Physicians Realty Trust 10-Q 5 Nov 18 2018 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2018	Oct. 26, 2018
Entity Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2018
Document Fiscal Year Focus	2,018
Document Fiscal Period Focus	Q3
Entity Registrant Name	Physicians Realty Trust
Entity Central Index Key	1,574,540
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Filer Category	Large Accelerated Filer
Entity Emerging Growth Company	false
Entity Small Business	false
Entity Common Stock, Shares Outstanding (in shares)		182,321,984
Operating Partnership
Entity Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2018
Document Fiscal Year Focus	2,018
Document Fiscal Period Focus	Q3
Entity Registrant Name	Physicians Realty L.P.
Entity Central Index Key	1,583,994
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Filer Category	Non-accelerated Filer

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Investment properties:
Land and improvements	$ 207,473	$ 217,695
Building and improvements	3,588,302	3,568,858
Tenant improvements	32,852	23,056
Acquired lease intangibles	449,656	458,713
Gross real estate property	4,278,283	4,268,322
Accumulated depreciation	(369,103)	(300,458)
Net real estate property	3,909,180	3,967,864
Real estate held for sale	35,426	0
Real estate loans receivable	47,911	76,195
Investments in unconsolidated entities	1,328	1,329
Net real estate investments	3,993,845	4,045,388
Cash and cash equivalents	4,463	2,727
Tenant receivables, net	5,686	9,966
Other assets	148,567	106,302
Total assets	4,152,561	4,164,383
Liabilities:
Credit facility	420,900	324,394
Notes payable	966,788	966,603
Mortgage debt	134,724	186,471
Accounts payable	3,824	11,023
Dividends and distributions payable	43,599	43,804
Accrued expenses and other liabilities	61,346	56,405
Acquired lease intangibles, net	14,229	15,702
Total liabilities	1,645,410	1,604,402
Redeemable noncontrolling interest - Series A Preferred Units (2018) and partially owned properties	24,520	12,347
Equity:
Common shares, $0.01 par value, 500,000,000 common shares authorized, 182,173,601 and 181,440,051 common shares issued and outstanding as of September 30, 2018 and December 31, 2017, respectively	1,822	1,814
Additional paid-in capital	2,785,797	2,772,823
Accumulated deficit	(396,127)	(315,417)
Accumulated other comprehensive income	20,485	13,952
Total shareholders’ equity	2,411,977	2,473,172
Noncontrolling interests:
Operating Partnership	69,993	73,844
Partially owned properties	661	618
Total noncontrolling interests	70,654	74,462
Total equity	2,482,631	2,547,634
Total liabilities and equity	4,152,561	4,164,383
Operating Partnership
Investment properties:
Land and improvements	207,473	217,695
Building and improvements	3,588,302	3,568,858
Tenant improvements	32,852	23,056
Acquired lease intangibles	449,656	458,713
Gross real estate property	4,278,283	4,268,322
Accumulated depreciation	(369,103)	(300,458)
Net real estate property	3,909,180	3,967,864
Real estate held for sale	35,426	0
Real estate loans receivable	47,911	76,195
Investments in unconsolidated entities	1,328	1,329
Net real estate investments	3,993,845	4,045,388
Cash and cash equivalents	4,463	2,727
Tenant receivables, net	5,686	9,966
Other assets	148,567	106,302
Total assets	4,152,561	4,164,383
Liabilities:
Credit facility	420,900	324,394
Notes payable	966,788	966,603
Mortgage debt	134,724	186,471
Accounts payable	3,824	11,023
Dividends and distributions payable	43,599	43,804
Accrued expenses and other liabilities	61,346	56,405
Acquired lease intangibles, net	14,229	15,702
Total liabilities	1,645,410	1,604,402
Redeemable noncontrolling interest - Series A Preferred Units (2018) and partially owned properties	24,520	12,347
Equity:
General partners’ capital, 182,173,601 and 181,440,051 units issued and outstanding as of September 30, 2018 and December 31, 2017, respectively	2,391,492	2,459,220
Limited partners’ capital, 5,291,504 and 5,364,632 units issued and outstanding as of September 30, 2018 and December 31, 2017, respectively	69,993	73,844
Accumulated other comprehensive income	20,485	13,952
Total partners’ capital	2,481,970	2,547,016
Noncontrolling interests:
Noncontrolling interest - partially owned properties	661	618
Total capital	2,482,631	2,547,634
Total liabilities and equity	$ 4,152,561	$ 4,164,383

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 2018	Dec. 31, 2017
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	500,000,000	500,000,000
Common stock, shares issued (in shares)	182,173,601	181,440,051
Common stock, shares outstanding (in shares)	182,173,601	181,440,051
Operating Partnership
General partners' capital account, units issued (in units)	182,173,601	181,440,051
General partners' capital account, units outstanding (in units)	182,173,601	181,440,051
Limited partners' capital account, units issued (in units)	5,291,504	5,364,632
Limited partners' capital account, units outstanding (in units)	5,291,504	5,364,632

Consolidated Statements of Inco

Consolidated Statements of Income - USD ($) $ in Thousands		3 Months Ended		9 Months Ended
		Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Revenues:
Rental revenues		$ 76,461	$ 69,408	$ 235,740	$ 186,515
Expense recoveries		23,629	21,102	72,225	53,564
Interest income on real estate loans and other		4,938	2,489	9,275	6,185
Total revenues		105,028	92,999	317,240	246,264
Expenses:
Interest expense		16,326	11,998	49,974	33,285
General and administrative		6,593	5,860	22,156	16,845
Operating expenses		29,870	27,471	90,670	70,079
Depreciation and amortization		42,723	32,975	119,024	89,031
Acquisition expenses		0	2,184	0	12,831
Total expenses		95,512	80,488	281,824	222,071
Income before equity in income of unconsolidated entities and gain on sale of investment properties, net:		9,516	12,511	35,416	24,193
Equity in income of unconsolidated entities		28	28	85	85
Gain on sale of investment properties, net		14,227	0	11,664	5,308
Net income		23,771	12,539	47,165	29,586
Net income attributable to noncontrolling interests:
Operating Partnership		(656)	(362)	(1,300)	(823)
Partially owned properties	[1]	(119)	(53)	(374)	(379)
Net income attributable to controlling interests		22,996	12,124	45,491	28,384
Preferred distributions		(284)	(106)	(1,055)	(505)
Net income attributable to common shareholders		$ 22,712	$ 12,018	$ 44,436	$ 27,879
Net income per share:
Basic (in dollars per share)		$ 0.12	$ 0.07	$ 0.24	$ 0.18
Diluted (in dollars per share)		$ 0.12	$ 0.07	$ 0.24	$ 0.18
Weighted average common shares:
Weighted average common shares - basic (in shares)		182,076,513	177,847,424	181,963,693	157,542,167
Weighted average common shares - diluted (in shares)		187,473,230	183,298,145	187,622,109	162,480,918
Dividends and distributions declared per common share and OP Unit (in dollars per share)		$ 0.23	$ 0.23	$ 0.69	$ 0.685
Operating Partnership
Revenues:
Rental revenues		$ 76,461	$ 69,408	$ 235,740	$ 186,515
Expense recoveries		23,629	21,102	72,225	53,564
Interest income on real estate loans and other		4,938	2,489	9,275	6,185
Total revenues		105,028	92,999	317,240	246,264
Expenses:
Interest expense		16,326	11,998	49,974	33,285
General and administrative		6,593	5,860	22,156	16,845
Operating expenses		29,870	27,471	90,670	70,079
Depreciation and amortization		42,723	32,975	119,024	89,031
Acquisition expenses		0	2,184	0	12,831
Total expenses		95,512	80,488	281,824	222,071
Income before equity in income of unconsolidated entities and gain on sale of investment properties, net:		9,516	12,511	35,416	24,193
Equity in income of unconsolidated entities		28	28	85	85
Gain on sale of investment properties, net		14,227	0	11,664	5,308
Net income		23,771	12,539	47,165	29,586
Net income attributable to noncontrolling interests:
Partially owned properties	[2]	(119)	(53)	(374)	(379)
Net income attributable to controlling interests		23,652	12,486	46,791	29,207
Preferred distributions		(284)	(106)	(1,055)	(505)
Net income attributable to common shareholders		$ 23,368	$ 12,380	$ 45,736	$ 28,702
Net income per share:
Earnings per unit - basic (in dollars per share)		$ 0.12	$ 0.07	$ 0.24	$ 0.18
Earnings per unit - diluted (in dollars per share)		$ 0.12	$ 0.07	$ 0.24	$ 0.18
Weighted average common shares:
Weighted average limited partnership units outstanding, basic (in shares)		187,367,538	183,227,405	187,342,453	162,205,324
Weighted average common shares - diluted (in shares)		187,473,230	183,298,145	187,622,109	162,480,918
Distributions declared per common unit (dollars per share)		$ 0.23	$ 0.23	$ 0.69	$ 0.685
[1]	Includes amounts attributable to redeemable noncontrolling interests.
[2]	Includes amounts attributable to redeemable noncontrolling interests.

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Net income	$ 23,771	$ 12,539	$ 47,165	$ 29,586
Other comprehensive income:
Change in fair value of interest rate swap agreements	914	(916)	6,533	(1,696)
Total other comprehensive income	914	(916)	6,533	(1,696)
Comprehensive income	24,685	11,623	53,698	27,890
Comprehensive income attributable to noncontrolling interests - Operating Partnership	(679)	(339)	(1,484)	(774)
Comprehensive income attributable to noncontrolling interests - partially owned properties	(119)	(53)	(374)	(379)
Comprehensive income attributable to common shareholders	23,887	11,231	51,840	26,737
Operating Partnership
Net income	23,771	12,539	47,165	29,586
Other comprehensive income:
Change in fair value of interest rate swap agreements	914	(916)	6,533	(1,696)
Total other comprehensive income	914	(916)	6,533	(1,696)
Comprehensive income	24,685	11,623	53,698	27,890
Comprehensive income attributable to noncontrolling interests - partially owned properties	(119)	(53)	(374)	(379)
Comprehensive income attributable to common shareholders	$ 24,566	$ 11,570	$ 53,324	$ 27,511

Consolidated Statement of Equit

Consolidated Statement of Equity - 9 months ended Sep. 30, 2018 - USD ($) $ in Thousands	Total	Par Value	Additional Paid in Capital	Accumulated Deficit	Accumulated Other Comprehensive Income	Total Shareholders’ Equity	Operating Partnership Noncontrolling Interest	Partially Owned Properties Noncontrolling Interest	Total Noncontrolling Interests
Balance at Dec. 31, 2017	$ 2,547,634	$ 1,814	$ 2,772,823	$ (315,417)	$ 13,952	$ 2,473,172	$ 73,844	$ 618	$ 74,462
Stockholders' Equity Attributable to Parent [Abstract]
Net proceeds from sale of common shares	8,054	5	8,049			8,054
Restricted share award grants, net	4,711	2	4,847	(138)		4,711
Purchase of OP Units	(1,555)						(1,555)		(1,555)
Conversion of OP Units	0	1	1,326			1,327	(1,327)		(1,327)
Dividends/distributions declared	(129,386)			(125,810)		(125,810)	(3,576)		(3,576)
Preferred distributions	(1,055)			(1,055)		(1,055)
Distributions	(122)							(122)	(122)
Change in market value of Redeemable Noncontrolling Interest	861		59	802		861
Change in fair value of interest rate swap agreements	6,533				6,533	6,533
Net income	46,956			45,491		45,491	1,300	165	1,465
Adjustment for Noncontrolling Interests ownership in Operating Partnership	0		(1,307)			(1,307)	1,307		1,307
Balance at Sep. 30, 2018	$ 2,482,631	$ 1,822	$ 2,785,797	$ (396,127)	$ 20,485	$ 2,411,977	$ 69,993	$ 661	$ 70,654

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017
Cash Flows from Operating Activities:
Net income	$ 47,165	$ 29,586
Adjustments to reconcile net income to net cash provided by operating activities
Depreciation and amortization	119,024	89,031
Amortization of deferred financing costs	1,808	1,731
Amortization of lease inducements and above/below-market lease intangibles	3,518	3,780
Straight-line rental revenue/expense	(17,270)	(11,168)
Amortization of discount on unsecured senior notes	430	177
Amortization of above market assumed debt	(47)	(163)
Gain on sale of investment properties, net	(11,664)	(5,308)
Equity in income of unconsolidated entities	(85)	(85)
Distributions from unconsolidated entities	86	112
Change in fair value of derivative	(17)	160
Provision for bad debts	82	(297)
Non-cash share compensation	6,675	4,976
Net change in fair value of contingent consideration	(50)	4
Change in operating assets and liabilities:
Tenant receivables	3,891	(754)
Other assets	(2,799)	(541)
Accounts payable	(7,199)	2,167
Accrued expenses and other liabilities	1,916	14,834
Net cash provided by operating activities	145,464	128,242
Cash Flows from Investing Activities:
Proceeds on sales of investment properties	217,222	18,150
Acquisition of investment properties, net	(242,827)	(916,270)
Escrowed cash - acquisition deposits/earnest deposits	2,780	(25,271)
Capital expenditures on investment properties	(26,358)	(14,819)
Issuance of real estate loans receivable	(2,000)	(38,844)
Repayment of real estate loans receivable	13,582	1,507
Issuance of note receivable	(20,385)	0
Repayment of note receivable	0	16,423
Leasing commissions	(2,561)	(1,184)
Lease inducements	(73)	(2,508)
Net cash used in investing activities	(60,620)	(962,816)
Cash Flows from Financing Activities:
Net proceeds from sale of common shares	8,054	804,453
Proceeds from credit facility borrowings	345,000	627,000
Repayment of credit facility borrowings	(246,000)	(889,000)
Proceeds from issuance of mortgage debt	0	61,000
Proceeds from issuance of senior unsecured notes	0	396,108
Principal payments on mortgage debt	(51,840)	(40,999)
Debt issuance costs	(4,267)	(1,129)
OP Unit distributions - General Partner	(126,088)	(101,846)
OP Unit distributions - Limited Partner	(3,640)	(3,154)
Preferred OP Units distributions - Limited Partner	(627)	(519)
Contributions from noncontrolling interest	0	47
Distributions to noncontrolling interests - partially owned properties	(396)	(1,653)
Payments of employee taxes for withheld stock-based compensation shares	(1,749)	(2,583)
Purchase of Series A Preferred Units	0	(19,961)
Purchase of Limited Partner Units	(1,555)	(3,757)
Net cash (used in) provided by financing activities	(83,108)	824,007
Net increase (decrease) in cash and cash equivalents	1,736	(10,567)
Cash and cash equivalents, beginning of period	2,727	15,491
Cash and cash equivalents, end of period	4,463	4,924
Supplemental disclosure of cash flow information - interest paid during the period	53,370	33,307
Supplemental disclosure of noncash activity - change in fair value of interest rate swap agreements	6,533	(1,696)
Supplemental disclosure of noncash activity - assumed debt	0	26,379
Supplemental disclosure of noncash activity - issuance of OP Units and Series A Preferred Units in connection with acquisitions	22,651	44,978
Operating Partnership
Cash Flows from Operating Activities:
Net income	47,165	29,586
Adjustments to reconcile net income to net cash provided by operating activities
Depreciation and amortization	119,024	89,031
Amortization of deferred financing costs	1,808	1,731
Amortization of lease inducements and above/below-market lease intangibles	3,518	3,780
Straight-line rental revenue/expense	(17,270)	(11,168)
Amortization of discount on unsecured senior notes	430	177
Amortization of above market assumed debt	(47)	(163)
Gain on sale of investment properties, net	(11,664)	(5,308)
Equity in income of unconsolidated entities	(85)	(85)
Distributions from unconsolidated entities	86	112
Change in fair value of derivative	(17)	160
Provision for bad debts	82	(297)
Non-cash share compensation	6,675	4,976
Net change in fair value of contingent consideration	(50)	4
Change in operating assets and liabilities:
Tenant receivables	3,891	(754)
Other assets	(2,799)	(541)
Accounts payable	(7,199)	2,167
Accrued expenses and other liabilities	1,916	14,834
Net cash provided by operating activities	145,464	128,242
Cash Flows from Investing Activities:
Proceeds on sales of investment properties	217,222	18,150
Acquisition of investment properties, net	(242,827)	(916,270)
Escrowed cash - acquisition deposits/earnest deposits	2,780	(25,271)
Capital expenditures on investment properties	(26,358)	(14,819)
Issuance of real estate loans receivable	(2,000)	(38,844)
Repayment of real estate loans receivable	13,582	1,507
Issuance of note receivable	(20,385)	0
Repayment of note receivable	0	16,423
Leasing commissions	(2,561)	(1,184)
Lease inducements	(73)	(2,508)
Net cash used in investing activities	(60,620)	(962,816)
Cash Flows from Financing Activities:
Net proceeds from sale of common shares	8,054	804,453
Proceeds from credit facility borrowings	345,000	627,000
Repayment of credit facility borrowings	(246,000)	(889,000)
Proceeds from issuance of mortgage debt	0	61,000
Proceeds from issuance of senior unsecured notes	0	396,108
Principal payments on mortgage debt	(51,840)	(40,999)
Debt issuance costs	(4,267)	(1,129)
OP Unit distributions - General Partner	(126,088)	(101,846)
OP Unit distributions - Limited Partner	(3,640)	(3,154)
Preferred OP Units distributions - Limited Partner	(627)	(519)
Contributions from noncontrolling interest	0	47
Distributions to noncontrolling interests - partially owned properties	(396)	(1,653)
Payments of employee taxes for withheld stock-based compensation shares	(1,749)	(2,583)
Purchase of Series A Preferred Units	0	(19,961)
Purchase of Limited Partner Units	(1,555)	(3,757)
Net cash (used in) provided by financing activities	(83,108)	824,007
Net increase (decrease) in cash and cash equivalents	1,736	(10,567)
Cash and cash equivalents, beginning of period	2,727	15,491
Cash and cash equivalents, end of period	4,463	4,924
Supplemental disclosure of cash flow information - interest paid during the period	53,370	33,307
Supplemental disclosure of noncash activity - change in fair value of interest rate swap agreements	6,533	(1,696)
Supplemental disclosure of noncash activity - assumed debt	0	26,379
Supplemental disclosure of noncash activity - issuance of OP Units and Series A Preferred Units in connection with acquisitions	$ 22,651	$ 44,978

Consolidated Statement of Chang

Consolidated Statement of Changes in Capital $ in Thousands	9 Months Ended
	Sep. 30, 2018USD ($)
Increase (Decrease) in Partners' Capital [Roll Forward]
Distributions	$ (122)
Change in fair value of interest rate swap agreements	6,533
Net income	46,956
Operating Partnership
Increase (Decrease) in Partners' Capital [Roll Forward]
Beginning balance	2,547,634
Net proceeds from sale of Trust common shares and issuance of common units	8,054
Trust restricted share award grants, net	4,711
Purchase of OP Units	(1,555)
Conversion of OP Units	0
OP Units - distributions	(129,386)
Preferred distributions	(1,055)
Distributions	(122)
Change in market value of Redeemable Limited Partners	59
Buyout of Noncontrolling Interest - partially owned properties	802
Change in fair value of interest rate swap agreements	6,533
Net income	46,956
Adjustments for Limited Partners ownership in Operating Partnership	0
Ending balance	2,482,631
Operating Partnership | Accumulated Other Comprehensive Income
Increase (Decrease) in Partners' Capital [Roll Forward]
Beginning balance	13,952
Change in fair value of interest rate swap agreements	6,533
Ending balance	20,485
Operating Partnership | General Partner
Increase (Decrease) in Partners' Capital [Roll Forward]
Beginning balance	2,459,220
Net proceeds from sale of Trust common shares and issuance of common units	8,054
Trust restricted share award grants, net	4,711
Conversion of OP Units	1,327
OP Units - distributions	(125,810)
Preferred distributions	(1,055)
Change in market value of Redeemable Limited Partners	59
Buyout of Noncontrolling Interest - partially owned properties	802
Net income	45,491
Adjustments for Limited Partners ownership in Operating Partnership	(1,307)
Ending balance	2,391,492
Operating Partnership | Limited Partner
Increase (Decrease) in Partners' Capital [Roll Forward]
Beginning balance	73,844
Purchase of OP Units	(1,555)
Conversion of OP Units	(1,327)
OP Units - distributions	(3,576)
Net income	1,300
Adjustments for Limited Partners ownership in Operating Partnership	1,307
Ending balance	69,993
Operating Partnership | Total Partners’ Capital
Increase (Decrease) in Partners' Capital [Roll Forward]
Beginning balance	2,547,016
Net proceeds from sale of Trust common shares and issuance of common units	8,054
Trust restricted share award grants, net	4,711
Purchase of OP Units	(1,555)
OP Units - distributions	(129,386)
Preferred distributions	(1,055)
Change in market value of Redeemable Limited Partners	59
Buyout of Noncontrolling Interest - partially owned properties	802
Change in fair value of interest rate swap agreements	6,533
Net income	46,791
Ending balance	2,481,970
Partially Owned Properties Noncontrolling Interest
Increase (Decrease) in Partners' Capital [Roll Forward]
Distributions	(122)
Net income	165
Partially Owned Properties Noncontrolling Interest | Operating Partnership
Increase (Decrease) in Partners' Capital [Roll Forward]
Beginning balance	618
Distributions	(122)
Net income	165
Ending balance	$ 661

