Universal Health Realty Income Trust (UHT) 10-Q 8 Aug 24 2024 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	6 Months Ended
	Jun. 30, 2024	Jul. 31, 2024
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Jun. 30, 2024
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q2
Entity Registrant Name	UNIVERSAL HEALTH REALTY INCOME TRUST
Entity Central Index Key	0000798783
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		13,848,952
Entity Current Reporting Status	Yes
Entity Shell Company	false
Entity File Number	1-9321
Entity Tax Identification Number	23-6858580
Entity Address, Address Line One	UNIVERSAL CORPORATE CENTER
Entity Address, Address Line Two	367 SOUTH GULPH ROAD
Entity Address, City or Town	KING OF PRUSSIA
Entity Address, State or Province	PA
Entity Address, Postal Zip Code	19406-0958
City Area Code	610
Local Phone Number	265-0688
Entity Interactive Data Current	Yes
Title of 12(b) Security	Shares of beneficial interest, $0.01 par value
Trading Symbol	UHT
Security Exchange Name	NYSE
Entity Incorporation, State or Country Code	MD
Document Quarterly Report	true
Document Transition Report	false

Condensed Consolidated Statemen

Condensed Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands		3 Months Ended		6 Months Ended
		Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Revenues:
Revenues, Total		$ 24,734	$ 23,806	$ 49,875	$ 47,032
Expenses:
Depreciation and amortization		6,806	6,849	13,615	13,467
Other operating expenses		6,975	8,250	14,506	15,771
Costs and Expenses, Total		15,150	16,422	30,828	31,863
Income before equity in income of unconsolidated limited liability companies ("LLCs") and interest expense		9,584	7,384	19,047	15,169
Equity in income of unconsolidated LLCs		272	268	656	639
Interest expense, net		(4,580)	(4,176)	(9,127)	(7,873)
Net income		$ 5,276	$ 3,476	$ 10,576	$ 7,935
Basic earnings per share		$ 0.38	$ 0.25	$ 0.77	$ 0.58
Diluted earnings per share		$ 0.38	$ 0.25	$ 0.76	$ 0.57
Weighted average number of shares outstanding - Basic		13,798	13,784	13,795	13,781
Weighted average number of shares outstanding - Diluted		13,832	13,809	13,828	13,806
Management Service
Expenses:
Advisory fees to UHS		$ 1,369	$ 1,323	$ 2,707	$ 2,625
UHS Facilities
Revenues:
Lease revenue	[1]	8,454	8,236	17,118	16,023
Interest income on financing leases - UHS facilities		1,359	1,365	2,720	2,731
UHS Facilities | Other
Revenues:
Other revenue		220	245	440	476
Non-Related Parties
Revenues:
Lease revenue		14,359	13,668	28,846	27,029
Non-Related Parties | Other
Revenues:
Other revenue		$ 342	$ 292	$ 751	$ 773
[1] Includes bonus rental on McAllen Medical Center, a UHS acute care hospital fa cility of $ 758 and $ 730 for the three-month periods ended June 30, 2024 and 2023, respectively, and $ 1,541 and $ 1,495 for the six-month periods ended June 30, 2024 and 2023, respectively.

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Income (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
UHS Hospital Facilities | McAllen Medical Center
Bonus rental	$ 758	$ 730	$ 1,541	$ 1,495

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Statement of Comprehensive Income [Abstract]
Net Income (Loss)	$ 5,276	$ 3,476	$ 10,576	$ 7,935
Other comprehensive gain/(loss):
Unrealized derivative (loss)/gain on cash flow hedges	(1,062)	715	(871)	(1,032)
Total other comprehensive (loss)/gain:	(1,062)	715	(871)	(1,032)
Total comprehensive income	$ 4,214	$ 4,191	$ 9,705	$ 6,903

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Real Estate Investments:
Buildings and improvements and construction in progress	$ 651,638	$ 649,374
Accumulated depreciation	(274,622)	(262,449)
Real Estate Investment Property, Net, Total	377,016	386,925
Land	56,870	56,870
Net Real Estate Investments	433,886	443,795
Financing receivable from UHS	83,043	83,279
Net Real Estate Investments and Financing receivable	516,929	527,074
Investments in limited liability companies ("LLCs")	14,328	9,102
Other Assets:
Cash and cash equivalents	5,577	8,212
Lease and other receivables from UHS	6,816	6,180
Lease receivable - other	7,905	8,166
Intangible assets (net of accumulated amortization of $11.4 million and $12.5 million, respectively)	8,193	9,110
Right-of-use land assets, net	10,932	10,946
Deferred charges, notes receivable and other assets, net	15,871	17,579
Total Assets	586,551	596,369
Liabilities:
Line of credit borrowings	342,900	326,600
Mortgage notes payable, non-recourse to us, net	19,970	32,863
Accrued interest	1,024	490
Accrued expenses and other liabilities	10,145	13,500
Ground lease liabilities, net	10,932	10,946
Tenant reserves, deposits and deferred and prepaid rents	10,879	11,036
Total Liabilities	395,850	395,435
Equity:
Preferred shares of beneficial interest, $.01 par value; 5,000,000 shares authorized; none issued and outstanding
Common shares, $.01 par value; 95,000,000 shares authorized; issued and outstanding: 2024 - 13,848,950; 2023 - 13,823,899	138	138
Capital in excess of par value	270,592	270,398
Cumulative net income	836,637	826,061
Cumulative dividends	(923,107)	(902,975)
Accumulated other comprehensive income	6,441	7,312
Total Equity	190,701	200,934
Total Liabilities and Equity	$ 586,551	$ 596,369

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Millions	Jun. 30, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Intangible assets, accumulated amortization	$ 11.4	$ 12.5
Preferred shares of beneficial interest, par value	$ 0.01	$ 0.01
Preferred shares of beneficial interest, shares authorized	5,000,000	5,000,000
Preferred shares of beneficial interest, issued	0	0
Preferred shares of beneficial interest, outstanding	0	0
Common shares, par value	$ 0.01	$ 0.01
Common shares, shares authorized	95,000,000	95,000,000
Common shares, issued	13,848,950	13,823,899
Common shares, outstanding	13,848,950	13,823,899

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Changes in Equity - USD ($) $ in Thousands	Total	Common stock	Capital in excess of par value	Cumulative net income	Cumulative dividends	Accumulated other comprehensive income/(loss)
Balance at Dec. 31, 2022	$ 229,101	$ 138	$ 269,472	$ 810,661	$ (863,181)	$ 12,011
Balance, Shares at Dec. 31, 2022		13,803
Shares of Beneficial Interest:
Issued, net	75		75
Issued, net (in shares)		19
Restricted stock-based compensation expense	376		376
Dividends and dividend equivalents	(19,820)				(19,820)
Comprehensive income:
Net income	7,935			7,935
Unrealized net gain/(loss) on cash flow hedges	(1,032)					(1,032)
Subtotal - comprehensive income	6,903			7,935		(1,032)
Balance at Jun. 30, 2023	216,635	$ 138	269,923	818,596	(883,001)	10,979
Balance, Shares at Jun. 30, 2023		13,822
Balance at Mar. 31, 2023	222,170	$ 138	269,698	815,120	(873,050)	10,264
Balance, Shares at Mar. 31, 2023		13,804
Shares of Beneficial Interest:
Issued, net	37		37
Issued, net (in shares)		18
Restricted stock-based compensation expense	188		188
Dividends and dividend equivalents	(9,951)				(9,951)
Comprehensive income:
Net income	3,476			3,476
Unrealized net gain/(loss) on cash flow hedges	715					715
Subtotal - comprehensive income	4,191			3,476		715
Balance at Jun. 30, 2023	216,635	$ 138	269,923	818,596	(883,001)	10,979
Balance, Shares at Jun. 30, 2023		13,822
Balance at Dec. 31, 2023	200,934	$ 138	270,398	826,061	(902,975)	7,312
Balance, Shares at Dec. 31, 2023		13,824
Shares of Beneficial Interest:
Issued, net	(207)		(207)
Issued, net (in shares)		26
Repurchased	(12)		(12)
Repurchased (in shares)		(1)
Restricted stock-based compensation expense	413		413
Dividends and dividend equivalents	(20,132)				(20,132)
Comprehensive income:
Net income	10,576			10,576
Unrealized net gain/(loss) on cash flow hedges	(871)					(871)
Subtotal - comprehensive income	9,705			10,576		(871)
Balance at Jun. 30, 2024	190,701	$ 138	270,592	836,637	(923,107)	6,441
Balance, Shares at Jun. 30, 2024		13,849
Balance at Mar. 31, 2024	196,458	$ 138	270,454	831,361	(912,998)	7,503
Balance, Shares at Mar. 31, 2024		13,825
Shares of Beneficial Interest:
Issued, net	(61)		(61)
Issued, net (in shares)		25
Repurchased	(12)		(12)
Repurchased (in shares)		(1)
Restricted stock-based compensation expense	211		211
Dividends and dividend equivalents	(10,109)				(10,109)
Comprehensive income:
Net income	5,276			5,276
Unrealized net gain/(loss) on cash flow hedges	(1,062)					(1,062)
Subtotal - comprehensive income	4,214			5,276		(1,062)
Balance at Jun. 30, 2024	$ 190,701	$ 138	$ 270,592	$ 836,637	$ (923,107)	$ 6,441
Balance, Shares at Jun. 30, 2024		13,849

Condensed Consolidated Statem_5

Condensed Consolidated Statements of Changes in Equity (Parenthetical) - $ / shares	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Statement of Stockholders' Equity [Abstract]
Dividends and dividend equivalents, per share	$ 0.73	$ 0.72	$ 1.455	$ 1.435

Condensed Consolidated Statem_6

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023
Cash flows from operating activities:
Net income	$ 10,576	$ 7,935
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	13,615	13,467
Amortization related to above/below market leases, net	(89)	(73)
Amortization of debt premium		(24)
Amortization of deferred financing costs	383	347
Stock-based compensation expense	413	376
Changes in assets and liabilities:
Lease receivable	(375)	(490)
Accrued expenses and other liabilities	(1,309)	(618)
Tenant reserves, deposits and deferred and prepaid rents	(157)	(241)
Accrued interest	534	(38)
Leasing costs paid	(764)	(604)
Other, net	1,038	2,285
Net cash provided by operating activities	23,865	22,322
Cash flows from investing activities:
Investments in LLCs	(5,892)	(3,869)
Advances made to third-party partners	(128)
Cash distributions from LLCs	688	369
Advance received from LLC		3,500
Additions to real estate investments, net	(4,335)	(8,789)
Deposit on real estate assets		(100)
Net cash used in investing activities	(9,667)	(8,889)
Cash flows from financing activities:
Net borrowings on the line of credit	16,300	13,300
Repayments of mortgage notes payable	(12,918)	(4,995)
Financing costs paid	(49)	(132)
Dividends paid	(20,156)	(19,837)
Issuance of shares of beneficial interest, net	(10)	76
Net cash used in financing activities	(16,833)	(11,588)
(Decrease)/increase in cash and cash equivalents	(2,635)	1,845
Cash and cash equivalents, beginning of period	8,212	7,614
Cash and cash equivalents, end of period	5,577	9,459
Supplemental disclosures of cash flow information:
Interest paid	8,211	7,736
Invoices accrued for construction and improvements	$ 902	$ 1,808

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ 5,276	$ 3,476	$ 10,576	$ 7,935

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Jun. 30, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false
Rule 10b5-1 Arr Modified Flag	false
Non Rule 10b5-1 Arr Modified Flag	false

General

General	6 Months Ended
	Jun. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
General	(1) General This Quarterly Report on Form 10-Q is for the quarter ended June 30, 2024. In this Quarterly Report, “we,” “us,” “our” and the “Trust” refer to Universal Health Realty Income Trust and its subsidiaries. In this Quarterly Report on Form 10-Q, the term “revenues” does not include the revenues of the unconsolidated LLCs in which we have various non-controlling equity interests ranging from 33 % to 95 %. As of June 30, 2024, we had investments in four jointly-owned LLCs/LPs. We currently account for our share of the income/loss from these investments by the equity method (see Note 5 ). The condensed consolidated financial statements included herein have been prepared by us, without audit, pursuant to the rules and regulations of the SEC and reflect all normal and recurring adjustments which, in our opinion, are necessary to fairly present results for the interim periods. Certain information and footnote disclosures normally included in financial statements prepared in accordance with generally accepted accounting principles in the United States of America (U.S. GAAP) have been condensed or omitted pursuant to such rules and regulations, although we believe that the accompanying disclosures are adequate to make the information presented not misleading. It is suggested that these condensed consolidated financial statements be read in conjunction with the consolidated financial statements, the notes thereto and accounting policies included in our Annual Report on Form 10-K for the year ended December 31, 2023. The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires us to make estimates and assumptions that affect the amounts reported in our consolidated financial statements and accompanying notes.

