MPT Operating Partnership 10-K 1 Mar 21 2020 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($) shares in Millions, $ in Billions	12 Months Ended
	Dec. 31, 2020	Feb. 19, 2021	Jun. 30, 2020
Document Information [Line Items]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2020
Document Fiscal Year Focus	2020
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		580
Entity Public Float			$ 9.8
Title of 12(b) Security	Common stock, par value $0.001 per share, of Medical Properties Trust, Inc.
Security Exchange Name	NYSE
Entity File Number	001-32559
Entity Tax Identification Number	20-0191742
Entity Address, Address Line One	1000 Urban Center Drive
Entity Address, Address Line Two	Suite 501
Entity Address, City or Town	Birmingham
Entity Address, State or Province	AL
Entity Address, Postal Zip Code	35242
City Area Code	205
Local Phone Number	969-3755
Entity Incorporation, State or Country Code	MD
Document Annual Report	true
Document Transition Report	false
Entity Interactive Data Current	Yes
Documents Incorporated by Reference	Portions of the definitive Proxy Statement of Medical Properties Trust, Inc. for the Annual Meeting of Stockholders to be held on May 26, 2021 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, 2020
Document Fiscal Year Focus	2020
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

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Real estate assets
Land	$ 1,463,200	$ 1,017,402
Buildings and improvements	9,286,507	6,295,084
Construction in progress	30,139	168,212
Intangible lease assets	1,299,081	622,056
Investment in financing leases	2,010,922	2,060,302
Mortgage loans	248,080	1,275,022
Gross investment in real estate assets	14,337,929	11,438,078
Accumulated depreciation	(728,176)	(504,651)
Accumulated amortization	(105,353)	(65,391)
Net investment in real estate assets	13,504,400	10,868,036
Cash and cash equivalents	549,884	1,462,286
Interest and rent receivables	46,208	31,357
Straight-line rent receivables	490,462	334,231
Equity investments	1,123,623	926,990
Other loans	858,368	544,832
Other assets	256,069	299,599
Total Assets	16,829,014	14,467,331
Liabilities
Debt, net	8,865,458	7,023,679
Accounts payable and accrued expenses	438,750	291,489
Deferred revenue	36,177	16,098
Obligations to tenants and other lease liabilities	144,772	107,911
Total Liabilities	9,485,157	7,439,177
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 — 541,419 shares at December 31, 2020 and 517,522 shares at December 31, 2019	541	518
Limited Partners:
Additional paid-in capital	7,461,503	7,008,199
Retained (deficit) earnings	(71,411)	83,012
Accumulated other comprehensive loss	(51,324)	(62,905)
Treasury shares, at cost	(777)	(777)
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital)	7,338,532	7,028,047
Non-controlling interests	5,325	107
Total Equity / Capital	7,343,857	7,028,154
Total Liabilities and Equity / Capital	16,829,014	14,467,331
MPT Operating Partnership, L.P. [Member]
Real estate assets
Land	1,463,200	1,017,402
Buildings and improvements	9,286,507	6,295,084
Construction in progress	30,139	168,212
Intangible lease assets	1,299,081	622,056
Investment in financing leases	2,010,922	2,060,302
Mortgage loans	248,080	1,275,022
Gross investment in real estate assets	14,337,929	11,438,078
Accumulated depreciation	(728,176)	(504,651)
Accumulated amortization	(105,353)	(65,391)
Net investment in real estate assets	13,504,400	10,868,036
Cash and cash equivalents	549,884	1,462,286
Interest and rent receivables	46,208	31,357
Straight-line rent receivables	490,462	334,231
Equity investments	1,123,623	926,990
Other loans	858,368	544,832
Other assets	256,069	299,599
Total Assets	16,829,014	14,467,331
Liabilities
Debt, net	8,865,458	7,023,679
Accounts payable and accrued expenses	290,757	152,999
Deferred revenue	36,177	16,098
Obligations to tenants and other lease liabilities	144,772	107,911
Payable due to Medical Properties Trust, Inc.	147,603	138,100
Total Liabilities	9,484,767	7,438,787
Commitments and Contingencies
Limited Partners:
Accumulated other comprehensive loss	(51,324)	(62,905)
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital)	7,338,922	7,028,437
Non-controlling interests	5,325	107
Total Equity / Capital	7,344,247	7,028,544
Total Liabilities and Equity / Capital	16,829,014	14,467,331
General Partner [Member] | MPT Operating Partnership, L.P. [Member]
Limited Partners:
Total Equity / Capital	73,977	70,939
General partner — issued and outstanding — 5,414 units at December 31, 2020 and 5,176 units at December 31, 2019	73,977	70,939
Common Units [Member] | MPT Operating Partnership, L.P. [Member]
Limited Partners:
Common units — issued and outstanding — 536,005 units at December 31, 2020 and 512,346 units at December 31, 2019	$ 7,316,269	$ 7,020,403

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Dec. 31, 2020	Dec. 31, 2019
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	541,419,000	517,522,000
Common stock, shares outstanding	541,419,000	517,522,000
General Partner [Member] | MPT Operating Partnership, L.P. [Member]
General partner, units issued	5,414,000	5,176,000
General partner, units outstanding	5,414,000	5,176,000
Common Units [Member] | MPT Operating Partnership, L.P. [Member]
Limited Partners, units issued	536,005,000	512,346,000
Limited Partners, units outstanding	536,005,000	512,346,000
LTIP Units [Member] | MPT Operating Partnership, L.P. [Member]
LTIP Units, shares issued	0	232,000
LTIP Units, shares outstanding	0	232,000

Consolidated Statements of Net

Consolidated Statements of Net Income - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Revenues
Rent billed	$ 741,311	$ 474,151	$ 473,343
Straight-line rent	158,881	110,456	74,741
Income from financing leases	206,550	119,617	73,983
Interest and other income	142,496	149,973	162,455
Total revenues	1,249,238	854,197	784,522
Expenses
Interest	328,728	237,830	223,274
Real estate depreciation and amortization	264,245	152,313	133,083
Property-related	24,890	23,992	9,237
General and administrative	131,663	96,411	81,003
Total expenses	749,526	510,546	446,597
Other income (expense)
(Loss) gain on sale of real estate	(2,833)	41,560	719,392
Real estate impairment charges	(19,006)	(21,031)	(48,007)
Earnings from equity interests	20,417	16,051	14,165
Debt refinancing and unutilized financing costs	(28,180)	(6,106)
Other (including mark-to-market adjustments on equity securities)	(6,782)	(345)	(4,071)
Total other income (expense)	(36,384)	30,129	681,479
Income before income tax	463,328	373,780	1,019,404
Income tax (expense) benefit	(31,056)	2,621	(927)
Net income	432,272	376,401	1,018,477
Net income attributable to non-controlling interests	(822)	(1,717)	(1,792)
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 431,450	$ 374,684	$ 1,016,685
Earnings per share (unit) basic
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.81	$ 0.87	$ 2.77
Weighted average shares (units) outstanding basic	529,239	427,075	365,364
Earnings per share (unit) diluted
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.81	$ 0.87	$ 2.76
Weighted average shares (units) outstanding diluted	530,461	428,299	366,271
MPT Operating Partnership, L.P. [Member]
Revenues
Rent billed	$ 741,311	$ 474,151	$ 473,343
Straight-line rent	158,881	110,456	74,741
Income from financing leases	206,550	119,617	73,983
Interest and other income	142,496	149,973	162,455
Total revenues	1,249,238	854,197	784,522
Expenses
Interest	328,728	237,830	223,274
Real estate depreciation and amortization	264,245	152,313	133,083
Property-related	24,890	23,992	9,237
General and administrative	131,663	96,411	81,003
Total expenses	749,526	510,546	446,597
Other income (expense)
(Loss) gain on sale of real estate	(2,833)	41,560	719,392
Real estate impairment charges	(19,006)	(21,031)	(48,007)
Earnings from equity interests	20,417	16,051	14,165
Debt refinancing and unutilized financing costs	(28,180)	(6,106)
Other (including mark-to-market adjustments on equity securities)	(6,782)	(345)	(4,071)
Total other income (expense)	(36,384)	30,129	681,479
Income before income tax	463,328	373,780	1,019,404
Income tax (expense) benefit	(31,056)	2,621	(927)
Net income	432,272	376,401	1,018,477
Net income attributable to non-controlling interests	(822)	(1,717)	(1,792)
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 431,450	$ 374,684	$ 1,016,685
Earnings per share (unit) basic
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.81	$ 0.87	$ 2.77
Weighted average shares (units) outstanding basic	529,239	427,075	365,364
Earnings per share (unit) diluted
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.81	$ 0.87	$ 2.76
Weighted average shares (units) outstanding diluted	530,461	428,299	366,271

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Net income	$ 432,272	$ 376,401	$ 1,018,477
Other comprehensive income:
Unrealized loss on interest rate swap, net of tax	(33,091)	(9,033)	(3,317)
Foreign currency translation gain (loss)	44,672	4,330	(28,836)
Total comprehensive income	443,853	371,698	986,324
Comprehensive income attributable to non-controlling interests	(822)	(1,717)	(1,792)
Comprehensive income attributable to MPT common stockholders (Operating Partnership Partners)	443,031	369,981	984,532
MPT Operating Partnership, L.P. [Member]
Net income	432,272	376,401	1,018,477
Other comprehensive income:
Unrealized loss on interest rate swap, net of tax	(33,091)	(9,033)	(3,317)
Foreign currency translation gain (loss)	44,672	4,330	(28,836)
Total comprehensive income	443,853	371,698	986,324
Comprehensive income attributable to non-controlling interests	(822)	(1,717)	(1,792)
Comprehensive income attributable to MPT common stockholders (Operating Partnership Partners)	$ 443,031	$ 369,981	$ 984,532

Consolidated Statements of Equi

Consolidated Statements of Equity / Capital - USD ($) shares in Thousands, $ in Thousands	Total	MPT Operating Partnership, L.P. [Member]	MPT Operating Partnership, L.P. [Member]General Partner [Member]	Cumulative Effect, Period of Adoption, Adjustment [Member]	Cumulative Effect, Period of Adoption, Adjustment [Member]MPT Operating Partnership, L.P. [Member]	Cumulative Effect, Period of Adoption, Adjustment [Member]MPT Operating Partnership, L.P. [Member]General Partner [Member]	Common Par Value [Member]	Common Par Value [Member]MPT Operating Partnership, L.P. [Member]Limited Partner [Member]	Common Par Value [Member]Cumulative Effect, Period of Adoption, Adjustment [Member]MPT Operating Partnership, L.P. [Member]Limited Partner [Member]	Additional Paid-in Capital [Member]	Retained Earnings (Deficit) [Member]	Retained Earnings (Deficit) [Member]Cumulative Effect, Period of Adoption, Adjustment [Member]	Accumulated Other Comprehensive Loss [Member]	Accumulated Other Comprehensive Loss [Member]MPT Operating Partnership, L.P. [Member]	Treasury Shares [Member]	Non-Controlling Interests [Member]	Non-Controlling Interests [Member]MPT Operating Partnership, L.P. [Member]	Long Term Incentive Plan [Member]MPT Operating Partnership, L.P. [Member]Limited Partner [Member]
Beginning balance at Dec. 31, 2017	$ 3,835,205	$ 3,835,595	$ 38,489		$ 1,938	$ 19	$ 364	$ 3,808,583	$ 1,919	$ 4,333,027	$ (485,932)		$ (26,049)	$ (26,049)	$ (777)	$ 14,572	$ 14,572
Beginning balance (Accounting Standards Update 2016-02) at Dec. 31, 2017				$ 1,938								$ 1,938
Beginning balance (in shares) at Dec. 31, 2017			3,644				364,424	360,780										292
Net income	1,018,477	1,018,477	$ 10,167					$ 1,006,518			1,016,685					1,792	1,792
Unrealized loss on interest rate swap, net of tax	(3,317)	(3,317)											(3,317)	(3,317)
Foreign currency translation gain (loss)	(28,836)	(28,836)											(28,836)	(28,836)
Stock vesting and amortization of stock-based compensation	16,505	16,505	$ 165				$ 1	$ 16,340		16,504
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)			6				599	593
Conversion of LTIP units to common units (shares)								60										(60)
Redemption of MOP units	(816)	(816)						$ (816)		(816)
Redemption of common units (shares)								(60)
Distributions to non-controlling interests, net	(2,534)	(2,534)														(2,534)	(2,534)
Proceeds from offering (net of offering costs)	94,239	94,239	$ 942				$ 6	$ 93,297		94,233
Proceeds from offering (net of offering costs) (shares)			56				5,614	5,558
Dividends (Distributions) declared	(369,923)	(369,923)	$ (3,698)					$ (366,225)			(369,923)
Ending balance at Dec. 31, 2018	4,560,938	4,561,328	$ 46,084				$ 371	$ 4,559,616		4,442,948	162,768		(58,202)	(58,202)	(777)	13,830	13,830
Ending balance (in shares) at Dec. 31, 2018			3,706				370,637	366,931										232
Net income	376,401	376,401	$ 3,746					$ 370,938			374,684					1,717	1,717
Unrealized loss on interest rate swap, net of tax	(9,033)	(9,033)											(9,033)	(9,033)
Foreign currency translation gain (loss)	4,330	4,330											4,330	4,330
Stock vesting and amortization of stock-based compensation	32,188	32,188	$ 322				$ 2	$ 31,866		32,186
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)			15				1,536	1,521
Distributions to non-controlling interests, net	(15,440)	(15,440)														(15,440)	(15,440)
Proceeds from offering (net of offering costs)	2,533,210	2,533,210	$ 25,332				$ 145	$ 2,507,878		2,533,065
Proceeds from offering (net of offering costs) (shares)			1,455				145,349	143,894
Dividends (Distributions) declared	(454,440)	(454,440)	$ (4,545)					$ (449,895)			(454,440)
Ending balance at Dec. 31, 2019	7,028,154	7,028,544	$ 70,939				$ 518	$ 7,020,403		7,008,199	83,012		(62,905)	(62,905)	(777)	107	107
Ending balance (Accounting Standards Update 2016-13) at Dec. 31, 2019				$ (8,399)	$ (8,399)	$ (84)			$ (8,315)			$ (8,399)
Ending balance (in shares) at Dec. 31, 2019			5,176				517,522	512,346										232
Net income	432,272	432,272	$ 4,315					$ 427,135			431,450					822	822
Unrealized loss on interest rate swap, net of tax	(33,091)	(33,091)											(33,091)	(33,091)
Foreign currency translation gain (loss)	44,672	44,672											44,672	44,672
Stock vesting and amortization of stock-based compensation	47,154	47,154	$ 472				$ 2	$ 46,682		47,152
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)			29				2,893	2,864
Sale of non-controlling interests	5,097	5,097														5,097	5,097
Conversion of LTIP units to common units (shares)								232										(232)
Redemption of MOP units	(4,928)	(4,928)						$ (4,928)		(4,928)
Redemption of common units (shares)								(232)
Distributions to non-controlling interests, net	(701)	(701)														(701)	(701)
Proceeds from offering (net of offering costs)	411,101	411,101	$ 4,111				$ 21	$ 406,990		411,080
Proceeds from offering (net of offering costs) (shares)			209				21,004	20,795
Dividends (Distributions) declared	(577,474)	(577,474)	$ (5,776)					$ (571,698)			(577,474)
Ending balance at Dec. 31, 2020	$ 7,343,857	$ 7,344,247	$ 73,977				$ 541	$ 7,316,269		$ 7,461,503	$ (71,411)		$ (51,324)	$ (51,324)	$ (777)	$ 5,325	$ 5,325
Ending balance (in shares) at Dec. 31, 2020			5,414				541,419	536,005

Consolidated Statements of Eq_2

Consolidated Statements of Equity / Capital (Parenthetical) - $ / shares	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
MPT Operating Partnership, L.P. [Member]
Dividends (Distributions) declared per common share / unit	$ 1.08	$ 1.02	$ 1
MPT Operating Partnership, L.P. [Member] | General Partner [Member]
Dividends (Distributions) declared per common share / unit	1.08	1.02	1
Retained Earnings (Deficit) [Member]
Dividends (Distributions) declared per common share / unit	1.08	1.02	1
Common Par Value [Member] | MPT Operating Partnership, L.P. [Member] | Limited Partner [Member]
Dividends (Distributions) declared per common share / unit	$ 1.08	$ 1.02	$ 1

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Operating activities
Net income	$ 432,272	$ 376,401	$ 1,018,477
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	275,953	156,575	141,492
Amortization of deferred financing costs and debt discount	13,099	8,881	7,363
Straight-line rent revenue and other	(226,906)	(138,806)	(100,594)
Share / (Unit)-based compensation expense	47,154	32,188	16,505
Loss (gain) from sale of real estate	2,833	(41,560)	(719,392)
Impairment charges	19,006	21,031	48,007
Straight-line rent and other write-off	26,415	22,447	18,002
Debt refinancing and unutilized financing costs	28,180	6,106
Pre-acquisition rent collected - Circle Transaction	(35,020)
Other adjustments	17,429	(2,271)	(3,768)
Changes in:
Interest and rent receivables	(2,438)	12,906	46,498
Other assets	18,264	(4,992)	(18,051)
Accounts payable and accrued expenses	(18,424)	39,630	(5,596)
Deferred revenue	19,819	5,581	145
Net cash provided by operating activities	617,636	494,117	449,088
Investing activities
Cash paid for acquisitions and other related investments	(4,249,180)	(4,565,594)	(1,430,995)
Net proceeds from sale of real estate	94,177	111,766	1,513,666
Principal received on loans receivable	1,306,187	920	885,917
Investment in loans receivable	(62,651)	(54,088)	(212,002)
Construction in progress and other	(68,350)	(83,798)	(53,967)
Return of equity investment	69,224
Capital additions and other investments, net	(36,180)	(293,163)	(138,441)
Net cash (used for) provided by investing activities	(2,946,773)	(4,883,957)	564,178
Financing activities
Proceeds from term debt, net of discount	2,215,950	3,048,424	759,735
Payments of term debt	(800,000)
Revolving credit facilities, net	162,633	(65,736)	(811,718)
Dividends / Distribution paid	(567,969)	(411,697)	(363,906)
Lease deposits and other obligations to tenants	21,706	(12,260)	(20,606)
Proceeds from sale of common shares, net of offering costs	411,101	2,533,210	94,239
Payment of debt refinancing, deferred financing costs and other financing activities	(42,347)	(50,057)	(3,614)
Net cash provided by (used for) financing activities	1,401,074	5,041,884	(345,870)
(Decrease) increase in cash, cash equivalents, and restricted cash for the year	(928,063)	652,044	667,396
Effect of exchange rate changes	16,441	(6,478)	(17,218)
Cash, cash equivalents, and restricted cash at beginning of year	1,467,991	822,425	172,247
Cash, cash equivalents, and restricted cash at end of year	556,369	1,467,991	822,425
Interest paid, including capitalized interest of $3,030 in 2020, $3,936 in 2019, and $1,480 in 2018	309,920	211,163	221,779
Supplemental schedule of non-cash financing activities:
Dividends declared, unpaid	147,666	138,161	95,419
Cash, cash equivalents, and restricted cash are comprised of the following:
Cash and cash equivalents at beginning of period	1,462,286	820,868	171,472
Restricted cash, included in Other assets at beginning of period	$ 5,705	$ 1,557	$ 775
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	us-gaap:OtherAssets	us-gaap:OtherAssets	us-gaap:OtherAssets
Cash, cash equivalents, and restricted cash at beginning of year	$ 1,467,991	$ 822,425	$ 172,247
Cash and cash equivalents at end of period	549,884	1,462,286	820,868
Restricted cash, included in Other assets at end of period	6,485	$ 5,705	$ 1,557
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]		us-gaap:OtherAssets	us-gaap:OtherAssets
Cash, cash equivalents, and restricted cash at end of year	556,369	$ 1,467,991	$ 822,425
MPT Operating Partnership, L.P. [Member]
Operating activities
Net income	432,272	376,401	1,018,477
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	275,953	156,575	141,492
Amortization of deferred financing costs and debt discount	13,099	8,881	7,363
Straight-line rent revenue and other	(226,906)	(138,806)	(100,594)
Share / (Unit)-based compensation expense	47,154	32,188	16,505
Loss (gain) from sale of real estate	2,833	(41,560)	(719,392)
Impairment charges	19,006	21,031	48,007
Straight-line rent and other write-off	26,415	22,447	18,002
Debt refinancing and unutilized financing costs	28,180	6,106
Pre-acquisition rent collected - Circle Transaction	(35,020)
Other adjustments	17,429	(2,271)	(3,768)
Changes in:
Interest and rent receivables	(2,438)	12,906	46,498
Other assets	18,264	(4,992)	(18,051)
Accounts payable and accrued expenses	(18,424)	39,630	(5,596)
Deferred revenue	19,819	5,581	145
Net cash provided by operating activities	617,636	494,117	449,088
Investing activities
Cash paid for acquisitions and other related investments	(4,249,180)	(4,565,594)	(1,430,995)
Net proceeds from sale of real estate	94,177	111,766	1,513,666
Principal received on loans receivable	1,306,187	920	885,917
Investment in loans receivable	(62,651)	(54,088)	(212,002)
Construction in progress and other	(68,350)	(83,798)	(53,967)
Return of equity investment	69,224
Capital additions and other investments, net	(36,180)	(293,163)	(138,441)
Net cash (used for) provided by investing activities	(2,946,773)	(4,883,957)	564,178
Financing activities
Proceeds from term debt, net of discount	2,215,950	3,048,424	759,735
Payments of term debt	(800,000)
Revolving credit facilities, net	162,633	(65,736)	(811,718)
Dividends / Distribution paid	(567,969)	(411,697)	(363,906)
Lease deposits and other obligations to tenants	21,706	(12,260)	(20,606)
Proceeds from sale of units, net of offering costs	411,101	2,533,210	94,239
Payment of debt refinancing, deferred financing costs and other financing activities	(42,347)	(50,057)	(3,614)
Net cash provided by (used for) financing activities	1,401,074	5,041,884	(345,870)
(Decrease) increase in cash, cash equivalents, and restricted cash for the year	(928,063)	652,044	667,396
Effect of exchange rate changes	16,441	(6,478)	(17,218)
Cash, cash equivalents, and restricted cash at beginning of year	1,467,991	822,425	172,247
Cash, cash equivalents, and restricted cash at end of year	556,369	1,467,991	822,425
Interest paid, including capitalized interest of $3,030 in 2020, $3,936 in 2019, and $1,480 in 2018	309,920	211,163	221,779
Supplemental schedule of non-cash financing activities:
Dividends declared, unpaid	147,666	138,161	95,419
Cash, cash equivalents, and restricted cash are comprised of the following:
Cash and cash equivalents at beginning of period	1,462,286	820,868	171,472
Restricted cash, included in Other assets at beginning of period	$ 5,705	$ 1,557	$ 775
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	us-gaap:OtherAssets	us-gaap:OtherAssets	us-gaap:OtherAssets
Cash, cash equivalents, and restricted cash at beginning of year	$ 1,467,991	$ 822,425	$ 172,247
Cash and cash equivalents at end of period	549,884	1,462,286	820,868
Restricted cash, included in Other assets at end of period	$ 6,485	$ 5,705	$ 1,557
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	us-gaap:OtherAssets	us-gaap:OtherAssets	us-gaap:OtherAssets
Cash, cash equivalents, and restricted cash at end of year	$ 556,369	$ 1,467,991	$ 822,425

Consolidated Statements of Ca_2

Consolidated Statements of Cash Flows (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Interest paid, capitalized	$ 3,030	$ 3,936	$ 1,480
MPT Operating Partnership, L.P. [Member]
Interest paid, capitalized	$ 3,030	$ 3,936	$ 1,480

Organization

Organization	12 Months Ended
	Dec. 31, 2020
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Organization	1. Organization Medical Properties Trust, Inc., a Maryland corporation, was formed on August 27, 2003, under the Maryland General Corporation Law for the purpose of engaging in the business of investing in, owning, and leasing healthcare real estate. Our operating partnership subsidiary, MPT Operating Partnership, L.P., (the “Operating Partnership”) through which we conduct all of our operations, was formed in September 2003. Through another wholly-owned subsidiary, Medical Properties Trust, LLC, we are the sole general partner of the Operating Partnership. At present, we directly own all of the limited partnership interests in the Operating Partnership and have elected to report our required disclosures and that of the Operating Partnership on a combined basis, except where material differences exist. We have operated as a real estate investment trust (“REIT”) since April 6, 2004, and accordingly, elected REIT status upon the filing in September 2005 of the calendar year 2004 federal income tax return. Accordingly, we will generally not be subject to United States (“U.S.”) federal income tax, provided that we continue to qualify as a REIT and our distributions to our stockholders equal or exceed our taxable income. Certain non-real estate activities we undertake are conducted by entities which we elected to be treated as taxable REIT subsidiaries (“TRS”). Our TRS entities are subject to both U.S. federal and state income taxes. For our properties located outside the U.S., we are subject to the local taxes of the jurisdictions where our properties reside and/or legal entities are domiciled; however, we do not expect to incur substantial additional taxes 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, inpatient physical rehabilitation hospitals, long-term acute care hospitals, freestanding ER/urgent care facilities, and behavioral health facilities. We also make mortgage and other loans to operators of similar facilities. In addition, we may obtain profits or equity interests in our tenants, from time-to-time, in order to enhance our overall return. Our business model facilitates acquisitions and recapitalizations, and allows operators of healthcare facilities to unlock the value of their real estate to fund facility improvements, technology upgrades, and other investments in operations. At December 31, 2020, we have investments in 392 facilities in 33 states in the U.S., in six countries in Europe, one country in South America, and across Australia. We manage our business as a single business segment.

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2020
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Use of Estimates: The preparation of our consolidated financial statements in conformity with accounting principles generally accepted in the U.S. requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. During 2020, the global outbreak of a novel coronavirus, or COVID-19, spread all over the world including countries where we own and lease facilities. The World Health Organization designated COVID-19 as a pandemic, and numerous countries, including the U.S., declared national emergencies with respect to COVID-19. As the global impact of the outbreak evolved, many countries reacted by instituting quarantines and restrictions on travel, closing financial markets and/or restricting trade- including requiring medically necessary elective surgeries at hospitals to be deferred. Although hospitals are back accepting patients and performing medically necessary elective surgeries, many of these trade restrictions are still in place. We believe the estimates and assumptions underlying our consolidated financial statements are reasonable and supportable based on the information available as of December 31, 2020 (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). However, the ultimate impact to our tenants’ results of operations and liquidity and their ability to pay our rent and interest due to the impact of COVID-19 cannot be predicted with 100% confidence, particularly given the full scope, severity, and duration of the pandemic and the actions needed (including vaccine rollouts worldwide) to contain the pandemic or mitigate its impact is uncertain. This makes any estimates and assumptions as of December 31, 2020 inherently less certain than they would be absent the potential impact of COVID-19. Actual results could differ from those estimates. Principles of Consolidation: Property holding entities and other subsidiaries of which we own 100% of the equity or have a controlling financial interest evidenced by ownership of a majority voting interest are consolidated. All inter-company balances and transactions are eliminated. For entities in which we own less than 100% of the equity interest, we consolidate the property if we have the direct or indirect ability to control the entities’ activities based upon the terms of the respective entities’ ownership agreements. For these entities, we record a non-controlling interest representing equity held by non-controlling interests. We continually evaluate all of our transactions and investments to determine if they represent variable interests in a variable interest entity. If we determine that we have a variable interest in a variable interest entity, we then evaluate if we are the primary beneficiary of the variable interest entity. The evaluation is a qualitative assessment as to whether we have the ability to direct the activities of a variable interest entity that most significantly impact the entity’s economic performance. We consolidate each variable interest entity in which we, by virtue of or transactions with our investments in the entity, are considered to be the primary beneficiary. At December 31, 2020, we had loans and/or equity investments in certain variable interest entities approximating $230 million, which represents our maximum exposure to loss as a result of our involvement in such entities. We have determined that we were not the primary beneficiary of any variable interest entity in which we hold a variable interest because we do not control the activities (such as the day-to-day operations) that most significantly impact the economic performance of these entities. Investments in Unconsolidated Entities: Investments in entities in which we have the ability to significantly influence (but not control) are accounted for by the equity method, such as our joint venture with Primotop Holdings S.à.r.l. (“Primotop”) as discussed in Note 3 . Under the equity method of accounting, our share of the investee’s earnings or losses are included in the “Earnings from equity interests” line of our consolidated statements of net income. Except for our joint venture with Primotop, we have elected to record our share of such investee’s earnings or losses on a lag basis. The initial carrying value of investments in unconsolidated entities is based on the amount paid to purchase the interest in the investee entity. Subsequently, our investments are increased/decreased by our share in the investees’ earnings/losses and decreased by cash distributions from our investees. To the extent that our cost basis is different from the basis reflected at the investee entity level, the basis difference is generally amortized over the lives of the related assets and liabilities, and such amortization is included in our share of equity in earnings of the investee. We evaluate our equity method investments for impairment based upon a comparison of the fair value of the equity method investment to its carrying value, when impairment indicators exist. If we determine a decline in the fair value of an investment in an unconsolidated investee entity below its carrying value is 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 investments in Steward Health Care System LLC (“Steward”) and Median Kliniken S.á.r.l. (“MEDIAN”)) are accounted for at cost, less any impairment, plus or minus changes resulting from observable price changes in orderly transactions involving the investee. Any cash distributions on these types of investments are recorded to income upon receipt. 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. On January 1, 2019, we adopted Accounting Standards Update (“ASU”) 2016-02, “Leases”, (“ASU 2016-02”). ASU 2016-02 sets out the principles for the recognition, measurement, presentation, and disclosure of leases for both parties to a contract (i.e. lessees and lessors). We adopted this standard using the modified retrospective approach and elected the package of practical expedients permitted under the transition guidance within the new standard, which among other things permitted the following: no reassessment of whether existing contracts were or contained a lease and no reassessment of lease classification for existing leases. In addition, we made certain elections permitted which (1) allowed entities to apply the transition provisions of the new standard at its adoption date instead of at the earliest comparative period presented and (2) permitted lessors to account for lease and non-lease components as a single lease component in a contract if certain criteria were met. For lessors, this new standard of accounting for leases was substantially equivalent to previous guidance, but there were some differences which we highlight below: Operating Lease Revenue We receive income from operating leases based on the fixed required rents (base rents) per the lease agreements. Rent revenue from base rents is recorded on the straight-line method over the terms of the related lease agreements for new leases and the remaining terms of existing leases for those acquired as part of a property acquisition. The straight-line method records the periodic average amount of base rents earned over the term of a lease, taking into account contractual rent increases over the lease term. The straight-line method typically has the effect of recording more rent revenue from a lease than a tenant is required to pay early in the term of the lease. During the later parts of a lease term, this effect reverses with less rent revenue recorded than a tenant is required to pay. Rent revenue, as recorded on the straight-line method, in the 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 the lease accounting rules adopted on January 1, 2019, if an acquisition and subsequent lease of a property to the seller does not meet the definition of a sale, we must account for the transaction as a financing with income recognized using the imputed interest method. Another type of financing lease that we carried forward from the previous lease accounting guidance is a direct financing lease (“DFL”). For leases accounted for as DFLs, the future minimum lease payments are recorded as a receivable. The difference between the future minimum lease payments and the estimated residual values less the cost of the properties is recorded as unearned income. Unearned income is deferred and amortized to income over the lease terms to provide a constant yield when collectability of the lease payments is reasonably assured. Investments in DFLs are presented net of unearned income. Other Leasing Revenue We begin recording base rent income from our development projects when the lessee takes physical possession of the facility, which may be different from the stated start date of the lease. Also, during construction of our development projects, we may be entitled to accrue rent based on the cost paid during the construction period (construction period rent). We accrue construction period rent as a receivable with a corresponding offset to deferred revenue during the construction period. When the lessee takes physical possession of the facility, we begin recognizing the deferred construction period revenue on the straight-line method over the term of the lease. We also receive additional rent (contingent rent) under some leases based on increases in the consumer price index (“CPI”) (or similar index outside the U.S.) or when CPI exceeds the annual minimum percentage increase as stipulated in the lease. Contingent rents are recorded as rent billed revenue in the period earned. Starting January 1, 2019 (with the adoption of ASU 2016-02), tenant payments for ground leases along with other operating expenses, such as property taxes and insurance, that are paid directly by us and reimbursed by our tenants are presented on a gross basis with the related revenues recorded in “Interest and other income” and the related expenses in “Property-related” in our consolidated statements of net income. All payments of other operating expenses made directly by the tenant to the applicable government or appropriate third-party vendor are recorded on a net basis, consistent with how all tenant payments or reimbursements pursuant to our “triple-net” leases were accounted for prior to the adoption of ASU 2016-02. Interest Revenue We receive interest income from our tenants/borrowers on mortgage loans, working capital loans, and other long-term loans. Interest income from these loans is recognized as earned based upon the principal outstanding and terms of the loans. Other Revenue Commitment fees received from lessees for development and leasing services are initially recorded as deferred revenue and recognized as income over the initial term of a lease to produce a constant effective yield on the lease (interest method). Commitment and origination fees from lending services are also recorded as deferred revenue initially and recognized as income over the life of the loan using the interest method. Acquired Real Estate Purchase Price Allocation: 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 fair values. In making estimates of fair values for purposes of allocating purchase prices of acquired real estate, we may utilize a number of sources, from time-to-time, including available real estate broker data, independent appraisals that may be obtained in connection with the acquisition, internal data from previous acquisitions or developments, and other market data, including market comparables for significant assumptions such as market rental, capitalization, and discount rates. We also consider information obtained about each property as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the tangible and intangible assets acquired. We measure the aggregate value of lease intangible assets acquired based on the difference between (i) the property valued with new or in-place leases adjusted to market rental rates and (ii) the property valued as if vacant. Management’s estimates of value are made using methods similar to those used by independent appraisers (e.g., discounted cash flow analysis). Factors considered by management in our analysis include an estimate of carrying costs during hypothetical expected lease-up periods, considering current market conditions, and costs to execute similar leases. We also consider information obtained about each targeted facility as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the intangible assets acquired. In estimating carrying costs, management includes real estate taxes, insurance , and other operating expenses and estimates of lost rentals at market rates during the expected lease-up periods, which we expect to be about six months , but can be longer depending on specific local market conditions. Management also estimates costs to execute similar leases including leasing commissions, legal costs, and other related expenses to the extent that such costs are not already incurred in connection with a new lease origination as part of the transaction. Other intangible assets acquired may include customer relationship intangible values which are based on management’s evaluation of the specific characteristics of each prospective tenant’s lease and our overall relationship with that tenant. Characteristics to be considered by management in allocating these values include the nature and extent of our existing business relationships with the tenant, growth prospects for developing new business with the tenant, the tenant’s credit quality, and expectations of lease renewals, including those existing under the terms of the lease agreement, among other factors. We amortize the value of our lease intangible assets to expense over the term of the respective leases. If a lease is terminated early, the unamortized portion of the lease intangibles are charged to expense. We record above-market and below-market in-place lease values, if any, for our facilities, which are based on the present value of the difference between (i) the contractual amounts to be paid pursuant to the in-place leases and (ii) management’s estimate of fair market lease rates for the corresponding in-place leases, measured over a period equal to the remaining non-cancelable term of the lease. We amortize any resulting capitalized above-market lease values as a reduction of rental income over the lease term. We amortize any resulting capitalized below-market lease values as an increase to rental income over the lease term. If a lease is terminated early, the unamortized portion of the capitalized above/below market lease value is recognized in rental income at that time. Real Estate and Depreciation: Real estate, consisting of land, buildings and improvements, are maintained at cost. Although typically paid by our tenants, any expenditure for ordinary maintenance and repairs that we pay are expensed to operations as incurred. Significant renovations and improvements which improve and/or extend the useful life of the asset are capitalized and depreciated over their estimated useful lives. We record impairment losses on long-lived assets used in operations when events and circumstances indicate that the assets might be impaired and the undiscounted cash flows estimated to be generated by those assets, including an estimated liquidation amount, during the expected holding periods are less than the carrying amounts of those assets. Impairment losses are measured as the difference between carrying value and fair value of the assets. For assets held for sale, we cease recording depreciation expense and adjust the assets’ value to the lower of its carrying value or fair value, less cost of disposal. Fair value is based on estimated cash flows discounted at a risk-adjusted rate of interest. We classify real estate assets as held for sale when we have commenced an active program to sell the assets, and in the opinion of management, it is probable the asset will be sold within the next 12 months. Construction in progress includes the cost of land, the cost of construction of buildings, improvements, and fixed equipment, and costs for design and engineering. Other costs, such as interest, legal, property taxes, and corporate project supervision, which can be directly associated with the project during construction, are also included in construction in progress. We commence capitalization of costs associated with a development project when the development of the future asset is probable and activities necessary to get the underlying property ready for its intended use have been initiated. We stop the capitalization of costs when the property is substantially complete and ready for its intended use. Depreciation is calculated on the straight-line method over the estimated useful lives of the related real estate and other assets. Our weighted-average useful lives at December 31, 2020 are as follows: Buildings and improvements 39.0 years Lease intangibles 26.1 years Leasehold improvements 17.0 years Furniture, equipment, and other 9.8 years Credit Losses: Losses from Rent Receivables: Losses from Operating Lease Receivables: 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: With the adoption of ASU 2016-13, we made the accounting policy election to exclude interest receivables from the credit loss reserve analysis. Such receivables are impaired and an allowance recorded when it is deemed probable that we will be unable to collect all amounts due. Like operating lease receivables, the need for an allowance is based upon our assessment of the lessee’s overall financial condition, economic resources and payment record, the prospects for support from any financially responsible guarantors, and, if appropriate, the realizable value of any collateral. Financing leases are placed on non-accrual status when we determine that the collectability of contractual amounts is not reasonably assured. If on non-accrual status, we generally account for the financing lease on a cash basis, in which income is recognized only upon receipt of cash. Loans Upon adoption of ASU 2016-13, we recorded a credit loss reserve of $8.4 million with the effect recorded in equity as a cumulative effect of a change in accounting principle. 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 a TRS, MPT Development Services, Inc. (“MDS”), and with many other entities, which are single member LLCs that are disregarded for tax purposes and are reflected in the tax returns of MDS. MDS is not entitled to a dividends paid deduction and is subject to U.S. federal, state, and local income taxes. MDS is authorized to provide property development, leasing, and management services for third-party owned properties, and we will make non-mortgage loans to and/or investments in our lessees through this entity . With the property acquisitions and investments in Europe, Australia, and South America, we are subject to income taxes internationally. However, we do not expect to incur any additional income taxes in the U.S. as such income from our international properties flows through our REIT income tax returns. For our TRS and international subsidiaries, we determine deferred tax assets and liabilities based on the differences between the financial reporting and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Any increase or decrease in our deferred tax assets/liabilities that results from a change in circumstances and that causes us to change our judgment about expected future tax consequences of events, is reflected in our tax provision when such changes occur. Deferred income taxes also reflect the impact of operating loss carryforwards. A valuation allowance is provided if we believe it is more likely than not that all or some portion of our deferred tax assets will not be realized. Any increase or decrease in the valuation allowance that results from a change in circumstances, and that causes us to change our judgment about our ability to realize the related deferred tax asset, is reflected in our tax provision when such changes occur. The calculation of our income taxes involves dealing with uncertainties in the application of complex tax laws and regulations in a multitude of jurisdictions across our global operations. An income tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, on the basis of technical merits. However, if a more likely than not position cannot be reached, we record a liability as an offset to the tax benefit and adjust the liabilities when our judgment changes as a result of the evaluation of new information not previously available. Because of the complexity of some of these uncertainties, the ultimate resolution may result in a payment that is materially different from our current estimate of the uncertain tax position liabilities. These differences will be reflected as increases or decreases to income tax expense in the period in which new information is available. Stock-Based Compensation: We adopted the 2019 Equity Incentive Plan (the “Equity Incentive Plan”) during the second quarter of 2019. Awards of restricted stock and other equity-based awards with service conditions are valued at the average stock price per share on the date of grant and are amortized to compensation expense over the service periods (typically three years), using the straight-line method. Awards that contain market conditions are valued on the grant date using a Monte Carlo valuation model and are amortized to compensation expense over the derived service periods, which correspond to the periods over which we estimate the awards will be earned, which generally range from three to five years, using the straight-line method. Awards with performance conditions are valued at the average stock price per share on the date of grant and are amortized using the straight-line method over the service period, adjusted for the probability of achieving the performance conditions. Forfeitures of stock-based awards are recognized as they occur. Deferred Costs: Costs incurred that directly relate to the offerings of stock are deferred and netted against proceeds received from the offering. Leasing commissions and other leasing costs that would not have been incurred if the lease was not obtained are capitalized as deferred leasing costs and amortized on the straight-line method over the terms of the related lease agreements. Costs identifiable with loans made to borrowers are capitalized and recognized as a reduction in interest income over the life of the loan. Deferred Financing Costs: We generally capitalize financing costs incurred in connection with new financings and refinancings of debt. These costs are amortized over the lives of the related debt as an addition to interest expense. For debt with defined principal re-payment terms, the deferred costs are amortized to produce a constant effective yield on the debt (interest method) and are included within “Debt, net” on our consolidated balance sheets. For debt without defined principal repayment terms, such as our revolving credit facility, the deferred costs are amortized on the straight-line method over the term of the debt and are included as a component of “Other 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 on our consolidated balance sheets. Certain of our U.S. subsidiaries will enter into short-term and long-term transactions denominated in a foreign currency from time-to-time. Gains or losses resulting from these foreign currency transactions are revalued into U.S. dollars at the rates of exchange prevailing at the dates of the transactions. The effects of revaluation gains or losses on our short-term transactions are included in other income in the consolidated statements of income, while the revaluation effects on our long-term investments are recorded in “Accumulated other comprehensive income (loss)” on our consolidated balance sheets. Derivative Financial Investments and Hedging Activities: During our normal course of business, we may use certain types of derivative instruments for the purpose of managing interest rate and/or foreign currency risk. We record our derivative and hedging instruments at fair value on the balance sheet. Changes in the estimated fair value of derivative instruments that are not designated as hedges or that do not meet the criteria for hedge accounting are recognized in earnings. For derivatives designated as cash flow hedges, the change in the estimated fair value of the effective portion of the derivative is recognized in “A ccumulated 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 por tion is recognized in earnings . To qualify for hedge accounting, we formally document all relationships between hedging instruments and hedged items, as well as our risk management objective and strategy for undertaking the hedge prior to entering into a derivative transaction. This process includes specific identification of the hedging instrument and the hedge transaction, the nature of the risk being hedged and how the hedging instrument’s effectiveness in hedging the exposure to the hedged transaction’s variability in cash flows attributable to the hedged risk will be assessed. Both at the inception of the hedge and on an ongoing basis, we assess whether the derivatives that are used in hedging transactions are highly effective in offsetting changes in cash flows or fair values of hedged items. In addition, for cash flow hedges, we assess whether the underlying forecasted transaction will occur. We discontinue hedge accounting if a derivative is not determined to be highly effective as a hedge or that it is probable that the underlying forecasted transaction will not occur. Fair Value Measurement: We measure and disclose the estimated fair value of financial assets and liabilities utilizing a hierarchy of valuation techniques based on whether the inputs to a fair value measurement are considered to be observable or unobservable in a marketplace. Observable inputs reflect market data obtained from independent sources, while unobservable inputs reflect our market assumptions. This hierarchy requires the use of observable market data when available. These inputs have created the following fair value hierarchy: • Level 1 — quoted prices for identical instruments in active markets; • Level 2 — quoted prices for similar instruments in active markets; quoted prices for identical or similar instruments in markets that are not active; and model-derived valuations in which significant inputs and significant value drivers are observable in active markets; and • Level 3 — fair value measurements derived from valuation techniques in which one or more significant inputs or significant value drivers are unobservable . We measure fair value using a set of standardized procedures that are outlined herein for all assets and liabilities which are required to be measured at their estimated fair value on either a recurring or non-recurring basis. When available, we utilize quoted market prices from an independent third party source to determine fair value and classify such items in Level 1. In some instances where a market price is availab

