Physicians Realty Trust 10-Q 5 Nov 21 2021 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares	9 Months Ended
	Sep. 30, 2021	Oct. 29, 2021
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2021
Document Transition Report	false
Entity File Number	001-36007
Entity Registrant Name	PHYSICIANS REALTY TRUST
Entity Incorporation, State or Country Code	MD
Entity Tax Identification Number	46-2519850
Entity Address, Address Line One	309 N. Water Street, Suite 500
Entity Address, City or Town	Milwaukee,
Entity Address, State or Province	WI
Entity Address, Postal Zip Code	53202
City Area Code	414
Local Phone Number	367-5600
Title of 12(b) Security	Common stock, $0.01 par value per share
Trading Symbol	DOC
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Emerging Growth Company	false
Entity Small Business	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding (in shares)		220,289,484
Amendment Flag	false
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q3
Entity Central Index Key	0001574540
Current Fiscal Year End Date	--12-31

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Investment properties:
Land and improvements	$ 231,162	$ 231,621
Building and improvements	3,879,810	3,824,796
Tenant improvements	81,605	73,145
Acquired lease intangibles	409,048	406,935
Gross real estate property	4,601,625	4,536,497
Accumulated depreciation	(779,910)	(687,554)
Net real estate property	3,821,715	3,848,943
Real estate held for sale	44,706	0
Right-of-use lease assets, net	141,967	137,180
Real estate loans receivable, net	181,125	198,800
Investments in unconsolidated entities	78,562	77,755
Net real estate investments	4,268,075	4,262,678
Cash and cash equivalents	5,366	2,515
Tenant receivables, net	5,545	4,757
Other assets	130,489	144,000
Total assets	4,409,475	4,413,950
Liabilities:
Credit facility	401,548	412,322
Notes payable	969,313	968,653
Mortgage debt	50,042	57,875
Accounts payable	5,760	7,007
Dividends and distributions payable	53,730	52,116
Accrued expenses and other liabilities	79,621	91,929
Lease liabilities	78,682	74,116
Acquired lease intangibles, net	5,829	6,641
Total liabilities	1,644,525	1,670,659
Redeemable noncontrolling interest - Series A Preferred Units and partially owned properties	7,039	28,289
Equity:
Common shares, $0.01 par value, 500,000,000 common shares authorized, 217,409,035 and 209,550,592 common shares issued and outstanding as of September 30, 2021 and December 31, 2020, respectively	2,174	2,096
Additional paid-in capital	3,443,748	3,303,231
Accumulated deficit	(751,150)	(658,171)
Accumulated other comprehensive loss	(4,054)	(5,859)
Total shareholders’ equity	2,690,718	2,641,297
Noncontrolling interests:
Operating Partnership	66,736	73,302
Partially owned properties	457	403
Total noncontrolling interests	67,193	73,705
Total equity	2,757,911	2,715,002
Total liabilities and equity	$ 4,409,475	$ 4,413,950

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 2021	Dec. 31, 2020
Equity:
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 outstanding (in shares)	217,409,035	209,550,592
Common stock, shares issued (in shares)	217,409,035	209,550,592

Consolidated Statements of Inco

Consolidated Statements of Income - USD ($)		3 Months Ended		9 Months Ended
		Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Revenues:
Rental and related revenues		$ 110,314,000	$ 104,362,000	$ 326,017,000	$ 311,861,000
Interest income on real estate loans and other		4,997,000	5,204,000	15,558,000	14,199,000
Total revenues		115,311,000	109,566,000	341,575,000	326,060,000
Expenses:
Interest expense		13,498,000	13,698,000	40,754,000	43,521,000
General and administrative		9,534,000	8,346,000	28,116,000	25,565,000
Operating expenses		35,679,000	32,503,000	103,069,000	94,495,000
Depreciation and amortization		38,582,000	37,952,000	114,663,000	111,744,000
Impairment loss		340,000	0	340,000	0
Total expenses		97,633,000	92,499,000	286,942,000	275,325,000
Income before equity in loss of unconsolidated entities and gain on sale of investment properties, net:		17,678,000	17,067,000	54,633,000	50,735,000
Equity in loss of unconsolidated entities		(390,000)	(592,000)	(1,213,000)	(856,000)
Gain on sale of investment properties, net		4,757,000	0	5,111,000	0
Net income		22,045,000	16,475,000	58,531,000	49,879,000
Net income attributable to noncontrolling interests:
Operating Partnership		(529,000)	(425,000)	(1,405,000)	(1,305,000)
Partially owned properties	[1]	(152,000)	(151,000)	(455,000)	(441,000)
Net income attributable to controlling interest		21,364,000	15,899,000	56,671,000	48,133,000
Preferred distributions		0	(317,000)	(13,000)	(951,000)
Net income attributable to common shareholders		$ 21,364,000	$ 15,582,000	$ 56,658,000	$ 47,182,000
Net income per share:
Basic (in dollars per share)		$ 0.10	$ 0.07	$ 0.26	$ 0.23
Diluted (in dollars per share)		$ 0.10	$ 0.07	$ 0.26	$ 0.23
Weighted average common shares:
Weighted average common shares - basic (in shares)		217,406,657	208,187,129	214,616,482	202,717,190
Weighted average common shares - diluted (in shares)		223,992,049	215,129,968	221,399,649	209,555,060
Dividends and distributions declared per common share (in usd per share)		$ 0.23	$ 0.23	$ 0.69	$ 0.69
[1]	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, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Statement of Comprehensive Income [Abstract]
Net income	$ 22,045	$ 16,475	$ 58,531	$ 49,879
Other comprehensive income (loss):
Change in fair value of interest rate swap agreements, net	465	599	1,805	(10,630)
Total other comprehensive income (loss)	465	599	1,805	(10,630)
Comprehensive income	22,510	17,074	60,336	39,249
Comprehensive income attributable to noncontrolling interests - Operating Partnership	(541)	(442)	(1,449)	(1,024)
Comprehensive income attributable to noncontrolling interests - partially owned properties	(152)	(151)	(455)	(441)
Comprehensive income attributable to common shareholders	$ 21,817	$ 16,481	$ 58,432	$ 37,784

Consolidated Statement of Equit

Consolidated Statement of Equity - USD ($) $ in Thousands	Total	Cumulative effect of changes in accounting standard	Total Shareholders’  Equity	Total Shareholders’  EquityCumulative effect of changes in accounting standard	Par Value	Additional Paid in Capital	Additional Paid in CapitalCumulative effect of changes in accounting standard	Accumulated Deficit	Accumulated Other Comprehensive Income (Loss)	Total Noncontrolling Interests	Operating Partnership Noncontrolling Interest	Partially Owned Properties Noncontrolling Interest
Balance at Dec. 31, 2019	$ 2,480,984	$ (147)	$ 2,408,948	$ (147)	$ 1,900	$ 2,931,921	$ (147)	$ (529,194)	$ 4,321	$ 72,036	$ 71,697	$ 339
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net proceeds from sale of common shares	239,232		239,232		124	239,108
Restricted share award grants, net	(201)		(201)		2	245		(448)
Purchase of OP Units	(93)									(93)	(93)
Dividends/distributions declared	(47,911)		(46,636)					(46,636)		(1,275)	(1,275)
Preferred distributions	(317)		(317)					(317)
Distributions	(41)									(41)		(41)
Change in market value of Redeemable Noncontrolling Interest in Operating Partnership	(980)		(980)			581		(1,561)
Change in fair value of interest rate swap agreements	(9,986)		(9,986)						(9,986)
Adjustment for Noncontrolling Interests ownership in Operating Partnership	0		(2,038)			(2,038)				2,038	2,038
Net income	14,885		14,414					14,414		471	404	67
Balance at Mar. 31, 2020	2,675,425		2,602,289		2,026	3,169,670		(563,742)	(5,665)	73,136	72,771	365
Balance at Dec. 31, 2019	2,480,984	$ (147)	2,408,948	$ (147)	1,900	2,931,921	$ (147)	(529,194)	4,321	72,036	71,697	339
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Change in fair value of interest rate swap agreements	(10,630)
Balance at Sep. 30, 2020	2,715,183		2,643,076		2,082	3,275,187		(627,884)	(6,309)	72,107	71,676	431
Balance at Mar. 31, 2020	2,675,425		2,602,289		2,026	3,169,670		(563,742)	(5,665)	73,136	72,771	365
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net proceeds from sale of common shares	99,505		99,505		55	99,450
Restricted share award grants, net	2,226		2,226			3,017		(791)
Purchase of OP Units	(67)									(67)	(67)
Dividends/distributions declared	(49,195)		(47,924)					(47,924)		(1,271)	(1,271)
Preferred distributions	(317)		(317)					(317)
Distributions	(42)									(42)		(42)
Change in market value of Redeemable Noncontrolling Interest in Operating Partnership	(579)		(579)			(416)		(163)
Change in fair value of interest rate swap agreements	(1,243)		(1,243)						(1,243)
Adjustment for Noncontrolling Interests ownership in Operating Partnership	0		(806)			(806)				806	806
Net income	18,369		17,820					17,820		549	476	73
Balance at Jun. 30, 2020	2,744,082		2,670,971		2,081	3,270,915		(595,117)	(6,908)	73,111	72,715	396
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net proceeds from sale of common shares	1,529		1,529		1	1,528
Restricted share award grants, net	2,458		2,458			2,951		(493)
Purchase of OP Units	(355)									(355)	(355)
Dividends/distributions declared	(49,214)		(47,943)					(47,943)		(1,271)	(1,271)
Preferred distributions	(317)		(317)					(317)
Distributions	(41)									(41)		(41)
Change in market value of Redeemable Noncontrolling Interest in Operating Partnership	42		42			(45)		87
Change in fair value of interest rate swap agreements	599		599						599
Adjustment for Noncontrolling Interests ownership in Operating Partnership	0		(162)			(162)				162	162
Net income	16,400		15,899					15,899		501	425	76
Balance at Sep. 30, 2020	2,715,183		2,643,076		2,082	3,275,187		(627,884)	(6,309)	72,107	71,676	431
Balance at Dec. 31, 2020	2,715,002		2,641,297		2,096	3,303,231		(658,171)	(5,859)	73,705	73,302	403
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net proceeds from sale of common shares	52,432		52,432		28	52,404
Restricted share award grants, net	(993)		(993)		4	(333)		(664)
Purchase of OP Units	(269)									(269)	(269)
Dividends/distributions declared	(50,254)		(49,011)					(49,011)		(1,243)	(1,243)
Preferred distributions	(13)		(13)					(13)
Distributions	(73)									(73)		(73)
Change in market value of Redeemable Noncontrolling Interest in Operating Partnership	873		873			(23)		896
Change in fair value of interest rate swap agreements	797		797						797
Adjustment for Noncontrolling Interests ownership in Operating Partnership	0		1,136			1,136				(1,136)	(1,136)
Net income	17,729		17,194					17,194		535	459	76
Balance at Mar. 31, 2021	2,735,231		2,663,712		2,128	3,356,415		(689,769)	(5,062)	71,519	71,113	406
Balance at Dec. 31, 2020	2,715,002		2,641,297		2,096	3,303,231		(658,171)	(5,859)	73,705	73,302	403
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Change in fair value of interest rate swap agreements	1,805
Balance at Sep. 30, 2021	2,757,911		2,690,718		2,174	3,443,748		(751,150)	(4,054)	67,193	66,736	457
Balance at Mar. 31, 2021	2,735,231		2,663,712		2,128	3,356,415		(689,769)	(5,062)	71,519	71,113	406
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net proceeds from sale of common shares	82,827		82,827		46	82,781
Restricted share award grants, net	2,760		2,760			3,242		(482)
Purchase of OP Units	(5,063)									(5,063)	(5,063)
Dividends/distributions declared	(51,303)		(50,061)					(50,061)		(1,242)	(1,242)
Distributions	(50)									(50)		(50)
Change in market value of Redeemable Noncontrolling Interest in Operating Partnership	(388)		(388)					(388)
Change in fair value of interest rate swap agreements	543		543						543
Adjustment for Noncontrolling Interests ownership in Operating Partnership	0		(2,124)			(2,124)				2,124	2,124
Net income	18,606		18,113					18,113		493	417	76
Balance at Jun. 30, 2021	2,783,163		2,715,382		2,174	3,440,314		(722,587)	(4,519)	67,781	67,349	432
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net proceeds from sale of common shares	(117)		(117)			(117)
Restricted share award grants, net	3,755		3,755			3,642		113
Dividends/distributions declared	(51,295)		(50,062)					(50,062)		(1,233)	(1,233)
Distributions	(51)									(51)		(51)
Change in market value of Redeemable Noncontrolling Interest in Operating Partnership	22		22					22
Change in fair value of interest rate swap agreements	465		465						465
Adjustment for Noncontrolling Interests ownership in Operating Partnership	0		(91)			(91)				91	91
Net income	21,969		21,364					21,364		605	529	76
Balance at Sep. 30, 2021	$ 2,757,911		$ 2,690,718		$ 2,174	$ 3,443,748		$ (751,150)	$ (4,054)	$ 67,193	$ 66,736	$ 457