Organization and Business

Organization and Business	9 Months Ended
	Sep. 30, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Business	Organization and Business Physicians Realty Trust (the “Trust”) was organized in the state of Maryland on April 9, 2013. As of September 30, 2018 , the Trust was authorized to issue up to 500,000,000 common shares of beneficial interest, par value $0.01 per share (“common shares”). The Trust filed a Registration Statement on Form S-11 with the Securities and Exchange Commission (the “Commission”) with respect to a proposed underwritten initial public offering (the “IPO”) and completed the IPO of its common shares and commenced operations on July 24, 2013. The Trust contributed the net proceeds from the IPO to Physicians Realty L.P., a Delaware limited partnership, (the “Operating Partnership”), and is the sole general partner of the Operating Partnership. The Trust and the Operating Partnership are managed and operated as one entity. The Trust has no significant assets other than its investment in the Operating Partnership. The Trust’s operations are conducted through the Operating Partnership and wholly-owned and majority-owned subsidiaries of the Operating Partnership. The Trust, as the general partner of the Operating Partnership, controls the Operating Partnership and consolidates the assets, liabilities, and results of operations of the Operating Partnership. Therefore, the assets and liabilities of the Trust and the Operating Partnership are the same. The Trust is a self-managed real estate investment trust (“REIT”) formed primarily to acquire, selectively develop, own, and manage healthcare properties that are leased to physicians, hospitals, and healthcare delivery systems. ATM Program On August 5, 2016, the Trust and the Operating Partnership entered into separate At Market Issuance Sales Agreements (the “Sales Agreements”) with each of KeyBanc Capital Markets Inc., Credit Agricole Securities (USA) Inc., JMP Securities LLC, Raymond James & Associates, Inc., and Stifel Nicolaus & Company, Incorporated (the “Agents”), pursuant to which the Trust may issue and sell, from time to time, its common shares having an aggregate offering price of up to $300.0 million , through the Agents (the “ATM Program”). In accordance with the Sales Agreements, the Trust may offer and sell its common shares through any of the Agents, from time to time, by any method deemed to be an “at the market offering” as defined in Rule 415 under the Securities Act of 1933, as amended, which includes sales made directly on the New York Stock Exchange or other existing trading market, or sales made to or through a market maker. With the Trust’s express written consent, sales may also be made in negotiated transactions or any other method permitted by law. During the quarterly periods ended March 31, 2018, June 30, 2018, and September 30, 2018 , the Trust’s issuance and sale of common shares pursuant to the ATM Program are as follows (in thousands, except common shares and price): Common shares sold Weighted average price Net proceeds Quarterly period ended March 31, 2018 311,786 $ 17.85 $ 5,509 Quarterly period ended June 30, 2018 — — — Quarterly period ended September 30, 2018 114,203 17.15 1,947 Year to date 425,989 $ 17.66 $ 7,456 As of October 26, 2018 , the Trust has $164.9 million remaining available under the ATM Program.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2018
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies The accompanying unaudited consolidated financial statements reflect all adjustments which are, in the opinion of management, necessary for a fair presentation of the results for the periods ended September 30, 2018 and 2017 pursuant to the instructions to Form 10-Q and Article 10 of Regulation S-X. All such adjustments are of a normal recurring nature. Certain information and footnote disclosures normally included in financial statements prepared in accordance with accounting principles generally accepted in the United States (“GAAP”) have been condensed or omitted pursuant to such rules and regulations. These financial statements should be read in conjunction with the audited financial statements included in the Trust’s and the Operating Partnership’s combined Annual Report on Form 10-K for the year ended December 31, 2017 , filed with the Commission on March 1, 2018. Principles of Consolidation GAAP requires us to identify entities for which control is achieved through means other than voting rights and to determine which business enterprise is the primary beneficiary of variable interest entities (“VIEs”). ASC 810 broadly defines a VIE as an entity in which either (i) the equity investors as a group, if any, lack the power through voting or similar rights to direct the activities of such entity that most significantly impact such entity’s economic performance or (ii) the equity investment at risk is insufficient to finance that entity’s activities without additional subordinated financial support. We identify the primary beneficiary of a VIE as the enterprise that has both of the following characteristics: (i) the power to direct the activities of the VIE that most significantly impact the entity’s economic performance, and (ii) the obligation to absorb losses or receive benefits of the VIE that could potentially be significant to the entity. We consolidate our investment in a VIE when we determine that we are the VIE’s primary beneficiary. We may change our original assessment of a VIE upon subsequent events, such as the modification of contractual arrangements that affect the characteristics or adequacy of the entity’s equity investments at risk and the disposition of all, or a portion, of an interest held by the primary beneficiary. We perform this analysis on an ongoing basis. For property holding entities not determined to be VIEs, we consolidate such entities in which the Operating Partnership owns 100% of the equity or has a controlling financial interest evidenced by ownership of a majority voting interest. All intercompany balances and transactions are eliminated in consolidation. For entities in which the Operating Partnership owns less than 100% of the equity interest, the Operating Partnership consolidates the property if it has the direct or indirect ability to control the entities’ activities based upon the terms of the respective entities’ ownership agreements. For these entities, the Operating Partnership records a noncontrolling interest representing equity held by noncontrolling interests. Noncontrolling Interests The Company presents the portion of an equity interest it does not own, but controls (and thus consolidates) as noncontrolling interests and classifies such interests as a component of consolidated equity, separate from the Company’s total shareholders’ equity, on the consolidated balance sheets. Operating Partnership: Net income or loss is allocated to noncontrolling interests (limited partners) based on their respective ownership percentage of the Operating Partnership. The ownership percentage is calculated by dividing the number of OP Units held by the noncontrolling interests by the total OP Units held by the noncontrolling interests and the Trust. Issuance of additional common shares and OP Units changes the ownership interests of both the noncontrolling interests and the Trust. Such transactions and the related proceeds are treated as capital transactions. Noncontrolling interests in the Company include OP Units held by other investors. As of September 30, 2018 , the Trust held a 97.2% interest in the Operating Partnership. As the sole general partner and the majority interest holder, the Trust consolidates the financial position and results of operations of the Operating Partnership. Holders of OP Units may not transfer their OP Units without the Trust’s prior written consent, as general partner of the Operating Partnership. Beginning on the first anniversary of the issuance of OP Units, OP Unit holders may tender their units for redemption by the Operating Partnership in exchange for cash equal to the market price of the Trust’s common shares at the time of redemption or for unregistered common shares on a one-for-one basis. Such selection to pay cash or issue common shares to satisfy an OP Unit holder’s redemption request is solely within the control of the Trust. Accordingly, the Trust presents the OP Units of the Operating Partnership held by investors other than the Trust as noncontrolling interests within equity in the consolidated balance sheets. Partially Owned Properties: The Trust and Operating Partnership reflect noncontrolling interests in partially owned properties on the balance sheet for the portion of consolidated properties that are not wholly owned by the Company. The earnings or losses from those properties attributable to the noncontrolling interests are reflected as noncontrolling interests in partially owned properties in the consolidated statements of income. Redeemable Noncontrolling Interests - Series A Preferred Units and Partially Owned Properties On February 5, 2015, the Company entered into a Second Amended and Restated Agreement of Limited Partnership (the “Partnership Agreement”) which provides for the designation and issuance of the Series A Participating Redeemable Preferred Units of the Operating Partnership (“Series A Preferred Units”). Series A Preferred Units have priority over all other partnership interests of the Operating Partnership with respect to distributions and liquidation. Holders of Series A Preferred Units are entitled to a 5% cumulative return and upon redemption, the receipt of one common share and $200 . The holders of the Series A Preferred Units have agreed not to cause the Operating Partnership to redeem their Series A Preferred Units prior to one year from the issuance date. In addition, Series A Preferred Units are redeemable at the option of the holders which redemption obligation may be satisfied, at the Trust’s option, in cash or registered common shares. Instruments that require settlement in registered common shares may not be classified in permanent equity as it is not always completely within an issuer’s control to deliver registered common shares. Due to the redemption rights associated with the Series A Preferred Units, the Company classifies the Series A Preferred Units in the mezzanine section of its consolidated balance sheets. The Series A Preferred Units were evaluated for embedded features that should be bifurcated and separately accounted for as a freestanding derivative. The Company determined that the Series A Preferred Units contained features that require bifurcation. The Company records the carrying amount of the redeemable noncontrolling interests, less the value of the embedded derivative, at the greater of the carrying value or redemption value in the consolidated balance sheets. On January 9, 2018, the acquisition of the HealthEast Clinic & Specialty Center (“Hazelwood Medical Commons”) was partially funded with the issuance of 104,172 Series A Preferred Units, with a value of $22.7 million . Due to the redemption rights associated with the Series A Preferred Units, the Trust classifies the Series A Preferred Units in the mezzanine section of its consolidated balance sheets. As of September 30, 2018 , the value of the embedded derivative is $3.6 million and is classified in accrued expenses and other liabilities on the consolidated balance sheets. As of September 30, 2018 , there were 104,172 Series A Preferred Units outstanding. In connection with the acquisition of a medical office portfolio in Minnesota (the “Minnesota portfolio”), the Trust received a $5 million equity investment from a third party, effective March 1, 2015. On March 1, 2018, the equity investment was redeemed for $6.4 million . At any point subsequent to the third anniversary of the investment, the holder could require the Trust to redeem the instrument. Due to the redemption provision, which is outside of the control of the Trust, the Trust classified the investment in the mezzanine section of its consolidated balance sheets. The Trust recorded the carrying amount of the redeemable noncontrolling interests at the greater of the carrying value or redemption value. In connection with the acquisition on December 29, 2015 of a medical office building located on the campus of the Great Falls Clinic and Hospital in Great Falls, Montana, physicians affiliated with the seller retained a noncontrolling interest which may, at the holders’ option, be redeemed at any time. Due to the redemption provision, which is outside of the control of the Trust, the Trust classifies the investment in the mezzanine section of its consolidated balance sheets. The Trust records the carrying amount of the redeemable noncontrolling interests at the greater of the carrying value or redemption value. Dividends and Distributions On September 19, 2018 , the Trust announced that its Board of Trustees authorized and the Trust declared a cash dividend of $0.23 per common share for the quarterly period ended September 30, 2018 . The distribution was paid on October 18, 2018 to common shareholders and OP Unit holders of record as of the close of business on October 3, 2018 . All distributions paid by the Operating Partnership are declared and paid at the same time as dividends are distributed by the Trust to common shareholders. It has been the Operating Partnership’s policy to declare quarterly distributions so as to allow the Trust to comply with applicable provisions of the Internal Revenue Code of 1986, as amended (the “Code”), governing REITs. The declaration and payment of quarterly distributions remains subject to the review and approval of the Trust’s Board of Trustees. Our shareholders are entitled to reinvest all or a portion of any cash distribution on their common shares by participating in our Dividend Reinvestment and Share Purchase Plan (“DRIP”), subject to the terms of the plan. Tax Status of Dividends and Distributions Our distributions of current and accumulated earnings and profits for U.S. federal income tax purposes generally are taxable to shareholders as ordinary income. Distributions in excess of these earnings and profits generally are treated as a non-taxable reduction of the shareholders’ basis in the shares to the extent thereof (non-dividend distributions) and thereafter as taxable gain. Any cash distributions received by an OP Unit holder in respect of its OP Units generally will not be taxable to such OP Unit holder for U.S. federal income tax purposes, to the extent that such distribution does not exceed the OP Unit holder’s basis in its OP Units. Any such distribution will instead reduce the OP Unit holder’s basis in its OP Units (and OP Unit holders will be subject to tax on the taxable income allocated to them by the Operating Partnership with respect to their OP Units when such income is earned by the Operating Partnership, with such income allocation increasing the OP Unit holders’ basis in their OP Units). Purchases of Investment Properties With the adoption of ASU 2017-01 in January 2018, the majority of our future acquisitions will be accounted for as asset acquisitions, recording the purchase price for tangible and intangible assets and liabilities based on their relative fair values. Tangible assets primarily consist of land and buildings and improvements. Additionally, the purchase price includes acquisition related expenses, above- or below-market leases, in place leases, and above- or below-market debt assumed. Any future contingent consideration will be recorded when the contingency is resolved. The determination of the fair value requires us to make certain estimates and assumptions. The determination of fair value involves the use of significant judgment and estimation. The Company makes estimates of the fair value of the tangible and intangible acquired assets and assumed liabilities using information obtained from multiple sources as a result of pre-acquisition due diligence and generally includes the assistance of a third party appraiser. The Company estimates the fair value of an acquired asset on an “as-if-vacant” basis and its value is depreciated in equal amounts over the course of its estimated remaining useful life. The Company determines the allocated value of other fixed assets, such as site improvements, based upon the replacement cost and depreciates such value over the assets’ estimated remaining useful lives as determined at the applicable acquisition date. The fair value of land is determined either by considering the sales prices of similar properties in recent transactions or based on an internal analysis of recently acquired and existing comparable properties within the Company’s portfolio. The value of above- or below-market leases is estimated based on the present value (using a discount rate which reflected the risks associated with the leases acquired) of the difference between contractual amounts to be received pursuant to the leases and management’s estimate of market lease rates measured over a period equal to the estimated remaining term of the lease . The capitalized above-market or below-market lease intangibles are amortized as a reduction or addition to rental income over the estimated remaining term of the respective leases plus the term of any renewal options that the lessee would be economically compelled to exercise. In determining the value of in-place leases, management considers current market conditions and costs to execute similar leases in arriving at an estimate of the carrying costs during the expected lease-up period from vacant to existing occupancy. In estimating carrying costs, management includes real estate taxes, insurance, other operating expenses, estimates of lost rental revenue during the expected lease-up periods, and costs to execute similar leases, including leasing commissions, tenant improvements, legal, and other related costs based on current market demand. The values assigned to in-place leases are amortized to amortization expense over the estimated remaining term of the lease. If a lease terminates prior to its scheduled expiration, all unamortized costs related to that lease are written off, net of any required lease termination payments. The Company calculates the fair value of any long-term debt assumed by discounting the remaining contractual cash flows on each instrument at the current market rate for those borrowings, which the Company approximates based on the rate it would expect to incur on a replacement instrument on the date of acquisition, and recognizes any fair value adjustments related to long-term debt as effective yield adjustments over the remaining term of the instrument. Based on these estimates, the Company recognizes the acquired assets and assumed liabilities at their estimated relative fair values, which are generally determined using Level 3 inputs, such as market rental rates, capitalization rates, discount rates, or other available market data. Impairment of Intangible and Long-Lived Assets The Company periodically evaluates its long-lived assets, primarily consisting of investments in real estate, for impairment indicators or whenever events or changes in circumstances indicate that the recorded amount of an asset may not be fully recoverable. If indicators of impairment are present, the Company evaluates the carrying value of the related real estate properties in relation to the undiscounted expected future cash flows of the underlying operations. In performing this evaluation, management considers market conditions and current intentions with respect to holding or disposing of the real estate property. The Company adjusts the net book value of real estate properties to fair value if the sum of the expected future undiscounted cash flows, including sales proceeds, is less than book value. The Company recognizes an impairment loss at the time it makes any such determination. If the Company determines that an asset is impaired, the impairment to be recognized is measured as the amount by which the recorded amount of the asset exceeds its fair value. Fair value is typically determined using a discounted future cash flow analysis or other acceptable valuation techniques, which are based, in turn, upon Level 3 inputs, such as revenue and expense growth rates, capitalization rates, discount rates, or other available market data. The Company did not record any impairment charges in the three and nine month periods ended September 30, 2018 and 2017 . Assets Held for Sale The Company may sell properties from time to time for various reasons, including favorable market conditions. The Company classifies certain long-lived assets as held for sale once the criteria, as defined by GAAP, has been met. The Company classifies a real estate property, or portfolio, as held for sale when: (i) management has approved the disposal, (ii) the property is available for sale in its present condition, (iii) an active program to locate a buyer has been initiated, (iv) it is probable that the property will be disposed of within one year, (v) the property is being marketed at a reasonable price relative to its fair value, and (vi) it is unlikely that the disposal plan will significantly change or be withdrawn. Following the classification of a property as “held for sale,” no further depreciation or amortization is recorded on the assets and the assets are written down to the lower of carrying value or fair market value, less cost to sell. As of September 30, 2018 , the Company classified two properties as held for sale. Investments in Unconsolidated Entities The Company reports investments in unconsolidated entities over whose operating and financial policies it has the ability to exercise significant influence under the equity method of accounting. Under this method of accounting, the Company’s share of the investee’s earnings or losses is included in its consolidated statements of income. The initial carrying value of investments in unconsolidated entities is based on the amount paid to purchase the equity interest. Real Estate Loans Receivable Real estate loans receivable consists of seven mezzanine loans and one term loan as of September 30, 2018 . Generally, each mezzanine loan is collateralized by an ownership interest in the respective borrower, while the term loan is secured by a mortgage of a related medical office building. Interest income on the loans is recognized as earned based on the terms of the loans, subject to evaluation of collectability risks, and is included in the Company’s consolidated statements of income. On a quarterly basis, the Company evaluates the collectability of its loan portfolio, including related interest income receivable, and establishes a reserve for loan losses, if necessary. No such losses have been recognized to date. Rental Revenue Rental revenue is recognized on a straight-line basis over the terms of the related leases when collectability is reasonably assured. Recognizing rental revenue on a straight-line basis for leases may result in recognizing revenue for amounts more or less than amounts currently due from tenants. Amounts recognized in excess of amounts currently due from tenants, excluding assets classified as held for sale, net of related allowances, are included in other assets and were approximately $56.7 million and $47.6 million as of September 30, 2018 and December 31, 2017 , respectively. If the Company determines that collectability of straight-line rents is not reasonably assured, the Company limits future recognition to amounts contractually owed and, where appropriate, establishes an allowance for estimated losses. Allowance for doubtful accounts, excluding assets classified as held for sale, was approximately $0.2 million and $4.9 million as of September 30, 2018 and December 31, 2017 , respectively. Rental revenue is adjusted by amortization of lease inducements and above or below market rents on certain leases. Lease inducements and above or below market rents are amortized over the remaining life of the lease. Expense Recoveries Expense recoveries relate to tenant reimbursement of real estate taxes, insurance, and other operating expenses that are recognized as expense recovery revenue in the period the applicable expenses are incurred. The reimbursements are recorded gross, as the Company is generally the primary obligor with respect to real estate taxes and purchasing goods and services from third-party suppliers, has discretion in selecting the supplier, and bears the credit risk of tenant reimbursement. The Company has certain tenants with absolute net leases. Under these lease agreements, the tenant is responsible for operating and building expenses. Derivative Instruments When the Company has derivative instruments embedded in other contracts, it records them either as an asset or a liability measured at their fair value unless they qualify for a normal purchase or normal sale exception. When specific hedge accounting criteria are not met, changes in the Company’s derivative instruments’ fair value are recognized currently in earnings. Changes in the fair market values of the Company’s derivative instruments are recorded in the consolidated statements of income if the derivative instruments do not qualify for, or the Company does not elect to apply for, hedge accounting. If hedge accounting is applied to a derivative instrument, such changes are reported in accumulated other comprehensive income within the consolidated statement of equity or capital, exclusive of ineffectiveness amounts, which are recognized as adjustments to net income. To manage interest rate risk for certain of its variable-rate debt, the Company uses interest rate swaps as part of its risk management strategy. These derivatives are designed to mitigate the risk of future interest rate increases by providing a fixed interest rate for a limited, pre-determined period of time. Interest rate swaps designated as cash flow hedges involve the receipt of variable-rate amounts from a counterparty in exchange for the Company making fixed-rate payments over the life of the agreements without exchange of the underlying notional amount. As of September 30, 2018 , the Company had five outstanding interest rate swap contracts that are designated as cash flow hedges of interest rate risk. For presentational purposes, they are shown as one derivative due to the identical nature of their economic terms. Further detail is provided in Note 7 (Derivatives) . The effective portion of the change in the fair value of derivatives designated and that qualify as cash flow hedges is recorded in accumulated other comprehensive income (“AOCI”) on the consolidated balance sheets and is subsequently reclassified into earnings as interest expense for the period that the hedged forecasted transaction affects earnings. The ineffective portion of the change in fair value of the derivatives is recognized directly in earnings. For the three and nine months ended September 30, 2018 and the three months ended September 30, 2017 hedge ineffectiveness was insignificant. For the nine months ended September 30, 2017 , the Company recorded a $0.2 million loss as a result of hedge ineffectiveness. The Company expects hedge ineffectiveness to be insignificant in the next 12 months. Income Taxes The Trust elected to be taxed as a REIT for federal tax purposes commencing with the filing of its tax return for the short taxable year ending December 31, 2013. The Trust had no taxable income prior to electing REIT status. To qualify as a REIT, the Trust must meet certain organizational and operational requirements, including a requirement to distribute at least 90% of its annual REIT taxable income to its shareholders (which is computed without regard to the dividends paid deduction or net capital gain and which does not necessarily equal net income as calculated in accordance with GAAP). As a REIT, the Trust generally will not be subject to federal income tax to the extent it distributes qualifying dividends to its shareholders. If the Trust fails to qualify as a REIT in any taxable year, it will be subject to federal income tax (including any applicable alternative minimum tax) on its taxable income at regular corporate income tax rates and generally will not be permitted to qualify for treatment as a REIT for federal income tax purposes for the four taxable years following the year during which qualification is lost, unless the Internal Revenue Service grants the Trust relief under certain statutory provisions. Such an event could materially adversely affect the Trust’s net income and net cash available for distribution to shareholders. However, the Trust intends to continue to operate in such a manner as to continue qualifying for treatment as a REIT. Although the Trust continues to qualify for taxation as a REIT, in various instances, the Trust is subject to state and local taxes on its income and property, and federal income and excise taxes on its undistributed income. As discussed in Note 1 (Organization and Business) , the Trust conducts substantially all of its operations through the Operating Partnership. As a partnership, the Operating Partnership generally is not liable for federal income taxes. The income and loss from the operations of the Operating Partnership is included in the tax returns of its partners, including the Trust, who are responsible for reporting their allocable share of the partnership income and loss. Accordingly, no provision for income taxes has been made on the accompanying consolidated financial statements. Tenant Receivables, Net Tenant accounts receivable are stated net of the applicable allowance. Rental payments under these contracts are primarily due monthly. The Company assesses the collectability of tenant receivables, including straight-line rent receivables, and defers recognition of revenue if collectability is not reasonably assured. The Company bases its assessment of the collectability of rent receivables on several factors, including, among other things, payment history, the financial strength of the tenant, and current economic conditions. If management’s evaluation of these factors indicates it is probable that the Company will be unable to recover the full value of the receivable, the Company provides a reserve against the portion of the receivable that it estimates may not be recovered. At September 30, 2018 and December 31, 2017 , the allowance for doubtful accounts was $0.5 million and $1.6 million , respectively. Management Estimates The preparation of consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities as of the date of the consolidated financial statements and the amounts of revenue and expenses reported in the period. Significant estimates are made for the fair value assessments with respect to purchase price allocations, impairment assessments, and the valuation of financial instruments. Actual results could differ from these estimates. Contingent Liabilities Certain of our acquisitions provide for additional consideration to the seller in the form of an earn-out associated with lease-up contingencies. The Company recognizes the contingent liabilities only if certain parameters or other substantive contingencies are met, at which time the consideration becomes payable. Resolved contingent liabilities increase our acquired assets and reduce our liabilities. In January 2017, the FASB issued ASU No. 2017-01, Clarifying the Definition of a Business , which changes the definition of a business to assist entities with evaluating when a set of transferred assets and activities is a business. The Company adopted ASU 2017-01 on January 1, 2018. As such, the Company will record the majority of future real estate investments as asset acquisitions and any future contingent consideration will be recorded when the contingency is resolved. Prior to January 1, 2018, the Company recorded certain contingent liabilities which are included in accrued expenses and other liabilities on its consolidated balance sheets. These were recorded at fair value as of the acquisition date and until they expire, the Company reassesses the fair value at the end of each reporting period, with any changes being recognized in earnings. Reclassifications Certain prior period amounts have been reclassified to conform to the current financial statement presentation, with no effect on the previously reported consolidated balance sheets or consolidated statements of income. Segment Reporting Under the provision of Codification Topic 280, Segment Reporting , the Company has determined that it has one reportable segment with activities related to leasing and managing healthcare properties. New Accounting Pronouncements In May 2014, the FASB issued ASU 2014-09, Revenue from Contracts with Customers , which creates a new Topic, Accounting Standards Codification Topic 606. The standard is principle-based and provides a five-step model to determine when and how revenue is recognized. The core principle is that a company should recognize revenue when it transfers promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. We adopted ASU 2014-09 as of January 1, 2018 under the modified retrospective approach. Based on our assessment, we have identified all of our revenue streams and concluded rental income from leasing arrangements represents a substantial portion of our revenue. Income from leasing arrangements is specifically excluded from Topic 606 and will be evaluated with the anticipated adoption of ASU 2016-02, Leases . Therefore, the impact of adopting ASU 2014-09 was minimal on our current recognition and presentation of non-lease revenue. Upon adoption of ASU 2016-02, Topic 606 may apply to executory costs and other components of revenue due under leases that are deemed to be non-lease components (such as common area maintenance and other reimbursement revenue), even when the revenue for such activities is not separately stipulated in the lease. In that case, the revenue from these items previously recognized on a straight-line basis under the current lease guidance would be recognized under the new revenue guidance as the related services are delivered. In February 2016, the FASB issued ASU 2016-02, Leases . The update amends the existing accounting standards for lease accounting, including requiring lessees to recognize most leases on their balance sheets and making targeted changes to lessor accounting. The standard provides the option of a modified retrospective transition approach or a cumulative effect for all leases existing at, or entered into after, the date of initial application, with an option to use certain transition relief. In July 2018, the FASB issued ASU 2018-11, Leases, Targeted Improvements ("ASU 2018-11"). ASU 2018-11 provides entities with a transition method option to not restate comparative periods presented, but to recognize a cumulative-effect adjustment to the opening balance of retained earnings in the period of adoption. In addition, ASU 2018-11 provides entities with a practical expedient allowing lessors to not separate non-lease components from the associated lease components when certain criteria are met. ASU 2016-02 and ASU 2018-11 are effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2018, and early adoption is permitted. We expect to elect these practical expedients and adopt ASC 842 on January 1, 2019. As a result of adopting ASU 2016-02, the Company will recognize all of its operating leases for which it is the lessee, including ground leases, on its consolidated balance sheets as a lease liability and corresponding right-of-use asset. We have