Real Estate Activities

Real Estate Activities	12 Months Ended
	Dec. 31, 2020
Real Estate [Abstract]
Real Estate Activities	3. Real Estate Activities New Investments For the years ended December 31, 2020, 2019, and 2018, we acquired or invested in the following net assets (in thousands): 2020 2019 2018 Land and land improvements $ 365,281 $ 400,539 $ 71,880 Buildings 2,547,313 1,951,066 686,739 Intangible lease assets — subject to amortization (weighted-average useful life of 27.5 years in 2020, 19.1 years in 2019, and 27.9 years in 2018) 642,699 227,468 90,651 Investment in financing leases 114,797 1,386,797 — Equity investments 233,593 415,836 245,267 Mortgage loans 176,840 51,267 — Other loans and assets 309,523 135,258 336,458 Liabilities assumed (140,866 ) (2,637 ) — Total assets acquired $ 4,249,180 $ 4,565,594 $ 1,430,995 Loans repaid(1) (834,743 ) — (764,447 ) Total net assets acquired $ 3,414,437 $ 4,565,594 $ 666,548 (1) The 2020 column includes approximately $750 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. The 2018 column includes $0.8 billion of loans advanced to Steward in 2016 and repaid in 2018 as part of sale leaseback conversion described below. 2020 Activity Circle Transaction On January 8, 2020, we acquired a portfolio of 30 acute care hospitals located throughout the United Kingdom for a net purchase price of approximately £1.5 billion from affiliates of BMI Healthcare, Inc. (“BMI”), as part of a share purchase in which we also inherited certain deferred income tax liabilities and £27.6 million of unearned rent revenue. In a related transaction, affiliates of Circle Health Ltd. (“Circle”) entered into definitive agreements to acquire BMI and assume operations of its 52 facilities 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. Once final regulatory approval was received in the 2020 second quarter, these 30 leases with Circle were amended (effective June 16, 2020) to include two five-year Other Transactions On December 31, 2020, we acquired an inpatient rehabilitation hospital in South Carolina for approximately $17 million. As part of the transaction, we acquired the fee simple real estate of three inpatient rehabilitation hospitals and one long-term acute care hospital in exchange for the reduction of the mortgage loans made to Ernest for such properties in 2012. The approximate $115 million investment in all five of these facilities is leased to Ernest pursuant to an existing long-term master lease that has an initial term ending in December 2037 with multiple extension options and annual escalation provisions. On December 29, 2020, we increased our equity ownership and related investment in Infracore SA (“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 November 17, 2020, we invested in the real estate of three general acute care hospitals in Colombia for approximately $135 million. These properties will be operated by the new international joint venture discussed below. 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 an existing long-term master lease, which we extended its initial fixed term to August 2035 in connection with this transaction, 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 now subject to the Steward master lease that has an initial fixed term ending in October 2031 with multiple extension options and annual escalation provisions. 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. 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.à.r.l. (“MEDIAN”) pursuant to the existing master lease. One of the general acute care facilities, located in Darlington, United Kingdom, was acquired on August 7, 2020 for £29.4 million and is leased to Circle pursuant to a long-term lease. The other general acute care hospital, located in London, United Kingdom, was acquired on November 25, 2020 for £50 million via the purchase of a 999-year ground lease and is leased to The Royal Marsden NHS Foundation Trust pursuant to a long-term lease. The inpatient rehabilitation hospitals, one in Texas and one in Indiana, were acquired on December 17, 2020 for approximately $58 million and are leased to Curahealth Hospitals pursuant to a long-term lease. The private acute care hospital, located in Reading, United Kingdom, was acquired on December 18, 2020 for £85.0 million and is leased to Circle pursuant to the existing long-term Circle master lease. 2019 Activity LifePoint Acquisition On December 17, 2019, we acquired a portfolio of 10 acute care hospitals owned and operated by LifePoint Health, Inc. (“LifePoint”) for a combined purchase price of approximately $700.0 million. The properties are leased to LifePoint under one master lease agreement. The master lease had a 20-year initial term and two five-year Prospect Transaction On August 23, 2019, we invested in a portfolio of 14 acute care hospitals and two behavioral health facilities operated by Prospect Medical Holdings, Inc. (“Prospect”) for a combined purchase price of approximately $1.55 billion. Our investment included the acquisition of the real estate of 11 acute care hospitals and two behavioral health facilities for $1.4 billion. We are accounting for these properties as a financing (as presented in the “Investment in financing leases” line of the consolidated balance sheets) under lease accounting rules due to certain lessee end-of-term purchase options. In addition, we originated a $51.3 million mortgage loan, secured by a first mortgage on an acute care hospital, and a $112.9 million term loan which we expect will be converted into the acquisition of two additional acute care hospitals upon the satisfaction of certain conditions. The master leases and mortgage loan have substantially similar terms, with a 15-year fixed term subject to three extension options, plus annual inflation-based escalators. The agreements provide for the potential for a future purchase price adjustment of up to an additional $250.0 million, based on achievement of certain performance thresholds over a three-year Ramsay Acquisition On August 16, 2019, we acquired freehold interests in eight acute care hospitals located throughout England for an aggregate purchase price of approximately £347 million. The hospitals are leased to Ramsay pursuant to in-place net leases with remaining lease terms ending in 2037 and include annual fixed and periodic market-based escalations. Australia Transaction On June 6, 2019, we acquired 11 hospitals in Australia for a purchase price of approximately A$1.2 billion plus stamp duties and registration fees of A$66.6 million. The properties are leased to Healthscope, pursuant to master lease agreements that had an average initial term of 20 years, upon our acquisition, with annual fixed escalations and multiple extension options. Healthscope was acquired in a simultaneous transaction by Brookfield Business Partners L.P. and certain of its institutional partners. Switzerland Transactions On May 27, 2019, we invested in a portfolio of 13 acute care campuses and two additional properties in Switzerland for an aggregate purchase price of approximately CHF 236.6 million. The investment (which we account for under the equity method) was effected through our purchase of a stake in a Swiss healthcare real estate company, Infracore, from the previous majority shareholder, Aevis Victoria SA (“Aevis”). The facilities are leased to Swiss Medical Network, a wholly-owned Aevis subsidiary, pursuant to leases that had an average 23-year remaining term upon our acquisition and are subject to annual escalation provisions. Additionally, we purchased a 4.9% stake in Aevis for approximately CHF 47 million on June 28, 2019 that we are marking to fair value through income. Other Transactions On December 3, 2019, we invested in two acute care hospitals in Spain for a purchase price of approximately €117.3 million. The investment was effected through our purchase of a 45% stake in a Spanish entity. The facilities are leased to HM Hospitales pursuant to a master lease that had an initial lease term of 25 years upon our investment. The lease provides for annual inflation-based escalators. We are accounting for our 45% interest in this joint venture under the equity method. On November 28, 2019, we acquired an acute care hospital in Portugal for approximately €28.2 On August 30, 2019, we invested in a portfolio of facilities throughout various states for approximately $254 million. The properties are leased to Vibra Healthcare, LLC (“Vibra”) five-year On June 10, 2019, we acquired seven community hospitals in Kansas for approximately $145.4 million. The properties are leased to an affiliate of Saint Luke’s Health System (“SLHS”) pursuant to seven individual in-place leases that had an average remaining lease term of 14 years upon our acquisition. The leases provide for fixed escalations every five years and include two five-year Other acquisitions during 2019 included three acute care hospitals and one inpatient rehabilitation second third 2018 Activity Joint Venture Transaction On August 31, 2018, we completed a joint venture arrangement with Primotop pursuant to which we contributed 71 of our post-acute hospitals in Germany, with an aggregate fair value of €1.635 billion, for a 50% interest, while Primotop contributed cash for its 50% interest in the joint venture. As part of the transaction, we received an aggregate amount of approximately €1.14 billion, from the proceeds of the cash contributed by Primotop and the secured debt financing placed on the joint venture’s real estate, and we recognized an approximate €500 million gain on sale. At inception, our interest in the joint venture was made up of a 50% equity investment valued at approximately €210 million, which is being accounted for under the equity method of accounting, and a €290 million shareholder loan (with terms identical to Primotop’s shareholder loan). Other Transactions On August 31, 2018, we acquired an acute care facility in Pasco, Washington for $17.5 million. The property is leased to LifePoint, pursuant to the existing long-term master lease. On August 28, 2018, we acquired three inpatient rehabilitation hospitals in Germany for €17.3 million (including real estate transfer taxes). Upon acquisition, the properties were leased to MEDIAN, pursuant to a 27-year master lease with annual inflation-based escalators. During 2018, we acquired the fee simple real estate of five general acute care hospitals, four of which are located in Massachusetts and one located in Texas, from Steward in exchange for the reduction of $764.4 million of mortgage loans made to Steward in October 2016 and March 2018, along with additional cash consideration. These properties are being leased to Steward pursuant to the original master lease from October 2016. Development Activities 2020 Activity On November 23, 2020, we agreed to finance the development of and lease an inpatient rehabilitation facility in Stockton, California for $47.7 million. This facility will be leased to Ernest and is expected to commence rent in the first quarter of 2022. On May 15, 2020, we agreed to finance the development of and lease an inpatient rehabilitation facility in Bakersfield, California for $47.9 million. This facility will be leased to Ernest and is expected to commence rent in the fourth quarter of 2021. During the 2020 second quarter, we completed construction on one general acute care facility and one inpatient rehabilitation facility, both located in Birmingham, England. We began recognizing revenue on these two properties on June 29, 2020. These facilities are leased to Circle pursuant to a long-term lease. During the 2020 first quarter, we completed construction and began recording rental income on a general acute care facility located in Idaho Falls, Idaho. This facility commenced rent on January 21, 2020 and is leased to Surgery Partners, Inc. pursuant to an existing long-term lease. 2019 Activity On October 25, 2019, we entered into an agreement to finance the development of and lease a behavioral hospital in Houston, Texas, for $27.5 million. This facility commenced rent on December 18, 2020 and is leased to NeuroPsychiatric Hospitals pursuant to a long-term lease. 2018 Activity During the year ended December 31, 2018, we completed the construction of Ernest Flagstaff. This $25.5 million inpatient rehabilitation facility located in Flagstaff, Arizona opened on March 1, 2018 and is being leased to Ernest pursuant to a master lease that was amended in 2020 to extend its initial fixed term to 2037. This lease has annual escalation provisions and multiple extension options. See table below for a status summary of our current development projects (in thousands): Property Commitment Costs Incurred as of December 31, 2020 Estimated Rent Commencement Date Ernest (Bakersfield, California) $ 47,929 $ 19,034 4Q 2021 Ernest (Stockton, California) 47,700 11,105 1Q 2022 $ 95,629 $ 30,139 Disposals 2020 Activity During 2020, we completed the sale of nine facilities and six ancillary properties for approximately $94 million. The transactions resulted in a net loss of $2.8 million. 2019 Activity During 2019, we completed the sale of five facilities resulting in a gain on real estate of $41.6 million. 2018 Activity On October 4, 2018, we finalized a recapitalization agreement in which we sold our investment in the operations of Ernest and were repaid for our outstanding acquisition loans, working capital loans, and any unpaid interest. Total proceeds received from this transaction approximated $176 million. We retained ownership of the real estate and secured mortgage loans of our Ernest properties. On August 31, 2018, we completed the previously described joint venture arrangement with Primotop, in which we contributed the real estate of 71 of our post-acute hospitals in Germany, with a fair value of approximately €1.635 billion, resulting in a gain of approximately €500 million. See “New Investments” in this Note 3 for further details on this transaction On August 31, 2018, we sold a On June 4, 2018, we sold three long-term acute care hospitals located in California, Texas, and Oregon, that were leased and operated by Vibra, which included our equity investment in operations of the Texas facility. Total proceeds from the transaction were $53.3 million in cash, a mortgage loan in the amount of $18.3 million, and a $1.5 million working capital loan. The transaction resulted in a gain on real estate of $24.2 million, which was partially offset by a $5.1 million non-cash charge to revenue to write-off related straight-line rent receivables. On March 1, 2018, we sold the real estate of St. Joseph Medical Center in Houston, Texas, for approximately $148 million to Steward. In return, we received a mortgage loan equal to the purchase price, with such loan secured by the underlying real estate. This transaction resulted in a gain of $1.5 million, offset by a $1.7 million non-cash charge to revenue to write-off related straight-line rent receivables on this property. Summary of Operations for Disposed Assets in 2018 The following represents the operating results (excluding the St. Joseph sale in March 2018) of the properties sold in 2018 for the periods presented (in thousands): For the Year Ended 2018 Revenues $ 88,838 Real estate depreciation and amortization (15,849 ) Property-related expenses (531 ) Other(1) 709,717 Income from real estate dispositions, net $ 782,175 (1) Includes approximately $720 million of gains on sale for the twelve months ended December 31, 2018. Intangible Assets At December 31, 2020 and 2019, our intangible lease assets were $1.3 billion ($1.2 billion, net of accumulated amortization) and $622.1 million ($556.7 million, net of accumulated amortization), respectively. We recorded amortization expense related to intangible lease assets of $42.4 million, $21.5 million, and $17.6 million in 2020, 2019, and 2018, respectively, and expect to recognize amortization expense from existing lease intangible assets as follows (amounts in thousands): For the Year Ended December 31: 2021 $ 44,286 2022 44,272 2023 44,206 2024 44,173 2025 44,025 As of December 31, 2020, capitalized lease intangibles have a weighted-average remaining life of 21.3 years. Leasing Operations (Lessor) We acquire and develop healthcare facilities and lease the facilities to healthcare operating companies under long-term net leases (typical initial fixed terms of 15 years) and most include renewal options at the election of our tenants, generally in five year increments. Approximately 99% of our leases provide annual rent escalations based on increases in the CPI (or similar index outside the U.S.) and/or fixed minimum annual rent escalations ranging from 0.5% to 3.0%. Many of our domestic leases contain purchase options with pricing set at various terms but in no case less than our total investment. For five properties with a carrying value of $229 million, our leases require a residual value guarantee from the tenant. Our leases typically require the tenant to handle and bear most of the costs associated with our properties including repair/maintenance, property taxes, and insurance. We routinely inspect our properties to ensure the residual value of each of our assets is being maintained. Except for leases classified as financing leases as noted below, all of our leases are classified as operating leases. The following table summarizes total future minimum lease payments to be received, excluding operating expense reimbursements, from tenants under noncancelable leases as of December 31, 2020 (amounts in thousands): Total Under Operating Leases Total Under Financing Leases Total 2021 $ 858,067 $ 160,925 $ 1,018,992 2022 875,350 164,144 1,039,494 2023 890,761 167,427 1,058,188 2024 905,176 170,775 1,075,951 2025 919,984 174,191 1,094,175 Thereafter 22,102,425 4,593,755 26,696,180 $ 26,551,763 $ 5,431,217 $ 31,982,980 At December 31, 2020, leases on 13 Ernest facilities and five Prime facilities are accounted for as DFLs and leases on 13 of our Prospect facilities and five of our Ernest facilities are accounted for as a financing. The components of our total investment in financing leases consisted of the following (in thousands): As of December 31, 2020 As of December 31, 2019 Minimum lease payments receivable $ 1,228,966 $ 1,884,921 Estimated residual values 203,818 394,195 Less: Unearned income and allowance for credit loss (969,061 ) (1,618,252 ) Net investment in direct financing leases 463,723 660,864 Other financing leases (net of allowance for credit loss) 1,547,199 1,399,438 Total investment in financing leases $ 2,010,922 $ 2,060,302 Rent Deferrals Due to the COVID-19 pandemic and its impact on our tenants’ business during 2020, we agreed to defer collection on less than 2% of our annual rent. The amount of this deferral, net of subsequent collections, is approximately $11.4 million as of December 31, 2020. Pursuant to our agreements with the tenants, we expect such deferred rent to be paid over specified periods in the future, with interest. Adeptus Health As discussed in previous filings, our original real estate portfolio of approximately 60 properties leased to Adeptus Health, Inc. (“Adeptus”) has gone through significant changes starting with Adeptus filing for Chapter 11 bankruptcy in 2017. With this filing and other subsequent events (including COVID-19 implications in 2020), we have transitioned all of the facilities away from Adeptus. These transition measures have resulted in impairment charges including approximately $20 million (of which one-half Alecto Facilities As noted in previous filings, we originally leased four acute care facilities and had a mortgage loan on a fifth property (Olympia Medical Center) to Alecto Healthcare Services LLC (“Alecto”). During 2018 and 2019, we incurred approximately $30 million and $20 million in real estate impairment charges, respectively. During the second quarter of 2020, we re-leased one acute care facility to West Virginia University and sold another facility. We also donated the Wheeling facility to a local municipality, resulting in a $9.1 million real estate impairment charge in the first quarter of 2020. At December 31, 2020, we continue to lease one acute care facility to Alecto and have a mortgage loan on the second property, representing less than 0.5% of our total assets. Subsequent to year-end, Alecto completed the sale of Olympia Medical Center to the UCLA Health System. Our proceeds of approximately $43 million from this sale fully recovered our mortgage loan balance in addition to certain past due amounts. Other Leasing 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 Healthcare and Methodist Healthcare Ministries of South Texas, pursuant to a long-term master lease. As a result, we recorded an approximate $1.5 million write-off of straight-line rent in the 2020 third quarter. Loans The following is a summary of our loans (net of allowance for credit loss in 2020) ($ amounts in thousands): As of December 31, 2020 As of December 31, 2019 Balance Weighted-Average Interest Rate Balance Weighted-Average Interest Rate Mortgage loans $ 248,080 8.5 % $ 1,275,022 9.0 % Acquisition loans 338,273 7.6 % 123,893 7.7 % Other loans 520,095 5.8 % 420,939 5.7 % $ 1,106,448 $ 1,819,854 Our mortgage loans at December 31, 2020 cover six of our properties with four operators. The decrease from the prior year primarily relates to the conversion of Steward mortgage loans for the underlying fee simple real estate of two general acute care hospitals as more fully described under “New Investments” in this same Note 3, along with the repayment of approximately $328 million mortgage loans from Prime. The increase in acquisition loans primarily relates to the $205 million loan to the new international joint venture described under “New Investments” in this same Note 3 Other loans consist of loans to our tenants for working capital and other purposes and include our shareholder loan made to the joint venture with Primotop on August 31, 2018 (as more fully described above in this Note 3 ) in the amount of €290 million. Concentration of Credit Risks We monitor concentration risk in several ways due to the nature of our real estate assets that are vital to the communities in which they are located and given our history of being able to replace inefficient operators of our facilities, if needed, with more effective operators: 1) Facility concentration – We had no investment in any single property greater than 4% of our total assets at December 31, 2020 or December 31, 2019. 2) Operator concentration – For the year ended December 31, 2020, revenue from Steward, Circle, and Prospect represented 30%, 13%, and 12%, respectively, of our total revenues. In comparison, Steward represented 42% of our total revenues for the year ended December 31, 2019, while Circle and Prospect represented less than 10%. 3) Geographic concentration – At December 31, 2020, investments in the U.S, Europe, Australia, and South America represented approximately 65%, 28%, 6%, and 1%, respectively, of our total assets. In comparison, investments in the U.S., Europe, and Australia represented approximately 74%, 20%, and 6%, respectively, of our total assets at December 31, 2019. 4) Facility type concentration – For the year ended December 31, 2020, approximately 87% of our revenues are from our general acute care facilities, while rehabilitation and long-term acute care facilities made up 8% and 3%, respectively. Freestanding ER/urgent care facilities and behavioral health facilities combined to make up the additional 2%. In comparison, general acute care, rehabilitation, and long-term acute care facilities made up 82%, 10%, and 3%, respectively, of our total revenues for the year ended December 31, 2019, while freestanding ER/urgent care facilities and behavioral health facilities combined to make up the additional 5%. Related Party Transactions Lease and interest revenue earned from tenants and real estate joint ventures in which we had an equity interest (accounted for under either the equity or fair value option methods) during the year were $29.8 million, $85.3 million, and $102.2 million for 2020, 2019, and 2018, respectively. See subsections “New Investments” and “Disposals” in this Note 3 as it relates to our investments in the new international, Primotop, and Infracore ventures and the Ernest recapitalization for other related party transactions during 2020, 2019, and 2018.

Debt

Debt	12 Months Ended
	Dec. 31, 2020
Debt Disclosure [Abstract]
Debt	4. Debt The following is a summary of debt (dollar amounts in thousands): As of December 31, 2020 As of December 31, 2019 Revolving credit facility(A) $ 165,407 $ — Term loan 200,000 200,000 British pound sterling term loan(B) 956,900 — Australian term loan facility(B) 923,280 842,520 4.000% Senior Unsecured Notes due 2022(B) 610,800 560,650 2.550% Senior Unsecured Notes due 2023(B) 546,800 530,280 5.500% Senior Unsecured Notes due 2024 — 300,000 6.375% Senior Unsecured Notes due 2024 — 500,000 3.325% Senior Unsecured Notes due 2025(B) 610,800 560,650 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) 820,200 795,420 4.625% Senior Unsecured Notes due 2029 900,000 900,000 3.500% Senior Unsecured Notes due 2031 1,300,000 — $ 8,934,187 $ 7,089,520 Debt issue costs and discount, net (68,729 ) (65,841 ) $ 8,865,458 $ 7,023,679 (A) Includes £121 million of GBP-denominated borrowings that reflect the exchange rate at December 31, 2020. (B) Non-U.S. dollar denominated debt that reflects the exchange rate at period end. As of December 31, 2020, 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): 2021 $ 165,407 2022 810,800 2023 546,800 2024 923,280 2025 1,567,700 Thereafter 4,920,200 Total $ 8,934,187 Credit Facility Our current unsecured credit facility (“Credit Facility”) includes a $1.3 billion unsecured revolving loan facility and a $200 million unsecured term loan facility. At December 31, 2020, the maturity date of our unsecured revolving loan facility was in February 2021, while our term loan’s maturity date was February 1, 2022. The term loan and/or revolving loan commitments could be increased in an aggregate amount not to exceed $500 million. At our election, loans under the Credit Facility could be made as either ABR Loans or Eurodollar Loans. The applicable margin for term loans that are ABR Loans was adjustable on a sliding scale from 0.00% to 0.95% based on our current credit rating. The applicable margin for term loans that are Eurodollar Loans was adjustable on a sliding scale from 0.90% to 1.95% based on our current credit rating. The applicable margin for revolving loans that are ABR Loans was adjustable on a sliding scale from 0.00% to 0.65% based on our current credit rating. The applicable margin for revolving loans that are Eurodollar Loans was adjustable on a sliding scale from 0.875% to 1.65% based on our current credit rating. The commitment fee was adjustable on a sliding scale from 0.125% to 0.30% based on our current credit rating and was payable on the revolving loan facility. At December 31, 2020, we had $165.4 million outstanding on the revolving credit facility, whereas, we had no outstanding borrowings on our revolving credit facility at December 31, 2019. At December 31, 2020 and 2019, our availability under our revolving credit facility was $1.1 billion and $1.3 billion, respectively. The weighted-average interest rate on the revolving facility was 1.4% and 2.0% during 2020 and 2019, respectively. At December 31, 2020 and 2019, the interest rate in effect on our term loan was 1.65% and 3.30%, respectively. Our Credit Facility was amended in January 2021 – see Note 13 for details of this amendment. Non-U.S. Term Loans British Pound Sterling Term Loan On January 6, 2020, we entered into a £700 million unsecured sterling-denominated term loan with Bank of America, N.A., as administrative agent, and several lenders from time-to-time are parties thereto. The term loan matures on January 15, 2025. The applicable margin under the term loan is adjustable based on a pricing grid from 0.85% to 1.65% dependent on our current credit rating. On March 4, 2020, we entered into an interest rate swap transaction (effective March 6, 2020) to fix the interest rate to approximately 0.70% for the duration of the loan. The current applicable margin for the pricing grid (which can vary based on our credit rating) is 1.25% for an all-in fixed rate of 1.95%. Australian Term Loan On May 23, 2019, we entered into an A$1.2 billion term loan with Bank of America, N.A., as administrative agent, and several lenders from time-to-time are parties thereto. The term loan matures on May 23, 2024. The interest rate under the term loan is adjustable based on a pricing grid from 0.85% to 1.65%, dependent on our current senior unsecured credit rating. On June 27, 2019, we entered into an interest rate swap transaction (effective July 3, 2019) to fix the interest rate to approximately 1.20% for the duration of the loan as long as the reference rate stays above 0.00%. The current applicable margin for the pricing grid (which can vary based on our credit rating) is 1.25% for an all-in fixed rate of 2.45%. At December 31, 2020 and 2019, we had a derivative liability of approximately $51.3 million and $5.6 million, respectively, included in "Accounts payable and accrued expenses" in our consolidated balance sheets associated with these interest rate swaps. Senior Unsecured Notes The following are the basic terms of our senior unsecured notes. Typically, we may redeem some or all of the notes at any time, but may require a redemption premium that will decrease over time. In the event of a change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101 % of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase. 4.000% Senior Unsecured Notes due 2022 On August 19, 2015, we completed a €500 million senior unsecured notes offering. Interest on the notes is payable annually on August 19 of each year. The notes pay interest in cash at a rate of 4.000% per year. The notes mature on August 19, 2022. 2.550% Senior Unsecured Notes due 2023 On December 5, 2019, we completed a £400 million senior unsecured notes offering. Interest on the notes is payable annually on December 5 of each year. The notes pay interest in cash at a rate of 2.550% per year. The notes mature on December 5, 2023. 5.500% Senior Unsecured Notes due 2024 On April 17, 2014, we completed a $300 million senior unsecured notes offering. Interest on the notes was payable semi-annually on May 1 and November 1 of each year. The notes paid interest in cash at a rate of 5.500% per year. The notes were to mature on May 1, 2024; however, we redeemed the notes on December 19, 2020. 6.375% Senior Unsecured Notes due 2024 On February 22, 2016, we completed a $500 million senior unsecured notes offering. Interest on the notes was payable on March 1 and September 1 of each year. Interest on the notes was paid in cash at a rate of 6.375% per year. The notes were to mature on March 1, 2024; however, we redeemed the notes on December 19, 2020. 3.325% Senior Unsecured Notes due 2025 On March 24, 2017, we completed a €500 million senior unsecured notes offering. Interest on the notes is payable annually on March 24 of each year. The notes pay interest in cash at a rate of 3.325% per year. The notes mature on March 24, 2025. 5.250% Senior Unsecured Notes due 2026 On July 22, 2016, we completed a $500 million senior unsecured notes offering. Interest on the notes is payable on February 1 and August 1 of each year. Interest on the notes is to be paid in cash at a rate of 5.250% per year. The notes mature on August 1, 2026. 5.000% Senior Unsecured Notes due 2027 On September 7, 2017, we completed a $1.4 billion senior unsecured notes offering. Interest on the notes is payable on April 15 and October 15 of each year. The notes pay interest in cash at a rate of 5.000% per year. The notes mature on October 15, 2027. 3.692% Senior Unsecured Notes due 2028 On December 5, 2019, we completed a £600 million senior unsecured notes offering. The notes were issued at 99.998% of par value. Interest on the notes is payable on June 5 of each year. The notes pay interest in cash at a rate of 3.692% per year. The notes mature on June 5, 2028. 4.625% Senior Unsecured Notes due 2029 On July 26, 2019, we completed a $900 million senior unsecured notes offering. Interest on the notes is payable on February 1 and August 1 of each year, commencing on February 1, 2020. The notes were issued at 99.5% of par value, pay interest at a rate of 4.625% per year and mature on August 1, 2029. 3.500% Senior Unsecured Notes due 2031 On December 4, 2020, we completed a $1.3 billion senior unsecured notes offering. Interest on the notes is payable semi-annually on March 15 and September 15 of each year. The notes pay interest in cash at a rate of 3.500% per year. The notes mature on March 15, 2031. Other Activity In preparation of the joint venture with Primotop described under “2018 Activity” in Note 3 , we issued secured debt on August 3, 2018, resulting in gross proceeds of €655 million. Provisions of the secured debt included a term of seven years and a swapped fixed rate of approximately 2.3%. Subsequently, on August 31, 2018, the secured debt was contributed along with the related real estate of 71 properties to form the joint venture. Debt Refinancing and Unutilized Financing Costs 2020 With proceeds from our $1.3 billion, 3.500% Senior Unsecured Notes due 2031 offering completed on December 4, 2020, we redeemed all of our outstanding $500.0 million aggregate principal amount of 6.375% Senior Unsecured Notes due 2024 and $300.0 million aggregate principal amount of 5.500% Senior Unsecured Notes due 2024, including accrued and unpaid interest. As a result of these redemptions, we incurred a charge of approximately $28 million (including redemption premiums and accelerated amortization of deferred debt issuance costs). 2019 On July 10, 2019, we received a commitment to provide a senior unsecured bridge loan facility to fund our investment in Prospect. With this commitment, we paid approximately $4 million of underwriting and other fees. However, this commitment was cancelled with the completion of the debt and equity offerings in July 2019 (as more fully described above and in Note 9 ), which resulted in fully expensing the total amount of underwriting and other fees that were paid . In anticipation of funding our Australian acquisition in June 2019 and the Circle transaction in January 2020, we entered into term loans on the date these deals were signed that had a delayed draw feature. This feature allowed for us to not draw on the term loans until needed to fund these transactions. However, with this type of structure, we incurred approximately $2.0 million in accelerated debt issue cost amortization expense during 2019. Covenants Our debt facilities impose certain restrictions on us, including restrictions on our ability to: incur debts; create or incur liens; provide guarantees in respect of obligations of any other entity; make redemptions and repurchases of our capital stock; prepay, redeem, or repurchase debt; engage in mergers or consolidations; enter into affiliated transactions; dispose of real estate or other assets; and change our business. In addition, the credit agreements governing our Credit Facility limit the amount of dividends we can pay as a percentage of normalized adjusted funds from operations (“NAFFO”), as defined in the agreements, on a rolling four quarter basis. Through 2020, 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, 2020, we were in compliance with all such financial and operating covenants.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2020
Income Tax Disclosure [Abstract]
Income Taxes	5. Income Taxes Medical Properties Trust, Inc. We have maintained and intend to maintain our election as a REIT under the Code. To qualify as a REIT, we must meet a number of organizational and operational requirements, including a requirement to distribute at least 90% of our taxable income to our stockholders. As a REIT, we generally will not be subject to U.S. federal income tax if we distribute 100% of our taxable income to our stockholders and satisfy certain other requirements; instead, income tax is paid directly by our stockholders on the dividends distributed to them. If our taxable income exceeds our dividends in a tax year, REIT tax rules allow us to designate dividends from the subsequent tax year in order to avoid current taxation on undistributed income. If we fail to qualify as a REIT in any taxable year, we will be subject to federal income taxes at regular corporate rates, including any applicable alternative minimum tax. Taxable income from non-REIT activities managed through our TRS is subject to applicable U.S. federal, state, and local income taxes. Our international subsidiaries are also subject to income taxes in the jurisdictions in which they operate. From our TRS and our foreign operations, income tax benefit (expense) were as follows (in thousands): For the Years Ended December 31, 2020 2019 2018 Current income tax benefit (expense): Domestic $ 63 $ 61 $ 125 Foreign (10,203 ) (1,669 ) (3,294 ) (10,140 ) (1,608 ) (3,169 ) Deferred income tax benefit (expense): Domestic (10,680 ) 5,490 3,713 Foreign (10,236 ) (1,261 ) (1,471 ) (20,916 ) 4,229 2,242 Income tax benefit (expense) $ (31,056 ) $ 2,621 $ (927 ) A reconciliation of income tax benefit (expense) from the statutory income tax rate to the effective tax rate based on income before income taxes for the years ended December 31, 2020, 2019, and 2018 is as follows (in thousands): For the Years Ended December 31, 2020 2019 2018 Income before income tax $ 463,328 $ 373,780 $ 1,019,404 Income tax at the U.S. statutory federal rate (21% in 2020, 2019 and 2018) (97,299 ) (78,494 ) (214,075 ) Decrease (increase) in income tax resulting from: Foreign rate differential 2,160 438 2,643 State income taxes, net of federal benefit 970 1,621 (379 ) U.S. earnings not subject to federal income tax 82,921 85,495 208,472 Equity investments 380 1,091 46 Change in valuation allowance (8,514 ) (7,911 ) 2,668 Statutory tax rate change (9,471 ) — — Other items, net (2,203 ) 381 (302 ) Total income tax benefit (expense) $ (31,056 ) $ 2,621 $ (927 ) The foreign provision for income taxes is based on foreign profit before income taxes of $62.1 million, $10.7 million, and $18.6 million in 2020, 2019, and 2018, respectively. The domestic provision for income taxes is based on income before income taxes of $6.4 million in 2020 as compared with a loss before income taxes of $(44.1) million in 2019 from our TRS and income before income taxes of $8.0 million in 2018. At December 31, 2020 and 2019, components of our deferred tax assets and liabilities were as follows (in thousands): 2020 2019 Deferred tax assets: Operating loss and interest deduction carry forwards $ 150,001 $ 28,684 Interest rate swap 9,150 843 Other 6,973 868 Total deferred tax assets 166,124 30,395 Valuation allowance (36,977 ) (11,355 ) Total net deferred tax assets $ 129,147 $ 19,040 Deferred tax liabilities: Property and equipment $ (211,018 ) $ (7,324 ) Net unbilled revenue (14,776 ) (1,449 ) Other (4,010 ) (737 ) Total deferred tax liabilities (229,804 ) (9,510 ) Net deferred tax asset (liability) $ (100,657 ) $ 9,530 At December 31, 2020, we had net NOL and other tax attribute carryforwards as follows (in thousands): U.S. Foreign Gross NOL carryforwards $ 159,895 $ 528,567 Tax-effected NOL carryforwards $ 16,298 $ 133,703 Valuation allowance (6,193 ) (30,784 ) Net deferred tax asset - NOL carryforwards $ 10,105 $ 102,919 Expiration periods 2029-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 2020, a valuation allowance of $25.6 million has been recorded against a portion of our international deferred tax assets to recognize only the components of the deferred tax assets that is more likely than not to be realized. The valuation allowance was primarily recorded against deferred tax assets for NOLs, non-depreciable basis of real property, and other tax attributes that we believe will not be realized. We have no material uncertain tax position liabilities and related interest or penalties. REIT Status We have met the annual REIT distribution requirements by payment of at least 90% of our taxable income in 2020, 2019, and 2018. 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, 2020 2019 2018 Common share distribution $ 1.070000 $ 1.010000 $ 0.990000 Ordinary income 0.603050 0.701910 0.438792 Capital gains(1) — 0.275040 0.551208 Unrecaptured Sec. 1250 gain — 0.041160 0.132280 Section 199A Dividends 0.603050 0.701910 0.438792 Return of capital 0.466950 0.033050 — (1)Capital gains include unrecaptured Sec. 1250 gains. MPT Operating Partnership, L.P. As a partnership, the allocated share of income of the Operating Partnership is included in the income tax returns of the general and limited partners. Accordingly, no accounting for income taxes is generally required for such income of the Operating Partnership. However, the Operating Partnership has formed a TRS on behalf of Medical Properties Trust, Inc., which is subject to U.S. federal, state, and local income taxes at regular corporate rates, and its international subsidiaries are subject to income taxes in the jurisdictions in which they operate. See discussion above under Medical Properties Trust, Inc. for more details of income taxes associated with our TRS and international operations.

