165
Land at cost	99,659
Buildings at cost	37,486
Total at cost	137,145
Accumulated Depreciation	4,456
Encumbrances	$ 0
Date of Construction	1965
Date Acquired	Jun. 07, 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	$ 3,395
Initial costs, buildings	38,679
Land at cost	3,395
Buildings at cost	38,679
Total at cost	42,074
Accumulated Depreciation	2,927
Encumbrances	$ 0
Date of Construction	1965
Date Acquired	Jan. 09, 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	$ 6,856
Initial costs, buildings	14,731
Land at cost	6,856
Buildings at cost	14,731
Total at cost	21,587
Accumulated Depreciation	614
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] | Broomfield, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Life on which depreciation in latest income statements is computed (Years)	37 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	$ 6,510
Initial costs, buildings	60,125
Additions subsequent to acquisition, Improvements	3,935
Land at cost	6,510
Buildings at cost	64,060
Total at cost	70,570
Accumulated Depreciation	6,090
Encumbrances	$ 0
Date of Construction	1979
Date Acquired	Jun. 07, 2019
1979 [Member] | Godalming, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Date of Construction	1796
1979 [Member] | Phoenix, AZ [Member]
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	4,062
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] | Sunnybank, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,982
Initial costs, buildings	42,915
Land at cost	5,982
Buildings at cost	42,915
Total at cost	48,897
Accumulated Depreciation	4,580
Encumbrances	$ 0
Date of Construction	1979
Date Acquired	Jun. 07, 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	52,227
Land at cost	4,941
Buildings at cost	52,227
Total at cost	57,168
Accumulated Depreciation	1,663
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	$ 1,734
Land at cost	1,734
Total at cost	1,734
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	69,346
Land at cost	5,118
Buildings at cost	69,346
Total at cost	74,464
Accumulated Depreciation	2,185
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] | 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	7,674
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Feb. 07, 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	$ 2,829
Initial costs, buildings	10,795
Land at cost	2,829
Buildings at cost	10,795
Total at cost	13,624
Accumulated Depreciation	421
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	2,383
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Feb. 01, 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	213
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	1,494
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Oct. 02, 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	$ 24,672
Initial costs, buildings	79,057
Land at cost	24,672
Buildings at cost	79,057
Total at cost	103,729
Accumulated Depreciation	4,028
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Dec. 18, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
2003 [Member] | Bury, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 8,076
Initial costs, buildings	18,404
Land at cost	8,076
Buildings at cost	18,404
Total at cost	26,480
Accumulated Depreciation	796
Encumbrances	$ 0
Date of Construction	2003
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2003 [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	1,381
Encumbrances	$ 0
Date of Construction	2003
Date Acquired	May 02, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2003 [Member] | Youngstown, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,334
Initial costs, buildings	3,565
Additions subsequent to acquisition, Improvements	488
Land at cost	4,334
Buildings at cost	4,053
Total at cost	8,387
Accumulated Depreciation	2,527
Encumbrances	$ 0
Date of Construction	2003
Date Acquired	May 01, 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	$ 864
Initial costs, buildings	24,274
Land at cost	864
Buildings at cost	24,274
Total at cost	25,138
Accumulated Depreciation	1,839
Encumbrances	$ 0
Date of Construction	1990
Date Acquired	Jan. 09, 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	$ 4,962
Initial costs, buildings	25,007
Land at cost	4,962
Buildings at cost	25,007
Total at cost	29,969
Accumulated Depreciation	988
Encumbrances	$ 0
Date Acquired	Jun. 25, 2021
1990 [Member] | Darlington UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Date of Construction	1990
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	$ 5,296
Initial costs, buildings	58,249
Land at cost	5,296
Buildings at cost	58,249
Total at cost	63,545
Accumulated Depreciation	5,142
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	$ 11,854
Initial costs, buildings	5,983
Land at cost	11,854
Buildings at cost	5,983
Total at cost	17,837
Accumulated Depreciation	313
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] | Leeds, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 2,163
Initial costs, buildings	9,037
Land at cost	2,163
Buildings at cost	9,037
Total at cost	11,200
Accumulated Depreciation	379
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	$ 5,411
Initial costs, buildings	15,169
Land at cost	5,411