Acquisitions and Dispositions

Acquisitions and Dispositions	9 Months Ended
	Sep. 30, 2018
Business Combinations [Abstract]
Acquisitions and Dispositions	Acquisitions and Dispositions Effective January 1, 2018, with our adoption of ASU 2017-01, transaction costs incurred for asset acquisitions are capitalized as a component of purchase price and all other non-capitalizable costs are reflected in “General and Administrative Expenses” on our consolidated statements of income. Certain acquisitions that occurred prior to January 1, 2018 were accounted for as business combinations. During the nine months ended September 30, 2018 , the Company completed acquisitions of 4 operating healthcare properties and 1 land parcel located in 5 states for an aggregate purchase price of approximately $252.8 million . The Company completed a noncontrolling interest buyout for $6.4 million , and a $2.0 million loan transaction, resulting in total investment activity of approximately $261.3 million . The Company also acquired 2 properties and an adjacent land parcel through the conversion and satisfaction of a previously outstanding construction loan. Additionally, the Company acquired 2 parcels of land, which it had previously leased, as the result of a lease restructuring arrangement and equity recapitalization. During the three months ended September 30, 2018 , the Company completed the acquisition of the Northside Medical Midtown MOB located in Atlanta, GA for approximately $82.1 million . The Company also acquired 2 properties and an adjacent land parcel through the conversion and satisfaction of a previously outstanding construction loan, valued at an aggregate $18.8 million . Additionally, the Company acquired 2 parcels of land, which it had previously leased, as the result of a lease restructuring arrangement and equity recapitalization. For the three months ended September 30, 2018 , the Company recorded revenues and net income from its 2018 acquisitions of $3.9 million and $1.4 million , respectively. For the nine months ended September 30, 2018 , the Company recorded revenues and net income from its 2018 acquisitions of $9.3 million and $3.4 million , respectively. The following table summarizes the acquisition date fair values of the assets acquired and the liabilities assumed, which the Company determined using Level 2 and Level 3 inputs (in thousands): 1st Quarter 2nd Quarter 3rd Quarter Total Land $ 7,684 $ — $ 9,632 $ 17,316 Building and improvements 82,180 64,197 67,772 214,149 In-place lease intangibles 13,202 8,923 11,777 33,902 Above market in-place lease intangibles 969 — 98 1,067 Below market in-place lease intangibles (959 ) — — (959 ) Below market in-place ground lease — — 5,329 5,329 Mortgage escrow — — 7,862 7,862 Prepaid expenses (2,628 ) — — (2,628 ) Issuance of Series A Preferred Units (22,651 ) — — (22,651 ) Net assets acquired $ 77,797 $ 73,120 $ 102,470 $ 253,387 Dispositions During the three months ended March 31, 2018, the Company sold 2 medical office buildings located in Michigan and Florida for approximately $2.5 million and recognized a net gain on the sale of approximately $0.1 million . During the three months ended June 30, 2018, the Company sold 15 medical office buildings located in 3 states for approximately $90.7 million and recognized a net loss on the sale of approximately $2.6 million . During the three months ended September 30, 2018 , the Company sold 17 medical office buildings located in 7 states for approximately $127.2 million and recognized a net gain on the sale of approximately $14.2 million . The following table summarizes revenues and net income related to the disposed properties for the periods presented (in thousands): Three Months Ended Nine Months Ended 2018 2017 2018 2017 Revenues $ 947 $ 5,770 $ 12,295 $ 17,906 Income before net gain on sale of investment properties: $ 1,827 $ 1,411 $ 5,030 $ 4,956 Gain on sale of investment properties, net 14,227 — 11,664 — Net income $ 16,054 $ 1,411 $ 16,694 $ 4,956 Assets Held for Sale As of September 30, 2018 , the Company classified one portfolio comprised of two properties as held for sale. In accordance with this classification, the following assets are classified as held for sale in the accompanying consolidated balance sheets at September 30, 2018 . Land and improvements $ 3,780 Building and improvements 28,127 Acquired lease intangibles 6,077 Other assets 3,491 Real estate held for sale before accumulated deprecation 41,475 Accumulated depreciation (6,049 ) Real estate held for sale $ 35,426

Intangibles

Intangibles	9 Months Ended
	Sep. 30, 2018
Finite-Lived Intangible Assets, Net [Abstract]
Intangibles	Intangibles The following is a summary of the carrying amount of intangible assets and liabilities, excluding assets classified as held for sale if applicable, as of September 30, 2018 and December 31, 2017 (in thousands): September 30, 2018 December 31, 2017 Cost Accumulated Amortization Net Cost Accumulated Amortization Net Assets In-place leases $ 339,795 $ (102,068 ) $ 237,727 $ 343,429 $ (85,424 ) $ 258,005 Above-market leases 43,472 (11,787 ) 31,685 54,148 (11,968 ) 42,180 Leasehold interest 712 (226 ) 486 712 (183 ) 529 Below-market ground leases 65,677 (1,925 ) 63,752 60,424 (1,344 ) 59,080 Total $ 449,656 $ (116,006 ) $ 333,650 $ 458,713 $ (98,919 ) $ 359,794 Liabilities Below-market leases $ 14,870 $ (6,374 ) $ 8,496 $ 14,344 $ (4,479 ) $ 9,865 Above-market ground leases 5,965 (232 ) 5,733 5,965 (128 ) 5,837 Total $ 20,835 $ (6,606 ) $ 14,229 $ 20,309 $ (4,607 ) $ 15,702 The following is a summary of acquired lease intangible amortization for the three and nine month periods ended September 30, 2018 and 2017 , respectively (in thousands): Three Months Ended Nine Months Ended 2018 2017 2018 2017 Amortization expense related to in-place leases $ 16,274 $ 9,453 $ 38,251 $ 26,520 Decrease of rental income related to above-market leases 1,075 1,335 3,992 3,987 Decrease of rental income related to leasehold interest 15 15 44 44 Increase of rental income related to below-market leases 615 623 2,109 1,704 Decrease of operating expense related to above-market ground leases 33 34 104 49 Increase in operating expense related to below-market ground leases 255 208 745 581 In the three months ended September 30, 2018 , the Company amortized the remaining $6.6 million in-place lease intangibles on a lease which was terminated. In the nine months ended September 30, 2018 , the Company amortized in-place lease intangibles of $6.8 million from new properties purchased since September 30, 2017 , $6.6 million from a lease termination, offset by a $1.8 million decrease in amortization from our sold properties during the last twelve months. Future aggregate net amortization of the acquired lease intangibles, excluding two assets classified as held for sale, as of September 30, 2018 , is as follows (in thousands): Net Decrease in Revenue Net Increase in Expenses 2018 $ (573 ) $ 9,712 2019 (2,417 ) 35,517 2020 (2,554 ) 32,791 2021 (2,517 ) 30,513 2022 (2,055 ) 26,677 Thereafter (13,559 ) 160,536 Total $ (23,675 ) $ 295,746 As of September 30, 2018 , the weighted average amortization period for asset lease intangibles and liability lease intangibles is 20 and 21 years, respectively.

Other Assets

Other Assets	9 Months Ended
	Sep. 30, 2018
Other Assets, Unclassified [Abstract]
Other Assets	Other Assets Other assets consisted of the following, excluding assets classified as held for sale if applicable, as of September 30, 2018 and December 31, 2017 (in thousands): September 30, December 31, Straight line rent receivable, net $ 56,702 $ 47,599 Interest rate swap 21,200 14,693 Note receivable 20,628 — Prepaid expenses 17,060 18,103 Lease inducements, net 12,774 14,232 Escrows 9,552 1,996 Leasing commissions, net 5,826 4,128 Earnest deposits — 2,780 Other 4,825 2,771 Total $ 148,567 $ 106,302

Debt

Debt	9 Months Ended
	Sep. 30, 2018
Debt Disclosure [Abstract]
Debt	Debt The following is a summary of debt as of September 30, 2018 and December 31, 2017 (in thousands): September 30, December 31, Fixed interest mortgage notes $ 120,931 (1) $ 158,171 (2) Variable interest mortgage notes 13,908 (3) 28,509 (4) Total mortgage debt 134,839 186,680 $850 million unsecured revolving credit facility bearing variable interest of LIBOR plus 1.10% at September 30, 2018 and LIBOR plus 1.20% at December 30, 2017, due September 2022 179,000 80,000 $400 million senior unsecured notes bearing fixed interest of 4.30%, due March 2027 400,000 400,000 $350 million senior unsecured notes bearing fixed interest of 3.95%, due January 2028 350,000 350,000 $250 million unsecured term borrowing bearing fixed interest of 2.32% at September 30, 2018 and 2.87% at December 31, 2017, due June 2023 250,000 (5) 250,000 (6) $150 million senior unsecured notes bearing fixed interest of 4.03% to 4.74%, due January 2023 to 2031 150,000 150,000 $75 million senior unsecured notes bearing fixed interest of 4.09% to 4.24%, due August 2025 to 2027 75,000 75,000 Total principal 1,538,839 1,491,680 Unamortized deferred financing costs (10,407 ) (7,808 ) Unamortized discount (6,233 ) (6,663 ) Unamortized fair value adjustment 213 259 Total debt $ 1,522,412 $ 1,477,468 (1) Fixed interest mortgage notes, bearing interest from 3.00% to 5.50% , with a weighted average interest rate of 4.37% , and due in 2019, 2020, 2021, 2022, and 2024 collateralized by six properties with a net book value of $210.9 million . (2) Fixed interest mortgage notes, bearing interest from 3.00% to 5.50% , with a weighted average interest rate of 4.45% , and due in 2018, 2019, 2020, 2021, 2022, and 2024 collateralized by nine properties with a net book value of $267.7 million . (3) Variable interest mortgage notes, bearing variable interest of LIBOR plus 2.25% to Wall Street Journal Prime plus 1.75% , with a weighted average interest rate of 5.75% and due in 2018 and 2022 collateralized by two properties with a net book value of $31.8 million . (4) Variable interest mortgage notes, bearing variable interest of LIBOR plus 2.25% to 3.25% , with a weighted average interest rate of 4.50% and due 2018 collateralized by three properties with a net book value of $39.2 million . (5) The Trust’s borrowings under the term loan feature of the Credit Agreement bear interest at a rate which is determined by the Trust’s credit rating, currently equal to LIBOR + 1.25% . The Trust has entered into a pay-fixed receive-variable interest rate swap, fixing the LIBOR component of this rate at 1.07% . (6) The Trust’s borrowings under the term loan feature of the Credit Agreement bear interest at a rate which is determined by the Trust’s credit rating, equal to LIBOR + 1.80% . The Trust has entered into a pay-fixed receive-variable interest rate swap, fixing the LIBOR component of this rate at 1.07% . On August 7, 2018 , the Operating Partnership, as borrower, and the Trust executed a Second Amended and Restated Credit Agreement (the “Credit Agreement”) extending the maturity date of the revolving credit facility under the Credit Agreement and reducing the interest rate margin applicable to borrowings. The Credit Agreement includes unsecured revolving credit facility of $850 million and contains a 7 -year term loan feature of $250 million , bringing total borrowing capacity to $1.1 billion . The Credit Agreement also includes a swingline loan commitment for up to 10% of the maximum principal amount and provides an accordion feature allowing the Trust to increase borrowing capacity by up to an additional $500 million , subject to customary terms and conditions, resulting in a maximum borrowing capacity of $1.6 billion . The revolving credit facility under the Credit Agreement has a maturity date of September 18, 2022 , extended from September 18, 2020 per the amendment, and includes a one -year extension option. Borrowings under the Credit Agreement bear interest on the outstanding principal amount at an adjusted LIBOR rate, which is based on the Trust’s investment grade rating under the Credit Agreement. As of September 30, 2018 , the Trust had an investment grade rating of Baa3 from Moody’s and BBB- from S&P. As such, borrowings under the revolving credit facility of the Credit Agreement accrue interest on the outstanding principal at a rate of LIBOR + 1.10% , a reduction from LIBOR + 1.20% . The Credit Agreement includes a facility fee equal to 0.25% per annum, which is also determined by the Trust’s investment grade rating. On July 7, 2016, the Operating Partnership borrowed $250.0 million under the 7 -year term loan feature of the Credit Agreement. Pursuant to the credit agreement, borrowings under the term loan feature of the Credit Agreement bear interest on the outstanding principal amount at a rate which is determined by the Trust’s credit rating, currently equal to LIBOR + 1.25% , a reduction from LIBOR + 1.80% . The Trust simultaneously entered into a pay-fixed receive-variable rate swap for the full borrowing amount, fixing the LIBOR component of the borrowing rate to 1.07% , for a current all-in fixed rate of 2.32% . Both the borrowing and pay-fixed receive-variable swap have a maturity date of June 10, 2023 . Base Rate Loans, Adjusted LIBOR Rate Loans, and Letters of Credit (each, as defined in the Credit Agreement) will be subject to interest rates, based upon the Trust’s investment grade rating as follows: Credit Rating Margin for Revolving Loans: Adjusted LIBOR Rate Loans and Letter of Credit Fee Margin for Revolving Loans: Base Rate Loans Margin for Term Loans: Adjusted LIBOR Rate Loans and Letter of Credit Fee Margin for Term Loans: Base Rate Loans At Least A- or A3 LIBOR + 0.775% — % LIBOR + 0.85% — % At Least BBB+ or Baa1 LIBOR + 0.825% — % LIBOR + 0.90% — % At Least BBB or Baa2 LIBOR + 0.90% — % LIBOR + 1.00% — % At Least BBB- or Baa3 LIBOR + 1.10% 0.10 % LIBOR + 1.25% 0.25 % Below BBB- or Baa3 LIBOR + 1.45% 0.45 % LIBOR + 1.65% 0.65 % The Credit Agreement contains financial covenants that, among other things, require compliance with leverage and coverage ratios and maintenance of minimum tangible net worth, as well as covenants that may limit the Trust’s and the Operating Partnership’s ability to incur additional debt, grant liens, or make distributions. The Company may, at any time, voluntarily prepay any revolving or term loan under the Credit Agreement in whole or in part without premium or penalty. As of September 30, 2018 , the Company was in compliance with all financial covenants related to the Credit Agreement. The Credit Agreement includes customary representations and warranties by the Trust and the Operating Partnership and imposes customary covenants on the Operating Partnership and the Trust. The Credit Agreement also contains customary events of default, and if an event of default occurs and continues, the Operating Partnership is subject to certain actions by the administrative agent, including without limitation, the acceleration of repayment of all amounts outstanding under the Credit Agreement. As of September 30, 2018 , the Company had $179.0 million of borrowings outstanding under its unsecured revolving credit facility, and $250.0 million of borrowings outstanding under the term loan feature of the Credit Agreement. The Company has also issued a letter of credit for $17.0 million with no outstanding balance as of September 30, 2018 . As defined by the Credit Agreement, $654.0 million is available to borrow without adding additional properties to the unencumbered borrowing base of assets. On January 7, 2016, the Operating Partnership issued and sold $150.0 million aggregate principal amount of senior notes, comprised of (i) $15.0 million aggregate principal amount of 4.03% Senior Notes, Series A, due January 7, 2023, (ii) $45.0 million aggregate principal amount of 4.43% Senior Notes, Series B, due January 7, 2026, (iii) $45.0 million aggregate principal amount of 4.57% Senior Notes, Series C, due January 7, 2028, and (iv) $45.0 million aggregate principal amount of 4.74% Senior Notes, Series D, due January 7, 2031. On August 11, 2016, the note agreement for these notes was amended to make certain changes to its terms, including certain changes to affirmative covenants, negative covenants, and definitions contained therein. Interest on each respective series of the January 2016 Senior Notes is payable semi-annually. On August 11, 2016, the Operating Partnership issued and sold $75.0 million aggregate principal amount of senior notes, comprised of (i) $25.0 million aggregate principal amount of 4.09% Senior Notes, Series A, due August 11, 2025, (ii) $25.0 million aggregate principal amount of 4.18% Senior Notes, Series B, due August 11, 2026, and (iii) $25.0 million aggregate principal amount of 4.24% Senior Notes, Series C, due August 11, 2027. Interest on each respective series of the August 2016 Senior Notes is payable semi-annually. On March 7, 2017 , the Operating Partnership issued and sold $ 400.0 million aggregate principal amount of 4.30% Senior Notes which will mature on March 15, 2027 . The Senior Notes began accruing interest on March 7, 2017 and began paying interest semi-annually beginning September 15, 2017 . The Senior Notes were sold at an issue price of 99.68% of their face value, before the underwriters’ discount. Our net proceeds from the offering, after deducting underwriting discounts and expenses, were approximately $396.1 million . On December 1, 2017 , the Operating Partnership issued and sold $350.0 million aggregate principal amount of 3.95% Senior Notes which will mature on January 15, 2028 . The Senior Notes began accruing interest on December 1, 2017 and will begin paying interest semi-annually beginning July 15, 2018 . The Senior Notes were sold at an issue price of 99.78% of their face value, before the underwriters’ discount. Our net proceeds from the offering, after deducting underwriting discounts and expenses, were approximately $347.0 million . Certain properties have mortgage debt that contains financial covenants. As of September 30, 2018 , the Trust was in compliance with all mortgage debt financial covenants. Scheduled principal payments due on debt as of September 30, 2018 , are as follows (in thousands): 2018 (1) $ 7,267 2019 44,355 2020 25,721 2021 8,592 2022 204,178 Thereafter 1,248,726 Total Payments $ 1,538,839 (1) As of September 30, 2018 , a $6.8 million mortgage was in the process of being refinanced. The refinance agreement is expected to be completed by the end of the year and will mature in 2028 . As of September 30, 2018 , the Company had total consolidated indebtedness of approximately $1.5 billion . The weighted average interest rate on consolidated indebtedness was 3.81% (based on the 30-day LIBOR rate as of September 30, 2018 , of 2.18% ). For the three month periods ended September 30, 2018 and 2017 , the Company incurred interest expense on its debt, exclusive of deferred financing cost amortization, of $16.5 million and $11.4 million , respectively. For the nine month periods ended September 30, 2018 and 2017 , the Company incurred interest expense on its debt, exclusive of deferred financing cost amortization, of $50.1 million and $31.6 million , respectively.