Earnings Per Share_Unit

Earnings Per Share/Unit	12 Months Ended
	Dec. 31, 2020
Earnings Per Share [Abstract]
Earnings Per Share/Unit	6. Earnings Per Share/Unit Medical Properties Trust, Inc. Our earnings per share were calculated based on the following (amounts in thousands): For the Years Ended December 31, 2020 2019 2018 Numerator: Net income $ 432,272 $ 376,401 $ 1,018,477 Non-controlling interests’ share in earnings (822 ) (1,717 ) (1,792 ) Participating securities’ share in earnings (2,105 ) (2,308 ) (3,685 ) Net income, less participating securities’ share in earnings $ 429,345 $ 372,376 $ 1,013,000 Denominator: Basic weighted-average common shares 529,239 427,075 365,364 Dilutive potential common shares 1,222 1,224 907 Diluted weighted-average common shares 530,461 428,299 366,271 MPT Operating Partnership, L.P. Our earnings per unit were calculated based on the following (amounts in thousands): For the Years Ended December 31, 2020 2019 2018 Numerator: Net income $ 432,272 $ 376,401 $ 1,018,477 Non-controlling interests’ share in earnings (822 ) (1,717 ) (1,792 ) Participating securities’ share in earnings (2,105 ) (2,308 ) (3,685 ) Net income, less participating securities’ share in earnings $ 429,345 $ 372,376 $ 1,013,000 Denominator: Basic weighted-average units 529,239 427,075 365,364 Dilutive potential units 1,222 1,224 907 Diluted weighted-average units 530,461 428,299 366,271

Stock Awards

Stock Awards	12 Months Ended
	Dec. 31, 2020
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock Awards	7. Stock Awards Stock Awards Our Equity Incentive Plan, adopted during the second quarter of 2019 and replaced the previous plan, authorizes the issuance of common stock options, restricted stock, restricted stock units, deferred stock units, stock appreciation rights, performance units, and awards of interests in our Operating Partnership. Our Equity Incentive Plan is administered by the Compensation Committee of the Board of Directors. We have reserved 12.9 ten years For the past three years, we have only granted restricted stock and restricted stock units pursuant to our Equity Incentive Plan. These stock-based awards have been granted in the form of service-based awards and performance awards based on company-specific performance hurdles. See below for further details on each of these stock-based awards: Service-Based Awards In 2020, 2019, and 2018, the Compensation Committee granted service-based awards to employees and non-employee directors. Service-based awards vest as the employee/director provides the required service (typically over three years Performance-Based Awards In 2020, 2019, and 2018, 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 2020, 2019, and 2018, a target number of stock awards were granted to employees that could be earned based on the achievement of specific performance thresholds as set by our Compensation Committee. The performance thresholds were based on a three-year Certain performance awards granted were subject to a modifier which increases or decreases the actual shares earned in each performance period. The modifier for the 2020 awards was based on two components: 1) how our total shareholder return (“TSR”) compared to the SNL U.S. REIT Healthcare Index (“SNL Index”) and 2) how our TSR compared to a threshold set by the Compensation Committee. For 2019 and 2018 awards, the modifier was based on how our TSR compared to the SNL Index. The following summarizes stock-based award activity in 2020 and 2019 (which includes awards granted in 2020, 2019, 2018, and any applicable prior years), respectively: For the Year Ended December 31, 2020: Vesting Based on Service Vesting Based on Market/Performance Conditions Shares Weighted-Average Value at Award Date Shares Weighted-Average Value at Award Date Nonvested awards at beginning of the year 1,122,440 $ 17.11 5,481,155 $ 11.66 Awarded 635,855 $ 19.65 1,800,898 $ 19.42 Vested (699,215 ) $ 16.80 (2,193,906 ) $ 11.35 Forfeited (2,026 ) $ 18.40 (1,164 ) $ 18.22 Nonvested awards at end of year 1,057,054 $ 18.79 5,086,983 $ 14.41 For the Year Ended December 31, 2019: Vesting Based on Service Vesting Based on Market/Performance Conditions Shares Weighted-Average Value at Award Date Shares Weighted-Average Value at Award Date Nonvested awards at beginning of the year 923,848 $ 14.29 4,133,435 $ 9.21 Awarded 681,378 $ 19.24 2,438,292 $ 15.25 Vested (478,104 ) $ 14.73 (1,051,637 ) $ 10.43 Forfeited (4,682 ) $ 13.44 (38,935 ) $ 10.13 Nonvested awards at end of year 1,122,440 $ 17.11 5,481,155 $ 11.66 The value of stock-based awards is charged to compensation expense over the service periods. For the years ended December 31, 2020, 2019, and 2018, we recorded $47.2 million, $32.2 million, and $16.5 million, respectively, of non-cash compensation expense. The remaining unrecognized cost from stock-based awards at December 31, 2020, is $53.6 million, which will be recognized over a weighted-average period of 1.3 years. Stock-based awards that vested in 2020, 2019, and 2018, had a value of $58.9 million, $25.9 million, and $8.4 million, respectively.

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2020
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	8. Commitments and Contingencies Commitments On December 30, 2020, we entered into definitive agreements to acquire a portfolio of between 35 and 40 behavioral health facilities located throughout the United Kingdom for an aggregate purchase price of approximately £800 million from the Priory Group. The transaction is structured to occur in two primary phases. On December 30, 2020, an affiliate of Waterland Private Equity Fund VII C.V. (“Waterland VII”) entered into definitive agreements to acquire all of the outstanding equity interests in the entity that owns the Priory Group from its current owner, Acadia Healthcare Company, Inc. In separate agreements entered into with Waterland VII on the same date, we agreed to provide a short-term interim acquisition loan to Waterland VII at the closing of Waterland VII’s acquisition of Priory Group. Upon closing of the first phase of the transaction on January 19, 2021, we funded an £800 million interim acquisition loan secured by mortgages on an identified portfolio of Priory Group real estate assets. In phase two, in a series of transactions we expect will be completed during the first half of 2021, we will acquire a portfolio of select real estate assets from Priory Group (now owned by Waterland VII) in individual sale-and-leaseback transactions, subject to customary real estate and other closing conditions. As all conditions to closing for a particular asset are satisfied, the applicable purchase price for the asset will be paid by us by proportionally converting and reducing the principal balance of the interim acquisition loan we made to Waterland VII in phase one. The aggregate purchase price for the real estate assets we acquire from the Priory Group is thus expected to be approximately £800 million, being the total amount of the interim acquisition loan, plus customary stamp duty, tax and other transaction costs. The properties we acquire will be subject to a master lease type structure with an initial term of 25 years and two 10-year extension options, with annual inflation-based escalators. Pending its conversion and offset, the initial interim acquisition loan will bear interest at a rate similar to the initial lease rate we will receive under the lease transactions. In addition to the £800 million initial interim acquisition loan described above, we also agreed to provide Waterland VII with a 364-day £250 million acquisition loan, which we funded on January 19, 2021, in connection with the closing of Waterland VII’s acquisition of the Priory Group. The loan is secured by the same security assets securing the £800 million interim acquisition loan. In connection with these transactions, we also acquired a 9.9% passive equity interest in the Waterland VII affiliate that indirectly owns the Priory Group for a nominal amount. To help fund this acquisition, we entered into a $900 million interim credit facility on January 15, 2021, of which we utilized £500 million along with £350 million from our revolving facility and the rest from cash on-hand. Contingencies We are a party to various legal proceedings incidental to our business. In the opinion of management, after consultation with legal counsel, the ultimate liability, if any, with respect to these proceedings is not presently expected to materially affect our financial position, results of operations, or cash flows.

Common Stock_Partner's Capital

Common Stock/Partner's Capital	12 Months Ended
	Dec. 31, 2020
Equity [Abstract]
Common Stock/Partner's Capital	9. Common Stock/Partner’s Capital Medical Properties Trust, Inc. 2020 Activity In 2020, we sold 21.0 million shares of common stock under our at-the-market equity offering program, resulting in net proceeds of approximately $411 million. 2019 Activity On November 4, 2019, we filed Articles of Amendment to our charter with the Maryland State Department of Assessments and Taxation increasing the number of authorized shares of common stock, par value $0.001 per share, available for issuance from 500 million to 750 million. On November 8, 2019, we completed an underwritten public offering of 57.5 million shares (including the exercise of the underwriters’ 30-day option to purchase an additional 7.5 million shares) of our common stock, resulting in net proceeds of $1.026 billion, after deducting underwriting discounts and commissions and offering expenses. On July 18, 2019, we completed an underwritten public offering of 51.75 million shares (including the exercise of the underwriters’ 30-day option to purchase an additional 6.75 million shares) of our common stock, resulting in net proceeds of $858.1 million, after deducting underwriting discounts and commissions and offering expenses. In 2019, we sold 36.1 million shares of common stock under our at-the-market equity offering program, resulting in net proceeds of approximately $650 million. On December 27, 2019, we entered into a new at-the-market equity offering program, which gives us the ability to sell up to $1.0 billion of stock with a commission rate up to 2.0%. 2018 Activity In the 2018 fourth quarter, we sold 5.6 million shares of common stock under our at-the-market equity offering program, resulting in net proceeds of approximately $95 million. MPT Operating Partnership, L.P. At December 31, 2020, 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 via its ownership of the common units and its indirect ownership of MPT TRS, Inc. 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. In 2018, approximately 60 thousand LTIP units were converted to common units and then redeemed for approximately $0.8 million of cash. For each share of common stock issued by Medical Properties Trust, Inc., the Operating Partnership issues a corresponding number of operating partnership units.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	12 Months Ended
	Dec. 31, 2020
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	10. Fair Value of Financial Instruments We have various assets and liabilities that are considered financial instruments. We estimate that the carrying value of cash and cash equivalents and accounts payable and accrued expenses approximate their fair values. We estimate the fair value of our interest and rent receivables using Level 2 inputs such as discounting the estimated future cash flows using the current rates at which similar receivables would be made to others with similar credit ratings and for the same remaining maturities. The fair value of our mortgage loans and other loans are estimated by using Level 2 inputs such as discounting the estimated future cash flows using the current rates which similar loans would be made to borrowers with similar credit ratings and for the same remaining maturities. We determine the fair value of our senior unsecured notes using Level 2 inputs such as quotes from securities dealers and market makers. We estimate the fair value of our revolving credit facility and term loans using Level 2 inputs based on the present value of future payments, discounted at a rate which we consider appropriate for such debt. Fair value estimates are made at a specific point in time, are subjective in nature, and involve uncertainties and matters of significant judgment. Settlement of such fair value amounts may not be a prudent management decision. The following table summarizes fair value estimates for our financial instruments (in thousands): December 31, 2020 December 31, 2019 Asset (Liability) Book Value Fair Value Book Value Fair Value Interest and rent receivables $ 46,208 $ 45,381 $ 31,357 $ 30,472 Loans(1) 751,341 756,608 1,704,854 1,742,153 Debt, net (8,865,458 ) (9,226,564 ) (7,023,679 ) (7,331,816 ) (1) Excludes the $205 million acquisition loan to the new international joint venture and investment in the real estate of three hospitals in Colombia discussed in Note 3 as they are recorded at fair value and discussed below Items Measured at Fair Value on a Recurring Basis Our equity investment and related loan to the new international joint venture and our loan investment in the real estate of three hospitals operated by subsidiaries of the international joint venture in Colombia 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 during 2020. Our Ernest mortgage loans were measured at fair value on a recurring basis in prior periods as we elected to account for these investments using the fair value option method in 2012 when we acquired an equity interest in Ernest. Such equity interest was sold in October 2018, and the mortgage loans were converted to fee simple real estate on December 31, 2020 as discussed in Note 3 . We elected to account for each of these investments at fair value due to the size of the investments and because we believe this method was more reflected of current values. At December 31, 2020 and 2019, the amounts recorded under the fair value option method were as follows (in thousands): As of December 31, 2020 As of December 31, 2019 Asset (Liability) Fair Value Original Cost Fair Value Original Cost Asset Type Classification Mortgage loans $ 136,332 $ 136,332 $ 115,000 $ 115,000 Mortgage loans Equity investment and other loans 218,775 218,775 — — Equity investments/Other loans Our loans to the new 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 which similar loans would be made to borrowers with similar credit ratings and the same remaining maturities. Our equity investment in 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 the equity investment as Level 3, as we use certain unobservable inputs to the valuation methodology that are significant to the fair value measurement, and the valuation requires management judgment due to absence of quoted market prices. For this cash flow model, 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 investee. However, we will modify such projections as needed based on our review and analysis of historical results, meetings with key members of management, and our understanding of trends and developments within the healthcare industry. Given our equity investment is in an entity that was a start-up company in 2020, we have not recognized any unrealized gain/loss on such investment in 2020. Items Measured at Fair Value on a Nonrecurring Basis In addition to items that are measured at fair value on a recurring basis, we have assets and liabilities that are measured at fair value on a nonrecurring basis, such as long-lived asset impairments (see Note 3 ). Fair value is based on estimated cash flows discounted at a risk-adjusted rate of interest by using either Level 2 or 3 inputs as more fully described in Note 2 .

Leases (Lessee)

Leases (Lessee)	12 Months Ended
	Dec. 31, 2020
Leases [Abstract]
Leases (Lessee)	11. Leases (Lessee) We lease the land underlying certain of our facilities (for which we sublease to our tenants), along with corporate office and equipment. Our leases have remaining lease terms 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 2020 2019 Operating lease cost (1) (2) $ 9,910 $ 9,262 Finance lease cost: Amortization of right-of-use assets Real estate depreciation and amortization 51 51 Interest on lease liabilities Interest 128 117 Sublease income Other (2,614 ) (3,478 ) Total lease cost $ 7,475 $ 5,952 (1) Includes short-term leases. (2) $6.0 million and $5.8 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2020 and 2019, respectively. For 2018, our total lease expense was $9.4 million, which was offset by sublease rental income of $4.3 million. 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, 2020 are as follows (amounts in thousands): Operating Leases Finance Leases Amounts To Be Received From Subleases Net Payments 2021 $ 7,186 $ 126 $ (2,952 ) $ 4,360 2022 7,384 128 (3,238 ) 4,274 2023 7,451 129 (3,240 ) 4,340 2024 6,557 130 (3,259 ) 3,428 2025 5,660 131 (3,303 ) 2,488 Thereafter 257,730 4,783 (78,494 ) 184,019 (1) Total undiscounted minimum lease payments $ 291,968 $ 5,427 $ (94,486 ) $ 202,909 Less: interest (201,962 ) (3,492 ) Present value of lease liabilities $ 90,006 $ 1,935 (1) Reflects certain ground leases, in which we are the lessee, that have longer initial fixed terms than our existing sublease to our tenants. However, we would expect to either renew the related sublease, enter into a lease with a new tenant, or early terminate the ground lease to reduce or avoid any significant impact from such ground leases. Supplemental balance sheet information is as follows (in thousands, except lease terms and discount rate): Balance Sheet Classification December 31, 2020 December 31, 2019 Right of use assets: Operating leases - real estate Land $ 73,373 $ 59,492 Finance leases - real estate Land 1,836 1,888 Total real estate right of use assets $ 75,209 $ 61,380 Operating leases - corporate Other assets 8,234 9,866 Total right of use assets $ 83,443 $ 71,246 Lease liabilities: Operating leases Obligations to tenants and other lease liabilities $ 90,006 $ 76,353 Financing leases Obligations to tenants and other lease liabilities 1,935 1,932 Total lease liabilities $ 91,941 $ 78,285 Weighted-average remaining lease term: Operating leases 41.1 31.9 Finance leases 35.9 36.9 Weighted-average discount rate: Operating leases 6.4 % 6.3 % Finance leases 6.6 % 6.6 % The following is supplemental cash flow information (in thousands): For the Years Ended December 31, 2020 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 6,080 $ 5,937 Operating cash flows from finance leases 125 114 Financing cash flows from finance leases — 10 Non-cash activities - Right-of-use assets obtained in exchange for lease obligations: Operating leases 13,832 1,818 Finance leases — —

Other Assets

Other Assets	12 Months Ended
	Dec. 31, 2020
Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract]
Other Assets	12. Other Assets The following is a summary of our other assets on our consolidated balance sheets (in thousands): At December 31, 2020 2019 Debt issue costs, net(1) $ 192 $ 2,492 Other corporate assets 167,929 206,765 Prepaids and other assets 87,948 90,342 Total other assets $ 256,069 $ 299,599 (1) Other corporate assets include leasehold improvements associated with our corporate offices, furniture and fixtures, equipment, software, deposits, right-of-use assets associated with corporate leases, etc. Included in prepaids and other assets is prepaid insurance, prepaid taxes, deferred income tax assets (net of valuation allowances, if any), and lease inducements made to tenants, among other items. In addition to the assets above, we have equity investments of $1.1 billion and $927 million at December 31, 2020 and 2019, respectively. The increase year-over-year is related to our additional investment in Infracore as discussed further in Note 3

Subsequent Events

Subsequent Events	12 Months Ended
	Dec. 31, 2020
Subsequent Events [Abstract]
Subsequent Events	13. Subsequent Events Equity Offering On January 11, 2021, we completed an underwritten public offering of 36.8 million shares (including the exercise of the underwriters’ 30-day option to purchase an additional 4.8 million shares) of our common stock, resulting in net proceeds of approximately $711.0 million, after deducting underwriting discounts and commissions and offering expenses. Credit Facility Amendment On January 15, 2021, we amended our Credit Facility. The amendment extended the maturity of our revolving facility to February 2024 and can be extended for an additional 12 months at our option. The maturity date of our $200 million unsecured term loan facility was extended to February 1, 2026. In addition to extending the maturity date, the amendment improved interest rate pricing for both facilities. Under the amended Credit Facility and at our election, loans may be made as either ABR Loans or Eurocurrency Loans. The applicable margin for term loans that are ABR Loans is adjustable on a sliding scale from 0.00% to 0.85% based on our current credit rating. The applicable margin for term loans that are Eurocurrency Loans is adjustable on a sliding scale from 0.85% to 1.85% based on our current credit rating. The applicable margin for revolving loans that are ABR Loans is adjustable on a sliding scale from 0.00% to 0.55% based on our current credit rating. The applicable margin for revolving loans that are Eurocurrency Loans is adjustable on a sliding scale from 0.825% to 1.55% based on our current credit rating. The amended Credit Facility retained the facility fee that is adjustable on a sliding scale from 0.125% to 0.30% based on our current credit rating and is payable on the revolving loan facility.

Schedule II_ Valuation and Qual

Schedule II: Valuation and Qualifying Accounts	12 Months Ended
	Dec. 31, 2020
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, 2020 Additions Deductions Year Ended December 31, Balance at Beginning of Year(1) Charged Against Operations(1) Charged to Other Accounts Net Recoveries/ Write-offs(1) Balance at End of Year(1) (In thousands) 2020 $ 109,803 $ 58,044 (2) $ 22,944 (3) $ (44,154 ) (4) $ 146,637 2019 $ 66,131 $ 50,893 (5) $ — $ (7,221 ) (6) $ 109,803 2018 $ 16,397 $ 57,285 (7) $ — $ (7,551 ) (8) $ 66,131 (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 $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. (3) 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. (4) 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. (5) Represents a $21.0 million increase to real estate impairment reserves, $22.0 million increase in accounts receivable and other reserves, and a $7.9 million increase in our tax valuation allowance to reserve against an increase in our net deferred tax assets in 2019. (6) Includes a $7.2 million decrease in real estate impairment reserves related to disposals in 2019. (7) Represents a $48 million increase to real estate impairment reserves and a $9.3 million increase in accounts receivable reserves during 2018. (8) Includes a $7.7 million decrease in valuation allowances (which includes $4.4 million release of domestic valuation allowances in the 2018 fourth quarter) that was originally recorded to reserve against our net deferred tax assets.