Buildings at cost	15,169
Total at cost	20,580
Accumulated Depreciation	651
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	$ 33,024
Initial costs, buildings	43,823
Land at cost	33,024
Buildings at cost	43,823
Total at cost	76,847
Accumulated Depreciation	3,816
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	8,323
Land at cost	1,220
Buildings at cost	8,323
Total at cost	9,543
Accumulated Depreciation	3,099
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] | 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	3,308
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	3,408
Encumbrances	$ 0
Date of Construction	1953
Date Acquired	Dec. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	30 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	5,481
Land at cost	14,360
Buildings at cost	375,635
Total at cost	389,995
Accumulated Depreciation	22,737
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, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,695
Initial costs, buildings	73,773
Additions subsequent to acquisition, Improvements	4,499
Land at cost	12,695
Buildings at cost	78,272
Total at cost	90,967
Accumulated Depreciation	10,931
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	1,420
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] | Mesa, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,604
Initial costs, buildings	16,400
Land at cost	2,604
Buildings at cost	16,400
Total at cost	19,004
Accumulated Depreciation	283
Encumbrances	$ 0
Date of Construction	2019
Date Acquired	Apr. 18, 2022
Life on which depreciation in latest income statements is computed (Years)	40 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	1,172
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
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	574
Encumbrances	$ 0
Date of Construction	2011
Date Acquired	Feb. 29, 2012
Life on which depreciation in latest income statements is computed (Years)	40 years
1959 [Member] | Canterbury, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Life on which depreciation in latest income statements is computed (Years)	40 years
1959 [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	3,104
Encumbrances	$ 0
Date of Construction	1959
Date Acquired	Aug. 01, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1959 [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	278
Encumbrances	$ 0
Date of Construction	1959
Date Acquired	Jul. 06, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1994 [Member] | Cheadle, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 28,297
Initial costs, buildings	89,982
Land at cost	28,297
Buildings at cost	89,982
Total at cost	118,279
Accumulated Depreciation	3,652
Encumbrances	$ 0
Date of Construction	1994
Date Acquired	Jul. 08, 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	$ 6,374
Initial costs, buildings	28,612
Land at cost	6,374
Buildings at cost	28,612
Total at cost	34,986
Accumulated Depreciation	2,164
Encumbrances	$ 0
Date of Construction	1994
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
2001 [Member] | Cologne Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Initial costs, land	$ 4,292
Initial costs, buildings	14,512
Land at cost	4,292
Buildings at cost	14,512
Total at cost	18,804
Accumulated Depreciation	2,031
Encumbrances	$ 0
Date of Construction	2001
Date Acquired	Aug. 07, 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	$ 1,981
Initial costs, buildings	33,995
Land at cost	1,981
Buildings at cost	33,995
Total at cost	35,976
Accumulated Depreciation	2,106
Encumbrances	$ 0
Date of Construction	2001
Date Acquired	Aug. 07, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
2001 [Member] | Hope, AR [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,651
Initial costs, buildings	3,359
Additions subsequent to acquisition, Improvements	2,733
Land at cost	1,651
Buildings at cost	6,092
Total at cost	7,743
Accumulated Depreciation	1,146
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	$ 6,373
Additions subsequent to acquisition, Improvements	69,916
Land at cost	6,373
Buildings at cost	69,916
Total at cost	76,289
Encumbrances	$ 0
Date of Construction	2001
Date Acquired	Jun. 27, 2018
Life on which depreciation in latest income statements is computed (Years)	46 years
1925 [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	549
Encumbrances	$ 0
Date of Construction	1925
Date Acquired	Sep. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1935 [Member] | Darlington UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 20,165
Initial costs, buildings	45,806
Land at cost	20,165
Buildings at cost	45,806
Total at cost	65,971
Accumulated Depreciation	2,012
Encumbrances	$ 0
Date of Construction	1935
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1960 [Member] | Darlington UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 4,962
Initial costs, buildings	25,007
Land at cost	4,962
Buildings at cost	25,007
Total at cost	29,969
Accumulated Depreciation	988
Encumbrances	$ 0
Date of Construction	1960
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1960 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,274
Initial costs, buildings	27,324
Additions subsequent to acquisition, Improvements	32,499
