Universal Health Realty Income Trust (UHT) 10-Q 10 Aug 20 2020 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	6 Months Ended
	Jun. 30, 2020	Jul. 31, 2020
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Jun. 30, 2020
Document Fiscal Year Focus	2020
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		13,769,667
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
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 ($) $ in Thousands		3 Months Ended		6 Months Ended
		Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Revenues:
Revenues, Total		$ 19,281	$ 19,326	$ 38,488	$ 38,438
Expenses:
Depreciation and amortization		6,381	6,426	12,761	13,134
Other operating expenses		5,576	5,330	10,959	10,540
Costs and Expenses, Total		12,984	12,738	25,763	25,626
Income before equity in income of unconsolidated limited liability companies ("LLCs"), interest expense and gain on sale		6,297	6,588	12,725	12,812
Equity in income of unconsolidated LLCs		419	454	854	884
Gain on sale of land					250
Interest expense, net		(2,016)	(2,781)	(4,325)	(5,473)
Net income		$ 4,700	$ 4,261	$ 9,254	$ 8,473
Basic earnings per share		$ 0.34	$ 0.31	$ 0.67	$ 0.62
Diluted earnings per share		$ 0.34	$ 0.31	$ 0.67	$ 0.62
Weighted average number of shares outstanding - Basic		13,739	13,730	13,737	13,729
Weighted average number of shares outstanding - Diluted		13,761	13,749	13,759	13,748
Non-Related Parties
Revenues:
Lease revenue		$ 12,843	$ 13,178	$ 25,685	$ 25,909
Other
Revenues:
Other revenue		236	288	506	663
Management Service
Expenses:
Advisory fees to UHS		1,027	982	2,043	1,952
UHS Facilities
Revenues:
Lease revenue	[1]	5,981	5,651	11,862	11,444
UHS Facilities | Other
Revenues:
Other revenue		$ 221	$ 209	$ 435	$ 422
[1]	Includes bonus rental on UHS hospital facilities of $1,417 and $1,352 for the three-month periods ended June 30, 2020 and 2019, respectively, and $2,797 and $2,746 for the six-month periods ended June 30, 2020 and 2019, respectively.

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Income (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
UHS Hospital Facilities
Bonus rental	$ 1,417	$ 1,352	$ 2,797	$ 2,746

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Statement Of Income And Comprehensive Income [Abstract]
Net income	$ 4,700	$ 4,261	$ 9,254	$ 8,473
Other comprehensive loss:
Unrealized derivative losses on cash flow hedges	(1,272)		(5,943)	(132)
Total other comprehensive loss:	(1,272)		(5,943)	(132)
Total comprehensive income	$ 3,428	$ 4,261	$ 3,311	$ 8,341

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2020		Dec. 31, 2019
Real Estate Investments:
Buildings and improvements and construction in progress	$ 586,391		$ 572,503
Accumulated depreciation	(205,720)		(194,888)
Real Estate Investment Property, Net, Total	380,671		377,615
Land	54,892		54,892
Net Real Estate Investments	435,563		432,507
Investments in limited liability companies ("LLCs")	4,408		6,918
Other Assets:
Cash and cash equivalents	6,342		6,110
Lease and other receivables from UHS	3,023		2,963
Lease receivable - other	7,354		7,640
Intangible assets (net of accumulated amortization of $18.4 million and $26.5 million, respectively)	12,948		14,553
Right-of-use land assets, net	8,929		8,944
Deferred charges and other assets, net	8,039		9,154
Total Assets	486,606		488,789
Liabilities:
Line of credit borrowings	221,250		212,950
Mortgage notes payable, non-recourse to us, net	59,871	[1]	60,744
Accrued interest	346		374
Accrued expenses and other liabilities	18,287		12,888
Ground lease liabilities, net	8,929		8,944
Tenant reserves, deposits and deferred and prepaid rents	11,683		11,155
Total Liabilities	320,366		307,055
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: 2020 - 13,769,586; 2019 - 13,757,498	138		138
Capital in excess of par value	266,843		266,723
Cumulative net income	670,534		661,280
Cumulative dividends	(766,342)		(747,417)
Accumulated other comprehensive (loss)/income	(4,933)		1,010
Total Equity	166,240		181,734
Total Liabilities and Equity	$ 486,606		$ 488,789
[1]	All mortgage loans require monthly principal payments through maturity and either fully amortize or include a balloon principal payment upon maturity.