SCHEDULE III - REAL ESTATE INVE

SCHEDULE III - REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION	12 Months Ended
	Dec. 31, 2020
Real Estate And Accumulated Depreciation Disclosure [Abstract]
SCHEDULE III - REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION	SCHEDULE III — REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION December 31, 2020 Initial Costs Additions Subsequent to Acquisition Cost at December 31, 2020(1) Accumulated Life on which depreciation in latest income statements is Location Type of Property Land Buildings Improve- ments Carrying Costs Land Buildings Total Depreciation Encum- brances Date of Construction Date Acquired computed (Years) (Dollar amounts in thousands) Ashtead, UK Acute care general hospital $ 39,518 $ 76,020 $ 1,029 $ — $ 40,547 $ 76,020 $ 116,567 $ 2,648 $ — 1981 August 16, 2019 40 Bassenheim, Germany Rehabilitation hospital 1,081 5,853 183 — 1,264 5,853 7,117 311 — 1887, 1983 February 9, 2019 39 Bath, UK Acute care general hospital 1,620 33,584 — — 1,620 33,584 35,204 5,457 — 2008, 2009 July 1, 2014 40 Bath, UK Acute care general hospital 7,519 14,016 205 — 7,724 14,016 21,740 364 — 1992 January 9, 2020 40 Birmingham, UK Acute care general hospital 9,397 48,175 — — 9,397 48,175 57,572 599 — 2017 April 3, 2017 40 Birmingham, UK Acute care general hospital 10,317 100,791 390 — 10,707 100,791 111,498 2,545 — 1982 January 9, 2020 40 Birmingham, UK Rehabilitation hospital — 20,011 — — — 20,011 20,011 249 — 2018 June 29, 2020 40 Braunfels, Germany Acute care general hospital 2,345 14,992 62 — 2,407 14,992 17,399 2,084 — 1977 June 30, 2015 40 Heidelberg, Germany Rehabilitation hospital 6,823 39,424 79 — 6,902 39,424 46,326 4,459 — 1885, 1991 June 22, 2016 40 Cologne, Germany Acute care general hospital 4,788 16,560 111 — 4,899 16,560 21,459 1,475 — 2011 June 23, 2017 40 Bad Salzuflen, Germany Rehabilitation hospital 10,624 29,415 999 — 11,623 29,415 41,038 2,473 — 1974, 2016 November 30, 2017 40 Bad Salzuflen, Germany Rehabilitation hospital 7,523 25,869 376 — 7,899 25,869 33,768 2,072 — 1989, 2016 November 30, 2017 40 Bad Oeynhausen, Germany Rehabilitation hospital 1,110 3,045 135 — 1,245 3,045 4,290 263 — 1973, 2010 November 30, 2017 40 Dormagen, Germany Rehabilitation hospital 1,963 6,251 150 — 2,113 6,251 8,364 388 — 1993, 2006 August 28, 2018 40 Grefath, Germany Rehabilitation hospital 1,220 3,351 108 — 1,328 3,351 4,679 212 — 1886, 1983 August 28, 2018 40 Remscheid, Germany Rehabilitation hospital 1,097 2,797 64 — 1,161 2,797 3,958 173 — 1951, 1983 August 28, 2018 40 Houston, TX Acute care general hospital 3,501 34,530 8,477 16,589 3,274 59,823 63,097 16,224 — 1960 August 10, 2007 40 San Diego, CA Acute care general hospital 12,663 52,431 — — 12,663 52,431 65,094 12,999 — 1973 February 9, 2011 40 Alvin, TX Freestanding ER 105 4,087 — — 105 4,087 4,192 666 — 2014 March 19, 2014 40 Houston, TX Freestanding ER 950 3,996 — — 950 3,996 4,946 425 — 2016 September 26, 2016 40 Aurora, CO Freestanding ER 2,939 4,812 — — 2,939 4,812 7,751 632 — 2015 September 17, 2015 40 Ft. Worth, TX Freestanding ER 2,741 4,392 — — 2,741 4,392 7,133 631 — 2015 March 27, 2015 40 Aberdeen, UK Acute care general hospital 4,429 108,150 137 — 4,566 108,150 112,716 2,712 — 1985 January 9, 2020 40 Ayer, MA Acute care general hospital 9,048 77,913 2,300 — 9,048 80,213 89,261 4,637 — 1970-2013 June 27, 2018 47 Basingstoke, UK Acute care general hospital 13,670 53,891 205 — 13,875 53,891 67,766 1,361 — 1984 January 9, 2020 40 Beckenham, UK Acute care general hospital 5,810 22,493 55 — 5,864 22,494 28,358 566 — 1981 January 9, 2020 40 Bedford, UK Acute care general hospital 1,599 8,057 55 — 1,654 8,057 9,711 205 — 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 5,379 — 1984 April 1, 2008 42 Big Spring, TX Acute care general hospital 1,655 21,254 — — 1,655 21,254 22,909 1,058 — 1973 April 12, 2019 41 Blackburn, UK Acute care general hospital 2,734 54,763 123 — 2,857 54,763 57,620 1,377 — 1957 January 9, 2020 40 Blue Springs, MO Acute care general hospital 4,347 23,494 — — 4,347 23,494 27,841 3,651 — 1980 February 13, 2015 40 Boardman, OH Long term acute care hospital 79 275 — — 79 275 354 10 — 2008 August 30, 2019 40 Boise, ID Long term acute care hospital 1,558 11,027 — — 1,558 11,027 12,585 634 — 2008 February 29, 2012 50 Initial Costs Additions Subsequent to Acquisition Cost at December 31, 2020(1) Accumulated Life on which depreciation in latest income statements is Location Type of Property Land Buildings Improve- ments Carrying Costs Land Buildings Total Depreciation Encum- brances Date of Construction Date Acquired computed (Years) (Dollar amounts in thousands) Bolton, UK Acute care general hospital 1,640 47,818 62 — 1,702 47,818 49,520 1,199 — 1989 January 9, 2020 40 Boonton Township, NJ Behavioral health facility 6,712 17,031 — — 6,712 17,031 23,743 79 — 1952, 1971-1978 September 30, 2015 40 Bossier City, LA Long term acute care hospital 900 17,818 944 — 900 18,762 19,662 5,736 — 1982 April 1, 2008 40 Bowling Green, KY Rehabilitation hospital 3,486 56,296 — — 3,486 56,296 59,782 2,092 — 1992 August 30, 2019 40 Brighton, MA Acute care general hospital 18,540 146,491 39,279 — 18,540 185,770 204,310 16,411 — 1917-2009 October 3, 2016 41 Brockton, MA Acute care general hospital 18,328 67,248 4,937 — 18,328 72,185 90,513 9,289 — 1965-2010 October 3, 2016 41 Broomfield, CO Freestanding ER 825 3,895 — — 825 3,895 4,720 633 — 2014 July 3, 2014 40 Bundoora, Australia Acute care general hospital 7,049 67,900 302 — 7,351 67,900 75,251 2,959 — 1979 June 7, 2019 37 Casper, WY Rehabilitation hospital 1,836 — — — 1,836 — 1,836 — — 2012 February 29, 2012 — Glendale, AZ Freestanding ER 1,144 6,087 — — 1,144 6,087 7,231 634 — 2016 October 21, 2016 40 New Orleans, LA Freestanding ER 2,850 6,125 — — 2,850 6,125 8,975 651 — 2016 September 23, 2016 40 Campbelltown, Australia Acute care general hospital 1,117 58,005 54 — 1,171 58,005 59,176 2,302 — 2007 June 7, 2019 40 Canterbury, UK Acute care general hospital 9,774 29,624 89 — 9,863 29,624 39,487 746 — 1982 January 9, 2020 40 Carmarthen, UK Acute care general hospital 875 27,462 102 — 977 27,462 28,439 693 — 1990 January 9, 2020 40 Carrollton, TX Acute care general hospital 729 34,342 374 — 729 34,716 35,445 4,689 — 2015 July 17, 2015 40 Caterham, UK Acute care general hospital 10,927 22,384 403 — 11,330 22,384 33,714 791 — 1982 August 16, 2019 40 Cedar Hill. TX Freestanding ER 1,122 3,644 — — 1,122 3,644 4,766 592 — 2014 June 23, 2014 40 Spring, TX Freestanding ER 1,310 3,639 — — 1,310 3,639 4,949 591 — 2014 July 15, 2014 40 Chandler, AZ Freestanding ER 3,674 4,783 — — 3,674 4,783 8,457 678 — 2015 April 24, 2015 40 Chandler, AZ Freestanding ER 750 3,853 — — 750 3,853 4,603 506 — 2015 October 7, 2015 40 Cheadle, UK Acute care general hospital 32,808 174,982 410 — 33,218 174,982 208,200 4,401 — 1981 January 9, 2020 40 Cheraw, SC Acute care general hospital 657 19,576 — — 657 19,576 20,233 6,675 — 1982 April 1, 2008 42 Crown Point, IN Long term acute care hospital 302 528 — — 302 528 830 22 — 2008 August 30, 2019 40 Katy, TX Freestanding ER 2,211 3,873 — — 2,211 3,873 6,084 500 — 2015 October 21, 2015 40 Webster, TX Long term acute care hospital 663 33,751 — — 663 33,751 34,414 8,438 — 2004 December 21, 2010 40 Clarksville, TX Rehabilitation hospital 2,460 25,530 — — 2,460 25,530 27,990 — — 2019 December 17, 2020 39 Commerce City, TX Freestanding ER 707 4,248 — — 707 4,248 4,955 646 — 2014 December 11, 2014 40 Conroe, TX Freestanding ER 1,338 1,699 — — 1,338 1,699 3,037 482 — 2015 July 29, 2015 40 Converse, TX Freestanding ER 750 4,423 — — 750 4,423 5,173 636 — 2015 April 10, 2015 40 Croydon, UK Acute care general hospital 10,458 44,782 218 — 10,676 44,782 55,458 1,134 — 1982 January 9, 2020 40 The Woodlands, TX Freestanding ER 2,019 4,524 — — 2,019 4,524 6,543 537 — 2016 March 28, 2016 40 Houston, TX Freestanding ER 1,903 1,276 — — 1,903 1,276 3,179 408 — 2017 May 8, 2017 35 Dahlen, Germany Rehabilitation hospital 1,017 12,526 466 — 1,483 12,526 14,009 143 — 1994 July 8, 2020 40 Dallas, TX Long term acute care hospital 1,000 13,589 — 368 1,421 13,536 14,957 4,850 — 2006 September 5, 2006 40 Darlington, UK Acute care general hospital 1,873 38,465 369 — 2,242 38,465 40,707 411 — 2001 August 7, 2020 40 Denver, CO Freestanding ER 1,295 4,276 — — 1,295 4,276 5,571 597 — 2015 June 8, 2015 40 Denville, NJ Acute care general hospital 15,709 55,772 — — 15,709 55,772 71,481 254 — 1953, 1969-2008 September 30, 2015 40 DeSoto, TX Freestanding ER 750 4,234 — — 750 4,234 4,984 485 — 2016 May 23, 2016 40 Detroit, MI Long term acute care hospital 1,220 8,687 — (364 ) 1,220 8,323 9,543 2,686 — 1956 May 22, 2008 40 San Antonio, TX Freestanding ER 3,216 4,801 — — 3,216 4,801 8,017 490 — 2016 December 9, 2016 40 Dodge City, KS Acute care general hospital 1,124 52,705 — — 1,124 52,705 53,829 1,422 — 1976 December 17, 2019 40 Dorchester, MA Acute care general hospital 14,428 219,575 6,638 — 14,428 226,213 240,641 12,424 — 1953-2015 October 15, 2018 42 Dorchester, UK Acute care general hospital 533 33,653 62 — 595 33,653 34,248 845 — 1981 January 9, 2020 40 Initial Costs Additions Subsequent to Acquisition Cost at December 31, 2020(1) Accumulated Life on which depreciation in latest income statements is Location Type of Property Land Buildings Improve- ments Carrying Costs Land Buildings Total Depreciation Encum- brances Date of Construction Date Acquired computed (Years) (Dollar amounts in thousands) Dover, NJ Acute care general hospital 3,865 8,693 — — 3,865 8,693 12,558 42 — 1925, 1927-2008 September 30, 2015 40 Droitwich, UK Acute care general hospital — 16,427 82 — 82 16,427 16,509 416 — 1984 January 9, 2020 40 El Paso, TX Rehabilitation hospital 4,268 21,328 — — 4,268 21,328 25,596 — — 2018 December 17, 2020 38 Euxton, UK Acute care general hospital 4,088 38,183 870 — 4,958 38,183 43,141 1,369 — 1981 August 16, 2019 40 Houston, TX Freestanding ER 1,345 3,678 — — 1,345 3,678 5,023 598 — 2014 June 20, 2014 40 Fairmont, CA Acute care general hospital 1,000 6,072 5,278 — 1,277 11,073 12,350 2,331 — 1939, 1972, 1985 September 19, 2014 40 Fall River, MA Acute care general hospital 3,526 82,358 24,463 — 3,526 106,821 110,347 10,619 — 1950-2012 October 3, 2016 41 Firestone, TX Freestanding ER 495 3,963 — — 495 3,963 4,458 652 — 2014 June 6, 2014 40 Flagstaff, AZ Rehabilitation hospital 3,049 22,464 — — 3,049 22,464 25,513 1,591 — 2016 August 23, 2016 40 Florence, AZ Acute care general hospital 900 28,462 105 — 900 28,567 29,467 6,246 — 2012 February 7, 2012 40 Folsom, CA Long term acute care hospital 3,291 21,293 — — 3,291 21,293 24,584 843 — 2009 August 30, 2019 40 Fort Lauderdale, FL Rehabilitation hospital 3,499 21,939 — 1 3,499 21,940 25,439 6,962 — 1985 April 22, 2008 40 Fountain, CO Freestanding ER 1,508 4,131 — — 1,508 4,131 5,639 663 — 2014 July 31, 2014 40 Fresno, CA Rehabilitation hospital 5,507 70,473 — — 5,507 70,473 75,980 2,532 — 1991 August 30, 2019 40 Frisco, TX Freestanding ER 1,500 2,431 27 (89 ) 1,411 2,458 3,869 631 — 2014 June 13, 2014 40 Garden Grove, CA Acute care general hospital 5,502 10,748 — 51 5,502 10,799 16,301 3,277 — 1982 November 25, 2008 40 Garland, TX Freestanding ER 3,441 4,648 — — 3,441 4,648 8,089 484 — 2016 November 15, 2016 40 Garden Grove, CA Medical Office Building 862 7,888 — 28 862 7,916 8,778 2,396 — 1982 November 25, 2008 40 Gilbert, AZ Acute care general hospital 150 10,449 — — 150 10,449 10,599 3,838 — 2005 January 4, 2011 40 Gilbert, AZ Freestanding ER 1,517 4,661 — — 1,517 4,661 6,178 631 — 2015 July 22, 2015 40 Glasgow, UK Acute care general hospital 6,767 141,275 150 — 6,917 141,275 148,192 3,542 — 1983 January 9, 2020 40 Glen Waverly, Australia Rehabilitation hospital 32,590 25,179 885 — 33,475 25,179 58,654 1,421 — 1972 June 7, 2019 32 Glendale, AZ Freestanding ER 1,229 4,046 — — 1,229 4,046 5,275 565 — 2015 June 5, 2015 40 Gloucester, UK Acute care general hospital 4,919 65,900 1,073 — 5,992 65,900 71,892 2,327 — 1990 August 16, 2019 40 Goodyear, AZ Freestanding ER 1,800 4,713 — — 1,800 4,713 6,513 560 — 2016 April 4, 2016 40 Great Missenden, UK Acute care general hospital 12,303 112,924 335 — 12,638 112,924 125,562 2,845 — 1981 January 9, 2020 40 Guildford, UK Acute care general hospital 7,259 39,114 130 — 7,389 39,114 46,503 986 — 1989 January 9, 2020 40 Halsall, UK Acute care general hospital 1,539 33,458 624 — 2,163 33,458 35,621 1,185 — 1986 August 16, 2019 40 Harrow, UK Acute care general hospital 41,010 43,396 226 — 41,236 43,396 84,632 1,100 — 1980 January 9, 2020 40 Hartsville, SC Acute care general hospital 2,050 43,970 — — 2,050 43,970 46,020 6,698 — 1999 August 31, 2015 34 Hastings, PA Acute care general hospital 603 8,834 — — 603 8,834 9,437 363 — 1924 December 17, 2019 30 Hausman, TX Acute care general hospital 1,500 8,957 — — 1,500 8,957 10,457 1,734 — 2013 March 1, 2013 40 Haverhill, MA Acute care general hospital 5,651 105,848 3,384 — 5,651 109,232 114,883 6,674 — 1982-2005 August 31, 2018 40 Helotes, TX Freestanding ER 1,900 5,115 — — 1,900 5,115 7,015 618 — 2016 March 10, 2016 40 Highland Village, TX Freestanding ER 3,314 1,551 — — 3,314 1,551 4,865 377 — 2015 September 22, 2015 40 Hill County, TX Acute care general hospital 1,120 17,882 — — 1,120 17,882 19,002 12,288 — 1980 September 17, 2010 15 Warren, OH Rehabilitation hospital 2,417 15,857 1,384 — 2,417 17,241 19,658 2,006 — 1922-2000 May 1, 2017 46 Hoover, AL Freestanding ER — 7,581 — — — 7,581 7,581 1,254 — 2015 May 1, 2015 34 Hoover, AL Medical Office Building — 1,034 296 — — 1,330 1,330 188 — 2015 May 1, 2015 34 Hope, AR Acute care general hospital 1,651 3,359 2,274 — 1,651 5,633 7,284 655 — 1984-2001 September 29, 2017 41 Hot Springs, AR Acute care general hospital 5,844 59,432 21,221 — 5,844 80,653 86,497 11,013 — 1985 August 31, 2015 40 Houston, TX Acute care general hospital 28,687 104,028 17,462 — 28,687 121,490 150,177 6,714 — 1940-1950 September 29, 2017 41 Initial Costs Additions Subsequent to Acquisition Cost at December 31, 2020(1) Accumulated Life on which depreciation in latest income statements is Location Type of Property Land Buildings Improve- ments Carrying Costs Land Buildings Total Depreciation Encum- brances Date of Construction Date Acquired computed (Years) (Dollar amounts in thousands) Houston, TX Behavioral health facility 6,063 19,874 — — 6,063 19,874 25,937 — — 2020 October 25, 2019 40 Highlands Ranch, CO Freestanding ER 4,200 4,779 — — 4,200 4,779 8,979 528 — 2016 July 25, 2016 40 Idaho Falls, ID Acute care general hospital 1,822 37,467 11,236 4,665 1,822 53,368 55,190 13,527 — 2002 April 1, 2008 40 Idaho Falls, ID Acute care general hospital 380 108,903 — — 380 108,903 109,283 2,486 — 2020 December 19, 2017 40 Johnstown, PA Acute care general hospital 8,877 247,042 — 116 8,877 247,158 256,035 8,359 — 1924 December 17, 2019 30 Kansas City, KS Acute care general hospital 2,351 13,665 — — 2,351 13,665 16,016 468 — 2017 June 10, 2019 50 Kansas City, MO Acute care general hospital 10,497 64,419 — — 10,497 64,419 74,916 9,713 — 1978 February 13, 2015 40 Katy, TX Freestanding ER 1,604 4,174 — — 1,604 4,174 5,778 443 — 2016 October 10, 2016 40 Kingswood, Australia Acute care general hospital 25,723 85,264 496 — 26,219 85,264 111,483 3,435 — 2000 June 7, 2019 40 Camden, SC Acute care general hospital — 22,739 — — — 22,739 22,739 2,721 — 1954-2004 October 30, 2015 39 Lafayette, IN Rehabilitation hospital 800 14,968 (25 ) — 800 14,943 15,743 2,946 — 2013 February 1, 2013 40 Lander, WY Acute care general hospital 761 42,849 — — 761 42,849 43,610 1,145 — 1983 December 17, 2019 40 Lawton, OK Acute care general hospital 3,944 63,031 — — 3,944 63,031 66,975 1,692 — 1985 December 17, 2019 40 Layton, UT Acute care general hospital 14,360 370,154 3,034 — 14,360 373,188 387,548 4,914 — 1976-2010 September 29, 2017 40 Leawood, KS Acute care general hospital 2,513 13,938 — — 2,513 13,938 16,451 474 — 2017 June 10, 2019 50 Lehi, UT Acute care general hospital 13,403 29,950 601 (35 ) 13,368 30,551 43,919 2,899 — 2015 September 29, 2017 45 Lewiston, ID Acute care general hospital 5,389 75,435 — — 5,389 75,435 80,824 9,353 — 1922 May 1, 2017 40 Little Elm, TX Freestanding ER 1,241 3,491 — — 1,241 3,491 4,732 615 — 2013 December 1, 2013 40 Liverpool, Australia Acute care general hospital 14,605 45,773 101 — 14,706 45,773 60,479 2,432 — 1975 June 7, 2019 30 London, UK Acute care general hospital 9,842 65,503 82 — 9,924 65,503 75,427 1,643 — 1984 January 9, 2020 40 London, UK Acute care general hospital 3,500 4,454 27 — 3,527 4,454 7,981 113 — 1987 January 9, 2020 40 London, UK Acute care general hospital 13,342 87,261 27 — 13,369 87,261 100,630 2,183 — 1977 January 9, 2020 40 Longmont, CO Freestanding ER 1,826 4,181 — — 1,826 4,181 6,007 514 — 2016 February 10, 2016 40 Lubbock, TX Rehabilitation hospital 1,376 28,292 3,648 — 1,376 31,940 33,316 4,281 — 2008 June 16, 2015 40 Lynwood, CA Acute care general hospital 30,116 148,527 — — 30,116 148,527 178,643 1,555 — 1940, 1989-2000 August 13, 2020 40 Mandeville, LA Freestanding ER 2,800 5,370 — — 2,800 5,370 8,170 559 — 2016 October 28, 2016 40 Marrero, LA Freestanding ER 1,632 5,801 — — 1,632 5,801 7,433 653 — 2016 July 15, 2016 40 McKinney, TX Freestanding ER 2,722 4,060 — — 2,722 4,060 6,782 739 — 2015 July 31, 2015 30 McMinnville, OR Acute care general hospital 5,000 97,900 — — 5,000 97,900 102,900 11,641 — 1996 August 31, 2015 41 Melbourne, FL Acute care general hospital 5,642 17,087 13,443 — 5,642 30,530 36,172 2,132 — 2002 May 1, 2017 42 Mesa, AZ Acute care general hospital 6,534 100,042 1,885 — 6,534 101,927 108,461 19,203 — 2007 September 26, 2013 40 Meyersdale, PA Acute care general hospital 390 4,280 — — 390 4,280 4,670 183 — 1960 December 17, 2019 30 Milton Keynes, UK Acute care general hospital 5,536 38,506 96 — 5,632 38,506 44,138 969 — 1983 January 9, 2020 40 Mount Pleasant, SC Long term acute care hospital 597 2,198 — — 597 2,198 2,795 85 — 2012 August 30, 2019 40 Phoenix, AZ Acute care general hospital 5,576 45,782 — — 5,576 45,782 51,358 4,483 — 2017 February 10, 2017 40 Methuen, MA Acute care general hospital 23,809 89,505 9,184 — 23,809 98,689 122,498 11,290 — 1950-2011 October 3, 2016 41 Bloomington, IN Acute care general hospital 2,392 28,212 5,000 408 2,392 33,620 36,012 11,742 — 2006 August 8, 2006 40 Montclair, NJ Acute care general hospital 7,900 99,640 577 — 8,477 99,640 108,117 17,270 — 1920-2000 April 1, 2014 40 San Antonio, TX Freestanding ER 351 3,952 — — 351 3,952 4,303 666 — 2014 January 1, 2014 40 Newark, NJ Acute care general hospital 32,957 24,553 — — 32,957 24,553 57,510 106 — 1919, 1920-2003 May 2, 2016 40 New Braunfels, TX Rehabilitation hospital 1,853 10,622 — — 1,853 10,622 12,475 23 — 2011 February 29, 2012 40 Colorado Springs, CO Freestanding ER 600 4,231 — — 600 4,231 4,831 697 — 2014 June 5, 2014 40 Initial Costs Additions Subsequent to Acquisition Cost at December 31, 2020(1) Accumulated Life on which depreciation in latest income statements is Location Type of Property Land Buildings Improve- ments Carrying Costs Land Buildings Total Depreciation Encum- brances Date of Construction Date Acquired computed (Years) (Dollar amounts in thousands) Northland, MO Long term acute care hospital 834 17,182 — — 834 17,182 18,016 4,260 — 2007 February 14, 2011 40 Norwood, MA Acute care general hospital 7,073 154,496 35,897 — 7,073 190,393 197,466 9,055 — 1926-2001 June 27, 2018 46 Nottingham, UK Acute care general hospital 5,058 49,340 260 — 5,318 49,340 54,658 1,251 — 1983 January 9, 2020 40 Altoona, WI Acute care general hospital — 29,062 — — — 29,062 29,062 4,601 — 2014 August 31, 2014 40 Odessa, TX Acute care general hospital 6,535 123,518 4,571 — 6,535 128,089 134,624 10,331 — 1973-2004 September 29, 2017 41 Ogden, UT Rehabilitation hospital 1,759 16,414 — — 1,759 16,414 18,173 2,792 — 2014 March 1, 2014 40 Olathe, KS Acute care general hospital 3,485 14,484 — — 3,485 14,484 17,969 498 — 2018 June 10, 2019 50 Olympia, WA Acute care general hospital 7,220 89,348 15,930 — 7,220 105,278 112,498 11,733 — 1984 July 22, 2016 40 Orpington, UK Acute care general hospital 10,936 45,864 164 — 11,100 45,864 56,964 1,157 — 1987 January 9, 2020 40 Ottumwa, IA Acute care general hospital 2,377 48,697 — — 2,377 48,697 51,074 1,811 — 1950 December 17, 2019 30 Overland Park, KS Acute care general hospital 2,974 14,405 — — 2,974 14,405 17,379 498 — 2017 June 10, 2019 50 Overland Park, KS Acute care general hospital 3,191 14,263 — — 3,191 14,263 17,454 518 — 2019 June 10, 2019 50 Overlook, TX Acute care general hospital 2,452 9,666 7 — 2,452 9,673 12,125 1,897 — 2012 February 1, 2013 40 Palestine, TX Acute care general hospital 1,848 95,257 — — 1,848 95,257 97,105 2,496 — 1988 December 17, 2019 40 San Diego, CA Acute care general hospital 6,550 15,653 — 77 6,550 15,730 22,280 5,372 — 1964 May 9, 2007 40 Parker, CO Freestanding ER 1,300 4,448 — — 1,300 4,448 5,748 574 — 2015 November 6, 2015 40 Pasco, WA Acute care general hospital 2,594 13,195 — — 2,594 13,195 15,789 1,052 — 1920 August 31, 2018 30 Pearland, TX Freestanding ER 1,075 3,577 — — 1,075 3,577 4,652 566 — 2014 September 8, 2014 40 Perth, Australia Acute care general hospital 112,312 39,888 1,772 — 112,546 41,426 153,972 2,160 — 1965 June 7, 2019 30 Petersburg, VA Rehabilitation hospital 1,302 9,121 — — 1,302 9,121 10,423 2,850 — 2006 July 1, 2008 40 Phoenix, AZ Acute care general hospital 2,396 26,521 12,253 — 2,396 38,774 41,170 2,521 — 1979 September 29, 2017 42 Phoenix, AZ Acute care general hospital 12,695 73,773 4,978 — 12,695 78,751 91,446 6,703 — 1968-1976 September 29, 2017 43 Plano, TX Freestanding ER 4,343 2,492 — — 4,343 2,492 6,835 375 — 2016 September 30, 2016 40 Poole, UK Acute care general hospital 1,942 41,213 555 — 2,497 41,213 43,710 1,868 — 1996 April 3, 2019 40 Poplar Bluff, MO Acute care general hospital 2,659 38,693 — 1 2,659 38,694 41,353 12,278 — 1980 April 22, 2008 40 Port Arthur, TX Acute care general hospital 12,972 78,051 3,384 — 12,972 81,435 94,407 14,383 — 2005 September 26, 2013 40 Port Huron, MI Acute care general hospital 2,531 14,252 — — 2,531 14,252 16,783 2,434 — 1953, 1973-1983 December 31, 2015 30 Post Falls, ID Rehabilitation hospital 417 12,175 1,905 — 767 13,730 14,497 2,412 — 2013 December 31, 2013 40 Princes Risborough, UK Acute care general hospital 5,006 — — — 5,006 — 5,006 — — N/A January 9, 2020 40 San Antonio, TX Freestanding ER 2,485 4,253 — — 2,485 4,253 6,738 443 — 2016 October 27, 2016 40 Reading, UK Acute care general hospital 36,861 49,579 501 — 37,362 49,579 86,941 1,727 — 1990 August 16, 2019 40 Reading, UK Acute care general hospital 27,272 88,860 641 — 27,913 88,860 116,773 — — 2012 December 18, 2020 40 Redding, CA Acute care general hospital 1,555 53,863 — 13 1,555 53,876 55,431 18,079 — 1974 August 10, 2007 40 Richmond, VA Long term acute care hospital 1,304 10,071 — — 1,304 10,071 11,375 435 — 1989 August 30, 2019 40 Ringwood, Australia Acute care general hospital 4,413 20,469 146 — 4,559 20,469 25,028 954 — 1973 June 7, 2019 35 Riverton, WY Acute care general hospital 1,163 29,647 — — 1,163 29,647 30,810 919 — 1983 December 17, 2019 36 Austin, TX Freestanding ER 3,782 4,200 — — 3,782 4,200 7,982 434 — 2017 March 2, 2017 40 Roaring Springs, PA Acute care general hospital 1,446 9,549 — — 1,446 9,549 10,995 405 — 1924 December 17, 2019 30 Rochdale, MA Long term acute care hospital 654 3,368 — — 654 3,368 4,022 132 — 1989 August 30, 2019 40 Rochdale, MA Acute care general hospital 67 344 — — 67 344 411 13 — 1989 August 30, 2019 40 Rochdale, UK Acute care general hospital 3,691 43,759 150 — 3,841 43,759 47,600 1,104 — 1965 January 9, 2020 40 Rockledge, FL Acute care general hospital 13,919 23,282 5,512 — 13,919 28,794 42,713 3,413 — 1950, 1970 May 1, 2017 42 Roeland Park, KS Acute care general hospital 1,569 15,103 — — 1,569 15,103 16,672 509 — 2018 June 10, 2019 50 Rosenberg, TX Freestanding ER 1,309 4,505 — — 1,309 4,505 5,814 563 — 2016 January 15, 2016 40 Initial Costs Additions Subsequent to Acquisition Cost at December 31, 2020(1) Accumulated Life on which depreciation in latest income statements is Location Type of Property Land Buildings Improve- ments Carrying Costs Land Buildings Total Depreciation Encum- brances Date of Construction Date Acquired computed (Years) (Dollar amounts in thousands) Rowley, UK Acute care general hospital 2,515 19,652 608 — 3,123 19,652 22,775 717 — 1986 August 16, 2019 40 Columbus, OH Freestanding ER 1,726 — — — 1,726 — 1,726 — — 2016 August 30, 2016 - Salt Lake City, UT Acute care general hospital 13,590 101,915 15,109 — 13,590 117,024 130,614 8,751 — 1906-1987 September 29, 2017 41 San Antonio, TX Acute care general hospital 8,053 29,333 1,945 — 8,053 31,278 39,331 2,735 — 1978-2002 September 29, 2017 41 San Bernardino, CA Acute care general hospital 2,209 37,498 — — 2,209 37,498 39,707 1,366 — 1993 August 30, 2019 40 San Dimas, CA Acute care general hospital 6,161 6,839 — 34 6,161 6,873 13,034 2,080 — 1972 November 25, 2008 40 San Dimas, CA Medical Office Building 1,915 5,085 — 18 1,915 5,103 7,018 1,545 — 1979 November 25, 2008 40 Phoenix, AZ Freestanding ER 1,132 5,052 — — 1,132 5,052 6,184 474 — 2017 April 13, 2017 40 Sebastian, FL Acute care general hospital 5,733 49,136 52,394 — 5,733 101,530 107,263 5,392 — 1974 May 1, 2017 41 Sharon, PA Acute care general hospital 6,179 9,066 6,435 — 6,179 15,501 21,680 2,356 — 1950-1980 May 1, 2017 41 Shawnee, KS Acute care general hospital 3,076 14,945 — — 3,076 14,945 18,021 587 — 2018 June 10, 2019 50 Sheffield, UK Acute care general hospital 6,835 47,906 267 — 7,102 47,906 55,008 1,215 — 2008 January 9, 2020 40 Sherman, TX Acute care general hospital 3,363 10,932 — — 3,363 10,932 14,295 3,169 — 1913, 1960-2010 October 31, 2014 40 Sienna, TX Freestanding ER 1,000 2,027 — — 1,000 2,027 3,027 554 — 2014 August 20, 2014 40 Spartanburg, SC Rehabilitation hospital 1,135 15,717 — — 1,135 15,717 16,852 2,899 — 2013 August 1, 2013 40 St. Albans Park, Australia Acute care general hospital 2,298 23,474 4,921 — 2,893 27,800 30,693 1,008 — 1985 June 7, 2019 40 Stockton, CA Rehabilitation hospital 2,932 — — — 2,932 — 2,932 — — 2021 November 23, 2020 40 Strathpine, Australia Acute care general hospital 2,781 38,949 330 — 3,111 38,949 42,060 1,585 — 1985 June 7, 2019 40 Sunnybank, Australia Acute care general hospital 6,377 48,465 379 — 6,756 48,465 55,221 2,318 — 1979 June 7, 2019 34 Sussex, NJ Freestanding ER 477 2,097 — — 477 2,097 2,574 10 — 1920 September 30, 2015 40 Swindon, UK Acute care general hospital 5,577 64,181 144 — 5,721 64,181 69,902 1,614 — 1984 January 9, 2020 40 Houston, TX Freestanding ER 1,423 1,890 — — 1,423 1,890 3,313 532 — 2015 February 18, 2015 40 Taunton, MA Acute care general hospital 4,428 73,228 11,290 — 4,428 84,518 88,946 8,573 — 1940-2015 October 3, 2016 41 Tempe, AZ Acute care general hospital 6,050 10,986 6,773 — 6,050 17,759 23,809 1,457 — 1940 September 29, 2017 41 Texarkana, TX Acute care general hospital 14,562 — — — 14,562 — 14,562 — — 2017 September 29, 2017 - Thornton, CO Freestanding ER 1,350 4,259 — — 1,350 4,259 5,609 674 — 2014 August 29, 2014 40 Toledo, OH Rehabilitation hospital 1,186 17,740 — — 1,186 17,740 18,926 2,107 — 2016 April 1, 2016 40 Tomball, TX Long term acute care hospital 1,299 23,982 — — 1,299 23,982 25,281 5,996 — 2005 December 21, 2010 40 Torquay, UK Acute care general hospital 2,840 38,379 360 — 3,200 38,379 41,579 1,319 — 1981 August 16, 2019 40 Houston, TX Acute care general hospital 4,047 36,862 — — 4,047 36,862 40,909 4,147 — 2016 July 7, 2016 40 League City, TX Freestanding ER 1,336 3,901 — — 1,336 3,901 5,237 536 — 2015 June 19, 2015 40 Anaheim, CA Acute care general hospital 1,875 21,813 — 10 1,875 21,823 23,698 7,729 — 1964 November 8, 2006 40 Viseu, Portugal Acute care general hospital 2,319 31,963 486 — 2,805 31,963 34,768 971 — 2016 November 28, 2019 37 Wantirna, Australia Acute care general hospital 27,854 229,129 1,050 — 28,904 229,129 258,033 9,208 — 1984 June 7, 2019 40 Warren, OH Acute care general hospital 5,385 47,588 9,893 — 5,385 57,481 62,866 5,935 — 1982 May 1, 2017 41 Watsonville, CA Acute care general hospital 16,488 17,800 — — 16,488 17,800 34,288 818 — 1983 September 30, 2019 39 West Jordan, UT Acute care general hospital 16,896 233,256 3,319 — 16,896 236,575 253,471 3,185 — 1983 September 29, 2017 40 West Monroe, LA Acute care general hospital 12,000 69,433 16,187 — 12,552 85,068 97,620 14,060 — 1962 September 26, 2013 40 San Antonio, TX Acute care general hospital 2,248 5,880 — — 2,248 5,880 8,128 1,199 — 2012 October 2, 2012 40 West Valley City, UT Acute care general hospital 5,374 58,314 7,150 (114 ) 5,260 65,464 70,724 19,035 — 1980 April 22, 2008 40 Wichita, KS Rehabilitation hospital 1,019 18,373 — 1 1,019 18,374 19,393 5,856 — 1992 April 4, 2008 40 Winchester, UK Acute care general hospital 6,835 11,035 130 — 6,965 11,035 18,000 284 — 1911 January 9, 2020 40 Windsor, UK Acute care general hospital 12,973 112,450 109 — 13,082 112,450 125,532 2,818 — 1955 January 9, 2020 40 Worthing, UK Acute care general hospital 7,108 32,370 103 — 7,211 32,370 39,581 816 — 1994 January 9, 2020 40 Youngstown, OH Acute care general hospital 4,335 3,565 824 — 4,335 4,389 8,724 2,160 — 1929-2003 May 1, 2017 41 $ 1,442,071 $ 8,857,393 $ 428,465 $ 21,778 $ 1,463,201 $ 9,286,506 $ 10,749,707 $ 728,176 (1) The aggregate cost for federal income tax purposes is $10.9 The changes in total real estate assets (excluding construction in progress, intangible lease assets, investment in financing leases, and mortgage loans) are as follows for the years ended (in thousands): December 31, 2020 December 31, 2019 December 31, 2018 COST Balance at beginning of period $ 7,312,486 $ 4,781,149 $ 5,438,148 Acquisitions 2,912,594 2,436,265 758,619 Transfers from construction in progress 202,999 — 25,513 Additions 55,137 173,785 96,775 Dispositions (105,360 ) (106,536 ) (1,318,238 ) Other 371,851 (2) 27,823 (2) (219,668 ) (2) Balance at end of period $ 10,749,707 $ 7,312,486 $ 4,781,149 The changes in accumulated depreciation are as follows for the years ended (in thousands): December 31, 2020 December 31, 2019 December 31, 2018 ACCUMULATED DEPRECIATION Balance at beginning of period $ 504,651 $ 414,331 $ 407,349 Depreciation 222,580 130,851 115,497 Depreciation on disposed property (6,653 ) (40,952 ) (101,967 ) Other 7,598 421 (6,548 ) Balance at end of period $ 728,176 $ 504,651 $ 414,331 (2) Includes foreign currency fluctuations for all years and $13.8 million and $61.4 million of right-of-use assets in 2020 and 2019, respectively.

SCHEDULE IV - MORTGAGE LOANS ON

SCHEDULE IV - MORTGAGE LOANS ON REAL ESTATE	12 Months Ended
	Dec. 31, 2020
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, 2020 Column A Column B Column C Column D Column E Column F Column G(1) Column H Description Interest Rate Final Maturity Date Periodic Payment Terms Prior Liens Face Amount of Mortgages Carrying Amount of Mortgages Principal Amount of Loans Subject to Delinquent Principal or Interest (Dollar amounts in thousands) Long-term first mortgage loan: Payable in monthly installments of interest plus principal payable in full at maturity Olympia Medical Center 11.14 % 2024 (2) (3 ) $ 25,000 $ 25,000 (4 ) East Ohio Regional Hospital 8.00 % 2025 (3 ) 1,750 1,750 (4 ) Colombia(5) 8.95 % 2035 (3 ) 136,332 136,332 (4 ) St. Luke's Hospital (6) 2021 (3 ) 15,000 15,000 (4 ) Vibra 11.50 % 2024 (3 ) 18,986 18,986 (4 ) Prospect 7.50 % 2034 (3 ) 51,267 51,267 (4 ) $ 248,335 $ 248,335 (7 ) (1) The aggregate cost for federal income tax purposes is $248.3 million. (2) Loan was paid off subsequent to December 31, 2020. (3) There were no prior liens on loans as of December 31, 2020. (4) The mortgage loan was not delinquent with respect to principal or interest. (5) Mortgage loans covering three properties. (6) Principal only due to short-term nature of loan. (7) Excludes allowance for credit loss of $0.3 million at December 31, 2020. Changes in mortgage loans (excluding allowance for credit loss for 2020 only and unamortized loan issue costs for 2019 and 2018 only) for the years ended December 31, 2020, 2019, and 2018 are summarized as follows: Year Ended December 31, 2020 2019 2018 (Dollar amounts in thousands) Balance at beginning of year $ 1,274,995 $ 1,213,283 $ 1,778,264 Additions during year: New mortgage loans and additional advances on existing loans 193,590 61,712 50,783 Exchange rate fluctuations 9,785 — — 1,478,370 1,274,995 1,829,047 Deductions during year: Collection of principal (1,230,035 ) (8) — (615,764 ) (1,230,035 ) — (615,764 ) Balance at end of year $ 248,335 $ 1,274,995 $ 1,213,283 (8) 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, 2020
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. During 2020, the global outbreak of a novel coronavirus, or COVID-19, spread all over the world including countries where we own and lease facilities. The World Health Organization designated COVID-19 as a pandemic, and numerous countries, including the U.S., declared national emergencies with respect to COVID-19. As the global impact of the outbreak evolved, many countries reacted by instituting quarantines and restrictions on travel, closing financial markets and/or restricting trade- including requiring medically necessary elective surgeries at hospitals to be deferred. Although hospitals are back accepting patients and performing medically necessary elective surgeries, many of these trade restrictions are still in place. We believe the estimates and assumptions underlying our consolidated financial statements are reasonable and supportable based on the information available as of December 31, 2020 (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). However, the ultimate impact to our tenants’ results of operations and liquidity and their ability to pay our rent and interest due to the impact of COVID-19 cannot be predicted with 100% confidence, particularly given the full scope, severity, and duration of the pandemic and the actions needed (including vaccine rollouts worldwide) to contain the pandemic or mitigate its impact is uncertain. This makes any estimates and assumptions as of December 31, 2020 inherently less certain than they would be absent the potential impact of COVID-19. Actual results could differ from those estimates.
Principles of Consolidation	Principles of Consolidation: Property holding entities and other subsidiaries of which we own 100% of the equity or have a controlling financial interest evidenced by ownership of a majority voting interest are consolidated. All inter-company balances and transactions are eliminated. For entities in which we own less than 100% of the equity interest, we consolidate the property if we have the direct or indirect ability to control the entities’ activities based upon the terms of the respective entities’ ownership agreements. For these entities, we record a non-controlling interest representing equity held by non-controlling interests. We continually evaluate all of our transactions and investments to determine if they represent variable interests in a variable interest entity. If we determine that we have a variable interest in a variable interest entity, we then evaluate if we are the primary beneficiary of the variable interest entity. The evaluation is a qualitative assessment as to whether we have the ability to direct the activities of a variable interest entity that most significantly impact the entity’s economic performance. We consolidate each variable interest entity in which we, by virtue of or transactions with our investments in the entity, are considered to be the primary beneficiary. At December 31, 2020, we had loans and/or equity investments in certain variable interest entities approximating $230 million, which represents our maximum exposure to loss as a result of our involvement in such entities. We have determined that we were not the primary beneficiary of any variable interest entity in which we hold a variable interest because we do not control the activities (such as the day-to-day operations) that most significantly impact the economic performance of these entities.
Investments in Unconsolidated Entities	Investments in Unconsolidated Entities: Investments in entities in which we have the ability to significantly influence (but not control) are accounted for by the equity method, such as our joint venture with Primotop Holdings S.à.r.l. (“Primotop”) as discussed in Note 3 . Under the equity method of accounting, our share of the investee’s earnings or losses are included in the “Earnings from equity interests” line of our consolidated statements of net income. Except for our joint venture with Primotop, we have elected to record our share of such investee’s earnings or losses on a lag basis. The initial carrying value of investments in unconsolidated entities is based on the amount paid to purchase the interest in the investee entity. Subsequently, our investments are increased/decreased by our share in the investees’ earnings/losses and decreased by cash distributions from our investees. To the extent that our cost basis is different from the basis reflected at the investee entity level, the basis difference is generally amortized over the lives of the related assets and liabilities, and such amortization is included in our share of equity in earnings of the investee. We evaluate our equity method investments for impairment based upon a comparison of the fair value of the equity method investment to its carrying value, when impairment indicators exist. If we determine a decline in the fair value of an investment in an unconsolidated investee entity below its carrying value is 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 investments in Steward Health Care System LLC (“Steward”) and Median Kliniken S.á.r.l. (“MEDIAN”)) are accounted for at cost, less any impairment, plus or minus changes resulting from observable price changes in orderly transactions involving the investee. Any cash distributions on these types of investments are recorded to income upon receipt. 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. On January 1, 2019, we adopted Accounting Standards Update (“ASU”) 2016-02, “Leases”, (“ASU 2016-02”). ASU 2016-02 sets out the principles for the recognition, measurement, presentation, and disclosure of leases for both parties to a contract (i.e. lessees and lessors). We adopted this standard using the modified retrospective approach and elected the package of practical expedients permitted under the transition guidance within the new standard, which among other things permitted the following: no reassessment of whether existing contracts were or contained a lease and no reassessment of lease classification for existing leases. In addition, we made certain elections permitted which (1) allowed entities to apply the transition provisions of the new standard at its adoption date instead of at the earliest comparative period presented and (2) permitted lessors to account for lease and non-lease components as a single lease component in a contract if certain criteria were met. For lessors, this new standard of accounting for leases was substantially equivalent to previous guidance, but there were some differences which we highlight below: Operating Lease Revenue We receive income from operating leases based on the fixed required rents (base rents) per the lease agreements. Rent revenue from base rents is recorded on the straight-line method over the terms of the related lease agreements for new leases and the remaining terms of existing leases for those acquired as part of a property acquisition. The straight-line method records the periodic average amount of base rents earned over the term of a lease, taking into account contractual rent increases over the lease term. The straight-line method typically has the effect of recording more rent revenue from a lease than a tenant is required to pay early in the term of the lease. During the later parts of a lease term, this effect reverses with less rent revenue recorded than a tenant is required to pay. Rent revenue, as recorded on the straight-line method, in the 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 the lease accounting rules adopted on January 1, 2019, if an acquisition and subsequent lease of a property to the seller does not meet the definition of a sale, we must account for the transaction as a financing with income recognized using the imputed interest method. Another type of financing lease that we carried forward from the previous lease accounting guidance is a direct financing lease (“DFL”). For leases accounted for as DFLs, the future minimum lease payments are recorded as a receivable. The difference between the future minimum lease payments and the estimated residual values less the cost of the properties is recorded as unearned income. Unearned income is deferred and amortized to income over the lease terms to provide a constant yield when collectability of the lease payments is reasonably assured. Investments in DFLs are presented net of unearned income. Other Leasing Revenue We begin recording base rent income from our development projects when the lessee takes physical possession of the facility, which may be different from the stated start date of the lease. Also, during construction of our development projects, we may be entitled to accrue rent based on the cost paid during the construction period (construction period rent). We accrue construction period rent as a receivable with a corresponding offset to deferred revenue during the construction period. When the lessee takes physical possession of the facility, we begin recognizing the deferred construction period revenue on the straight-line method over the term of the lease. We also receive additional rent (contingent rent) under some leases based on increases in the consumer price index (“CPI”) (or similar index outside the U.S.) or when CPI exceeds the annual minimum percentage increase as stipulated in the lease. Contingent rents are recorded as rent billed revenue in the period earned. Starting January 1, 2019 (with the adoption of ASU 2016-02), tenant payments for ground leases along with other operating expenses, such as property taxes and insurance, that are paid directly by us and reimbursed by our tenants are presented on a gross basis with the related revenues recorded in “Interest and other income” and the related expenses in “Property-related” in our consolidated statements of net income. All payments of other operating expenses made directly by the tenant to the applicable government or appropriate third-party vendor are recorded on a net basis, consistent with how all tenant payments or reimbursements pursuant to our “triple-net” leases were accounted for prior to the adoption of ASU 2016-02. Interest Revenue We receive interest income from our tenants/borrowers on mortgage loans, working capital loans, and other long-term loans. Interest income from these loans is recognized as earned based upon the principal outstanding and terms of the loans. Other Revenue Commitment fees received from lessees for development and leasing services are initially recorded as deferred revenue and recognized as income over the initial term of a lease to produce a constant effective yield on the lease (interest method). Commitment and origination fees from lending services are also recorded as deferred revenue initially and recognized as income over the life of the loan using the interest method.
Acquired Real Estate Purchase Price Allocation	Acquired Real Estate Purchase Price Allocation: 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 fair values. In making estimates of fair values for purposes of allocating purchase prices of acquired real estate, we may utilize a number of sources, from time-to-time, including available real estate broker data, independent appraisals that may be obtained in connection with the acquisition, internal data from previous acquisitions or developments, and other market data, including market comparables for significant assumptions such as market rental, capitalization, and discount rates. We also consider information obtained about each property as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the tangible and intangible assets acquired. We measure the aggregate value of lease intangible assets acquired based on the difference between (i) the property valued with new or in-place leases adjusted to market rental rates and (ii) the property valued as if vacant. Management’s estimates of value are made using methods similar to those used by independent appraisers (e.g., discounted cash flow analysis). Factors considered by management in our analysis include an estimate of carrying costs during hypothetical expected lease-up periods, considering current market conditions, and costs to execute similar leases. We also consider information obtained about each targeted facility as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the intangible assets acquired. In estimating carrying costs, management includes real estate taxes, insurance , and other operating expenses and estimates of lost rentals at market rates during the expected lease-up periods, which we expect to be about six months , but can be longer depending on specific local market conditions. Management also estimates costs to execute similar leases including leasing commissions, legal costs, and other related expenses to the extent that such costs are not already incurred in connection with a new lease origination as part of the transaction. Other intangible assets acquired may include customer relationship intangible values which are based on management’s evaluation of the specific characteristics of each prospective tenant’s lease and our overall relationship with that tenant. Characteristics to be considered by management in allocating these values include the nature and extent of our existing business relationships with the tenant, growth prospects for developing new business with the tenant, the tenant’s credit quality, and expectations of lease renewals, including those existing under the terms of the lease agreement, among other factors. We amortize the value of our lease intangible assets to expense over the term of the respective leases. If a lease is terminated early, the unamortized portion of the lease intangibles are charged to expense. We record above-market and below-market in-place lease values, if any, for our facilities, which are based on the present value of the difference between (i) the contractual amounts to be paid pursuant to the in-place leases and (ii) management’s estimate of fair market lease rates for the corresponding in-place leases, measured over a period equal to the remaining non-cancelable term of the lease. We amortize any resulting capitalized above-market lease values as a reduction of rental income over the lease term. We amortize any resulting capitalized below-market lease values as an increase to rental income over the lease term. If a lease is terminated early, the unamortized portion of the capitalized above/below market lease value is recognized in rental income at that time.
Real Estate and Depreciation	Real Estate and Depreciation: Real estate, consisting of land, buildings and improvements, are maintained at cost. Although typically paid by our tenants, any expenditure for ordinary maintenance and repairs that we pay are expensed to operations as incurred. Significant renovations and improvements which improve and/or extend the useful life of the asset are capitalized and depreciated over their estimated useful lives. We record impairment losses on long-lived assets used in operations when events and circumstances indicate that the assets might be impaired and the undiscounted cash flows estimated to be generated by those assets, including an estimated liquidation amount, during the expected holding periods are less than the carrying amounts of those assets. Impairment losses are measured as the difference between carrying value and fair value of the assets. For assets held for sale, we cease recording depreciation expense and adjust the assets’ value to the lower of its carrying value or fair value, less cost of disposal. Fair value is based on estimated cash flows discounted at a risk-adjusted rate of interest. We classify real estate assets as held for sale when we have commenced an active program to sell the assets, and in the opinion of management, it is probable the asset will be sold within the next 12 months. Construction in progress includes the cost of land, the cost of construction of buildings, improvements, and fixed equipment, and costs for design and engineering. Other costs, such as interest, legal, property taxes, and corporate project supervision, which can be directly associated with the project during construction, are also included in construction in progress. We commence capitalization of costs associated with a development project when the development of the future asset is probable and activities necessary to get the underlying property ready for its intended use have been initiated. We stop the capitalization of costs when the property is substantially complete and ready for its intended use. Depreciation is calculated on the straight-line method over the estimated useful lives of the related real estate and other assets. Our weighted-average useful lives at December 31, 2020 are as follows: Buildings and improvements 39.0 years Lease intangibles 26.1 years Leasehold improvements 17.0 years Furniture, equipment, and other 9.8 years
Losses from Rent Receivables	Credit Losses: Losses from Rent Receivables: Losses from Operating Lease Receivables: 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: With the adoption of ASU 2016-13, we made the accounting policy election to exclude interest receivables from the credit loss reserve analysis. Such receivables are impaired and an allowance recorded when it is deemed probable that we will be unable to collect all amounts due. Like operating lease receivables, the need for an allowance is based upon our assessment of the lessee’s overall financial condition, economic resources and payment record, the prospects for support from any financially responsible guarantors, and, if appropriate, the realizable value of any collateral. Financing leases are placed on non-accrual status when we determine that the collectability of contractual amounts is not reasonably assured. If on non-accrual status, we generally account for the financing lease on a cash basis, in which income is recognized only upon receipt of cash.
Loans	Loans Upon adoption of ASU 2016-13, we recorded a credit loss reserve of $8.4 million with the effect recorded in equity as a cumulative effect of a change in accounting principle.
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 a TRS, MPT Development Services, Inc. (“MDS”), and with many other entities, which are single member LLCs that are disregarded for tax purposes and are reflected in the tax returns of MDS. MDS is not entitled to a dividends paid deduction and is subject to U.S. federal, state, and local income taxes. MDS is authorized to provide property development, leasing, and management services for third-party owned properties, and we will make non-mortgage loans to and/or investments in our lessees through this entity . With the property acquisitions and investments in Europe, Australia, and South America, we are subject to income taxes internationally. However, we do not expect to incur any additional income taxes in the U.S. as such income from our international properties flows through our REIT income tax returns. For our TRS and international subsidiaries, we determine deferred tax assets and liabilities based on the differences between the financial reporting and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Any increase or decrease in our deferred tax assets/liabilities that results from a change in circumstances and that causes us to change our judgment about expected future tax consequences of events, is reflected in our tax provision when such changes occur. Deferred income taxes also reflect the impact of operating loss carryforwards. A valuation allowance is provided if we believe it is more likely than not that all or some portion of our deferred tax assets will not be realized. Any increase or decrease in the valuation allowance that results from a change in circumstances, and that causes us to change our judgment about our ability to realize the related deferred tax asset, is reflected in our tax provision when such changes occur. The calculation of our income taxes involves dealing with uncertainties in the application of complex tax laws and regulations in a multitude of jurisdictions across our global operations. An income tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, on the basis of technical merits. However, if a more likely than not position cannot be reached, we record a liability as an offset to the tax benefit and adjust the liabilities when our judgment changes as a result of the evaluation of new information not previously available. Because of the complexity of some of these uncertainties, the ultimate resolution may result in a payment that is materially different from our current estimate of the uncertain tax position liabilities. These differences will be reflected as increases or decreases to income tax expense in the period in which new information is available.
Stock-Based Compensation	Stock-Based Compensation: We adopted the 2019 Equity Incentive Plan (the “Equity Incentive Plan”) during the second quarter of 2019. Awards of restricted stock and other equity-based awards with service conditions are valued at the average stock price per share on the date of grant and are amortized to compensation expense over the service periods (typically three years), using the straight-line method. Awards that contain market conditions are valued on the grant date using a Monte Carlo valuation model and are amortized to compensation expense over the derived service periods, which correspond to the periods over which we estimate the awards will be earned, which generally range from three to five years, using the straight-line method. Awards with performance conditions are valued at the average stock price per share on the date of grant and are amortized using the straight-line method over the service period, adjusted for the probability of achieving the performance conditions. Forfeitures of stock-based awards are recognized as they occur.
Deferred Costs	Deferred Costs: Costs incurred that directly relate to the offerings of stock are deferred and netted against proceeds received from the offering. Leasing commissions and other leasing costs that would not have been incurred if the lease was not obtained are capitalized as deferred leasing costs and amortized on the straight-line method over the terms of the related lease agreements. Costs identifiable with loans made to borrowers are capitalized and recognized as a reduction in interest income over the life of the loan.
Deferred Financing Costs	Deferred Financing Costs: We generally capitalize financing costs incurred in connection with new financings and refinancings of debt. These costs are amortized over the lives of the related debt as an addition to interest expense. For debt with defined principal re-payment terms, the deferred costs are amortized to produce a constant effective yield on the debt (interest method) and are included within “Debt, net” on our consolidated balance sheets. For debt without defined principal repayment terms, such as our revolving credit facility, the deferred costs are amortized on the straight-line method over the term of the debt and are included as a component of “Other 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 on our consolidated balance sheets. Certain of our U.S. subsidiaries will enter into short-term and long-term transactions denominated in a foreign currency from time-to-time. Gains or losses resulting from these foreign currency transactions are revalued into U.S. dollars at the rates of exchange prevailing at the dates of the transactions. The effects of revaluation gains or losses on our short-term transactions are included in other income in the consolidated statements of income, while the revaluation effects on our long-term investments are recorded in “Accumulated other comprehensive income (loss)” on our consolidated balance sheets.
Derivative Financial Investments and Hedging Activities	Derivative Financial Investments and Hedging Activities: During our normal course of business, we may use certain types of derivative instruments for the purpose of managing interest rate and/or foreign currency risk. We record our derivative and hedging instruments at fair value on the balance sheet. Changes in the estimated fair value of derivative instruments that are not designated as hedges or that do not meet the criteria for hedge accounting are recognized in earnings. For derivatives designated as cash flow hedges, the change in the estimated fair value of the effective portion of the derivative is recognized in “A ccumulated 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 por tion 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 new international joint venture along with any related investments such as loans (see Note 3 for more details), we have elected to account for these investments at fair value due to the size of the investments and because we believe this method is more reflective of current values. We have not made a similar election for other investments that existed at December 31, 2020.
Leases (Lessee)	Leases (Lessee) Pursuant to ASU 2016-02, we are required to apply a dual approach, classifying leases as either financing or operating leases based on the principle of whether or not the lease is effectively a financed purchase by the lessee. This classification determines whether lease expense is recognized based on an effective interest method (for finance leases) or on a straight-line basis (for operating leases) over the term of the lease. Starting January 1, 2019, we began recording 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, similar to previous guidance for operating leases.
Reclassification	Reclassifications: Certain amounts in the consolidated financial statements for prior periods have been reclassified to conform to the current period presentation.
Recent Accounting Developments	Recent Accounting Developments Reference Rate Reform In March 2020, the Financial Accounting Standards Board (“FASB”) issued ASU No. 2020-04, “Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting” (“ASU 2020-04”) to simplify the accounting for contract modifications made to replace LIBOR or other reference rates that are expected to be discontinued because of reference rate reform. The guidance provides optional expedients and exceptions for applying U.S. GAAP to contracts, hedging relationships, and other transactions affected by reference rate reform if certain criterion are met. The optional expedients and exceptions can be applied to contract modifications made until December 31, 2022. On January 7, 2021, the FASB issued ASU No. 2021-01, “Reference Rate Reform (Topic 848)” (“ASU 2021-01”), which clarifies that certain optional expedients and exceptions in Topic 848 for contract modifications and hedge accounting apply to derivatives that are affected by the discounting transition. The amendments in ASU 2021-01 are elective and apply to our debt and derivative instruments that may be modified as a result of reference rate reform. We are continuing to evaluate these standards, as well as the timing of the transition of various rates in our debt and derivative instruments affected by reference rate reform.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2020
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, 2020 are as follows: Buildings and improvements 39.0 years Lease intangibles 26.1 years Leasehold improvements 17.0 years Furniture, equipment, and other 9.8 years

Real Estate Activities (Tables)

Real Estate Activities (Tables)	12 Months Ended
	Dec. 31, 2020
Real Estate [Line Items]
Net Assets Acquired	For the years ended December 31, 2020, 2019, and 2018, we acquired or invested in the following net assets (in thousands): 2020 2019 2018 Land and land improvements $ 365,281 $ 400,539 $ 71,880 Buildings 2,547,313 1,951,066 686,739 Intangible lease assets — subject to amortization (weighted-average useful life of 27.5 years in 2020, 19.1 years in 2019, and 27.9 years in 2018) 642,699 227,468 90,651 Investment in financing leases 114,797 1,386,797 — Equity investments 233,593 415,836 245,267 Mortgage loans 176,840 51,267 — Other loans and assets 309,523 135,258 336,458 Liabilities assumed (140,866 ) (2,637 ) — Total assets acquired $ 4,249,180 $ 4,565,594 $ 1,430,995 Loans repaid(1) (834,743 ) — (764,447 ) Total net assets acquired $ 3,414,437 $ 4,565,594 $ 666,548 (1) The 2020 column includes approximately $750 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. The 2018 column includes $0.8 billion of loans advanced to Steward in 2016 and repaid in 2018 as part of sale leaseback conversion described below.
Summary of Status on Current Development Projects	See table below for a status summary of our current development projects (in thousands): Property Commitment Costs Incurred as of December 31, 2020 Estimated Rent Commencement Date Ernest (Bakersfield, California) $ 47,929 $ 19,034 4Q 2021 Ernest (Stockton, California) 47,700 11,105 1Q 2022 $ 95,629 $ 30,139
Amortization Expense from Existing Lease Intangible Assets	We recorded amortization expense related to intangible lease assets of $42.4 million, $21.5 million, and $17.6 million in 2020, 2019, and 2018, respectively, and expect to recognize amortization expense from existing lease intangible assets as follows (amounts in thousands): For the Year Ended December 31: 2021 $ 44,286 2022 44,272 2023 44,206 2024 44,173 2025 44,025
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, 2020 (amounts in thousands): Total Under Operating Leases Total Under Financing Leases Total 2021 $ 858,067 $ 160,925 $ 1,018,992 2022 875,350 164,144 1,039,494 2023 890,761 167,427 1,058,188 2024 905,176 170,775 1,075,951 2025 919,984 174,191 1,094,175 Thereafter 22,102,425 4,593,755 26,696,180 $ 26,551,763 $ 5,431,217 $ 31,982,980
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, 2020 As of December 31, 2019 Minimum lease payments receivable $ 1,228,966 $ 1,884,921 Estimated residual values 203,818 394,195 Less: Unearned income and allowance for credit loss (969,061 ) (1,618,252 ) Net investment in direct financing leases 463,723 660,864 Other financing leases (net of allowance for credit loss) 1,547,199 1,399,438 Total investment in financing leases $ 2,010,922 $ 2,060,302
Summary of Loans (Net of Allowance for Credit Loss)	The following is a summary of our loans (net of allowance for credit loss in 2020) ($ amounts in thousands): As of December 31, 2020 As of December 31, 2019 Balance Weighted-Average Interest Rate Balance Weighted-Average Interest Rate Mortgage loans $ 248,080 8.5 % $ 1,275,022 9.0 % Acquisition loans 338,273 7.6 % 123,893 7.7 % Other loans 520,095 5.8 % 420,939 5.7 % $ 1,106,448 $ 1,819,854
2018 [Member]
Real Estate [Line Items]
Summary of Operations for Disposed Assets	The following represents the operating results (excluding the St. Joseph sale in March 2018) of the properties sold in 2018 for the periods presented (in thousands): For the Year Ended 2018 Revenues $ 88,838 Real estate depreciation and amortization (15,849 ) Property-related expenses (531 ) Other(1) 709,717 Income from real estate dispositions, net $ 782,175 (1) Includes approximately $720 million of gains on sale for the twelve months ended December 31, 2018.