Land at cost	3,274
Buildings at cost	59,823
Total at cost	63,097
Accumulated Depreciation	19,503
Encumbrances	$ 0
Date of Construction	1960
Date Acquired	Aug. 10, 2007
Life on which depreciation in latest income statements is computed (Years)	40 years
1960 [Member] | 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	276
Encumbrances	$ 0
Date of Construction	1960
Date Acquired	Jul. 06, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1960 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,848
Initial costs, buildings	14,858
Land at cost	5,848
Buildings at cost	14,858
Total at cost	20,706
Accumulated Depreciation	613
Encumbrances	$ 0
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1960 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Date of Construction	1960
1960 [Member] | Meyersdale, PA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 390
Initial costs, buildings	4,280
Land at cost	390
Buildings at cost	4,280
Total at cost	4,670
Accumulated Depreciation	548
Encumbrances	$ 0
Date of Construction	1960
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
1960 [Member] | Sherman, 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	3,940
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	$ 2,762
Initial costs, buildings	9,849
Land at cost	2,762
Buildings at cost	9,849
Total at cost	12,611
Accumulated Depreciation	453
Encumbrances	$ 0
Date of Construction	1840
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1993 [Member] | Dahlen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,303
Initial costs, buildings	10,996
Land at cost	1,303
Buildings at cost	10,996
Total at cost	12,299
Accumulated Depreciation	730
Encumbrances	$ 0
Date of Construction	1993
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
1993 [Member] | Dormagen Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,852
Initial costs, buildings	5,477
Land at cost	1,852
Buildings at cost	5,477
Total at cost	7,329
Accumulated Depreciation	631
Encumbrances	$ 0
Date of Construction	1993
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
1993 [Member] | San Bernardino, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,209
Initial costs, buildings	37,498
Land at cost	2,209
Buildings at cost	37,498
Total at cost	39,707
Accumulated Depreciation	3,415
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	$ 6,856
Initial costs, buildings	14,731
Land at cost	6,856
Buildings at cost	14,731
Total at cost	21,587
Accumulated Depreciation	614
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	3,308
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	222,271
Additions subsequent to acquisition, Improvements	75,494
Land at cost	75,339
Buildings at cost	297,765
Total at cost	373,104
Accumulated Depreciation	8,995
Encumbrances	$ 0
Date of Construction	1969
Date Acquired	Aug. 01, 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	276
Encumbrances	$ 0
Date of Construction	1969
Date Acquired	Jul. 06, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1997 [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	549
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] | Bromley, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 6,856
Initial costs, buildings	14,731
Land at cost	6,856
Buildings at cost	14,731
Total at cost	21,587
Accumulated Depreciation	614
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] | McKinney, Texas [Member]
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	$ 8,296
Initial costs, buildings	24,677
Land at cost	8,296
Buildings at cost	24,677
Total at cost	32,973
Accumulated Depreciation	991
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	$ 2,841
Land at cost	2,841
Total at cost	2,841
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	$ 20,165
Initial costs, buildings	45,806
Land at cost	20,165
Buildings at cost	45,806
Total at cost	65,971
Accumulated Depreciation	2,012
Encumbrances	$ 0
Date Acquired	Jun. 25, 2021
2020 [Member] | Darlington UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Date of Construction	2020
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	45,076
Land at cost	4,790
Buildings at cost	45,076
Total at cost	49,866
Accumulated Depreciation	1,408
Encumbrances	$ 0
Date of Construction	2020
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2020 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
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	107,608
Land at cost	1,880
Buildings at cost	107,608
Total at cost	109,488
Accumulated Depreciation	7,835
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, TX [Member]
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	1,122
Encumbrances	$ 0
Date of Construction	2020
Date Acquired	Oct. 25, 2019
2020 [Member] | Tadley, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 19,853
Initial costs, buildings	18,090
Land at cost	19,853
Buildings at cost	18,090
Total at cost	37,943
Accumulated Depreciation	891
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] | Woking, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 6,871
Initial costs, buildings	4,442
Land at cost	6,871
Buildings at cost	4,442
Total at cost	11,313
Accumulated Depreciation	204