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($)	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Cash Flows from Operating Activities:
Net income	$ 58,531,000	$ 49,879,000
Adjustments to reconcile net income to net cash provided by operating activities
Depreciation and amortization	114,663,000	111,744,000
Amortization of deferred financing costs	1,744,000	1,789,000
Amortization of lease inducements and above/below-market lease intangibles	3,526,000	3,504,000
Straight-line rental revenue/expense	(7,276,000)	(9,624,000)
Amortization of discount on unsecured senior notes	489,000	469,000
Amortization of above market assumed debt	(47,000)	(47,000)
Gain on sale of investment properties, net	(5,111,000)	0
Equity in loss of unconsolidated entities	1,213,000	856,000
Distributions from unconsolidated entities	5,261,000	4,305,000
Change in fair value of derivative	0	15,000
Provision for bad debts	(139,000)	512,000
Non-cash share compensation	10,840,000	9,161,000
Net change in fair value of contingent consideration	0	(715,000)
Impairment loss	340,000	0
Change in operating assets and liabilities:
Tenant receivables	(2,913,000)	626,000
Other assets	3,300,000	(6,777,000)
Accounts payable	(1,247,000)	1,774,000
Accrued expenses and other liabilities	(7,427,000)	(1,111,000)
Net cash provided by operating activities	175,747,000	166,360,000
Cash Flows from Investing Activities:
Proceeds from sale of investment properties	31,093,000	0
Acquisition of investment properties, net	(120,617,000)	(34,529,000)
Investment in unconsolidated entities	(7,281,000)	0
Escrowed cash - acquisition deposits/earnest deposits	(1,154,000)	(150,000)
Capital expenditures on investment properties	(22,159,000)	(20,673,000)
Investment in real estate loans receivable	(14,406,000)	(32,630,000)
Repayment of real estate loans receivable	18,902,000	944,000
Leasing commissions	(3,343,000)	(1,887,000)
Net cash used in investing activities	(118,965,000)	(88,925,000)
Cash Flows from Financing Activities:
Net proceeds from sale of common shares	135,142,000	340,266,000
Proceeds from credit facility borrowings	304,000,000	235,000,000
Repayment of credit facility borrowings	(311,000,000)	(479,000,000)
Principal payments on mortgage debt	(7,833,000)	(24,974,000)
Debt issuance costs	(5,300,000)	(63,000)
Payments made on financing lease	(1,700,000)	0
Dividends paid - shareholders	(148,478,000)	(138,778,000)
Distributions to noncontrolling interests - Operating Partnership	(3,792,000)	(3,821,000)
Preferred distributions paid - OP Unit holder	(303,000)	(951,000)
Distributions to noncontrolling interests - partially owned properties	(491,000)	(437,000)
Payments of employee taxes for withheld stock-based compensation shares	(4,183,000)	(2,848,000)
Purchase of Series A Preferred Units	(4,661,000)	0
Purchase of OP Units	(5,332,000)	(515,000)
Net cash used in financing activities	(53,931,000)	(76,121,000)
Net increase in cash and cash equivalents	2,851,000	1,314,000
Cash and cash equivalents, beginning of period	2,515,000	2,355,000
Cash and cash equivalents, end of period	5,366,000	3,669,000
Supplemental Cash Flow Information [Abstract]
Supplemental disclosure of cash flow information - interest paid during the period	49,160,000	52,000,000
Supplemental disclosure of noncash activity—settlement of note receivable in exchange for Series A Preferred Units	20,646,000	0
Supplemental disclosure of noncash activity—change in fair value of interest rate swap agreements	1,805,000	(10,630,000)
Supplemental disclosure of noncash activity—Conversion of loan receivable in connection to the acquisition of investment property	$ 15,500,000	$ 0

Organization and Business

Organization and Business	9 Months Ended
	Sep. 30, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Business	Organization and Business Physicians Realty Trust (the “Trust” or the “Company”) was organized in the state of Maryland on April 9, 2013. As of September 30, 2021, the Trust was authorized to issue up to 500,000,000 common shares of beneficial interest, par value $0.01 per share. The Trust filed a Registration Statement on Form S-11 with 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’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. The Trust is a self-managed REIT formed primarily to acquire, selectively develop, own, and manage health care properties that are leased to physicians, hospitals, and health care delivery systems. ATM Program In November 2019, the Trust and the Operating Partnership entered into separate At Market Issuance Sales Agreements (the “2019 Sales Agreements”) with each of KeyBanc Capital Markets Inc., Credit Agricole Securities (USA) Inc., BMO Capital Markets Corp., Raymond James & Associates, Inc., and Stifel, Nicolaus & Company, Incorporated, in their capacity as agents and as forward sellers (the “2019 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 $500 million, through the 2019 Agents (the “2019 ATM Program”). The 2019 Sales Agreements contemplate that, in addition to the issuance and sale of the Trust’s common shares through the 2019 Agents, the Trust may also enter into one or more forward sales agreements from time to time in the future with each of KeyBanc Capital Markets, Inc., Credit Agricole Securities (USA) Inc., BMO Capital Markets Corp., Raymond James & Associates, Inc., and Stifel, Nicolaus & Company, Incorporated, or one of their respective affiliates. In May 2021, the Trust and the Operating Partnership entered into an At Market Issuance Sales Agreement (the “2021 Sales Agreement”) with KeyBanc Capital Markets Inc., Credit Agricole Securities (USA) Inc., BMO Capital Markets Corp., and Raymond James & Associates, Inc. in their capacity as agents for the Company and/or forward sellers and Stifel, Nicolaus & Company, Incorporated in its capacity as sales agent for the Company (collectively, the “2021 Agents”) and Bank of Montreal, Credit Agricole Corporate and Investments Bank, KeyBanc Capital Markets Inc., and Raymond James & Associates, Inc. as forward purchasers for the Company (the “Forward Purchasers”), pursuant to which the Trust may issue and sell, from time to time, its common shares having an aggregate offering price of up to $500 million through the 2021 Agents (the “2021 ATM Program”). The 2021 Sales Agreement contemplates that, in addition to the issuance and sale of the Trust’s common shares through the 2021 Agents, the Trust may also enter into one or more forward sales agreements from time to time in the future with each of the Forward Purchasers. Upon entry into the 2021 Sales Agreement, we terminated the 2019 ATM Program. During the quarterly periods ended March 31, 2021, June 30, 2021, and September 30, 2021, the Trust’s issuance and sale of common shares pursuant to the ATM Programs is as follows (in thousands, except common shares and price): Common Weighted average price Net Quarterly period ended March 31, 2021 2,887,296 $ 18.32 $ 52,358 Quarterly period ended June 30, 2021 4,532,343 18.39 82,519 Quarterly period ended September 30, 2021 — — — Year to date 7,419,639 $ 18.36 $ 134,877 As of September 30, 2021, the Trust has $465.3 million remaining available under the 2021 ATM Program.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2021
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, 2021 and 2020 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 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 2020 Annual Report. The Company has consistently applied its accounting policies to all periods presented in these consolidated financial statements. Noncontrolling Interests As of September 30, 2021, the Trust held a 97.6% 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. Redeemable Noncontrolling Interests - Series A Preferred Units and Partially Owned Properties In connection with the acquisition of the HealthEast Clinic & Specialty Center (“Hazelwood Medical Commons Transaction”) that occurred on January 9, 2018, the Company issued 116,110 Series A Participating Redeemable Preferred Units of the Operating Partnership (“Series A Preferred Units”). On January 4, 2021, these Series A Preferred Units were redeemed for a total value of $25.3 million and as a result of this redemption, there are no Series A Preferred Units outstanding as of September 30, 2021. In connection with the Company’s acquisitions of the medical office building, ambulatory surgery center, and hospital located on the Great Falls Hospital campus in Great Falls, Montana, physicians affiliated with the sellers retained non-controlling interests which may, at the holders’ option, be redeemed at any time after May 1, 2023. 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 22, 2021, 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, 2021. The dividend was paid on October 15, 2021 to common shareholders and holders of record of partnership interests of the Operating Partnership (“OP Units”) as of the close of business on October 4, 2021. Tax Status of Dividends and Distributions The Company’s 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 in respect of 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). 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. The Company recorded a $0.3 million impairment charge for the three and nine months ended September 30, 2021, and did not record an impairment charge for the three and nine months ended September 30, 2020. 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, have been met. The Company classifies a real estate property as held for sale when: (i) management has approved the disposition of the property, (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 disposition plan will significantly change or be withdrawn. Following the classification of a property as “held for sale,” no further depreciation or amortization is recorded for the asset and the book value of the asset is written down to the lower of carrying value or fair market value, less cost to sell . As of September 30, 2021, the Company classified four properties as held for sale. Real Estate Loans Receivable, Net Real estate loans receivable consists of 22 mezzanine loans, three term loans, and one construction loan as of September 30, 2021. Generally, each mezzanine loan is collateralized by a pledge of the borrower’s ownership interest in the respective real estate owner, each term loan is secured by a mortgage of a related medical office building, and construction loans are secured by mortgages on the land and the improvements as constructed. In accordance with the adoption of ASU 2016-13, Financial Instruments - Credit Losses (“ASU 2016-13”) on January 1, 2020, the Company adjusted the opening balance of retained earnings by $0.1 million. The reserve for loan losses was $0.1 million as of September 30, 2021. Rental and Related Revenues Rental revenue is recognized on a straight-line basis over the terms of the related leases when collectability is probable. 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, are included in other assets and were approximately $93.7 million and $86.6 million as of September 30, 2021 and December 31, 2020, respectively. If the Company determines that collectability of straight-line rents is not probable, income recognition is limited to the lesser of cash collected, or lease income reflected on a straight-line basis, plus variable rent when it becomes accruable. In accordance with ASC 842, Leases , if the collectability of a lease changes after the commencement date, any difference between lease income that would have been recognized and the lease payments shall be recognized as an adjustment to lease income. Bad debt recognized as an adjustment to rental and related revenues was insignificant for the three and nine months ended September 30, 2021. Bad debt recognized as an adjustment to rental and related revenues was $0.4 million and $0.5 million for the three and nine months ended September 30, 2020, respectively. Rental revenue is adjusted by the amortization of lease inducements and above-market or below-market rents on certain leases. Lease inducements and above-market or below-market rents are amortized on a straight-line basis over the remaining lease term. Rental and related revenues also include expense recoveries, which relate to tenant reimbursement of real estate taxes, insurance, and other operating expenses that are recognized 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. New Accounting Pronouncements 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 previously by the other-than-temporary impairment model. ASU 2016-13 applies to most financial assets measured at amortized cost and certain other instruments, including certain receivables, loans, held-to-maturity debt securities, net investments in leases, and off-balance-sheet credit exposures (e.g., loan commitments). ASU 2016-13 requires that financial statement assets measured at an amortized cost be presented at the net amount expected to be collected through an allowance for credit losses that is deducted from the amortized cost basis. ASU 2018-19 also clarifies that receivables arising from operating leases are not within the scope of Subtopic 326-20. Instead, impairment of these receivables should be accounted for in accordance with ASC 842. The Company has adopted ASU 2016-13 as of the effective date, January 1, 2020, with a cumulative effect adjustment to the opening balance of retained earnings of $0.1 million. In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848) Facilitation of the Effects of Reference Rate Reform on Financial Reporting , that provides optional relief to applying reference rate reform to changing reference rates, contracts, hedging relationships, and other transactions that reference LIBOR, which will be discontinued by the end of 2021. The amendments in this update are effective immediately and may be applied through December 31, 2022. The Company is evaluating how the transition away from LIBOR will impact the Company, and if the optional relief in this standard will be adopted. The Company does not expect the adoption of the standard to have a material impact on the Company’s consolidated financial statements if adopted. In August 2020, the FASB issued ASU 2020-06, Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40) , which simplifies the accounting for certain financial instruments with characteristics of liabilities and equity, including convertible instruments and contracts on an entity’s own equity. The ASU is part of the FASB’s simplification initiative, which aims to reduce unnecessary complexity in U.S. GAAP. This guidance is effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2021, with early adoption permitted. The Company is currently evaluating the impact ASU 2020-06 will have on its consolidated financial statements.