Relationship with Universal Hea

Relationship with Universal Health Services, Inc. ("UHS") and Related Party Transactions	6 Months Ended
	Jun. 30, 2024
Related Party Transactions [Abstract]
Relationship with Universal Health Services, Inc. ("UHS") and Related Party Transactions	(2) Relationship wit h Universal Health Services, Inc. (“UHS”) and Related Party Transactions Leases: We commenced operations in 1986 by purchasing certain properties from subsidiaries of UHS and immediately leasing the properties back to the res pective subsidiaries. The base rentals and lease and renewal terms for each of the hospitals leased to subsidiaries of UHS as of June 30, 2024, are provided below. The base rents are paid monthly. The lease on McAllen Medical Center also provides for bonus rent which is paid quarterly based upon a computation that compares the hospital’s current quarter revenue to a corresponding quarter in the base year. The hospital leases with subsidiaries of UHS, with the exception of the lease on Clive Behavioral Health Hospital (which is operated by UHS in a joint venture with an unrelated third party), are unconditionally guaranteed by UHS and are cross-defaulted with one another. The lease for the Clive facility is guaranteed on a several basis by UHS ( 52 %) and Catholic Health Initiatives-Iowa ( 48 %). The combined revenues generated from the leases on the three acute care and three behavioral health care hospital facilities leased to subsidiaries of UHS at June 30, 2024, accounted f or approximately 24 % and 25 % of our consolidated revenues for the three months ended June 30, 2024 and 2023, respectively and approximately 24 % and 25 % of our consolidated revenues for the six months ended June 30, 2024 and 2023, respectively. In addition to the six UHS hospital facilities, we have twenty-one properties consisting of medical/office buildings, (including one newly constructed medical office building ("MOB") that was substantially completed during the first quarter of 2023 and one MOB that was acquired during the third quarter of 2023), and free-standing emergency departments ("FEDs") that are either wholly or jointly-owned by us that include tenants which are subsidiaries of UHS. The aggregate revenues generated from UHS-related tenants comprised approximately 41 % of our consolidated revenues during each of the three and six-month periods ended June 30, 2024 and 2023 . On December 31, 202 1, we entered into an asset purchase and sale agreement with UHS and certain of its affiliates, which was amended during the first quarter of 2022, pursuant to the terms of which: (i) a wholly-owned subsidiary of UHS purchased from us, the real estate assets of the Inland Valley Campus of Southwest Healthcare System located in Wildomar, California, at its fair market value of $ 79.6 million; (ii) two wholly-owned subsidiaries of UHS transferred to us, the real estate assets of Aiken Regional Medical Center (“Aiken”), located in Aiken, South Carolina (which includes an acute care hospital and a behavioral health pavilion), at its fair-market value of approximately $ 57.7 million, and Canyon Creek Behavioral Health (“Canyon Creek”), located in Temple, Texas, at its fair-market value of approximately $ 26.0 million, and; (iii) we paid approximately $ 4.1 million in cash to UHS. As a result of UHS’ purchase option within the lease agreements of Aiken and Canyon Creek, the transaction is accounted for as a failed sale leaseback in accordance with U.S. GAAP and the properties acquired by us in connection with the asset purchase and sale agreement with UHS, as amended, were accounted for as financing arrangements. Our consolidated balance sheets as of June 30, 2024 and December 31, 2023 include financing receivables related to this transaction of $ 83.0 million and $ 83.3 million, respectively. Also on December 31, 2021, Aiken and Canyon Creek (as lessees), entered into a master lease and individual property leases as amended, (with us as lessor), for initial lease terms on each property of approximately twelve years , ending on December 31, 2033 . Subject to the terms of the master lease, Aiken and Canyon Creek have the right to renew their leases, at the then current fair market rent (as defined in the master lease), for seven , five-year optional renewal terms. Pursuant to the leases, as amended during the first quarter of 2022, the aggregate annual rental rat e during 2024 on the acquired properties, which is payable to us on a monthly basis, is approximately $ 5.9 million ($ 4.1 million related to Aiken and $ 1.8 million related to Canyon Creek). The portion of the lease payments that is included in our consolidated statements of income, and reflected as interest income on financing leases, was approximately $ 1.4 million for each of the three months ended June 30, 2024 and 2023, and approximately $2.7 million for each of the six-month periods ended June 30, 2024 and 2023. There is no bonus rental component applicable to either of these leases. Pursuant to the terms of the master leases by and among us and certain subsidiaries of UHS, dated December 24, 1986 and December 31, 2021 (the “Master Leases”), which govern the leases of McAllen Medical Center, Wellington Regional Medical Center (governed by the Master Lease dated December 24, 1986), Aiken Regional Medical Center and Canyon Creek Behavioral Health (governed by the Master Lease dated December 31, 2021, as amended), all of which are hospital properties that are wholly-owned subsidiaries of UHS, UHS has the option, among other things, to renew the leases at the lease terms described below by providing notice to us at least 90 days prior to the termination of the then current term. UHS also has the right to purchase the respective leased facilities from us at their appraised fair market value upon any of the following: (i) at the end of the lease terms or any renewal terms; (ii) upon one month’s notice should a change of control of the Trust occur, or; (iii) within the time period as specified in the leases in the event that UHS provides notice to us of their intent to offer a substitution property/properties in exchange for one (or more) of the four wholly-owned UHS hospital facilities leased from us, should we be unable to reach an agreement with UHS on the properties to be substituted. Additionally, UHS has rights of first refusal to: (i) purchase the respective leased facilities during and for a specified period after the lease terms at the same price, terms and conditions of any third-party offer, or; (ii) renew the lease on the respective leased facility a t the end of, and for a specified period after, the lease term at the same terms and conditions pursuant to any third-party offer. In addition, a wholly-owned subsidiary of UHS is the managing, majority member in a joint-venture with an unrelated third-party that operates, and leases from us, Clive Behavioral Health. This 100 -bed behavioral health care facility is located in Clive, Iowa and was completed and opened in late December, 2020, and the hospital lease commenced on December 31, 2020. The lease on this facility is triple net and has an initial term of 20 years with five 10 -year renewal options . On each January 1 st through 2040 (and potentially through 2070 if the first three of five, 10-year renewal options are exercised), the annual rental will increase by 2.75 % on a cumulative and compounded basis. The first three of the five 10-year renewal options will provide for annual rental as stipulated in the lease (2041 through 2070) and the two additional 10 -year lease renewal options will be at fair market value lease rates ( 2071 through 2090 ). Pursuant to the lease on this facility, the joint venture has the option to, among other things, renew the lease at the terms specified in the lease agreement by providing notice to us at least 270 days prior to the termination of the then current term. The joint venture also has the right to purchase the leased facility from us at its appraised fair market value upon either of the following: (i) by providing notice at least 270 days prior to the end of the lease terms or any renewal terms, or; (ii) upon 30 days’ notice anytime within 12 months of a change of control of the Trust (UHS also has this right should the joint venture decline to exercise its purchase right). Additionally, the joint venture has rights of first offer to purchase the facility prior to any third-party sale. The table below details the existing lease terms and renewal options for each of the hospital leases that are related to UHS as of June 30, 2024, consisting of three acute care hospitals and three behavioral health hospitals: Hospital Name Annual End of Renewal McAllen Medical Center $ 5,485,000 December, 2026 5 (a) Wellington Regional Medical Center $ 6,639,000 December, 2026 5 (b) Aiken Regional Medical Center/Aurora Pavilion Behavioral Health Services $ 4,072,000 December, 2033 35 (c) Canyon Creek Behavioral Health $ 1,841,000 December, 2033 35 (c) Clive Behavioral Health Hospital $ 2,775,000 December, 2040 50 (d) (a) UHS has one 5-year renewal option at existing lease rates (through 2031 ). (b) UHS has one 5-year renewal option at fair market value lease rates (through 2031 ; see additional disclosure below). The annual rental will increase by 2.5 % on an annual compounded basis on each January 1 st through 2026. (c) UHS has seven 5-year renewal options at fair market value lease rates ( 2034 through 2068 ). The annual rental rate will increase by 2.25 % on a cumulative and compounded basis on each January 1 st through 2033. (d) The UHS-related joint venture has five 10-year renewal options; the first three of the five 10-year renewal options will be at computed lease rates as stipulated in the lease ( 2041 through 2070 ) and the last two 10-year renewal options will be at fair market lease rates ( 2071 through 2090 ). On each January 1 st through 2040 (and potentially through 2070 if the first three of five, 10-year renewal options are exercised), the annual rental will increase by 2.75 % on a cumulative and compounded basis. Upon the December 31, 2021 expiration of the lease on Wellington Regional Medical Center located in West Palm Beach, Florida, a wholly-owned subsidiary of UHS exercised its fair market value renewal option and renewed the lease for a 5 -year term scheduled to expire on December 31, 2026. Effective January 1, 2024, the annual lease rate for this hospital, which is payable to us monthly, is $ 6.6 million and on each January 1 st thereafter through 2026, the annual rent will increase by 2.50 % on a cumulative and compounded basis (there is no bonus rental component of the lease payment). Management cannot predict whether the leases with wholly-owned subsidiaries of UHS, which have renewal options at existing lease rates or fair market value lease rates, or any of our other leases, will be renewed at the end of their lease term. If the leases are not renewed at their current rates or the fair market value lease rates, we would be required to find other operators for those facilities and/or enter into leases on terms potentially less favorable to us than the current leases. In addition, if subsidiaries of UHS exercise their options to purchase the respective leased hospital or FED facilities upon expiration of the lease terms, our future revenues could decrease if we were unable to earn a favorable rate of return on the sale proceeds received, as compared to the rental revenue currently earned pursuant to these leases. During the third quarter of 2023, we acquired the McAllen Doctor's Center, an MOB located in McAllen, Texas for a purchase price of approximately $ 7.6 million, including transaction costs. The building has approximately 79,500 rentable square feet and is 100 % master leased to McAllen Hospitals, L.P, a wholly-owned subsidiary of UHS. The triple-net master lease is for twelve year s scheduled to expire on August 31, 2035 . McAllen Hospitals, L.P. has the option to renew the lease term for three consecutive ten-year terms. The initial annual base rent is approximately $ 624,000 . During the first quarter of 2023, construction was substantially completed on S ierra Medical Plaza I, a multi-tenant MOB located in Reno, Nevada, consisting of approximately 86,000 rentable square feet. This MOB is located on the campus of the Northern Nevada Sierra Medical Center, a newly constructed acute care hospital that is owned and operated by a wholly-owned subsidiary of UHS, which was completed and opened during April of 2022 . The cost of the MOB is estimated to be approximately $ 35 million, approximately $ 30 million of which was incurred as of June 30, 2024. In connection with this MOB, we entered into a ground lease and master flex-lease agreement with a wholly-owned subsidiary of UHS. The master flex lease agreement has a ten-year term scheduled to expire on March 31, 2033, and covers approximately 68 % of the rentable square feet of the MOB at an initial minimum rent of $ 1.3 million annually plus a pro-rata share of the common area maintenance expenses. The master flex-lease is subject to a reduction during the term based upon the execution of third-party leases. The ground lease and the master flex lease each commenced during March, 2023. We are the lessee on thirteen ground leases with subsidiaries of UHS (for consolidated and unconsolidated investments), including one that commenced in March, 2023. The remaining lease terms on the ground leases with subsidiaries of UHS range from approximately 25 years to approximately 74 years. The annual aggregate lease payments on these properties are approximately $ 571,000 during each of the years ended 2024 through 2028, and an aggregate of $ 31.3 million thereafter. See Note 7 for additional lease accounting disclosure. Officers and Employees: Our officers are all employees of a wholly-owned subsidiary of UHS and although as of June 30, 2024 we had no salaried employees, our officers do typically receive annual stock-based compensation awards in the form of restricted stock. In special circumstances, if warranted and deemed appropriate by the Compensation Committee of the Board of Trustees, our officers may also receive one-time special compensation awards in the form of restricted stock and/or cash bonuses. Advisory Agreement: UHS of Delaware, Inc. (the “Advisor”), a wholly-owned subsidiary of UHS, serves as Advisor to us under an advisory agreement dated December 24, 1986, and as amended and restated as of January 1, 2019 (the “Advisory Agreement”). Pursuant to the Advisory Agreement, the Advisor is obligated to present an investment program to us, to use its best efforts to obtain investments suitable for such program (although it is not obligated to present any particular investment opportunity to us), to provide administrative services to us and to conduct our day-to-day affairs. All transactions between us and UHS must be approved by the Trustees who are unaffiliated with UHS (the “Independent Trustees”). In performing its services under the Advisory Agreement, the Advisor may utilize independent professional services, including accounting, legal, tax and other services, for which the Advisor is reimbursed directly by us. The Advisory Agreement may be terminated for any reason upon sixty days written notice by us or the Advisor. The Advisory Agreement expires on December 31 of each year; however, it is renewable by us, subject to a determination by the Independent Trustees, that the Advisor’s performance has been satisfactory. The Advisory Agreement was renewed for 2024 with the same terms as the Advisory Agreement in place during 2023 and 2022. Our advisory fee for the three months ended June 30, 2024 and 2023, was computed at 0.70 % of our average invested real estate assets, as derived from our condensed consolidated balance sheets. Based upon a review of our advisory fee and other general and administrative expenses, as compared to an industry peer group, the advisory fee computation remained unchanged for 2024 as compared to 2023 and 2022. The average real estate assets for advisory fee calculation purposes exclude certain items from our condensed consolidated balance sheet such as, among other things, accumulated depreciation, cash and cash equivalents, lease receivables, deferred charges and oth er assets. The advisory fee is payable quarterly, subject to adjustment at year-end based upon our audited financial statements. Advisory fees incurred and paid (or payable) to UHS amounted to approximately $ 1.4 million and $ 1.3 million for the three-month periods ended June 30, 2024 and 2023, respectively, and were based upon average invested real estate assets of $ 782 million and $ 756 million, respectively. Advisory fees incurred and paid (or payable) to UHS amounted to approximately $ 2.7 million and $ 2.6 million for the six-month periods ended June 30, 2024 and 2023, respectively, and were based upon average invested real estate assets of $ 773 million and $ 750 million, respectively. Share Ownership: As of June 30, 2024 and December 31, 2023, UHS owned 5.7 % of our outstanding shares of beneficial interest. SEC reporting requirements of UHS: UHS is subject to the reporting requirements of the SEC and is required to file annual reports containing audited financial information and quarterly reports containing unaudited financial information. Since the aggregate revenues generated from the UHS-related tenant s comprised approximately 41 % of our consolidated revenues during each of the three and six-month periods ended June 30, 2024 and 2023, and since a subsidiary of UHS is our Advi sor, you are encouraged to obtain the publicly available filings for Universal Health Services, Inc. from the SEC’s website. These filings are the sole responsibility of UHS and are not incorporated by reference herein.