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 [Member] | Halsall, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,912
Initial costs, buildings	29,573
Land at cost	1,912
Buildings at cost	29,573
Total at cost	31,485
Accumulated Depreciation	2,618
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 [Member] | Rowley, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,760
Initial costs, buildings	17,370
Land at cost	2,760
Buildings at cost	17,370
Total at cost	20,130
Accumulated Depreciation	1,585
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	9,332
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	1,090
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	247,158
Land at cost	8,877
Buildings at cost	247,158
Total at cost	256,035
Accumulated Depreciation	25,076
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	1,216
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] | 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	4,043
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	Aug. 01, 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	78,415
Land at cost	28,687
Buildings at cost	182,443
Total at cost	211,130
Accumulated Depreciation	12,756
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] | 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	9,018
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	5,434
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
1950 [Member] | Rockledge, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 13,919
Initial costs, buildings	23,282
Additions subsequent to acquisition, Improvements	8,338
Land at cost	13,919
Buildings at cost	31,620
Total at cost	45,539
Accumulated Depreciation	5,521
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	May 01, 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	3,091
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	May 01, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1950 [Member] | Surrey, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 14,280
Initial costs, buildings	8,741
Land at cost	14,280
Buildings at cost	8,741
Total at cost	23,021
Accumulated Depreciation	25
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1991 [Member] | Fresno, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 5,507
Initial costs, buildings	70,473
Land at cost	5,507
Buildings at cost	70,473
Total at cost	75,980
Accumulated Depreciation	6,329
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	$ 6,049
Initial costs, buildings	34,547
Land at cost	6,049
Buildings at cost	34,547
Total at cost	40,596
Accumulated Depreciation	5,644
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	$ 10,340
Initial costs, buildings	10,166
Land at cost	10,340
Buildings at cost	10,166
Total at cost	20,506
Accumulated Depreciation	567
Encumbrances	$ 0
Date of Construction	1700
Date Acquired	Jun. 25, 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	65,282
Land at cost	14,010
Buildings at cost	65,282
Total at cost	79,292
Accumulated Depreciation	2,646
Encumbrances	$ 0
Date of Construction	1966
Date Acquired	Jul. 06, 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	$ 1,355
Initial costs, buildings	14,824
Land at cost	1,355
Buildings at cost	14,824
Total at cost	16,179
Accumulated Depreciation	603
Encumbrances	$ 0
Date Acquired	Jun. 25, 2021
1900 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,848
Initial costs, buildings	14,858
Land at cost	5,848
Buildings at cost	14,858
Total at cost	20,706
Accumulated Depreciation	613
Encumbrances	$ 0
Date Acquired	Jun. 25, 2021
1900 [Member] | York, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 20,534
Land at cost	20,534
Buildings at cost	68,118
Total at cost	88,652
Accumulated Depreciation	2,699
Encumbrances	$ 0
Date of Construction	1900
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 hours
1796 [Member] | Godalming, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 8,880
Initial costs, buildings	18,014
Land at cost	8,880
Buildings at cost	18,014
Total at cost	26,894
Accumulated Depreciation	783
Encumbrances	$ 0
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	$ 1,164
Initial costs, buildings	2,937
Land at cost	1,164
Buildings at cost	2,937
Total at cost	4,101
Accumulated Depreciation	346
Encumbrances	$ 0
Date of Construction	1886
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
1998 [Member] | Hassocks, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,205
Initial costs, buildings	27,215
Land at cost	5,205
Buildings at cost	27,215
Total at cost	32,420
Accumulated Depreciation	1,255
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	$ 6,049
Initial costs, buildings	34,547
Land at cost	6,049
Buildings at cost	34,547
Total at cost	40,596
Accumulated Depreciation	5,644
Encumbrances	$ 0
Date of Construction	1885
Date Acquired	Jun. 22, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1901 [Member] | Hemel Hempstead, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 11,854
Initial costs, buildings	5,983
Land at cost	11,854
Buildings at cost	5,983
Total at cost	17,837
Accumulated Depreciation	313
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] | 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	18,823
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	7,195