Investment and Disposition Acti

Investment and Disposition Activity	9 Months Ended
	Sep. 30, 2021
Business Combination and Asset Acquisition [Abstract]
Investment and Disposition Activity	Investment and Disposition Activity During the nine months ended September 30, 2021, the Company completed the acquisition of eight medical office facilities and three medical condominium units for an aggregate investment of approximately $122.7 million, excluding the conversion of a previously outstanding construction loan of $15.5 million. The Company also funded three mezzanine loans for $8.9 million and closed on a $10.5 million construction loan, funding $5.5 million as of September 30, 2021. Additionally, the Company acquired a membership interest in one joint venture for $7.3 million and paid $0.3 million of additional purchase consideration under an earn-out agreement, resulting in total investment activity of approximately $144.7 million. As part of these investments, the Company incurred approximately $1.6 million of capitalized costs. Investment activity for the three months ended September 30, 2021 is summarized below: Investment (1) Location Acquisition Investment Amount InterMed MOB - Davis Joint Venture (2) Portland, ME August 18, 2021 $ 7,291 Atkins Portfolio (5 MOBs) Various August 30, 2021 54,090 HonorHealth - Sonoran MOB Phoenix, AZ September 23, 2021 31,750 Loan Investments Various Various 3,734 $ 96,865 (1) “MOB” means medical office building (2) The Company purchased a 49% membership interest in this property through the Davis Joint Venture. The following table summarizes the acquisition date fair values of the assets acquired and the liabilities assumed during the nine months ended September 30, 2021, which the Company determined using Level 2 and Level 3 inputs (in thousands): 1st Quarter 2nd Quarter 3rd Quarter Total Land $ 189 $ 2,655 $ 8,054 $ 10,898 Building and improvements 917 44,743 66,652 112,312 In-place lease intangibles 29 4,442 8,216 12,687 Above market in-place lease intangibles — — 241 241 Below market in-place lease intangibles — — (151) (151) Right-of-use asset — — 1,700 1,700 Prepaid expenses — 129 — 129 Net assets acquired $ 1,135 $ 51,969 $ 84,712 $ 137,816 Assets Held for Sale As of September 30, 2021, the Company classified four assets 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, 2021 (in thousands). Land and improvements $ 7,660 Building and improvements 49,930 Tenant improvements 455 Acquired lease intangibles 3,141 Real estate held for sale before accumulated depreciation 61,186 Accumulated depreciation (16,480) Real estate held for sale $ 44,706

Intangibles

Intangibles	9 Months Ended
	Sep. 30, 2021
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, 2021 and December 31, 2020 (in thousands): September 30, 2021 December 31, 2020 Cost Accumulated Net Cost Accumulated Net Assets In-place leases $ 364,750 $ (193,231) $ 171,519 $ 362,837 $ (173,862) $ 188,975 Above-market leases $ 43,586 $ (23,373) $ 20,213 $ 43,386 $ (20,670) $ 22,716 Leasehold interest $ 712 $ (406) $ 306 $ 712 $ (361) $ 351 Liabilities Below-market leases $ 15,980 $ (10,151) $ 5,829 $ 15,882 $ (9,241) $ 6,641 The following is a summary of acquired lease intangible amortization for the three and nine month periods ended September 30, 2021 and 2020 (in thousands): Three Months Ended Nine Months Ended 2021 2020 2021 2020 Amortization expense related to in-place leases $ 8,103 $ 9,088 $ 24,590 $ 26,190 Decrease in rental income related to above-market leases 897 954 2,744 2,918 Decrease in rental income related to leasehold interest 15 15 45 45 Increase in rental income related to below-market leases 324 397 963 1,102 Future aggregate net amortization of acquired lease intangibles, excluding four assets classified as held for sale, as of September 30, 2021, is as follows (in thousands): Net Decrease in Net Increase in 2021 $ 547 $ 7,954 2022 1,963 29,276 2023 1,656 26,546 2024 1,589 23,350 2025 1,590 19,817 Thereafter 7,345 64,576 Total $ 14,690 $ 171,519

Other Assets

Other Assets	9 Months Ended
	Sep. 30, 2021
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, 2021 and December 31, 2020 (in thousands): September 30, December 31, Straight line rent receivable, net $ 93,747 $ 86,551 Leasing commissions, net 11,441 9,282 Prepaid expenses 8,943 9,401 Lease inducements, net 8,518 9,396 Escrows 1,546 1,507 Notes receivable, net 1,045 23,760 Other 5,249 4,103 Total $ 130,489 $ 144,000

Debt

Debt	9 Months Ended
	Sep. 30, 2021
Debt Disclosure [Abstract]
Debt	Debt The following is a summary of debt as of September 30, 2021 and December 31, 2020 (in thousands): September 30, December 31, Fixed interest mortgage notes (1) $ 44,420 $ 51,896 Variable interest mortgage note (2) 5,748 6,105 Total mortgage debt 50,168 58,001 Unsecured revolving credit facility bearing variable interest (3) 159,000 166,000 $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 2.07%, due June 2023 (4) 250,000 250,000 $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 1,434,168 1,449,001 Unamortized deferred financing costs (8,925) (5,369) Unamortized discounts (4,366) (4,855) Unamortized fair value adjustments 26 73 Total debt $ 1,420,903 $ 1,438,850 (1) As of September 30, 2021, fixed interest mortgage notes bear interest from 4.63% to 5.50%, due in 2022 and 2024, with a weighted average interest rate of 4.79%. As of December 31, 2020, fixed interest mortgage notes bear interest from 4.63% to 5.50%, due in 2021, 2022, and 2024, with a weighted average interest rate of 4.78%. The notes are collateralized by three properties with a net book value of $97.0 million as of September 30, 2021 and four properties with a net book value of $110.3 million as of December 31, 2020. (2) Variable interest mortgage note bears variable interest of LIBOR plus 2.75%, for an interest rate of 2.83% and 2.90% as of September 30, 2021 and December 31, 2020, respectively. The note is due in 2028 and is collateralized by one property with a net book value of $8.1 million as of September 30, 2021 and $8.3 million as of December 31, 2020. (3) As of September 30, 2021, the amount of commitments under the revolving credit facility was $1.0 billion bearing variable interest of LIBOR plus 0.85%, due September 2025. As of December 31, 2020, the amount of commitments under the revolving credit facility was $850.0 million bearing variable interest of LIBOR plus 0.90%, due September 2022. (4) The Operating Partnership’s borrowings under the term loan feature of the Credit Agreement bears interest at a rate which is determined by the Trust’s credit rating, currently equal to LIBOR + 1.00%. The Operating Partnership has entered into a pay-fixed receive-variable interest rate swap, fixing the LIBOR component of this rate at 1.07%. On September 24, 2021, the Operating Partnership, as borrower, and the Trust, as guarantor, executed a Third Amended and Restated Credit Agreement (the “Credit Agreement”) which extended the maturity date of the revolving credit facility under the Credit Agreement to September 24, 2025 and reduced the interest rate margin applicable to borrowings. The Credit Agreement includes an unsecured revolving credit facility of $1.0 billion and contains a term loan feature of $250.0 million, bringing total borrowing capacity to $1.3 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 Operating Partnership to increase borrowing capacity by up to an additional $500.0 million, subject to customary terms and conditions, resulting in a maximum borrowing capacity of $1.75 billion. The revolving credit facility under the Credit Agreement also includes two, six-month extension options. 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, 2021, the Trust had investment grade ratings of BBB from S&P, Baa2 from Moody’s, and BBB from Fitch. As such, borrowings under the revolving credit facility of the Credit Agreement accrue interest on the outstanding principal at a rate of LIBOR + 0.85%. The Credit Agreement includes a facility fee equal to 0.20% 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 + 1.00%. The Operating Partnership 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 2.07%. 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 Applicable Margin for Revolving Loans: LIBOR Rate Loans Applicable Margin for Revolving Loans: Base Rate Loans Applicable Margin for Term Loans: LIBOR Rate Loans Applicable Margin for Term Loans: Base Rate Loans At Least A- or A3 LIBOR + 0.725% — % LIBOR + 0.85% — % At Least BBB+ or Baa1 LIBOR + 0.775% — % LIBOR + 0.90% — % At Least BBB or Baa2 LIBOR + 0.85% — % LIBOR + 1.00% — % At Least BBB- or Baa3 LIBOR + 1.05% 0.05 % LIBOR + 1.25% 0.25 % Below BBB- or Baa3 LIBOR + 1.40% 0.40 % 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, 2021, 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, 2021, the Company had $159.0 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. As defined by the Credit Agreement, the current unencumbered borrowing base allows the Company to borrow an additional $841.0 million before reaching the maximum allowed under the credit facility. Notes Payable As of September 30, 2021, the Company had $975.0 million aggregate principal amount of senior notes issued and outstanding by the Operating Partnership, comprised of $15.0 million maturing in 2023, $25.0 million maturing in 2025, $70.0 million maturing in 2026, $425.0 million maturing in 2027, $395.0 million maturing in 2028, and $45.0 million maturing in 2031. Certain properties have mortgage debt that contains financial covenants. As of September 30, 2021, the Trust was in compliance with all mortgage debt financial covenants. Scheduled principal payments due on consolidated debt as of September 30, 2021, are as follows (in thousands): 2021 $ 463 2022 20,825 2023 266,008 2024 23,669 2025 184,476 Thereafter 938,727 Total Payments $ 1,434,168 As of September 30, 2021, the Company had total consolidated indebtedness of approximately $1.4 billion. The weighted average interest rate on consolidated indebtedness was 3.48% (based on the 30-day LIBOR rate as of September 30, 2021, of 0.08%). For the three month periods ended September 30, 2021 and 2020, the Company incurred interest expense on its debt, exclusive of deferred financing cost amortization, of $12.9 million and $13.1 million, respectively. For the nine month periods ending September 30, 2021 and 2020, the Company incurred interest expense on its debt, exclusive of deferred financing cost amortization, of $39.0 million and $41.7 million, respectively.

Derivatives

Derivatives	9 Months Ended
	Sep. 30, 2021
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. As a result of the Company’s adoption of ASU 2017-12 as of January 1, 2019, the entire change in the fair value of its derivatives designated and qualified as cash flow hedges are recorded in accumulated other comprehensive income on the consolidated balance sheets and are subsequently reclassified into earnings in the period in which the hedged forecasted transaction affects earnings. 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, 2021, 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. See Note 2 (Summary of Significant Accounting Policies) of the 2020 Annual Report for a further discussion of our 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) 2.07 % Effective date 7/7/2016 Maturity date 6/10/2023 Liability balance at September 30, 2021 (included in Accrued expenses and other liabilities) $ 3,567 Liability balance at December 31, 2020 (included in Accrued expenses and other liabilities) $ 5,317

Accrued Expenses and Other Liab

Accrued Expenses and Other Liabilities	9 Months Ended
	Sep. 30, 2021
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, 2021 and December 31, 2020 (in thousands): September 30, December 31, Real estate taxes payable $ 27,033 $ 23,436 Prepaid rent 18,606 22,248 Accrued interest 5,746 16,009 Accrued expenses 5,619 5,721 Accrued incentive compensation 4,950 1,945 Security deposits 3,885 3,714 Interest rate swap 3,567 5,317 Tenant improvement allowances 1,857 1,917 Embedded derivative — 4,944 Other 8,358 6,678 Total $ 79,621 $ 91,929

Stock-based Compensation

Stock-based Compensation	9 Months Ended
	Sep. 30, 2021
Share-based Payment Arrangement [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 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, which made shares available for awards for participants. On April 30, 2019, at the Annual Meeting of Shareholders of Physicians Realty Trust, the Trust’s shareholders approved the Amended and Restated Physicians Realty Trust 2013 Equity Incentive Plan (“2013 Plan”). The amendment increased the number of common shares authorized for issuance under the 2013 Plan to a total of 7,000,000 common shares authorized for issuance. The 2013 Plan term was also extended to 2029. 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, 2021, the Trust granted a total of 224,163 restricted common shares with a total value of $3.9 million to its officers and certain of its employees, which have a vesting period of one A summary of the status of the Trust’s non-vested restricted common shares as of September 30, 2021 and changes during the nine month period then ended follow: Common Shares Weighted Non-vested at December 31, 2020 215,822 $ 18.73 Granted 224,163 17.42 Vested (185,968) 18.94 Non-vested at September 30, 2021 254,017 $ 17.42 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 ending September 30, 2021 and 2020, the Company recognized non-cash share compensation of $1.0 million and $0.9 million, respectively. For the nine month periods ending September 30, 2021 and 2020, the Company recognized non-cash share compensation of $2.8 million and $2.6 million, respectively. Unrecognized compensation expense at September 30, 2021 was $2.4 million. Restricted Share Units In January 2021, under the 2013 Plan, the Company granted 13,343 restricted share units to certain of its trustees in lieu of all or a portion of such trustee’s 2021 cash retainer. These units are subject to certain timing conditions and a one-year service period. Each restricted share unit contains one dividend equivalent. Each 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. With respect to the performance and timing conditions of the January 2021 grants, the grant date fair value of $17.80 per unit was based on the share price at the date of grant. In March 2021, under the 2013 Plan, the Company granted restricted share units at a target level of 265,275 to its officers and certain of its employees and 43,582 to its trustees. Units granted to officers and certain employees under the Company’s 2013 Plan are subject to certain performance and market conditions and a three-year service period. Units granted to trustees are subject to certain timing conditions and a two-year service period. Each restricted share unit contains one dividend equivalent. Each 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 under the Company’s 2013 Plan in 2021 vest based on two certain market conditions. The awards containing 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 values of $27.53 and $30.82 per unit for the March 2021 grant using the following assumptions: Volatility 33.3 % Dividend assumption reinvested Expected term in years 2.84 years Risk-free rate 0.25 % Share price (per share) $ 17.21 The remaining 60% of the restricted share units issued to officers and certain employees under the Company’s 2013 Plan, and 100% of other restricted share units issued to trustees vest based upon certain performance or timing conditions. With respect to the performance and timing conditions of the March 2021 grants, the grant date fair value of $17.21 per unit was based on the share price at the date of grant. The combined weighted average grant date fair value of the March 2021 restricted share units issued to officers and certain employees is $22.00 per unit. The following is a summary of the activity in the Trust’s restricted share units during the nine months ended September 30, 2021: Executive Awards Trustee Awards Restricted Share Weighted Restricted Share Weighted Non-vested at December 31, 2020 964,139 $ 21.17 59,820 $ 18.81 Granted 265,275 22.00 56,925 17.35 Vested (252,844) (1) 16.58 (40,394) 18.57 Non-vested at September 30, 2021 976,570 $ 22.59 76,351 $ 17.84 (1) Restricted units vested by Company executives in 2021 resulted in the issuance of 399,165 common shares, less 162,173 common shares withheld to cover minimum withholding tax obligations, for multiple employees. For the three month periods ending September 30, 2021 and 2020, the Company recognized non-cash share compensation expense of $2.7 million and $2.2 million, respectively. For the nine month periods ending September 30, 2021 and 2020, the Company recognized non-cash share compensation of $8.0 million and $6.5 million, respectively. Unrecognized compensation expense at September 30, 2021 was $12.7 million.