Dividends and Equity Issuance P

Dividends and Equity Issuance Program	6 Months Ended
	Jun. 30, 2024
Equity [Abstract]
Dividends and Equity Issuance Program	(3) Dividends and Equity Issuance Program Dividends and dividend equivalents: We declared an d paid dividends of approximately $ 10.2 million, or $ .730 per share, during the second quarter of 2024 and approximately $ 10.0 million, or $ .720 per share, during the second quarter of 2023. We declared and paid dividends of approximately $ 20.2 million, or $ 1.455 per share, during the six-month period ended June 30, 224, and approximately $ 19.8 million, or $ 1.435 per share, during the comparable period of 2023. Amounts reflected above include accrued dividends that were paid related to the vesting of restricted stock. Dividend equivalents, which are applicable to shares of unvested restricted stock, were accrued during the first six months of 2024 and 2023 and were or will be pai d upon vesting of the restricted stock. Equity Issuance Program: During the second quarter of 2024, we filed a shelf registration statement on Form S-3 (File No. 333-278730) (the "Form S-3"), registering the offer and sale, from time-to-time, of an indeterminate amount of the common shares of beneficial interest, preferred shares and debt securities up to an aggregate initial offering price of $ 100 million to or through one or more underwriters, dealers or agents, or directly to purchasers. The Form S-3 became effective on April 30, 2024. No shares were issued under the Form S-3 since the effective date of April 30, 2024 through June 30, 2024. As of June 30, 2024, we have paid or incurred approximately $ 287,000 in various fees and expenses related to the Form S-3. The availability of the potential liquidity under this shelf registration statement depends on investor demand, market conditions and other factors. We make no assurance regarding when, or if, we will issue any securities under this registration statement.

Acquisitions and Divestitures

Acquisitions and Divestitures	3 Months Ended
	Mar. 31, 2024
Business Combinations [Abstract]
Acquisitions and Divestitures	(4) Acquisitions and Divestitures Six Months Ended June 30, 2024: Acquisitions: There were no acquisitions during the first six months of 2024. Divestitures: There were no divestitures during the first six months of 2024. Six Months Ended June 30, 2023: New Construction: In January 2022, we entered into a ground lease and master flex-lease agreement with a wholly-owned subsidiary of UHS to develop, construct and own the real property of Sierra Medical Plaza I, an MOB located in Reno, Nevada, consisting of approximately 86,000 rentable square feet. This MOB is located on the campus of the Northern Nevada Sierra Medical Center, a hospital that is owned and operated by a wholly-owned subsidiary of UHS, which was completed and opened during April of 2022. Construction of this MOB, for which we engaged a non-related third party to act as construction manager, commenced in January, 2022, and was substantially completed in March, 2023. The master flex lease agreement in connection with this building, which commenced in March, 2023 and has a ten-year term scheduled to expire on March 31, 2033 , covers approximately 68 % of the rentable square feet of the MOB at an initial minimum rent of $ 1.3 million annually, plus pro-rata share of the common area maintenance expenses. This master flex lease agreement is subject to reduction based upon the execution of third-party leases. Additionally, during March, 2023, the ground lease for this property commenced and a right-of-use asset and lease liability was recorded in connection with this lease. The cost of the MOB is estimated to be approximately $ 35 million, approximately $ 30 million of which was incurred as of June 30, 2024. Acquisitions: There were no acquisitions during the first six months of 2023. Divestitures: There were no divestitures during the first six months of 2023.

Summarized Financial Informatio

Summarized Financial Information of Equity Affiliates	6 Months Ended
	Jun. 30, 2024
Equity Method Investments and Joint Ventures [Abstract]
Summarized Financial Information of Equity Affiliates	(5) Summarized Financial Information of Equity Affiliates In accordance with U.S. GAAP and guidance relating to accounting for investments and real estate ventures, we account for our unconsolidated investments in LLCs/LPs which we do not control using the equity method of accounting. The third-party members in these investments have equal voting rights with regards to issues such as, but not limited to: (i) divestiture of property; (ii) annual budget approval, and; (iii) financing commitments. These investments, which represen t 33 % to 95 % non-controlling ownership interests, are recorded initially at our cost and subsequently adjusted for our net equity in the net income, cash contributions to, and distributions from, the investments. Pursuant to certain agreements, allocations of sales proceeds and profits and losses of some of the LLC investments may be allocated disproportionately as compared to ownership interests after specified preferred return rate thresholds have been satisfied. Distributions received from equity method investees in the consolidated statements of cash flows are classified based upon the nature of the distribution. Returns on investments are presented net of equity in income from unconsolidated investments as cash flows from operating activities. Returns of investments are classified as cash flows from investing activities. At June 30, 2024, we have non-controlling equity investments o r commitments in four jointly-owned LLCs/LPs which own MOBs. As of June 30, 2024 we accounted for these LLCs/LPs on an unconsolidated basis pursuant to t he equity method since they are not variable interest entities which we are the primary beneficiary nor do we have a controlling voting interest. The majority of these entities are joint-ventures between us and non-related parties that hold minority ownership interests in the entities. Each entity is generally self-sustained from a cash flow perspective and generates sufficient cash flow to meet its operating cash flow requirements and service the third-party debt (if applicable) that is non-recourse to us. Although there is typically no ongoing financial support required from us to these entities since they are cash-flow sufficient, we may, from time to time, provide funding for certain purposes such as, but not limited to, significant capital expenditures, leasehold improvements and debt financing. Although we are not obligated to do so, if approved by us at our sole discretion, additional cash funding is typically advanced as equity or member loans. These entities maintain property insurance on the properties. The following property table represents the four LLCs/LPs in which we owned a non-controlling interest and were accounted for under the equity method as of June 30, 2024: Name of LLC/LP Ownership Property Owned by LLC/LP Suburban Properties 33 % St. Matthews Medical Plaza II Brunswick Associates (a.)(b.) 74 % Mid Coast Hospital MOB FTX MOB Phase II (c.) 95 % Forney Medical Plaza II Grayson Properties II (d.)(e.) 95 % Texoma Medical Plaza II (a.) This LLC has a third-party term loan of $ 8.3 million, which is non-recourse to us, outstanding as of June 30, 2024. (b.) We are the lessee with a third party on a ground lease for land. (c.) During the first quarter of 2021, this LP paid off its $ 4.7 million mortgage loan upon maturity, utilizing pro rata equity contributions from the limited partners as well as a $ 3.5 million member loan from us to the LP which was funded utilizing borrowings from our revolving credit agreement. During the first quarter of 2023, the LP repaid $ 175,000 of the member loan and the remaining $ 3.3 million member loan balance was converted to an equity investment in the LP. (d.) This LP constructed, owns and operates the Texoma Medical Plaza II, on which construction substantially completed in December 2020. The MOB is located in Denison, Texas, on the campus of a hospital owned and operated by a wholly-owned subsidiary of UHS. We have committed to invest up to $ 10.2 million in equity and debt financing, of which $ 7.5 million, net, has been funded as of June 30, 2024. This LP entered into a third-party construction loan commitment, which is non-recourse to us, which had an outstanding balance of $ 7.0 million as of June 30, 2024. Monthly principal and interest payments on this loan commenced on January 1, 2023. During the first quarter of 2024, $ 5.7 million of the third-party construction loan was repaid utilizing pro rata equity contributions from the partners. The third-party partner's share of the pro rata equity contributions was partially funded with a six-month, $ 128,000 partner loan from us, which was repaid during July, 2024 with interest. Our share of the pro rata equity contributions, as well as the third-party partner loan, were funded utilizing borrowings fro m our revolving credit agreement. As a result of the repayment of a portion of the construction loan, an associated $ 3.1 million letter of credit was terminated. (e.) We are the lessee with a UHS-related party for the land related to this property. Below are the condensed combined statements of income (unaudited) for the four LLCs/LPs accounted for under the equity method at June 30, 2024 and 2023: Three Months Ended Six Months Ended 2024 2023 2024 2023 (amounts in thousands) (amounts in thousands) Revenues $ 2,057 $ 2,043 $ 4,307 $ 4,269 Operating expenses 826 812 1,724 1,717 Depreciation and amortization 472 461 946 916 Interest, net 142 198 301 439 Net income $ 617 $ 572 $ 1,336 $ 1,197 Our share of net income $ 272 $ 268 $ 656 $ 639 Below are the condensed combined balance sheets (unaudited) for the four above-mentioned LLCs/LPs that were accounted for under the equity meth od as of June 30, 2024 and December 31, 2023: June 30, December 31, (amounts in thousands) Net property, including construction in progress $ 27,688 $ 28,488 Other assets (a.) 4,679 4,667 Total assets $ 32,367 $ 33,155 Other liabilities (a.) $ 2,272 $ 2,074 Mortgage notes payable, non-recourse to us 15,280 21,206 Equity 14,815 9,875 Total liabilities and equity $ 32,367 $ 33,155 Investments in and advances to LLCs before amounts included in accrued expenses and other liabilities $ 14,328 $ 9,102 Amounts included in accrued expenses and other liabilities ( 1,751 ) ( 1,729 ) Our share of equity in LLCs, net $ 12,577 $ 7,373 (a.) Other assets and other liabilities as of June 30, 2024 and December 31, 2023 include approximately $ 650,000 and $ 651,000 , respectively, of right-of-use land assets and right-of-use land liabilities related to ground leases whereby the LLC/LP is the lessee, with third party lessors, including subsidiaries of UHS. As o f June 30, 2024, and December 31, 2023, aggregate principal amounts due on mortgage notes payable by unconsolidated LLCs/LPs, which are accounted for under the equity method and are non-recourse to us, are as follows (amounts in thousands): Mortgage Loan Balance (a.) Name of LLC/LP 6/30/2024 12/31/2023 Maturity Date Brunswick Associates (2.80% fixed rate mortgage loan) $ 8,314 $ 8,453 December, 2030 Grayson Properties II (3.70% fixed rate construction loan) (b.) 6,966 12,753 March, 2026 $ 15,280 $ 21,206 (a.) All mortgage loans require monthly principal payments through maturity and include a balloon principal payment upon maturity. (b.) This construction loan required interest on the outstanding principal balance to be paid on a monthly basis through December 1, 2022. On January 1, 2023, monthly principal and interest payments on this loan commenced. During the first quarter of 2024, $ 5.7 million of the third-party construction loan was repaid utilizing pro-rate equity contributions from the partners, as discussed above. As a result of the repayment of a portion of the construction loan, an associated $ 3.1 million letter of credit was terminated. Pursuant to the operating and/or partnership agreements of the four LLCs/LPs in which we continue to hold non-controlling ownership interests, the third-party member and the Trust, at any time, potentially subject to certain conditions, have the right to make an offer (“Offering Member”) to the other member(s) (“Non-Offering Member”) in which it either agrees to: (i) sell the entire ownership interest of the Offering Member to the Non-Offering Member (“Offer to Sell”) at a price as determined by the Offering Member (“Transfer Price”), or; (ii) purchase the entire ownership interest of the Non-Offering Member (“Offer to Purchase”) at the equivalent proportionate Transfer Price. The Non-Offering Member has 60 to 90 days to either: (i) purchase the entire ownership interest of the Offering Member at the Transfer Price, or; (ii) sell its entire ownership interest to the Offering Member at the equivalent proportionate Transfer Price. The closing of the transfer must occur within 60 to 90 days of the acceptance by the Non-Offering Member.

Recent Accounting Pronouncement

Recent Accounting Pronouncements	6 Months Ended
	Jun. 30, 2024
Accounting Policies [Abstract]
Recent Accounting Pronouncements	(6) Recent Accounting Pronouncements Segment Reporting In November, 2023, the FASB issued ASU 2023-07, Segment Reporting, Topic 280, "Improvements to Reportable Segment Disclosures ("ASU 2023-07") which was issued to improve the disclosures about s public entity's reportable segments and address requests from investors for additional, more detailed information about a reportable segment's expenses. The ASU requires existing annual segment disclosures to also be disclosed on an interim basis and also requires disclosures around significant segment expenses and disclosures to identify the title and position of the chief operating decision maker ("CODM"). The standard is effective for the fiscal year ended December 31, 2024 and interim periods thereafter. We do no t expect the standard to have a material impact on our consolidated financial statements. Reference Rate Reform In March 2020, the FASB issued an accounting standard classified under FASB ASC Topic 848, “Reference Rate Reform.” The amendments in this update contain practical expedients for reference rate reform related activities that impact debt, leases, derivatives and other contracts. The guidance in ASC 848 is optional and may be elected over time as reference rate reform activities occur. Beginning in the first quarter of 2020, we elected to apply the hedge accounting expedients related to probability and the assessments of effectiveness for future LIBOR-indexed cash flows to assume that the index upon which future hedged transactions will be based matches the index on the corresponding derivatives. Application of these expedients preserves the presentation of derivatives consistent with past presentation. We will continue to evaluate the impact of the guidance and may apply other elections as applicable as additional changes in the market occur. In December 2022, the FASB issued ASU 2022-06, Deferral of the Sunset Date of Topic 848 (“ASU 2022-06”) which was issued to defer the sunset date of Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform to December 31, 2024. ASU 2022-06 is effective immediately for all companies. ASU 2022-06 has no impact on the Company’s condensed consolidated financial statements for the three and six months ended June 30, 2024.