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	$ 1,822
Initial costs, buildings	37,467
Additions subsequent to acquisition, Improvements	15,921
Land at cost	1,822
Buildings at cost	53,388
Total at cost	55,210
Accumulated Depreciation	16,455
Encumbrances	$ 0
Date of Construction	2002
Date Acquired	Apr. 01, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
2002 [Member] | Melbourne, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,642
Initial costs, buildings	17,087
Additions subsequent to acquisition, Improvements	21,818
Land at cost	5,642
Buildings at cost	38,905
Total at cost	44,547
Accumulated Depreciation	4,054
Encumbrances	$ 0
Date of Construction	2002
Date Acquired	May 01, 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	4,701
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	$ 2,340
Initial costs, buildings	15,949
Land at cost	2,340
Buildings at cost	15,949
Total at cost	18,289
Accumulated Depreciation	648
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] | Cadiz Spain [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 290
Initial costs, buildings	6,593
Land at cost	290
Buildings at cost	6,593
Total at cost	6,883
Accumulated Depreciation	118
Encumbrances	$ 0
Date of Construction	2000
Date Acquired	Apr. 29, 2022
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	$ 23,216
Initial costs, buildings	75,501
Additions subsequent to acquisition, Improvements	11,829
Land at cost	23,216
Buildings at cost	87,330
Total at cost	110,546
Accumulated Depreciation	6,888
Encumbrances	$ 0
Date of Construction	2000
Date Acquired	Jun. 07, 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	9,018
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] | Montclair, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
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	$ 9,502
Initial costs, buildings	8,504
Land at cost	9,502
Buildings at cost	8,504
Total at cost	18,006
Accumulated Depreciation	419
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 [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	22,329
Encumbrances	$ 0
Date of Construction	2000
Date Acquired	Apr. 01, 2014
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	3,150
Encumbrances	$ 0
Date of Construction	2000
Date Acquired	May 01, 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	$ 6,917
Initial costs, buildings	15,434
Land at cost	6,917
Buildings at cost	15,434
Total at cost	22,351
Accumulated Depreciation	626
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	231
Encumbrances	$ 0
Date of Construction	1967
Date Acquired	Jul. 06, 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	$ 13,022
Initial costs, buildings	40,532
Additions subsequent to acquisition, Improvements	196
Land at cost	13,022
Buildings at cost	40,728
Total at cost	53,750
Accumulated Depreciation	4,879
Encumbrances	$ 0
Date of Construction	1975
Date Acquired	Jun. 07, 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	6,038
Encumbrances	$ 0
Date of Construction	1975
Date Acquired	Aug. 01, 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	$ 3,117
Initial costs, buildings	3,937
Land at cost	3,117
Buildings at cost	3,937
Total at cost	7,054
Accumulated Depreciation	300
Encumbrances	$ 0
Date of Construction	1987
Date Acquired	Jan. 09, 2020
1987 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
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	$ 9,811
Initial costs, buildings	40,540
Land at cost	9,811
Buildings at cost	40,540
Total at cost	50,351
Accumulated Depreciation	3,069
Encumbrances	$ 0
Date of Construction	1987
Date Acquired	Jan. 09, 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	14,618
Encumbrances	$ 0
Date of Construction	1987
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 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	$ 6,373
Additions subsequent to acquisition, Improvements	69,916
Land at cost	6,373
Buildings at cost	69,916
Total at cost	76,289
Encumbrances	$ 0
Date of Construction	1926
Date Acquired	Jun. 27, 2018
Life on which depreciation in latest income statements is computed (Years)	46 years
1996 [Member] | Mcminnville, OR [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,000
Initial costs, buildings	97,900
Land at cost	5,000
Buildings at cost	97,900
Total at cost	102,900
Accumulated Depreciation	16,630
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	$ 2,206
Initial costs, buildings	36,429
Land at cost	2,206
Buildings at cost	36,429
Total at cost	38,635
Accumulated Depreciation	3,538
Encumbrances	$ 0
Date of Construction	1996
Date Acquired	Apr. 03, 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	4,744
Encumbrances	$ 0
Date of Construction	1955
Date Acquired	Aug. 01, 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	$ 11,564
Initial costs, buildings	99,395
Land at cost	11,564
Buildings at cost	99,395
Total at cost	110,959
Accumulated Depreciation	7,474
Encumbrances	$ 0
Date of Construction	1955
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1988 [Member] | Miami, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 20,430
Initial costs, buildings	33,881
Additions subsequent to acquisition, Improvements	10,364
Land at cost	20,430