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2021
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. As part of the Company’s acquisition process, Level 3 inputs are used to measure the fair value of the assets acquired and liabilities assumed. The Company’s derivative instruments as of September 30, 2021 consist of 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 7 (Derivatives) of this report and Note 2 (Summary of Significant Accounting Policies) of Part II, Item 8 (Financial Statements and Supplementary Data) of our 2020 Annual Report. The interest rate swaps are not 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 was one asset measured at fair value as of September 30, 2021 that had a previous carrying value of $2.3 million. During the three and nine months ended September 30, 2021, the Company recorded an impairment charge of $0.3 million against the asset, a medical office building located in Michigan that is currently classified as held for sale. 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, 2021, the Company classified four properties, as held for sale. Upon classification as held for sale, the Company records the value of the assets at the lower of their carrying value or fair value, less costs to sell. Fair value is generally based on discounted cash flow analyses, which involves 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, 2021, the fair value exceeds the carrying value of the four 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, 2021 December 31, 2020 Carrying Fair Carrying Fair Assets: Real estate loans receivable, net $ 181,125 $ 177,859 $ 198,800 $ 198,814 Notes receivable, net $ 1,045 $ 1,045 $ 23,760 $ 23,760 Liabilities: Credit facility $ (409,000) $ (409,000) $ (416,000) $ (416,000) Notes payable $ (975,000) $ (1,066,869) $ (975,000) $ (1,063,367) Mortgage debt $ (50,194) $ (51,458) $ (58,074) $ (59,651) Derivative liabilities $ (3,567) $ (3,567) $ (10,261) $ (10,261)

Tenant Operating Leases

Tenant Operating Leases	9 Months Ended
	Sep. 30, 2021
Leases [Abstract]
Tenant Operating Leases	Tenant Operating Leases The Company is a lessor of medical office buildings and other health care facilities. Leases have expirations from 2021 through 2043. As of September 30, 2021, the future minimum rental payments on non-cancelable leases, exclusive of expense recoveries and minimum rental payments for the four assets classified as held for sale, were as follows (in thousands): 2021 $ 77,498 2022 305,188 2023 297,695 2024 285,362 2025 269,862 Thereafter 961,607 Total $ 2,197,212 For the three month periods ending September 30, 2021 and 2020, we recognized $110.3 million and $104.4 million, respectively, of rental and other lease-related income related to our operating leases, of which $29.2 million and $26.3 million, respectively, were variable lease payments. For the nine month periods ending September 30, 2021 and 2020, we recognized $326.0 million and $311.9 million, respectively, of rental and other leased-related income related to our operating leases, of which $84.0 million and $76.1 million, respectively, were variable lease payments.

Rent Expense

Rent Expense	9 Months Ended
	Sep. 30, 2021
Leases [Abstract]
Rent Expense	Rent Expense The Company leases the rights to parking structures at two of its properties, the air space above one property, and the land upon which 82 of its properties are located from third party land owners pursuant to separate leases. In addition, the Company has nine corporate leases, primarily for office space. The Company’s leases include both fixed and variable rental payments and may also include escalation clauses and renewal options. These leases have terms of up to 86 years remaining, excluding extension options, with a weighted average remaining term of 43 years. At the inception of a new lease, the Company establishes an operating or finance lease asset and operating or finance lease liability calculated as the present value of future minimum lease payments. As our leases do not provide an implicit rate, we calculate a discount rate that approximates our incremental borrowing rate available at lease commencement to determine the present value of future minimum lease payments. The approximated weighted average discount rate was 4.4% as of September 30, 2021. There are no operating or finance leases that have not yet commenced that would have a significant impact on the Company’s consolidated balance sheets. As of September 30, 2021, the future minimum lease obligations under non-cancelable parking, air, ground, and corporate leases, exclusive of the four assets classified as held for sale, were as follows (in thousands): 2021 $ 849 2022 3,719 2023 3,693 2024 3,676 2025 3,657 Thereafter 180,378 Total undiscounted lease payments $ 195,972 Less: Interest (117,290) Present value of lease liabilities $ 78,682 Lease costs consisted of the following for the nine months ended September 30, 2021 (in thousands): Fixed lease cost $ 1,823 Variable lease cost 751 Total lease cost $ 2,574

Credit Concentration

Credit Concentration	9 Months Ended
	Sep. 30, 2021
Concentration Risks, Types, No Concentration Percentage [Abstract]
Credit Concentration	Credit Concentration The Company uses annualized base rent (“ABR”) as its credit concentration metric. ABR is calculated by multiplying contractual base rent for the month ended September 30, 2021 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, 2021, excluding the four assets classified as held for sale (in thousands): Tenant Total ABR Percent of ABR CommonSpirit - CHI - Nebraska $ 17,656 5.7 % Northside Hospital 15,245 4.9 % UofL Health - Louisville, Inc. 12,526 4.1 % US Oncology 11,080 3.6 % Baylor Scott and White Health 8,156 2.6 % Remaining portfolio 244,512 79.1 % Total $ 309,175 100.0 % ABR collected from the Company’s top five tenant relationships comprises 20.9% of its total ABR for the period ending September 30, 2021. Total ABR from CommonSpirit Health affiliated tenants totals 16.5%, including the affiliates disclosed above. The following table summarizes certain information about the Company’s top five geographic concentrations as of September 30, 2021, excluding the four assets classified as held for sale (in thousands): State Total ABR Percent of ABR Texas $ 47,331 15.3 % Georgia 25,618 8.3 % Indiana 22,784 7.4 % Nebraska 18,993 6.1 % Minnesota 17,827 5.8 % Other 176,622 57.1 % Total $ 309,175 100.0 %

Earnings Per Share

Earnings Per Share	9 Months Ended
	Sep. 30, 2021
Earnings Per Share [Abstract]
Earnings Per Share	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 2021 2020 2021 2020 Numerator for earnings per share - basic: Net income $ 22,045 $ 16,475 $ 58,531 $ 49,879 Net income attributable to noncontrolling interests: Operating Partnership (529) (425) (1,405) (1,305) Partially owned properties (152) (151) (455) (441) Preferred distributions — (317) (13) (951) Numerator for earnings per share - basic $ 21,364 $ 15,582 $ 56,658 $ 47,182 Numerator for earnings per share - diluted: Numerator for earnings per share - basic $ 21,364 $ 15,582 $ 56,658 $ 47,182 Operating Partnership net income 529 425 1,405 1,305 Numerator for earnings per share - diluted $ 21,893 $ 16,007 $ 58,063 $ 48,487 Denominator for earnings per share - basic and diluted: Weighted average number of shares outstanding - basic 217,406,657 208,187,129 214,616,482 202,717,190 Effect of dilutive securities: Noncontrolling interest - Operating Partnership units 5,406,070 5,643,669 5,498,046 5,655,870 Restricted common shares 98,597 70,819 95,999 72,522 Restricted share units 1,080,725 1,228,351 1,189,122 1,109,478 Denominator for earnings per share - diluted: 223,992,049 215,129,968 221,399,649 209,555,060 Earnings per share - basic $ 0.10 $ 0.07 $ 0.26 $ 0.23 Earnings per share - diluted $ 0.10 $ 0.07 $ 0.26 $ 0.23

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2021
Subsequent Events [Abstract]
Subsequent Events	Subsequent EventsSince September 30, 2021, the Company issued 2,877,988 shares pursuant to its 2021 ATM program at a weighted average price of $18.61 for net proceeds of $53.0 million. On October 1, 2021, the Company entered into a master transaction agreement with Landmark Healthcare Companies LLC to acquire 15 medical office buildings located in eight states (the “Landmark Portfolio”) for an aggregate purchase price of $764.3 million, subject to closing prorations and other adjustments. Subject to the satisfaction of certain conditions to closing, the Company expects to complete the acquisition of the Landmark Portfolio in the fourth quarter of 2021. There can be no assurance that any or all of the conditions to closing will be satisfied or, if satisfied, that the Company will complete the acquisition of the Landmark Portfolio in a timely manner or at all. On October 13, 2021, the Operating Partnership issued and sold $500.0 million aggregate principal amount of 2.625% senior notes, which will mature on November 1, 2031. The senior notes were sold at an issue price of 99.789% of their face value, before the underwriters’ discount. The Company’s net proceeds from the offering, after deducting underwriting discounts and expenses, were approximately $495.1 million. On October 13, 2021, the Company used the proceeds from the senior notes to pay off the existing balance of the unsecured revolving credit facility and the term loan feature of the Credit Agreement for $168.0 million and $250.0 million, respectively. The Operating Partnership simultaneously terminated the existing pay-fixed receive-variable rate swaps associated with the full term loan borrowing of $250.0 million. As part of the termination, the Company made total cash payments of $3.3 million to the counterparties of the swap agreements. On October 15, 2021, the Company completed the acquisition of the remaining 51% membership interest in MedCore Realty Eden Hill, LLC for approximately $33.2 million. This joint venture owns a 140,205 square foot medical office facility located in Dover, Delaware. On October 27, 2021, the Company completed the acquisition of a newly completed 109,423 square foot medical office facility located in Scottsdale, Arizona for a purchase price of approximately $67.3 million. On November 2, 2021, the Company sold the LifeCare portfolio, which included three long-term acute care hospital (“LTACH”) properties, for approximately $62.0 million and recognized a net gain on the sale of approximately $18.7 million. These assets were also classified as held for sale as of September 30, 2021.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2021
Accounting Policies [Abstract]
Noncontrolling Interests	Noncontrolling Interests As of September 30, 2021, the Trust held a 97.6% 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.
Tax Status of Dividends and Distributions	Tax Status of Dividends and Distributions The Company’s 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 in respect of 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).
Impairment of Intangible and Long-Lived Assets	Impairment of Intangible and Long-Lived AssetsThe 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.
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, have been met. The Company classifies a real estate property as held for sale when: (i) management has approved the disposition of the property, (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 disposition plan will significantly change or be withdrawn. Following the classification of a property as “held for sale,” no further depreciation or amortization is recorded for the asset and the book value of the asset is written down to the lower of carrying value or fair market value, less cost to sell .
Real Estate Loans Receivable, Net	Real Estate Loans Receivable, Net
Rental and Related Revenues	Rental and Related Revenues Rental revenue is recognized on a straight-line basis over the terms of the related leases when collectability is probable. 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, are included in other assets and were approximately $93.7 million and $86.6 million as of September 30, 2021 and December 31, 2020, respectively. If the Company determines that collectability of straight-line rents is not probable, income recognition is limited to the lesser of cash collected, or lease income reflected on a straight-line basis, plus variable rent when it becomes accruable. In accordance with ASC 842, Leases , if the collectability of a lease changes after the commencement date, any difference between lease income that would have been recognized and the lease payments shall be recognized as an adjustment to lease income. Bad debt recognized as an adjustment to rental and related revenues was insignificant for the three and nine months ended September 30, 2021. Bad debt recognized as an adjustment to rental and related revenues was $0.4 million and $0.5 million for the three and nine months ended September 30, 2020, respectively. Rental revenue is adjusted by the amortization of lease inducements and above-market or below-market rents on certain leases. Lease inducements and above-market or below-market rents are amortized on a straight-line basis over the remaining lease term. Rental and related revenues also include expense recoveries, which relate to tenant reimbursement of real estate taxes, insurance, and other operating expenses that are recognized 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.
New Accounting Pronouncements	New Accounting Pronouncements 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 previously by the other-than-temporary impairment model. ASU 2016-13 applies to most financial assets measured at amortized cost and certain other instruments, including certain receivables, loans, held-to-maturity debt securities, net investments in leases, and off-balance-sheet credit exposures (e.g., loan commitments). ASU 2016-13 requires that financial statement assets measured at an amortized cost be presented at the net amount expected to be collected through an allowance for credit losses that is deducted from the amortized cost basis. ASU 2018-19 also clarifies that receivables arising from operating leases are not within the scope of Subtopic 326-20. Instead, impairment of these receivables should be accounted for in accordance with ASC 842. The Company has adopted ASU 2016-13 as of the effective date, January 1, 2020, with a cumulative effect adjustment to the opening balance of retained earnings of $0.1 million. In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848) Facilitation of the Effects of Reference Rate Reform on Financial Reporting , that provides optional relief to applying reference rate reform to changing reference rates, contracts, hedging relationships, and other transactions that reference LIBOR, which will be discontinued by the end of 2021. The amendments in this update are effective immediately and may be applied through December 31, 2022. The Company is evaluating how the transition away from LIBOR will impact the Company, and if the optional relief in this standard will be adopted. The Company does not expect the adoption of the standard to have a material impact on the Company’s consolidated financial statements if adopted. In August 2020, the FASB issued ASU 2020-06, Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40) , which simplifies the accounting for certain financial instruments with characteristics of liabilities and equity, including convertible instruments and contracts on an entity’s own equity. The ASU is part of the FASB’s simplification initiative, which aims to reduce unnecessary complexity in U.S. GAAP. This guidance is effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2021, with early adoption permitted. The Company is currently evaluating the impact ASU 2020-06 will have on its consolidated financial statements.
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. As a result of the Company’s adoption of ASU 2017-12 as of January 1, 2019, the entire change in the fair value of its derivatives designated and qualified as cash flow hedges are recorded in accumulated other comprehensive income on the consolidated balance sheets and are subsequently reclassified into earnings in the period in which the hedged forecasted transaction affects earnings. 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, 2021, 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. See Note 2 (Summary of Significant Accounting Policies) of the 2020 Annual Report for a further discussion of our derivatives.
Fair Value Measurements	The Company’s derivative instruments as of September 30, 2021 consist of 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 7 (Derivatives) of this report and Note 2 (Summary of Significant Accounting Policies) of Part II, Item 8 (Financial Statements and Supplementary Data) of our 2020 Annual Report. The interest rate swaps are not 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 was one asset measured at fair value as of September 30, 2021 that had a previous carrying value of $2.3 million. During the three and nine months ended September 30, 2021, the Company recorded an impairment charge of $0.3 million against the asset, a medical office building located in Michigan that is currently classified as held for sale. 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, 2021, the Company classified four properties, as held for sale. Upon classification as held for sale, the Company records the value of the assets at the lower of their carrying value or fair value, less costs to sell. Fair value is generally based on discounted cash flow analyses, which involves 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, 2021, the fair value exceeds the carrying value of the four assets classified as held for sale and therefore, are recorded at respective carrying value.
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 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.