Lease Accounting

Lease Accounting	6 Months Ended
	Jun. 30, 2024
Leases [Abstract]
Lease Accounting	(7) Lease Accounting As Lessor: We lease most of our operating properties to customers under agreements that are typically classified as operating leases (as noted below, two of our leases are accounted for as financing arrangements effective on December 31, 2021). We recognize the total minimum lease payments provided for under the operating leases on a straight-line basis over the lease term. Generally, under the terms of our leases, the majority of our rental expenses, including common area maintenance, real estate taxes and insurance are recovered from our customers. We record amounts reimbursed by customers in the period that the applicable expenses are incurred, which is generally ratably throughout the term of the lease. We have elected the package of practical expedients that allows lessors to not separate lease and non-lease components by class of underlying asset. This practical expedient allowed us to not separate expenses reimbursed by our customers (“tenant reimbursements”) from the associated rental revenue if certain criteria were met. We assessed these criteria and concluded that the timing and pattern of transfer for rental revenue and the associated tenant reimbursements are the same, and for the leases that qualify as operating leases, we accounted for and presented rental revenue and tenant reimbursements as a single component under Lease revenue in our consolidated statements of income for the three and six months ended June 30, 2024 and 2023. On December 31, 2021, as a result of the asset purchase and sale transaction with UHS, as amended during the first quarter of 2022, the real estate assets of two wholly-owned subsidiaries of UHS were transferred to us (Aiken and Canyon Creek). As discussed in Note 2 , these assets are accounted for as financing arrangements and our consolidated balance sheets at June 30, 2024 and December 31, 2023 reflect financing receivables related to this transaction amounting to $ 83.0 million and $ 83.3 million, respectively. Pursuant to the leases, as amended during the first quarter of 2022, the aggregate annual rental during 2024 on the acquired properties, which is payable to us on a monthly basis, amounts to approximately $ 5.9 million ($ 4.1 million related to Aiken and $ 1.8 million related to Canyon Creek). The portion of these lease payments that will be included in our consolidated statements of income, and reflected as interest income on financing leases, is expected to be approximately $ 5.4 million during the full year of 2024. Lease revenue will not be impacted by the lease payments received related to these two properties. The components of the “Lease revenue – UHS facilities” and “Lease revenue – Non-related parties” captions for the three and six month periods ended June 30, 2024 and 2023 are disaggregated below (in thousands). Base rents are primarily stated rent amounts provided for under the leases that are recognized on a straight-line basis over the term of the lease. Bonus rents and tenant reimbursements represent amounts where tenants are contractually obligated to pay an amount that is variable in nature. Three Months Ended Six Months Ended June 30, June 30, 2024 2023 2024 2023 UHS facilities: Base rents $ 6,888 $ 6,506 $ 13,860 $ 12,780 Bonus rents (a.) 758 730 1,541 1,494 Tenant reimbursements 808 1,000 1,717 1,749 Lease revenue - UHS facilities $ 8,454 $ 8,236 $ 17,118 $ 16,023 Non-related parties: Base rents 10,872 10,480 22,044 20,714 Tenant reimbursements 3,487 3,188 6,802 6,315 Lease revenue - Non-related parties $ 14,359 $ 13,668 $ 28,846 $ 27,029 (a.) Consists of bonus rental earned in connection with McAllen Medical Center. Disclosures Related to Certain Hospital Facilities: Vacant Specialty Facility and Land: Chicago, Illinois - Land: The lease on this facility expired on December 31, 2021. Demolition of the former hospital was completed during 2023. The aggregate demolition expenses amounted to approximately $ 1.5 million, of which approximately $ 1.1 million were incurred during the first and second quarters of 2023, and $ 332,000 were incurred during the fourth quarter of 2022. Evansville, Indiana - Specialty Facility: The lease on this specialty facility expired during 2019, and the facility has been vacant since that time. We continue to market the Chicago, Illinois, and Evansville, Indiana properties to third parties. Future operating expenses related to these properties will be incurred by us during the time they remain owned and unleased. Former facility - Corpus Christi, Texas: In December, 2023, we sold this vacant specialty facility. As Lessee: We are the lessee with various third parties, including subsidiaries of UHS, in connection with ground leases for land at fifteen of our consolidated properties. Our right-of-use land assets represent our right to use the land for the lease term and our lease liabilities represent our obligation to make lease payments arising from the leases. Right-of-use assets and lease liabilities were recognized upon adoption of Topic 842 based on the present value of lease payments over the lease term. We utilized our estimated incremental borrowing rate, which was derived from information available as of January 1, 2019, or the commencement date of the ground lease, whichever is later, in determining the present value of lease payments for active leases on that date. A right-of-use asset and lease liability are not recognized for leases with an initial term of 12 months or less, as these short-term leases are accounted for similarly to previous guidance for operating leases. We do not currently have any ground leases with an initial term of 12 months or less. As of June 30, 2024, our condensed consolidated balance sheet includes right-of-use land assets of approximately $ 10.9 million and ground lease liabilities of approximately $ 10.9 million. During the first quarter of 2023, the ground lease for the newly constructed and substantially completed Sierra Medical Plaza I commenced and a right-of-use asset and lease liability was recorded in connection with this lease.

Debt and Financial Instruments

Debt and Financial Instruments	6 Months Ended
	Jun. 30, 2024
Debt Disclosure [Abstract]
Debt and Financial Instruments	$ 125,000 $ 182,508 $ 191,824 Total leverage < = 60 % 44.0 % 44.5 % Secured leverage < 30 % 2.5 % 4.1 % Unencumbered leverage < 60 % 45.3 % 44.2 % Fixed charge coverage > 1.50 x 3.2 x 3.1 x As indicated on the following table, we have various mortgages, all of which are non-recourse to us, included on our condensed consolidated balance sheet as of June 30, 2024 (amounts in thousands): Facility Name Outstanding thousands) (a.) Interest Maturity Tuscan Professional Building fixed rate mortgage loan (b.) $ 717 5.56 % June, 2025 Phoenix Children’s East Valley Care Center fixed rate 7,789 3.95 % January, 2030 Rosenberg Children's Medical Plaza fixed rate mortgage loan 11,638 4.42 % September, 2033 Total, excluding net debt premium and net financing fees 20,144 Less net financing fees ( 174 ) Total mortgages notes payable, non-recourse to us, net $ 19,970 (a.) All mortgage loans require monthly principal payments through maturity and either fully amortize or include a balloon principal payment upon maturity. (b.) This loan is scheduled to mature within the next twelve months, at which time we will either refinance pursuant to a new mortgage loan or repay the mortgage balance in full utilizing borrowings under our Credit Agreement. On April 10, 2024, the $ 12.2 million fixed rate mortgage loan on Summerlin Hospital Medical Office Building III was fully repaid utilizing borrowings under our Credit Agreement. At June 30, 2024 and December 31, 2023, we had various mortgages, all of which were non-recourse to us, included in our condensed consolidated balance sheet. The mortgages are secured by the real property of the buildings as well as property leases and rents. The mortgages outstanding as of June 30, 2024, had a combined carrying value of approximately $ 20.1 million and a combined fair value of approximately $ 18.4 million. The mortgages outstanding as of December 31, 2023, had a combined carrying value of approximately $ 33.1 million and a combined fair value of approximately $ 31.2 million. The fair value of our debt wa s computed based upon quotes received from financial institutions. We consider these to be “level 2” in the fair value hierarchy as outlined in the authoritative guidance for disclosure in connection with debt instruments. Changes in market rates on our fixed rate debt impacts the fair value of debt, but it has no impact on interest incurred or cash flow. Financial Instruments: In December 2023, we ente red into an interest rate swap agreement on a total notional amount of $ 25 million with a fixed interest rate of 3.9495 % that we designated as a cash flow hedge. The interest rate swap became effective on December 1, 2023 and is scheduled to mature on December 1, 2027 . If one-month term SOFR is above 3.9495 %, the counterparty pays us, and if one-month term SOFR is less than 3.9495 %, we pay the counterparty, the difference between the fixed rate of 3.9495 % and one-month term SOFR. In March 2020, we entered into an interest rate swap agreement on a total notional amount of $ 55 million with a fixed interest rate of 0.565 % that we designated as a cash flow hedge. The interest rate swap became effective on March 25, 2020 and is scheduled to mature on March 25, 2027 . On May 15, 2023, this interest rate swap agreement was modified to replace the benchmark rate from LIBOR to term SOFR. If one-month term SOFR is above 0.505 %, the counterparty pays us, and if one-month term SOFR is less than 0.505 %, we pay the counterparty, the difference between the fixed rate of 0.505 % and one-month term SOFR. In January 2020, we entered into an interest rate swap agreement on a total notional amount of $ 35 million with a fixed interest rate of 1.4975 % that we designated as a cash flow hedge. The interest rate swap became effective on January 15, 2020 and is scheduled to mature on September 16, 2024 . On May 15, 2023, this interest rate swap agreement was modified to replace the benchmark rate from LIBOR to term SOFR. If the one-month term SOFR is above 1.41 %, the counterparty pays us, and if the one-month term SOFR is less than 1.41 %, we pay the counterparty, the difference between the fixed rate of 1.41 % and one-month term SOFR. Although we can provide no assurance we will ultimately do so, at a future date in 2024, we are considering replacing this interest rate swap agreement with either an interest rate swap or interest rate cap agreement on a total notional amount of approximately $ 35 million. During the third quarter of 2019, we entered into an interest rate swap agreement on a total notional amount of $ 50 million with a fixed interest rate of 1.144 % that we designated as a cash flow hedge. The interest rate swap became effective on September 16, 2019 and is scheduled to mature on September 16, 2024 . On May 15, 2023, this interest rate swap agreement was modified to replace the benchmark rate from LIBOR to term SOFR. If one-month term SOFR is above 1.065 %, the counterparty pays us, and if one-month term SOFR is less than 1.065 %, we pay the counterparty, the difference between the fixed rate of 1.065 % and one-month term SOFR. Although we can provide no assurance we will ultimately do so, at a future date in 2024, we are considering replacing this interest rate swap agreement with either an interest rate swap or interest rate cap agreement on a total notional amount of approximately $ 50 million. We measure our interest rate swaps at fair value on a recurring basis. The fair value of our interest rate swaps is based on quotes from third parties. We consider those inputs to be “level 2” in the fair value hierarchy as outlined in the authoritative guidance for disclosures in connection with derivative instruments and hedging activities. At June 30, 2024, the fair value of our interest rate swaps was a net asset of $ 6.4 million which is included in deferred charges and other assets on the accompanying condensed consolidated balance sheet. During the second quarter of 2024, we received approximately $ 1.6 million from the counterparty, adjusted for the previous quarter accrual, pursuant to the terms of the swaps. During the first six months of 2024, we received approximately $ 3.3 million from the counterparty, adjusted for the previous quarter accrual, pursuant to the terms of the swaps. During the second quarter of 2023, we received approximately $ 1.4 million from the counterparty, adjusted for the previous quarter accrual, pursuant to the terms of the swaps. During the first six months of 2023, we received approximately $ 2.6 million from the counterparty, adjusted for the previous quarter accrual, pursuant to the terms of the swaps. Cash flow hedges are accounted for by recording the fair value of the derivative instrument on the balance sheet as either an asset or a liability, with a corresponding amount recorded in accumulated other comprehensive income (“AOCI”) within shareholders’ equity. Amounts are reclassified from AOCI to the income statement in the period or periods the hedged transaction affects earnings. We do not expect any gains or losses on our interest rate swaps to be reclassified to earnings in the next twelve months. " id="sjs-B4" xml:space="preserve">(8) Debt and Financial Instruments Debt: Management routinely monitors and analyzes the Trust’s capital structure in an effort to maintain the targeted balance among capital resources including the level of borrowings pursuant to our revolving credit facility, the level of borrowings pursuant to non-recourse mortgage debt secured by the real property of our properties and our level of equity including consideration of equity issuances. This ongoing analysis considers factors such as the current debt market and interest rate environment, the current/projected occupancy and financial performance of our properties, the current loan-to-value ratio of our properties, the Trust’s current stock price, the capital resources required for anticipated acquisitions and the expected capital to be generated by anticipated divestitures. This analysis, together with consideration of the Trust’s current balance of revolving credit agreement borrowings, non-recourse mortgage borrowings and equity, assists management in deciding which capital resource to utilize when events such as refinancing of specific debt components occur or additional funds are required to finance the Trust’s growth. On May 15, 2023 we entered into the first amendment to our amended and restated revolving credit agreement ("Credit Agreement") dated as of July 2, 2021 among the Trust as borrower, the lenders party thereto and Wells Fargo Bank, N.A., as administrative agent. The amendment replaced LIBOR with term SOFR plus .10 % ("adjusted term SOFR") as an alternative benchmark rate under the Credit Agreement for settings of benchmark rates that occur on or after the closing date in accordance with the benchmark replacement provisions set forth in the Credit Agreement. On July 2, 2021, we entered into an amended and restated Credit Agreement to amend and restate the previously existing $ 350 million credit agreement, as amended and dated June 5, 2020. Among other things, under the Credit Agreement, our aggregate revolving credit commitment was increased to $ 375 million from $ 350 million. The Credit Agreement, which is scheduled to mature on July 2, 2025 , provides for a revolving credit facility in an aggregate principal amount of $ 375 million, including a $ 40 million sublimit for letters of credit and a $ 30 million sublimit for swingline/short-term loans. Under the terms of the Credit Agreement, we may request that the revolving line of credit be increased by up to an additional $ 50 million. Borrowings under the new facility are guaranteed by certain subsidiaries of the Trust. In addition, borrowings under the new facility are secured by first priority security interests in and liens on all equity interests in most of the Trust’s wholly-owned subsidiaries. Borrowings under the Credit Agreement will bear interest at a rate equal to, at our option, at adjusted term SOFR for either one, three, or six months or the Base Rate, plus in either case, a specified margin depending on our total leverage ratio, as determined by the formula set forth in the Credit Agreement. The applicable margin after the first amendment ranges from 1.10 % to 1.35 % for adjusted term SOFR loans and 0.10 % to 0.35 % for Base Rate loans. The Credit Agreement, as amended by the first amendment, defines “Base Rate” as the greatest of (a) the Administrative Agent’s prime rate, (b) the federal funds effective rate plus 1/2 of 1% and (c) one month adjusted term SOFR plus 1 %. The Trust will also pay a quarterly revolving facility fee ranging from 0.15 % to 0.35 % (depending on the Trust’s total leverage ratio) on the committed amount of the Credit Agreement. The Credit Agreement also provides for options to extend the maturity date and borrowing availability for two additional six-month periods. The margins over adjusted term SOFR, Base Rate and the facility fee are based upon our total leverage ratio. At June 30, 2024, the applicable margin over the adjusted term SOFR rate was 1.20 %, the margin over the Base Rate was 0.20 % and the facility fee was 0.20 %. At June 30, 2024, we had $ 342.9 million of outstanding borrowings pursuant to the terms of our $ 375 million Credit Agreement and $ 32.1 million of available borrowing capacity. There are no compensating balance requirements. At December 31, 2023, we had $ 326.6 million of outstanding borrowings, $ 3.1 million of outstanding letters of credit and $ 45.3 million of available borrowing capacity. In our consolidated statements of cash flows, we report cash flows pursuant to our Credit Agreement on a net basis. Aggregate borrowings under our Credit Agreement were $ 25.2 million and $ 14.8 million during the quarters ended June 30, 2024 and 2023, respectively, and aggregate repayments were $ 15.9 million and $ 11.8 million during the quarters ended June 30, 2024 and 2023, respectively. Aggregate borrowings under our Credit Agreement were $ 47.0 million and $ 34.5 million during the six-months ended June 30, 2024 and 2023, respectively, and aggregate repayments were $ 30.7 million and $ 21.2 million during the six-months ended June 30, 2024 and 2023, respectively. The Credit Agreement contains customary affirmative and negative covenants, including limitations on certain indebtedness, liens, acquisitions and other investments, fundamental changes, asset dispositions and dividends and other distributions. The Credit Agreement also contains restrictive covenants regarding the Trust’s ratio of total debt to total assets, the fixed charge coverage ratio, the ratio of total secured debt to total asset value, the ratio of total unsecured debt to total unencumbered asset value, and minimum tangible net worth, as well as customary events of default, the occurrence of which may trigger an acceleration of amounts then outstanding under the Credit Agreement. We are in compliance with all of the covenants in the Credit Agreement at June 30, 2024, and were in compliance with all of the covenants of the Credit Agreement at December 31, 2023. We also believe that we would remain in compliance if, based on the assumption that the majority of the potential new borrowings will be used to fund investments, the full amount of our commitment was borrowed. The following table includes a summary of the required compliance ratios, giving effect to the covenants contained in the Credit Agreement (dollar amounts in thousands): Covenant June 30, December 31, Tangible net worth > $ 125,000 $ 182,508 $ 191,824 Total leverage < = 60 % 44.0 % 44.5 % Secured leverage < 30 % 2.5 % 4.1 % Unencumbered leverage < 60 % 45.3 % 44.2 % Fixed charge coverage > 1.50 x 3.2 x 3.1 x As indicated on the following table, we have various mortgages, all of which are non-recourse to us, included on our condensed consolidated balance sheet as of June 30, 2024 (amounts in thousands): Facility Name Outstanding thousands) (a.) Interest Maturity Tuscan Professional Building fixed rate mortgage loan (b.) $ 717 5.56 % June, 2025 Phoenix Children’s East Valley Care Center fixed rate 7,789 3.95 % January, 2030 Rosenberg Children's Medical Plaza fixed rate mortgage loan 11,638 4.42 % September, 2033 Total, excluding net debt premium and net financing fees 20,144 Less net financing fees ( 174 ) Total mortgages notes payable, non-recourse to us, net $ 19,970 (a.) All mortgage loans require monthly principal payments through maturity and either fully amortize or include a balloon principal payment upon maturity. (b.) This loan is scheduled to mature within the next twelve months, at which time we will either refinance pursuant to a new mortgage loan or repay the mortgage balance in full utilizing borrowings under our Credit Agreement. On April 10, 2024, the $ 12.2 million fixed rate mortgage loan on Summerlin Hospital Medical Office Building III was fully repaid utilizing borrowings under our Credit Agreement. At June 30, 2024 and December 31, 2023, we had various mortgages, all of which were non-recourse to us, included in our condensed consolidated balance sheet. The mortgages are secured by the real property of the buildings as well as property leases and rents. The mortgages outstanding as of June 30, 2024, had a combined carrying value of approximately $ 20.1 million and a combined fair value of approximately $ 18.4 million. The mortgages outstanding as of December 31, 2023, had a combined carrying value of approximately $ 33.1 million and a combined fair value of approximately $ 31.2 million. The fair value of our debt wa s computed based upon quotes received from financial institutions. We consider these to be “level 2” in the fair value hierarchy as outlined in the authoritative guidance for disclosure in connection with debt instruments. Changes in market rates on our fixed rate debt impacts the fair value of debt, but it has no impact on interest incurred or cash flow. Financial Instruments: In December 2023, we ente red into an interest rate swap agreement on a total notional amount of $ 25 million with a fixed interest rate of 3.9495 % that we designated as a cash flow hedge. The interest rate swap became effective on December 1, 2023 and is scheduled to mature on December 1, 2027 . If one-month term SOFR is above 3.9495 %, the counterparty pays us, and if one-month term SOFR is less than 3.9495 %, we pay the counterparty, the difference between the fixed rate of 3.9495 % and one-month term SOFR. In March 2020, we entered into an interest rate swap agreement on a total notional amount of $ 55 million with a fixed interest rate of 0.565 % that we designated as a cash flow hedge. The interest rate swap became effective on March 25, 2020 and is scheduled to mature on March 25, 2027 . On May 15, 2023, this interest rate swap agreement was modified to replace the benchmark rate from LIBOR to term SOFR. If one-month term SOFR is above 0.505 %, the counterparty pays us, and if one-month term SOFR is less than 0.505 %, we pay the counterparty, the difference between the fixed rate of 0.505 % and one-month term SOFR. In January 2020, we entered into an interest rate swap agreement on a total notional amount of $ 35 million with a fixed interest rate of 1.4975 % that we designated as a cash flow hedge. The interest rate swap became effective on January 15, 2020 and is scheduled to mature on September 16, 2024 . On May 15, 2023, this interest rate swap agreement was modified to replace the benchmark rate from LIBOR to term SOFR. If the one-month term SOFR is above 1.41 %, the counterparty pays us, and if the one-month term SOFR is less than 1.41 %, we pay the counterparty, the difference between the fixed rate of 1.41 % and one-month term SOFR. Although we can provide no assurance we will ultimately do so, at a future date in 2024, we are considering replacing this interest rate swap agreement with either an interest rate swap or interest rate cap agreement on a total notional amount of approximately $ 35 million. During the third quarter of 2019, we entered into an interest rate swap agreement on a total notional amount of $ 50 million with a fixed interest rate of 1.144 % that we designated as a cash flow hedge. The interest rate swap became effective on September 16, 2019 and is scheduled to mature on September 16, 2024 . On May 15, 2023, this interest rate swap agreement was modified to replace the benchmark rate from LIBOR to term SOFR. If one-month term SOFR is above 1.065 %, the counterparty pays us, and if one-month term SOFR is less than 1.065 %, we pay the counterparty, the difference between the fixed rate of 1.065 % and one-month term SOFR. Although we can provide no assurance we will ultimately do so, at a future date in 2024, we are considering replacing this interest rate swap agreement with either an interest rate swap or interest rate cap agreement on a total notional amount of approximately $ 50 million. We measure our interest rate swaps at fair value on a recurring basis. The fair value of our interest rate swaps is based on quotes from third parties. We consider those inputs to be “level 2” in the fair value hierarchy as outlined in the authoritative guidance for disclosures in connection with derivative instruments and hedging activities. At June 30, 2024, the fair value of our interest rate swaps was a net asset of $ 6.4 million which is included in deferred charges and other assets on the accompanying condensed consolidated balance sheet. During the second quarter of 2024, we received approximately $ 1.6 million from the counterparty, adjusted for the previous quarter accrual, pursuant to the terms of the swaps. During the first six months of 2024, we received approximately $ 3.3 million from the counterparty, adjusted for the previous quarter accrual, pursuant to the terms of the swaps. During the second quarter of 2023, we received approximately $ 1.4 million from the counterparty, adjusted for the previous quarter accrual, pursuant to the terms of the swaps. During the first six months of 2023, we received approximately $ 2.6 million from the counterparty, adjusted for the previous quarter accrual, pursuant to the terms of the swaps. Cash flow hedges are accounted for by recording the fair value of the derivative instrument on the balance sheet as either an asset or a liability, with a corresponding amount recorded in accumulated other comprehensive income (“AOCI”) within shareholders’ equity. Amounts are reclassified from AOCI to the income statement in the period or periods the hedged transaction affects earnings. We do not expect any gains or losses on our interest rate swaps to be reclassified to earnings in the next twelve months.