Buildings at cost	44,245
Total at cost	64,675
Accumulated Depreciation	593
Encumbrances	$ 0
Date of Construction	1988
Date Acquired	Apr. 25, 2022
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	7,489
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	22,329
Encumbrances	$ 0
Date of Construction	1920
Date Acquired	Apr. 01, 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	1,953
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	1,381
Encumbrances	$ 0
Date of Construction	1920
Date Acquired	May 02, 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	130
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	1,381
Encumbrances	$ 0
Date of Construction	1919
Date Acquired	May 02, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1958 [Member] | Miami, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 20,430
Initial costs, buildings	33,881
Additions subsequent to acquisition, Improvements	10,364
Land at cost	20,430
Buildings at cost	44,245
Total at cost	64,675
Accumulated Depreciation	593
Encumbrances	$ 0
Date of Construction	1958
Date Acquired	Apr. 25, 2022
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	$ 7,946
Initial costs, buildings	30,465
Land at cost	7,946
Buildings at cost	30,465
Total at cost	38,411
Accumulated Depreciation	1,221
Encumbrances	$ 0
Date of Construction	1958
Date Acquired	Jul. 06, 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	278
Encumbrances	$ 0
1995 [Member] | Norwalk, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Date of Construction	1995
Date Acquired	Jul. 06, 2021
1906 [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	14,618
Encumbrances	$ 0
Date of Construction	1906
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1906 [Member] | Royston, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 6,391
Initial costs, buildings	19,028
Land at cost	6,391
Buildings at cost	19,028
Total at cost	25,419
Accumulated Depreciation	899
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	$ 8,296
Initial costs, buildings	24,677
Land at cost	8,296
Buildings at cost	24,677
Total at cost	32,973
Accumulated Depreciation	991
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	$ 1,641
Initial costs, buildings	21,072
Land at cost	1,641
Buildings at cost	21,072
Total at cost	22,713
Accumulated Depreciation	838
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	$ 1,017
Initial costs, buildings	2,451
Land at cost	1,017
Buildings at cost	2,451
Total at cost	3,468
Accumulated Depreciation	282
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	3,940
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	$ 6,116
Initial costs, buildings	17,961
Land at cost	6,116
Buildings at cost	17,961
Total at cost	24,077
Accumulated Depreciation	835
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] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, buildings	$ 104,028
Additions subsequent to acquisition, Improvements	78,415
Land at cost	28,687
Buildings at cost	182,443
Total at cost	211,130
Accumulated Depreciation	12,756
Encumbrances	$ 0
Date of Construction	1940
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1940 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Initial costs, land	$ 28,687
1940 [Member] | Tempe, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,050
Initial costs, buildings	10,986
Additions subsequent to acquisition, Improvements	5,084
Land at cost	6,050
Buildings at cost	16,070
Total at cost	22,120
Accumulated Depreciation	2,410
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	$ 1,641
Initial costs, buildings	21,072
Land at cost	1,641
Buildings at cost	21,072
Total at cost	22,713
Accumulated Depreciation	838
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] | Miami, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 20,430
Initial costs, buildings	33,881
Additions subsequent to acquisition, Improvements	10,364
Land at cost	20,430
Buildings at cost	44,245
Total at cost	64,675
Accumulated Depreciation	593
Encumbrances	$ 0
Date of Construction	1962
Date Acquired	Apr. 25, 2022
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	$ 11,702
Initial costs, buildings	69,433
Additions subsequent to acquisition, Improvements	19,116
Land at cost	12,254
Buildings at cost	87,997
Total at cost	100,251
Accumulated Depreciation	18,622
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	$ 6,156
Initial costs, buildings	9,754
Land at cost	6,156
Buildings at cost	9,754
Total at cost	15,910
Accumulated Depreciation	754
Encumbrances	$ 0
Date of Construction	1911
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1800 [Member] | Woking, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 6,871
Initial costs, buildings	4,442
Land at cost	6,871
Buildings at cost	4,442
Total at cost	11,313
Accumulated Depreciation	204
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	$ 4,334
Initial costs, buildings	3,565
Additions subsequent to acquisition, Improvements	488
Land at cost	4,334
Buildings at cost	4,053
Total at cost	8,387
Accumulated Depreciation	2,527
Encumbrances	$ 0
Date of Construction	1929
Date Acquired	May 01, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
[1] 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.