Debt (Tables)

Debt (Tables)	12 Months Ended
	Dec. 31, 2020
Debt Disclosure [Abstract]
Summary of Debt	The following is a summary of debt (dollar amounts in thousands): As of December 31, 2020 As of December 31, 2019 Revolving credit facility(A) $ 165,407 $ — Term loan 200,000 200,000 British pound sterling term loan(B) 956,900 — Australian term loan facility(B) 923,280 842,520 4.000% Senior Unsecured Notes due 2022(B) 610,800 560,650 2.550% Senior Unsecured Notes due 2023(B) 546,800 530,280 5.500% Senior Unsecured Notes due 2024 — 300,000 6.375% Senior Unsecured Notes due 2024 — 500,000 3.325% Senior Unsecured Notes due 2025(B) 610,800 560,650 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) 820,200 795,420 4.625% Senior Unsecured Notes due 2029 900,000 900,000 3.500% Senior Unsecured Notes due 2031 1,300,000 — $ 8,934,187 $ 7,089,520 Debt issue costs and discount, net (68,729 ) (65,841 ) $ 8,865,458 $ 7,023,679 (A) Includes £121 million of GBP-denominated borrowings that reflect the exchange rate at December 31, 2020. (B) Non-U.S. dollar denominated debt that reflects the exchange rate at period end.
Principal Payments Due on Debt	As of December 31, 2020, 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): 2021 $ 165,407 2022 810,800 2023 546,800 2024 923,280 2025 1,567,700 Thereafter 4,920,200 Total $ 8,934,187

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2020
Income Tax Disclosure [Abstract]
Schedule of Income Tax Benefit (Expense)	From our TRS and our foreign operations, income tax benefit (expense) were as follows (in thousands): For the Years Ended December 31, 2020 2019 2018 Current income tax benefit (expense): Domestic $ 63 $ 61 $ 125 Foreign (10,203 ) (1,669 ) (3,294 ) (10,140 ) (1,608 ) (3,169 ) Deferred income tax benefit (expense): Domestic (10,680 ) 5,490 3,713 Foreign (10,236 ) (1,261 ) (1,471 ) (20,916 ) 4,229 2,242 Income tax benefit (expense) $ (31,056 ) $ 2,621 $ (927 )
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 benefit (expense) from the statutory income tax rate to the effective tax rate based on income before income taxes for the years ended December 31, 2020, 2019, and 2018 is as follows (in thousands): For the Years Ended December 31, 2020 2019 2018 Income before income tax $ 463,328 $ 373,780 $ 1,019,404 Income tax at the U.S. statutory federal rate (21% in 2020, 2019 and 2018) (97,299 ) (78,494 ) (214,075 ) Decrease (increase) in income tax resulting from: Foreign rate differential 2,160 438 2,643 State income taxes, net of federal benefit 970 1,621 (379 ) U.S. earnings not subject to federal income tax 82,921 85,495 208,472 Equity investments 380 1,091 46 Change in valuation allowance (8,514 ) (7,911 ) 2,668 Statutory tax rate change (9,471 ) — — Other items, net (2,203 ) 381 (302 ) Total income tax benefit (expense) $ (31,056 ) $ 2,621 $ (927 )
Schedule of Deferred Tax Assets and Liabilities	At December 31, 2020 and 2019, components of our deferred tax assets and liabilities were as follows (in thousands): 2020 2019 Deferred tax assets: Operating loss and interest deduction carry forwards $ 150,001 $ 28,684 Interest rate swap 9,150 843 Other 6,973 868 Total deferred tax assets 166,124 30,395 Valuation allowance (36,977 ) (11,355 ) Total net deferred tax assets $ 129,147 $ 19,040 Deferred tax liabilities: Property and equipment $ (211,018 ) $ (7,324 ) Net unbilled revenue (14,776 ) (1,449 ) Other (4,010 ) (737 ) Total deferred tax liabilities (229,804 ) (9,510 ) Net deferred tax asset (liability) $ (100,657 ) $ 9,530
Schedule of Net NOL and Other Tax Attribute Carryforwards	At December 31, 2020, we had net NOL and other tax attribute carryforwards as follows (in thousands): U.S. Foreign Gross NOL carryforwards $ 159,895 $ 528,567 Tax-effected NOL carryforwards $ 16,298 $ 133,703 Valuation allowance (6,193 ) (30,784 ) Net deferred tax asset - NOL carryforwards $ 10,105 $ 102,919 Expiration periods 2029-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, 2020 2019 2018 Common share distribution $ 1.070000 $ 1.010000 $ 0.990000 Ordinary income 0.603050 0.701910 0.438792 Capital gains(1) — 0.275040 0.551208 Unrecaptured Sec. 1250 gain — 0.041160 0.132280 Section 199A Dividends 0.603050 0.701910 0.438792 Return of capital 0.466950 0.033050 — (1)Capital gains include unrecaptured Sec. 1250 gains.

Earnings Per Share_Unit (Tables

Earnings Per Share/Unit (Tables)	12 Months Ended
	Dec. 31, 2020
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, 2020 2019 2018 Numerator: Net income $ 432,272 $ 376,401 $ 1,018,477 Non-controlling interests’ share in earnings (822 ) (1,717 ) (1,792 ) Participating securities’ share in earnings (2,105 ) (2,308 ) (3,685 ) Net income, less participating securities’ share in earnings $ 429,345 $ 372,376 $ 1,013,000 Denominator: Basic weighted-average common shares 529,239 427,075 365,364 Dilutive potential common shares 1,222 1,224 907 Diluted weighted-average common shares 530,461 428,299 366,271 MPT Operating Partnership, L.P. Our earnings per unit were calculated based on the following (amounts in thousands): For the Years Ended December 31, 2020 2019 2018 Numerator: Net income $ 432,272 $ 376,401 $ 1,018,477 Non-controlling interests’ share in earnings (822 ) (1,717 ) (1,792 ) Participating securities’ share in earnings (2,105 ) (2,308 ) (3,685 ) Net income, less participating securities’ share in earnings $ 429,345 $ 372,376 $ 1,013,000 Denominator: Basic weighted-average units 529,239 427,075 365,364 Dilutive potential units 1,222 1,224 907 Diluted weighted-average units 530,461 428,299 366,271

Stock Awards (Tables)

Stock Awards (Tables)	12 Months Ended
	Dec. 31, 2020
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock-based Award Activity	The following summarizes stock-based award activity in 2020 and 2019 (which includes awards granted in 2020, 2019, 2018, and any applicable prior years), respectively: For the Year Ended December 31, 2020: Vesting Based on Service Vesting Based on Market/Performance Conditions Shares Weighted-Average Value at Award Date Shares Weighted-Average Value at Award Date Nonvested awards at beginning of the year 1,122,440 $ 17.11 5,481,155 $ 11.66 Awarded 635,855 $ 19.65 1,800,898 $ 19.42 Vested (699,215 ) $ 16.80 (2,193,906 ) $ 11.35 Forfeited (2,026 ) $ 18.40 (1,164 ) $ 18.22 Nonvested awards at end of year 1,057,054 $ 18.79 5,086,983 $ 14.41 For the Year Ended December 31, 2019: Vesting Based on Service Vesting Based on Market/Performance Conditions Shares Weighted-Average Value at Award Date Shares Weighted-Average Value at Award Date Nonvested awards at beginning of the year 923,848 $ 14.29 4,133,435 $ 9.21 Awarded 681,378 $ 19.24 2,438,292 $ 15.25 Vested (478,104 ) $ 14.73 (1,051,637 ) $ 10.43 Forfeited (4,682 ) $ 13.44 (38,935 ) $ 10.13 Nonvested awards at end of year 1,122,440 $ 17.11 5,481,155 $ 11.66

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	12 Months Ended
	Dec. 31, 2020
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, 2020 December 31, 2019 Asset (Liability) Book Value Fair Value Book Value Fair Value Interest and rent receivables $ 46,208 $ 45,381 $ 31,357 $ 30,472 Loans(1) 751,341 756,608 1,704,854 1,742,153 Debt, net (8,865,458 ) (9,226,564 ) (7,023,679 ) (7,331,816 ) (1) Excludes the $205 million acquisition loan to the new international joint venture and investment in the real estate of three hospitals in Colombia discussed in Note 3 as they are recorded at fair value and discussed below
Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis	At December 31, 2020 and 2019, the amounts recorded under the fair value option method were as follows (in thousands): As of December 31, 2020 As of December 31, 2019 Asset (Liability) Fair Value Original Cost Fair Value Original Cost Asset Type Classification Mortgage loans $ 136,332 $ 136,332 $ 115,000 $ 115,000 Mortgage loans Equity investment and other loans 218,775 218,775 — — Equity investments/Other loans

Leases (Lessee) (Tables)

Leases (Lessee) (Tables)	12 Months Ended
	Dec. 31, 2020
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 2020 2019 Operating lease cost (1) (2) $ 9,910 $ 9,262 Finance lease cost: Amortization of right-of-use assets Real estate depreciation and amortization 51 51 Interest on lease liabilities Interest 128 117 Sublease income Other (2,614 ) (3,478 ) Total lease cost $ 7,475 $ 5,952 (1) Includes short-term leases. (2) $6.0 million and $5.8 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2020 and 2019, respectively.
Schedule Of Future Minimum Rental Payments For Leases Sublease Receivable And Net Payments Table Text Block	Fixed minimum payments due over the remaining lease term under non-cancelable leases of more than one year and amounts to be received in the future from non-cancelable subleases over their remaining lease term at December 31, 2020 are as follows (amounts in thousands): Operating Leases Finance Leases Amounts To Be Received From Subleases Net Payments 2021 $ 7,186 $ 126 $ (2,952 ) $ 4,360 2022 7,384 128 (3,238 ) 4,274 2023 7,451 129 (3,240 ) 4,340 2024 6,557 130 (3,259 ) 3,428 2025 5,660 131 (3,303 ) 2,488 Thereafter 257,730 4,783 (78,494 ) 184,019 (1) Total undiscounted minimum lease payments $ 291,968 $ 5,427 $ (94,486 ) $ 202,909 Less: interest (201,962 ) (3,492 ) Present value of lease liabilities $ 90,006 $ 1,935 (1) Reflects certain ground leases, in which we are the lessee, that have longer initial fixed terms than our existing sublease to our tenants. However, we would expect to either renew the related sublease, enter into a lease with a new tenant, or early terminate the ground lease to reduce or avoid any significant impact from such ground leases.
Summary of Supplemental Balance Sheet Information	Supplemental balance sheet information is as follows (in thousands, except lease terms and discount rate): Balance Sheet Classification December 31, 2020 December 31, 2019 Right of use assets: Operating leases - real estate Land $ 73,373 $ 59,492 Finance leases - real estate Land 1,836 1,888 Total real estate right of use assets $ 75,209 $ 61,380 Operating leases - corporate Other assets 8,234 9,866 Total right of use assets $ 83,443 $ 71,246 Lease liabilities: Operating leases Obligations to tenants and other lease liabilities $ 90,006 $ 76,353 Financing leases Obligations to tenants and other lease liabilities 1,935 1,932 Total lease liabilities $ 91,941 $ 78,285 Weighted-average remaining lease term: Operating leases 41.1 31.9 Finance leases 35.9 36.9 Weighted-average discount rate: Operating leases 6.4 % 6.3 % 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, 2020 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 6,080 $ 5,937 Operating cash flows from finance leases 125 114 Financing cash flows from finance leases — 10 Non-cash activities - Right-of-use assets obtained in exchange for lease obligations: Operating leases 13,832 1,818 Finance leases — —

Other Assets (Tables)

Other Assets (Tables)	12 Months Ended
	Dec. 31, 2020
Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract]
Summary of Other Assets	The following is a summary of our other assets on our consolidated balance sheets (in thousands): At December 31, 2020 2019 Debt issue costs, net(1) $ 192 $ 2,492 Other corporate assets 167,929 206,765 Prepaids and other assets 87,948 90,342 Total other assets $ 256,069 $ 299,599 (1)

Organization - Additional Infor

Organization - Additional Information (Detail)	Dec. 31, 2020FacilityStateCountry
Business Acquisition [Line Items]
Number of facilities | Facility	392
Number of states | State	33
Europe [Member]
Business Acquisition [Line Items]
Number of countries	6
South America [Member]
Business Acquisition [Line Items]
Number of countries	1

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Jan. 01, 2020
Significant Accounting Policies [Line Items]
Threshold ownership percentage for inter company balances and transactions elimination	100.00%
Loans and/or equity investments in variable interest entities	$ 230
Change in Accounting Principle, Accounting Standards Update, Adopted [true false]	true	true
Change in Accounting Principle, Accounting Standards Update, Adoption Date	Jan. 1, 2020	Jan. 1, 2019
Accounting Standards Update [Extensible List]	us-gaap:AccountingStandardsUpdate201613Member	us-gaap:AccountingStandardsUpdate201602Member
Expected lease-up periods for estimating lost rentals, in months	6 months
Percentage of ordinary taxable income to be distributed for real estate investment trust qualification	90.00%	90.00%	90.00%
Number of years of federal income tax at corporate rates on failure to qualify as REIT	4 years
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
ASU 2016-13 [Member]
Significant Accounting Policies [Line Items]
Credit loss reserve expected				$ 8.4

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, 2020
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 1 month 6 days
Leasehold improvements [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	17 years
Furniture, equipment and other [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	9 years 9 months 18 days

Real Estate Activities - Net As

Real Estate Activities - Net Assets Acquired (Detail) - USD ($) $ in Thousands		Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Business Acquisition [Line Items]
Total assets acquired		$ 4,249,180	$ 4,565,594	$ 1,430,995
Liabilities assumed		(140,866)	(2,637)
Loans repaid	[1]	(834,743)		(764,447)
Total net assets acquired		3,414,437	4,565,594	666,548
Land and Land Improvements [Member]
Business Acquisition [Line Items]
Total assets acquired		365,281	400,539	71,880
Building [Member]
Business Acquisition [Line Items]
Total assets acquired		2,547,313	1,951,066	686,739
Intangible Lease Assets - Subject to Amortization [Member]
Business Acquisition [Line Items]
Total assets acquired		642,699	227,468	90,651
Mortgage Loans [Member]
Business Acquisition [Line Items]
Total assets acquired		176,840	51,267
Investments in Financing Leases [Member]
Business Acquisition [Line Items]
Total assets acquired		114,797	1,386,797
Equity Investments [Member]
Business Acquisition [Line Items]
Total assets acquired		233,593	415,836	245,267
Other Loans And Assets
Business Acquisition [Line Items]
Total assets acquired		$ 309,523	$ 135,258	$ 336,458
[1]	The 2020 column includes approximately $750 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. The 2018 column includes $0.8 billion of loans advanced to Steward in 2016 and repaid in 2018 as part of sale leaseback conversion described below.

Real Estate Activities - Net _2

Real Estate Activities - Net Assets Acquired (Parenthetical) (Detail) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Business Acquisition [Line Items]
Weighted-average useful life of acquired intangible lease assets (in years)		21 years 3 months 18 days
Loans repaid	[1]	$ 834,743		$ 764,447
Steward [Member]
Business Acquisition [Line Items]
Loans repaid		750,000		$ 800,000
Ernest [Member]
Business Acquisition [Line Items]
Loans repaid		$ 100,000
Intangible Lease Assets - Subject to Amortization [Member]
Business Acquisition [Line Items]
Weighted-average useful life of acquired intangible lease assets (in years)		27 years 6 months	19 years 1 month 6 days	27 years 10 months 24 days
[1]	The 2020 column includes approximately $750 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. The 2018 column includes $0.8 billion of loans advanced to Steward in 2016 and repaid in 2018 as part of sale leaseback conversion described below.

Real Estate Activities - 2020 A

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

Dec. 29, 2020CHF (SFr)

Dec. 18, 2020GBP (£)Hospital

Dec. 17, 2020USD ($)Hospital

Nov. 25, 2020GBP (£)

Nov. 17, 2020USD ($)Hospital

Aug. 13, 2020USD ($)

Aug. 07, 2020GBP (£)Hospital

Aug. 05, 2020EUR (€)

Jul. 08, 2020USD ($)Hospital

Jun. 16, 2020RenewalOption

Jan. 08, 2020GBP (£)Hospital

Dec. 17, 2019USD ($)Hospital

Dec. 31, 2020USD ($)FacilityHospital

Jun. 24, 2020CHF (SFr)

May 13, 2020USD ($)

Dec. 31, 2019USD ($)

Dec. 31, 2018USD ($)

Business Acquisition [Line Items]

Term of lease extension, years

5 years

Acquisition loan | $

$ 4,249,180

$ 4,565,594

$ 1,430,995

Term of lease

15 years

Joint Venture Partner [Member]

Business Acquisition [Line Items]

Ownership interest

49.00%

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

Business Acquisition [Line Items]

Acquisition loan | $

$ 205,000

Steward [Member]

Business Acquisition [Line Items]

Initial fixed term of lease

2031-10

Infracore SA [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

Initial term

2037-12

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

10

2

Purchase price of acquisition | $

$ 700,000

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

Business Acquisition [Line Items]

Purchase price of acquisition | £

£ 50

Lessor operating lease ground lease term

999 years

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

Business Acquisition [Line Items]

Number of facilities acquired

30

Purchase price of acquisition | £

£ 1,500

Unearned rent revenue | £

£ 27.6

Number of leased properties

52

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] | Colombia [Member]

Business Acquisition [Line Items]

Number of facilities acquired

3

Purchase price of acquisition | $

$ 135,000

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

Business Acquisition [Line Items]

Purchase price of acquisition | $

$ 300,000

Initial fixed term of lease

2035-08

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 Activities - 2019 A

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

Dec. 29, 2020CHF (SFr)

Dec. 17, 2020USD ($)Hospital

Nov. 25, 2020GBP (£)

Dec. 17, 2019USD ($)HospitalRenewalOptionLease

Dec. 03, 2019EUR (€)Hospital

Nov. 28, 2019EUR (€)

Aug. 30, 2019USD ($)RenewalOption

Aug. 23, 2019USD ($)HospitalRenewalOptionHealth_Center

Aug. 16, 2019GBP (£)Hospital

Jun. 28, 2019CHF (SFr)

Jun. 10, 2019USD ($)HospitalRenewalOption

Jun. 06, 2019AUD ($)Hospital

May 27, 2019CHF (SFr)_Campus

Apr. 12, 2019Hospital

Aug. 28, 2018EUR (€)Hospital

Dec. 31, 2020USD ($)Hospital

Dec. 31, 2019USD ($)Hospital

Aug. 31, 2018

Business Acquisition [Line Items]

Term of lease

15 years

Term of lease extension, years

5 years

Mortgage loan balance | $

$ 1,106,448,000

$ 1,819,854,000

Weighted average remaining lease term

41 years 1 month 6 days

31 years 10 months 24 days

Other Acquisitions [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | $

$ 135,000,000

Ramsay Health Care [Member]

Business Acquisition [Line Items]

Lease term ending period

2037

Infracore SA [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | SFr

SFr 206.5

Swiss Medical Network [Member]

Business Acquisition [Line Items]

Weighted average remaining lease term

23 years

Aevis Victoria SA [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | SFr

SFr 47

Ownership interest in joint venture under the cost method

4.90%

Vibra [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | $

$ 254,000,000

Term of lease

20 years

Number of lease extension options | RenewalOption

3

Lease extension options, description

three five-year extension options

Existence of option to extend

true

Term of lease extension, years

5 years

Switzerland [Member] | Infracore SA [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | SFr

SFr 236.6

Spain [Member] | Spanish PropCo. [Member]

Business Acquisition [Line Items]

Ownership interest in joint venture under the equity method

45.00%

Prospect [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | $

$ 1,550,000,000

Term of lease

15 years

Number of lease extension options | RenewalOption

3

Existence of option to extend

true

Term loan | $

$ 112,900,000

Additional number of businesses acquired

2

Future purchase price adjustment | $

$ 250,000,000

Performance thresholds achievement period

3 years

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

Business Acquisition [Line Items]

Purchase price of acquisition | $

$ 1,400,000,000

Secure Income REIT [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | £

£ 347

Secure Income REIT [Member] | United Kingdom [Member]

Business Acquisition [Line Items]

Number of private hospitals acquired

8

Acute Care Hospital [Member]

Business Acquisition [Line Items]

Number of facilities acquired

10

2

Purchase price of acquisition | $

$ 700,000,000

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

Business Acquisition [Line Items]

Number of facilities acquired

3

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

Business Acquisition [Line Items]

Purchase price of acquisition | £

£ 50

Acute Care Hospital [Member] | Spain [Member]

Business Acquisition [Line Items]

Number of facilities acquired

2

Purchase price of acquisition | €

€ 117.3

Acute Care Hospital [Member] | Portugal [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | €

€ 28.2

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

Business Acquisition [Line Items]

Number of facilities acquired

1

Acute Care Hospital [Member] | Germany [Member]

Business Acquisition [Line Items]

Ownership interest in joint venture under the equity method

50.00%

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

Business Acquisition [Line Items]

Number of facilities acquired

1

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

Business Acquisition [Line Items]

Number of facilities acquired

1

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

Business Acquisition [Line Items]

Mortgage loan balance | $

$ 51,300,000

Life Point [Member]

Business Acquisition [Line Items]

Number of master leases | Lease

1

Term of lease

20 years

Number of lease extension options | RenewalOption

2

Lease extension options, description

two five-year extension options

Existence of option to extend

true

Term of lease extension, years

5 years

Acute Care Campus [Member] | Switzerland [Member] | Infracore SA [Member]

Business Acquisition [Line Items]

Number of facilities acquired | _Campus

13

Acute Care Campus [Member] | Prospect [Member]

Business Acquisition [Line Items]

Number of facilities acquired

14

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

Business Acquisition [Line Items]

Number of facilities acquired

11

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

Business Acquisition [Line Items]

Number of facilities acquired | Health_Center

2

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

Business Acquisition [Line Items]

Number of facilities acquired | Health_Center

2

Hospital [Member] | Healthscope [Member]

Business Acquisition [Line Items]

Term of lease

20 years

Hospital [Member] | Australia [Member]

Business Acquisition [Line Items]

Number of facilities acquired

11

Purchase price of acquisition | $

$ 1,200

Stamp duties and registration fees | $

$ 66.6

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

Business Acquisition [Line Items]

Number of facilities acquired | _Campus

2

HM Hospital [Member] | Spain [Member]

Business Acquisition [Line Items]

Term of lease

25 years

Jose de Mello [Member] | Portugal [Member]

Business Acquisition [Line Items]

Term of lease

17 years

Inpatient Rehabilitation Hospital [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | $

$ 58,000,000

Inpatient Rehabilitation Hospital [Member] | Texas [Member]

Business Acquisition [Line Items]

Number of facilities acquired

1

Inpatient Rehabilitation Hospital [Member] | Germany [Member]

Business Acquisition [Line Items]

Number of facilities acquired

3

Purchase price of acquisition | €

€ 17.3

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

Business Acquisition [Line Items]

Number of facilities acquired

1

Community Hospital [Member]

Business Acquisition [Line Items]

Number of facilities acquired

7

Number of lease extension options | RenewalOption

2

Lease extension options, description

two five-year extension options

Existence of option to extend

true

Term of lease extension, years

5 years

Leases fixed escalations

5 years

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

Business Acquisition [Line Items]

Term of lease

14 years

Community Hospital [Member] | Kansas [Member]

Business Acquisition [Line Items]

Number of facilities acquired

7

Purchase price of acquisition | $

$ 145,400,000

Real Estate Activities - 2018 A

Real Estate Activities - 2018 Activity - Additional Information (Detail) $ in Thousands, € in Millions	Dec. 17, 2020USD ($)Hospital	Dec. 17, 2019USD ($)Hospital	Aug. 31, 2018EUR (€)	Aug. 28, 2018EUR (€)Hospital	Aug. 31, 2018USD ($)Hospital	Aug. 31, 2018EUR (€)Hospital	Mar. 31, 2018USD ($)	Oct. 31, 2016USD ($)	Dec. 31, 2020USD ($)Hospital	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)Hospital
Business Acquisition [Line Items]
Ownership interest in joint venture under the equity method value included in other assets									$ 1,123,623	$ 926,990
Gain on sale of real estate									$ (2,800)
Term of lease									15 years
Mortgage financing									$ 193,590	61,712	$ 50,783
Acute Care Hospital [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Hospital		10							2
Gain on sale of real estate										$ 41,600
Purchase price of acquisition		$ 700,000
Inpatient Rehabilitation Hospital [Member]
Business Acquisition [Line Items]
Purchase price of acquisition	$ 58,000
General Acute Care Hospital and Healthcare System [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Hospital											5
Mortgage financing							$ 764,400	$ 764,400
Germany [Member] | Acute Care Hospital [Member]
Business Acquisition [Line Items]
Ownership interest in joint venture under the equity method			50.00%			50.00%
Ownership interest in joint venture under the equity method value included in other assets | €			€ 210			€ 210
Shareholder loan to joint venture | €			290			290
Gain on sale of real estate | €						500
Germany [Member] | Rehabilitation Hospital with Covenant Health System [Member] | MEDIAN [Member]
Business Acquisition [Line Items]
Term of lease				27 years
Germany [Member] | Inpatient Rehabilitation Hospital [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Hospital				3
Purchase price of acquisition | €				€ 17.3
Germany [Member] | Fair Value [Member] | Acute Care Hospital [Member]
Business Acquisition [Line Items]
Aggregate fair value of ownership interest | €			€ 1,635			€ 1,635
Pasco, Washington [Member] | Acute Care Hospital [Member]
Business Acquisition [Line Items]
Purchase price of acquisition					$ 17,500
Massachusetts [Member] | General Acute Care Hospital and Healthcare System [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Hospital											4
Texas [Member] | Inpatient Rehabilitation Hospital [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Hospital	1
Texas [Member] | General Acute Care Hospital and Healthcare System [Member] | Steward [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Hospital											1
Primotop Holdings S.a.r.l. [Member] | Germany [Member] | Acute Care Hospital [Member]
Business Acquisition [Line Items]
Ownership interest in joint venture under the equity method			50.00%			50.00%
Number of facilities acquired | Hospital					71	71
Proceeds from joint venture | €						€ 1,140
Gain on sale of real estate | €			€ 500

Real Estate Activities - Develo

Real Estate Activities - Development Activities - Additional Information (Detail) $ in Thousands	Dec. 17, 2019Hospital	Oct. 25, 2019USD ($)	Jun. 30, 2020Hospital	Dec. 31, 2020USD ($)Hospital	Dec. 31, 2018USD ($)	Nov. 23, 2020USD ($)	May 15, 2020USD ($)
Business Acquisition [Line Items]
Expected commence rent | $				$ 95,629
Acute Care Hospital [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Hospital	10			2
Behavioral Hospital [Member] | Houston, Texas [Member]
Business Acquisition [Line Items]
Estimated total development cost | $		$ 27,500
Development Activities [Member] | Ernest [Member]
Business Acquisition [Line Items]
Expected commence rent | $						$ 47,700	$ 47,900
Estimated total development cost | $					$ 25,500
Initial fixed term of lease					2037
Development Activities [Member] | Circle [Member] | Birmingham, England [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Hospital			2
Development Activities [Member] | Circle [Member] | Acute Care Hospital [Member] | Birmingham, England [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Hospital			1
Development Activities [Member] | Circle [Member] | Inpatient Rehabilitation Hospital [Member] | Birmingham, England [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Hospital			1

Real Estate Activities - Summar

Real Estate Activities - Summary of Status on Current Development Projects (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2020USD ($)
Business Acquisition [Line Items]
Commitment	$ 95,629
Costs Incurred as of December 31, 2020	30,139
Ernest [Member] | Bakersfield, California [Member]
Business Acquisition [Line Items]
Commitment	47,929
Costs Incurred as of December 31, 2020	$ 19,034
Estimated Rent Commencement Date	4Q 2021
Ernest [Member] | Stockton, California [Member]
Business Acquisition [Line Items]
Commitment	$ 47,700
Costs Incurred as of December 31, 2020	$ 11,105
Estimated Rent Commencement Date	1Q 2022

Real Estate Activities - Dispos

Real Estate Activities - Disposals - Additional Information (Detail) $ in Thousands, € in Millions	Oct. 04, 2018USD ($)	Aug. 31, 2018USD ($)Hospital	Aug. 31, 2018EUR (€)Hospital	Jun. 04, 2018USD ($)Hospital	Mar. 01, 2018USD ($)	Aug. 31, 2018EUR (€)	Dec. 31, 2020USD ($)FacilityProperty	Dec. 31, 2019USD ($)Hospital	Dec. 31, 2018USD ($)
Debt Instrument [Line Items]
Number of facilities sold | Facility							9
Number of properties sold | Property							6
Proceeds from sale of facilities							$ 94
Gain (loss) on real estate dispositions							(2,800)
Loans, Balance							1,106,448	$ 1,819,854
Net proceeds from sale of real estate							$ 94,177	111,766	$ 1,513,666
Houston, Texas [Member] | Steward Health Care System LLC [Member] | St. Joseph Medical Center [Member]
Debt Instrument [Line Items]
Gain (loss) on real estate dispositions					$ 1,500
Gain offset by non-cash charges					1,700
Net proceeds from sale of real estate					$ 148,000
Ernest [Member]
Debt Instrument [Line Items]
Proceeds from sale of facilities	$ 176,000
North Cypress [Member] | Houston, Texas [Member]
Debt Instrument [Line Items]
Proceeds from sale of facilities		$ 148,000
Gain (loss) on real estate dispositions		102,400
Gain offset by non-cash charges		$ 2,500
Vibra [Member] | California, Texas, and Oregon [Member]
Debt Instrument [Line Items]
Proceeds from sale of facilities				$ 53,300
Gain (loss) on real estate dispositions				24,200
Gain offset by non-cash charges				5,100
Vibra [Member] | California, Texas, and Oregon [Member] | Working Capital Loans [Member]
Debt Instrument [Line Items]
Loans, Balance				1,500
Vibra [Member] | California, Texas, and Oregon [Member] | Mortgage Loans [Member]
Debt Instrument [Line Items]
Loans, Balance				$ 18,300
Acute Care Hospital [Member]
Debt Instrument [Line Items]
Gain (loss) on real estate dispositions								$ 41,600
Number of hospitals sold | Hospital								5
Acute Care Hospital [Member] | Germany [Member]
Debt Instrument [Line Items]
Gain (loss) on real estate dispositions | €						€ 500
Acute Care Hospital [Member] | Primotop Holdings S.a.r.l. [Member] | Germany [Member]
Debt Instrument [Line Items]
Number of properties sold | Hospital		71	71
Proceeds from sale of facilities | €			€ 1,635
Gain (loss) on real estate dispositions | €			€ 500
General Acute Care Hospital and Healthcare System [Member] | North Cypress [Member] | Houston, Texas [Member]
Debt Instrument [Line Items]
Number of properties sold | Hospital		1	1
Long-term Acute Care Hospital [Member] | Vibra [Member] | California, Texas, and Oregon [Member]
Debt Instrument [Line Items]
Number of properties sold | Hospital				3

Real Estate Activities - Summ_2

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

Real Estate Activities - Summ_3

Real Estate Activities - Summary of Operations for Disposed Assets (Parenthetical) (Detail) € in Millions, $ in Millions	1 Months Ended	12 Months Ended
	Aug. 31, 2018EUR (€)	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Gain on sale of real estate		$ (2.8)
Acute Care Hospital [Member]
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Gain on sale of real estate			$ 41.6
Germany [Member] | Acute Care Hospital [Member]
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Gain on sale of real estate | €	€ 500
2018 [Member] | Germany [Member] | Acute Care Hospital [Member]
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Gain on sale of real estate				$ 720

Real Estate Activities - Intang

Real Estate Activities - Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Business Combinations [Abstract]
Intangible lease assets	$ 1,299,081	$ 622,056
Accumulated amortization, net	1,200,000	556,700
Amortization expense related to intangible lease assets	$ 42,400	$ 21,500	$ 17,600
Capitalized lease intangibles, weighted average life (in years)	21 years 3 months 18 days

Real Estate Activities - Amorti

Real Estate Activities - Amortization Expense from Existing Lease Intangible Assets (Detail) $ in Thousands	Dec. 31, 2020USD ($)
Business Combinations [Abstract]
2021	$ 44,286
2022	44,272
2023	44,206
2024	44,173
2025	$ 44,025

Real Estate Activities - Leasin

Real Estate Activities - Leasing Operations (Lessor) - Additional Information (Detail) $ in Millions	12 Months Ended
	Dec. 31, 2020USD ($)LeaseProperty
Lessor Lease Description [Line Items]
Term of lease	15 years
Lease renewal term	5 years
Annual rent escalations	99.00%
Number of properties | Property	5
Carrying value of lease requiring residual value guarantee | $	$ 229
Ernest [Member]
Lessor Lease Description [Line Items]
Number of direct financing leases	13
Number of financing leases	5
Prime Facilities [Member]
Lessor Lease Description [Line Items]
Number of direct financing leases	5
Prospect [Member]
Lessor Lease Description [Line Items]
Number of financing leases	13
Minimum [Member]
Lessor Lease Description [Line Items]
Fixed minimum annual escalations	0.50%
Maximum [Member]
Lessor Lease Description [Line Items]
Fixed minimum annual escalations	3.00%

Real Estate Activities - Summ_4

Real Estate Activities - Summary of Total Future Minimum Lease Payments to be Received (Detail) - Minimum [Member] $ in Thousands	Dec. 31, 2020USD ($)
Lessor Lease Description [Line Items]
2021	$ 1,018,992
2022	1,039,494
2023	1,058,188
2024	1,075,951
2025	1,094,175
Thereafter	26,696,180
Future minimum lease payments to be received	31,982,980
Operating Leases [Member]
Lessor Lease Description [Line Items]
2021	858,067
2022	875,350
2023	890,761
2024	905,176
2025	919,984
Thereafter	22,102,425
Future minimum lease payments to be received	26,551,763
Financing Leases [Member]
Lessor Lease Description [Line Items]
2021	160,925
2022	164,144
2023	167,427
2024	170,775
2025	174,191
Thereafter	4,593,755
Future minimum lease payments to be received	$ 5,431,217