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Millions	Jun. 30, 2020	Dec. 31, 2019
Statement Of Financial Position [Abstract]
Intangible assets, accumulated amortization	$ 18.4	$ 26.5
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	13,769,586	13,757,498
Common shares, outstanding	13,769,586	13,757,498

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Changes in Equity - USD ($) shares in Thousands, $ 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, 2018	$ 198,610	$ 137	$ 266,031	$ 642,316	$ (710,006)	$ 132
Balance, Shares at Dec. 31, 2018		13,747
Shares of Beneficial Interest:
Issued, net	(109)	$ 1	(110)
Issued (in shares)		10
Restricted stock-based compensation expense	331		331
Dividends and dividend equivalents	(18,633)				(18,633)
Comprehensive income:
Net income	8,473			8,473
Unrealized loss on cash flow hedges	(132)					(132)
Subtotal - comprehensive income	8,341			8,473		(132)
Balance at Jun. 30, 2019	188,540	$ 138	266,252	650,789	(728,639)
Balance, Shares at Jun. 30, 2019		13,757
Balance at Mar. 31, 2019	193,627	$ 137	266,247	646,528	(719,285)
Balance, Shares at Mar. 31, 2019		13,748
Shares of Beneficial Interest:
Issued, net	(166)	$ 1	(167)
Issued (in shares)		9
Restricted stock-based compensation expense	172		172
Dividends and dividend equivalents	(9,354)				(9,354)
Comprehensive income:
Net income	4,261			4,261
Subtotal - comprehensive income	4,261			4,261
Balance at Jun. 30, 2019	188,540	$ 138	266,252	650,789	(728,639)
Balance, Shares at Jun. 30, 2019		13,757
Balance at Dec. 31, 2019	181,734	$ 138	266,723	661,280	(747,417)	1,010
Balance, Shares at Dec. 31, 2019		13,757
Shares of Beneficial Interest:
Issued, net	(297)		(297)
Issued (in shares)		13
Restricted stock-based compensation expense	417		417
Dividends and dividend equivalents	(18,925)				(18,925)
Comprehensive income:
Net income	9,254			9,254
Unrealized loss on cash flow hedges	(5,943)					(5,943)
Subtotal - comprehensive income	3,311			9,254		(5,943)
Balance at Jun. 30, 2020	166,240	$ 138	266,843	670,534	(766,342)	(4,933)
Balance, Shares at Jun. 30, 2020		13,770
Balance at Mar. 31, 2020	172,440	$ 138	266,970	665,834	(756,841)	(3,661)
Balance, Shares at Mar. 31, 2020		13,758
Shares of Beneficial Interest:
Issued, net	(347)		(347)
Issued (in shares)		12
Restricted stock-based compensation expense	220		220
Dividends and dividend equivalents	(9,501)				(9,501)
Comprehensive income:
Net income	4,700			4,700
Unrealized loss on cash flow hedges	(1,272)					(1,272)
Subtotal - comprehensive income	3,428			4,700		(1,272)
Balance at Jun. 30, 2020	$ 166,240	$ 138	$ 266,843	$ 670,534	$ (766,342)	$ (4,933)
Balance, Shares at Jun. 30, 2020		13,770

Condensed Consolidated Statem_5

Condensed Consolidated Statements of Changes in Equity (Parenthetical) - $ / shares	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Statement Of Stockholders Equity [Abstract]
Dividend, per share	$ 0.69	$ 0.68	$ 1.375	$ 1.355

Condensed Consolidated Statem_6

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019
Cash flows from operating activities:
Net income	$ 9,254	$ 8,473
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	12,761	13,134
Amortization related to above/(below) market leases, net	(93)	(102)
Amortization of debt premium	(27)	(27)
Amortization of deferred financing costs	329	324
Stock-based compensation expense	417	331
Gain on sale of land		(250)
Changes in assets and liabilities:
Lease receivable	226	332
Accrued expenses and other liabilities	107	(420)
Tenant reserves, deposits and deferred and prepaid rents	528	(382)
Accrued interest	(28)	(28)
Leasing costs paid	(387)	(591)
Other, net	118	657
Net cash provided by operating activities	23,205	21,451
Cash flows from investing activities:
Investments in LLCs	(3,204)	(598)
Cash distributions from LLCs	5,196	348
Additions to real estate investments, net	(13,302)	(2,956)
Cash proceeds received from divestiture of property, net		245
Net cash used in investing activities	(11,310)	(2,961)
Cash flows from financing activities:
Net borrowings/(repayments) on line of credit	8,300	(4,850)
Repayments of mortgage notes payable	(907)	(3,351)
Financing costs paid	(362)	(35)
Dividends paid	(18,917)	(9,279)
Issuance of shares of beneficial interest, net	223	61
Net cash used in financing activities	(11,663)	(17,454)
Increase in cash and cash equivalents	232	1,036
Cash and cash equivalents, beginning of period	6,110	5,036
Cash and cash equivalents, end of period	6,342	6,072
Supplemental disclosures of cash flow information:
Interest paid	4,047	5,204
Invoices accrued for construction and improvements	$ 2,071	$ 1,025