Schedule III - Real Estate In_3

Schedule III - Real Estate Investments and Accumulated Depreciation (Parenthetical) (Detail) $ in Billions	Dec. 31, 2022 USD ($)
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]
Aggregate cost for federal income tax purposes	$ 11

Schedule III - Changes in Total

Schedule III - Changes in Total Real Estate Assets (Detail) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2022		Dec. 31, 2021		Dec. 31, 2020
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]
Balance at beginning of period		$ 13,628,749	[1]	$ 10,749,707		$ 7,312,486
Acquisitions		622,999		3,023,966		2,912,594
Transfers from construction in progress		47,431				202,999
Additions		150,290		167,164		55,137
Dispositions		(1,471,529)		(229,584)		(105,360)
Other	[2]	(677,416)		(82,504)		371,851
Balance at end of period		$ 12,300,524		$ 13,628,749	[1]	$ 10,749,707
[1] 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. Includes foreign currency fluctuations for all years and $ 13.8 million of right-of-use assets in 2020.

Schedule III - Changes in Accum

Schedule III - Changes in Accumulated Depreciation (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022		Dec. 31, 2021		Dec. 31, 2020
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]
Balance at beginning of period	$ 950,369	[1]	$ 728,176		$ 504,651
Depreciation	277,032		262,063		222,580
Depreciation on disposed property	(185,519)		(35,551)		(6,653)
Other	(33,542)		(4,319)		7,598
Balance at end of period	$ 1,008,340		$ 950,369	[1]	$ 728,176
[1] 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 III - Changes in Acc_2

Schedule III - Changes in Accumulated Depreciation (Parenthetical) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]
Changes in right-of-use asset	$ 23,066	$ 1,120	$ 13,800
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 ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Mortgage Loans on Real Estate [Line Items]
Face Amount of Mortgages	$ 364,420
Carrying Amount of Mortgages	$ 364,420	$ 213,320	$ 248,335	$ 1,274,995
Long-Term First Mortgage Loan [Member]
Mortgage Loans on Real Estate [Line Items]
Periodic Payment Terms	Payable in monthlyinstallments of interest plusprincipal 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	$ 117,360
Carrying Amount of Mortgages	$ 117,360
Long-Term First Mortgage Loan [Member] | Springstone Inc. [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	7%
Final Maturity Date	2041
Face Amount of Mortgages	$ 22,900
Carrying Amount of Mortgages	$ 22,900
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	$ 7,986
Carrying Amount of Mortgages	$ 7,986
Long-Term First Mortgage Loan [Member] | Prospect [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	7.96%
Final Maturity Date	2034
Face Amount of Mortgages	$ 151,267
Carrying Amount of Mortgages	$ 151,267
Long-Term First Mortgage Loan [Member] | Infracore [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	4.20%
Final Maturity Date	2023
Face Amount of Mortgages	$ 64,907
Carrying Amount of Mortgages	$ 64,907

Schedule IV - Schedule of Mor_2

Schedule IV - Schedule of Mortgage Loans on Real Estate (Parenthetical) (Detail)	Dec. 31, 2022 USD ($) Property
Mortgage Loans on Real Estate [Line Items]
Prior Liens	$ 0
Carrying amount of mortgages, federal income tax purposes	364,400,000
Unamortized loan issue costs	$ 300,000
Colombia [Member] | Long-Term First Mortgage Loan [Member]
Mortgage Loans on Real Estate [Line Items]
Number of properties | Property	3

Schedule IV - Changes in Mortga

Schedule IV - Changes in Mortgage Loans Excluding Allowance for Credit Loss (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Abstract]
Balance at beginning of year	$ 213,320	$ 248,335	$ 1,274,995
New mortgage loans and additional advances on existing loans	177,924	1,128,695	193,590
Exchange rate fluctuations	(15,824)	(3,640)	9,785
Mortgage loans on real estate including additions during year	375,420	1,373,390	1,478,370
Collection of principal	(11,000)	(1,160,070)	(1,230,035)
Deductions during year	(11,000)	(1,160,070)	(1,230,035)
Balance at end of year	$ 364,420	$ 213,320	$ 248,335

Schedule IV - Changes in Mort_2

Schedule IV - Changes in Mortgage Loans Excluding Allowance for Credit Loss (Parenthetical) (Detail) $ in Thousands, £ in Millions		Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)	Mar. 31, 2021 GBP (£)	Dec. 31, 2020 USD ($)
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 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.