Segment Reporting

Segment Reporting	6 Months Ended
	Jun. 30, 2024
Segment Reporting [Abstract]
Segment Reporting	(9) Segment Reporting Our primary business is investing in and leasing healthcare and human service facilities through direct ownership or through joint ventures, which aggregate into a single reportable segment. We actively manage our portfolio of healthcare and human service facilities and may from time to time make decisions to sell lower performing properties not meeting our long-term investment objectives. The proceeds of sales are typically reinvested in new developments or acquisitions, which we believe will meet our planned rate of return. It is our intent that all healthcare and human service facilities will be owned or developed for investment purposes. Our revenue and net income are generated from the operation of our investment portfolio. Our portfolio is located throughout the United States, however, we do not distinguish or group our operations on a geographical basis for purposes of allocating resources or measuring performance. We review operating and financial data for each property on an individual basis; therefore, we define an operating segment as our individual properties. Individual properties have been aggregated into one reportable segment based upon their similarities with regard to both the nature and economics of the facilities, tenants and operational processes, as well as long-term average financial performance. No individual property meets the requirements necessary to be considered its own segme nt.

Relationship with Universal H_2

Relationship with Universal Health Services, Inc. ("UHS") and Related Party Transactions (Tables)	6 Months Ended
	Jun. 30, 2024
Related Party Transactions [Abstract]
Existing Lease Terms and Renewal Options for Each of UHS Hospital Facilities	The table below details the existing lease terms and renewal options for each of the hospital leases that are related to UHS as of June 30, 2024, consisting of three acute care hospitals and three behavioral health hospitals: Hospital Name Annual End of Renewal McAllen Medical Center $ 5,485,000 December, 2026 5 (a) Wellington Regional Medical Center $ 6,639,000 December, 2026 5 (b) Aiken Regional Medical Center/Aurora Pavilion Behavioral Health Services $ 4,072,000 December, 2033 35 (c) Canyon Creek Behavioral Health $ 1,841,000 December, 2033 35 (c) Clive Behavioral Health Hospital $ 2,775,000 December, 2040 50 (d) (a) UHS has one 5-year renewal option at existing lease rates (through 2031 ). (b) UHS has one 5-year renewal option at fair market value lease rates (through 2031 ; see additional disclosure below). The annual rental will increase by 2.5 % on an annual compounded basis on each January 1 st through 2026. (c) UHS has seven 5-year renewal options at fair market value lease rates ( 2034 through 2068 ). The annual rental rate will increase by 2.25 % on a cumulative and compounded basis on each January 1 st through 2033. (d) The UHS-related joint venture has five 10-year renewal options; the first three of the five 10-year renewal options will be at computed lease rates as stipulated in the lease ( 2041 through 2070 ) and the last two 10-year renewal options will be at fair market lease rates ( 2071 through 2090 ). On each January 1 st through 2040 (and potentially through 2070 if the first three of five, 10-year renewal options are exercised), the annual rental will increase by 2.75 % on a cumulative and compounded basis.

Summarized Financial Informat_2

Summarized Financial Information of Equity Affiliates (Tables)	6 Months Ended
	Jun. 30, 2024
Equity Method Investments and Joint Ventures [Abstract]
Limited Liability Companies Accounted for Under Equity Method	The following property table represents the four LLCs/LPs in which we owned a non-controlling interest and were accounted for under the equity method as of June 30, 2024: Name of LLC/LP Ownership Property Owned by LLC/LP Suburban Properties 33 % St. Matthews Medical Plaza II Brunswick Associates (a.)(b.) 74 % Mid Coast Hospital MOB FTX MOB Phase II (c.) 95 % Forney Medical Plaza II Grayson Properties II (d.)(e.) 95 % Texoma Medical Plaza II (a.) This LLC has a third-party term loan of $ 8.3 million, which is non-recourse to us, outstanding as of June 30, 2024. (b.) We are the lessee with a third party on a ground lease for land. (c.) During the first quarter of 2021, this LP paid off its $ 4.7 million mortgage loan upon maturity, utilizing pro rata equity contributions from the limited partners as well as a $ 3.5 million member loan from us to the LP which was funded utilizing borrowings from our revolving credit agreement. During the first quarter of 2023, the LP repaid $ 175,000 of the member loan and the remaining $ 3.3 million member loan balance was converted to an equity investment in the LP. (d.) This LP constructed, owns and operates the Texoma Medical Plaza II, on which construction substantially completed in December 2020. The MOB is located in Denison, Texas, on the campus of a hospital owned and operated by a wholly-owned subsidiary of UHS. We have committed to invest up to $ 10.2 million in equity and debt financing, of which $ 7.5 million, net, has been funded as of June 30, 2024. This LP entered into a third-party construction loan commitment, which is non-recourse to us, which had an outstanding balance of $ 7.0 million as of June 30, 2024. Monthly principal and interest payments on this loan commenced on January 1, 2023. During the first quarter of 2024, $ 5.7 million of the third-party construction loan was repaid utilizing pro rata equity contributions from the partners. The third-party partner's share of the pro rata equity contributions was partially funded with a six-month, $ 128,000 partner loan from us, which was repaid during July, 2024 with interest. Our share of the pro rata equity contributions, as well as the third-party partner loan, were funded utilizing borrowings fro m our revolving credit agreement. As a result of the repayment of a portion of the construction loan, an associated $ 3.1 million letter of credit was terminated. (e.) We are the lessee with a UHS-related party for the land related to this property.
Condensed Combined Statements of Income (Unaudited) for LLCs/LPs Accounted Under Equity Method	Below are the condensed combined statements of income (unaudited) for the four LLCs/LPs accounted for under the equity method at June 30, 2024 and 2023: Three Months Ended Six Months Ended 2024 2023 2024 2023 (amounts in thousands) (amounts in thousands) Revenues $ 2,057 $ 2,043 $ 4,307 $ 4,269 Operating expenses 826 812 1,724 1,717 Depreciation and amortization 472 461 946 916 Interest, net 142 198 301 439 Net income $ 617 $ 572 $ 1,336 $ 1,197 Our share of net income $ 272 $ 268 $ 656 $ 639
Condensed Combined Balance Sheets (Unaudited) for LLCs/LPs Accounted Under Equity Method	Below are the condensed combined balance sheets (unaudited) for the four above-mentioned LLCs/LPs that were accounted for under the equity meth od as of June 30, 2024 and December 31, 2023: June 30, December 31, (amounts in thousands) Net property, including construction in progress $ 27,688 $ 28,488 Other assets (a.) 4,679 4,667 Total assets $ 32,367 $ 33,155 Other liabilities (a.) $ 2,272 $ 2,074 Mortgage notes payable, non-recourse to us 15,280 21,206 Equity 14,815 9,875 Total liabilities and equity $ 32,367 $ 33,155 Investments in and advances to LLCs before amounts included in accrued expenses and other liabilities $ 14,328 $ 9,102 Amounts included in accrued expenses and other liabilities ( 1,751 ) ( 1,729 ) Our share of equity in LLCs, net $ 12,577 $ 7,373 (a.) Other assets and other liabilities as of June 30, 2024 and December 31, 2023 include approximately $ 650,000 and $ 651,000 , respectively, of right-of-use land assets and right-of-use land liabilities related to ground leases whereby the LLC/LP is the lessee, with third party lessors, including subsidiaries of UHS.
Aggregate Principal Amounts Due on Mortgage Notes Payable by Unconsolidated LLC's/LPs Accounted Under Equity Method	As o f June 30, 2024, and December 31, 2023, aggregate principal amounts due on mortgage notes payable by unconsolidated LLCs/LPs, which are accounted for under the equity method and are non-recourse to us, are as follows (amounts in thousands): Mortgage Loan Balance (a.) Name of LLC/LP 6/30/2024 12/31/2023 Maturity Date Brunswick Associates (2.80% fixed rate mortgage loan) $ 8,314 $ 8,453 December, 2030 Grayson Properties II (3.70% fixed rate construction loan) (b.) 6,966 12,753 March, 2026 $ 15,280 $ 21,206 (a.) All mortgage loans require monthly principal payments through maturity and include a balloon principal payment upon maturity. (b.) This construction loan required interest on the outstanding principal balance to be paid on a monthly basis through December 1, 2022. On January 1, 2023, monthly principal and interest payments on this loan commenced. During the first quarter of 2024, $ 5.7 million of the third-party construction loan was repaid utilizing pro-rate equity contributions from the partners, as discussed above. As a result of the repayment of a portion of the construction loan, an associated $ 3.1 million letter of credit was terminated.