General

General	6 Months Ended
	Jun. 30, 2020
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, 2020. 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, 2020, we had investments in five jointly-owned LLCs/LPs (including one under construction which is scheduled to be completed in late 2020). We currently account for our share of the income/loss from these investments by the equity method (see Note 5). These LLCs are included in our consolidated financial statements for all periods presented on an unconsolidated basis since they are not variable interest entities for which we are the primary beneficiary, nor do we hold a controlling voting interest. 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, 2019. In March 2020, the World Health Organization declared the COVID-19 outbreak a pandemic and the federal government declared COVID-19 a national emergency. As a result of various policies implemented by the federal and state governments, and varying by individual state, many non-essential businesses in the nation were closed for varying periods of time. With the exception of the operators of our four preschool and childcare centers, which were closed from mid-March until mid-June, we believe that most of the tenants occupying our hospitals, medical office buildings (“MOBs”) and ambulatory care centers were permitted to continue operating if they elected to do so. Although COVID-19 has not had a material adverse impact on our results of operations through June 30, 2020, we believe that the potentially adverse impact that the pandemic may have on the future operations and financial results of our tenants, and in turn ours, will depend upon many factors, most of which are beyond our, or our tenants’, ability to control or predict. Many of our properties are located in states that have experienced significant increases in COVID-19 infections in June, July and early August. Such states include Arizona, California, Florida, Georgia, Nevada and Texas. Such factors include, but are not limited to, the length of time and severity of the spread of the pandemic; the volume of cancelled or rescheduled elective procedures and the volume of COVID-19 patients treated by the operators of our hospitals and other healthcare facilities; measures our tenants are taking to respond to the COVID-19 pandemic; the impact of government and administrative regulation, including travel bans and restrictions, shelter-in-place or stay-at-home orders, quarantines, the promotion of social distancing, business shutdowns and limitations on business activity; changes in patient volumes at our tenants’ hospitals and other healthcare facilities due to patients’ general concerns related to the risk of contracting COVID-19 from interacting with the healthcare system; the impact of stimulus on the health care industry and our tenants; changes in patient volumes and payer mix caused by deteriorating macroeconomic conditions (including increases in uninsured and underinsured patients as the result of business closings and layoffs); potential disruptions to clinical staffing and shortages and disruptions related to supplies required for our tenants’ employees and patients, including equipment, pharmaceuticals and medical supplies, particularly personal protective equipment, or PPE; potential increases to expenses incurred by our tenants related to staffing, supply chain or other expenditures; the impact of our indebtedness and the ability to refinance such indebtedness on acceptable terms; disruptions in the financial markets and the business of financial institutions as the result of the COVID-19 pandemic which could impact our ability to access capital or increase associated borrowing costs; and changes in general economic conditions nationally and regionally in the markets our properties are located resulting from the COVID-19 pandemic, including increased unemployment and underemployment levels and reduced consumer spending and confidence. Since the underlying businesses in each of our properties are operated by the tenants, we can provide no assurance that the businesses will continue to operate in the future, or stay current with their lease obligations. Bonus rents earned by us on the three acute care hospitals leased to wholly-owned subsidiaries of Universal Health Services, Inc., are computed based upon a computation that compares each hospital’s current quarter revenue to the corresponding quarter in the base year, we could therefore experience significant declines in future bonus rental revenue earned on these properties should those hospitals experience significant declines in patient volumes and revenues. These hospitals believe that, to the extent that they experience revenue declines and increased expenses resulting from the COVID-19 pandemic, as ultimately measured over the life of the pandemic, they are eligible for emergency fund grants as provided for by the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”). Certain factors may result in the inability or unwillingness on the part of some of our tenants to make timely payment of their rent to us at current levels or to seek to amend or terminate their leases which, in turn, would have an adverse effect on our occupancy levels and our revenue and cash flow and the value of our properties, and potentially, our ability to maintain our dividend at current levels. Due to COVID-19 restrictions and its impact on the economy, we may experience a decrease in prospective tenants which could unfavorably impact the volume of new leases, as well as the renewal rate of existing leases. The COVID-19 pandemic could also impact our indebtedness and the ability to refinance such indebtedness on acceptable terms, as well as risks associated with disruptions in the financial markets and the business of financial institutions as the result of the COVID-19 pandemic which could impact us from a financing perspective; and changes in general economic conditions nationally and regionally in the markets our properties are located resulting from the COVID-19 pandemic. Decreases in cash flows and results of operations may have an impact on the inputs and assumptions used in significant accounting estimates, including potential impairments of intangible and long-lived assets. 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, 2020