Organization and Business (Tabl

Organization and Business (Tables)	9 Months Ended
	Sep. 30, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Schedule of Sale or Issuance of Common Stock	During the quarterly periods ended March 31, 2021, June 30, 2021, and September 30, 2021, the Trust’s issuance and sale of common shares pursuant to the ATM Programs is as follows (in thousands, except common shares and price): Common Weighted average price Net Quarterly period ended March 31, 2021 2,887,296 $ 18.32 $ 52,358 Quarterly period ended June 30, 2021 4,532,343 18.39 82,519 Quarterly period ended September 30, 2021 — — — Year to date 7,419,639 $ 18.36 $ 134,877

Investment and Disposition Ac_2

Investment and Disposition Activity (Tables)	9 Months Ended
	Sep. 30, 2021
Business Combination and Asset Acquisition [Abstract]
Asset Acquisition	Investment activity for the three months ended September 30, 2021 is summarized below: Investment (1) Location Acquisition Investment Amount InterMed MOB - Davis Joint Venture (2) Portland, ME August 18, 2021 $ 7,291 Atkins Portfolio (5 MOBs) Various August 30, 2021 54,090 HonorHealth - Sonoran MOB Phoenix, AZ September 23, 2021 31,750 Loan Investments Various Various 3,734 $ 96,865 (1) “MOB” means medical office building (2) The Company purchased a 49% membership interest in this property through the Davis Joint Venture. The following table summarizes the acquisition date fair values of the assets acquired and the liabilities assumed during the nine months ended September 30, 2021, which the Company determined using Level 2 and Level 3 inputs (in thousands): 1st Quarter 2nd Quarter 3rd Quarter Total Land $ 189 $ 2,655 $ 8,054 $ 10,898 Building and improvements 917 44,743 66,652 112,312 In-place lease intangibles 29 4,442 8,216 12,687 Above market in-place lease intangibles — — 241 241 Below market in-place lease intangibles — — (151) (151) Right-of-use asset — — 1,700 1,700 Prepaid expenses — 129 — 129 Net assets acquired $ 1,135 $ 51,969 $ 84,712 $ 137,816
Disposal Groups, Including Discontinued Operations	Assets Held for Sale As of September 30, 2021, the Company classified four assets 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, 2021 (in thousands). Land and improvements $ 7,660 Building and improvements 49,930 Tenant improvements 455 Acquired lease intangibles 3,141 Real estate held for sale before accumulated depreciation 61,186 Accumulated depreciation (16,480) Real estate held for sale $ 44,706

Intangibles (Tables)

Intangibles (Tables)	9 Months Ended
	Sep. 30, 2021
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, 2021 and December 31, 2020 (in thousands): September 30, 2021 December 31, 2020 Cost Accumulated Net Cost Accumulated Net Assets In-place leases $ 364,750 $ (193,231) $ 171,519 $ 362,837 $ (173,862) $ 188,975 Above-market leases $ 43,586 $ (23,373) $ 20,213 $ 43,386 $ (20,670) $ 22,716 Leasehold interest $ 712 $ (406) $ 306 $ 712 $ (361) $ 351 Liabilities Below-market leases $ 15,980 $ (10,151) $ 5,829 $ 15,882 $ (9,241) $ 6,641
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, 2021 and 2020 (in thousands): Three Months Ended Nine Months Ended 2021 2020 2021 2020 Amortization expense related to in-place leases $ 8,103 $ 9,088 $ 24,590 $ 26,190 Decrease in rental income related to above-market leases 897 954 2,744 2,918 Decrease in rental income related to leasehold interest 15 15 45 45 Increase in rental income related to below-market leases 324 397 963 1,102
Schedule of future amortization of the acquired lease intangibles	Future aggregate net amortization of acquired lease intangibles, excluding four assets classified as held for sale, as of September 30, 2021, is as follows (in thousands): Net Decrease in Net Increase in 2021 $ 547 $ 7,954 2022 1,963 29,276 2023 1,656 26,546 2024 1,589 23,350 2025 1,590 19,817 Thereafter 7,345 64,576 Total $ 14,690 $ 171,519

Other Assets (Tables)

Other Assets (Tables)	9 Months Ended
	Sep. 30, 2021
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, 2021 and December 31, 2020 (in thousands): September 30, December 31, Straight line rent receivable, net $ 93,747 $ 86,551 Leasing commissions, net 11,441 9,282 Prepaid expenses 8,943 9,401 Lease inducements, net 8,518 9,396 Escrows 1,546 1,507 Notes receivable, net 1,045 23,760 Other 5,249 4,103 Total $ 130,489 $ 144,000

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2021
Debt Disclosure [Abstract]
Schedule of debt	The following is a summary of debt as of September 30, 2021 and December 31, 2020 (in thousands): September 30, December 31, Fixed interest mortgage notes (1) $ 44,420 $ 51,896 Variable interest mortgage note (2) 5,748 6,105 Total mortgage debt 50,168 58,001 Unsecured revolving credit facility bearing variable interest (3) 159,000 166,000 $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 2.07%, due June 2023 (4) 250,000 250,000 $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 1,434,168 1,449,001 Unamortized deferred financing costs (8,925) (5,369) Unamortized discounts (4,366) (4,855) Unamortized fair value adjustments 26 73 Total debt $ 1,420,903 $ 1,438,850 (1) As of September 30, 2021, fixed interest mortgage notes bear interest from 4.63% to 5.50%, due in 2022 and 2024, with a weighted average interest rate of 4.79%. As of December 31, 2020, fixed interest mortgage notes bear interest from 4.63% to 5.50%, due in 2021, 2022, and 2024, with a weighted average interest rate of 4.78%. The notes are collateralized by three properties with a net book value of $97.0 million as of September 30, 2021 and four properties with a net book value of $110.3 million as of December 31, 2020. (2) Variable interest mortgage note bears variable interest of LIBOR plus 2.75%, for an interest rate of 2.83% and 2.90% as of September 30, 2021 and December 31, 2020, respectively. The note is due in 2028 and is collateralized by one property with a net book value of $8.1 million as of September 30, 2021 and $8.3 million as of December 31, 2020. (3) As of September 30, 2021, the amount of commitments under the revolving credit facility was $1.0 billion bearing variable interest of LIBOR plus 0.85%, due September 2025. As of December 31, 2020, the amount of commitments under the revolving credit facility was $850.0 million bearing variable interest of LIBOR plus 0.90%, due September 2022. (4) The Operating Partnership’s borrowings under the term loan feature of the Credit Agreement bears interest at a rate which is determined by the Trust’s credit rating, currently equal to LIBOR + 1.00%. The Operating Partnership 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 Applicable Margin for Revolving Loans: LIBOR Rate Loans Applicable Margin for Revolving Loans: Base Rate Loans Applicable Margin for Term Loans: LIBOR Rate Loans Applicable Margin for Term Loans: Base Rate Loans At Least A- or A3 LIBOR + 0.725% — % LIBOR + 0.85% — % At Least BBB+ or Baa1 LIBOR + 0.775% — % LIBOR + 0.90% — % At Least BBB or Baa2 LIBOR + 0.85% — % LIBOR + 1.00% — % At Least BBB- or Baa3 LIBOR + 1.05% 0.05 % LIBOR + 1.25% 0.25 % Below BBB- or Baa3 LIBOR + 1.40% 0.40 % LIBOR + 1.65% 0.65 %
Schedule of principal payments due on debt	Scheduled principal payments due on consolidated debt as of September 30, 2021, are as follows (in thousands): 2021 $ 463 2022 20,825 2023 266,008 2024 23,669 2025 184,476 Thereafter 938,727 Total Payments $ 1,434,168

Derivatives (Tables)

Derivatives (Tables)	9 Months Ended
	Sep. 30, 2021
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) 2.07 % Effective date 7/7/2016 Maturity date 6/10/2023 Liability balance at September 30, 2021 (included in Accrued expenses and other liabilities) $ 3,567 Liability balance at December 31, 2020 (included in Accrued expenses and other liabilities) $ 5,317

Accrued Expenses and Other Li_2

Accrued Expenses and Other Liabilities (Tables)	9 Months Ended
	Sep. 30, 2021
Other Liabilities Disclosure [Abstract]
Schedule of accrued expenses and other liabilities	Accrued expenses and other liabilities consisted of the following as of September 30, 2021 and December 31, 2020 (in thousands): September 30, December 31, Real estate taxes payable $ 27,033 $ 23,436 Prepaid rent 18,606 22,248 Accrued interest 5,746 16,009 Accrued expenses 5,619 5,721 Accrued incentive compensation 4,950 1,945 Security deposits 3,885 3,714 Interest rate swap 3,567 5,317 Tenant improvement allowances 1,857 1,917 Embedded derivative — 4,944 Other 8,358 6,678 Total $ 79,621 $ 91,929

Stock-based Compensation (Table

Stock-based Compensation (Tables)	9 Months Ended
	Sep. 30, 2021
Share-based Payment Arrangement [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, 2021 and changes during the nine month period then ended follow: Common Shares Weighted Non-vested at December 31, 2020 215,822 $ 18.73 Granted 224,163 17.42 Vested (185,968) 18.94 Non-vested at September 30, 2021 254,017 $ 17.42
Schedule of weighted average grant date fair value assumptions	The Company utilized a Monte Carlo simulation to calculate the weighted average grant date fair values of $27.53 and $30.82 per unit for the March 2021 grant using the following assumptions: Volatility 33.3 % Dividend assumption reinvested Expected term in years 2.84 years Risk-free rate 0.25 % Share price (per share) $ 17.21
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, 2021: Executive Awards Trustee Awards Restricted Share Weighted Restricted Share Weighted Non-vested at December 31, 2020 964,139 $ 21.17 59,820 $ 18.81 Granted 265,275 22.00 56,925 17.35 Vested (252,844) (1) 16.58 (40,394) 18.57 Non-vested at September 30, 2021 976,570 $ 22.59 76,351 $ 17.84 (1) Restricted units vested by Company executives in 2021 resulted in the issuance of 399,165 common shares, less 162,173 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, 2021
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, 2021 December 31, 2020 Carrying Fair Carrying Fair Assets: Real estate loans receivable, net $ 181,125 $ 177,859 $ 198,800 $ 198,814 Notes receivable, net $ 1,045 $ 1,045 $ 23,760 $ 23,760 Liabilities: Credit facility $ (409,000) $ (409,000) $ (416,000) $ (416,000) Notes payable $ (975,000) $ (1,066,869) $ (975,000) $ (1,063,367) Mortgage debt $ (50,194) $ (51,458) $ (58,074) $ (59,651) Derivative liabilities $ (3,567) $ (3,567) $ (10,261) $ (10,261)

Tenant Operating Leases (Tables

Tenant Operating Leases (Tables)	9 Months Ended
	Sep. 30, 2021
Leases [Abstract]
Lessor, operating lease, payments to be received, maturity	As of September 30, 2021, the future minimum rental payments on non-cancelable leases, exclusive of expense recoveries and minimum rental payments for the four assets classified as held for sale, were as follows (in thousands): 2021 $ 77,498 2022 305,188 2023 297,695 2024 285,362 2025 269,862 Thereafter 961,607 Total $ 2,197,212

Rent Expense (Tables)

Rent Expense (Tables)	9 Months Ended
	Sep. 30, 2021
Leases [Abstract]
Schedule of future minimum lease obligations under non-cancelable ground leases	As of September 30, 2021, the future minimum lease obligations under non-cancelable parking, air, ground, and corporate leases, exclusive of the four assets classified as held for sale, were as follows (in thousands): 2021 $ 849 2022 3,719 2023 3,693 2024 3,676 2025 3,657 Thereafter 180,378 Total undiscounted lease payments $ 195,972 Less: Interest (117,290) Present value of lease liabilities $ 78,682
Lease cost	Lease costs consisted of the following for the nine months ended September 30, 2021 (in thousands): Fixed lease cost $ 1,823 Variable lease cost 751 Total lease cost $ 2,574

Credit Concentration (Tables)

Credit Concentration (Tables)	9 Months Ended
	Sep. 30, 2021
Concentration Risks, Types, No Concentration Percentage [Abstract]
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, 2021, excluding the four assets classified as held for sale (in thousands): Tenant Total ABR Percent of ABR CommonSpirit - CHI - Nebraska $ 17,656 5.7 % Northside Hospital 15,245 4.9 % UofL Health - Louisville, Inc. 12,526 4.1 % US Oncology 11,080 3.6 % Baylor Scott and White Health 8,156 2.6 % Remaining portfolio 244,512 79.1 % Total $ 309,175 100.0 % The following table summarizes certain information about the Company’s top five geographic concentrations as of September 30, 2021, excluding the four assets classified as held for sale (in thousands): State Total ABR Percent of ABR Texas $ 47,331 15.3 % Georgia 25,618 8.3 % Indiana 22,784 7.4 % Nebraska 18,993 6.1 % Minnesota 17,827 5.8 % Other 176,622 57.1 % Total $ 309,175 100.0 %