Derivatives

Derivatives	9 Months Ended
	Sep. 30, 2018
Derivative Instrument Detail [Abstract]
Derivatives	Derivatives In the normal course of business, a variety of financial instruments are used to manage or hedge interest rate risk. The Company has implemented ASC 815, Derivatives and Hedging (ASC 815), which establishes accounting and reporting standards requiring that all derivatives, including certain derivative instruments embedded in other contracts, be recorded as either an asset or a liability measured at their fair value unless they qualify for a normal purchase or normal sales exception. When specific hedge accounting criteria are not met, ASC 815 requires that changes in a derivative’s fair value be recognized currently in earnings. Changes in the fair market values of the Company’s derivative instruments are recorded in the consolidated statements of income if such derivatives do not qualify for, or the Company does not elect to apply for, hedge accounting. If hedge accounting is applied to a derivative instrument, such changes are reported in accumulated other comprehensive income within the consolidated statements of equity, exclusive of ineffectiveness amounts, which are recognized as adjustments to net income. To manage interest rate risk for certain of its variable-rate debt, the Company uses interest rate swaps as part of its risk management strategy. These derivatives are designed to mitigate the risk of future interest rate increases by providing a fixed interest rate for a limited, pre-determined period of time. Interest rate swaps designated as cash flow hedges involve the receipt of variable-rate amounts from a counterparty in exchange for the Company making fixed-rate payments over the life of the agreements without exchange of the underlying notional amount. As of September 30, 2018 , the Company had five outstanding interest rate swap contracts that are designated as cash flow hedges of interest rate risk. For presentational purposes, they are shown as one derivative due to the identical nature of their economic terms. The effective portion of the change in the fair value of derivatives designated and that qualify as cash flow hedges is recorded in accumulated other comprehensive income (“AOCI”) on the consolidated balance sheets and is subsequently reclassified into earnings as interest expense for the period that the hedged forecasted transaction affects earnings. The ineffective portion of the change in fair value of the derivatives is recognized directly in earnings. Hedge ineffectiveness was insignificant for the three and nine months ended September 30, 2018 and the three months ended September 30, 2017 . For the nine months ended September 30, 2017 the Company recognized a $0.2 million loss as a result of hedge ineffectiveness. The Company expects hedge ineffectiveness to be insignificant in the next 12 months. The following table summarizes the location and aggregate fair value of the interest rate swaps on the Company’s consolidated balance sheets (in thousands): Total notional amount $ 250,000 Effective fixed interest rate (1) 2.32 % Effective date 7/7/2016 Maturity date 6/10/2023 Asset balance at September 30, 2018 (included in Other assets) $ 21,200 Asset balance at December 31, 2017 (included in Other assets) $ 14,693 (1) 1.07% effective swap rate plus 1.25% spread per Credit Agreement. As of December 31, 2017 , the effective fixed interest rate was 2.87% with a 1.07% effective swap rate plus 1.80% spread per the previous Credit Agreement.

Accrued Expenses and Other Liab

Accrued Expenses and Other Liabilities	9 Months Ended
	Sep. 30, 2018
Other Liabilities Disclosure [Abstract]
Accrued Expenses and Other Liabilities	Accrued Expenses and Other Liabilities Accrued expenses and other liabilities consisted of the following as of September 30, 2018 and December 31, 2017 (in thousands): September 30, December 31, Real estate taxes payable $ 22,476 $ 16,103 Prepaid rent 10,830 10,496 Accrued interest 5,894 11,107 Accrued expenses 5,605 8,751 Embedded derivative 3,575 — Security deposits 3,408 2,882 Tenant improvement allowance 2,995 3,065 Accrued incentive compensation 2,973 1,625 Contingent consideration 753 1,454 Other 2,837 922 Total $ 61,346 $ 56,405

Stock-based Compensation

Stock-based Compensation	9 Months Ended
	Sep. 30, 2018
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Stock-based Compensation	Stock-based Compensation The Company follows ASC 718, Compensation - Stock Compensation (“ASC 718”), in accounting for its share-based payments. This guidance requires measurement of the cost of employee services received in exchange for stock compensation based on the grant-date fair value of the employee stock awards. This cost is recognized as compensation expense ratably over the employee’s requisite service period. Incremental compensation costs arising from subsequent modifications of awards after the grant date must be recognized when incurred. Share-based payments classified as liability awards are marked to fair value at each reporting period. Any common shares issued pursuant to the Company's incentive equity compensation and employee stock purchase plans will result in the Operating Partnership issuing OP Units to the Trust on a one-for-one basis, with the Operating Partnership receiving the net cash proceeds of such issuances. Certain of the Company’s employee stock awards vest only upon the achievement of performance targets. ASC 718 requires recognition of compensation cost only when achievement of performance conditions is considered probable. Consequently, the Company’s determination of the amount of stock compensation expense requires a significant level of judgment in estimating the probability of achievement of these performance targets. Subsequent changes in actual experience are monitored and estimates are updated as information is available. In connection with the IPO, the Trust adopted the 2013 Equity Incentive Plan (“2013 Plan”), which made available 600,000 common shares to be administered by the Compensation Committee of the Board of Trustees. On August 7, 2014, at the Annual Meeting of Shareholders of Physicians Realty Trust, the Trust’s shareholders approved an amendment to the 2013 Plan to increase the number of common shares authorized for issuance under the 2013 Plan by 1,850,000 common shares, for a total of 2,450,000 common shares authorized for issuance. Restricted Common Shares Restricted common shares granted under the 2013 Plan are eligible for dividends as well as the right to vote. In the nine month period ended September 30, 2018 , the Trust granted a total of 206,446 restricted common shares with a total value of $3.1 million to its officers and certain of its employees, which have a vesting period of one to three years. A summary of the status of the Trust’s non-vested restricted common shares as of September 30, 2018 and changes during the nine month period then ended follow: Common Shares Weighted Average Grant Date Fair Value Non-vested at December 31, 2017 173,276 $ 19.36 Granted 206,446 14.87 Vested (142,243 ) 19.65 Non-vested at September 30, 2018 237,479 $ 15.28 For all service awards, the Company records compensation expense for the entire award on a straight-line basis over the requisite service period. For the three month periods ended September 30, 2018 and 2017 , the Company recognized non-cash share compensation of $0.8 million . For the nine month periods ended September 30, 2018 and 2017 , the Company recognized non-cash share compensation of $2.3 million . Unrecognized compensation expense at September 30, 2018 was $1.8 million . Restricted Share Units In March 2018 , under the 2013 Plan, the Trust granted restricted share units at a target level of 254,282 to its officers and certain of its employees and 50,745 to its trustees, which are subject to certain performance, timing, and market conditions and three -year and two -year service periods for officers/employees and trustees, respectively. In addition, each restricted share unit contains one dividend equivalent. The recipient will accrue dividend equivalents on awarded share units equal to the cash dividend that would have been paid on the awarded share unit had the awarded share unit been an issued and outstanding common share on the record date for the dividend. Approximately 40% of the restricted share units issued to officers and certain employees vest based on certain market conditions. The market conditions were valued with the assistance of independent valuation specialists. The Company utilized a Monte Carlo simulation to calculate the weighted average grant date fair value of $19.28 per unit for the March 2018 grant using the following assumptions: Volatility 21.7 % Dividend assumption reinvested Expected term in years 2.8 years Risk-free rate 2.40 % Share price (per share) $ 14.78 The remaining 60% of the restricted share units issued to officers and certain employees, and 100% of restricted share units issued to trustees, vest based upon certain performance or timing conditions. With respect to the performance conditions of the March 2018 grant, the grant date fair value of $14.78 per unit was based on the share price at the date of grant. The combined weighted average grant date fair value of the March 2018 restricted share units issued to officers and certain employees is $16.58 per unit. The following is a summary of the activity in the Trust’s restricted share units during the nine months ended September 30, 2018 : Executive Awards Trustee Awards Restricted Share Units Weighted Average Grant Date Fair Value Restricted Share Weighted Non-vested at December 31, 2017 354,123 $ 26.30 51,220 $ 19.04 Granted 254,282 16.58 50,745 14.78 Vested (75,250 ) (1) 21.16 (34,807 ) 18.67 Non-vested at September 30, 2018 533,155 $ 22.66 67,158 $ 16.01 (1) Restricted units vested by Company executives in 2018 resulted in the issuance of 126,108 common shares, less 56,502 common shares withheld to cover minimum withholding tax obligations, for multiple employees. For the three month periods ending September 30, 2018 and 2017 , the Trust recognized non-cash share restricted unit compensation expense of $1.2 million and $1.0 million , respectively. For the nine month periods ending September 30, 2018 and 2017 , the Trust recognized non-cash share restricted unit compensation expense of $4.3 million and $2.7 million , respectively. Unrecognized compensation expense at September 30, 2018 was $6.4 million .

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2018
Fair Value Disclosures [Abstract]
Fair Value Measurements	Fair Value Measurements ASC Topic 820, Fair Value Measurement (“ASC 820”), requires certain assets and liabilities be reported and/or disclosed at fair value in the financial statements and provides a framework for establishing that fair value. The framework for determining fair value is based on a hierarchy that prioritizes the valuation techniques and inputs used to measure fair value. In general, fair values determined by Level 1 inputs use quoted prices in active markets for identical assets or liabilities that the Company has the ability to access. Fair values determined by Level 2 inputs use other inputs that are observable, either directly or indirectly. These Level 2 inputs include quoted prices for similar assets and liabilities in active markets, and other inputs such as interest rates and yield curves that are observable at commonly quoted intervals. Level 3 inputs are unobservable inputs, including inputs that are available in situations where there is little, if any, market activity for the related asset. These Level 3 fair value measurements are based primarily on management’s own estimates using pricing models, discounted cash flow methodologies, or similar techniques taking into account the characteristics of the asset or liability. In instances where inputs used to measure fair value fall into different levels of the fair value hierarchy, fair value measurements in their entirety are categorized based on the lowest level input that is significant to the valuation. The assessment of the significance of particular inputs to these fair value measurements requires judgment and considers factors specific to each asset or liability. The Company’s derivative instruments as of September 30, 2018 consist of one embedded derivative as detailed in the Redeemable Noncontrolling Interests - Series A Preferred Units and Partially Owned Properties section of Note 2 ( Summary of Significant Accounting Policies ) and five interest rate swaps. For presentational purposes, the Company’s interest rate swaps are shown as a single derivative due to the identical nature of their economic terms, as detailed in the Derivative Instruments section of Note 2 (Summary of Significant Accounting Policies) and Note 7 (Derivatives) . Neither the embedded derivative nor the interest rate swaps are traded on an exchange. The Company’s derivative assets and liabilities are recorded at fair value based on a variety of observable inputs including contractual terms, interest rate curves, yield curves, measure of volatility, and correlations of such inputs. The Company measures its derivatives at fair value on a recurring basis. The fair values are based on Level 2 inputs described above. The Company considers its own credit risk, as well as the credit risk of its counterparties, when evaluating the fair value of its derivatives. The Company also has assets that under certain conditions are subject to measurement at fair value on a non-recurring basis. This generally includes assets subject to impairment. There were no such assets measured at fair value as of September 30, 2018 . The carrying amounts of cash and cash equivalents, tenant receivables, payables, and accrued interest are reasonable estimates of fair value because of the short-term maturities of these instruments. Fair values for real estate loans receivable and mortgage debt are estimated based on rates currently prevailing for similar instruments of similar maturities and are based primarily on Level 2 inputs. As of September 30, 2018 , the Company classified one portfolio, comprised of two properties, as held for sale. Upon classification as held for sale, the Company records the portfolio at the lower of its carrying amount or fair value, less costs to sell. Fair value is generally based on discounted cash flow analyses, which involved management’s best estimate of market participants’ holding period, market comparables, future occupancy levels, rental rates, capitalization rates, lease-up periods, and capital requirements. As of September 30, 2018 , fair value exceeds carrying value of our assets classified as held for sale and therefore, are recorded at respective carrying value. The following table presents the fair value of the Company’s financial instruments (in thousands): September 30, December 31, Carrying Amount Fair Value Carrying Amount Fair Value Assets: Real estate loans receivable $ 47,911 $ 46,218 $ 76,195 $ 75,288 Notes receivable $ 20,628 $ 20,628 $ — $ — Derivative assets $ 21,200 $ 21,200 $ 14,693 $ 14,693 Liabilities: Credit facility $ (429,000 ) $ (429,000 ) $ (330,000 ) $ (330,000 ) Notes payable $ (975,000 ) $ (909,510 ) $ (975,000 ) $ (970,975 ) Mortgage debt $ (135,052 ) $ (133,963 ) $ (186,939 ) $ (185,743 )

Tenant Operating Leases

Tenant Operating Leases	9 Months Ended
	Sep. 30, 2018
Leases [Abstract]
Tenant Operating Leases	Tenant Operating Leases The Company is lessor of medical office buildings and other healthcare facilities. Leases have expirations from 2018 through 2039 . As of September 30, 2018 , the future minimum rental payments on non-cancelable leases, exclusive of expense recoveries and two assets classified as held for sale, were as follows (in thousands): 2018 $ 70,531 2019 282,261 2020 278,483 2021 273,233 2022 262,669 Thereafter 1,310,257 Total $ 2,477,434

Rent Expense

Rent Expense	9 Months Ended
	Sep. 30, 2018
Leases [Abstract]
Rent Expense	Rent Expense The Company leases the rights to parking structures at three of its properties, the air space above one property, and the land upon which 76 of its properties are located from third party land owners pursuant to separate leases. In addition, the Company leases five individual office spaces. The Company’s leases require fixed rental payments and may also include escalation clauses and renewal options. These leases have terms of up to 87 years remaining, excluding extension options. As of September 30, 2018 , the future minimum lease obligations under non-cancelable parking, air, ground, and office leases, exclusive of the two assets classified as held for sale, were as follows (in thousands): 2018 $ 794 2019 3,058 2020 3,013 2021 3,037 2022 3,030 Thereafter 146,119 Total $ 159,051 Rent expense for the parking, air, and ground leases of $0.6 million for the three months ended both September 30, 2018 and 2017 and $1.8 million for the nine months ended both September 30, 2018 and 2017 are reported in operating expenses in the consolidated statements of income. Rent expense for office leases was insignificant for the three months ended ended September 30, 2018 and 2017 and the nine months ended September 30, 2018 and 2017 . Rent expense is reported within general and administrative expenses in the consolidated statements of income.

Credit Concentration

Credit Concentration	9 Months Ended
	Sep. 30, 2018
Concentration Risks, Types, No Concentration Percentage [Abstract]
Credit Concentration	Credit Concentration The Company uses annualized base rent (“ABR”) as its credit concentration metric. A nnualized base rent is calculated by multiplying contractual base rent for the month ended September 30, 2018 by 12, excluding the impact of concessions and straight-line rent. The following table summarizes certain information about the Company’s top five tenant credit concentrations as of September 30, 2018 , excluding assets classified as held for sale (in thousands): Tenant Total ABR Percent of ABR CHI - Nebraska $ 16,336 5.8 % CHI - KentuckyOne Health 13,574 4.8 % Northside Hospital 9,860 3.5 % Baylor Scott and White Health 7,583 2.7 % Ascension - St. Vincent's - Indianapolis 7,271 2.6 % Remaining portfolio 226,666 80.6 % Total $ 281,290 100.0 % Annualized base rent collected from the Company’s top five tenant relationships comprises 19.4% of its total annualized base rent for the period ending September 30, 2018 . Total annualized base rent from CHI affiliated tenants totals 19.5% , including the affiliates disclosed above. Consolidated financial statements of CHI, the parent of the subsidiaries and affiliates of the entities party to master lease agreements, are publicly available on the Catholic Health Initiatives website (www.catholichealthinitiatvies.org/). Information included on the CHI website is not incorporated by reference within this Quarterly Report on Form 10-Q. The following table summarizes certain information about the Company’s top five geographic concentrations as of September 30, 2018 , excluding two assets classified as held for sale (in thousands): State Total ABR Percent of ABR Texas $ 42,458 15.1 % Georgia 24,372 8.7 % Indiana 19,749 7.0 % Nebraska 17,734 6.3 % Minnesota 16,858 6.0 % Other 160,119 56.9 % Total $ 281,290 100.0 %

Earnings Per Share and Earnings

Earnings Per Share and Earnings Per Unit	9 Months Ended
	Sep. 30, 2018
Earnings Per Share [Abstract]
Earnings Per Share and Earnings Per Unit	Earnings Per Share and Earnings Per Unit For the three and nine months ended September 30, 2018 , total restricted share units of 600,313 were excluded from the computation of diluted earnings per share and diluted earnings per unit as their impact would have been anti-dilutive. The following table shows the amounts used in computing the Trust’s basic and diluted earnings per share (in thousands, except share and per share data): Three Months Ended Nine Months Ended 2018 2017 2018 2017 Numerator for earnings per share - basic: Net income $ 23,771 $ 12,539 $ 47,165 $ 29,586 Net income attributable to noncontrolling interests: Operating Partnership (656 ) (362 ) (1,300 ) (823 ) Partially owned properties (119 ) (53 ) (374 ) (379 ) Preferred distributions (284 ) (106 ) (1,055 ) (505 ) Numerator for earnings per share - basic $ 22,712 $ 12,018 $ 44,436 $ 27,879 Numerator for earnings per share - diluted: Numerator for earnings per share - basic $ 22,712 $ 12,018 $ 44,436 $ 27,879 Operating Partnership net income 656 362 1,300 823 Numerator for earnings per share - diluted $ 23,368 $ 12,380 $ 45,736 $ 28,702 Denominator for earnings per share - basic and diluted: Weighted average number of shares outstanding - basic 182,076,513 177,847,424 181,963,693 157,542,167 Effect of dilutive securities: Noncontrolling interest - Operating Partnership units 5,291,025 5,379,981 5,378,760 4,663,157 Restricted common shares 105,692 70,740 80,272 85,689 Restricted share units — — 199,384 189,905 Denominator for earnings per share - diluted: 187,473,230 183,298,145 187,622,109 162,480,918 Earnings per share - basic $ 0.12 $ 0.07 $ 0.24 $ 0.18 Earnings per share - diluted $ 0.12 $ 0.07 $ 0.24 $ 0.18 The following table shows the amounts used in computing the Operating Partnership’s basic and diluted earnings per unit (in thousands, except unit and per unit data): Three Months Ended Nine Months Ended 2018 2017 2018 2017 Numerator for earnings per unit - basic and diluted: Net income $ 23,771 $ 12,539 $ 47,165 $ 29,586 Net income attributable to noncontrolling interests - partially owned properties (119 ) (53 ) (374 ) (379 ) Preferred distributions (284 ) (106 ) (1,055 ) (505 ) Numerator for earnings per unit - basic and diluted $ 23,368 $ 12,380 $ 45,736 $ 28,702 Denominator for earnings per unit - basic and diluted: Weighted average number of units outstanding - basic 187,367,538 183,227,405 187,342,453 162,205,324 Effect of dilutive securities: Restricted common shares 105,692 70,740 80,272 85,689 Restricted share units — — 199,384 189,905 Denominator for earnings per unit - diluted 187,473,230 183,298,145 187,622,109 162,480,918 Earnings per unit - basic $ 0.12 $ 0.07 $ 0.24 $ 0.18 Earnings per unit - diluted $ 0.12 $ 0.07 $ 0.24 $ 0.18