Real Estate Activities - Compon

Real Estate Activities - Components of Total Investment in Financing Leases (Detail) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Direct Financing Lease Net Investment In Leases [Abstract]
Minimum lease payments receivable	$ 1,228,966	$ 1,884,921
Estimated residual values	203,818	394,195
Less: Unearned income and allowance for credit loss	(969,061)	(1,618,252)
Net investment in direct financing leases	463,723	660,864
Other financing leases (net of allowance for credit loss)	1,547,199	1,399,438
Total investment in financing leases	$ 2,010,922	$ 2,060,302

Real Estate Activities - Rent D

Real Estate Activities - Rent Deferrals - Additional Information (Detail) - COVID-19 Pandemic [Member] $ in Millions	Dec. 31, 2020USD ($)
Business Acquisition [Line Items]
Deferred lease income	$ 11.4
Maximum [Member]
Business Acquisition [Line Items]
Percentage of deferred revenue lease	2.00%

Real Estate Activities - Adeptu

Real Estate Activities - Adeptus Health - Additional Information (Detail) - Adeptus Health [Member] $ in Millions	12 Months Ended
	Dec. 31, 2020USD ($)FacilityLease	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)
Business Acquisition [Line Items]
Number of leased properties | Lease	60
Real estate impairment charge	$ 20	$ 2	$ 24
Straight-line rent and other write-off, net of tax	$ 10		$ 6
Number of facilities transitioned | Facility	18
Maximum [Member]
Business Acquisition [Line Items]
Percentage of vacant on leased property	1.00%

Real Estate Activities - Alecto

Real Estate Activities - Alecto Facilities - Additional Information (Detail) - Alecto Healthcare Services [Member] $ in Millions	3 Months Ended		12 Months Ended
	Jun. 30, 2020Property	Mar. 31, 2020USD ($)	Dec. 31, 2020USD ($)Property	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)
Business Acquisition [Line Items]
Number of leased properties			4
Real estate impairment charge | $		$ 9.1		$ 20	$ 30
Number of re-leased properties	1
Number of additional leased properties			1
Proceeds from sale of mortgage loans | $			$ 43
Total Gross Assets [Member] | Customer Concentration Risk [Member] | Maximum [Member]
Business Acquisition [Line Items]
Percentage of total assets			0.50%

Real Estate Activities - Other

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

Real Estate Activities - Summ_5

Real Estate Activities - Summary of Loans (Net of Allowance for Credit Loss) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Loans [Line Items]
Mortgage loans	$ 248,080	$ 1,275,022
Acquisition loans	338,273	123,893
Other loans	520,095	420,939
Total	$ 1,106,448	$ 1,819,854
Mortgage Loans [Member]
Loans [Line Items]
Loans, Weighted Average Interest Rate	8.50%	9.00%
Acquisition Loans [Member]
Loans [Line Items]
Loans, Weighted Average Interest Rate	7.60%	7.70%
Other Loans [Member]
Loans [Line Items]
Loans, Weighted Average Interest Rate	5.80%	5.70%

Real Estate Activities - Loans

Real Estate Activities - Loans - Additional Information (Detail) $ in Thousands, € in Millions	12 Months Ended
	Dec. 31, 2020USD ($)PropertyOperator	Dec. 31, 2019USD ($)	Aug. 31, 2018EUR (€)
Loans [Line Items]
Repayments of mortgage loans	$ 800,000
Acquisition loans	338,273	$ 123,893
Joint Venture Partner [Member]
Loans [Line Items]
Acquisition loans	$ 205,000
Primotop Holdings S.a.r.l. [Member]
Loans [Line Items]
Shareholder loan to joint venture | €			€ 290
Mortgage Loans [Member] | Steward Health Care System LLC [Member]
Loans [Line Items]
Number of real estate properties | Property	6
Number of operators | Operator	4
Mortgage Loans [Member] | Prime Healthcare Services [Member]
Loans [Line Items]
Repayments of mortgage loans	$ 328,000

Real Estate Activities - Concen

Real Estate Activities - Concentration of Credit Risks and Related Party Transactions - Additional Information (Detail) $ in Millions	12 Months Ended
	Dec. 31, 2020USD ($)Investment	Dec. 31, 2019USD ($)Investment	Dec. 31, 2018USD ($)
Related Party Transactions [Member]
Business Acquisition [Line Items]
Lease and interest revenue earned from tenants | $	$ 29.8	$ 85.3	$ 102.2
Total Gross Assets [Member] | Geographic Concentration [Member] | U.S. [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	65.00%	74.00%
Total Gross Assets [Member] | Geographic Concentration [Member] | Europe [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	28.00%	20.00%
Total Gross Assets [Member] | Geographic Concentration [Member] | Australia [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	6.00%	6.00%
Total Gross Assets [Member] | Geographic Concentration [Member] | South America [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	1.00%
Revenue [Member] | Customer Concentration Risk [Member] | General Acute Care Hospital and Healthcare System [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	87.00%	82.00%
Revenue [Member] | Customer Concentration Risk [Member] | Rehabilitation Hospital with Covenant Health System [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	8.00%	10.00%
Revenue [Member] | Customer Concentration Risk [Member] | Freestanding ER/Urgent Care Facilities and Behavioral Health Facilities [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	2.00%	5.00%
Revenue [Member] | Customer Concentration Risk [Member] | Long-term Acute Care Hospital [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	3.00%	3.00%
Revenue [Member] | Credit Concentration Risk [Member] | Steward Health Care System LLC [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	30.00%	42.00%
Revenue [Member] | Credit Concentration Risk [Member] | Circle [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	13.00%
Revenue [Member] | Credit Concentration Risk [Member] | Circle [Member] | Maximum [Member]
Business Acquisition [Line Items]
Percentage of concentration risk		10.00%
Revenue [Member] | Credit Concentration Risk [Member] | Prospect [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	12.00%
Revenue [Member] | Credit Concentration Risk [Member] | Prospect [Member] | Maximum [Member]
Business Acquisition [Line Items]
Percentage of concentration risk		10.00%
Pro Forma [Member] | Total Gross Assets [Member] | Customer Concentration Risk [Member]
Business Acquisition [Line Items]
Number of investment in property | Investment	0	0
Maximum percentage of entity's assets invested on single property	4.00%	4.00%

Debt - Summary of Debt (Detail)

Debt - Summary of Debt (Detail) - USD ($) $ in Thousands		Dec. 31, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Debt		$ 8,934,187	$ 7,089,520
Debt issue costs and discount, net		(68,729)	(65,841)
Debt, net		8,865,458	7,023,679
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Debt	[1]	165,407
Term Loan [Member]
Debt Instrument [Line Items]
Debt		200,000	200,000
Term Loan [Member] | British Pound Sterling [Member]
Debt Instrument [Line Items]
Debt	[2]	956,900
Term Loan [Member] | Australia [Member]
Debt Instrument [Line Items]
Debt	[2]	923,280	842,520
4.000% Senior Unsecured Notes Due 2022 [Member]
Debt Instrument [Line Items]
Debt	[2]	610,800	560,650
2.550% Senior Unsecured Notes due 2023 [Member]
Debt Instrument [Line Items]
Debt	[2]	546,800	530,280
5.500% Senior Unsecured Notes Due 2024 [Member]
Debt Instrument [Line Items]
Debt			300,000
6.375% Senior Unsecured Notes due 2024 [Member]
Debt Instrument [Line Items]
Debt			500,000
5.250% Senior Unsecured Notes Due 2026 [Member]
Debt Instrument [Line Items]
Debt		500,000	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]	820,200	795,420
4.625% Senior Unsecured Notes Due 2029 [Member]
Debt Instrument [Line Items]
Debt		900,000	900,000
3.325% Senior Unsecured Notes Due 2025 [Member]
Debt Instrument [Line Items]
Debt	[2]	610,800	$ 560,650
3.500% Senior Unsecured Notes Due 2031 [Member]
Debt Instrument [Line Items]
Debt		$ 1,300,000
[1]	Includes £121 million of GBP-denominated borrowings that reflect the exchange rate at December 31, 2020.
[2]	Non-U.S. dollar denominated debt that reflects the exchange rate at period end.

Debt - Summary of Debt (Parenth

Debt - Summary of Debt (Parenthetical) (Detail) $ in Thousands, £ in Millions		Dec. 31, 2020USD ($)		Dec. 31, 2020GBP (£)		Dec. 04, 2020	Dec. 31, 2019USD ($)		Jul. 26, 2019	Sep. 07, 2017	Mar. 24, 2017	Jul. 22, 2016	Feb. 22, 2016	Aug. 19, 2015	Apr. 17, 2014
Debt Instrument [Line Items]
Debt		$ 8,934,187					$ 7,089,520
GBP-denominated Borrowings [Member]
Debt Instrument [Line Items]
Debt | £				£ 121
4.000% Senior Unsecured Notes Due 2022 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		4.00%	[1]	4.00%	[1]		4.00%	[1]						4.00%
Debt	[1]	$ 610,800					$ 560,650
2.550% Senior Unsecured Notes due 2023 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	[1]	2.55%		2.55%			2.55%
Debt	[1]	$ 546,800					$ 530,280
5.500% Senior Unsecured Notes Due 2024 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		5.50%		5.50%			5.50%								5.50%
Debt							$ 300,000
6.375% Senior Unsecured Notes due 2024 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		6.375%		6.375%			6.375%						6.375%
Debt							$ 500,000
3.325% Senior Unsecured Notes Due 2025 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		3.325%	[1]	3.325%	[1]		3.325%	[1]			3.325%
Debt	[1]	$ 610,800					$ 560,650
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		5.00%		5.00%			5.00%			5.00%
Debt		$ 1,400,000					$ 1,400,000
3.692% Senior Unsecured Notes due 2028 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	[1]	3.692%		3.692%			3.692%
Debt	[1]	$ 820,200					$ 795,420
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
3.500% Senior Unsecured Notes Due 2031 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		3.50%		3.50%		3.50%	3.50%
Debt		$ 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, 2020	Dec. 31, 2019
Debt Disclosure [Abstract]
2021	$ 165,407
2022	810,800
2023	546,800
2024	923,280
2025	1,567,700
Thereafter	4,920,200
Total	$ 8,934,187	$ 7,089,520

Debt - Credit Facility - Additi

Debt - Credit Facility - Additional Information (Detail) - USD ($)	Feb. 01, 2017	Dec. 31, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Aggregate committed amount of credit facility	$ 500,000,000
Minimum [Member]
Debt Instrument [Line Items]
Commitment fee	0.125%
Maximum [Member]
Debt Instrument [Line Items]
Commitment fee	0.30%
Unsecured Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Amount of senior unsecured debt	$ 1,300,000,000
Debt instrument, maturity month and year	2021-02
Aggregate committed amount of credit facility		$ 1,100,000,000	$ 1,300,000,000
Credit facilities, amount outstanding		$ 165,400,000	$ 0
Credit facilities, weighted average interest rate		1.40%	2.00%
Term Loans [Member]
Debt Instrument [Line Items]
Amount of senior unsecured debt	$ 200,000,000
Debt instrument maturity date	Feb. 1, 2022
Interest rate at end of period		1.65%	3.30%
Alternate Base Rate [Member] | Minimum [Member]
Debt Instrument [Line Items]
Applicable margin	0.00%
Applicable margin for revolving loans	0.00%
Alternate Base Rate [Member] | Maximum [Member]
Debt Instrument [Line Items]
Applicable margin	0.95%
Applicable margin for revolving loans	0.65%
Eurodollar Loans [Member] | Minimum [Member]
Debt Instrument [Line Items]
Applicable margin	0.90%
Applicable margin for revolving loans	0.875%
Eurodollar Loans [Member] | Maximum [Member]
Debt Instrument [Line Items]
Applicable margin	1.95%
Applicable margin for revolving loans	1.65%

Debt - British Pound Sterling T

Debt - British Pound Sterling Term Loan - Additional Information (Detail)	Mar. 04, 2020	Jan. 06, 2020GBP (£)	Dec. 31, 2020	Feb. 01, 2017USD ($)
Debt Instrument [Line Items]
Maximum borrowing capacity | $				$ 500,000,000
Term Loan [Member] | Bank of America, N.A | British Pound Sterling [Member]
Debt Instrument [Line Items]
Maximum borrowing capacity | £		£ 700,000,000
Debt instrument maturity date		Jan. 15, 2025
Debt instrument effective date	Mar. 6, 2020
Effective interest rate	0.70%
Senior unsecured notes, interest rate			1.95%
Term Loan [Member] | Bank of America, N.A | British Pound Sterling [Member] | Minimum [Member]
Debt Instrument [Line Items]
Applicable margin adjustable based on pricing grid, percentage		0.85%
Term Loan [Member] | Bank of America, N.A | British Pound Sterling [Member] | Maximum [Member]
Debt Instrument [Line Items]
Applicable margin adjustable based on pricing grid, percentage		1.65%
Term Loan [Member] | Bank of America, N.A | Credit Rating | British Pound Sterling [Member]
Debt Instrument [Line Items]
Variable interest rate			1.25%

Debt - Australian Term Loan - A

Debt - Australian Term Loan - Additional Information (Detail)	Jun. 27, 2019	May 23, 2019AUD ($)	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)	Feb. 01, 2017USD ($)
Debt Instrument [Line Items]
Maximum borrowing capacity					$ 500,000,000
Accounts Payable and Accrued Expenses
Debt Instrument [Line Items]
Derivative liability			$ 51,300,000	$ 5,600,000
Term Loan [Member] | Bank of America, N.A | Australia [Member]
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 1,200,000,000
Debt instrument maturity date		May 23, 2024
Debt instrument effective date	Jul. 3, 2019
Effective interest rate	1.20%
Senior unsecured notes, interest rate	2.45%
Reference rate	0.00%
Term Loan [Member] | Bank of America, N.A | Australia [Member] | Minimum [Member]
Debt Instrument [Line Items]
Applicable margin adjustable based on pricing grid, percentage		0.85%
Term Loan [Member] | Bank of America, N.A | Australia [Member] | Maximum [Member]
Debt Instrument [Line Items]
Applicable margin adjustable based on pricing grid, percentage		1.65%
Term Loan [Member] | Bank of America, N.A | Australia [Member] | Credit Rating
Debt Instrument [Line Items]
Variable interest rate	1.25%

Debt - Senior Unsecured Notes -

Debt - Senior Unsecured Notes - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2020
Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest	101.00%

Debt - 4.000% Senior Unsecured

Debt - 4.000% Senior Unsecured Notes Due 2022 - Additional Information (Detail) - 4.000% Senior Unsecured Notes Due 2022 [Member] - EUR (€)	Aug. 19, 2015	Dec. 31, 2020		Dec. 31, 2019	[1]
Debt Instrument [Line Items]
Senior unsecured notes face amount	€ 500,000,000
Senior unsecured notes, payable term		Interest on the notes is payable annually on August 19 of each year.
Senior unsecured notes, interest rate	4.00%	4.00%	[1]	4.00%
Debt instrument maturity date	Aug. 19, 2022
[1]	Non-U.S. dollar denominated debt that reflects the exchange rate at period end.

Debt - 2.550% Senior Unsecured

Debt - 2.550% Senior Unsecured Notes Due 2023 - Additional Information (Detail) - 2.550% Senior Unsecured Notes due 2023 [Member] - GBP (£)	Dec. 05, 2019	Dec. 31, 2020
Debt Instrument [Line Items]
Senior unsecured notes face amount	£ 400,000,000
Senior unsecured notes, payable term		Interest on the notes is payable annually on December 5 of each year.
Debt instrument maturity date	Dec. 5, 2023

Debt - 5.500% Senior Unsecured

Debt - 5.500% Senior Unsecured Notes Due 2024 - Additional Information (Detail) - 5.500% Senior Unsecured Notes Due 2024 [Member] - USD ($)	Apr. 17, 2014	Dec. 31, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Senior unsecured notes face amount	$ 300,000,000
Senior unsecured notes, payable term		Interest on the notes was payable semi-annually on May 1 and November 1 of each year.
Senior unsecured notes, interest rate	5.50%	5.50%	5.50%
Debt instrument maturity date	May 1, 2024
Debt instrument, redemption date	Dec. 19, 2020

Debt - 6.375% Senior Unsecured

Debt - 6.375% Senior Unsecured Notes Due 2024 - Additional Information (Detail) - 6.375% Senior Unsecured Notes due 2024 [Member] - USD ($)	Feb. 22, 2016	Dec. 31, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Senior unsecured notes face amount	$ 500,000,000
Senior unsecured notes, payable term		Interest on the notes was payable on March 1 and September 1 of each year.
Senior unsecured notes, interest rate	6.375%	6.375%	6.375%
Debt instrument maturity date	Mar. 1, 2024
Debt instrument, redemption date	Dec. 19, 2020

Debt - 3.325% Senior Unsecured

Debt - 3.325% Senior Unsecured Notes Due 2025 - Additional Information (Detail) - 3.325% Senior Unsecured Notes Due 2025 [Member] - EUR (€)	Mar. 24, 2017	Dec. 31, 2020		Dec. 31, 2019	[1]
Debt Instrument [Line Items]
Senior unsecured notes face amount	€ 500,000,000
Senior unsecured notes, payable term		Interest on the notes is payable annually on March 24 of each year.
Senior unsecured notes, interest rate	3.325%	3.325%	[1]	3.325%
Debt instrument maturity date	Mar. 24, 2025
[1]	Non-U.S. dollar denominated debt that reflects the exchange rate at period end.

Debt - 5.250% Senior Unsecured

Debt - 5.250% Senior Unsecured Notes Due 2026 - Additional Information (Detail) - 5.250% Senior Unsecured Notes Due 2026 [Member] - USD ($)	Jul. 22, 2016	Dec. 31, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Senior unsecured notes face amount	$ 500,000,000
Senior unsecured notes, payable term		Interest on the notes is payable on February 1 and August 1 of each year.
Senior unsecured notes, interest rate	5.25%	5.25%	5.25%
Debt instrument maturity date	Aug. 1, 2026

Debt - 5.000% Senior Unsecured

Debt - 5.000% Senior Unsecured Notes Due 2027 - Additional Information (Detail) - 5.000% Senior Unsecured Notes Due 2027 [Member] - USD ($)	Sep. 07, 2017	Dec. 31, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Senior unsecured notes face amount	$ 1,400,000,000
Senior unsecured notes, payable term		Interest on the notes is payable on April 15 and October 15 of each year.
Senior unsecured notes, interest rate	5.00%	5.00%	5.00%
Debt instrument maturity date	Oct. 15, 2027

Debt - 3.692% Senior Unsecured

Debt - 3.692% Senior Unsecured Notes Due 2028 - Additional Information (Detail) - 3.692% Senior Unsecured Notes due 2028 [Member] - GBP (£)	Dec. 05, 2019	Dec. 31, 2020
Debt Instrument [Line Items]
Senior unsecured notes face amount	£ 600,000,000
Percentage of par value on senior notes	99.998%
Senior unsecured notes, payable term		Interest on the notes is payable on June 5 of each year.
Debt instrument maturity date	Jun. 5, 2028

Deb - 4.625% Senior Unsecured N

Deb - 4.625% Senior Unsecured Notes Due 2029 - Additional Information (Detail) - 4.625% Senior Unsecured Notes Due 2029 [Member] - USD ($)	Jul. 26, 2019	Dec. 31, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Senior unsecured notes face amount	$ 900,000,000
Senior unsecured notes, payable term		Interest on the notes is payable on February 1 and August 1 of each year, commencing on February 1, 2020.
Percentage of par value on senior notes	99.50%
Senior unsecured notes, interest rate	4.625%	4.625%	4.625%
Debt instrument maturity date	Aug. 1, 2029

Deb - 3.500% Senior Unsecured N

Deb - 3.500% Senior Unsecured Notes Due 2031 - Additional Information (Detail) - 3.500% Senior Unsecured Notes Due 2031 [Member] - USD ($)	Dec. 04, 2020	Dec. 31, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Senior unsecured notes face amount	$ 1,300,000,000
Senior unsecured notes, interest rate	3.50%	3.50%	3.50%
Senior unsecured notes, payable term		Interest on the notes is payable semi-annually on March 15 and September 15 of each year.
Debt instrument maturity date	Mar. 15, 2031

Debt - Additional Information (

Debt - Additional Information (Detail) € in Millions	Dec. 04, 2020USD ($)	Dec. 17, 2019Hospital	Aug. 31, 2018Hospital	Aug. 03, 2018EUR (€)	Jul. 31, 2019USD ($)	Aug. 31, 2018Hospital	Dec. 31, 2020USD ($)Hospital	Dec. 31, 2019	Dec. 23, 2019USD ($)	Feb. 22, 2016USD ($)	Apr. 17, 2014USD ($)
3.500% Senior Unsecured Notes Due 2031 [Member]
Debt Instrument [Line Items]
Senior unsecured notes face amount	$ 1,300,000,000
Senior unsecured notes, interest rate	3.50%						3.50%	3.50%
Senior unsecured notes, maturity year	2031
6.375% Senior Unsecured Notes due 2024 [Member]
Debt Instrument [Line Items]
Senior unsecured notes face amount										$ 500,000,000
Senior unsecured notes, interest rate							6.375%	6.375%		6.375%
Senior unsecured notes, maturity year							2024
Senior unsecured notes redemption amount including accrued and unpaid interest							$ 500,000,000
5.500% Senior Unsecured Notes Due 2024 [Member]
Debt Instrument [Line Items]
Senior unsecured notes face amount											$ 300,000,000
Senior unsecured notes, interest rate							5.50%	5.50%			5.50%
Senior unsecured notes, maturity year							2024
Senior unsecured notes redemption amount including accrued and unpaid interest							$ 300,000,000
Term Loans [Member]
Debt Instrument [Line Items]
Debt refinancing costs							$ 28,000,000
Accelerated debt issue cost amortization expense									$ 2,000,000
Senior Unsecured Term Loan Facility [Member] | Barclays Bank P L C [Member]
Debt Instrument [Line Items]
Underwriting and other fees					$ 4,000,000
Acute Care Hospital [Member]
Debt Instrument [Line Items]
Number of facilities acquired | Hospital		10					2
Primotop Holdings S.a.r.l. [Member] | Germany [Member] | Acute Care Hospital [Member]
Debt Instrument [Line Items]
Proceeds from issuance of new secured debt | €				€ 655
Number of facilities acquired | Hospital						71
Primotop Holdings S.a.r.l. [Member] | Germany [Member] | Acute Care Hospital [Member] | Secured Debt [Member]
Debt Instrument [Line Items]
Number of facilities acquired | Hospital			71
Debt instrument term			7 years
Debt instrument swapped fixed rate			2.30%			2.30%

Debt - Covenants - Additional I

Debt - Covenants - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2020
Debt Disclosure [Abstract]
Percentage of dividends which could be paid from adjusted operating funds	95.00%
Percentage of dividends which could be paid from operation funds	95.00%
Maximum percentage of total unencumbered assets	150.00%

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Percentage of ordinary taxable income to be distributed for real estate investment trust qualification	90.00%	90.00%	90.00%
Percentage of taxable income to be distributed for federal income tax assumption	100.00%
Amount of foreign income (loss) before income taxes	$ 62,100,000	$ 10,700,000	$ 18,600,000
Amount of domestic income (loss) before income taxes	6,400,000	$ (44,100,000)	$ 8,000,000
Valuation allowance not expected to be realized	25,600,000
Uncertain tax position liabilities and related interest or penalties	$ 0

Income Taxes - Schedule of Inco

Income Taxes - Schedule of Income Tax Benefit (Expense) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Current income tax benefit (expense):
Domestic	$ 63	$ 61	$ 125
Foreign	(10,203)	(1,669)	(3,294)
Total income tax expense	(10,140)	(1,608)	(3,169)
Deferred income tax benefit (expense):
Domestic	(10,680)	5,490	3,713
Foreign	(10,236)	(1,261)	(1,471)
Total income tax expense	(20,916)	4,229	2,242
Income tax benefit (expense)	$ (31,056)	$ 2,621	$ (927)

Income Taxes - Summary of Recon

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 (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Income before income tax	$ 463,328	$ 373,780	$ 1,019,404
Income tax at the U.S. statutory federal rate (21% in 2020, 2019 and 2018)	(97,299)	(78,494)	(214,075)
Decrease (increase) in income tax resulting from:
Foreign rate differential	2,160	438	2,643
State income taxes, net of federal benefit	970	1,621	(379)
U.S. earnings not subject to federal income tax	82,921	85,495	208,472
Equity investments	380	1,091	46
Change in valuation allowance	(8,514)	(7,911)	2,668
Statutory tax rate change	(9,471)
Other items, net	(2,203)	381	(302)
Income tax benefit (expense)	$ (31,056)	$ 2,621	$ (927)

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, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Income tax at the US statutory federal rate	21.00%	21.00%	21.00%

Income Taxes - Schedule of Defe

Income Taxes - Schedule of Deferred Tax Assets and liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Operating loss and interest deduction carry forwards	$ 150,001	$ 28,684
Interest rate swap	9,150	843
Other	6,973	868
Total deferred tax assets	166,124	30,395
Valuation allowance	(36,977)	(11,355)
Total net deferred tax assets	129,147	19,040
Property and equipment	(211,018)	(7,324)
Net unbilled revenue	(14,776)	(1,449)
Other	(4,010)	(737)
Total deferred tax liabilities	(229,804)	(9,510)
Net deferred tax assets		$ 9,530
Net deferred tax liabilities	$ (100,657)

Income Taxes - Schedule of Net

Income Taxes - Schedule of Net NOL and Other Tax Attribute Carryforwards (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2020USD ($)
U.S. [Member]
Income Taxes [Line Items]
Gross NOL carryforwards	$ 159,895
Tax-effected NOL carryforwards	16,298
Valuation allowance	(6,193)
Net deferred tax asset - NOL carryforwards	$ 10,105
Expiration periods	2029
Expiration periods	indefinite
Foreign [Member]
Income Taxes [Line Items]
Gross NOL carryforwards	$ 528,567
Tax-effected NOL carryforwards	133,703
Valuation allowance	(30,784)
Net deferred tax asset - NOL carryforwards	$ 102,919
Expiration periods	indefinite

Income Taxes - Schedule of Per

Income Taxes - Schedule of Per Share Distributions to Stockholders (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Common share distribution	$ 1.070000	$ 1.010000	$ 0.990000
Ordinary income	0.603050	0.701910	0.438792
Capital gains		0.275040	0.551208
Unrecaptured Sec. 1250 gain		0.041160	0.132280
Section 199A Dividends	0.603050	0.701910	$ 0.438792
Return of capital	$ 0.466950	$ 0.033050

Earnings Per Share_Unit - Calcu

Earnings Per Share/Unit - Calculation of Earnings Per Share (Detail) - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Net income	$ 432,272	$ 376,401	$ 1,018,477
Non-controlling interests’ share in earnings	(822)	(1,717)	(1,792)
Participating securities’ share in earnings	(2,105)	(2,308)	(3,685)
Net income, less participating securities’ share in earnings	$ 429,345	$ 372,376	$ 1,013,000
Basic weighted-average common shares	529,239	427,075	365,364
Dilutive potential common shares	1,222	1,224	907
Diluted weighted-average common shares	530,461	428,299	366,271
MPT Operating Partnership, L.P. [Member]
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Net income	$ 432,272	$ 376,401	$ 1,018,477
Non-controlling interests’ share in earnings	(822)	(1,717)	(1,792)
Participating securities’ share in earnings	(2,105)	(2,308)	(3,685)
Net income, less participating securities’ share in earnings	$ 429,345	$ 372,376	$ 1,013,000
Basic weighted-average common shares	529,239	427,075	365,364
Dilutive potential common shares	1,222	1,224	907
Diluted weighted-average common shares	530,461	428,299	366,271

Stock Awards - Additional Infor

Stock Awards - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share / (Unit)-based compensation expense	$ 47,154	$ 32,188	$ 16,505
Stock-based compensation expense, unrecognized cost	$ 53,600
Stock-based compensation expense, unrecognized cost, reorganization period (in years)	1 year 3 months 18 days
Stock-based awards, fair value	$ 58,900	$ 25,900	$ 8,400
Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock awards vesting period in years	10 years
Equity Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Reserved shares of new common stock for awards under the Equity Incentive Plan	12,900,000
Common stock remaining for future stock awards transferred to the equity incentive plan	8,400,000
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, 2020	Dec. 31, 2019
Vesting Based on Service [Member]
Employee Restricted Equity Awards Vesting Activity [Line Items]
Nonvested awards at beginning of the year, Shares	1,122,440	923,848
Awarded, Shares	635,855	681,378
Vested, Shares	(699,215)	(478,104)
Forfeited, Shares	(2,026)	(4,682)
Nonvested awards at end of year, Shares	1,057,054	1,122,440
Nonvested awards at beginning of the year, Weighted Average Value at Award Date	$ 17.11	$ 14.29
Awarded, Weighted Average Value at Award Date	19.65	19.24
Vested, Weighted Average Value at Award Date	16.80	14.73
Forfeited, Weighted Average Value at Award Date	18.40	13.44
Nonvested awards at end of year, Weighted Average Value at Award Date	$ 18.79	$ 17.11
Vesting Based on Market/Performance Conditions [Member]
Employee Restricted Equity Awards Vesting Activity [Line Items]
Nonvested awards at beginning of the year, Shares	5,481,155	4,133,435
Awarded, Shares	1,800,898	2,438,292
Vested, Shares	(2,193,906)	(1,051,637)
Forfeited, Shares	(1,164)	(38,935)
Nonvested awards at end of year, Shares	5,086,983	5,481,155
Nonvested awards at beginning of the year, Weighted Average Value at Award Date	$ 11.66	$ 9.21
Awarded, Weighted Average Value at Award Date	19.42	15.25
Vested, Weighted Average Value at Award Date	11.35	10.43
Forfeited, Weighted Average Value at Award Date	18.22	10.13
Nonvested awards at end of year, Weighted Average Value at Award Date	$ 14.41	$ 11.66

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Detail) £ in Millions	Jan. 19, 2021GBP (£)Extension	Dec. 30, 2020GBP (£)Health_Center	Jan. 15, 2021USD ($)	Jan. 15, 2021GBP (£)	Dec. 31, 2020	Feb. 01, 2017USD ($)
Commitment And Contingencies [Line Items]
Term of lease					15 years
Aggregate committed amount of credit facility | $						$ 500,000,000
Waterland Private Equity Fund VII C.V [Member]
Commitment And Contingencies [Line Items]
Purchase price of acquisition		£ 800
Date of acquisition agreement		Dec. 30, 2020
Waterland Private Equity Fund VII C.V [Member] | Subsequent Event
Commitment And Contingencies [Line Items]
Payment for acquisition	£ 800
Lease extension options, description	two 10-year
Term of lease	25 years
Number of lease extension options | Extension	2
Extension term of lease	10 years
Purchase price of acquisition with 364-day acquisition loan	£ 250
Ownership interest in joint venture under the equity method	9.90%
Waterland Private Equity Fund VII C.V [Member] | Subsequent Event | Interim Credit Facility [Member]
Commitment And Contingencies [Line Items]
Aggregate committed amount of credit facility | $			$ 900,000,000
Amount utilized from credit facility				£ 500
Waterland Private Equity Fund VII C.V [Member] | Subsequent Event | Revolving Credit Facility [Member]
Commitment And Contingencies [Line Items]
Credit facilities, amount outstanding				£ 350
Behavioral Health Care Facilities [Member] | Waterland Private Equity Fund VII C.V [Member] | Minimum [Member]
Commitment And Contingencies [Line Items]
Number of facilities acquired | Health_Center		35
Behavioral Health Care Facilities [Member] | Waterland Private Equity Fund VII C.V [Member] | Maximum [Member]
Commitment And Contingencies [Line Items]
Number of facilities acquired | Health_Center		40

Common Stock_Partners' Capital

Common Stock/Partners' Capital - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	Dec. 28, 2020	Dec. 27, 2019	Nov. 08, 2019	Jul. 18, 2019	Dec. 31, 2018	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Nov. 04, 2019	Nov. 03, 2019
Class Of Stock [Line Items]
Proceeds from sale of common shares / units, net of offering costs						$ 411,101	$ 2,533,210	$ 94,239
Common stock, par value						$ 0.001	$ 0.001		$ 0.001
Common stock, shares authorized						750,000,000	750,000,000		750,000,000	500,000,000
Common stock, shares issued						541,419,000	517,522,000
Redemption of common units						$ 4,928		816
MPT Operating Partnership, L.P. [Member]
Class Of Stock [Line Items]
Redemption of common units	$ 4,900					$ 4,928		$ 816
MPT Operating Partnership, L.P. [Member] | Medical Properties Trust, LLC. [Member]
Class Of Stock [Line Items]
Percentage of ownership of general partner						100.00%
MPT Operating Partnership, L.P. [Member] | Operating Partnership [Member]
Class Of Stock [Line Items]
Percentage of ownership limited partner						100.00%
Aberdeen United Kingdom | MPT TRS, Inc [Member]
Class Of Stock [Line Items]
Percentage of ownership of general partner						100.00%
At-the-Market Equity Offering Program [Member]
Class Of Stock [Line Items]
Proceeds from sale of common shares / units, net of offering costs					$ 95,000		$ 650,000
At-the-Market Equity Offering Program [Member] | Maximum [Member]
Class Of Stock [Line Items]
Value of stock		$ 1,000
Sales commission percentage		2.00%
Public Offering [Member]
Class Of Stock [Line Items]
Proceeds from sale of common shares / units, net of offering costs			$ 1,026,000	$ 6,750
Common stock, shares issued			57,500,000	51,750,000
Additional shares purchased by underwriters			7,500,000	858,100,000
Common Par Value [Member]
Class Of Stock [Line Items]
Number of share sold						21,004,000	145,349,000	5,614,000
Common Par Value [Member] | MPT Operating Partnership, L.P. [Member] | Limited Partner [Member]
Class Of Stock [Line Items]
Number of share sold						20,795,000	143,894,000	5,558,000
Conversion of LTIP units to common units	232,000					232,000		60,000
Redemption of common units						$ 4,928		$ 816
Common Par Value [Member] | At-the-Market Equity Offering Program [Member]
Class Of Stock [Line Items]
Number of share sold					5,600,000	21,000,000	36,100,000

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, 2020	Dec. 31, 2019
Fair Value Disclosures [Abstract]
Interest and rent receivables, Book value	$ 46,208	$ 31,357
Loans, Book value	751,341	1,704,854
Debt, net Book value	(8,865,458)	(7,023,679)
Interest and rent receivables, Fair value	45,381	30,472
Loans, Fair value	756,608	1,742,153
Debt, net Fair value	$ (9,226,564)	$ (7,331,816)

Fair Value of Financial Instr_4

Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Parenthetical) (Detail) - Fair Value, Recurring $ in Millions	12 Months Ended
	Dec. 31, 2020USD ($)Health_Center	Dec. 31, 2019USD ($)Health_Center
Colombia [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Number of facilities acquired | Health_Center	3
Acquisition Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair value | $	$ 205	$ 205
Book value | $	$ 205	$ 205
Acquisition Loans [Member] | Colombia [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Number of facilities acquired | Health_Center	3	3

Fair Value of Financial Instr_5

Fair Value of Financial Instruments - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2020Health_Center
Fair Value, Recurring | Colombia [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Number of facilities acquired	3

Fair Value of Financial Instr_6

Fair Value of Financial Instruments - Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis (Detail) - Fair Value, Recurring - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Mortgage Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair value	$ 136,332	$ 115,000
Original Cost	136,332	$ 115,000
Equity Method Investment and Other Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair value	218,775
Original Cost	$ 218,775

Leases (Lessee) - Summary of Le

Leases (Lessee) - Summary of Lease Expense (Detail) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Lessee Lease Description [Line Items]
Operating lease cost	[1],[2]	$ 9,910	$ 9,262
Finance lease cost:
Sublease income				$ (4,300)
Total lease cost		7,475	5,952
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	117
Other [Member]
Finance lease cost:
Sublease income		$ (2,614)	$ (3,478)
[1]	$6.0 million and $5.8 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2020 and 2019, respectively.
[2]	Includes short-term leases.

Leases (Lessee) - Summary of _2

Leases (Lessee) - Summary of Lease Expense (Parenthetical) (Detail) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2020	Dec. 31, 2019
Lessee Lease Description [Line Items]
Operating lease cost	[1],[2]	$ 9,910	$ 9,262
Property-related [Member]
Lessee Lease Description [Line Items]
Operating lease cost		$ 6,000	$ 5,800
[1]	$6.0 million and $5.8 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2020 and 2019, respectively.
[2]	Includes short-term leases.