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 2021
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 2021 2020 2021 2020 Numerator for earnings per share - basic: Net income $ 22,045 $ 16,475 $ 58,531 $ 49,879 Net income attributable to noncontrolling interests: Operating Partnership (529) (425) (1,405) (1,305) Partially owned properties (152) (151) (455) (441) Preferred distributions — (317) (13) (951) Numerator for earnings per share - basic $ 21,364 $ 15,582 $ 56,658 $ 47,182 Numerator for earnings per share - diluted: Numerator for earnings per share - basic $ 21,364 $ 15,582 $ 56,658 $ 47,182 Operating Partnership net income 529 425 1,405 1,305 Numerator for earnings per share - diluted $ 21,893 $ 16,007 $ 58,063 $ 48,487 Denominator for earnings per share - basic and diluted: Weighted average number of shares outstanding - basic 217,406,657 208,187,129 214,616,482 202,717,190 Effect of dilutive securities: Noncontrolling interest - Operating Partnership units 5,406,070 5,643,669 5,498,046 5,655,870 Restricted common shares 98,597 70,819 95,999 72,522 Restricted share units 1,080,725 1,228,351 1,189,122 1,109,478 Denominator for earnings per share - diluted: 223,992,049 215,129,968 221,399,649 209,555,060 Earnings per share - basic $ 0.10 $ 0.07 $ 0.26 $ 0.23 Earnings per share - diluted $ 0.10 $ 0.07 $ 0.26 $ 0.23

Organization and Business - Add

Organization and Business - Additional Information (Details) - $ / shares	Sep. 30, 2021	Dec. 31, 2020
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) - Private Placement - ATM Program - USD ($)	1 Months Ended		3 Months Ended			9 Months Ended
	May 31, 2021	Nov. 30, 2019	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Sep. 30, 2021
Maximum
Class of Stock [Line Items]
Aggregate offering price of common stock	$ 500,000,000	$ 500,000,000
Operating Partnership
Class of Stock [Line Items]
Common shares sold (in shares)			0	4,532,343	2,887,296	7,419,639
Weighted average price (in dollars per share)			$ 0	$ 18.39	$ 18.32	$ 18.36
Proceeds from issuance of common stock			$ 0	$ 82,519,000	$ 52,358,000	$ 134,877,000
Sale of stock, remaining authorized amount			$ 465,300,000			$ 465,300,000

Summary of Significant Accoun_3

Summary of Significant Accounting Policies - Noncontrolling Interests (Details) - USD ($) $ in Thousands	Jan. 04, 2021	Jan. 09, 2018	Sep. 30, 2021	Sep. 30, 2020
Business Acquisition [Line Items]
Purchase of Series A Preferred Units			$ 4,661	$ 0
Physicians Realty Trust
Business Acquisition [Line Items]
Percentage of interest held			97.60%
Hazelwood Medical commons | Hazelwood Medical commons
Business Acquisition [Line Items]
Number of units issued for funding purchase price (in shares)		116,110
Hazelwood Medical commons | Series A Preferred Stock
Business Acquisition [Line Items]
Purchase of Series A Preferred Units	$ 25,300
Preferred units, outstanding (in shares)			0

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Dividends and Distributions (Details) - $ / shares	Sep. 22, 2021	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
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	$ 0.69

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Impairment of Intangible and Long-Lived Assets (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Accounting Policies [Abstract]
Impairment loss	$ 340,000	$ 0	$ 340,000	$ 0

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Assets Held for Sale (Details)	Sep. 30, 2021property
Accounting Policies [Abstract]
Number of real estate properties held for sale	4

Summary of Significant Accoun_7

Summary of Significant Accounting Policies - Real Estate Loans Receivable, Net (Details) $ in Thousands	Sep. 30, 2021USD ($)loan	Jun. 30, 2021USD ($)	Mar. 31, 2021USD ($)	Dec. 31, 2020USD ($)	Sep. 30, 2020USD ($)	Jun. 30, 2020USD ($)	Mar. 31, 2020USD ($)	Dec. 31, 2019USD ($)
Property, Plant and Equipment [Line Items]
Cumulative effect of changes in accounting	$ (2,757,911)	$ (2,783,163)	$ (2,735,231)	$ (2,715,002)	$ (2,715,183)	$ (2,744,082)	$ (2,675,425)	$ (2,480,984)
Financing receivable, allowance for credit loss	$ 100
Cumulative effect of changes in accounting standard
Property, Plant and Equipment [Line Items]
Cumulative effect of changes in accounting								147
Mezzanine Loan Receivable
Property, Plant and Equipment [Line Items]
Number of mezzanine loans collateralized | loan	22
Construction Loans
Property, Plant and Equipment [Line Items]
Number of mezzanine loans collateralized | loan	1
Term Loan Receivable
Property, Plant and Equipment [Line Items]
Number of mezzanine loans collateralized | loan	3
Retained Earnings
Property, Plant and Equipment [Line Items]
Cumulative effect of changes in accounting	$ 751,150	$ 722,587	$ 689,769	$ 658,171	$ 627,884	$ 595,117	$ 563,742	529,194
Retained Earnings | Cumulative effect of changes in accounting standard | Accounting Standards Update 2016-13 [Member]
Property, Plant and Equipment [Line Items]
Cumulative effect of changes in accounting								$ 100

Summary of Significant Accoun_8

Summary of Significant Accounting Policies - Rental and Related Revenues (Details) - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2020	Sep. 30, 2021	Dec. 31, 2020
Accounting Policies [Abstract]
Straight line rent receivable, net			$ 93,747	$ 86,551
Allowance for loan and lease loss, recovery of bad debts	$ 400	$ 500

Summary of Significant Accoun_9

Summary of Significant Accounting Policies - New Accounting Pronouncements (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2019
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Cumulative effect of changes in accounting	$ (2,757,911)	$ (2,783,163)	$ (2,735,231)	$ (2,715,002)	$ (2,715,183)	$ (2,744,082)	$ (2,675,425)	$ (2,480,984)
Cumulative effect of changes in accounting standard
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Cumulative effect of changes in accounting								147
Retained Earnings
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Cumulative effect of changes in accounting	$ 751,150	$ 722,587	$ 689,769	$ 658,171	$ 627,884	$ 595,117	$ 563,742	$ 529,194

Investment and Disposition Ac_3

Investment and Disposition Activity - Narrative (Details) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2021USD ($)mezzanine_loanproperty	Sep. 30, 2021USD ($)healthcarepropertypropertycondominium_unitmezzanine_loan
Asset Acquisition [Line Items]
Number of operating healthcare properties | healthcareproperty		8
Asset acquisition, consideration transferred	$ 96,865
Construction loan	10,500	$ 10,500
Payments for loans receivable and payments to acquire real estate	144,700	144,700
Asset acquisition, capitalized costs	$ 1,600	$ 1,600
Number of real estate properties held for sale | property	4	4
Two Medical Condominium Units Acquired in 2021
Asset Acquisition [Line Items]
Number of medical condominium units | condominium_unit		3
Asset acquisition, consideration transferred		$ 122,700
Earn-Out Investments
Asset Acquisition [Line Items]
Asset acquisition, consideration transferred		300
Real Estate Loan
Asset Acquisition [Line Items]
Payments for (proceeds from) loans receivable		$ 8,900
Number of mezzanine loans collateralized | mezzanine_loan	3	3
Construction Loans
Asset Acquisition [Line Items]
Payments for (proceeds from) loans receivable		$ 5,500
Previously Outstanding Construction Loan
Asset Acquisition [Line Items]
Payments for (proceeds from) loans receivable		$ 15,500

Investment and Disposition Ac_4

Investment and Disposition Activity - Summary of Investment Activity (Details) - USD ($) $ in Thousands	Sep. 23, 2021	Aug. 30, 2021	Aug. 18, 2021	Sep. 30, 2021
Asset Acquisition [Line Items]
Asset acquisition, consideration transferred				$ 96,865
InterMed MOB - Davis Joint Venture
Asset Acquisition [Line Items]
Asset acquisition, consideration transferred			$ 7,291
Noncontrolling interest, ownership in joint venture				49.00%
Atkins Portfolio (5 MOBs)
Asset Acquisition [Line Items]
Asset acquisition, consideration transferred		$ 54,090
HonorHealth - Sonoran MOB
Asset Acquisition [Line Items]
Asset acquisition, consideration transferred	$ 31,750
Loan Investments
Asset Acquisition [Line Items]
Asset acquisition, consideration transferred				$ 3,734

Investment and Disposition Ac_5

Investment and Disposition Activity - Summary of Acquisition Date Fair Values (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021
Asset Acquisition [Line Items]
Land	$ 10,898
Building and improvements	112,312
Right-of-use asset	1,700
Prepaid expenses	129
Net assets acquired	137,816
1st Quarter
Asset Acquisition [Line Items]
Land			$ 189
Building and improvements			917
Right-of-use asset			0
Prepaid expenses			0
Net assets acquired			1,135
2nd Quarter
Asset Acquisition [Line Items]
Land		$ 2,655
Building and improvements		44,743
Right-of-use asset		0
Prepaid expenses		129
Net assets acquired		51,969
3rd Quarter
Asset Acquisition [Line Items]
Land	8,054
Building and improvements	66,652
Right-of-use asset	1,700
Prepaid expenses	0
Net assets acquired	84,712
In-place lease intangibles
Asset Acquisition [Line Items]
In-place lease intangibles	12,687
In-place lease intangibles | 1st Quarter
Asset Acquisition [Line Items]
In-place lease intangibles			29
In-place lease intangibles | 2nd Quarter
Asset Acquisition [Line Items]
In-place lease intangibles		4,442
In-place lease intangibles | 3rd Quarter
Asset Acquisition [Line Items]
In-place lease intangibles	8,216
Above-market leases
Asset Acquisition [Line Items]
Above market in-place lease intangibles	241
Above-market leases | 1st Quarter
Asset Acquisition [Line Items]
Above market in-place lease intangibles			0
Above-market leases | 2nd Quarter
Asset Acquisition [Line Items]
Above market in-place lease intangibles		0
Above-market leases | 3rd Quarter
Asset Acquisition [Line Items]
Above market in-place lease intangibles	241
Below-market leases
Asset Acquisition [Line Items]
Below market in-place lease intangibles	(151)
Below-market leases | 1st Quarter
Asset Acquisition [Line Items]
Below market in-place lease intangibles			$ 0
Below-market leases | 2nd Quarter
Asset Acquisition [Line Items]
Below market in-place lease intangibles		$ 0
Below-market leases | 3rd Quarter
Asset Acquisition [Line Items]
Below market in-place lease intangibles	$ (151)

Investment and Disposition Ac_6

Investment and Disposition Activity - Assets Held for Sale (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Business Combination and Asset Acquisition [Abstract]
Disposal Group, Including Discontinued Operations, Land and Improvements	$ 7,660
Disposal Group, Including Discontinued Operations, Building and Improvements	49,930
Disposal Group, Including Discontinued Operations, Tenant Improvements	455
Disposal Group, Including Discontinued Operations, Acquired Lease Intangibles	3,141
Real Estate Held For Sale, Gross	61,186
Accumulated depreciation	(16,480)
Real estate held for sale	$ 44,706	$ 0

Intangibles - Summary of Carryi

Intangibles - Summary of Carrying Amount of Intangible Assets and Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Liabilities
Below-market leases, net	$ 5,829	$ 6,641
In-place leases
Assets:
Cost	364,750	362,837
Accumulated Amortization	(193,231)	(173,862)
Net	171,519	188,975
Above-market leases
Assets:
Cost	43,586	43,386
Accumulated Amortization	(23,373)	(20,670)
Net	20,213	22,716
Leasehold interest
Assets:
Cost	712	712
Accumulated Amortization	(406)	(361)
Net	306	351
Below-market leases
Liabilities
Below-market leases, cost	15,980	15,882
Below-market leases, accumulated amortization	(10,151)	(9,241)
Below-market leases, net	$ 5,829	$ 6,641

Intangibles - Summary of Acquir

Intangibles - Summary of Acquired Amortization (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Amortization expense related to in-place leases
Intangibles
Amortization expense related to in-place leases	$ 8,103	$ 9,088	$ 24,590	$ 26,190
Decrease in rental income related to above-market leases
Intangibles
Decrease of rental income	897	954	2,744	2,918
Decrease in rental income related to leasehold interest
Intangibles
Decrease of rental income	15	15	45	45
Increase in rental income related to below-market leases
Intangibles
Increase in rental income related to below-market leases	$ 324	$ 397	$ 963	$ 1,102

Intangibles - Additional Inform

Intangibles - Additional Information (Details)	9 Months Ended
	Sep. 30, 2021property
Intangibles
Number of real estate properties held for sale	4
In-place lease intangibles
Intangibles
Weighted average amortization period for lease intangibles	8 years
Above-market leases
Intangibles
Weighted average amortization period for lease intangibles	8 years
Leasehold interest
Intangibles
Weighted average amortization period for lease intangibles	8 years
Increase in rental income related to below-market leases
Intangibles
Weighted average amortization period for lease intangibles	7 years