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2018
Accounting Policies [Abstract]
Principles of Consolidation	Principles of Consolidation GAAP requires us to identify entities for which control is achieved through means other than voting rights and to determine which business enterprise is the primary beneficiary of variable interest entities (“VIEs”). ASC 810 broadly defines a VIE as an entity in which either (i) the equity investors as a group, if any, lack the power through voting or similar rights to direct the activities of such entity that most significantly impact such entity’s economic performance or (ii) the equity investment at risk is insufficient to finance that entity’s activities without additional subordinated financial support. We identify the primary beneficiary of a VIE as the enterprise that has both of the following characteristics: (i) the power to direct the activities of the VIE that most significantly impact the entity’s economic performance, and (ii) the obligation to absorb losses or receive benefits of the VIE that could potentially be significant to the entity. We consolidate our investment in a VIE when we determine that we are the VIE’s primary beneficiary. We may change our original assessment of a VIE upon subsequent events, such as the modification of contractual arrangements that affect the characteristics or adequacy of the entity’s equity investments at risk and the disposition of all, or a portion, of an interest held by the primary beneficiary. We perform this analysis on an ongoing basis. For property holding entities not determined to be VIEs, we consolidate such entities in which the Operating Partnership owns 100% of the equity or has a controlling financial interest evidenced by ownership of a majority voting interest. All intercompany balances and transactions are eliminated in consolidation. For entities in which the Operating Partnership owns less than 100% of the equity interest, the Operating Partnership consolidates the property if it has the direct or indirect ability to control the entities’ activities based upon the terms of the respective entities’ ownership agreements. For these entities, the Operating Partnership records a noncontrolling interest representing equity held by noncontrolling interests.
Noncontrolling Interests	Noncontrolling Interests The Company presents the portion of an equity interest it does not own, but controls (and thus consolidates) as noncontrolling interests and classifies such interests as a component of consolidated equity, separate from the Company’s total shareholders’ equity, on the consolidated balance sheets. Operating Partnership: Net income or loss is allocated to noncontrolling interests (limited partners) based on their respective ownership percentage of the Operating Partnership. The ownership percentage is calculated by dividing the number of OP Units held by the noncontrolling interests by the total OP Units held by the noncontrolling interests and the Trust. Issuance of additional common shares and OP Units changes the ownership interests of both the noncontrolling interests and the Trust. Such transactions and the related proceeds are treated as capital transactions. Noncontrolling interests in the Company include OP Units held by other investors. As of September 30, 2018 , the Trust held a 97.2% interest in the Operating Partnership. As the sole general partner and the majority interest holder, the Trust consolidates the financial position and results of operations of the Operating Partnership. Holders of OP Units may not transfer their OP Units without the Trust’s prior written consent, as general partner of the Operating Partnership. Beginning on the first anniversary of the issuance of OP Units, OP Unit holders may tender their units for redemption by the Operating Partnership in exchange for cash equal to the market price of the Trust’s common shares at the time of redemption or for unregistered common shares on a one-for-one basis. Such selection to pay cash or issue common shares to satisfy an OP Unit holder’s redemption request is solely within the control of the Trust. Accordingly, the Trust presents the OP Units of the Operating Partnership held by investors other than the Trust as noncontrolling interests within equity in the consolidated balance sheets. Partially Owned Properties: The Trust and Operating Partnership reflect noncontrolling interests in partially owned properties on the balance sheet for the portion of consolidated properties that are not wholly owned by the Company. The earnings or losses from those properties attributable to the noncontrolling interests are reflected as noncontrolling interests in partially owned properties in the consolidated statements of income. Redeemable Noncontrolling Interests - Series A Preferred Units and Partially Owned Properties On February 5, 2015, the Company entered into a Second Amended and Restated Agreement of Limited Partnership (the “Partnership Agreement”) which provides for the designation and issuance of the Series A Participating Redeemable Preferred Units of the Operating Partnership (“Series A Preferred Units”). Series A Preferred Units have priority over all other partnership interests of the Operating Partnership with respect to distributions and liquidation. Holders of Series A Preferred Units are entitled to a 5% cumulative return and upon redemption, the receipt of one common share and $200 . The holders of the Series A Preferred Units have agreed not to cause the Operating Partnership to redeem their Series A Preferred Units prior to one year from the issuance date. In addition, Series A Preferred Units are redeemable at the option of the holders which redemption obligation may be satisfied, at the Trust’s option, in cash or registered common shares. Instruments that require settlement in registered common shares may not be classified in permanent equity as it is not always completely within an issuer’s control to deliver registered common shares. Due to the redemption rights associated with the Series A Preferred Units, the Company classifies the Series A Preferred Units in the mezzanine section of its consolidated balance sheets. The Series A Preferred Units were evaluated for embedded features that should be bifurcated and separately accounted for as a freestanding derivative. The Company determined that the Series A Preferred Units contained features that require bifurcation. The Company records the carrying amount of the redeemable noncontrolling interests, less the value of the embedded derivative, at the greater of the carrying value or redemption value in the consolidated balance sheets. On January 9, 2018, the acquisition of the HealthEast Clinic & Specialty Center (“Hazelwood Medical Commons”) was partially funded with the issuance of 104,172 Series A Preferred Units, with a value of $22.7 million . Due to the redemption rights associated with the Series A Preferred Units, the Trust classifies the Series A Preferred Units in the mezzanine section of its consolidated balance sheets. As of September 30, 2018 , the value of the embedded derivative is $3.6 million and is classified in accrued expenses and other liabilities on the consolidated balance sheets. As of September 30, 2018 , there were 104,172 Series A Preferred Units outstanding. In connection with the acquisition of a medical office portfolio in Minnesota (the “Minnesota portfolio”), the Trust received a $5 million equity investment from a third party, effective March 1, 2015. On March 1, 2018, the equity investment was redeemed for $6.4 million . At any point subsequent to the third anniversary of the investment, the holder could require the Trust to redeem the instrument. Due to the redemption provision, which is outside of the control of the Trust, the Trust classified the investment in the mezzanine section of its consolidated balance sheets. The Trust recorded the carrying amount of the redeemable noncontrolling interests at the greater of the carrying value or redemption value. In connection with the acquisition on December 29, 2015 of a medical office building located on the campus of the Great Falls Clinic and Hospital in Great Falls, Montana, physicians affiliated with the seller retained a noncontrolling interest which may, at the holders’ option, be redeemed at any time. Due to the redemption provision, which is outside of the control of the Trust, the Trust classifies the investment in the mezzanine section of its consolidated balance sheets. The Trust records the carrying amount of the redeemable noncontrolling interests at the greater of the carrying value or redemption value.
Dividends and Distributions	Dividends and Distributions On September 19, 2018 , the Trust announced that its Board of Trustees authorized and the Trust declared a cash dividend of $0.23 per common share for the quarterly period ended September 30, 2018 . The distribution was paid on October 18, 2018 to common shareholders and OP Unit holders of record as of the close of business on October 3, 2018 . All distributions paid by the Operating Partnership are declared and paid at the same time as dividends are distributed by the Trust to common shareholders. It has been the Operating Partnership’s policy to declare quarterly distributions so as to allow the Trust to comply with applicable provisions of the Internal Revenue Code of 1986, as amended (the “Code”), governing REITs. The declaration and payment of quarterly distributions remains subject to the review and approval of the Trust’s Board of Trustees. Our shareholders are entitled to reinvest all or a portion of any cash distribution on their common shares by participating in our Dividend Reinvestment and Share Purchase Plan (“DRIP”), subject to the terms of the plan. Tax Status of Dividends and Distributions Our distributions of current and accumulated earnings and profits for U.S. federal income tax purposes generally are taxable to shareholders as ordinary income. Distributions in excess of these earnings and profits generally are treated as a non-taxable reduction of the shareholders’ basis in the shares to the extent thereof (non-dividend distributions) and thereafter as taxable gain. Any cash distributions received by an OP Unit holder in respect of its OP Units generally will not be taxable to such OP Unit holder for U.S. federal income tax purposes, to the extent that such distribution does not exceed the OP Unit holder’s basis in its OP Units. Any such distribution will instead reduce the OP Unit holder’s basis in its OP Units (and OP Unit holders will be subject to tax on the taxable income allocated to them by the Operating Partnership with respect to their OP Units when such income is earned by the Operating Partnership, with such income allocation increasing the OP Unit holders’ basis in their OP Units).
Purchase of Investment Properties	Purchases of Investment Properties With the adoption of ASU 2017-01 in January 2018, the majority of our future acquisitions will be accounted for as asset acquisitions, recording the purchase price for tangible and intangible assets and liabilities based on their relative fair values. Tangible assets primarily consist of land and buildings and improvements. Additionally, the purchase price includes acquisition related expenses, above- or below-market leases, in place leases, and above- or below-market debt assumed. Any future contingent consideration will be recorded when the contingency is resolved. The determination of the fair value requires us to make certain estimates and assumptions. The determination of fair value involves the use of significant judgment and estimation. The Company makes estimates of the fair value of the tangible and intangible acquired assets and assumed liabilities using information obtained from multiple sources as a result of pre-acquisition due diligence and generally includes the assistance of a third party appraiser. The Company estimates the fair value of an acquired asset on an “as-if-vacant” basis and its value is depreciated in equal amounts over the course of its estimated remaining useful life. The Company determines the allocated value of other fixed assets, such as site improvements, based upon the replacement cost and depreciates such value over the assets’ estimated remaining useful lives as determined at the applicable acquisition date. The fair value of land is determined either by considering the sales prices of similar properties in recent transactions or based on an internal analysis of recently acquired and existing comparable properties within the Company’s portfolio. The value of above- or below-market leases is estimated based on the present value (using a discount rate which reflected the risks associated with the leases acquired) of the difference between contractual amounts to be received pursuant to the leases and management’s estimate of market lease rates measured over a period equal to the estimated remaining term of the lease . The capitalized above-market or below-market lease intangibles are amortized as a reduction or addition to rental income over the estimated remaining term of the respective leases plus the term of any renewal options that the lessee would be economically compelled to exercise. In determining the value of in-place leases, management considers current market conditions and costs to execute similar leases in arriving at an estimate of the carrying costs during the expected lease-up period from vacant to existing occupancy. In estimating carrying costs, management includes real estate taxes, insurance, other operating expenses, estimates of lost rental revenue during the expected lease-up periods, and costs to execute similar leases, including leasing commissions, tenant improvements, legal, and other related costs based on current market demand. The values assigned to in-place leases are amortized to amortization expense over the estimated remaining term of the lease. If a lease terminates prior to its scheduled expiration, all unamortized costs related to that lease are written off, net of any required lease termination payments. The Company calculates the fair value of any long-term debt assumed by discounting the remaining contractual cash flows on each instrument at the current market rate for those borrowings, which the Company approximates based on the rate it would expect to incur on a replacement instrument on the date of acquisition, and recognizes any fair value adjustments related to long-term debt as effective yield adjustments over the remaining term of the instrument. Based on these estimates, the Company recognizes the acquired assets and assumed liabilities at their estimated relative fair values, which are generally determined using Level 3 inputs, such as market rental rates, capitalization rates, discount rates, or other available market data.
Impairment of Intangible and Long-Lived Assets	Impairment of Intangible and Long-Lived Assets The Company periodically evaluates its long-lived assets, primarily consisting of investments in real estate, for impairment indicators or whenever events or changes in circumstances indicate that the recorded amount of an asset may not be fully recoverable. If indicators of impairment are present, the Company evaluates the carrying value of the related real estate properties in relation to the undiscounted expected future cash flows of the underlying operations. In performing this evaluation, management considers market conditions and current intentions with respect to holding or disposing of the real estate property. The Company adjusts the net book value of real estate properties to fair value if the sum of the expected future undiscounted cash flows, including sales proceeds, is less than book value. The Company recognizes an impairment loss at the time it makes any such determination. If the Company determines that an asset is impaired, the impairment to be recognized is measured as the amount by which the recorded amount of the asset exceeds its fair value. Fair value is typically determined using a discounted future cash flow analysis or other acceptable valuation techniques, which are based, in turn, upon Level 3 inputs, such as revenue and expense growth rates, capitalization rates, discount rates, or other available market data.
Assets Held for Sale	Assets Held for Sale The Company may sell properties from time to time for various reasons, including favorable market conditions. The Company classifies certain long-lived assets as held for sale once the criteria, as defined by GAAP, has been met. The Company classifies a real estate property, or portfolio, as held for sale when: (i) management has approved the disposal, (ii) the property is available for sale in its present condition, (iii) an active program to locate a buyer has been initiated, (iv) it is probable that the property will be disposed of within one year, (v) the property is being marketed at a reasonable price relative to its fair value, and (vi) it is unlikely that the disposal plan will significantly change or be withdrawn. Following the classification of a property as “held for sale,” no further depreciation or amortization is recorded on the assets and the assets are written down to the lower of carrying value or fair market value, less cost to sell.
Investments in Unconsolidated Entities	Investments in Unconsolidated Entities The Company reports investments in unconsolidated entities over whose operating and financial policies it has the ability to exercise significant influence under the equity method of accounting. Under this method of accounting, the Company’s share of the investee’s earnings or losses is included in its consolidated statements of income. The initial carrying value of investments in unconsolidated entities is based on the amount paid to purchase the equity interest.
Real Estate Loans Receivable	Real Estate Loans Receivable Real estate loans receivable consists of seven mezzanine loans and one term loan as of September 30, 2018 . Generally, each mezzanine loan is collateralized by an ownership interest in the respective borrower, while the term loan is secured by a mortgage of a related medical office building. Interest income on the loans is recognized as earned based on the terms of the loans, subject to evaluation of collectability risks, and is included in the Company’s consolidated statements of income. On a quarterly basis, the Company evaluates the collectability of its loan portfolio, including related interest income receivable, and establishes a reserve for loan losses, if necessary. No such losses have been recognized to date.
Rental Revenue	Rental Revenue Rental revenue is recognized on a straight-line basis over the terms of the related leases when collectability is reasonably assured. Recognizing rental revenue on a straight-line basis for leases may result in recognizing revenue for amounts more or less than amounts currently due from tenants. Amounts recognized in excess of amounts currently due from tenants, excluding assets classified as held for sale, net of related allowances, are included in other assets and were approximately $56.7 million and $47.6 million as of September 30, 2018 and December 31, 2017 , respectively. If the Company determines that collectability of straight-line rents is not reasonably assured, the Company limits future recognition to amounts contractually owed and, where appropriate, establishes an allowance for estimated losses. Allowance for doubtful accounts, excluding assets classified as held for sale, was approximately $0.2 million and $4.9 million as of September 30, 2018 and December 31, 2017 , respectively. Rental revenue is adjusted by amortization of lease inducements and above or below market rents on certain leases. Lease inducements and above or below market rents are amortized over the remaining life of the lease.
Expense Recoveries	Expense Recoveries Expense recoveries relate to tenant reimbursement of real estate taxes, insurance, and other operating expenses that are recognized as expense recovery revenue in the period the applicable expenses are incurred. The reimbursements are recorded gross, as the Company is generally the primary obligor with respect to real estate taxes and purchasing goods and services from third-party suppliers, has discretion in selecting the supplier, and bears the credit risk of tenant reimbursement. The Company has certain tenants with absolute net leases. Under these lease agreements, the tenant is responsible for operating and building expenses.
Derivative Instruments	Derivative Instruments When the Company has derivative instruments embedded in other contracts, it records them either as an asset or a liability measured at their fair value unless they qualify for a normal purchase or normal sale exception. When specific hedge accounting criteria are not met, changes in the Company’s derivative instruments’ fair value are recognized currently in earnings. Changes in the fair market values of the Company’s derivative instruments are recorded in the consolidated statements of income if the derivative instruments do not qualify for, or the Company does not elect to apply for, hedge accounting. If hedge accounting is applied to a derivative instrument, such changes are reported in accumulated other comprehensive income within the consolidated statement of equity or capital, exclusive of ineffectiveness amounts, which are recognized as adjustments to net income. To manage interest rate risk for certain of its variable-rate debt, the Company uses interest rate swaps as part of its risk management strategy. These derivatives are designed to mitigate the risk of future interest rate increases by providing a fixed interest rate for a limited, pre-determined period of time. Interest rate swaps designated as cash flow hedges involve the receipt of variable-rate amounts from a counterparty in exchange for the Company making fixed-rate payments over the life of the agreements without exchange of the underlying notional amount. As of September 30, 2018 , the Company had five outstanding interest rate swap contracts that are designated as cash flow hedges of interest rate risk. For presentational purposes, they are shown as one derivative due to the identical nature of their economic terms. Further detail is provided in Note 7 (Derivatives) . The effective portion of the change in the fair value of derivatives designated and that qualify as cash flow hedges is recorded in accumulated other comprehensive income (“AOCI”) on the consolidated balance sheets and is subsequently reclassified into earnings as interest expense for the period that the hedged forecasted transaction affects earnings. The ineffective portion of the change in fair value of the derivatives is recognized directly in earnings. For the three and nine months ended September 30, 2018 and the three months ended September 30, 2017 hedge ineffectiveness was insignificant. For the nine months ended September 30, 2017 , the Company recorded a $0.2 million loss as a result of hedge ineffectiveness. The Company expects hedge ineffectiveness to be insignificant in the next 12 months.
Income Taxes	Income Taxes The Trust elected to be taxed as a REIT for federal tax purposes commencing with the filing of its tax return for the short taxable year ending December 31, 2013. The Trust had no taxable income prior to electing REIT status. To qualify as a REIT, the Trust must meet certain organizational and operational requirements, including a requirement to distribute at least 90% of its annual REIT taxable income to its shareholders (which is computed without regard to the dividends paid deduction or net capital gain and which does not necessarily equal net income as calculated in accordance with GAAP). As a REIT, the Trust generally will not be subject to federal income tax to the extent it distributes qualifying dividends to its shareholders. If the Trust fails to qualify as a REIT in any taxable year, it will be subject to federal income tax (including any applicable alternative minimum tax) on its taxable income at regular corporate income tax rates and generally will not be permitted to qualify for treatment as a REIT for federal income tax purposes for the four taxable years following the year during which qualification is lost, unless the Internal Revenue Service grants the Trust relief under certain statutory provisions. Such an event could materially adversely affect the Trust’s net income and net cash available for distribution to shareholders. However, the Trust intends to continue to operate in such a manner as to continue qualifying for treatment as a REIT. Although the Trust continues to qualify for taxation as a REIT, in various instances, the Trust is subject to state and local taxes on its income and property, and federal income and excise taxes on its undistributed income. As discussed in Note 1 (Organization and Business) , the Trust conducts substantially all of its operations through the Operating Partnership. As a partnership, the Operating Partnership generally is not liable for federal income taxes. The income and loss from the operations of the Operating Partnership is included in the tax returns of its partners, including the Trust, who are responsible for reporting their allocable share of the partnership income and loss. Accordingly, no provision for income taxes has been made on the accompanying consolidated financial statements.
Tenant Receivables, Net	Tenant Receivables, Net Tenant accounts receivable are stated net of the applicable allowance. Rental payments under these contracts are primarily due monthly. The Company assesses the collectability of tenant receivables, including straight-line rent receivables, and defers recognition of revenue if collectability is not reasonably assured. The Company bases its assessment of the collectability of rent receivables on several factors, including, among other things, payment history, the financial strength of the tenant, and current economic conditions. If management’s evaluation of these factors indicates it is probable that the Company will be unable to recover the full value of the receivable, the Company provides a reserve against the portion of the receivable that it estimates may not be recovered.
Management Estimates	Management Estimates The preparation of consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities as of the date of the consolidated financial statements and the amounts of revenue and expenses reported in the period. Significant estimates are made for the fair value assessments with respect to purchase price allocations, impairment assessments, and the valuation of financial instruments. Actual results could differ from these estimates.
Contingent Liabilities	Contingent Liabilities Certain of our acquisitions provide for additional consideration to the seller in the form of an earn-out associated with lease-up contingencies. The Company recognizes the contingent liabilities only if certain parameters or other substantive contingencies are met, at which time the consideration becomes payable. Resolved contingent liabilities increase our acquired assets and reduce our liabilities. In January 2017, the FASB issued ASU No. 2017-01, Clarifying the Definition of a Business , which changes the definition of a business to assist entities with evaluating when a set of transferred assets and activities is a business. The Company adopted ASU 2017-01 on January 1, 2018. As such, the Company will record the majority of future real estate investments as asset acquisitions and any future contingent consideration will be recorded when the contingency is resolved. Prior to January 1, 2018, the Company recorded certain contingent liabilities which are included in accrued expenses and other liabilities on its consolidated balance sheets. These were recorded at fair value as of the acquisition date and until they expire, the Company reassesses the fair value at the end of each reporting period, with any changes being recognized in earnings.
Reclassifications	Reclassifications Certain prior period amounts have been reclassified to conform to the current financial statement presentation, with no effect on the previously reported consolidated balance sheets or consolidated statements of income.
Segment Reporting	Segment Reporting Under the provision of Codification Topic 280, Segment Reporting , the Company has determined that it has one reportable segment with activities related to leasing and managing healthcare properties.
New Accounting Pronouncements	New Accounting Pronouncements In May 2014, the FASB issued ASU 2014-09, Revenue from Contracts with Customers , which creates a new Topic, Accounting Standards Codification Topic 606. The standard is principle-based and provides a five-step model to determine when and how revenue is recognized. The core principle is that a company should recognize revenue when it transfers promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. We adopted ASU 2014-09 as of January 1, 2018 under the modified retrospective approach. Based on our assessment, we have identified all of our revenue streams and concluded rental income from leasing arrangements represents a substantial portion of our revenue. Income from leasing arrangements is specifically excluded from Topic 606 and will be evaluated with the anticipated adoption of ASU 2016-02, Leases . Therefore, the impact of adopting ASU 2014-09 was minimal on our current recognition and presentation of non-lease revenue. Upon adoption of ASU 2016-02, Topic 606 may apply to executory costs and other components of revenue due under leases that are deemed to be non-lease components (such as common area maintenance and other reimbursement revenue), even when the revenue for such activities is not separately stipulated in the lease. In that case, the revenue from these items previously recognized on a straight-line basis under the current lease guidance would be recognized under the new revenue guidance as the related services are delivered. In February 2016, the FASB issued ASU 2016-02, Leases . The update amends the existing accounting standards for lease accounting, including requiring lessees to recognize most leases on their balance sheets and making targeted changes to lessor accounting. The standard provides the option of a modified retrospective transition approach or a cumulative effect for all leases existing at, or entered into after, the date of initial application, with an option to use certain transition relief. In July 2018, the FASB issued ASU 2018-11, Leases, Targeted Improvements ("ASU 2018-11"). ASU 2018-11 provides entities with a transition method option to not restate comparative periods presented, but to recognize a cumulative-effect adjustment to the opening balance of retained earnings in the period of adoption. In addition, ASU 2018-11 provides entities with a practical expedient allowing lessors to not separate non-lease components from the associated lease components when certain criteria are met. ASU 2016-02 and ASU 2018-11 are effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2018, and early adoption is permitted. We expect to elect these practical expedients and adopt ASC 842 on January 1, 2019. As a result of adopting ASU 2016-02, the Company will recognize all of its operating leases for which it is the lessee, including ground leases, on its consolidated balance sheets as a lease liability and corresponding right-of-use asset. We have detailed our future minimum lease obligations under non-cancelable leases in Note 12 (Rent Expense). The Company is currently assessing the material impact of the adoption of ASU 2016-02 as well as the adoption of the practical expedients and transition methods to its consolidated financial statements. In June 2016, the FASB issued ASU 2016-13, Financial Instruments - Credit Losses, which changes the impairment model for most financial instruments by requiring companies to recognize an allowance for expected losses, rather than incur losses as required currently by the other-than-temporary impairment model. ASU 2016-13 will apply to most financial assets measured at amortized cost and certain other instruments, including trade and other receivables, loans, held-to-maturity debt securities, net investments in leases, and off-balance-sheet credit exposures (e.g., loan commitments). ASU 2016-13 is effective for reporting periods beginning after December 15, 2019, with early adoption permitted, and will be applied as a cumulative adjustment to retained earnings as of the effective date. We are currently assessing the potential effect the adoption of ASU 2016-13 will have on our consolidated financial statements. In August 2016, the FASB issued ASU 2016-15, S tatement of Cash Flows: Classification of Certain Cash Receipts and Cash Payment. ASU 2016-15 clarifies the guidance on the classification of certain cash receipts and payments in the statement of cash flows to reduce diversity in practice with respect to: (i) debt prepayment or debt extinguishment costs; (ii) settlement of zero-coupon debt instruments or other debt instruments with coupon interest rates that are insignificant in relation to the effective interest rate of the borrowing; (iii) contingent consideration payments made after a business combination; (iv) proceeds from the settlement of insurance claims; (v) proceeds from the settlement of corporate-owned life insurance policies, including bank-owned life insurance policies; (vi) distributions received from equity method investees; (vii) beneficial interests in securitization transactions; and (viii) separately identifiable cash flows and application of the predominance principle. ASU 2016-15 is effective for fiscal years beginning after December 15, 2017 with early adoption permitted. The Company adopted ASU 2016-15 on January 1, 2018, with no material effect on its consolidated financial statements and no adjustments made to prior periods. In November 2016, the FASB issued ASU 2016-18, Statement of Cash Flows: Restricted Cash , which will require companies to include restricted cash with cash and cash equivalents when reconciling the beginning-of-period and end-of-period total amounts shown in the statement of cash flows. ASU 2016-18 will require disclosure of a reconciliation between the balance sheet and the statement of cash flows when the balance sheet includes more than one line item for cash, cash equivalents, restricted cash, and restricted cash equivalents. An entity with material restricted cash and restricted cash equivalents balances will be required to disclose the nature of the restrictions. ASU 2016-18 is effective for reporting periods beginning after December 15, 2017 and is required to be applied retrospectively to all periods presented. The Company adopted ASU 2016-18 on January 1, 2018, with no material effect on its consolidated financial statements and no adjustments made to prior periods. In January 2017, the FASB issued ASU No. 2017-01, Clarifying the Definition of a Business , which changes the definition of a business to assist entities with evaluating when a set of transferred assets and activities is a business. ASU 2017-01 states that when substantially all of the fair value of the gross assets acquired (or disposed of) is concentrated in a single identifiable asset or group of similar identifiable assets, the set is not a business. If this initial test is not met, a set cannot be considered a business unless it includes an acquired input and a substantive process that together significantly contribute to the ability to create outputs. In addition, ASU 2017-01 clarifies the requirements for a set of activities to be considered a business and narrows the definition of an output. This ASU is to be applied prospectively and is effective for fiscal years, and interim periods within those years, beginning after December 15, 2017. The Company adopted ASU 2017-01 on January 1, 2018 and as a result, have classified our real estate acquisitions completed during the nine months ended September 30, 2018 as asset acquisitions rather than business combinations due to the fact that substantially all of the fair value of the gross assets acquired were concentrated in a single asset or group of similar identifiable assets. The Company has recorded identifiable assets acquired, liabilities assumed, and any noncontrolling interests associated with any asset acquisitions at cost on a relative fair value basis and has capitalized transaction costs incurred. In August 2017, the FASB issued ASU 2017-12, Derivatives and Hedging: Targeted Improvements to Accounting for Hedging Activities , which expands and refines hedge accounting for both nonfinancial and financial risk components and aligns the recognition and presentation of the effects of the hedging instrument and the hedged item in the financial statements. It also includes certain targeted improvements to simplify the application of current guidance related to hedge accounting. The standard is effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2018, with early adoption permitted. The Company is currently in the process of evaluating the effects this standard will have on its consolidated financial statements.