Leases (Lessee) - Additional In

Leases (Lessee) - Additional Information (Detail) $ in Millions	12 Months Ended
	Dec. 31, 2018USD ($)
Leases [Abstract]
Lease expenses	$ 9.4
Sublease rental income	$ 4.3

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, 2020	Dec. 31, 2019
Leases [Abstract]
Operating Leases, 2021		$ 7,186
Operating Leases, 2022		7,384
Operating Leases, 2023		7,451
Operating Leases, 2024		6,557
Operating Leases, 2025		5,660
Operating Leases, Thereafter		257,730
Operating Leases, Total undiscounted minimum lease payments		291,968
Operating Leases, Less: interest		(201,962)
Operating Leases, Present value of lease liabilities		90,006	$ 76,353
Finance Leases, 2021		126
Finance Leases, 2022		128
Finance Leases, 2023		129
Finance Leases, 2024		130
Finance Leases, 2025		131
Finance Leases, Thereafter		4,783
Finance Leases, Total undiscounted minimum lease payments		5,427
Finance Leases, Less: interest		(3,492)
Finance Leases, Present value of lease liabilities		1,935	$ 1,932
Amounts To Be Received From Subleases, 2021		(2,952)
Amounts To Be Received From Subleases, 2022		(3,238)
Amounts To Be Received From Subleases, 2023		(3,240)
Amounts To Be Received From Subleases, 2024		(3,259)
Amounts To Be Received From Subleases, 2025		(3,303)
Amounts To Be Received From Subleases, Thereafter		(78,494)
Amounts To Be Received From Subleases, Total undiscounted minimum lease payments		(94,486)
Net Payments, 2021		4,360
Net Payments, 2022		4,274
Net Payments, 2023		4,340
Net Payments, 2024		3,428
Net Payments, 2025		2,488
Net Payments, Thereafter	[1]	184,019
Net Payments, Total undiscounted minimum lease payments		$ 202,909
[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, 2020	Dec. 31, 2019
Right of use assets:
Operating leases	$ 8,234	$ 9,866
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List]	us-gaap:OtherAssets
Total real estate right of use assets	$ 75,209	61,380
Total right of use assets	83,443	71,246
Lease liabilities:
Operating leases	$ 90,006	76,353
Operating Lease, Liability, Statement of Financial Position [Extensible List]	mpw:ObligationsToTenantsAndOtherLeaseLiabilities
Financing leases	$ 1,935	1,932
Finance Lease, Liability, Statement of Financial Position [Extensible List]	mpw:ObligationsToTenantsAndOtherLeaseLiabilities
Total lease liabilities	$ 91,941	$ 78,285
Weighted-average remaining lease term:
Operating leases	41 years 1 month 6 days	31 years 10 months 24 days
Finance leases	35 years 10 months 24 days	36 years 10 months 24 days
Weighted-average discount rate:
Operating leases	6.40%	6.30%
Finance leases	6.60%	6.60%
Real Estate [Member]
Right of use assets:
Operating leases	$ 73,373	$ 59,492
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List]	us-gaap:Land
Finance leases	$ 1,836	$ 1,888
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List]	us-gaap:Land

Leases (Lessee) - Summary of _3

Leases (Lessee) - Summary of Supplemental Cash Flow Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 6,080	$ 5,937
Operating cash flows from finance leases	125	114
Financing cash flows from finance leases		10
Non-cash activities - Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$ 13,832	$ 1,818

Other Assets - Summary of Other

Other Assets - Summary of Other Assets (Detail) - USD ($) $ in Thousands		Dec. 31, 2020	Dec. 31, 2019
Other Assets [Abstract]
Debt issue costs, net	[1]	$ 192	$ 2,492
Other corporate assets		167,929	206,765
Prepaids and other assets		87,948	90,342
Total other assets		$ 256,069	$ 299,599
[1]	Relates to our revolving credit facility

Other Assets - Additional Infor

Other Assets - Additional Information (Detail) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Other Assets [Abstract]
Equity investments	$ 1,123,623	$ 926,990

Subsequent Events - Additional

Subsequent Events - Additional Information (Detail) - USD ($) $ in Thousands, shares in Millions	Jan. 15, 2021	Jan. 11, 2021	Nov. 08, 2019	Jul. 18, 2019	Feb. 01, 2017	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Subsequent Event [Line Items]
Proceeds from sale of common shares, net of offering costs						$ 411,101	$ 2,533,210	$ 94,239
Minimum [Member]
Subsequent Event [Line Items]
Commitment fee					0.125%
Maximum [Member]
Subsequent Event [Line Items]
Commitment fee					0.30%
Term Loan [Member]
Subsequent Event [Line Items]
Amount of senior unsecured debt					$ 200,000
Debt instrument maturity date					Feb. 1, 2022
Unsecured Revolving Credit Facility [Member]
Subsequent Event [Line Items]
Amount of senior unsecured debt					$ 1,300,000
Debt instrument, maturity month and year					2021-02
Alternate Base Rate [Member] | Minimum [Member]
Subsequent Event [Line Items]
Applicable margin for revolving loans					0.00%
Alternate Base Rate [Member] | Maximum [Member]
Subsequent Event [Line Items]
Applicable margin for revolving loans					0.65%
Eurodollar Loans [Member] | Minimum [Member]
Subsequent Event [Line Items]
Applicable margin for revolving loans					0.875%
Eurodollar Loans [Member] | Maximum [Member]
Subsequent Event [Line Items]
Applicable margin for revolving loans					1.65%
Subsequent Event [Member] | Minimum [Member]
Subsequent Event [Line Items]
Commitment fee	0.125%
Subsequent Event [Member] | Maximum [Member]
Subsequent Event [Line Items]
Commitment fee	0.30%
Subsequent Event [Member] | Term Loan [Member]
Subsequent Event [Line Items]
Amount of senior unsecured debt	$ 200,000
Debt instrument maturity date	Feb. 1, 2026
Subsequent Event [Member] | Unsecured Revolving Credit Facility [Member]
Subsequent Event [Line Items]
Debt instrument, maturity month and year	2024-02
Subsequent Event [Member] | Alternate Base Rate [Member] | Minimum [Member]
Subsequent Event [Line Items]
Applicable margin for term loan	0.00%
Applicable margin for revolving loans	0.00%
Subsequent Event [Member] | Alternate Base Rate [Member] | Maximum [Member]
Subsequent Event [Line Items]
Applicable margin for term loan	0.85%
Applicable margin for revolving loans	0.55%
Subsequent Event [Member] | Eurodollar Loans [Member] | Minimum [Member]
Subsequent Event [Line Items]
Applicable margin for term loan	0.85%
Applicable margin for revolving loans	0.825%
Subsequent Event [Member] | Eurodollar Loans [Member] | Maximum [Member]
Subsequent Event [Line Items]
Applicable margin for term loan	1.85%
Applicable margin for revolving loans	1.55%
Public Offering [Member]
Subsequent Event [Line Items]
Proceeds from sale of common shares, net of offering costs			$ 1,026,000	$ 6,750
Public Offering [Member] | Subsequent Event [Member]
Subsequent Event [Line Items]
Shares issued in underwritten public offering		36.8
Proceeds from sale of common shares, net of offering costs		$ 711,000
Over-Allotment Option [Member] | Subsequent Event [Member]
Subsequent Event [Line Items]
Shares issued in underwritten public offering		4.8

Schedule II - Schedule of Valua

Schedule II - Schedule of Valuation and Qualifying Accounts (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Valuation And Qualifying Accounts [Abstract]
Balance at Beginning of Year	$ 109,803	$ 66,131	$ 16,397
Additions, Charged Against Operations	58,044	50,893	57,285
Addition, Charged to Other Accounts	22,944
Deductions, Net Recoveries/Write-offs	(44,154)	(7,221)	(7,551)
Balance at End of Year	$ 146,637	$ 109,803	$ 66,131

Schedule II - Schedule of Val_2

Schedule II - Schedule of Valuation and Qualifying Accounts (Parenthetical) (Detail) - USD ($) $ in Millions	Jan. 08, 2020	Dec. 31, 2018	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Jan. 01, 2020
Increase in real estate impairment reserves			$ 19	$ 21	$ 48
Increase in accounts receivable and other reserves			23.9	22
Increase (decrease) in valuation allowances			0.8
Valuation allowances recorded as part of the purchase price allocation of the Circle Transaction	$ 14.5
Increase (decrease) in real estate impairment reserves related to disposals			40.5	(7.2)
Credit loss recovery related to loan paydowns			2.9
Increase in accounts receivable reserves					9.3
Increase in credit loss reserves on financing-type receivables			3.3
Accounting Standards Update 2016-13
Credit loss reserve expected						$ 8.4
Domestic Valuation Allowances [Member]
Increase (decrease) in valuation allowances		$ (4.4)
Valuation Allowance, Deferred Tax Asset [Member]
Increase (decrease) in valuation allowances			$ 11.9	$ 7.9	$ (7.7)