Intangibles - Future Aggregate

Intangibles - Future Aggregate Net Amortization of Acquired Lease Intangibles (Details) $ in Thousands	Sep. 30, 2021USD ($)
Net Decrease in  Revenue
2021	$ 547
2022	1,963
2023	1,656
2024	1,589
2025	1,590
Thereafter	7,345
Total	14,690
Net Increase in  Expenses
2021	7,954
2022	29,276
2023	26,546
2024	23,350
2025	19,817
Thereafter	64,576
Total	$ 171,519

Other Assets - Schedule of Othe

Other Assets - Schedule of Other Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Other Assets, Unclassified [Abstract]
Straight line rent receivable, net	$ 93,747	$ 86,551
Leasing commissions, net	11,441	9,282
Prepaid expenses	8,943	9,401
Lease inducements, net	8,518	9,396
Escrows	1,546	1,507
Notes receivable, net	1,045	23,760
Other	5,249	4,103
Total	$ 130,489	$ 144,000

Debt - Summary of Debt (Details

Debt - Summary of Debt (Details)	Jul. 07, 2016	Sep. 30, 2021USD ($)healthcareproperty	Dec. 31, 2020USD ($)healthcareproperty	Sep. 24, 2021USD ($)
Debt
Long-term debt, gross		$ 1,434,168,000	$ 1,449,001,000
Unamortized deferred financing costs		(8,925,000)	(5,369,000)
Unamortized discounts		(4,366,000)	(4,855,000)
Unamortized fair value adjustments		26,000	73,000
Total debt		$ 1,420,903,000	1,438,850,000
2021 Third Amended and Restated Credit Agreement
Debt
Current borrowing capacity				$ 1,300,000,000
2018 Credit Agreement Amendment | London Interbank Offered Rate (LIBOR)
Debt
Reference rate (as a percent)		0.85%
Mortgages
Debt
Long-term debt, gross		$ 50,168,000	58,001,000
Mortgages | Fixed interest rate mortgage notes
Debt
Long-term debt, gross		$ 44,420,000	$ 51,896,000
Weighted average interest rate			4.78%
Pledged assets separately reported real estate pledged as collateral number | healthcareproperty		3	4
Pledged assets, not separately reported, real estate		$ 97,000,000	$ 110,300,000
Mortgages | Fixed interest rate mortgage notes | Minimum
Debt
Interest rate (as a percent)			4.63%
Mortgages | Fixed interest rate mortgage notes | Maximum
Debt
Interest rate (as a percent)			5.50%
Mortgages | Variable interest mortgage note
Debt
Long-term debt, gross		$ 5,748,000	$ 6,105,000
Weighted average interest rate		2.83%	2.90%
Pledged assets separately reported real estate pledged as collateral number | healthcareproperty		1
Pledged assets, not separately reported, real estate		$ 8,100,000	$ 8,300,000
Mortgages | Variable interest mortgage note | London Interbank Offered Rate (LIBOR)
Debt
Reference rate (as a percent)		2.75%
Mortgages | Mortgage notes bearing fixed interest rate due in 2022 and 2024
Debt
Weighted average interest rate		4.79%
Mortgages | Mortgage notes bearing fixed interest rate due in 2022 and 2024 | Minimum
Debt
Interest rate (as a percent)		4.63%
Mortgages | Mortgage notes bearing fixed interest rate due in 2022 and 2024 | Maximum
Debt
Interest rate (as a percent)		5.50%
Revolving credit facility
Debt
Current borrowing capacity		$ 841,000,000
Revolving credit facility | Unsecured Revolving Credit Facility Bearing Variable Interest
Debt
Long-term debt, gross		$ 159,000,000	$ 166,000,000
Revolving credit facility | 2021 Third Amended and Restated Credit Agreement
Debt
Reference rate (as a percent)		0.85%
Current borrowing capacity				$ 1,000,000,000
Revolving credit facility | $850.0 million revolving credit facility due September 2022
Debt
Reference rate (as a percent)			0.90%
Current borrowing capacity			$ 850,000,000
Senior notes
Debt
Total debt		$ 975,000,000
Senior notes | $400 million senior unsecured notes bearing fixed interest of 4.30%, due March 2027
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%
Senior notes | $350 million senior unsecured notes bearing fixed interest of 3.95%, due January 2028
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%
Senior notes | $150 million senior unsecured notes bearing fixed interest of 4.03% to 4.74%, due January 2023 to 2031
Debt
Long-term debt, gross		$ 150,000,000	150,000,000
Debt instrument, face amount		$ 150,000,000
Senior notes | $150 million senior unsecured notes bearing fixed interest of 4.03% to 4.74%, due January 2023 to 2031 | Minimum
Debt
Interest rate (as a percent)		4.03%
Senior notes | $150 million senior unsecured notes bearing fixed interest of 4.03% to 4.74%, due January 2023 to 2031 | Maximum
Debt
Interest rate (as a percent)		4.74%
Senior notes | $75 million senior unsecured notes bearing fixed interest of 4.09% to 4.24%, due August 2025 to 2027
Debt
Long-term debt, gross		$ 75,000,000	75,000,000
Debt instrument, face amount		$ 75,000,000
Senior notes | $75 million senior unsecured notes bearing fixed interest of 4.09% to 4.24%, due August 2025 to 2027 | Minimum
Debt
Interest rate (as a percent)		4.09%
Senior notes | $75 million senior unsecured notes bearing fixed interest of 4.09% to 4.24%, due August 2025 to 2027 | Maximum
Debt
Interest rate (as a percent)		4.24%
Unsecured Debt | $250 million unsecured term borrowing bearing fixed interest, 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)		2.07%
Unsecured Debt | 2018 Credit Agreement Amendment | London Interbank Offered Rate (LIBOR)
Debt
Reference rate (as a percent)	1.00%	1.00%

Debt - Additional Information (

Debt - Additional Information (Details)	Jul. 07, 2016USD ($)	Sep. 30, 2021USD ($)extensionOptionRate	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)extensionOptionRate	Sep. 30, 2020USD ($)	Sep. 24, 2021USD ($)	Dec. 31, 2020USD ($)	Aug. 07, 2018
Debt
Long-term debt		$ 1,420,903,000		$ 1,420,903,000			$ 1,438,850,000
Long-term debt, gross		1,434,168,000		1,434,168,000			1,449,001,000
Interest expense, debt		12,900,000	$ 13,100,000	$ 39,000,000	$ 41,700,000
2021 Third Amended and Restated Credit Agreement
Debt
Current borrowing capacity						$ 1,300,000,000
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						1,750,000,000
2018 Credit Agreement Amendment
Debt
Unused fee (as a percent)				0.20%
2018 Credit Agreement Amendment | London Interbank Offered Rate (LIBOR)
Debt
Reference rate (as a percent)				0.85%
Revolving credit facility
Debt
Current borrowing capacity		$ 841,000,000		$ 841,000,000
Number of extension options | extensionOption		2		2
Term of extension option				6 months
Amount outstanding		$ 159,000,000		$ 159,000,000
Revolving credit facility | 2021 Third Amended and Restated Credit Agreement
Debt
Current borrowing capacity						1,000,000,000
Reference rate (as a percent)				0.85%
Term Loan
Debt
Amount outstanding	$ 250,000,000	$ 250,000,000		$ 250,000,000
Term Loan | 2021 Third Amended and Restated Credit Agreement
Debt
Current borrowing capacity						$ 250,000,000
Term Loan | 2018 Credit Agreement Amendment
Debt
Debt instrument, term	7 years
Unsecured Debt | 2018 Credit Agreement Amendment | London Interbank Offered Rate (LIBOR)
Debt
Reference rate (as a percent)	1.00%			1.00%
Unsecured Debt | $250 million unsecured term borrowing bearing fixed interest, due June 2023
Debt
Interest rate (as a percent)		2.07%		2.07%
Long-term debt, gross		$ 250,000,000		$ 250,000,000			$ 250,000,000
Senior notes
Debt
Long-term debt		975,000,000		975,000,000
Senior notes | Senior Notes Due 2023
Debt
Long-term debt		15,000,000		15,000,000
Senior notes | Senior Notes Due 2025
Debt
Long-term debt		25,000,000		25,000,000
Senior notes | Senior Notes Due 2026
Debt
Long-term debt		70,000,000		70,000,000
Senior notes | Senior Notes Due 2027
Debt
Long-term debt		425,000,000		425,000,000
Senior notes | Senior Notes Due 2028
Debt
Long-term debt		395,000,000		395,000,000
Senior notes | Senior Notes Due 2031
Debt
Long-term debt		$ 45,000,000		$ 45,000,000
Interest Rate Swap | Unsecured Debt
Debt
Effective fixed interest rate (as a percent) | Rate		2.07%		2.07%
Interest Rate Swap | Unsecured Debt | London Interbank Offered Rate (LIBOR)
Debt
Effective fixed interest rate (as a percent)	1.07%	1.07%		1.07%
Operating Partnership | Revolving credit facility
Debt
Interest rate at end of period (as a percent)		3.48%		3.48%
Operating Partnership | Revolving credit facility | London Interbank Offered Rate (LIBOR)
Debt
Reference rate (as a percent)				0.08%

Debt - Trust Investment Grade R

Debt - Trust Investment Grade Rating (Details)	9 Months Ended
	Sep. 30, 2021
At Least A- or A3 | Adjusted LIBOR rate loans and letter of credit | London Interbank Offered Rate (LIBOR)
Debt
Reference rate (as a percent)	0.725%
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)	0.775%
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)	0.85%
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)	1.05%
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)	1.40%
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%
Applicable 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%
Applicable 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%
Applicable 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%
Applicable Margin for Revolving Loans: Base Rate Loans | At Least BBB- or Baa3 | Base rate loans | Base rate
Debt
Reference rate (as a percent)	0.05%
Applicable Margin for Revolving Loans: Base Rate Loans | Below BBB- or Baa3 | Base rate loans | Base rate
Debt
Reference rate (as a percent)	0.40%
Applicable 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%
Applicable 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%
Applicable 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%
Applicable 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%
Applicable 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	Sep. 30, 2021	Dec. 31, 2020
Debt Disclosure [Abstract]
2021	$ 463
2022	20,825
2023	266,008
2024	23,669
2025	184,476
Thereafter	938,727
Total Payments	$ 1,434,168	$ 1,449,001

Derivatives - Additional Inform

Derivatives - Additional Information (Details)	Sep. 30, 2021instrument
Interest Rate Swap
Derivative [Line Items]
Outstanding interest rate swap contracts designated as cash flow hedges	5

Derivatives - Location and Aggr

Derivatives - Location and Aggregate Fair Value of Interest Rate Swaps (Details) - USD ($)	Jul. 07, 2016	Sep. 30, 2021	Dec. 31, 2020
Derivative [Line Items]
Total notional amount		$ 250,000,000
Effective date		Jul. 7, 2016
Maturity date		Jun. 10, 2023
Interest Rate Swap | Carrying Amount
Derivative [Line Items]
Liability balance at September 30, 2021 (included in Accrued expenses and other liabilities)		$ 3,567,000	$ 5,317,000
Liability balance at December 31, 2020 (included in Accrued expenses and other liabilities)		$ 3,567,000	$ 5,317,000
London Interbank Offered Rate (LIBOR) | 2018 Credit Agreement Amendment
Derivative [Line Items]
Reference rate (as a percent)		0.85%
Unsecured Debt | Interest Rate Swap
Derivative [Line Items]
Effective fixed interest rate (as a percent)		2.07%
Unsecured Debt | London Interbank Offered Rate (LIBOR) | 2018 Credit Agreement Amendment
Derivative [Line Items]
Reference rate (as a percent)	1.00%	1.00%
Unsecured Debt | London Interbank Offered Rate (LIBOR) | Interest Rate Swap
Derivative [Line Items]
Effective fixed interest rate (as a percent)	1.07%	1.07%

Accrued Expenses and Other Li_3

Accrued Expenses and Other Liabilities - Schedule of Accrued Expense and Other Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Other Liabilities Disclosure [Abstract]
Real estate taxes payable	$ 27,033	$ 23,436
Prepaid rent	18,606	22,248
Accrued interest	5,746	16,009
Accrued expenses	5,619	5,721
Accrued incentive compensation	4,950	1,945
Security deposits	3,885	3,714
Interest rate swap	3,567	5,317
Tenant improvement allowances	1,857	1,917
Embedded derivative	0	4,944
Other	8,358	6,678
Total	$ 79,621	$ 91,929

Stock-based Compensation - Addi

Stock-based Compensation - Additional Information (Details)	Apr. 30, 2019shares
Restricted common shares | 2013 Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Maximum number of shares authorized (in shares)	7,000,000

Stock-based Compensation - Rest

Stock-based Compensation - Restricted Common Shares (Narrative) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Non-cash share compensation			$ 10,840	$ 9,161
2013 Plan | Restricted common shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)			224,163
Non-cash share compensation	$ 1,000	$ 900	$ 2,800	$ 2,600
Unrecognized compensation expense	$ 2,400		$ 2,400
2013 Plan | Restricted common shares | Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period			1 year
2013 Plan | Restricted common shares | Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period			3 years
Officers and Certain Employees | 2013 Plan | Restricted common shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)			224,163
Grant date value			$ 3,900