Lease Accounting (Tables)

Lease Accounting (Tables)	6 Months Ended
	Jun. 30, 2024
Leases [Abstract]
Components of the "Lease Revenue - UHS facilities" and "Lease Revenue - Non-related Parties" Captions	The components of the “Lease revenue – UHS facilities” and “Lease revenue – Non-related parties” captions for the three and six month periods ended June 30, 2024 and 2023 are disaggregated below (in thousands). Base rents are primarily stated rent amounts provided for under the leases that are recognized on a straight-line basis over the term of the lease. Bonus rents and tenant reimbursements represent amounts where tenants are contractually obligated to pay an amount that is variable in nature. Three Months Ended Six Months Ended June 30, June 30, 2024 2023 2024 2023 UHS facilities: Base rents $ 6,888 $ 6,506 $ 13,860 $ 12,780 Bonus rents (a.) 758 730 1,541 1,494 Tenant reimbursements 808 1,000 1,717 1,749 Lease revenue - UHS facilities $ 8,454 $ 8,236 $ 17,118 $ 16,023 Non-related parties: Base rents 10,872 10,480 22,044 20,714 Tenant reimbursements 3,487 3,188 6,802 6,315 Lease revenue - Non-related parties $ 14,359 $ 13,668 $ 28,846 $ 27,029 (a.) Consists of bonus rental earned in connection with McAllen Medical Center.

Debt and Financial Instruments

Debt and Financial Instruments (Tables)	6 Months Ended
	Jun. 30, 2024
Debt Disclosure [Abstract]
Summary of Required Compliance Ratios Giving Effect to New Covenants in Credit Agreement	The following table includes a summary of the required compliance ratios, giving effect to the covenants contained in the Credit Agreement (dollar amounts in thousands): Covenant June 30, December 31, Tangible net worth > $ 125,000 $ 182,508 $ 191,824 Total leverage < = 60 % 44.0 % 44.5 % Secured leverage < 30 % 2.5 % 4.1 % Unencumbered leverage < 60 % 45.3 % 44.2 % Fixed charge coverage > 1.50 x 3.2 x 3.1 x
Outstanding Mortgages, Excluding Net Debt Premium	As indicated on the following table, we have various mortgages, all of which are non-recourse to us, included on our condensed consolidated balance sheet as of June 30, 2024 (amounts in thousands): Facility Name Outstanding thousands) (a.) Interest Maturity Tuscan Professional Building fixed rate mortgage loan (b.) $ 717 5.56 % June, 2025 Phoenix Children’s East Valley Care Center fixed rate 7,789 3.95 % January, 2030 Rosenberg Children's Medical Plaza fixed rate mortgage loan 11,638 4.42 % September, 2033 Total, excluding net debt premium and net financing fees 20,144 Less net financing fees ( 174 ) Total mortgages notes payable, non-recourse to us, net $ 19,970 (a.) All mortgage loans require monthly principal payments through maturity and either fully amortize or include a balloon principal payment upon maturity. (b.) This loan is scheduled to mature within the next twelve months, at which time we will either refinance pursuant to a new mortgage loan or repay the mortgage balance in full utilizing borrowings under our Credit Agreement.

General - Additional Informatio

General - Additional Information (Detail)	Jun. 30, 2024 Property
Limited Liability Companies
Organization Consolidation And Presentation Of Financial Statements [Line Items]
Number of real estate investments	4
4 Unconsolidated Limited Liability Companies / Limited Partner | Minimum
Organization Consolidation And Presentation Of Financial Statements [Line Items]
Non-controlling equity interest, ownership percentage	33%
4 Unconsolidated Limited Liability Companies / Limited Partner | Maximum
Organization Consolidation And Presentation Of Financial Statements [Line Items]
Non-controlling equity interest, ownership percentage	95%

Relationship with Universal H_3

Relationship with Universal Health Services, Inc. ("UHS") and Related Party Transactions - Additional Information (Detail)

3 Months Ended

6 Months Ended

12 Months Ended

Jun. 30, 2024 USD ($) Lease Time Hospital

Sep. 30, 2023 USD ($) ft²

Jun. 30, 2023 USD ($)

Mar. 31, 2023 USD ($) ft²

Mar. 31, 2022 USD ($) Subsidiary

Jun. 30, 2024 USD ($) Time Lease Bed Hospital Property RenewalOption

Jun. 30, 2023 USD ($)

Dec. 31, 2024 USD ($)

Dec. 31, 2021 USD ($)

Mar. 31, 2024 USD ($)

Dec. 31, 2023 USD ($)

Jan. 31, 2022 ft²

Related Party Transaction [Line Items]

Number of bed facility | Bed

100

Annual advisory fee as percentage of average invested real estate assets

0.70%

0.70%

0.70%

0.70%

McAllen Medical Center

Related Party Transaction [Line Items]

Initial rent

$ 624,000

Rentable square feet | ft²

79,500

Payment to acquire business

$ 7,600,000

Percentage of lease guaranteed

100%

Aiken Regional Medical Center

Related Party Transaction [Line Items]

Monthly lease rent receivable

$ 4,100,000

$ 4,100,000

$ 4,100,000

Canyon Creek Behavioral Health

Related Party Transaction [Line Items]

Monthly lease rent receivable

$ 1,800,000

1,800,000

$ 1,800,000

Aiken Regional Medical Center and Canyon Creek Behavioral Health

Related Party Transaction [Line Items]

Lease expiration date

Dec. 31, 2033

Lease renewal term

5 years

5 years

Monthly lease rent receivable

$ 5,900,000

$ 5,900,000

$ 5,900,000

Lease payments expected

$ 1,400,000

$ 1,400,000

Term of lease

12 years

Number of term renewal options | Time

7

7

Forecast | Aiken Regional Medical Center and Canyon Creek Behavioral Health

Related Party Transaction [Line Items]

Lease payments expected

$ 5,400,000

Universal Health Services, Inc

Related Party Transaction [Line Items]

Number of acute care hospital leased | Hospital

3

3

Number of behavioral health care hospital leased | Hospital

3

3

Number of hospital facilities leased | Hospital

6

Number of medical office buildings and free standing emergency departments | Property

21

Financing receivable

$ 83,000,000

$ 83,000,000

$ 83,300,000

Lease revenue

[1]

$ 8,454,000

$ 8,236,000

$ 17,118,000

$ 16,023,000

Option to renew lease, notice period prior to termination date of current term

90 days

Number of ground leases | Lease

13

13

Aggregate lease payments for 2024

$ 571,000

$ 571,000

Aggregate lease payments for 2025

571,000

571,000

Aggregate lease payments for 2026

571,000

571,000

Aggregate lease payments for 2027

571,000

571,000

Aggregate lease payments for 2028

$ 571,000

$ 571,000

Aggregate lease payments for thereafter

$ 31,300,000

Percentage ownership of outstanding shares

5.70%

5.70%

5.70%

Percentage of lease guaranteed

52%

Universal Health Services, Inc | Minimum

Related Party Transaction [Line Items]

Remaining lease terms on ground leases

25 years

Universal Health Services, Inc | Maximum

Related Party Transaction [Line Items]

Remaining lease terms on ground leases

74 years

Universal Health Services, Inc | Acute Care Hospitals

Related Party Transaction [Line Items]

Number of hospitals operating lease terms of existing and renewal options | Hospital

3

Universal Health Services, Inc | Wellington Regional Medical Center

Related Party Transaction [Line Items]

Percentage of annual rental increase on cumulative and compound basis

2.50%

Renewal options term at fair market value lease rates

5 years

Renewal options at fair market value lease rates expiration year

2031

Universal Health Services, Inc | McAllen Medical Center

Related Party Transaction [Line Items]

Lease expiration date

Aug. 31, 2035

Term of lease

12 years

Universal Health Services, Inc | Clive, Iowa | Clive Behavioral Health

Related Party Transaction [Line Items]

Initial lease term on property

20 years

Lessee operating lease, existence of option to extend

true

Percentage of annual rental increase on cumulative and compound basis

2.75%

Option to renew lease, notice period prior to termination date of current term

270 days

Renewal option term

10 years

Operating Lease Additional Number Of Renewal Options At Fair Market Value Lease Rates | RenewalOption

2

Renewal options term at fair market value lease rates

10 years

Period to purchase respective leased facilities prior to end of lease term or renewal terms

270 days

Number of term renewal options | Time

5

5

Number of lease renewal option exercised | Time

3

Universal Health Services, Inc | Clive, Iowa | Clive Behavioral Health | Minimum

Related Party Transaction [Line Items]

Renewal options at fair market value lease rates expiration year

2071

Universal Health Services, Inc | Clive, Iowa | Clive Behavioral Health | Maximum

Related Party Transaction [Line Items]

Renewal options at fair market value lease rates expiration year

2090

Universal Health Services, Inc | Palm Beach, Florida | Wellington Regional Medical Center

Related Party Transaction [Line Items]

Monthly lease rent receivable

$ 6,600,000

Percentage of annual rental increase on cumulative and compound basis

2.50%

Operating lease renewal term

5 years

5 years

Universal Health Services, Inc | Subsidiary

Related Party Transaction [Line Items]

Number of wholly-owned subsidiaries | Subsidiary

2

Financing receivable

$ 83,000,000

$ 83,000,000

$ 83,300,000

Universal Health Services, Inc | Asset Purchase and Sale Agreement | Subsidiary

Related Party Transaction [Line Items]

Cash received for sale of real estate asset

$ 4,100,000

Universal Health Services, Inc | Asset Purchase and Sale Agreement | Subsidiary | Inland Valley Campus of Southwest Healthcare System | Wildomar, California

Related Party Transaction [Line Items]

Fair market value of real estate asset sold

79,600,000

Universal Health Services, Inc | Asset Purchase and Sale Agreement | Subsidiary | Aiken Regional Medical Center | Aiken, South Carolina

Related Party Transaction [Line Items]

Fair market value of real estate assets received

57,700,000

Universal Health Services, Inc | Asset Purchase and Sale Agreement | Subsidiary | Canyon Creek Behavioral Health | Temple, Texas

Related Party Transaction [Line Items]

Fair market value of real estate assets received

$ 26,000,000

Universal Health Services, Inc | Ground Lease and Master Flex-lease Agreement | Reno, Nevada | Sierra Medical Plaza I

Related Party Transaction [Line Items]

Cost of medical office building incurred

$ 30,000,000

30,000,000

Rentable square feet | ft²

86,000

86,000

Cost of medical office building

$ 35,000,000

35,000,000

Percentage of rentable square feet

68%

68%

Universal Health Services, Inc | Ground Lease and Master Flex-lease Agreement | Reno, Nevada | Sierra Medical Plaza I | Minimum

Related Party Transaction [Line Items]

Initial rent

$ 1,300,000

$ 1,300,000

Universal Health Services, Inc | Master Flex Lease Agreement | Reno, Nevada | Sierra Medical Plaza I

Related Party Transaction [Line Items]

Lease expiration date

Mar. 31, 2033

Lease renewal term

10 years

10 years

Term of lease

10 years

Universal Health Services of Delaware Inc

Related Party Transaction [Line Items]

Advisory fee

1,400,000

$ 1,300,000

2,700,000

$ 2,600,000

Average invested real estate assets

$ 782,000,000

$ 756,000,000

$ 773,000,000

$ 750,000,000

Catholic Health Initiatives Iowa

Related Party Transaction [Line Items]

Percentage of lease guaranteed

48%

[1] Includes bonus rental on McAllen Medical Center, a UHS acute care hospital fa cility of $ 758 and $ 730 for the three-month periods ended June 30, 2024 and 2023, respectively, and $ 1,541 and $ 1,495 for the six-month periods ended June 30, 2024 and 2023, respectively.

Relationship with Universal H_4

Relationship with Universal Health Services, Inc. ("UHS") and Related Party Transactions - Additional Information (Detail 1) - USD ($)		3 Months Ended		6 Months Ended
		Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Bonus Rents | Aiken Regional Medical Center and Canyon Creek Behavioral Health
Related Party Transaction [Line Items]
Lease revenue				$ 0
Universal Health Services, Inc
Related Party Transaction [Line Items]
Lease revenue	[1]	$ 8,454,000	$ 8,236,000	17,118,000	$ 16,023,000
Universal Health Services, Inc | Bonus Rents
Related Party Transaction [Line Items]
Lease revenue	[2]	$ 758,000	$ 730,000	$ 1,541,000	$ 1,494,000
Universal Health Services, Inc | Revenues | Customer Concentration Risk
Related Party Transaction [Line Items]
Percentage of revenues generated from leases and tenants		24%	25%	24%	25%
Universal Health Services, Inc | Revenues | Customer Concentration Risk | Tenants
Related Party Transaction [Line Items]
Percentage of revenues generated from leases and tenants		41%	41%	41%	41%
[1] Includes bonus rental on McAllen Medical Center, a UHS acute care hospital fa cility of $ 758 and $ 730 for the three-month periods ended June 30, 2024 and 2023, respectively, and $ 1,541 and $ 1,495 for the six-month periods ended June 30, 2024 and 2023, respectively. Consists of bonus rental earned in connection with McAllen Medical Center.