Organization and Business (Tabl

Organization and Business (Tables)	9 Months Ended
	Sep. 30, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Schedule of Trust's common shares issuance and sale	During the quarterly periods ended March 31, 2018, June 30, 2018, and September 30, 2018 , the Trust’s issuance and sale of common shares pursuant to the ATM Program are as follows (in thousands, except common shares and price): Common shares sold Weighted average price Net proceeds Quarterly period ended March 31, 2018 311,786 $ 17.85 $ 5,509 Quarterly period ended June 30, 2018 — — — Quarterly period ended September 30, 2018 114,203 17.15 1,947 Year to date 425,989 $ 17.66 $ 7,456

Acquisitions and Dispositions (

Acquisitions and Dispositions (Tables)	9 Months Ended
	Sep. 30, 2018
Business Combinations [Abstract]
Schedule of preliminary purchase price allocations of assets acquired and liabilities assumed	The following table summarizes the acquisition date fair values of the assets acquired and the liabilities assumed, which the Company determined using Level 2 and Level 3 inputs (in thousands): 1st Quarter 2nd Quarter 3rd Quarter Total Land $ 7,684 $ — $ 9,632 $ 17,316 Building and improvements 82,180 64,197 67,772 214,149 In-place lease intangibles 13,202 8,923 11,777 33,902 Above market in-place lease intangibles 969 — 98 1,067 Below market in-place lease intangibles (959 ) — — (959 ) Below market in-place ground lease — — 5,329 5,329 Mortgage escrow — — 7,862 7,862 Prepaid expenses (2,628 ) — — (2,628 ) Issuance of Series A Preferred Units (22,651 ) — — (22,651 ) Net assets acquired $ 77,797 $ 73,120 $ 102,470 $ 253,387
Revenues and net income related to disposition	The following table summarizes revenues and net income related to the disposed properties for the periods presented (in thousands): Three Months Ended Nine Months Ended 2018 2017 2018 2017 Revenues $ 947 $ 5,770 $ 12,295 $ 17,906 Income before net gain on sale of investment properties: $ 1,827 $ 1,411 $ 5,030 $ 4,956 Gain on sale of investment properties, net 14,227 — 11,664 — Net income $ 16,054 $ 1,411 $ 16,694 $ 4,956
Real estate held for sale	In accordance with this classification, the following assets are classified as held for sale in the accompanying consolidated balance sheets at September 30, 2018 . Land and improvements $ 3,780 Building and improvements 28,127 Acquired lease intangibles 6,077 Other assets 3,491 Real estate held for sale before accumulated deprecation 41,475 Accumulated depreciation (6,049 ) Real estate held for sale $ 35,426

Intangibles (Tables)

Intangibles (Tables)	9 Months Ended
	Sep. 30, 2018
Finite-Lived Intangible Assets, Net [Abstract]
Summary of the carrying amount of intangible assets and liabilities	The following is a summary of the carrying amount of intangible assets and liabilities, excluding assets classified as held for sale if applicable, as of September 30, 2018 and December 31, 2017 (in thousands): September 30, 2018 December 31, 2017 Cost Accumulated Amortization Net Cost Accumulated Amortization Net Assets In-place leases $ 339,795 $ (102,068 ) $ 237,727 $ 343,429 $ (85,424 ) $ 258,005 Above-market leases 43,472 (11,787 ) 31,685 54,148 (11,968 ) 42,180 Leasehold interest 712 (226 ) 486 712 (183 ) 529 Below-market ground leases 65,677 (1,925 ) 63,752 60,424 (1,344 ) 59,080 Total $ 449,656 $ (116,006 ) $ 333,650 $ 458,713 $ (98,919 ) $ 359,794 Liabilities Below-market leases $ 14,870 $ (6,374 ) $ 8,496 $ 14,344 $ (4,479 ) $ 9,865 Above-market ground leases 5,965 (232 ) 5,733 5,965 (128 ) 5,837 Total $ 20,835 $ (6,606 ) $ 14,229 $ 20,309 $ (4,607 ) $ 15,702
Summary of the carrying amount of acquired lease intangibles	The following is a summary of acquired lease intangible amortization for the three and nine month periods ended September 30, 2018 and 2017 , respectively (in thousands): Three Months Ended Nine Months Ended 2018 2017 2018 2017 Amortization expense related to in-place leases $ 16,274 $ 9,453 $ 38,251 $ 26,520 Decrease of rental income related to above-market leases 1,075 1,335 3,992 3,987 Decrease of rental income related to leasehold interest 15 15 44 44 Increase of rental income related to below-market leases 615 623 2,109 1,704 Decrease of operating expense related to above-market ground leases 33 34 104 49 Increase in operating expense related to below-market ground leases 255 208 745 581
Schedule of future amortization of the acquired lease intangibles	Future aggregate net amortization of the acquired lease intangibles, excluding two assets classified as held for sale, as of September 30, 2018 , is as follows (in thousands): Net Decrease in Revenue Net Increase in Expenses 2018 $ (573 ) $ 9,712 2019 (2,417 ) 35,517 2020 (2,554 ) 32,791 2021 (2,517 ) 30,513 2022 (2,055 ) 26,677 Thereafter (13,559 ) 160,536 Total $ (23,675 ) $ 295,746

Other Assets (Tables)

Other Assets (Tables)	9 Months Ended
	Sep. 30, 2018
Other Assets, Unclassified [Abstract]
Schedule of other assets	Other assets consisted of the following, excluding assets classified as held for sale if applicable, as of September 30, 2018 and December 31, 2017 (in thousands): September 30, December 31, Straight line rent receivable, net $ 56,702 $ 47,599 Interest rate swap 21,200 14,693 Note receivable 20,628 — Prepaid expenses 17,060 18,103 Lease inducements, net 12,774 14,232 Escrows 9,552 1,996 Leasing commissions, net 5,826 4,128 Earnest deposits — 2,780 Other 4,825 2,771 Total $ 148,567 $ 106,302

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2018
Debt Disclosure [Abstract]
Schedule of debt	The following is a summary of debt as of September 30, 2018 and December 31, 2017 (in thousands): September 30, December 31, Fixed interest mortgage notes $ 120,931 (1) $ 158,171 (2) Variable interest mortgage notes 13,908 (3) 28,509 (4) Total mortgage debt 134,839 186,680 $850 million unsecured revolving credit facility bearing variable interest of LIBOR plus 1.10% at September 30, 2018 and LIBOR plus 1.20% at December 30, 2017, due September 2022 179,000 80,000 $400 million senior unsecured notes bearing fixed interest of 4.30%, due March 2027 400,000 400,000 $350 million senior unsecured notes bearing fixed interest of 3.95%, due January 2028 350,000 350,000 $250 million unsecured term borrowing bearing fixed interest of 2.32% at September 30, 2018 and 2.87% at December 31, 2017, due June 2023 250,000 (5) 250,000 (6) $150 million senior unsecured notes bearing fixed interest of 4.03% to 4.74%, due January 2023 to 2031 150,000 150,000 $75 million senior unsecured notes bearing fixed interest of 4.09% to 4.24%, due August 2025 to 2027 75,000 75,000 Total principal 1,538,839 1,491,680 Unamortized deferred financing costs (10,407 ) (7,808 ) Unamortized discount (6,233 ) (6,663 ) Unamortized fair value adjustment 213 259 Total debt $ 1,522,412 $ 1,477,468 (1) Fixed interest mortgage notes, bearing interest from 3.00% to 5.50% , with a weighted average interest rate of 4.37% , and due in 2019, 2020, 2021, 2022, and 2024 collateralized by six properties with a net book value of $210.9 million . (2) Fixed interest mortgage notes, bearing interest from 3.00% to 5.50% , with a weighted average interest rate of 4.45% , and due in 2018, 2019, 2020, 2021, 2022, and 2024 collateralized by nine properties with a net book value of $267.7 million . (3) Variable interest mortgage notes, bearing variable interest of LIBOR plus 2.25% to Wall Street Journal Prime plus 1.75% , with a weighted average interest rate of 5.75% and due in 2018 and 2022 collateralized by two properties with a net book value of $31.8 million . (4) Variable interest mortgage notes, bearing variable interest of LIBOR plus 2.25% to 3.25% , with a weighted average interest rate of 4.50% and due 2018 collateralized by three properties with a net book value of $39.2 million . (5) The Trust’s borrowings under the term loan feature of the Credit Agreement bear interest at a rate which is determined by the Trust’s credit rating, currently equal to LIBOR + 1.25% . The Trust has entered into a pay-fixed receive-variable interest rate swap, fixing the LIBOR component of this rate at 1.07% . (6) The Trust’s borrowings under the term loan feature of the Credit Agreement bear interest at a rate which is determined by the Trust’s credit rating, equal to LIBOR + 1.80% . The Trust has entered into a pay-fixed receive-variable interest rate swap, fixing the LIBOR component of this rate at 1.07% .
Schedule of adjusted LIBOR rate loans and interest rates based on credit rating	Base Rate Loans, Adjusted LIBOR Rate Loans, and Letters of Credit (each, as defined in the Credit Agreement) will be subject to interest rates, based upon the Trust’s investment grade rating as follows: Credit Rating Margin for Revolving Loans: Adjusted LIBOR Rate Loans and Letter of Credit Fee Margin for Revolving Loans: Base Rate Loans Margin for Term Loans: Adjusted LIBOR Rate Loans and Letter of Credit Fee Margin for Term Loans: Base Rate Loans At Least A- or A3 LIBOR + 0.775% — % LIBOR + 0.85% — % At Least BBB+ or Baa1 LIBOR + 0.825% — % LIBOR + 0.90% — % At Least BBB or Baa2 LIBOR + 0.90% — % LIBOR + 1.00% — % At Least BBB- or Baa3 LIBOR + 1.10% 0.10 % LIBOR + 1.25% 0.25 % Below BBB- or Baa3 LIBOR + 1.45% 0.45 % LIBOR + 1.65% 0.65 %
Schedule of principal payments due on debt	Scheduled principal payments due on debt as of September 30, 2018 , are as follows (in thousands): 2018 (1) $ 7,267 2019 44,355 2020 25,721 2021 8,592 2022 204,178 Thereafter 1,248,726 Total Payments $ 1,538,839 (1) As of September 30, 2018 , a $6.8 million mortgage was in the process of being refinanced. The refinance agreement is expected to be completed by the end of the year and will mature in 2028 .

Derivatives (Tables)

Derivatives (Tables)	9 Months Ended
	Sep. 30, 2018
Derivative Instrument Detail [Abstract]
Schedule of interest rate derivatives	The following table summarizes the location and aggregate fair value of the interest rate swaps on the Company’s consolidated balance sheets (in thousands): Total notional amount $ 250,000 Effective fixed interest rate (1) 2.32 % Effective date 7/7/2016 Maturity date 6/10/2023 Asset balance at September 30, 2018 (included in Other assets) $ 21,200 Asset balance at December 31, 2017 (included in Other assets) $ 14,693 (1) 1.07% effective swap rate plus 1.25% spread per Credit Agreement. As of December 31, 2017 , the effective fixed interest rate was 2.87% with a 1.07% effective swap rate plus 1.80% spread per the previous Credit Agreement.

Accrued Expenses and Other Li_2

Accrued Expenses and Other Liabilities (Tables)	9 Months Ended
	Sep. 30, 2018
Other Liabilities Disclosure [Abstract]
Schedule of accrued expenses and other liabilities	Accrued expenses and other liabilities consisted of the following as of September 30, 2018 and December 31, 2017 (in thousands): September 30, December 31, Real estate taxes payable $ 22,476 $ 16,103 Prepaid rent 10,830 10,496 Accrued interest 5,894 11,107 Accrued expenses 5,605 8,751 Embedded derivative 3,575 — Security deposits 3,408 2,882 Tenant improvement allowance 2,995 3,065 Accrued incentive compensation 2,973 1,625 Contingent consideration 753 1,454 Other 2,837 922 Total $ 61,346 $ 56,405

Stock-based Compensation (Table

Stock-based Compensation (Tables)	9 Months Ended
	Sep. 30, 2018
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Schedule of non-vested restricted common shares	A summary of the status of the Trust’s non-vested restricted common shares as of September 30, 2018 and changes during the nine month period then ended follow: Common Shares Weighted Average Grant Date Fair Value Non-vested at December 31, 2017 173,276 $ 19.36 Granted 206,446 14.87 Vested (142,243 ) 19.65 Non-vested at September 30, 2018 237,479 $ 15.28
Schedule of weighted average grant date fair value assumptions	The Company utilized a Monte Carlo simulation to calculate the weighted average grant date fair value of $19.28 per unit for the March 2018 grant using the following assumptions: Volatility 21.7 % Dividend assumption reinvested Expected term in years 2.8 years Risk-free rate 2.40 % Share price (per share) $ 14.78
Summary of the activity in the restricted share units	The following is a summary of the activity in the Trust’s restricted share units during the nine months ended September 30, 2018 : Executive Awards Trustee Awards Restricted Share Units Weighted Average Grant Date Fair Value Restricted Share Weighted Non-vested at December 31, 2017 354,123 $ 26.30 51,220 $ 19.04 Granted 254,282 16.58 50,745 14.78 Vested (75,250 ) (1) 21.16 (34,807 ) 18.67 Non-vested at September 30, 2018 533,155 $ 22.66 67,158 $ 16.01 (1) Restricted units vested by Company executives in 2018 resulted in the issuance of 126,108 common shares, less 56,502 common shares withheld to cover minimum withholding tax obligations, for multiple employees.

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2018
Fair Value Disclosures [Abstract]
Schedule of fair value of other financial instruments	The following table presents the fair value of the Company’s financial instruments (in thousands): September 30, December 31, Carrying Amount Fair Value Carrying Amount Fair Value Assets: Real estate loans receivable $ 47,911 $ 46,218 $ 76,195 $ 75,288 Notes receivable $ 20,628 $ 20,628 $ — $ — Derivative assets $ 21,200 $ 21,200 $ 14,693 $ 14,693 Liabilities: Credit facility $ (429,000 ) $ (429,000 ) $ (330,000 ) $ (330,000 ) Notes payable $ (975,000 ) $ (909,510 ) $ (975,000 ) $ (970,975 ) Mortgage debt $ (135,052 ) $ (133,963 ) $ (186,939 ) $ (185,743 )

Tenant Operating Leases (Tables

Tenant Operating Leases (Tables)	9 Months Ended
	Sep. 30, 2018
Leases [Abstract]
Schedule of future minimum rental payments on non-cancelable leases, exclusive of expense recoveries	As of September 30, 2018 , the future minimum rental payments on non-cancelable leases, exclusive of expense recoveries and two assets classified as held for sale, were as follows (in thousands): 2018 $ 70,531 2019 282,261 2020 278,483 2021 273,233 2022 262,669 Thereafter 1,310,257 Total $ 2,477,434

Rent Expense (Tables)

Rent Expense (Tables)	9 Months Ended
	Sep. 30, 2018
Leases [Abstract]
Schedule of future minimum lease obligations under non-cancelable ground leases	As of September 30, 2018 , the future minimum lease obligations under non-cancelable parking, air, ground, and office leases, exclusive of the two assets classified as held for sale, were as follows (in thousands): 2018 $ 794 2019 3,058 2020 3,013 2021 3,037 2022 3,030 Thereafter 146,119 Total $ 159,051

Credit Concentration (Tables)

Credit Concentration (Tables) - Sales Revenue, Services, Net	9 Months Ended
	Sep. 30, 2018
Customer Concentration Risk
Concentration Risk [Line Items]
Schedules of concentration of risk, by risk factor	The following table summarizes certain information about the Company’s top five tenant credit concentrations as of September 30, 2018 , excluding assets classified as held for sale (in thousands): Tenant Total ABR Percent of ABR CHI - Nebraska $ 16,336 5.8 % CHI - KentuckyOne Health 13,574 4.8 % Northside Hospital 9,860 3.5 % Baylor Scott and White Health 7,583 2.7 % Ascension - St. Vincent's - Indianapolis 7,271 2.6 % Remaining portfolio 226,666 80.6 % Total $ 281,290 100.0 %
Geographic Concentration Risk
Concentration Risk [Line Items]
Schedules of concentration of risk, by risk factor	The following table summarizes certain information about the Company’s top five geographic concentrations as of September 30, 2018 , excluding two assets classified as held for sale (in thousands): State Total ABR Percent of ABR Texas $ 42,458 15.1 % Georgia 24,372 8.7 % Indiana 19,749 7.0 % Nebraska 17,734 6.3 % Minnesota 16,858 6.0 % Other 160,119 56.9 % Total $ 281,290 100.0 %

Earnings Per Share and Earnin_2

Earnings Per Share and Earnings Per Unit (Tables)	9 Months Ended
	Sep. 30, 2018
Earnings Per Share [Abstract]
Schedule of amounts used in computing basic and diluted earnings per share	The following table shows the amounts used in computing the Trust’s basic and diluted earnings per share (in thousands, except share and per share data): Three Months Ended Nine Months Ended 2018 2017 2018 2017 Numerator for earnings per share - basic: Net income $ 23,771 $ 12,539 $ 47,165 $ 29,586 Net income attributable to noncontrolling interests: Operating Partnership (656 ) (362 ) (1,300 ) (823 ) Partially owned properties (119 ) (53 ) (374 ) (379 ) Preferred distributions (284 ) (106 ) (1,055 ) (505 ) Numerator for earnings per share - basic $ 22,712 $ 12,018 $ 44,436 $ 27,879 Numerator for earnings per share - diluted: Numerator for earnings per share - basic $ 22,712 $ 12,018 $ 44,436 $ 27,879 Operating Partnership net income 656 362 1,300 823 Numerator for earnings per share - diluted $ 23,368 $ 12,380 $ 45,736 $ 28,702 Denominator for earnings per share - basic and diluted: Weighted average number of shares outstanding - basic 182,076,513 177,847,424 181,963,693 157,542,167 Effect of dilutive securities: Noncontrolling interest - Operating Partnership units 5,291,025 5,379,981 5,378,760 4,663,157 Restricted common shares 105,692 70,740 80,272 85,689 Restricted share units — — 199,384 189,905 Denominator for earnings per share - diluted: 187,473,230 183,298,145 187,622,109 162,480,918 Earnings per share - basic $ 0.12 $ 0.07 $ 0.24 $ 0.18 Earnings per share - diluted $ 0.12 $ 0.07 $ 0.24 $ 0.18 The following table shows the amounts used in computing the Operating Partnership’s basic and diluted earnings per unit (in thousands, except unit and per unit data): Three Months Ended Nine Months Ended 2018 2017 2018 2017 Numerator for earnings per unit - basic and diluted: Net income $ 23,771 $ 12,539 $ 47,165 $ 29,586 Net income attributable to noncontrolling interests - partially owned properties (119 ) (53 ) (374 ) (379 ) Preferred distributions (284 ) (106 ) (1,055 ) (505 ) Numerator for earnings per unit - basic and diluted $ 23,368 $ 12,380 $ 45,736 $ 28,702 Denominator for earnings per unit - basic and diluted: Weighted average number of units outstanding - basic 187,367,538 183,227,405 187,342,453 162,205,324 Effect of dilutive securities: Restricted common shares 105,692 70,740 80,272 85,689 Restricted share units — — 199,384 189,905 Denominator for earnings per unit - diluted 187,473,230 183,298,145 187,622,109 162,480,918 Earnings per unit - basic $ 0.12 $ 0.07 $ 0.24 $ 0.18 Earnings per unit - diluted $ 0.12 $ 0.07 $ 0.24 $ 0.18

Organization and Business - Add

Organization and Business - Additional Information (Details) - $ / shares	Sep. 30, 2018	Dec. 31, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Common stock, shares authorized (in shares)	500,000,000	500,000,000
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01

Organization and Business - ATM

Organization and Business - ATM Program (Details) - USD ($)	Aug. 05, 2016	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2018	Oct. 26, 2018
Subsequent Event
Class of Stock [Line Items]
Sale of stock, remaining authorized amount						$ 164,900,000
Private Placement | 2016 ATM Program
Class of Stock [Line Items]
Common shares sold (in shares)		114,203	0	311,786	425,989
Weighted average price (in dollars per share)		$ 17.15	$ 0	$ 17.85	$ 17.66
Net proceeds		$ 1,947,000	$ 0	$ 5,509,000	$ 7,456,000
Maximum | Private Placement | 2016 ATM Program
Class of Stock [Line Items]
Aggregate offering price of common stock	$ 300,000,000

Summary of Significant Accoun_3

Summary of Significant Accounting Policies - Principles of Consolidation (Details)	9 Months Ended
	Sep. 30, 2018
Accounting Policies [Abstract]
Ownership interest in consolidated subsidiaries (as a percent)	100.00%

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Noncontrolling Interests (Details) $ / shares in Units, $ in Thousands	Mar. 01, 2018USD ($)	Jan. 09, 2018USD ($)shares	Feb. 05, 2015$ / shares	Sep. 30, 2018USD ($)shares	Dec. 31, 2017USD ($)	Mar. 01, 2015USD ($)
Business Acquisition [Line Items]
Percentage of interest held				97.20%
Unit conversion ratio				1
Embedded derivative				$ 3,575	$ 0
Equity method investment						$ 5,000
Redemption value of equity investment	$ 6,400
HealthEast Clinic & Specialty Center
Business Acquisition [Line Items]
Number of units issued for funding purchase price (in shares) | shares		104,172		104,172
Consideration transferred, equity interests issued and issuable		$ 22,700
Embedded derivative				$ 3,600
Series A Preferred Units
Business Acquisition [Line Items]
Cumulative preferred return			5.00%
Redeemable noncontrolling interest, equity, preferred, redemption shares in exchange			1
Redemption value (in dollars per share) | $ / shares			$ 200
Period in which preferred units will be redeemable			1 year