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, 2021$ / sharesshares
Common Shares
Non-vested at the beginning of the period (in shares) | shares	215,822
Granted (in shares) | shares	224,163
Vested (in shares) | shares	(185,968)
Non-vested at the end of the period (in shares) | shares	254,017
Weighted Average Grant Date Fair Value
Non-vested at beginning of period (in dollars per share) | $ / shares	$ 18.73
Granted (in dollars per share) | $ / shares	17.42
Vested (in dollars per share) | $ / shares	18.94
Non-vested at end of period (in dollars per share) | $ / shares	$ 17.42

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, 2021	Jan. 31, 2021	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Non-cash share compensation					$ 10,840	$ 9,161
2013 Plan | Restricted share units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Non-cash share compensation			$ 2,700	$ 2,200	8,000	$ 6,500
Unrecognized compensation expense			$ 12,700		$ 12,700
2013 Plan | Market Based Restricted Stock Units (RSUs) | Share-based Payment Arrangement, Tranche One
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in dollars per share)	$ 27.53
2013 Plan | Market Based Restricted Stock Units (RSUs) | Share-based Payment Arrangement, Tranche Two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in dollars per share)	$ 30.82
Officers and Certain Employees | 2013 Plan | Restricted share units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)	265,275
Vesting period	3 years	1 year
Officers and Certain Employees | 2013 Plan | Performance based restricted stock units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Performance conditions grant date fair value (in dollars per share)	$ 17.21
Vesting percentage	60.00%
Granted (in dollars per share)	$ 22
Percentage of restricted share units issued to trustees	100.00%
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%
Trustees | 2013 Plan | Restricted share units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)	43,582	13,343
Number of dividend equivalent included in each award (in shares)	1	1
Vesting period	2 years
Trustees | 2013 Plan | Performance based restricted stock units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Performance conditions grant date fair value (in dollars per share)		$ 17.80

Stock-based Compensation - Re_3

Stock-based Compensation - Restricted Share Assumptions (Details) - 2013 Plan - Restricted share units (RSUs)	1 Months Ended
	Mar. 31, 2021$ / shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Volatility	33.30%
Expected term in years	2 years 10 months 2 days
Risk-free rate	0.25%
Share price (per share)	$ 17.21

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, 2021	Dec. 31, 2020
Weighted Average Grant Date Fair Value
Common stock, shares issued (in shares)	217,409,035	209,550,592
2013 Plan | Executive Awards
Restricted Share Units
Non-vested at the beginning of the period (in shares)	964,139
Granted (in shares)	265,275
Vested (in shares)	(252,844)
Non-vested at the end of the period (in shares)	976,570
Weighted Average Grant Date Fair Value
Non-vested at beginning of period (in dollars per share)	$ 21.17
Granted (in dollars per share)	22
Vested (in dollars per share)	16.58
Non-vested at end of period (in dollars per share)	$ 22.59
Common stock, shares issued (in shares)	399,165
Restricted stock, shares issued net of shares for tax withholdings (in shares)	162,173
2013 Plan | Trustee Awards
Restricted Share Units
Non-vested at the beginning of the period (in shares)	59,820
Granted (in shares)	56,925
Vested (in shares)	(40,394)
Non-vested at the end of the period (in shares)	76,351
Weighted Average Grant Date Fair Value
Non-vested at beginning of period (in dollars per share)	$ 18.81
Granted (in dollars per share)	17.35
Vested (in dollars per share)	18.57
Non-vested at end of period (in dollars per share)	$ 17.84

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2021USD ($)instrumentpropertyasset	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)instrumentpropertyasset	Sep. 30, 2020USD ($)
Fair value of other financial instruments
Impairment loss	$ 340,000	$ 0	$ 340,000	$ 0
Number of real estate properties held for sale | property	4		4
Fair value, measurements, nonrecurring
Fair value of other financial instruments
Number of assets measured at fair value | asset	1		1
Assets subject to impairment, carrying value	$ 2,300,000		$ 2,300,000
Interest Rate Swap
Fair value of other financial instruments
Outstanding interest rate swap contracts designated as cash flow hedges | instrument	5		5

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value of Company's Financial Instruments (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Assets:
Notes receivable, net	$ 1,045	$ 23,760
Liabilities:
Credit facility	(401,548)	(412,322)
Notes payable	(969,313)	(968,653)
Mortgage debt	(50,042)	(57,875)
Carrying Amount
Assets:
Real estate loans receivable, net	181,125	198,800
Notes receivable, net	1,045	23,760
Liabilities:
Credit facility	(409,000)	(416,000)
Notes payable	(975,000)	(975,000)
Mortgage debt	(50,194)	(58,074)
Carrying Amount | Derivative liabilities
Liabilities:
Derivative liabilities	(3,567)	(10,261)
Fair Value
Assets:
Real estate loans receivable, net	177,859	198,814
Notes receivable, net	1,045	23,760
Liabilities:
Credit facility	(409,000)	(416,000)
Notes payable	(1,066,869)	(1,063,367)
Mortgage debt	(51,458)	(59,651)
Fair Value | Derivative liabilities
Liabilities:
Derivative liabilities	$ (3,567)	$ (10,261)

Tenant Operating Leases - Sched

Tenant Operating Leases - Schedule of Future Minimum Rental Payments (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021USD ($)property	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)property	Sep. 30, 2020USD ($)
Leases [Abstract]
Number of real estate properties held for sale | property	4		4
2021	$ 77,498		$ 77,498
2022	305,188		305,188
2023	297,695		297,695
2024	285,362		285,362
2025	269,862		269,862
Thereafter	961,607		961,607
Total	2,197,212		2,197,212
Operating lease, lease income	110,300	$ 104,400	326,000	$ 311,900
Operating lease, variable lease income	$ 29,200	$ 26,300	$ 84,000	$ 76,100

Rent Expense - Additional Infor

Rent Expense - Additional Information (Details)	9 Months Ended
	Sep. 30, 2021leaseproperty
Leases [Abstract]
Number of properties subject to parking lease	2
Number of properties subject to air space lease	1
Number of properties subject to ground leases	82
Number of office space leases | lease	9
Maximum lease terms	86 years
Operating lease, weighted average remaining lease term	43 years
Operating lease, weighted average discount rate, percent	4.40%
Number of real estate properties held for sale	4

Rent Expense - Schedule of Futu

Rent Expense - Schedule of Future Minimum Lease Obligations (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Leases [Abstract]
2021	$ 849
2022	3,719
2023	3,693
2024	3,676
2025	3,657
Thereafter	180,378
Total undiscounted lease payments	195,972
Less: Interest	(117,290)
Present value of lease liabilities	$ 78,682	$ 74,116

Rent Expense - Lease Cost (Deta

Rent Expense - Lease Cost (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2021USD ($)
Leases [Abstract]
Fixed lease cost	$ 1,823
Variable lease cost	751
Total lease cost	$ 2,574

Credit Concentration - Schedule

Credit Concentration - Schedule of ABR (Annualized Base Rent) (Details) - Sales Revenue, Services, Net $ in Thousands	9 Months Ended
	Sep. 30, 2021USD ($)Rate
Customer Concentration Risk
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 309,175
Percent of ABR (annualized base rent) | Rate	100.00%
Customer Concentration Risk | CommonSpirit - CHI - Nebraska
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 17,656
Percent of ABR (annualized base rent)	5.70%
Customer Concentration Risk | Northside Hospital
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 15,245
Percent of ABR (annualized base rent)	4.90%
Customer Concentration Risk | UofL Health - Louisville, Inc.
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 12,526
Percent of ABR (annualized base rent)	4.10%
Customer Concentration Risk | US Oncology
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 11,080
Percent of ABR (annualized base rent)	3.60%
Customer Concentration Risk | Baylor Scott and White Health
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 8,156
Percent of ABR (annualized base rent)	2.60%
Customer Concentration Risk | Remaining portfolio
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 244,512
Percent of ABR (annualized base rent) | Rate	79.10%
Geographic Concentration Risk
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 309,175
Percent of ABR (annualized base rent) | Rate	100.00%
Geographic Concentration Risk | Texas
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 47,331
Percent of ABR (annualized base rent)	15.30%
Geographic Concentration Risk | Georgia
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 25,618
Percent of ABR (annualized base rent)	8.30%
Geographic Concentration Risk | Indiana
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 22,784
Percent of ABR (annualized base rent)	7.40%
Geographic Concentration Risk | Nebraska
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 18,993
Percent of ABR (annualized base rent)	6.10%
Geographic Concentration Risk | Minnesota
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 17,827
Percent of ABR (annualized base rent)	5.80%
Geographic Concentration Risk | Other
Concentration Risk [Line Items]
Total ABR (annualized base rent)	$ 176,622
Percent of ABR (annualized base rent)	57.10%

Credit Concentration - Addition

Credit Concentration - Additional Information (Details)	9 Months Ended
	Sep. 30, 2021propertyRate
Concentration Risk [Line Items]
Number of real estate properties held for sale | property	4
Sales Revenue, Services, Net | Customer Concentration Risk
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)	20.90%
CHI Portfolio | Sales Revenue, Services, Net | Customer Concentration Risk
Concentration Risk [Line Items]
Percent of ABR (annualized base rent)	16.50%

Earnings Per Share - Schedule o

Earnings Per Share - Schedule of Earnings Per Share and Earnings Per Unit (Details) - USD ($) $ / shares in Units, $ in Thousands		3 Months Ended		9 Months Ended
		Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Numerator for earnings per share - basic:
Net income		$ 22,045	$ 16,475	$ 58,531	$ 49,879
Net income attributable to noncontrolling interests:
Operating Partnership		(529)	(425)	(1,405)	(1,305)
Partially owned properties	[1]	(152)	(151)	(455)	(441)
Preferred distributions		0	(317)	(13)	(951)
Net income attributable to common shareholders		21,364	15,582	56,658	47,182
Numerator for earnings per share - diluted:
Numerator for earnings per share - basic		21,364	15,582	56,658	47,182
Operating Partnership net income		529	425	1,405	1,305
Numerator for earnings per share - diluted		$ 21,893	$ 16,007	$ 58,063	$ 48,487
Denominator for earnings per share - basic and diluted:
Weighted average number of shares outstanding - basic (in shares)		217,406,657	208,187,129	214,616,482	202,717,190
Effect of dilutive securities:
Noncontrolling interest - Operating Partnership units (in shares)		5,406,070	5,643,669	5,498,046	5,655,870
Denominator for earnings per share - diluted (in shares)		223,992,049	215,129,968	221,399,649	209,555,060
Earnings per share - basic (in dollars per share)		$ 0.10	$ 0.07	$ 0.26	$ 0.23
Earnings per share - diluted (in dollars per share)		$ 0.10	$ 0.07	$ 0.26	$ 0.23
Restricted common shares
Effect of dilutive securities:
Restricted common shares/units (in shares)		98,597	70,819	95,999	72,522
Restricted share units
Effect of dilutive securities:
Restricted common shares/units (in shares)		1,080,725	1,228,351	1,189,122	1,109,478
[1]	Includes amounts attributable to redeemable noncontrolling interests.

Subsequent Events - Narrative (

Subsequent Events - Narrative (Details) $ / shares in Units, $ in Thousands	Nov. 02, 2021USD ($)property	Oct. 27, 2021USD ($)ft²	Oct. 15, 2021USD ($)ft²	Oct. 13, 2021USD ($)	Oct. 01, 2021USD ($)statebuilding	Nov. 05, 2021USD ($)$ / sharesshares	Sep. 30, 2021USD ($)	Jul. 07, 2016USD ($)
Subsequent Event [Line Items]
Asset acquisition, consideration transferred							$ 96,865
Revolving credit facility
Subsequent Event [Line Items]
Amount outstanding							159,000
Term Loan
Subsequent Event [Line Items]
Amount outstanding							$ 250,000	$ 250,000
Subsequent Event
Subsequent Event [Line Items]
Payments for termination of swap agreements				$ 3,300
Subsequent Event | Disposal Group, Held-for-sale, Not Discontinued Operations | LifeCare 2.0 Portfolio
Subsequent Event [Line Items]
Number of real estate properties | property	3
Proceeds from sale of property held-for-sale	$ 62,000
Disposal group, not discontinued operation, gain (loss) on disposal	$ 18,700
Subsequent Event | Operating Partnership | 2021 ATM Program
Subsequent Event [Line Items]
Common shares sold (in shares) | shares						2,877,988
Weighted average price on sale of common shares (in USD per share) | $ / shares						$ 18.61
Proceeds from issuance of common stock						$ 53,000
Subsequent Event | Senior notes | 2.625% Senior Notes, Due November 2031
Subsequent Event [Line Items]
Debt instrument, face amount				$ 500,000
Interest rate (as a percent)				2.625%
Debt instrument, redemption price, percentage				99.789%
Proceeds from issuance of long-term debt				$ 495,100
Subsequent Event | Revolving credit facility
Subsequent Event [Line Items]
Amount outstanding				168,000
Subsequent Event | Term Loan
Subsequent Event [Line Items]
Amount outstanding				$ 250,000
Subsequent Event | Landmark Healthcare Companies
Subsequent Event [Line Items]
Number of medical office buildings | building					15
Number of states in which operating healthcare properties are located | state					8
Asset acquisition, consideration transferred					$ 764,300
Subsequent Event | MedCore Realty Eden Hill, LLC
Subsequent Event [Line Items]
Asset acquisition, consideration transferred			$ 33,200
Noncontrolling interest, ownership in joint venture			51.00%
Area of real estate property (square feet) | ft²			140,205
Subsequent Event | Medical Office Facility, Scottsdale, Arizona
Subsequent Event [Line Items]
Asset acquisition, consideration transferred		$ 67,300
Area of real estate property (square feet) | ft²		109,423