Existing Lease Terms and Renewa

Existing Lease Terms and Renewal Options for Each of UHS Hospital Facilities (Detail) - Universal Health Services, Inc	6 Months Ended
	Jun. 30, 2024 USD ($)
McAllen Medical Center
Operating Leased Assets [Line Items]
Annual Minimum Rent	$ 5,485,000	[1]
End of Lease Term	2026-12	[1]
Renewal Term (years)	5 years	[1]
Wellington Regional Medical Center
Operating Leased Assets [Line Items]
Annual Minimum Rent	$ 6,639,000	[2]
End of Lease Term	2026-12	[2]
Renewal Term (years)	5 years	[2]
Aiken Regional Medical Center/Aurora Pavilion Behavioral Health Services
Operating Leased Assets [Line Items]
Annual Minimum Rent	$ 4,072,000	[3]
End of Lease Term	2033-12	[3]
Renewal Term (years)	35 years	[3]
Canyon Creek Behavioral Health
Operating Leased Assets [Line Items]
Annual Minimum Rent	$ 1,841,000	[3]
End of Lease Term	2033-12	[3]
Renewal Term (years)	35 years	[3]
Clive Behavioral Health Hospital
Operating Leased Assets [Line Items]
Annual Minimum Rent	$ 2,775,000	[4]
End of Lease Term	2040-12	[4]
Renewal Term (years)	50 years	[4]
[1] UHS has one 5-year renewal option at existing lease rates (through 2031 ). UHS has one 5-year renewal option at fair market value lease rates (through 2031 ; see additional disclosure below). The annual rental will increase by 2.5 % on an annual compounded basis on each January 1 st through 2026. UHS has seven 5-year renewal options at fair market value lease rates ( 2034 through 2068 ). The annual rental rate will increase by 2.25 % on a cumulative and compounded basis on each January 1 st through 2033. The UHS-related joint venture has five 10-year renewal options; the first three of the five 10-year renewal options will be at computed lease rates as stipulated in the lease ( 2041 through 2070 ) and the last two 10-year renewal options will be at fair market lease rates ( 2071 through 2090 ). On each January 1 st through 2040 (and potentially through 2070 if the first three of five, 10-year renewal options are exercised), the annual rental will increase by 2.75 % on a cumulative and compounded basis.

Existing Lease Terms and Rene_2

Existing Lease Terms and Renewal Options for Each of UHS Hospital Facilities (Parenthetical) (Detail) - Universal Health Services, Inc	6 Months Ended
	Jun. 30, 2024 Renewaloptions
McAllen Medical Center
Operating Leased Assets [Line Items]
Number of renewal option at existing lease rates	1
Renewal option term at existing lease rates	5 years
Renewal option at existing lease rates expiration year	2031
Wellington Regional Medical Center
Operating Leased Assets [Line Items]
Number of renewal options at fair market value lease rates	1
Renewal options term at fair market value lease rates	5 years
Renewal options at fair market value lease rates expiration year	2031
Percentage of annual rental increase	2.50%
Aiken Regional Medical Center and Canyon Creek Behavioral Health
Operating Leased Assets [Line Items]
Number of renewal options at fair market value lease rates	7
Renewal options term at fair market value lease rates	5 years
Percentage of annual rental increase on cumulative and compound basis	2.25%
Aiken Regional Medical Center and Canyon Creek Behavioral Health | Minimum
Operating Leased Assets [Line Items]
Renewal options at fair market value lease rates expiration year	2034
Aiken Regional Medical Center and Canyon Creek Behavioral Health | Maximum
Operating Leased Assets [Line Items]
Renewal options at fair market value lease rates expiration year	2068
Clive Behavioral Health Hospital
Operating Leased Assets [Line Items]
Number of renewal options at fair market value lease rates	5
Renewal options term at fair market value lease rates	10 years
Clive Behavioral Health Hospital | First Three Year Renewal Options
Operating Leased Assets [Line Items]
Percentage of annual rental increase on cumulative and compound basis	2.75%
Clive Behavioral Health Hospital | Minimum | First Three Year Renewal Options
Operating Leased Assets [Line Items]
Renewal options at lease rate stipulated in lease expiration year	2041
Clive Behavioral Health Hospital | Minimum | Last Two Year Renewal Options
Operating Leased Assets [Line Items]
Renewal options at fair market value lease rates expiration year	2071
Clive Behavioral Health Hospital | Maximum | First Three Year Renewal Options
Operating Leased Assets [Line Items]
Renewal options at lease rate stipulated in lease expiration year	2070
Clive Behavioral Health Hospital | Maximum | Last Two Year Renewal Options
Operating Leased Assets [Line Items]
Renewal options at fair market value lease rates expiration year	2090

Dividends and Equity Issuance_2

Dividends and Equity Issuance Program - Additional Information (Detail) - USD ($)	2 Months Ended	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Dividends and Equity Issuance [Line Items]
Dividends declared and paid		$ 10,200,000	$ 10,000,000	$ 20,156,000	$ 19,837,000
Declared and paid dividends, per share		$ 0.73	$ 0.72	$ 1.455	$ 1.435
Aggregate initial offering price of threshold amount	$ 100,000,000	$ 100,000,000		$ 100,000,000
Share issued	0
Other Expenses
Dividends and Equity Issuance [Line Items]
Net cash proceeds from stock issued				$ 287,000

Acquisitions and Divestitures -

Acquisitions and Divestitures - Additional Information (Detail) $ in Millions	3 Months Ended	6 Months Ended
	Mar. 31, 2023 USD ($) ft²	Jun. 30, 2024 USD ($) Acquisition Disposition	Jun. 30, 2023 USD ($) Disposition Acquisition	Jan. 31, 2022 ft²
Business Acquisitions And Dispositions [Line Items]
Number of acquisitions | Acquisition		0	0
Number of dispositions | Disposition		0	0
Sierra Medical Plaza I | Reno, Nevada | Ground Lease and Master Flex-lease Agreement | Universal Health Services, Inc
Business Acquisitions And Dispositions [Line Items]
Percentage of rentable square feet	68%		68%
Rentable square feet | ft²	86,000			86,000
Cost of medical office building	$ 35	$ 35
Cost of medical office building incurred	30	$ 30
Sierra Medical Plaza I | Reno, Nevada | Ground Lease and Master Flex-lease Agreement | Universal Health Services, Inc | Minimum [Member]
Business Acquisitions And Dispositions [Line Items]
Initial rent	$ 1.3		$ 1.3
Sierra Medical Plaza I | Reno, Nevada | Master Flex Lease Agreement | Universal Health Services, Inc
Business Acquisitions And Dispositions [Line Items]
Lease expiration date			Mar. 31, 2033
Lease contract term			10 years

Summarized Financial Informat_3

Summarized Financial Information of Equity Affiliates - Additional Information (Detail)	6 Months Ended
	Jun. 30, 2024 Property
Limited Liability Companies | Medical office buildings
Schedule Of Equity Method Investments [Line Items]
Number of real estate investments	4
Minimum
Schedule Of Equity Method Investments [Line Items]
Number of days for Non-Offering Member either to purchase or sell its entire ownership interest to or from Offering Member	60 days
Maximum
Schedule Of Equity Method Investments [Line Items]
Number of days for Non-Offering Member either to purchase or sell its entire ownership interest to or from Offering Member	90 days
4 Unconsolidated Limited Liability Companies / Limited Partner | Minimum
Schedule Of Equity Method Investments [Line Items]
Non-controlling equity interest, ownership percentage	33%
4 Unconsolidated Limited Liability Companies / Limited Partner | Maximum
Schedule Of Equity Method Investments [Line Items]
Non-controlling equity interest, ownership percentage	95%

Limited Liability Companies Acc

Limited Liability Companies Accounted for Under Equity Method (Detail)	6 Months Ended
	Jun. 30, 2024
Suburban Properties
Schedule Of Equity Method Investments [Line Items]
Ownership	33%
Property Owned by LLC/LP	St. Matthews Medical Plaza II
Brunswick Associates
Schedule Of Equity Method Investments [Line Items]
Ownership	74%	[1],[2]
Property Owned by LLC/LP	Mid Coast Hospital MOB	[1],[2]
FTX MOB Phase II limited partnership
Schedule Of Equity Method Investments [Line Items]
Ownership	95%	[3]
Property Owned by LLC/LP	Forney Medical Plaza II	[3]
Grayson Properties Two L P
Schedule Of Equity Method Investments [Line Items]
Ownership	95%	[4],[5]
Property Owned by LLC/LP	Texoma Medical Plaza II	[4],[5]
[1] This LLC has a third-party term loan of $ 8.3 million, which is non-recourse to us, outstanding as of June 30, 2024. We are the lessee with a third party on a ground lease for land. During the first quarter of 2021, this LP paid off its $ 4.7 million mortgage loan upon maturity, utilizing pro rata equity contributions from the limited partners as well as a $ 3.5 million member loan from us to the LP which was funded utilizing borrowings from our revolving credit agreement. During the first quarter of 2023, the LP repaid $ 175,000 of the member loan and the remaining $ 3.3 million member loan balance was converted to an equity investment in the LP. This LP constructed, owns and operates the Texoma Medical Plaza II, on which construction substantially completed in December 2020. The MOB is located in Denison, Texas, on the campus of a hospital owned and operated by a wholly-owned subsidiary of UHS. We have committed to invest up to $ 10.2 million in equity and debt financing, of which $ 7.5 million, net, has been funded as of June 30, 2024. This LP entered into a third-party construction loan commitment, which is non-recourse to us, which had an outstanding balance of $ 7.0 million as of June 30, 2024. Monthly principal and interest payments on this loan commenced on January 1, 2023. During the first quarter of 2024, $ 5.7 million of the third-party construction loan was repaid utilizing pro rata equity contributions from the partners. The third-party partner's share of the pro rata equity contributions was partially funded with a six-month, $ 128,000 partner loan from us, which was repaid during July, 2024 with interest. Our share of the pro rata equity contributions, as well as the third-party partner loan, were funded utilizing borrowings fro m our revolving credit agreement. As a result of the repayment of a portion of the construction loan, an associated $ 3.1 million letter of credit was terminated. We are the lessee with a UHS-related party for the land related to this property.

Limited Liability Companies A_2

Limited Liability Companies Accounted for Under Equity Method (Parenthetical) (Detail) - USD ($)	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2021	Jun. 30, 2024	Mar. 31, 2024
Brunswick Associates
Schedule Of Equity Method Investments [Line Items]
Third-party term loan			$ 8,300,000
FTX MOB Phase II limited partnership
Schedule Of Equity Method Investments [Line Items]
Repayment of loan	$ 175,000	$ 4,700,000
Member loan used to repay mortgage loan		$ 3,500,000
Conversion of Loan to Equity Method Investment	$ 3,300,000
Grayson Properties II LP
Schedule Of Equity Method Investments [Line Items]
Member loan used to repay mortgage loan			128,000
Construction loan			5,700,000	$ 5,700,000
Letters of Credit Terminated Amount			3,100,000
Construction loan outstanding balance			7,000,000
Grayson Properties II LP | Denison Texas
Schedule Of Equity Method Investments [Line Items]
Commitment to investment			7,500,000
Grayson Properties II LP | Maximum | Denison Texas
Schedule Of Equity Method Investments [Line Items]
Commitment to investment			$ 10,200,000

Condensed Combined Statements o

Condensed Combined Statements of Income (Unaudited) for LLCs/LPs Accounted Under Equity Method (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Schedule Of Equity Method Investments [Line Items]
Revenues	$ 24,734	$ 23,806	$ 49,875	$ 47,032
Net income			10,576	7,935
Our share of net income	272	268	656	639
Equity Method Investment, Nonconsolidated Investee or Group of Investees
Schedule Of Equity Method Investments [Line Items]
Revenues	2,057	2,043	4,307	4,269
Operating expenses	826	812	1,724	1,717
Depreciation and amortization	472	461	946	916
Interest, net	142	198	301	439
Net income	617	572	1,336	1,197
Equity Method Investment, Nonconsolidated Investee or Group of Investees
Schedule Of Equity Method Investments [Line Items]
Our share of net income	$ 272	$ 268	$ 656	$ 639

Condensed Combined Balance Shee

Condensed Combined Balance Sheets (Unaudited) for LLCs/LPs Accounted Under Equity Method (Detail) - USD ($) $ in Thousands		Jun. 30, 2024	Mar. 31, 2024	Dec. 31, 2023	Jun. 30, 2023	Mar. 31, 2023	Dec. 31, 2022
Schedule Of Equity Method Investments [Line Items]
Total Assets		$ 586,551		$ 596,369
Equity		190,701	$ 196,458	200,934	$ 216,635	$ 222,170	$ 229,101
Total Liabilities and Equity		586,551		596,369
Investments in and advances to LLCs before amounts included in accrued expenses and other liabilities		14,328		9,102
Equity Method Investment, Nonconsolidated Investee or Group of Investees
Schedule Of Equity Method Investments [Line Items]
Net property, including construction in progress		27,688		28,488
Other assets	[1]	4,679		4,667
Total Assets		32,367		33,155
Other liabilities	[1]	2,272		2,074
Mortgage notes payable, non-recourse to us		15,280		21,206
Equity		14,815		9,875
Total Liabilities and Equity		32,367		33,155
Investments in and advances to LLCs before amounts included in accrued expenses and other liabilities		14,328		9,102
Amounts included in accrued expenses and other liabilities		(1,751)		(1,729)
Equity Method Investment, Nonconsolidated Investee or Group of Investees
Schedule Of Equity Method Investments [Line Items]
Our share of equity in LLCs, net		$ 12,577		$ 7,373
[1] Other assets and other liabilities as of June 30, 2024 and December 31, 2023 include approximately $ 650,000 and $ 651,000 , respectively, of right-of-use land assets and right-of-use land liabilities related to ground leases whereby the LLC/LP is the lessee, with third party lessors, including subsidiaries of UHS.