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Dividends and Distributions (Details) - $ / shares	Sep. 19, 2018	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Accounting Policies [Abstract]
Dividends and distributions declared per common share and OP Unit (in dollars per share)	$ 0.23	$ 0.23	$ 0.23	$ 0.69	$ 0.685

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Impairment (Details) - USD ($)	3 Months Ended
	Sep. 30, 2018	Sep. 30, 2017
Accounting Policies [Abstract]
Impairment charges	$ 0	$ 0

Summary of Significant Accoun_7

Summary of Significant Accounting Policies - Assets Held for Sale (Details)	Sep. 30, 2018properties
Accounting Policies [Abstract]
Number of properties, held for sale	2

Summary of Significant Accoun_8

Summary of Significant Accounting Policies - Real Estate Loans Receivable (Details)	Sep. 30, 2018mezzanine_loan
Mezzanine Loan Receivable
Property, Plant and Equipment [Line Items]
Number of mezzanine loans collateralized	7
Term Loan Receivable
Property, Plant and Equipment [Line Items]
Number of mezzanine loans collateralized	1

Summary of Significant Accoun_9

Summary of Significant Accounting Policies - Rental Revenue (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Accounting Policies [Abstract]
Straight line rent receivable, net	$ 56,702	$ 47,599
Allowance against straight line rent	$ 200	$ 4,900

Summary of Significant Accou_10

Summary of Significant Accounting Policies - Derivative Instruments (Details) - Cash Flow Hedging - Interest Rate Swap $ in Millions	9 Months Ended
	Sep. 30, 2017USD ($)	Sep. 30, 2018instruments
Derivative [Line Items]
Outstanding interest rate swap contracts designated as cash flow hedges | instruments		5
Derivative, net hedge ineffectiveness gain (loss) | $	$ 0.2

Summary of Significant Accou_11

Summary of Significant Accounting Policies - Tenant Receivables, Net (Details) - USD ($) $ in Millions	Sep. 30, 2018	Dec. 31, 2017
Accounting Policies [Abstract]
Allowance for doubtful accounts receivable	$ 0.5	$ 1.6

Summary of Significant Accou_12

Summary of Significant Accounting Policies - Segment Reporting (Details)	9 Months Ended
	Sep. 30, 2018segments
Accounting Policies [Abstract]
Number of reportable segments	1

Acquisitions and Dispositions -

Acquisitions and Dispositions - Additional Information (Details) $ in Thousands	Mar. 01, 2018USD ($)	Sep. 30, 2018USD ($)properties	Sep. 30, 2017USD ($)	Sep. 30, 2018USD ($)propertiesstatesland	Sep. 30, 2017USD ($)
Noncash or Part Noncash Acquisitions [Line Items]
Noncontrolling interest buyout	$ 6,400
Recorded revenues		$ 105,028	$ 92,999	$ 317,240	$ 246,264
Net income		$ 23,771	$ 12,539	$ 47,165	$ 29,586
Four Healthcare Properties Acquired In 2018
Noncash or Part Noncash Acquisitions [Line Items]
Number of operating healthcare properties | properties				4
Number of land parcels | land				1
Number of states in which operating healthcare properties and land parcel located | states				5
Aggregate purchase price				$ 252,800
Noncontrolling Interest Buyout
Noncash or Part Noncash Acquisitions [Line Items]
Aggregate purchase price				261,300
Noncontrolling interest buyout				6,400
Loan transaction				$ 2,000
Conversion And Satisfaction Of Previously Outstanding Construction Loan
Noncash or Part Noncash Acquisitions [Line Items]
Number of operating healthcare properties | properties		2		2
Aggregate purchase price		$ 18,800
Lease Structuring Arrangement And Equity Recapitalization
Noncash or Part Noncash Acquisitions [Line Items]
Number of land parcels | land				2
Northside Midtown MOB
Noncash or Part Noncash Acquisitions [Line Items]
Aggregate purchase price		82,100
Total Asset Acquisitions
Noncash or Part Noncash Acquisitions [Line Items]
Recorded revenues		3,900		$ 9,300
Net income		$ 1,400		$ 3,400

Acquisitions and Dispositions_2

Acquisitions and Dispositions - Acquisition Date Fair Values of Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017
Business Acquisition [Line Items]
Land	$ 207,473			$ 217,695
Building and improvements	3,588,302			3,568,858
Acquired lease intangibles	449,656			458,713
Mortgage escrow	5,686			$ 9,966
1st Quarter
Business Acquisition [Line Items]
Land			$ 7,684
Building and improvements			82,180
Mortgage escrow			0
Prepaid expenses			(2,628)
Issuance of Series A Preferred Units			(22,651)
Net assets acquired			77,797
2nd Quarter
Business Acquisition [Line Items]
Land		$ 0
Building and improvements		64,197
Mortgage escrow		0
Prepaid expenses		0
Issuance of Series A Preferred Units		0
Net assets acquired		73,120
3rd Quarter
Business Acquisition [Line Items]
Land	9,632
Building and improvements	67,772
Mortgage escrow	7,862
Prepaid expenses	0
Issuance of Series A Preferred Units	0
Net assets acquired	102,470
Total
Business Acquisition [Line Items]
Land	17,316
Building and improvements	214,149
Mortgage escrow	7,862
Prepaid expenses	(2,628)
Issuance of Series A Preferred Units	(22,651)
Net assets acquired	253,387
In-place lease intangibles | 1st Quarter
Business Acquisition [Line Items]
Acquired lease intangibles			13,202
In-place lease intangibles | 2nd Quarter
Business Acquisition [Line Items]
Acquired lease intangibles		8,923
In-place lease intangibles | 3rd Quarter
Business Acquisition [Line Items]
Acquired lease intangibles	11,777
In-place lease intangibles | Total
Business Acquisition [Line Items]
Acquired lease intangibles	33,902
Above market in-place lease intangibles | 1st Quarter
Business Acquisition [Line Items]
Acquired lease intangibles			969
Above market in-place lease intangibles | 2nd Quarter
Business Acquisition [Line Items]
Acquired lease intangibles		0
Above market in-place lease intangibles | 3rd Quarter
Business Acquisition [Line Items]
Acquired lease intangibles	98
Above market in-place lease intangibles | Total
Business Acquisition [Line Items]
Acquired lease intangibles	1,067
Below market in-place lease intangibles | 1st Quarter
Business Acquisition [Line Items]
Acquired lease intangibles			(959)
Below market in-place lease intangibles | 2nd Quarter
Business Acquisition [Line Items]
Acquired lease intangibles		0
Below market in-place lease intangibles | 3rd Quarter
Business Acquisition [Line Items]
Acquired lease intangibles	0
Below market in-place lease intangibles | Total
Business Acquisition [Line Items]
Acquired lease intangibles	(959)
Below-market ground leases | 1st Quarter
Business Acquisition [Line Items]
Acquired lease intangibles			$ 0
Below-market ground leases | 2nd Quarter
Business Acquisition [Line Items]
Acquired lease intangibles		$ 0
Below-market ground leases | 3rd Quarter
Business Acquisition [Line Items]
Acquired lease intangibles	5,329
Below-market ground leases | Total
Business Acquisition [Line Items]
Acquired lease intangibles	$ 5,329

Acquisitions and Dispositions_3

Acquisitions and Dispositions - Dispositions (Details) - Disposal Group, Disposed of by Sale, Not Discontinued Operations $ in Thousands	3 Months Ended				9 Months Ended
	Sep. 30, 2018USD ($)statesbuildings	Jun. 30, 2018USD ($)statesbuildings	Mar. 31, 2018USD ($)buildings	Sep. 30, 2017USD ($)	Sep. 30, 2018USD ($)	Sep. 30, 2017USD ($)
Business Acquisition [Line Items]
Number of medical office buildings | buildings	17	15	2
Proceeds from divestiture of businesses	$ 127,200	$ 90,700	$ 2,500
Gain on sale of investment properties, net	$ 14,200	$ (2,600)	$ 100
Number of states in which operating healthcare properties and land parcel located | states	7	3
Dispositions, Second Quarter
Business Acquisition [Line Items]
Gain on sale of investment properties, net	$ 14,227			$ 0
Revenues	947			5,770
Income before net gain on sale of investment properties:	1,827			1,411
Net income	$ 16,054			$ 1,411
Dispositions, Year-to-date
Business Acquisition [Line Items]
Gain on sale of investment properties, net					$ 11,664	$ 0
Revenues					12,295	17,906
Income before net gain on sale of investment properties:					5,030	4,956
Net income					$ 16,694	$ 4,956

Acquisitions and Dispositions_4

Acquisitions and Dispositions - Assets Held for Sale (Details) $ in Thousands	Sep. 30, 2018USD ($)propertiesportfolio	Dec. 31, 2017USD ($)
Property, Plant and Equipment [Line Items]
Number of portfolios comprised of properties held for sale | portfolio	1
Number of properties, held for sale | properties	2
Real estate held for sale before accumulated deprecation	$ 41,475
Accumulated depreciation	(6,049)
Real estate held for sale	35,426	$ 0
Land and improvements
Property, Plant and Equipment [Line Items]
Real estate held for sale before accumulated deprecation	3,780
Building and improvements
Property, Plant and Equipment [Line Items]
Real estate held for sale before accumulated deprecation	28,127
Acquired lease intangibles
Property, Plant and Equipment [Line Items]
Real estate held for sale before accumulated deprecation	6,077
Other assets
Property, Plant and Equipment [Line Items]
Real estate held for sale before accumulated deprecation	$ 3,491

Intangibles - Summary of Carryi

Intangibles - Summary of Carrying Amount of Intangible Assets and Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Assets
Cost	$ 449,656	$ 458,713
Accumulated Amortization	(116,006)	(98,919)
Net	333,650	359,794
Liabilities
Cost	20,835	20,309
Accumulated Amortization	(6,606)	(4,607)
Net	14,229	15,702
In-place lease intangibles
Assets
Cost	339,795	343,429
Accumulated Amortization	(102,068)	(85,424)
Net	237,727	258,005
Above market in-place lease intangibles
Assets
Cost	43,472	54,148
Accumulated Amortization	(11,787)	(11,968)
Net	31,685	42,180
Leasehold interest
Assets
Cost	712	712
Accumulated Amortization	(226)	(183)
Net	486	529
Below-market ground leases
Assets
Cost	65,677	60,424
Accumulated Amortization	(1,925)	(1,344)
Net	63,752	59,080
Below-market leases
Liabilities
Below market lease, cost	14,870	14,344
Below market lease, accumulated amortization	(6,374)	(4,479)
Below market lease, net	8,496	9,865
Above-market ground leases
Liabilities
Cost	5,965	5,965
Accumulated Amortization	(232)	(128)
Net	$ 5,733	$ 5,837

Intangibles - Summary of Acquir

Intangibles - Summary of Acquired Amortization (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
In-place lease intangibles
Intangibles
Amortization expense related to in-place leases	$ 16,274	$ 9,453	$ 38,251	$ 26,520
Above market in-place lease intangibles
Intangibles
Decrease of rental income	1,075	1,335	3,992	3,987
Decrease of rental income related to leasehold interest
Intangibles
Decrease of rental income	15	15	44	44
Below market in-place lease intangibles
Intangibles
Increase of rental income related to below-market leases	615	623	2,109	1,704
Decrease of operating expense related to above-market ground leases
Intangibles
Decrease (increase) of operating expense	33	34	104	49
Below-market ground leases
Intangibles
Decrease (increase) of operating expense	$ 255	$ 208	$ 745	$ 581

Intangibles - Additional Inform

Intangibles - Additional Information (Details) $ in Millions	3 Months Ended	9 Months Ended
	Sep. 30, 2018USD ($)properties	Sep. 30, 2018USD ($)properties	Sep. 30, 2017USD ($)
Intangibles
Number of properties, held for sale | properties	2	2
Weighted average amortization period for lease intangibles		20 years
Weighted average amortization period for lease intangible liability		21 years
In-place lease intangibles
Intangibles
Impairment of intangible assets	$ (6.6)	$ (6.8)	$ (6.6)
Impairment of intangible assets, accumulated amortization			$ (1.8)

Intangibles - Future Aggregate

Intangibles - Future Aggregate Net Amortization of Acquired Lease Intangibles (Details 4) $ in Thousands	Sep. 30, 2018USD ($)
Net Decrease in Revenue
2,018	$ (573)
2,019	(2,417)
2,020	(2,554)
2,021	(2,517)
2,022	(2,055)
Thereafter	(13,559)
Total	(23,675)
Net Increase in Expenses
2,018	9,712
2,019	35,517
2,020	32,791
2,021	30,513
2,022	26,677
Thereafter	160,536
Total	$ 295,746

Other Assets - Schedule of Othe

Other Assets - Schedule of Other Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Other Assets, Unclassified [Abstract]
Straight line rent receivable, net	$ 56,702	$ 47,599
Interest rate swap	21,200	14,693
Note receivable	20,628	0
Prepaid expenses	17,060	18,103
Lease inducements, net	12,774	14,232
Escrows	9,552	1,996
Leasing commissions, net	5,826	4,128
Earnest deposits	0	2,780
Other	4,825	2,771
Total	$ 148,567	$ 106,302

Debt - Summary of Debt (Details

Debt - Summary of Debt (Details)	9 Months Ended	12 Months Ended
	Sep. 30, 2018USD ($)healthcareproperty	Dec. 31, 2017USD ($)properties	Dec. 01, 2017USD ($)	Mar. 07, 2017USD ($)	Aug. 11, 2016USD ($)	Jan. 07, 2016USD ($)
Debt
Long-term debt, gross	$ 1,538,839,000	$ 1,491,680,000
Unamortized deferred financing costs	(10,407,000)	(7,808,000)
Unamortized discount	(6,233,000)	(6,663,000)
Unamortized fair value adjustment	213,000	259,000
Total debt	1,522,412,000	1,477,468,000
Mortgages
Debt
Long-term debt, gross	134,839,000	186,680,000
Senior notes
Debt
Debt instrument, face amount			$ 350,000,000	$ 400,000,000	$ 75,000,000	$ 150,000,000
Effective fixed interest rate (as a percent)			3.95%	4.30%
Mortgage notes bearing fixed interest rate due in 2019, 2020, 2021, 2022, and 2024 | Mortgages
Debt
Long-term debt, gross	$ 120,931,000
Weighted average interest rate	4.37%
Pledged assets separately reported real estate pledged as collateral number | healthcareproperty	6
Pledged assets, not separately reported, real estate	$ 210,900,000
Mortgage notes bearing fixed interest rate due in 2019, 2020, 2021, 2022, and 2024 | Minimum | Mortgages
Debt
Interest rate (as a percent)	3.00%
Mortgage notes bearing fixed interest rate due in 2019, 2020, 2021, 2022, and 2024 | Maximum | Mortgages
Debt
Interest rate (as a percent)	5.50%
Mortgage notes bearing fixed interest rate due in 2018, 2019, 2020, 2021, 2022, and 2024 | Mortgages
Debt
Long-term debt, gross		$ 158,171,000
Weighted average interest rate		4.45%
Pledged assets separately reported real estate pledged as collateral number | properties		9
Pledged assets, not separately reported, real estate		$ 267,700,000
Mortgage notes bearing fixed interest rate due in 2018, 2019, 2020, 2021, 2022, and 2024 | Minimum | Mortgages
Debt
Interest rate (as a percent)		3.00%
Mortgage notes bearing fixed interest rate due in 2018, 2019, 2020, 2021, 2022, and 2024 | Maximum | Mortgages
Debt
Interest rate (as a percent)		5.50%
Mortgage notes bearing variable interest due in 2018 and 2022 | Mortgages
Debt
Long-term debt, gross	$ 13,908,000
Weighted average interest rate	5.75%
Pledged assets separately reported real estate pledged as collateral number | healthcareproperty	2
Pledged assets, not separately reported, real estate	$ 31,800,000
Mortgage notes bearing variable interest due 2018 | Mortgages
Debt
Long-term debt, gross		$ 28,509,000
Weighted average interest rate		4.50%
Pledged assets separately reported real estate pledged as collateral number | properties		3
Pledged assets, not separately reported, real estate		$ 39,200,000
$850 million unsecured revolving credit facility bearing variable interest of LIBOR plus 1.10% at September 30, 2018 and LIBOR plus 1.20% at December 30, 2017, due September 2022 | $850 million unsecured revolving credit facility bearing variable interest of LIBOR plus 1.10% at September 30, 2018 and LIBOR plus 1.20% at December 30, 2017, due September 2022
Debt
Long-term debt, gross	179,000,000	$ 80,000,000
Debt instrument, face amount	$ 850,000,000
Reference rate (as a percent)	1.10%	1.20%
$400 million senior unsecured notes bearing fixed interest of 4.30%, due March 2027 | Senior notes
Debt
Long-term debt, gross	$ 400,000,000	$ 400,000,000
Debt instrument, face amount	$ 400,000,000
Interest rate (as a percent)	4.30%
$350 million senior unsecured notes bearing fixed interest of 3.95%, due January 2028 | Senior notes
Debt
Long-term debt, gross	$ 350,000,000	350,000,000
Debt instrument, face amount	$ 350,000,000
Interest rate (as a percent)	3.95%
$250 million unsecured term borrowing bearing fixed interest of 2.32% at September 30, 2018 and 2.87% at December 31, 2017, due June 2023 | $250 million unsecured term borrowing bearing fixed interest of 2.32% at September 30, 2018 and 2.87% at December 31, 2017, due June 2023
Debt
Long-term debt, gross	$ 250,000,000	$ 250,000,000
Debt instrument, face amount	$ 250,000,000
Interest rate (as a percent)	2.32%	2.87%
$150 million senior unsecured notes bearing fixed interest of 4.03% to 4.74%, due January 2023 to 2031 | Senior notes
Debt
Long-term debt, gross	$ 150,000,000	$ 150,000,000
Debt instrument, face amount	$ 150,000,000
$150 million senior unsecured notes bearing fixed interest of 4.03% to 4.74%, due January 2023 to 2031 | Minimum | Senior notes
Debt
Interest rate (as a percent)	4.03%
$150 million senior unsecured notes bearing fixed interest of 4.03% to 4.74%, due January 2023 to 2031 | Maximum | Senior notes
Debt
Interest rate (as a percent)	4.74%
$75 million senior unsecured notes bearing fixed interest of 4.09% to 4.24%, due August 2025 to 2027 | Senior notes
Debt
Long-term debt, gross	$ 75,000,000	$ 75,000,000
Debt instrument, face amount	$ 75,000,000
$75 million senior unsecured notes bearing fixed interest of 4.09% to 4.24%, due August 2025 to 2027 | Minimum | Senior notes
Debt
Interest rate (as a percent)	4.09%
$75 million senior unsecured notes bearing fixed interest of 4.09% to 4.24%, due August 2025 to 2027 | Maximum | Senior notes
Debt
Interest rate (as a percent)	4.24%
London Interbank Offered Rate (LIBOR) | Mortgage notes bearing variable interest due in 2018 and 2022 | Minimum | Mortgages
Debt
Reference rate (as a percent)	1.75%
London Interbank Offered Rate (LIBOR) | Mortgage notes bearing variable interest due in 2018 and 2022 | Maximum | Mortgages
Debt
Reference rate (as a percent)	2.25%
London Interbank Offered Rate (LIBOR) | Mortgage notes bearing variable interest due 2018 | Minimum | Mortgages
Debt
Reference rate (as a percent)		2.25%
London Interbank Offered Rate (LIBOR) | Mortgage notes bearing variable interest due 2018 | Maximum | Mortgages
Debt
Reference rate (as a percent)		3.25%
London Interbank Offered Rate (LIBOR) | $250 million unsecured term borrowing bearing fixed interest of 2.32% at September 30, 2018 and 2.87% at December 31, 2017, due June 2023 | $250 million unsecured term borrowing bearing fixed interest of 2.32% at September 30, 2018 and 2.87% at December 31, 2017, due June 2023
Debt
Reference rate (as a percent)	1.25%
Effective fixed interest rate (as a percent)		1.07%
London Interbank Offered Rate (LIBOR) | 2018 Credit Agreement Amendment
Debt
Reference rate (as a percent)	1.10%
London Interbank Offered Rate (LIBOR) | 2018 Credit Agreement Amendment | $250 million unsecured term borrowing bearing fixed interest of 2.32% at September 30, 2018 and 2.87% at December 31, 2017, due June 2023
Debt
Reference rate (as a percent)	1.25%	1.80%

Debt - Additional Information (

Debt - Additional Information (Details) - USD ($)

Dec. 01, 2017

Mar. 07, 2017

Jun. 10, 2016

Sep. 30, 2018

Sep. 30, 2017

Sep. 30, 2018

Sep. 30, 2017

Dec. 31, 2017

Sep. 30, 2018

Sep. 30, 2018

Aug. 11, 2016

Jul. 07, 2016

Jan. 07, 2016

Debt

Long-term debt, gross

$ 1,491,680,000

$ 1,538,839,000

Interest expense, debt

$ 16,500,000

$ 11,400,000

$ 50,100,000

$ 31,600,000

2016 Credit Agreement Amendment | London Interbank Offered Rate (LIBOR)

Debt

Reference rate (as a percent)

1.20%

2018 Credit Agreement Amendment

Debt

Current borrowing capacity

$ 1,100,000,000

Maximum borrowing capacity as a percentage of maximum principal amount

10.00%

Accordion feature, increase limit

$ 500,000,000

Maximum borrowing capacity under accordion feature

1,600,000,000

Unused fee (as a percent)

0.25%

2018 Credit Agreement Amendment | London Interbank Offered Rate (LIBOR)

Debt

Reference rate (as a percent)

1.10%

Series A

Debt

Interest rate (as a percent)

4.09%

4.03%

Series B

Debt

Interest rate (as a percent)

4.18%

4.43%

Series C

Debt

Interest rate (as a percent)

4.57%

Series D

Debt

Interest rate (as a percent)

4.74%

Revolving credit facility

Debt

Current borrowing capacity

654,000,000

Amount outstanding

179,000,000

Term of extension option

1 year

Revolving credit facility | Operating Partnership

Debt

Interest rate at end of period (as a percent)

3.81%

3.81%

Revolving credit facility | London Interbank Offered Rate (LIBOR) | Operating Partnership

Debt

Reference rate (as a percent)