Schedule III - Real Estate In_2

Schedule III - Real Estate Investments and Accumulated Depreciation (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Initial costs, land	$ 1,442,071
Initial costs, buildings	8,857,393
Additions subsequent to acquisition, Improvements	428,465
Additions subsequent to acquisition, carrying costs	21,778
Land at cost	1,463,201
Buildings at cost	9,286,506
Total at cost	10,749,707	$ 7,312,486	$ 4,781,149	$ 5,438,148
Accumulated Depreciation	$ 728,176	$ 504,651
Princes Risborough, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,006
Land at cost	5,006
Total at cost	5,006
Encumbrances	$ 0
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Ashtead, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 39,518
Initial costs, buildings	76,020
Additions subsequent to acquisition, Improvements	1,029
Land at cost	40,547
Buildings at cost	76,020
Total at cost	116,567
Accumulated Depreciation	2,648
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	$ 5,810
Initial costs, buildings	22,493
Additions subsequent to acquisition, Improvements	55
Land at cost	5,864
Buildings at cost	22,494
Total at cost	28,358
Accumulated Depreciation	566
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Cheadle, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 32,808
Initial costs, buildings	174,982
Additions subsequent to acquisition, Improvements	410
Land at cost	33,218
Buildings at cost	174,982
Total at cost	208,200
Accumulated Depreciation	4,401
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Dorchester, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 533
Initial costs, buildings	33,653
Additions subsequent to acquisition, Improvements	62
Land at cost	595
Buildings at cost	33,653
Total at cost	34,248
Accumulated Depreciation	845
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Euxton, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,088
Initial costs, buildings	38,183
Additions subsequent to acquisition, Improvements	870
Land at cost	4,958
Buildings at cost	38,183
Total at cost	43,141
Accumulated Depreciation	1,369
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Great Missenden, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,303
Initial costs, buildings	112,924
Additions subsequent to acquisition, Improvements	335
Land at cost	12,638
Buildings at cost	112,924
Total at cost	125,562
Accumulated Depreciation	2,845
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Torquay, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,840
Initial costs, buildings	38,379
Additions subsequent to acquisition, Improvements	360
Land at cost	3,200
Buildings at cost	38,379
Total at cost	41,579
Accumulated Depreciation	1,319
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2008 [Member] | Bath, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,620
Initial costs, buildings	33,584
Land at cost	1,620
Buildings at cost	33,584
Total at cost	35,204
Accumulated Depreciation	5,457
Encumbrances	$ 0
Date of Construction	2008
Date Acquired	Jul. 1, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2008 [Member] | Boise, ID [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,558
Initial costs, buildings	11,027
Land at cost	1,558
Buildings at cost	11,027
Total at cost	12,585
Accumulated Depreciation	634
Encumbrances	$ 0
Date of Construction	2008
Date Acquired	Feb. 29, 2012
Life on which depreciation in latest income statements is computed (Years)	50 years
2008 [Member] | Boardman, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 79
Initial costs, buildings	275
Land at cost	79
Buildings at cost	275
Total at cost	354
Accumulated Depreciation	10
Encumbrances	$ 0
Date of Construction	2008
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2008 [Member] | Crown Point, IN [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 302
Initial costs, buildings	528
Land at cost	302
Buildings at cost	528
Total at cost	830
Accumulated Depreciation	22
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	254
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	42
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	4,281
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	$ 6,835
Initial costs, buildings	47,906
Additions subsequent to acquisition, Improvements	267
Land at cost	7,102
Buildings at cost	47,906
Total at cost	55,008
Accumulated Depreciation	1,215
Encumbrances	$ 0
Date of Construction	2008
Date Acquired	Jan. 9, 2020
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	$ 1,081
Initial costs, buildings	5,853
Additions subsequent to acquisition, Improvements	183
Land at cost	1,264
Buildings at cost	5,853
Total at cost	7,117
Accumulated Depreciation	311
Encumbrances	$ 0
Date of Construction	1887
Date Acquired	Feb. 9, 2019
Life on which depreciation in latest income statements is computed (Years)	39 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	$ 1,620
Initial costs, buildings	33,584
Land at cost	1,620
Buildings at cost	33,584
Total at cost	35,204
Accumulated Depreciation	5,457
Encumbrances	$ 0
Date of Construction	2009
Date Acquired	Jul. 1, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2009 [Member] | Brighton, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 18,540
Initial costs, buildings	146,491
Additions subsequent to acquisition, Improvements	39,279
Land at cost	18,540
Buildings at cost	185,770
Total at cost	204,310
Accumulated Depreciation	16,411
Encumbrances	$ 0
Date of Construction	2009
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
2009 [Member] | Folsom, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 3,291
Initial costs, buildings	21,293
Land at cost	3,291
Buildings at cost	21,293
Total at cost	24,584
Accumulated Depreciation	843
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	$ 1,081
Initial costs, buildings	5,853
Additions subsequent to acquisition, Improvements	183
Land at cost	1,264
Buildings at cost	5,853
Total at cost	7,117
Accumulated Depreciation	311
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Feb. 9, 2019
Life on which depreciation in latest income statements is computed (Years)	39 years
1983 [Member] | Grefath, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,220
Initial costs, buildings	3,351
Additions subsequent to acquisition, Improvements	108
Land at cost	1,328
Buildings at cost	3,351
Total at cost	4,679
Accumulated Depreciation	212
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member] | Remscheid, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,097
Initial costs, buildings	2,797
Additions subsequent to acquisition, Improvements	64
Land at cost	1,161
Buildings at cost	2,797
Total at cost	3,958
Accumulated Depreciation	173
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] | Glasgow, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,767
Initial costs, buildings	141,275
Additions subsequent to acquisition, Improvements	150
Land at cost	6,917
Buildings at cost	141,275
Total at cost	148,192
Accumulated Depreciation	3,542
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member] | 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	1,145
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] | Port Huron, MI [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,531
Initial costs, buildings	14,252
Land at cost	2,531
Buildings at cost	14,252
Total at cost	16,783
Accumulated Depreciation	2,434
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] | Milton Keynes, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,536
Initial costs, buildings	38,506
Additions subsequent to acquisition, Improvements	96
Land at cost	5,632
Buildings at cost	38,506
Total at cost	44,138
Accumulated Depreciation	969
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member] | Nottingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,058
Initial costs, buildings	49,340
Additions subsequent to acquisition, Improvements	260
Land at cost	5,318
Buildings at cost	49,340
Total at cost	54,658
Accumulated Depreciation	1,251
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member] | 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	919
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	818
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	$ 16,896
Initial costs, buildings	233,256
Additions subsequent to acquisition, Improvements	3,319
Land at cost	16,896
Buildings at cost	236,575
Total at cost	253,471
Accumulated Depreciation	3,185
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	40 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	$ 2,345
Initial costs, buildings	14,992
Additions subsequent to acquisition, Improvements	62
Land at cost	2,407
Buildings at cost	14,992
Total at cost	17,399
Accumulated Depreciation	2,084
Encumbrances	$ 0
Date of Construction	1977
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1977 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 13,342
Initial costs, buildings	87,261
Additions subsequent to acquisition, Improvements	27
Land at cost	13,369
Buildings at cost	87,261
Total at cost	100,630
Accumulated Depreciation	2,183
Encumbrances	$ 0
Date of Construction	1977
Date Acquired	Jan. 9, 2020
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	$ 6,823
Initial costs, buildings	39,424
Additions subsequent to acquisition, Improvements	79
Land at cost	6,902
Buildings at cost	39,424
Total at cost	46,326
Accumulated Depreciation	4,459
Encumbrances	$ 0
Date of Construction	1885
Date Acquired	Jun. 22, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1991 [Member] | Heidelberg, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 6,823
Initial costs, buildings	39,424
Additions subsequent to acquisition, Improvements	79
Land at cost	6,902
Buildings at cost	39,424
Total at cost	46,326
Accumulated Depreciation	4,459
Encumbrances	$ 0
Date of Construction	1991
Date Acquired	Jun. 22, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1991 [Member] | Fresno, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 5,507
Initial costs, buildings	70,473
Land at cost	5,507
Buildings at cost	70,473
Total at cost	75,980
Accumulated Depreciation	2,532
Encumbrances	$ 0
Date of Construction	1991
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1992 [Member] | Bath, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,519
Initial costs, buildings	14,016
Additions subsequent to acquisition, Improvements	205
Land at cost	7,724
Buildings at cost	14,016
Total at cost	21,740
Accumulated Depreciation	364
Encumbrances	$ 0
Date of Construction	1992
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1992 [Member] | Bowling Green, KY [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,486
Initial costs, buildings	56,296
Land at cost	3,486
Buildings at cost	56,296
Total at cost	59,782
Accumulated Depreciation	2,092
Encumbrances	$ 0
Date of Construction	1992
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1992 [Member] | Wichita, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,019
Initial costs, buildings	18,373
Additions subsequent to acquisition, carrying costs	1
Land at cost	1,019
Buildings at cost	18,374
Total at cost	19,393
Accumulated Depreciation	5,856
Encumbrances	$ 0
Date of Construction	1992
Date Acquired	Apr. 4, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
2018 [Member] | Birmingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, buildings	$ 20,011
Buildings at cost	20,011
Total at cost	20,011
Accumulated Depreciation	249
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] | 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	21,328
Land at cost	4,268
Buildings at cost	21,328
Total at cost	25,596
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Dec. 17, 2020
Life on which depreciation in latest income statements is computed (Years)	38 years
2018 [Member] | Olathe, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,485
Initial costs, buildings	14,484
Land at cost	3,485
Buildings at cost	14,484
Total at cost	17,969
Accumulated Depreciation	498
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Jun. 10, 2019
Life on which depreciation in latest income statements is computed (Years)	50 years
2018 [Member] | Roeland Park, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,569
Initial costs, buildings	15,103
Land at cost	1,569
Buildings at cost	15,103
Total at cost	16,672
Accumulated Depreciation	509
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	587
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Jun. 10, 2019
Life on which depreciation in latest income statements is computed (Years)	50 years
2011 [Member] | Cologne, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,788
Initial costs, buildings	16,560
Additions subsequent to acquisition, Improvements	111
Land at cost	4,899
Buildings at cost	16,560
Total at cost	21,459
Accumulated Depreciation	1,475
Encumbrances	$ 0
Date of Construction	2011
Date Acquired	Jun. 23, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2011 [Member] | Methuen, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 23,809
Initial costs, buildings	89,505
Additions subsequent to acquisition, Improvements	9,184
Land at cost	23,809
Buildings at cost	98,689
Total at cost	122,498
Accumulated Depreciation	11,290
Encumbrances	$ 0
Date of Construction	2011
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
2011 [Member] | New Braunfels, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,853
Initial costs, buildings	10,622
Land at cost	1,853
Buildings at cost	10,622
Total at cost	12,475
Accumulated Depreciation	23
Encumbrances	$ 0
Date of Construction	2011
Date Acquired	Feb. 29, 2012
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Birmingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 9,397
Initial costs, buildings	48,175
Land at cost	9,397
Buildings at cost	48,175
Total at cost	57,572
Accumulated Depreciation	599
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Apr. 3, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,903
Initial costs, buildings	1,276
Land at cost	1,903
Buildings at cost	1,276
Total at cost	3,179
Accumulated Depreciation	408
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	May 8, 2017
Life on which depreciation in latest income statements is computed (Years)	35 years
2017 [Member] | 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	468
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] | 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	474
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] | 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	474
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Jun. 10, 2019
Life on which depreciation in latest income statements is computed (Years)	50 years
2017 [Member] | Overland Park, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,974
Initial costs, buildings	14,405
Land at cost	2,974
Buildings at cost	14,405
Total at cost	17,379
Accumulated Depreciation	498
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] | Austin, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 3,782
Initial costs, buildings	4,200
Land at cost	3,782
Buildings at cost	4,200
Total at cost	7,982
Accumulated Depreciation	434
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Mar. 2, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Texarkana T X
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
1974 [Member] | Bad Salzuflen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 10,624
Initial costs, buildings	29,415
Additions subsequent to acquisition, Improvements	999
Land at cost	11,623
Buildings at cost	29,415
Total at cost	41,038
Accumulated Depreciation	2,473
Encumbrances	$ 0
Date of Construction	1974
Date Acquired	Nov. 30, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
1974 [Member] | Redding, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,555
Initial costs, buildings	53,863
Additions subsequent to acquisition, carrying costs	13
Land at cost	1,555
Buildings at cost	53,876
Total at cost	55,431
Accumulated Depreciation	18,079
Encumbrances	$ 0
Date of Construction	1974
Date Acquired	Aug. 10, 2007
Life on which depreciation in latest income statements is computed (Years)	40 years
1974 [Member] | Sebastian, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,733
Initial costs, buildings	49,136
Additions subsequent to acquisition, Improvements	52,394
Land at cost	5,733
Buildings at cost	101,530
Total at cost	107,263
Accumulated Depreciation	5,392
Encumbrances	$ 0
Date of Construction	1974
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1982 [Member] | Birmingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 10,317
Initial costs, buildings	100,791
Additions subsequent to acquisition, Improvements	390
Land at cost	10,707
Buildings at cost	100,791
Total at cost	111,498
Accumulated Depreciation	2,545
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Bedford, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,599
Initial costs, buildings	8,057
Additions subsequent to acquisition, Improvements	55
Land at cost	1,654
Buildings at cost	8,057
Total at cost	9,711
Accumulated Depreciation	205
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Bossier City, LA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 900
Initial costs, buildings	17,818
Additions subsequent to acquisition, Improvements	944
Land at cost	900
Buildings at cost	18,762
Total at cost	19,662
Accumulated Depreciation	5,736
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Apr. 1, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Cheraw, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 657
Initial costs, buildings	19,576
Land at cost	657
Buildings at cost	19,576
Total at cost	20,233
Accumulated Depreciation	6,675
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Apr. 1, 2008
Life on which depreciation in latest income statements is computed (Years)	42 years
1982 [Member] | Caterham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 10,927
Initial costs, buildings	22,384
Additions subsequent to acquisition, Improvements	403
Land at cost	11,330
Buildings at cost	22,384
Total at cost	33,714
Accumulated Depreciation	791
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Canterbury, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 9,774
Initial costs, buildings	29,624
Additions subsequent to acquisition, Improvements	89
Land at cost	9,863
Buildings at cost	29,624
Total at cost	39,487
Accumulated Depreciation	746
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Croydon, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 10,458
Initial costs, buildings	44,782
Additions subsequent to acquisition, Improvements	218
Land at cost	10,676
Buildings at cost	44,782
Total at cost	55,458
Accumulated Depreciation	1,134
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | 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	9,893
Land at cost	5,385
Buildings at cost	57,481
Total at cost	62,866
Accumulated Depreciation	5,935
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1982 [Member] | Haverhill, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,651
Initial costs, buildings	105,848
Additions subsequent to acquisition, Improvements	3,384
Land at cost	5,651
Buildings at cost	109,232
Total at cost	114,883
Accumulated Depreciation	6,674
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Aug. 31, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Garden Grove, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,502
Initial costs, buildings	10,748
Additions subsequent to acquisition, carrying costs	51
Land at cost	5,502
Buildings at cost	10,799
Total at cost	16,301
Accumulated Depreciation	3,277
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Nov. 25, 2008
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	$ 10,624
Initial costs, buildings	29,415
Additions subsequent to acquisition, Improvements	999
Land at cost	11,623
Buildings at cost	29,415
Total at cost	41,038
Accumulated Depreciation	2,473
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Nov. 30, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 950
Initial costs, buildings	3,996
Land at cost	950
Buildings at cost	3,996
Total at cost	4,946
Accumulated Depreciation	425
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] | 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	651
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Sep. 23, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Katy, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,604
Initial costs, buildings	4,174
Land at cost	1,604
Buildings at cost	4,174
Total at cost	5,778
Accumulated Depreciation	443
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Oct. 10, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | The Woodlands, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,019
Initial costs, buildings	4,524
Land at cost	2,019
Buildings at cost	4,524
Total at cost	6,543
Accumulated Depreciation	537
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Mar. 28, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | DeSoto, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 750
Initial costs, buildings	4,234
Land at cost	750
Buildings at cost	4,234
Total at cost	4,984
Accumulated Depreciation	485
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	May 23, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 3,216
Initial costs, buildings	4,801
Land at cost	3,216
Buildings at cost	4,801
Total at cost	8,017
Accumulated Depreciation	490
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Dec. 9, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | 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	634
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] | 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	560
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Apr. 4, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Flagstaff, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,049
Initial costs, buildings	22,464
Land at cost	3,049
Buildings at cost	22,464
Total at cost	25,513
Accumulated Depreciation	1,591
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	618
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] | Garland, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 3,441
Initial costs, buildings	4,648
Land at cost	3,441
Buildings at cost	4,648
Total at cost	8,089
Accumulated Depreciation	484
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Nov. 15, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | 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	528
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Jul. 25, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Longmont, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,826
Initial costs, buildings	4,181
Land at cost	1,826
Buildings at cost	4,181
Total at cost	6,007
Accumulated Depreciation	514
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	559
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	$ 1,632
Initial costs, buildings	5,801
Land at cost	1,632
Buildings at cost	5,801
Total at cost	7,433
Accumulated Depreciation	653
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Jul. 15, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Plano, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 4,343
Initial costs, buildings	2,492
Land at cost	4,343
Buildings at cost	2,492
Total at cost	6,835
Accumulated Depreciation	375
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Sep. 30, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,485
Initial costs, buildings	4,253
Land at cost	2,485
Buildings at cost	4,253
Total at cost	6,738
Accumulated Depreciation	443
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Oct. 27, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Rosenberg, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,309
Initial costs, buildings	4,505
Land at cost	1,309
Buildings at cost	4,505
Total at cost	5,814
Accumulated Depreciation	563
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] | Columbus, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,726
Land at cost	1,726
Total at cost	1,726
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Aug. 30, 2016
2016 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,047
Initial costs, buildings	36,862
Land at cost	4,047
Buildings at cost	36,862
Total at cost	40,909
Accumulated Depreciation	4,147
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Jul. 7, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Toledo, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,186
Initial costs, buildings	17,740
Land at cost	1,186
Buildings at cost	17,740
Total at cost	18,926
Accumulated Depreciation	2,107
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Apr. 1, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Viseu, Portugal [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,319
Initial costs, buildings	31,963
Additions subsequent to acquisition, Improvements	486
Land at cost	2,805
Buildings at cost	31,963
Total at cost	34,768
Accumulated Depreciation	971
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Nov. 28, 2019
Life on which depreciation in latest income statements is computed (Years)	37 years
1989 [Member] | Bad Salzuflen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 7,523
Initial costs, buildings	25,869
Additions subsequent to acquisition, Improvements	376
Land at cost	7,899
Buildings at cost	25,869
Total at cost	33,768
Accumulated Depreciation	2,072
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	$ 1,640
Initial costs, buildings	47,818
Additions subsequent to acquisition, Improvements	62
Land at cost	1,702
Buildings at cost	47,818
Total at cost	49,520
Accumulated Depreciation	1,199
Encumbrances	$ 0
Date of Construction	1989
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1989 [Member] | Guildford, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,259
Initial costs, buildings	39,114
Additions subsequent to acquisition, Improvements	130
Land at cost	7,389
Buildings at cost	39,114
Total at cost	46,503
Accumulated Depreciation	986
Encumbrances	$ 0
Date of Construction	1989
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1989 [Member] | Lynwood, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 30,116
Initial costs, buildings	148,527
Land at cost	30,116
Buildings at cost	148,527
Total at cost	178,643
Accumulated Depreciation	1,555
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	$ 1,304
Initial costs, buildings	10,071
Land at cost	1,304
Buildings at cost	10,071
Total at cost	11,375
Accumulated Depreciation	435
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	132
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	13
Encumbrances	$ 0
Date of Construction	1989
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 One [Member] | Bad Salzuflen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 7,523
Initial costs, buildings	25,869
Additions subsequent to acquisition, Improvements	376
Land at cost	7,899
Buildings at cost	25,869
Total at cost	33,768
Accumulated Depreciation	2,072
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Nov. 30, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
1960 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,501
Initial costs, buildings	34,530
Additions subsequent to acquisition, Improvements	8,477
Additions subsequent to acquisition, carrying costs	16,589
Land at cost	3,274
Buildings at cost	59,823
Total at cost	63,097
Accumulated Depreciation	16,224
Encumbrances	$ 0
Date of Construction	1960
Date Acquired	Aug. 10, 2007
Life on which depreciation in latest income statements is computed (Years)	40 years
1960 [Member] | Meyersdale, PA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 390
Initial costs, buildings	4,280
Land at cost	390
Buildings at cost	4,280
Total at cost	4,670
Accumulated Depreciation	183
Encumbrances	$ 0
Date of Construction	1960
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
1960 [Member] | Sherman Texas
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,363
Initial costs, buildings	10,932
Land at cost	3,363
Buildings at cost	10,932
Total at cost	14,295
Accumulated Depreciation	3,169
Encumbrances	$ 0
Date of Construction	1960
Date Acquired	Oct. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1973 [Member] | Bad Oeynhausen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,110
Initial costs, buildings	3,045
Additions subsequent to acquisition, Improvements	135
Land at cost	1,245
Buildings at cost	3,045
Total at cost	4,290
Accumulated Depreciation	263
Encumbrances	$ 0
Date of Construction	1973
Date Acquired	Nov. 30, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
1973 [Member] | San Diego, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,663
Initial costs, buildings	52,431
Land at cost	12,663
Buildings at cost	52,431
Total at cost	65,094
Accumulated Depreciation	12,999
Encumbrances	$ 0
Date of Construction	1973
Date Acquired	Feb. 9, 2011
Life on which depreciation in latest income statements is computed (Years)	40 years
1973 [Member] | Big Spring, 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
Land at cost	1,655
Buildings at cost	21,254
Total at cost	22,909
Accumulated Depreciation	1,058
Encumbrances	$ 0
Date of Construction	1973
Date Acquired	Apr. 12, 2019
Life on which depreciation in latest income statements is computed (Years)	41 years
1973 [Member] | Port Huron, MI [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,531
Initial costs, buildings	14,252
Land at cost	2,531
Buildings at cost	14,252
Total at cost	16,783
Accumulated Depreciation	2,434
Encumbrances	$ 0
Date of Construction	1973
Date Acquired	Dec. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	30 years
1973 [Member] | Odessa, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,535
Initial costs, buildings	123,518
Additions subsequent to acquisition, Improvements	4,571
Land at cost	6,535
Buildings at cost	128,089
Total at cost	134,624
Accumulated Depreciation	10,331
Encumbrances	$ 0
Date of Construction	1973
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1973 [Member] | Ringwood, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,413
Initial costs, buildings	20,469
Additions subsequent to acquisition, Improvements	146
Land at cost	4,559
Buildings at cost	20,469
Total at cost	25,028
Accumulated Depreciation	954
Encumbrances	$ 0
Date of Construction	1973
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	35 years
2010 [Member] | Bad Oeynhausen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,110
Initial costs, buildings	3,045
Additions subsequent to acquisition, Improvements	135
Land at cost	1,245
Buildings at cost	3,045
Total at cost	4,290
Accumulated Depreciation	263
Encumbrances	$ 0
Date of Construction	2010
Date Acquired	Nov. 30, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2010 [Member] | Brockton, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 18,328
Initial costs, buildings	67,248
Additions subsequent to acquisition, Improvements	4,937
Land at cost	18,328
Buildings at cost	72,185
Total at cost	90,513
Accumulated Depreciation	9,289
Encumbrances	$ 0
Date of Construction	2010
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
2010 [Member] | Layton, UT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 14,360
Initial costs, buildings	370,154
Additions subsequent to acquisition, Improvements	3,034
Land at cost	14,360
Buildings at cost	373,188
Total at cost	387,548
Accumulated Depreciation	4,914
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] | Sherman Texas
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	3,169
Encumbrances	$ 0
Date of Construction	2010
Date Acquired	Oct. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1993 [Member] | Dormagen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,963
Initial costs, buildings	6,251
Additions subsequent to acquisition, Improvements	150
Land at cost	2,113
Buildings at cost	6,251
Total at cost	8,364
Accumulated Depreciation	388
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	1,366
Encumbrances	$ 0
Date of Construction	1993
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2006 [Member] | Dormagen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,963
Initial costs, buildings	6,251
Additions subsequent to acquisition, Improvements	150
Land at cost	2,113
Buildings at cost	6,251
Total at cost	8,364
Accumulated Depreciation	388
Encumbrances	$ 0
Date of Construction	2006
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
2006 [Member] | Dallas, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,000
Initial costs, buildings	13,589
Additions subsequent to acquisition, carrying costs	368
Land at cost	1,421
Buildings at cost	13,536
Total at cost	14,957
Accumulated Depreciation	4,850
Encumbrances	$ 0
Date of Construction	2006
Date Acquired	Sep. 5, 2006
Life on which depreciation in latest income statements is computed (Years)	40 years
2006 [Member] | Bloomington, IN [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,392
Initial costs, buildings	28,212
Additions subsequent to acquisition, Improvements	5,000
Additions subsequent to acquisition, carrying costs	408
Land at cost	2,392
Buildings at cost	33,620
Total at cost	36,012
Accumulated Depreciation	11,742
Encumbrances	$ 0
Date of Construction	2006
Date Acquired	Aug. 8, 2006
Life on which depreciation in latest income statements is computed (Years)	40 years
2006 [Member] | Petersburg, VA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,302
Initial costs, buildings	9,121
Land at cost	1,302
Buildings at cost	9,121
Total at cost	10,423
Accumulated Depreciation	2,850
Encumbrances	$ 0
Date of Construction	2006
Date Acquired	Jul. 1, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1886 [Member] | Grefath, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,220
Initial costs, buildings	3,351
Additions subsequent to acquisition, Improvements	108
Land at cost	1,328
Buildings at cost	3,351
Total at cost	4,679
Accumulated Depreciation	212
Encumbrances	$ 0
Date of Construction	1886
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
1951 [Member] | Remscheid, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,097
Initial costs, buildings	2,797
Additions subsequent to acquisition, Improvements	64
Land at cost	1,161
Buildings at cost	2,797
Total at cost	3,958
Accumulated Depreciation	173
Encumbrances	$ 0
Date of Construction	1951
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,345
Initial costs, buildings	3,678
Land at cost	1,345
Buildings at cost	3,678
Total at cost	5,023
Accumulated Depreciation	598
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jun. 20, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | 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	666
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] | Cedar Hill. TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,122
Initial costs, buildings	3,644
Land at cost	1,122
Buildings at cost	3,644
Total at cost	4,766
Accumulated Depreciation	592
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jun. 23, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Spring, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,310
Initial costs, buildings	3,639
Land at cost	1,310
Buildings at cost	3,639
Total at cost	4,949
Accumulated Depreciation	591
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jul. 15, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Commerce City, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 707
Initial costs, buildings	4,248
Land at cost	707
Buildings at cost	4,248
Total at cost	4,955
Accumulated Depreciation	646
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] | 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	633
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jul. 3, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | 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	666
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jan. 1, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Firestone, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 495
Initial costs, buildings	3,963
Land at cost	495
Buildings at cost	3,963
Total at cost	4,458
Accumulated Depreciation	652
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jun. 6, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Fountain, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,508
Initial costs, buildings	4,131
Land at cost	1,508
Buildings at cost	4,131
Total at cost	5,639
Accumulated Depreciation	663
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] | Frisco, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,500
Initial costs, buildings	2,431
Additions subsequent to acquisition, Improvements	27
Additions subsequent to acquisition, carrying costs	(89)
Land at cost	1,411
Buildings at cost	2,458
Total at cost	3,869
Accumulated Depreciation	631
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jun. 13, 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	697
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jun. 5, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Altoona, WI [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, buildings	$ 29,062
Buildings at cost	29,062
Total at cost	29,062
Accumulated Depreciation	4,601
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Aug. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Ogden, UT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,759
Initial costs, buildings	16,414
Land at cost	1,759
Buildings at cost	16,414
Total at cost	18,173
Accumulated Depreciation	2,792
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Mar. 1, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | 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	566
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Sep. 8, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Sienna, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,000
Initial costs, buildings	2,027
Land at cost	1,000
Buildings at cost	2,027
Total at cost	3,027
Accumulated Depreciation	554
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Aug. 20, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Thornton, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,350
Initial costs, buildings	4,259
Land at cost	1,350
Buildings at cost	4,259
Total at cost	5,609
Accumulated Depreciation	674
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Aug. 29, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Aurora, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,939
Initial costs, buildings	4,812
Land at cost	2,939
Buildings at cost	4,812
Total at cost	7,751
Accumulated Depreciation	632
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Sep. 17, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Ft. Worth, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,741
Initial costs, buildings	4,392
Land at cost	2,741
Buildings at cost	4,392
Total at cost	7,133
Accumulated Depreciation	631
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Mar. 27, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Chandler, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 3,674
Initial costs, buildings	4,783
Land at cost	3,674
Buildings at cost	4,783
Total at cost	8,457
Accumulated Depreciation	678
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Apr. 24, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Carrollton, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 729
Initial costs, buildings	34,342
Additions subsequent to acquisition, Improvements	374
Land at cost	729
Buildings at cost	34,716
Total at cost	35,445
Accumulated Depreciation	4,689
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Jul. 17, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Katy, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,211
Initial costs, buildings	3,873
Land at cost	2,211
Buildings at cost	3,873
Total at cost	6,084
Accumulated Depreciation	500
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Oct. 21, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Conroe, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,338
Initial costs, buildings	1,699
Land at cost	1,338
Buildings at cost	1,699
Total at cost	3,037
Accumulated Depreciation	482
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Jul. 29, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Converse, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 750
Initial costs, buildings	4,423
Land at cost	750
Buildings at cost	4,423
Total at cost	5,173
Accumulated Depreciation	636
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	$ 1,295
Initial costs, buildings	4,276
Land at cost	1,295
Buildings at cost	4,276
Total at cost	5,571
Accumulated Depreciation	597
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Jun. 8, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Dorchester, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 14,428
Initial costs, buildings	219,575
Additions subsequent to acquisition, Improvements	6,638
Land at cost	14,428
Buildings at cost	226,213
Total at cost	240,641
Accumulated Depreciation	12,424
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Oct. 15, 2018
Life on which depreciation in latest income statements is computed (Years)	42 years
2015 [Member] | Glendale, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,229
Initial costs, buildings	4,046
Land at cost	1,229
Buildings at cost	4,046
Total at cost	5,275
Accumulated Depreciation	565
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Jun. 5, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Highland Village, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 3,314
Initial costs, buildings	1,551
Land at cost	3,314
Buildings at cost	1,551
Total at cost	4,865
Accumulated Depreciation	377
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	1,254
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	May 1, 2015
Life on which depreciation in latest income statements is computed (Years)	34 years
2015 [Member] | 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	631
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] | Lehi, UT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 13,403
Initial costs, buildings	29,950
Additions subsequent to acquisition, Improvements	601
Additions subsequent to acquisition, carrying costs	(35)
Land at cost	13,368
Buildings at cost	30,551
Total at cost	43,919
Accumulated Depreciation	2,899
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	45 years
2015 [Member] | McKinney, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,722
Initial costs, buildings	4,060
Land at cost	2,722
Buildings at cost	4,060
Total at cost	6,782
Accumulated Depreciation	739
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Jul. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	30 years
2015 [Member] | Parker, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,300
Initial costs, buildings	4,448
Land at cost	1,300
Buildings at cost	4,448
Total at cost	5,748
Accumulated Depreciation	574
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Nov. 6, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Taunton, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,428
Initial costs, buildings	73,228
Additions subsequent to acquisition, Improvements	11,290
Land at cost	4,428
Buildings at cost	84,518
Total at cost	88,946
Accumulated Depreciation	8,573
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
2015 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,423
Initial costs, buildings	1,890
Land at cost	1,423
Buildings at cost	1,890
Total at cost	3,313
Accumulated Depreciation	532
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Feb. 18, 2015
Life on which depreciation in latest income statements is computed (Years)	40 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	$ 1,336
Initial costs, buildings	3,901
Land at cost	1,336
Buildings at cost	3,901
Total at cost	5,237
Accumulated Depreciation	536
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Jun. 19, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1970 [Member] | Ayer, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 9,048
Initial costs, buildings	77,913
Additions subsequent to acquisition, Improvements	2,300
Land at cost	9,048
Buildings at cost	80,213
Total at cost	89,261
Accumulated Depreciation	4,637
Encumbrances	$ 0
Date of Construction	1970
Date Acquired	Jun. 27, 2018
Life on which depreciation in latest income statements is computed (Years)	47 years
1970 [Member] | Rockledge, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 13,919
Initial costs, buildings	23,282
Additions subsequent to acquisition, Improvements	5,512
Land at cost	13,919
Buildings at cost	28,794
Total at cost	42,713
Accumulated Depreciation	3,413
Encumbrances	$ 0
Date of Construction	1970
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	42 years
2013 [Member] | Ayer, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 9,048
Initial costs, buildings	77,913
Additions subsequent to acquisition, Improvements	2,300
Land at cost	9,048
Buildings at cost	80,213
Total at cost	89,261
Accumulated Depreciation	4,637
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Jun. 27, 2018
Life on which depreciation in latest income statements is computed (Years)	47 years
2013 [Member] | Hausman, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,500
Initial costs, buildings	8,957
Land at cost	1,500
Buildings at cost	8,957
Total at cost	10,457
Accumulated Depreciation	1,734
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Mar. 1, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2013 [Member] | Lafayette, IN [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 800
Initial costs, buildings	14,968
Additions subsequent to acquisition, Improvements	(25)
Land at cost	800
Buildings at cost	14,943
Total at cost	15,743
Accumulated Depreciation	2,946
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Feb. 1, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2013 [Member] | Little Elm, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,241
Initial costs, buildings	3,491
Land at cost	1,241
Buildings at cost	3,491
Total at cost	4,732
Accumulated Depreciation	615
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Dec. 1, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2013 [Member] | Post Falls, ID [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 417
Initial costs, buildings	12,175
Additions subsequent to acquisition, Improvements	1,905
Land at cost	767
Buildings at cost	13,730
Total at cost	14,497
Accumulated Depreciation	2,412
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Dec. 31, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2013 [Member] | Spartanburg, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,135
Initial costs, buildings	15,717
Land at cost	1,135
Buildings at cost	15,717
Total at cost	16,852
Accumulated Depreciation	2,899
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Aug. 1, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1984 [Member] | Bennettsville, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 794
Initial costs, buildings	15,773
Land at cost	794
Buildings at cost	15,773
Total at cost	16,567
Accumulated Depreciation	5,379
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Apr. 1, 2008
Life on which depreciation in latest income statements is computed (Years)	42 years
1984 [Member] | Basingstoke, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 13,670
Initial costs, buildings	53,891
Additions subsequent to acquisition, Improvements	205
Land at cost	13,875
Buildings at cost	53,891
Total at cost	67,766
Accumulated Depreciation	1,361
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1984 [Member] | Droitwich, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, buildings	$ 16,427
Additions subsequent to acquisition, Improvements	82
Land at cost	82
Buildings at cost	16,427
Total at cost	16,509
Accumulated Depreciation	416
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1984 [Member] | Hope, AR [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,651
Initial costs, buildings	3,359
Additions subsequent to acquisition, Improvements	2,274
Land at cost	1,651
Buildings at cost	5,633
Total at cost	7,284
Accumulated Depreciation	655
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1984 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 9,842
Initial costs, buildings	65,503
Additions subsequent to acquisition, Improvements	82
Land at cost	9,924
Buildings at cost	65,503
Total at cost	75,427
Accumulated Depreciation	1,643
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1984 [Member] | Olympia, WA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,220
Initial costs, buildings	89,348
Additions subsequent to acquisition, Improvements	15,930
Land at cost	7,220
Buildings at cost	105,278
Total at cost	112,498
Accumulated Depreciation	11,733
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Jul. 22, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1984 [Member] | Swindon, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,577
Initial costs, buildings	64,181
Additions subsequent to acquisition, Improvements	144
Land at cost	5,721
Buildings at cost	64,181
Total at cost	69,902
Accumulated Depreciation	1,614
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1984 [Member] | Wantirna, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 27,854
Initial costs, buildings	229,129
Additions subsequent to acquisition, Improvements	1,050
Land at cost	28,904
Buildings at cost	229,129
Total at cost	258,033
Accumulated Depreciation	9,208
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Blue Springs, MO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,347
Initial costs, buildings	23,494
Land at cost	4,347
Buildings at cost	23,494
Total at cost	27,841
Accumulated Depreciation	3,651
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Feb. 13, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Hill County, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,120
Initial costs, buildings	17,882
Land at cost	1,120
Buildings at cost	17,882
Total at cost	19,002
Accumulated Depreciation	12,288
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] | Harrow, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 41,010
Initial costs, buildings	43,396
Additions subsequent to acquisition, Improvements	226
Land at cost	41,236
Buildings at cost	43,396
Total at cost	84,632
Accumulated Depreciation	1,100
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | 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	6,435
Land at cost	6,179
Buildings at cost	15,501
Total at cost	21,680
Accumulated Depreciation	2,356
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1980 [Member] | Poplar Bluff, MO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,659
Initial costs, buildings	38,693
Additions subsequent to acquisition, carrying costs	1
Land at cost	2,659
Buildings at cost	38,694
Total at cost	41,353
Accumulated Depreciation	12,278
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] | West Valley City, UT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,374
Initial costs, buildings	58,314
Additions subsequent to acquisition, Improvements	7,150
Additions subsequent to acquisition, carrying costs	(114)
Land at cost	5,260
Buildings at cost	65,464
Total at cost	70,724
Accumulated Depreciation	19,035
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Apr. 22, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1985 [Member] | Aberdeen United Kingdom
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,429
Initial costs, buildings	108,150
Additions subsequent to acquisition, Improvements	137
Land at cost	4,566
Buildings at cost	108,150
Total at cost	112,716
Accumulated Depreciation	2,712
Encumbrances	$ 0
Date of Construction	1985
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1985 [Member] | Fairmont, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,000
Initial costs, buildings	6,072
Additions subsequent to acquisition, Improvements	5,278
Land at cost	1,277
Buildings at cost	11,073
Total at cost	12,350
Accumulated Depreciation	2,331
Encumbrances	$ 0
Date of Construction	1985
Date Acquired	Sep. 19, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1985 [Member] | Hot Springs, AR [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,844
Initial costs, buildings	59,432
Additions subsequent to acquisition, Improvements	21,221
Land at cost	5,844
Buildings at cost	80,653
Total at cost	86,497
Accumulated Depreciation	11,013
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] | Fort Lauderdale, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,499
Initial costs, buildings	21,939
Additions subsequent to acquisition, carrying costs	1
Land at cost	3,499
Buildings at cost	21,940
Total at cost	25,439
Accumulated Depreciation	6,962
Encumbrances	$ 0
Date of Construction	1985
Date Acquired	Apr. 22, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1985 [Member] | 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	1,692
Encumbrances	$ 0
Date of Construction	1985
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1985 [Member] | St. Albans Park, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,298
Initial costs, buildings	23,474
Additions subsequent to acquisition, Improvements	4,921
Land at cost	2,893
Buildings at cost	27,800
Total at cost	30,693
Accumulated Depreciation	1,008
Encumbrances	$ 0
Date of Construction	1985
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1985 [Member] | Strathpine, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,781
Initial costs, buildings	38,949
Additions subsequent to acquisition, Improvements	330
Land at cost	3,111
Buildings at cost	38,949
Total at cost	42,060
Accumulated Depreciation	1,585
Encumbrances	$ 0
Date of Construction	1985
Date Acquired	Jun. 7, 2019
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] | Fairmont, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,000
Initial costs, buildings	6,072
Additions subsequent to acquisition, Improvements	5,278
Land at cost	1,277
Buildings at cost	11,073
Total at cost	12,350
Accumulated Depreciation	2,331
Encumbrances	$ 0
Date of Construction	1972
Date Acquired	Sep. 19, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1972 [Member] | Glen Waverly, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 32,590
Initial costs, buildings	25,179
Additions subsequent to acquisition, Improvements	885
Land at cost	33,475
Buildings at cost	25,179
Total at cost	58,654
Accumulated Depreciation	1,421
Encumbrances	$ 0
Date of Construction	1972
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	32 years
1972 [Member] | San Dimas, CA [member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,161
Initial costs, buildings	6,839
Additions subsequent to acquisition, carrying costs	34
Land at cost	6,161
Buildings at cost	6,873
Total at cost	13,034
Accumulated Depreciation	2,080
Encumbrances	$ 0
Date of Construction	1972
Date Acquired	Nov. 25, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1957 [Member] | Blackburn, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,734
Initial costs, buildings	54,763
Additions subsequent to acquisition, Improvements	123
Land at cost	2,857
Buildings at cost	54,763
Total at cost	57,620
Accumulated Depreciation	1,377
Encumbrances	$ 0
Date of Construction	1957
Date Acquired	Jan. 9, 2020
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	79
Encumbrances	$ 0
Date of Construction	1952
Date Acquired	Sep. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2007 [Member] | Campbelltown, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,117
Initial costs, buildings	58,005
Additions subsequent to acquisition, Improvements	54
Land at cost	1,171
Buildings at cost	58,005
Total at cost	59,176
Accumulated Depreciation	2,302
Encumbrances	$ 0
Date of Construction	2007
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2007 [Member] | Mesa, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,534
Initial costs, buildings	100,042
Additions subsequent to acquisition, Improvements	1,885
Land at cost	6,534
Buildings at cost	101,927
Total at cost	108,461
Accumulated Depreciation	19,203
Encumbrances	$ 0
Date of Construction	2007
Date Acquired	Sep. 26, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2007 [Member] | Northland, MO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 834
Initial costs, buildings	17,182
Land at cost	834
Buildings at cost	17,182
Total at cost	18,016
Accumulated Depreciation	4,260
Encumbrances	$ 0
Date of Construction	2007
Date Acquired	Feb. 14, 2011
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 One [Member] | Chandler, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 750
Initial costs, buildings	3,853
Land at cost	750
Buildings at cost	3,853
Total at cost	4,603
Accumulated Depreciation	506
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Oct. 7, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 One [Member] | Hoover, AL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Medical Office Building
Initial costs, buildings	$ 1,034
Additions subsequent to acquisition, Improvements	296
Buildings at cost	1,330
Total at cost	1,330
Accumulated Depreciation	188
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	May 1, 2015
Life on which depreciation in latest income statements is computed (Years)	34 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	79
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	79
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] | 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	9,713
Encumbrances	$ 0
Date of Construction	1978
Date Acquired	Feb. 13, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1978 [Member] | San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 8,053
Initial costs, buildings	29,333
Additions subsequent to acquisition, Improvements	1,945
Land at cost	8,053
Buildings at cost	31,278
Total at cost	39,331
Accumulated Depreciation	2,735
Encumbrances	$ 0
Date of Construction	1978
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1917 [Member] | Brighton, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 18,540
Initial costs, buildings	146,491
Additions subsequent to acquisition, Improvements	39,279
Land at cost	18,540
Buildings at cost	185,770
Total at cost	204,310
Accumulated Depreciation	16,411
Encumbrances	$ 0
Date of Construction	1917
Date Acquired	Oct. 3, 2016
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	8,438
Encumbrances	$ 0
Date of Construction	2004
Date Acquired	Dec. 21, 2010
Life on which depreciation in latest income statements is computed (Years)	40 years
2004 [Member] | Camden, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, buildings	$ 22,739
Buildings at cost	22,739
Total at cost	22,739
Accumulated Depreciation	2,721
Encumbrances	$ 0
Date of Construction	2004
Date Acquired	Oct. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	39 years
2004 [Member] | Odessa, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,535
Initial costs, buildings	123,518
Additions subsequent to acquisition, Improvements	4,571
Land at cost	6,535
Buildings at cost	128,089
Total at cost	134,624
Accumulated Depreciation	10,331
Encumbrances	$ 0
Date of Construction	2004
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1965 [Member] | Brockton, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 18,328
Initial costs, buildings	67,248
Additions subsequent to acquisition, Improvements	4,937
Land at cost	18,328
Buildings at cost	72,185
Total at cost	90,513
Accumulated Depreciation	9,289
Encumbrances	$ 0
Date of Construction	1965
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
1965 [Member] | Perth, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 112,312
Initial costs, buildings	39,888
Additions subsequent to acquisition, Improvements	1,772
Land at cost	112,546
Buildings at cost	41,426
Total at cost	153,972
Accumulated Depreciation	2,160
Encumbrances	$ 0
Date of Construction	1965
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
1965 [Member] | Rochdale, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,691
Initial costs, buildings	43,759
Additions subsequent to acquisition, Improvements	150
Land at cost	3,841
Buildings at cost	43,759
Total at cost	47,600
Accumulated Depreciation	1,104
Encumbrances	$ 0
Date of Construction	1965
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1979 [Member] | Bundoora, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,049
Initial costs, buildings	67,900
Additions subsequent to acquisition, Improvements	302
Land at cost	7,351
Buildings at cost	67,900
Total at cost	75,251
Accumulated Depreciation	2,959
Encumbrances	$ 0
Date of Construction	1979
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	37 years
1979 [Member] | Phoenix, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,396
Initial costs, buildings	26,521
Additions subsequent to acquisition, Improvements	12,253
Land at cost	2,396
Buildings at cost	38,774
Total at cost	41,170
Accumulated Depreciation	2,521
Encumbrances	$ 0
Date of Construction	1979
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	42 years
1979 [Member] | San Dimas, CA [member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Medical Office Building
Initial costs, land	$ 1,915
Initial costs, buildings	5,085
Additions subsequent to acquisition, carrying costs	18
Land at cost	1,915
Buildings at cost	5,103
Total at cost	7,018
Accumulated Depreciation	1,545
Encumbrances	$ 0
Date of Construction	1979
Date Acquired	Nov. 25, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1979 [Member] | Sunnybank, Australia [member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,377
Initial costs, buildings	48,465
Additions subsequent to acquisition, Improvements	379
Land at cost	6,756
Buildings at cost	48,465
Total at cost	55,221
Accumulated Depreciation	2,318
Encumbrances	$ 0
Date of Construction	1979
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	34 years
2012 [Member] | Casper, WY [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,836
Land at cost	1,836
Total at cost	1,836
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Feb. 29, 2012
2012 [Member] | Fall River, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,526
Initial costs, buildings	82,358
Additions subsequent to acquisition, Improvements	24,463
Land at cost	3,526
Buildings at cost	106,821
Total at cost	110,347
Accumulated Depreciation	10,619
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
2012 [Member] | Florence, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 900
Initial costs, buildings	28,462
Additions subsequent to acquisition, Improvements	105
Land at cost	900
Buildings at cost	28,567
Total at cost	29,467
Accumulated Depreciation	6,246
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Feb. 7, 2012
Life on which depreciation in latest income statements is computed (Years)	40 years
2012 [Member] | Mount Pleasant, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 597
Initial costs, buildings	2,198
Land at cost	597
Buildings at cost	2,198
Total at cost	2,795
Accumulated Depreciation	85
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2012 [Member] | Overlook, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,452
Initial costs, buildings	9,666
Additions subsequent to acquisition, Improvements	7
Land at cost	2,452
Buildings at cost	9,673
Total at cost	12,125
Accumulated Depreciation	1,897
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Feb. 1, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2012 [Member] | Reading, United Kingdom [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 27,272
Initial costs, buildings	88,860
Additions subsequent to acquisition, Improvements	641
Land at cost	27,913
Buildings at cost	88,860
Total at cost	116,773
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Dec. 18, 2020
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	1,199
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Oct. 2, 2012
Life on which depreciation in latest income statements is computed (Years)	40 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	$ 875
Initial costs, buildings	27,462
Additions subsequent to acquisition, Improvements	102
Land at cost	977
Buildings at cost	27,462
Total at cost	28,439
Accumulated Depreciation	693
Encumbrances	$ 0
Date of Construction	1990
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1990 [Member] | Gloucester, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,919
Initial costs, buildings	65,900
Additions subsequent to acquisition, Improvements	1,073
Land at cost	5,992
Buildings at cost	65,900
Total at cost	71,892
Accumulated Depreciation	2,327
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] | Reading, United Kingdom [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 36,861
Initial costs, buildings	49,579
Additions subsequent to acquisition, Improvements	501
Land at cost	37,362
Buildings at cost	49,579
Total at cost	86,941
Accumulated Depreciation	1,727
Encumbrances	$ 0
Date of Construction	1990
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1956 [Member] | Detroit, MI [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,220
Initial costs, buildings	8,687
Additions subsequent to acquisition, carrying costs	(364)
Land at cost	1,220
Buildings at cost	8,323
Total at cost	9,543
Accumulated Depreciation	2,686
Encumbrances	$ 0
Date of Construction	1956
Date Acquired	May 22, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1953 [Member] | Dorchester, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 14,428
Initial costs, buildings	219,575
Additions subsequent to acquisition, Improvements	6,638
Land at cost	14,428
Buildings at cost	226,213
Total at cost	240,641
Accumulated Depreciation	12,424
Encumbrances	$ 0
Date of Construction	1953
Date Acquired	Oct. 15, 2018
Life on which depreciation in latest income statements is computed (Years)	42 years
1953 [Member] | Denville, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 15,709
Initial costs, buildings	55,772
Land at cost	15,709
Buildings at cost	55,772
Total at cost	71,481
Accumulated Depreciation	254
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 [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,531
Initial costs, buildings	14,252
Land at cost	2,531
Buildings at cost	14,252
Total at cost	16,783
Accumulated Depreciation	2,434
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] | Dodge City, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,124
Initial costs, buildings	52,705
Land at cost	1,124
Buildings at cost	52,705
Total at cost	53,829
Accumulated Depreciation	1,422
Encumbrances	$ 0
Date of Construction	1976
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1976 [Member] | Phoenix, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,695
Initial costs, buildings	73,773
Additions subsequent to acquisition, Improvements	4,978
Land at cost	12,695
Buildings at cost	78,751
Total at cost	91,446
Accumulated Depreciation	6,703
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] | 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	3,034
Land at cost	14,360
Buildings at cost	373,188
Total at cost	387,548
Accumulated Depreciation	4,914
Encumbrances	$ 0
Date of Construction	1976
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	40 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	25,530
Land at cost	2,460
Buildings at cost	25,530
Total at cost	27,990
Encumbrances	$ 0
Date of Construction	2019
Date Acquired	Dec. 17, 2020
Life on which depreciation in latest income statements is computed (Years)	39 years
2019 [Member] | Overland Park, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,191
Initial costs, buildings	14,263
Land at cost	3,191
Buildings at cost	14,263
Total at cost	17,454
Accumulated Depreciation	518
Encumbrances	$ 0
Date of Construction	2019
Date Acquired	Jun. 10, 2019
Life on which depreciation in latest income statements is computed (Years)	50 years
1994 [Member] | Dahlen, 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	12,526
Additions subsequent to acquisition, Improvements	466
Land at cost	1,483
Buildings at cost	12,526
Total at cost	14,009
Accumulated Depreciation	143
Encumbrances	$ 0
Date of Construction	1994
Date Acquired	Jul. 8, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1994 [Member] | Worthing, UK [member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,108
Initial costs, buildings	32,370
Additions subsequent to acquisition, Improvements	103
Land at cost	7,211
Buildings at cost	32,370
Total at cost	39,581
Accumulated Depreciation	816
Encumbrances	$ 0
Date of Construction	1994
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
2001 [Member] | Darlington, United Kingdom [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,873
Initial costs, buildings	38,465
Additions subsequent to acquisition, Improvements	369
Land at cost	2,242
Buildings at cost	38,465
Total at cost	40,707
Accumulated Depreciation	411
Encumbrances	$ 0
Date of Construction	2001
Date Acquired	Aug. 7, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
2001 [Member] | Hope, AR [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,651
Initial costs, buildings	3,359
Additions subsequent to acquisition, Improvements	2,274
Land at cost	1,651
Buildings at cost	5,633
Total at cost	7,284
Accumulated Depreciation	655
Encumbrances	$ 0
Date of Construction	2001
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
2001 [Member] | Norwood, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,073
Initial costs, buildings	154,496
Additions subsequent to acquisition, Improvements	35,897
Land at cost	7,073
Buildings at cost	190,393
Total at cost	197,466
Accumulated Depreciation	9,055
Encumbrances	$ 0
Date of Construction	2001
Date Acquired	Jun. 27, 2018
Life on which depreciation in latest income statements is computed (Years)	46 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	254
Encumbrances	$ 0
Date of Construction	1969
Date Acquired	Sep. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 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	42
Encumbrances	$ 0
Date of Construction	1925
Date Acquired	Sep. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1927 [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	42
Encumbrances	$ 0
Date of Construction	1927
Date Acquired	Sep. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1986 | Halsall, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,539
Initial costs, buildings	33,458
Additions subsequent to acquisition, Improvements	624
Land at cost	2,163
Buildings at cost	33,458
Total at cost	35,621
Accumulated Depreciation	1,185
Encumbrances	$ 0
Date of Construction	1986
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1986 | Rowley, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,515
Initial costs, buildings	19,652
Additions subsequent to acquisition, Improvements	608
Land at cost	3,123
Buildings at cost	19,652
Total at cost	22,775
Accumulated Depreciation	717
Encumbrances	$ 0
Date of Construction	1986
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1922 [Member] | Warren, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,417
Initial costs, buildings	15,857
Additions subsequent to acquisition, Improvements	1,384
Land at cost	2,417
Buildings at cost	17,241
Total at cost	19,658
Accumulated Depreciation	2,006
Encumbrances	$ 0
Date of Construction	1922
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	46 years
1922 [Member] | Lewiston, ID [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,389
Initial costs, buildings	75,435
Land at cost	5,389
Buildings at cost	75,435
Total at cost	80,824
Accumulated Depreciation	9,353
Encumbrances	$ 0
Date of Construction	1922
Date Acquired	May 1, 2017
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	6,698
Encumbrances	$ 0
Date of Construction	1999
Date Acquired	Aug. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	34 years
2000 [Member] | Warren, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,417
Initial costs, buildings	15,857
Additions subsequent to acquisition, Improvements	1,384
Land at cost	2,417
Buildings at cost	17,241
Total at cost	19,658
Accumulated Depreciation	2,006
Encumbrances	$ 0
Date of Construction	2000
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	46 years
2000 [Member] | 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	17,270
Encumbrances	$ 0
Date of Construction	2000
Date Acquired	Apr. 1, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2000 [Member] | Kingswood, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 25,723
Initial costs, buildings	85,264
Additions subsequent to acquisition, Improvements	496
Land at cost	26,219
Buildings at cost	85,264
Total at cost	111,483
Accumulated Depreciation	3,435
Encumbrances	$ 0
Date of Construction	2000
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2000 [Member] | Lynwood, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 30,116
Initial costs, buildings	148,527
Land at cost	30,116
Buildings at cost	148,527
Total at cost	178,643
Accumulated Depreciation	1,555
Encumbrances	$ 0
Date of Construction	2000
Date Acquired	Aug. 13, 2020
Life on which depreciation in latest income statements is computed (Years)	40 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	363
Encumbrances	$ 0
Date of Construction	1924
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
1924 [Member] | Johnstown, PA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 8,877
Initial costs, buildings	247,042
Additions subsequent to acquisition, carrying costs	116
Land at cost	8,877
Buildings at cost	247,158
Total at cost	256,035
Accumulated Depreciation	8,359
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	405
Encumbrances	$ 0
Date of Construction	1924
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
1939 [Member] | Fairmont, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,000
Initial costs, buildings	6,072
Additions subsequent to acquisition, Improvements	5,278
Land at cost	1,277
Buildings at cost	11,073
Total at cost	12,350
Accumulated Depreciation	2,331
Encumbrances	$ 0
Date of Construction	1939
Date Acquired	Sep. 19, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1950 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 28,687
Initial costs, buildings	104,028
Additions subsequent to acquisition, Improvements	17,462
Land at cost	28,687
Buildings at cost	121,490
Total at cost	150,177
Accumulated Depreciation	6,714
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1950 [Member] | Fall River, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,526
Initial costs, buildings	82,358
Additions subsequent to acquisition, Improvements	24,463
Land at cost	3,526
Buildings at cost	106,821
Total at cost	110,347
Accumulated Depreciation	10,619
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
1950 [Member] | Methuen, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 23,809
Initial costs, buildings	89,505
Additions subsequent to acquisition, Improvements	9,184
Land at cost	23,809
Buildings at cost	98,689
Total at cost	122,498
Accumulated Depreciation	11,290
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
1950 [Member] | Rockledge, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 13,919
Initial costs, buildings	23,282
Additions subsequent to acquisition, Improvements	5,512
Land at cost	13,919
Buildings at cost	28,794
Total at cost	42,713
Accumulated Depreciation	3,413
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	42 years
1950 [Member] | Sharon, PA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,179
Initial costs, buildings	9,066
Additions subsequent to acquisition, Improvements	6,435
Land at cost	6,179
Buildings at cost	15,501
Total at cost	21,680
Accumulated Depreciation	2,356
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1950 [Member] | Ottumwa, IA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,377
Initial costs, buildings	48,697
Land at cost	2,377
Buildings at cost	48,697
Total at cost	51,074
Accumulated Depreciation	1,811
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
Two Thousand Five | Haverhill, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,651
Initial costs, buildings	105,848
Additions subsequent to acquisition, Improvements	3,384
Land at cost	5,651
Buildings at cost	109,232
Total at cost	114,883
Accumulated Depreciation	6,674
Encumbrances	$ 0
Date of Construction	2005
Date Acquired	Aug. 31, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
Two Thousand Five | Gilbert, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 150
Initial costs, buildings	10,449
Land at cost	150
Buildings at cost	10,449
Total at cost	10,599
Accumulated Depreciation	3,838
Encumbrances	$ 0
Date of Construction	2005
Date Acquired	Jan. 4, 2011
Life on which depreciation in latest income statements is computed (Years)	40 years
Two Thousand Five | Port Arthur, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,972
Initial costs, buildings	78,051
Additions subsequent to acquisition, Improvements	3,384
Land at cost	12,972
Buildings at cost	81,435
Total at cost	94,407
Accumulated Depreciation	14,383
Encumbrances	$ 0
Date of Construction	2005
Date Acquired	Sep. 26, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Two Thousand Five | Tomball, TX [member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,299
Initial costs, buildings	23,982
Land at cost	1,299
Buildings at cost	23,982
Total at cost	25,281
Accumulated Depreciation	5,996
Encumbrances	$ 0
Date of Construction	2005
Date Acquired	Dec. 21, 2010
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, land	$ 28,687
Initial costs, buildings	104,028
Additions subsequent to acquisition, Improvements	17,462
Land at cost	28,687
Buildings at cost	121,490
Total at cost	150,177
Accumulated Depreciation	6,714
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] | 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	1,555
Encumbrances	$ 0
Date of Construction	1940
Date Acquired	Aug. 13, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1940 [Member] | Taunton, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,428
Initial costs, buildings	73,228
Additions subsequent to acquisition, Improvements	11,290
Land at cost	4,428
Buildings at cost	84,518
Total at cost	88,946
Accumulated Depreciation	8,573
Encumbrances	$ 0
Date of Construction	1940
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
1940 [Member] | Tempe, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,050
Initial costs, buildings	10,986
Additions subsequent to acquisition, Improvements	6,773
Land at cost	6,050
Buildings at cost	17,759
Total at cost	23,809
Accumulated Depreciation	1,457
Encumbrances	$ 0
Date of Construction	1940
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1982 One [Member] | Garden Grove, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Medical Office Building
Initial costs, land	$ 862
Initial costs, buildings	7,888
Additions subsequent to acquisition, carrying costs	28
Land at cost	862
Buildings at cost	7,916
Total at cost	8,778
Accumulated Depreciation	2,396
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Nov. 25, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
2020 [Member] | 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	19,874
Land at cost	6,063
Buildings at cost	19,874
Total at cost	25,937
Encumbrances	$ 0
Date of Construction	2020
Date Acquired	Oct. 25, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2020 [Member] | Idaho Falls, ID [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 380
Initial costs, buildings	108,903
Land at cost	380
Buildings at cost	108,903
Total at cost	109,283
Accumulated Depreciation	2,486
Encumbrances	$ 0
Date of Construction	2020
Date Acquired	Dec. 19, 2017
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	11,236
Additions subsequent to acquisition, carrying costs	4,665
Land at cost	1,822
Buildings at cost	53,368
Total at cost	55,190
Accumulated Depreciation	13,527
Encumbrances	$ 0
Date of Construction	2002
Date Acquired	Apr. 1, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
2002 [Member] | Melbourne, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,642
Initial costs, buildings	17,087
Additions subsequent to acquisition, Improvements	13,443
Land at cost	5,642
Buildings at cost	30,530
Total at cost	36,172
Accumulated Depreciation	2,132
Encumbrances	$ 0
Date of Construction	2002
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	42 years
2002 [Member] | San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 8,053
Initial costs, buildings	29,333
Additions subsequent to acquisition, Improvements	1,945
Land at cost	8,053
Buildings at cost	31,278
Total at cost	39,331
Accumulated Depreciation	2,735
Encumbrances	$ 0
Date of Construction	2002
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 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	17,270
Encumbrances	$ 0
Date of Construction	1920
Date Acquired	Apr. 1, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1920 [Member] | 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	106
Encumbrances	$ 0
Date of Construction	1920
Date Acquired	May 2, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1920 [Member] | 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	1,052
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] | Sussex, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
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	10
Encumbrances	$ 0
Date of Construction	1920
Date Acquired	Sep. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1954 [Member] | Camden, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, buildings	$ 22,739
Buildings at cost	22,739
Total at cost	22,739
Accumulated Depreciation	2,721
Encumbrances	$ 0
Date of Construction	1954
Date Acquired	Oct. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	39 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	$ 14,605
Initial costs, buildings	45,773
Additions subsequent to acquisition, Improvements	101
Land at cost	14,706
Buildings at cost	45,773
Total at cost	60,479
Accumulated Depreciation	2,432
Encumbrances	$ 0
Date of Construction	1975
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	30 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	$ 3,500
Initial costs, buildings	4,454
Additions subsequent to acquisition, Improvements	27
Land at cost	3,527
Buildings at cost	4,454
Total at cost	7,981
Accumulated Depreciation	113
Encumbrances	$ 0
Date of Construction	1987
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1987 [Member] | Salt Lake City, UT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 13,590
Initial costs, buildings	101,915
Additions subsequent to acquisition, Improvements	15,109
Land at cost	13,590
Buildings at cost	117,024
Total at cost	130,614
Accumulated Depreciation	8,751
Encumbrances	$ 0
Date of Construction	1987
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1987 [Member] | Orpington, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 10,936
Initial costs, buildings	45,864
Additions subsequent to acquisition, Improvements	164
Land at cost	11,100
Buildings at cost	45,864
Total at cost	56,964
Accumulated Depreciation	1,157
Encumbrances	$ 0
Date of Construction	1987
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 One [Member] | Phoenix, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,576
Initial costs, buildings	45,782
Land at cost	5,576
Buildings at cost	45,782
Total at cost	51,358
Accumulated Depreciation	4,483
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Feb. 10, 2017
Life on which depreciation in latest income statements is computed (Years)	40 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	11,641
Encumbrances	$ 0
Date of Construction	1996
Date Acquired	Aug. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	41 years
1996 [Member] | Poole, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,942
Initial costs, buildings	41,213
Additions subsequent to acquisition, Improvements	555
Land at cost	2,497
Buildings at cost	41,213
Total at cost	43,710
Accumulated Depreciation	1,868
Encumbrances	$ 0
Date of Construction	1996
Date Acquired	Apr. 3, 2019
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	106
Encumbrances	$ 0
Date of Construction	1919
Date Acquired	May 2, 2016
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	106
Encumbrances	$ 0
Date of Construction	2003
Date Acquired	May 2, 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	$ 4,335
Initial costs, buildings	3,565
Additions subsequent to acquisition, Improvements	824
Land at cost	4,335
Buildings at cost	4,389
Total at cost	8,724
Accumulated Depreciation	2,160
Encumbrances	$ 0
Date of Construction	2003
Date Acquired	May 1, 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	$ 7,073
Initial costs, buildings	154,496
Additions subsequent to acquisition, Improvements	35,897
Land at cost	7,073
Buildings at cost	190,393
Total at cost	197,466
Accumulated Depreciation	9,055
Encumbrances	$ 0
Date of Construction	1926
Date Acquired	Jun. 27, 2018
Life on which depreciation in latest income statements is computed (Years)	46 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	$ 12,695
Initial costs, buildings	73,773
Additions subsequent to acquisition, Improvements	4,978
Land at cost	12,695
Buildings at cost	78,751
Total at cost	91,446
Accumulated Depreciation	6,703
Encumbrances	$ 0
Date of Construction	1968
Date Acquired	Sep. 29, 2017
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	2,496
Encumbrances	$ 0
Date of Construction	1988
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1964 [Member] | San Diego, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,550
Initial costs, buildings	15,653
Additions subsequent to acquisition, carrying costs	77
Land at cost	6,550
Buildings at cost	15,730
Total at cost	22,280
Accumulated Depreciation	5,372
Encumbrances	$ 0
Date of Construction	1964
Date Acquired	May 9, 2007
Life on which depreciation in latest income statements is computed (Years)	40 years
1964 [Member] | Anaheim, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,875
Initial costs, buildings	21,813
Additions subsequent to acquisition, carrying costs	10
Land at cost	1,875
Buildings at cost	21,823
Total at cost	23,698
Accumulated Depreciation	7,729
Encumbrances	$ 0
Date of Construction	1964
Date Acquired	Nov. 8, 2006
Life on which depreciation in latest income statements is computed (Years)	40 years
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	15,109
Land at cost	13,590
Buildings at cost	117,024
Total at cost	130,614
Accumulated Depreciation	8,751
Encumbrances	$ 0
Date of Construction	1906
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1913 [Member] | Sherman Texas
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,363
Initial costs, buildings	10,932
Land at cost	3,363
Buildings at cost	10,932
Total at cost	14,295
Accumulated Depreciation	3,169
Encumbrances	$ 0
Date of Construction	1913
Date Acquired	Oct. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1929 [Member] | Youngstown, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,335
Initial costs, buildings	3,565
Additions subsequent to acquisition, Improvements	824
Land at cost	4,335
Buildings at cost	4,389
Total at cost	8,724
Accumulated Depreciation	2,160
Encumbrances	$ 0
Date of Construction	1929
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
Two Thousand Twenty One | Stockton, California [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,932
Land at cost	2,932
Total at cost	2,932
Encumbrances	$ 0
Date of Construction	2021
Date Acquired	Nov. 23, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
Nineteen Sixty Two | West Monroe, LA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,000
Initial costs, buildings	69,433
Additions subsequent to acquisition, Improvements	16,187
Land at cost	12,552
Buildings at cost	85,068
Total at cost	97,620
Accumulated Depreciation	14,060
Encumbrances	$ 0
Date of Construction	1962
Date Acquired	Sep. 26, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Nineteen Eleven | Winchester, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,835
Initial costs, buildings	11,035
Additions subsequent to acquisition, Improvements	130
Land at cost	6,965
Buildings at cost	11,035
Total at cost	18,000
Accumulated Depreciation	284
Encumbrances	$ 0
Date of Construction	1911
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
Nineteen Fifty Five | Windsor, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,973
Initial costs, buildings	112,450
Additions subsequent to acquisition, Improvements	109
Land at cost	13,082
Buildings at cost	112,450
Total at cost	125,532
Accumulated Depreciation	2,818
Encumbrances	$ 0
Date of Construction	1955
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years

Schedule III - Real Estate In_3

Schedule III - Real Estate Investments and Accumulated Depreciation (Parenthetical) (Detail) $ in Billions	Dec. 31, 2020USD ($)
Real Estate And Accumulated Depreciation Disclosure [Abstract]
Aggregate cost for federal income tax purposes	$ 10.9

Schedule III - Changes in Total

Schedule III - Changes in Total Real Estate Assets (Detail) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Real Estate And Accumulated Depreciation Disclosure [Abstract]
Balance at beginning of period		$ 7,312,486	$ 4,781,149	$ 5,438,148
Acquisitions		2,912,594	2,436,265	758,619
Transfers from construction in progress		202,999		25,513
Additions		55,137	173,785	96,775
Dispositions		(105,360)	(106,536)	(1,318,238)
Other	[1]	371,851	27,823	(219,668)
Balance at end of period		$ 10,749,707	$ 7,312,486	$ 4,781,149
[1]	Includes foreign currency fluctuations for all years and $13.8 million and $61.4 million of right-of-use assets in 2020 and 2019, respectively.

Schedule III - Changes in Accum

Schedule III - Changes in Accumulated Depreciation (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Real Estate And Accumulated Depreciation Disclosure [Abstract]
Balance at beginning of period	$ 504,651	$ 414,331	$ 407,349
Depreciation	222,580	130,851	115,497
Depreciation on disposed property	(6,653)	(40,952)	(101,967)
Other	7,598	421	(6,548)
Balance at end of period	$ 728,176	$ 504,651	$ 414,331

Schedule III - Changes in Acc_2

Schedule III - Changes in Accumulated Depreciation (Parenthetical) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Real Estate And Accumulated Depreciation Disclosure [Abstract]
Right-of-use-assets	$ 75,209	$ 61,380
Changes in right-of-use asset	$ 13,832	$ 1,818

Schedule IV - Schedule of Mortg

Schedule IV - Schedule of Mortgage Loans on Real Estate (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Mortgage Loans on Real Estate [Line Items]
Prior Liens	$ 0
Face Amount of Mortgages	248,335,000
Carrying Amount of Mortgages	248,335,000	$ 1,274,995,000	$ 1,213,283,000	$ 1,778,264,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member]
Mortgage Loans on Real Estate [Line Items]
Periodic Payment Terms	Payable in monthly installments of interest plus principal payable in full at maturity
Long-Term First Mortgage Loan [Member] | Colombia [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	8.95%
Final Maturity Date	2035
Face Amount of Mortgages	$ 136,332,000
Carrying Amount of Mortgages	136,332,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | East Ohio Regional Hospital [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	8.00%
Final Maturity Date	2025
Face Amount of Mortgages	$ 1,750,000
Carrying Amount of Mortgages	1,750,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Olympia Medical Center [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	11.14%
Final Maturity Date	2024
Face Amount of Mortgages	$ 25,000,000
Carrying Amount of Mortgages	25,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | St. Luke's Hospital [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	0.00%
Final Maturity Date	2021
Face Amount of Mortgages	$ 15,000,000
Carrying Amount of Mortgages	15,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Vibra [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	11.50%
Final Maturity Date	2024
Face Amount of Mortgages	$ 18,986,000
Carrying Amount of Mortgages	18,986,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Prospect [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	7.50%
Final Maturity Date	2034
Face Amount of Mortgages	$ 51,267,000
Carrying Amount of Mortgages	51,267,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0

Schedule IV - Schedule of Mor_2

Schedule IV - Schedule of Mortgage Loans on Real Estate (Parenthetical) (Detail)	12 Months Ended
	Dec. 31, 2020USD ($)Property
Mortgage Loans on Real Estate [Line Items]
Prior Liens	$ 0
Carrying amount of mortgages, federal income tax purposes	248,300,000
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
Interest Rate	8.95%

Schedule IV - Changes in Mortga

Schedule IV - Changes in Mortgage Loans Excluding Unamortized Loan Issue Costs (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Mortgage Loans On Real Estate [Abstract]
Balance at beginning of year	$ 1,274,995	$ 1,213,283	$ 1,778,264
New mortgage loans and additional advances on existing loans	193,590	61,712	50,783
Exchange rate fluctuations	9,785
Mortgage loans on real estate including additions during year	1,478,370	1,274,995	1,829,047
Collection of principal	(1,230,035)		(615,764)
Deductions during year	(1,230,035)		(615,764)
Balance at end of year	$ 248,335	$ 1,274,995	$ 1,213,283

Schedule IV - Changes in Mort_2

Schedule IV - Changes in Mortgage Loans Excluding Unamortized Loan Issue Costs (Parenthetical) (Detail) - USD ($) $ in Thousands		Dec. 31, 2020	Dec. 31, 2018
Mortgage Loans on Real Estate [Line Items]
Loans repaid	[1]	$ 834,743	$ 764,447
Mortgage Loans [Member]
Mortgage Loans on Real Estate [Line Items]
Loans repaid		$ 835,000
[1]	The 2020 column includes approximately $750 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. The 2018 column includes $0.8 billion of loans advanced to Steward in 2016 and repaid in 2018 as part of sale leaseback conversion described below.