Condensed Combined Balance Sh_2

Condensed Combined Balance Sheets for LLCs/LPs Accounted Under Equity Method (Parenthetical) (Detail) - USD ($)	Jun. 30, 2024	Dec. 31, 2023
Schedule Of Equity Method Investments [Line Items]
Right-of-use land assets	$ 10,932,000	$ 10,946,000
Right-of-use land liabilities	10,932,000	10,946,000
Limited Liability Companies
Schedule Of Equity Method Investments [Line Items]
Right-of-use land assets	650,000	651,000
Right-of-use land liabilities	$ 650,000	$ 651,000

Aggregate Principal Amounts Due

Aggregate Principal Amounts Due on Mortgage Notes Payable by Unconsolidated LLC's/LPs Accounted Under Equity Method (Detail) - Equity Method Investments - USD ($) $ in Thousands		6 Months Ended
		Jun. 30, 2024	Dec. 31, 2023
Schedule Of Equity Method Investments [Line Items]
Mortgage Loan Balance	[1]	$ 15,280	$ 21,206
Grayson Properties II LP
Schedule Of Equity Method Investments [Line Items]
Mortgage Loan Balance	[1],[2]	$ 6,966	12,753
Maturity Date	[2]	2026-03
Brunswick Associates
Schedule Of Equity Method Investments [Line Items]
Mortgage Loan Balance	[1]	$ 8,314	$ 8,453
Maturity Date		2030-12
[1] All mortgage loans require monthly principal payments through maturity and include a balloon principal payment upon maturity. This construction loan required interest on the outstanding principal balance to be paid on a monthly basis through December 1, 2022. On January 1, 2023, monthly principal and interest payments on this loan commenced. During the first quarter of 2024, $ 5.7 million of the third-party construction loan was repaid utilizing pro-rate equity contributions from the partners, as discussed above. As a result of the repayment of a portion of the construction loan, an associated $ 3.1 million letter of credit was terminated.

Recent Accounting Pronounceme_2

Recent Accounting Pronouncements - Additional Information (Details)	Jun. 30, 2024
ASU 2022-06
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted [true false]	true
Change in Accounting Principle, Accounting Standards Update, Immaterial Effect [true false]	true
ASU 2023-07
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted [true false]	true
Change in Accounting Principle, Accounting Standards Update, Immaterial Effect [true false]	true

Lease Accounting - Additional I

Lease Accounting - Additional Information (Detail)	3 Months Ended			6 Months Ended		12 Months Ended
	Jun. 30, 2024 USD ($)	Jun. 30, 2023 USD ($)	Dec. 31, 2022 USD ($)	Jun. 30, 2024 USD ($) Land Lease	Jun. 30, 2023 USD ($)	Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)	Mar. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Leases Disclosure [Line Items]
Lessee in connection with ground leases for land | Land				15
Right-of-use land assets	$ 10,932,000			$ 10,932,000			$ 10,946,000
Ground lease liabilities	10,932,000			10,932,000			10,946,000
Specialty Hospital In Chicago, Illinois | Chicago, Illinois
Leases Disclosure [Line Items]
Lease Demolition Cost							1,500,000
Other operating expenses demolition costs			$ 332,000		$ 1,100,000
Aiken Regional Medical Center and Canyon Creek Behavioral Health
Leases Disclosure [Line Items]
Monthly lease rent receivable	5,900,000			5,900,000				$ 5,900,000
Lease payments expected	1,400,000	$ 1,400,000
Aiken Regional Medical Center and Canyon Creek Behavioral Health | Forecast
Leases Disclosure [Line Items]
Lease payments expected						$ 5,400,000
Aiken Regional Medical Center
Leases Disclosure [Line Items]
Monthly lease rent receivable	4,100,000			4,100,000				4,100,000
Canyon Creek Behavioral Health
Leases Disclosure [Line Items]
Monthly lease rent receivable	1,800,000			1,800,000				$ 1,800,000
Universal Health Services, Inc
Leases Disclosure [Line Items]
Financing receivable	83,000,000			83,000,000			83,300,000
Universal Health Services, Inc | Wellington Regional Medical Center | Palm Beach, Florida
Leases Disclosure [Line Items]
Monthly lease rent receivable									$ 6,600,000
Universal Health Services, Inc | Subsidiary
Leases Disclosure [Line Items]
Financing receivable	$ 83,000,000			$ 83,000,000			$ 83,300,000
Financing Arrangements
Leases Disclosure [Line Items]
Number of lease property | Lease				2

Lease Accounting - Components o

Lease Accounting - Components of the "Lease Revenue - UHS facilities" and "Lease Revenue - Non-related Parties" Captions (Detail) - USD ($) $ in Thousands		3 Months Ended		6 Months Ended
		Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Universal Health Services, Inc
Leases Disclosure [Line Items]
Lease revenue	[1]	$ 8,454	$ 8,236	$ 17,118	$ 16,023
Universal Health Services, Inc | Base Rents
Leases Disclosure [Line Items]
Lease revenue		6,888	6,506	13,860	12,780
Universal Health Services, Inc | Bonus Rents
Leases Disclosure [Line Items]
Lease revenue	[2]	758	730	1,541	1,494
Universal Health Services, Inc | Tenant Reimbursements
Leases Disclosure [Line Items]
Lease revenue		808	1,000	1,717	1,749
Non-Related Parties
Leases Disclosure [Line Items]
Lease revenue		14,359	13,668	28,846	27,029
Non-Related Parties | Base Rents
Leases Disclosure [Line Items]
Lease revenue		10,872	10,480	22,044	20,714
Non-Related Parties | Tenant Reimbursements
Leases Disclosure [Line Items]
Lease revenue		$ 3,487	$ 3,188	$ 6,802	$ 6,315
[1] Includes bonus rental on McAllen Medical Center, a UHS acute care hospital fa cility of $ 758 and $ 730 for the three-month periods ended June 30, 2024 and 2023, respectively, and $ 1,541 and $ 1,495 for the six-month periods ended June 30, 2024 and 2023, respectively. Consists of bonus rental earned in connection with McAllen Medical Center.

Debt and Financial Instrument_2

Debt and Financial Instruments - Additional Information (Detail)

1 Months Ended

3 Months Ended

6 Months Ended

Apr. 10, 2024 USD ($)

May 15, 2023 USD ($)

Jul. 02, 2021 USD ($)

Mar. 27, 2018 USD ($) Option

Dec. 31, 2023 USD ($) Derivative

Mar. 31, 2020 USD ($) Derivative

Jan. 31, 2020 USD ($) Derivative

Jun. 30, 2024 USD ($)

Jun. 30, 2023 USD ($)

Mar. 31, 2023 USD ($)

Sep. 30, 2019 USD ($) Derivative

Jun. 30, 2024 USD ($)

Jun. 30, 2023 USD ($)

Debt Instrument [Line Items]

Net borrowings on the line of credit

$ 16,300,000

$ 13,300,000

Credit facility, Interest Rate Terms

Borrowings under the Credit Agreement will bear interest at a rate equal to, at our option, at adjusted term SOFR for either one, three, or six months or the Base Rate, plus in either case, a specified margin depending on our total leverage ratio, as determined by the formula set forth in the Credit Agreement. The applicable margin after the first amendment ranges from 1.10% to 1.35% for adjusted term SOFR loans and 0.10% to 0.35% for Base Rate loans.

Outstanding borrowings under revolving credit agreement

$ 326,600,000

$ 342,900,000

$ 342,900,000

Letters Of Credit Outstanding Amount

3,100,000

Available borrowing capacity

45,300,000

32,100,000

32,100,000

Compensating Balance Amount

0

0

Interest Rate Swap

Debt Instrument [Line Items]

Notional amount

$ 25,000,000

Derivative interest rate cap, payment received or accrued from counterparties

1,600,000

$ 1,400,000

3,300,000

2,600,000

Interest Rate Swap | Cash Flow Hedge

Debt Instrument [Line Items]

Number of interest rate cap agreements | Derivative

1

Derivative instruments, fixed rate

3.9495%

Expiration date of interest rate

Dec. 01, 2027

Interest Rate Swap Agreement One | Cash Flow Hedge

Debt Instrument [Line Items]

Number of interest rate cap agreements | Derivative

1

Derivative instruments, fixed rate

0.565%

Notional amount

$ 55,000,000

Expiration date of interest rate

Mar. 25, 2027

Interest Rate Swap Agreement Two | Cash Flow Hedge

Debt Instrument [Line Items]

Number of interest rate cap agreements | Derivative

1

Derivative instruments, fixed rate

1.4975%

Notional amount

$ 35,000,000

Expiration date of interest rate

Sep. 16, 2024

Interest Rate Swap Agreement Three | Cash Flow Hedge

Debt Instrument [Line Items]

Number of interest rate cap agreements | Derivative

1

Derivative instruments, fixed rate

1.144%

Notional amount

$ 50,000,000

Expiration date of interest rate

Sep. 16, 2024

Level 2

Debt Instrument [Line Items]

Mortgage debt

$ 33,100,000

20,100,000

20,100,000

Mortgage loan fair value

$ 31,200,000

18,400,000

18,400,000

Level 2 | Interest Rate Swap

Debt Instrument [Line Items]

Liability derivatives, fair value

6,400,000

6,400,000

Summerlin Hospital Medical Office Building III Fixed Rate Mortgage Loan

Debt Instrument [Line Items]

Repayment of mortgage loan

$ 12,200,000

Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate

Debt Instrument [Line Items]

Margin points added to the reference rate

0.10%

Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate | Interest Rate Swap | Cash Flow Hedge

Debt Instrument [Line Items]

Derivative instruments, fixed rate

3.9495%

Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate | Interest Rate Swap Agreement One | Cash Flow Hedge

Debt Instrument [Line Items]

Derivative instruments, fixed rate

0.505%

Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate | Interest Rate Swap Agreement Two | Cash Flow Hedge

Debt Instrument [Line Items]

Derivative instruments, fixed rate

1.41%

Notional amount

$ 35,000,000

Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate | Interest Rate Swap Agreement Three | Cash Flow Hedge

Debt Instrument [Line Items]

Derivative instruments, fixed rate

1.065%

Notional amount

$ 50,000,000

Credit Agreement

Debt Instrument [Line Items]

Outstanding borrowing

$ 350,000,000

$ 375,000,000

375,000,000

375,000,000

Net borrowings on the line of credit

350,000,000

$ 50,000,000

Unsecured revolving amended credit agreement terminated date

Jul. 02, 2025

Increase in borrowing capacity

$ 375,000,000

Number of additional six month extension options | Option

2

Aggregate borrowings under Credit Agreement

25,200,000

$ 14,800,000

47,000,000

34,500,000

Aggregate repayments

$ 15,900,000

$ 11,800,000

$ 30,700,000

$ 21,200,000

Credit Agreement | Swingline/Short-Term Loans

Debt Instrument [Line Items]

Outstanding borrowing

$ 30,000,000

Credit Agreement | Letters of Credit

Debt Instrument [Line Items]

Outstanding borrowing

$ 40,000,000

Revolving A Facility | Minimum

Debt Instrument [Line Items]

Facility fee payable on commitment

0.15%

Revolving A Facility | Minimum | Base Rate

Debt Instrument [Line Items]

Margin points added to the reference rate

0.10%

Revolving A Facility | Minimum | Federal Funds Effective Rate

Debt Instrument [Line Items]

Margin points added to the base rate

0.50%

Revolving A Facility | Minimum | Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate

Debt Instrument [Line Items]

Margin points added to the reference rate

1.10%

Margin points added to the base rate

1%

Revolving A Facility | Maximum

Debt Instrument [Line Items]

Facility fee payable on commitment

0.35%

Revolving A Facility | Maximum | Base Rate

Debt Instrument [Line Items]

Margin points added to the reference rate

0.35%

Revolving A Facility | Maximum | Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate

Debt Instrument [Line Items]

Margin points added to the reference rate

1.35%

Revolving B Facility | Base Rate

Debt Instrument [Line Items]

Margin points added to the reference rate

0.20%

Revolving B Facility | Federal Funds Effective Rate

Debt Instrument [Line Items]

Facility fee payable on commitment

0.20%

Revolving B Facility | Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate

Debt Instrument [Line Items]

Margin points added to the reference rate

1.20%

Summary of Required Compliance

Summary of Required Compliance Ratios in Connection with Terms of Credit Agreement (Detail) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Covenant, Tangible net worth	$ 125,000
Tangible net worth	$ 182,508	$ 191,824
Total leverage	44%	44.50%
Secured leverage	2.50%	4.10%
Unencumbered leverage	45.30%	44.20%
Fixed charge coverage	3.20%	3.10%
Maximum
Debt Instrument [Line Items]
Covenant, Total leverage	60%
Covenant, Secured leverage	30%
Covenant, Unencumbered leverage	60%
Minimum
Debt Instrument [Line Items]
Covenant, Fixed charge coverage	1.50%

Summary of Outstanding Mortgage

Summary of Outstanding Mortgages, Excluding Net Debt Premium (Detail) - USD ($) $ in Thousands		6 Months Ended
		Jun. 30, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Total mortgages notes payable, non-recourse to us, net		$ 19,970	$ 32,863
Nonrecourse
Debt Instrument [Line Items]
Outstanding Balance	[1]	20,144
Less net financing fees	[1]	(174)
Total mortgages notes payable, non-recourse to us, net	[1]	19,970
Tuscan Professional Building Fixed Rate Mortgage Loan | Nonrecourse
Debt Instrument [Line Items]
Outstanding Balance	[1],[2]	$ 717
Interest Rate	[2]	5.56%
Maturity Date	[2]	2025-06
Phoenix Children East Valley Care Center Fixed Rate Mortgage Loan | Nonrecourse
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 7,789
Interest Rate		3.95%
Maturity Date		2030-01
Rosenberg Children's Medical Plaza Fixed Rate Mortgage Loan | Nonrecourse
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 11,638
Interest Rate		4.42%
Maturity Date		2033-09
[1] All mortgage loans require monthly principal payments through maturity and either fully amortize or include a balloon principal payment upon maturity. This loan is scheduled to mature within the next twelve months, at which time we will either refinance pursuant to a new mortgage loan or repay the mortgage balance in full utilizing borrowings under our Credit Agreement.

Segment Reporting - Additional

Segment Reporting - Additional Information (Detail)	6 Months Ended
	Jun. 30, 2024 Segment
Segment Reporting [Abstract]
Number of reportable segments	1