2.18%

Revolving credit facility | 2018 Credit Agreement Amendment | Maximum

Debt

Current borrowing capacity

850,000,000

Term Loan

Debt

Amount outstanding

250,000,000

$ 250,000,000

Term Loan | 2018 Credit Agreement Amendment

Debt

Current borrowing capacity

$ 250,000,000

Debt instrument, term

7 years

Unsecured Debt | 2016 Credit Agreement Amendment | London Interbank Offered Rate (LIBOR)

Debt

Reference rate (as a percent)

1.80%

Unsecured Debt | 2018 Credit Agreement Amendment | London Interbank Offered Rate (LIBOR)

Debt

Reference rate (as a percent)

1.25%

1.80%

Unsecured Debt | $250 million unsecured term borrowing bearing fixed interest of 2.32% at September 30, 2018 and 2.87% at December 31, 2017, due June 2023

Debt

Interest rate (as a percent)

2.32%

2.32%

2.87%

Debt instrument, face amount

250,000,000

Long-term debt, gross

$ 250,000,000

250,000,000

Unsecured Debt | $250 million unsecured term borrowing bearing fixed interest of 2.32% at September 30, 2018 and 2.87% at December 31, 2017, due June 2023 | London Interbank Offered Rate (LIBOR)

Debt

Effective fixed interest rate (as a percent)

1.07%

Reference rate (as a percent)

1.25%

Letter of Credit

Debt

Amount outstanding

$ 17,000,000

Senior notes

Debt

Effective fixed interest rate (as a percent)

3.95%

4.30%

Debt instrument, face amount

$ 350,000,000

$ 400,000,000

$ 75,000,000

$ 150,000,000

Redemption price, percentage

99.78%

99.68%

Proceeds from issuance of debt

$ 347,000,000

$ 396,100,000

Senior notes | Series A

Debt

Debt instrument, face amount

25,000,000

15,000,000

Senior notes | Series B

Debt

Debt instrument, face amount

$ 25,000,000

45,000,000

Senior notes | Series C

Debt

Interest rate (as a percent)

4.24%

Debt instrument, face amount

$ 25,000,000

45,000,000

Senior notes | Series D

Debt

Debt instrument, face amount

$ 45,000,000

Interest Rate Swap | Unsecured Debt | London Interbank Offered Rate (LIBOR)

Debt

Effective fixed interest rate (as a percent)

1.07%

1.07%

1.07%

2.32%

1.07%

Interest rate (as a percent)

2.32%

2.32%

2.87%

Debt - Trust Investment Grade R

Debt - Trust Investment Grade Rating (Details)	9 Months Ended
	Sep. 30, 2018
At Least A- or A3 | Adjusted LIBOR rate loans and letter of credit | London Interbank Offered Rate (LIBOR)
Debt
Reference rate (as a percent)	0.775%
At Least A- or A3 | Adjusted LIBOR rate term loans and letter of credit | London Interbank Offered Rate (LIBOR)
Debt
Reference rate (as a percent)	0.85%
At Least BBB or Baa1 | Adjusted LIBOR rate loans and letter of credit | London Interbank Offered Rate (LIBOR)
Debt
Reference rate (as a percent)	0.825%
At Least BBB or Baa1 | Adjusted LIBOR rate term loans and letter of credit | London Interbank Offered Rate (LIBOR)
Debt
Reference rate (as a percent)	0.90%
At Least BBB or Baa2 | Adjusted LIBOR rate loans and letter of credit | London Interbank Offered Rate (LIBOR)
Debt
Reference rate (as a percent)	0.90%
At Least BBB or Baa2 | Adjusted LIBOR rate term loans and letter of credit | London Interbank Offered Rate (LIBOR)
Debt
Reference rate (as a percent)	1.00%
At Least BBB- or Baa3 | Adjusted LIBOR rate loans and letter of credit | London Interbank Offered Rate (LIBOR)
Debt
Reference rate (as a percent)	1.10%
At Least BBB- or Baa3 | Adjusted LIBOR rate term loans and letter of credit | London Interbank Offered Rate (LIBOR)
Debt
Reference rate (as a percent)	1.25%
Below BBB- or Baa3 | Adjusted LIBOR rate loans and letter of credit | London Interbank Offered Rate (LIBOR)
Debt
Reference rate (as a percent)	1.45%
Below BBB- or Baa3 | Adjusted LIBOR rate term loans and letter of credit | London Interbank Offered Rate (LIBOR)
Debt
Reference rate (as a percent)	1.65%
Margin for Revolving Loans: Base Rate Loans | At Least A- or A3 | Base rate loans | Base rate
Debt
Reference rate (as a percent)	0.00%
Margin for Revolving Loans: Base Rate Loans | At Least BBB or Baa1 | Base rate loans | Base rate
Debt
Reference rate (as a percent)	0.00%
Margin for Revolving Loans: Base Rate Loans | At Least BBB or Baa2 | Base rate loans | Base rate
Debt
Reference rate (as a percent)	0.00%
Margin for Revolving Loans: Base Rate Loans | At Least BBB- or Baa3 | Base rate loans | Base rate
Debt
Reference rate (as a percent)	0.10%
Margin for Revolving Loans: Base Rate Loans | Below BBB- or Baa3 | Base rate loans | Base rate
Debt
Reference rate (as a percent)	0.45%
Margin for Term Loans: Base Rate Loans | At Least A- or A3 | Base rate loans | Base rate
Debt
Reference rate (as a percent)	0.00%
Margin for Term Loans: Base Rate Loans | At Least BBB or Baa1 | Base rate loans | Base rate
Debt
Reference rate (as a percent)	0.00%
Margin for Term Loans: Base Rate Loans | At Least BBB or Baa2 | Base rate loans | Base rate
Debt
Reference rate (as a percent)	0.00%
Margin for Term Loans: Base Rate Loans | At Least BBB- or Baa3 | Base rate loans | Base rate
Debt
Reference rate (as a percent)	0.25%
Margin for Term Loans: Base Rate Loans | Below BBB- or Baa3 | Base rate loans | Base rate
Debt
Reference rate (as a percent)	0.65%

Debt - Scheduled Principal Paym

Debt - Scheduled Principal Payments (Details) - USD ($) $ in Thousands	3 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Dec. 31, 2017
Debt
2,018		$ 7,267
2,019		44,355
2,020		25,721
2,021		8,592
2,022		204,178
Thereafter		1,248,726
Total Payments		1,538,839	$ 1,491,680
Mortgages
Debt
Total Payments		$ 134,839	$ 186,680
Scenario, Forecast | Mortgages
Debt
Refinanced mortgage agreement	$ 6,800

Derivatives - Additional Inform

Derivatives - Additional Information (Details) - Cash Flow Hedging - Interest Rate Swap $ in Millions	9 Months Ended
	Sep. 30, 2017USD ($)	Sep. 30, 2018instruments
Derivative [Line Items]
Outstanding interest rate swap contracts designated as cash flow hedges | instruments		5
Derivative, net hedge ineffectiveness gain (loss) | $	$ 0.2

Derivatives - Location and Aggr

Derivatives - Location and Aggregate Fair Value of Interest Rate Swaps (Details) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2018	Dec. 31, 2017	Sep. 30, 2018	Sep. 30, 2018	Jul. 07, 2016
Derivative [Line Items]
Total notional amount			$ 250,000
Effective date	Jul. 7, 2016
Maturity date	Jun. 10, 2023
Interest Rate Swap | Carrying Amount | Recurring basis
Derivative [Line Items]
Asset balance (included in Other assets)		$ 14,693	$ 21,200
London Interbank Offered Rate (LIBOR) | 2018 Credit Agreement Amendment
Derivative [Line Items]
Reference rate (as a percent)	1.10%
London Interbank Offered Rate (LIBOR) | 2016 Credit Agreement Amendment
Derivative [Line Items]
Reference rate (as a percent)	1.20%
Unsecured Debt | London Interbank Offered Rate (LIBOR) | 2018 Credit Agreement Amendment
Derivative [Line Items]
Reference rate (as a percent)	1.25%	1.80%
Unsecured Debt | London Interbank Offered Rate (LIBOR) | 2016 Credit Agreement Amendment
Derivative [Line Items]
Reference rate (as a percent)		1.80%
Unsecured Debt | London Interbank Offered Rate (LIBOR) | Interest Rate Swap
Derivative [Line Items]
Effective fixed interest rate (as a percent)	1.07%	1.07%		2.32%	1.07%
Interest rate (as a percent)	2.32%	2.87%

Accrued Expenses and Other Li_3

Accrued Expenses and Other Liabilities - Schedule of Accrued Expense and Other Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Other Liabilities Disclosure [Abstract]
Real estate taxes payable	$ 22,476	$ 16,103
Prepaid rent	10,830	10,496
Accrued interest	5,894	11,107
Accrued expenses	5,605	8,751
Embedded derivative	3,575	0
Security deposits	3,408	2,882
Tenant improvement allowance	2,995	3,065
Accrued incentive compensation	2,973	1,625
Contingent consideration	753	1,454
Other	2,837	922
Total	$ 61,346	$ 56,405

Stock-based Compensation - Addi

Stock-based Compensation - Additional Information (Details) - Restricted common shares - 2013 Plan - shares	Aug. 07, 2014	Jul. 24, 2013
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Maximum number of shares authorized (in shares)	2,450,000	600,000
Increase in number of common shares authorized for issuance (in shares)	1,850,000

Stock-based Compensation - Rest

Stock-based Compensation - Restricted Common Shares (Narrative) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Non-cash share compensation			$ 6,675	$ 4,976
2013 Plan | Restricted common shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)			206,446
Non-cash share compensation	$ 800	$ 800	$ 2,300
Unrecognized compensation expense	$ 1,800		$ 1,800
Officers and Certain Employees | 2013 Plan | Restricted common shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)			206,446
Grant date value			$ 3,100
Minimum | Officers and Certain Employees | 2013 Plan | Restricted common shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period			1 year
Maximum | Officers and Certain Employees | 2013 Plan | Restricted common shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period			3 years

Stock-based Compensation - Summ

Stock-based Compensation - Summary of the Status of the Trust's Non-Vested Restricted Common Shares (Details) - 2013 Plan - Restricted common shares	9 Months Ended
	Sep. 30, 2018$ / sharesshares
Common Shares
Non-vested at the beginning of the period (in shares) | shares	173,276
Granted (in shares) | shares	206,446
Vested (in shares) | shares	(142,243)
Non-vested at the end of the period (in shares) | shares	237,479
Weighted Average Grant Date Fair Value
Non-vested at beginning of period (in dollars per share) | $ / shares	$ 19.36
Granted (in dollars per share) | $ / shares	14.87
Vested (in dollars per share) | $ / shares	19.65
Non-vested at end of period (in dollars per share) | $ / shares	$ 15.28

Stock-based Compensation - Re_2

Stock-based Compensation - Restricted Share Units (Narrative) (Details) - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended	3 Months Ended		9 Months Ended
	Mar. 31, 2018	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Non-cash share compensation				$ 6,675	$ 4,976
2013 Plan | Restricted share units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of dividend equivalent included in each award (in shares)	1
Non-cash share compensation		$ 1,200	$ 1,000	4,300	$ 2,700
Unrecognized compensation expense		$ 6,400		$ 6,400
2013 Plan | Performance based restricted stock units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in dollars per share)	$ 16.58
Performance conditions grant date fair value (in dollars per share)	$ 14.78
Officers and Certain Employees | 2013 Plan | Restricted share units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)	254,282
Vesting period	3 years
Officers and Certain Employees | 2013 Plan | Market Based Restricted Stock Units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting percentage	40.00%
Granted (in dollars per share)	$ 19.28
Officers and Certain Employees | 2013 Plan | Performance based restricted stock units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting percentage	60.00%
Trustees | 2013 Plan | Restricted share units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)	50,745
Vesting period	2 years
Trustees | 2013 Plan | Performance based restricted stock units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of restricted share units issued to trustees	100.00%

Stock-based Compensation - Re_3

Stock-based Compensation - Restricted Share Assumptions (Details) - 2013 Plan - Restricted share units (RSUs) - $ / shares	1 Months Ended
	Mar. 31, 2018	Sep. 30, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Volatility	21.70%
Expected term in years	2 years 9 months 18 days
Risk-free rate	2.40%
Share price (per share)		$ 14.78

Stock-based Compensation - Su_2

Stock-based Compensation - Summary of Activity in the Trust's Restricted Share Units (Details) - $ / shares	9 Months Ended
	Sep. 30, 2018	Dec. 31, 2017
Weighted Average Grant Date Fair Value
Common stock, shares issued (in shares)	182,173,601	181,440,051
2013 Plan | Executive Awards
Restricted Share Units
Non-vested at the beginning of the period (in shares)	354,123
Granted (in shares)	254,282
Vested (in shares)	(75,250)
Non-vested at the end of the period (in shares)	533,155
Weighted Average Grant Date Fair Value
Non-vested at beginning of period (in dollars per share)	$ 26.30
Granted (in dollars per share)	16.58
Vested (in dollars per share)	21.16
Non-vested at end of period (in dollars per share)	$ 22.66
Common stock, shares issued (in shares)	126,108
Restricted stock shares issued net of tax withholdings (in shares)	56,502
2013 Plan | Trustee Awards
Restricted Share Units
Non-vested at the beginning of the period (in shares)	51,220
Granted (in shares)	50,745
Vested (in shares)	(34,807)
Non-vested at the end of the period (in shares)	67,158
Weighted Average Grant Date Fair Value
Non-vested at beginning of period (in dollars per share)	$ 19.04
Granted (in dollars per share)	14.78
Vested (in dollars per share)	18.67
Non-vested at end of period (in dollars per share)	$ 16.01

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Details)	Sep. 30, 2018USD ($)instrumentspropertiesportfolio
Fair value of other financial instruments
Number of portfolios comprised of properties held for sale | portfolio	1
Number of properties, held for sale | properties	2
Fair value, measurements, nonrecurring
Fair value of other financial instruments
Assets subject to impairment fair value disclosure | $	$ 0
Cash Flow Hedging | Interest Rate Swap
Fair value of other financial instruments
Outstanding interest rate swap contracts designated as cash flow hedges | instruments	5

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value of Company's Financial Instruments (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Assets [Abstract]
Note receivable	$ 20,628	$ 0
Liabilities:
Credit facility	(420,900)	(324,394)
Notes payable	(966,788)	(966,603)
Carrying Amount | Recurring basis
Assets [Abstract]
Real estate loans receivable	47,911	76,195
Note receivable	20,628	0
Liabilities:
Credit facility	(429,000)	(330,000)
Notes payable	(975,000)	(975,000)
Mortgage debt	(135,052)	(186,939)
Carrying Amount | Interest Rate Swap | Recurring basis
Assets [Abstract]
Derivative assets	21,200	14,693
Fair Value | Recurring basis
Assets [Abstract]
Real estate loans receivable	46,218	75,288
Note receivable	20,628	0
Liabilities:
Credit facility	(429,000)	(330,000)
Notes payable	(909,510)	(970,975)
Mortgage debt	(133,963)	(185,743)
Fair Value | Interest Rate Swap | Recurring basis
Assets [Abstract]
Derivative assets	$ 21,200	$ 14,693

Tenant Operating Leases - Sched

Tenant Operating Leases - Schedule of Future Minimum Rental Payments (Details) $ in Thousands	Sep. 30, 2018USD ($)properties
Leases [Abstract]
Number of properties, held for sale | properties	2
Future minimum rental payments on non-cancelable leases
2,018	$ 70,531
2,019	282,261
2,020	278,483
2,021	273,233
2,022	262,669
Thereafter	1,310,257
Total	$ 2,477,434

Rent Expense - Additional Infor

Rent Expense - Additional Information (Details) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2018USD ($)propertieshealthcareproperty	Sep. 30, 2017USD ($)	Sep. 30, 2018USD ($)propertieshealthcareproperty	Sep. 30, 2017USD ($)
Operating Leased Assets [Line Items]
Number of properties subject to parking lease	3		3
Number of properties subject to air space lease | healthcareproperty	1		1
Number of properties subject to ground leases	76		76
Number of office space leases	5		5
Maximum lease terms			87 years
Number of properties, held for sale	2		2
Operating Expense | Parking, Air And Ground Leases
Operating Leased Assets [Line Items]
Rent expenses for parking, air, and ground leases | $	$ 0.6	$ 0.6	$ 1.8	$ 1.8

Rent Expense - Schedule of Futu

Rent Expense - Schedule of Future Minimum Lease Obligations (Details) $ in Thousands	Sep. 30, 2018USD ($)
Future minimum lease obligations under non-cancelable parking, air, and ground leases
2,018	$ 794
2,019	3,058
2,020	3,013
2,021	3,037
2,022	3,030
Thereafter	146,119
Total	$ 159,051

Credit Concentration - Schedule

Credit Concentration - Schedule of ABR (Annualized Base Rent) (Details) - Sales Revenue, Services, Net $ in Thousands	9 Months Ended
	Sep. 30, 2018USD ($)Rate
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 281,290
Percent of ABR (annualized base rent) | Rate	100.00%
Customer Concentration Risk | CHI - Nebraska
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 16,336
Percent of ABR (annualized base rent)	5.80%
Customer Concentration Risk | CHI - KentuckyOne Health
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 13,574
Percent of ABR (annualized base rent)	4.80%
Customer Concentration Risk | Northside Hospital
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 9,860
Percent of ABR (annualized base rent)	3.50%
Customer Concentration Risk | Baylor Scott and White Health
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 7,583
Percent of ABR (annualized base rent)	2.70%
Customer Concentration Risk | Ascension - St. Vincent's - Indianapolis
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 7,271
Percent of ABR (annualized base rent)	2.60%
Customer Concentration Risk | Remaining portfolio
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 226,666
Percent of ABR (annualized base rent) | Rate	80.60%
Geographic Concentration Risk | Texas
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 42,458
Percent of ABR (annualized base rent)	15.10%
Geographic Concentration Risk | Georgia
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 24,372
Percent of ABR (annualized base rent)	8.70%
Geographic Concentration Risk | Indiana
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 19,749
Percent of ABR (annualized base rent)	7.00%
Geographic Concentration Risk | Nebraska
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 17,734
Percent of ABR (annualized base rent)	6.30%
Geographic Concentration Risk | Minnesota
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 16,858
Percent of ABR (annualized base rent)	6.00%
Geographic Concentration Risk | Other
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 160,119
Percent of ABR (annualized base rent)	56.90%

Credit Concentration - Addition

Credit Concentration - Additional Information (Details)	9 Months Ended
	Sep. 30, 2018propertiesRate
Concentration Risk [Line Items]
Number of properties, held for sale | properties	2
Sales Revenue, Services, Net
Concentration Risk [Line Items]
Percent of ABR (annualized base rent) | Rate	100.00%
Top five tenant relationships | Sales Revenue, Services, Net | Customer Concentration Risk
Concentration Risk [Line Items]
Percent of ABR (annualized base rent)	19.40%
CHI Portfolio | Sales Revenue, Services, Net | Customer Concentration Risk
Concentration Risk [Line Items]
Percent of ABR (annualized base rent)	19.50%

Earnings Per Share and Earnin_3

Earnings Per Share and Earnings Per Unit - Schedule of Earnings Per Share and Earnings Per Unit (Details) - USD ($) $ / shares in Units, $ in Thousands		3 Months Ended		9 Months Ended
		Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Numerator for earnings per share - basic:
Net income		$ 23,771	$ 12,539	$ 47,165	$ 29,586
Net income attributable to noncontrolling interests:
Operating Partnership		(656)	(362)	(1,300)	(823)
Partially owned properties	[1]	(119)	(53)	(374)	(379)
Preferred distributions		(284)	(106)	(1,055)	(505)
Numerator for earnings per share - basic		22,712	12,018	44,436	27,879
Numerator for earnings per share - diluted:
Net income attributable to common shareholders		22,712	12,018	44,436	27,879
Operating Partnership net income		656	362	1,300	823
Numerator for earnings per share - diluted		$ 23,368	$ 12,380	$ 45,736	$ 28,702
Denominator for earnings per share - basic and diluted:
Weighted average number of shares outstanding - basic (in shares)		182,076,513	177,847,424	181,963,693	157,542,167
Effect of dilutive securities:
Noncontrolling interest - Operating Partnership units (in shares)		5,291,025	5,379,981	5,378,760	4,663,157
Denominator for earnings per share - diluted (in shares)		187,473,230	183,298,145	187,622,109	162,480,918
Earnings per share - basic (in dollars per share)		$ 0.12	$ 0.07	$ 0.24	$ 0.18
Earnings per share - diluted (in dollars per share)		$ 0.12	$ 0.07	$ 0.24	$ 0.18
Units excluded from the computation of diluted earnings per share (in shares)		600,313		600,313
Restricted common shares
Effect of dilutive securities:
Effect of dilutive securities, restricted shares and RSUs (in shares)		105,692	70,740	80,272	85,689
Restricted share units
Effect of dilutive securities:
Effect of dilutive securities, restricted shares and RSUs (in shares)		0	0	199,384	189,905
Operating Partnership
Numerator for earnings per share - basic:
Net income		$ 23,771	$ 12,539	$ 47,165	$ 29,586
Net income attributable to noncontrolling interests:
Partially owned properties	[2]	(119)	(53)	(374)	(379)
Preferred distributions		(284)	(106)	(1,055)	(505)
Numerator for earnings per share - basic		23,368	12,380	45,736	28,702
Numerator for earnings per unit - basic and diluted		23,368	12,380	45,736	28,702
Numerator for earnings per share - diluted:
Net income attributable to common shareholders		$ 23,368	$ 12,380	$ 45,736	$ 28,702
Denominator for earnings per unit - basic and diluted:
Weighted average number of units outstanding - basic (in shares)		187,367,538	183,227,405	187,342,453	162,205,324
Effect of dilutive securities:
Denominator for earnings per unit - diluted (in shares)		187,473,230	183,298,145	187,622,109	162,480,918
Earnings per unit - basic (in dollars per share)		$ 0.12	$ 0.07	$ 0.24	$ 0.18
Earnings per unit - diluted (in dollars per share)		$ 0.12	$ 0.07	$ 0.24	$ 0.18
Operating Partnership | Restricted common shares
Effect of dilutive securities:
Effect of dilutive securities, restricted shares and RSUs (in shares)		105,692	70,740	80,272	85,689
Operating Partnership | Restricted share units
Effect of dilutive securities:
Effect of dilutive securities, restricted shares and RSUs (in shares)		0	0	199,384	189,905
[1]	Includes amounts attributable to redeemable noncontrolling interests.
[2]	Includes amounts attributable to redeemable noncontrolling interests.