Related Party Transactions [Abstract]
Relationship with Universal Health Services, Inc. ("UHS") and Related Party Transactions	(2) Relationship with Universal Health Services, Inc. (“UHS”) and Related Party Transactions Leases: We commenced operations in 1986 by purchasing properties from certain subsidiaries of UHS and immediately leasing the properties back to the respective subsidiaries. Most of the leases were entered into at the time we commenced operations and provided for initial terms of 13 to 15 years with up to six additional 5-year renewal terms. The current base rentals and lease and renewal terms for each of the three hospital facilities leased to subsidiaries of UHS are provided below. The base rents are paid monthly and each lease also provides for additional or bonus rents which are computed and paid on a quarterly basis based upon a computation that compares current quarter revenue to a corresponding quarter in the base year. The three hospital leases with subsidiaries of UHS are unconditionally guaranteed by UHS and are cross-defaulted with one another. The combined revenues generated from the leases on the UHS hospital facilities accounted for approximately 22% and 21% of our consolidated revenues for the three months ended June 30, 2020 and 2019, respectively, and approximately 22% of our consolidated revenues for each of the six months ended June 30, 2020 and 2019. In addition, we have seventeen medical office buildings (“MOBs”), or free-standing emergency departments (“FEDs”), that are either wholly or jointly-owned by us (excluding new construction), that include tenants which are subsidiaries of UHS. The aggregate revenues generated from UHS-related tenants comprised approximately 32% and 30% of our consolidated revenues during the three-month periods ended June 30, 2020 and 2019, respectively, and approximately 32% and 31% of our consolidated revenues during the six-month periods ended June 30, 2020 and 2019, respectively. Pursuant to the Master Lease Document by and among us and certain subsidiaries of UHS, dated December 24, 1986 (the “Master Lease”), which governs the leases of all hospital properties with subsidiaries of UHS, UHS has the option 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 at the end of the lease terms or any renewal terms at the appraised fair market value. In addition, the Master Lease, as amended in 2006, includes a change of control provision whereby UHS has the right, upon one month’s notice should a change of control of the Trust occur, to purchase any or all of the three leased hospital properties listed below at their appraised fair market value. Additionally, UHS has rights of first refusal to: (i) purchase the respective leased facilities during and for 180 days 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 at the end of, and for 180 days after, the lease term at the same terms and conditions pursuant to any third-party offer. The table below details the existing lease terms and renewal options for our three Hospital Name Annual Minimum Rent End of Lease Term Renewal Term (years) McAllen Medical Center $ 5,485,000 December, 2026 5 (a.) Wellington Regional Medical Center $ 3,030,000 December, 2021 10 (b.) Southwest Healthcare System, Inland Valley Campus $ 2,648,000 December, 2021 10 (b.) (a . ) UHS has one (b . ) UHS has two Management cannot predict whether the leases with 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 lease revenue currently earned pursuant to these leases. We are the lessee on eleven ground leases with subsidiaries of UHS (for consolidated and unconsolidated investments). The remaining lease terms on the ground leases with subsidiaries of UHS range from approximately 29 years to approximately 79 years. The annual aggregate lease payments on these properties are approximately $482,000 for the year ended 2020 and $482,000 for each of the years ended 2021, 2022, 2023 and 2024, and an aggregate of $27.6 million thereafter. See Note 7 for further disclosure around our lease accounting. In late July, 2019 and September, 2019 we entered into two separate agreements with entities that are each related to wholly-owned subsidiaries of UHS in connection with newly constructed properties located in Clive, Iowa and Denison, Texas. Please see additional disclosure in Note 4, “ New Construction, Acquisitions and Dispositions”. Officers and Employees: Our officers are all employees of a wholly-owned subsidiary of UHS and although as of June 30, 2020 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. Our advisory fee for the three and six months ended June 30, 2020 and 2019, 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 2020, as compared to the last three years. 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 other 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 $1.0 million and $982,000 for the three months ended June 30, 2020 and 2019, respectively, and were based upon average invested real estate assets of $587 million and $561 million, respectively. Advisory fees incurred and paid (or payable) to UHS were approximately $2.0 million for each of the six months ended June 30, 2020 and 2019, and were based upon average invested real estate assets of $584 million and $558 million, respectively. Share Ownership: As of June 30, 2020 and December 31, 2019, 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 tenants comprised 32% and 30% of our consolidated revenues during the three-month periods ended June 30, 2020 and 2019, respectively, and 32% and 31% of our consolidated revenues during the six-month periods ended June 30, 2020 and 2019, respectively, and since a subsidiary of UHS is our Advisor, 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, 2020
Equity [Abstract]
Dividends and Equity Issuance Program	(3) Dividends and Equity Issuance Program Dividends and dividend equivalents: During the second quarter of 2020, we declared dividend and dividend equivalents of approximately $9.5 million, or $.69 per share and we paid dividends of approximately $9.5 million, or $.69 per share, on June 30, 2020. We declared and paid dividends of approximately $9.4 million, or $.68 per share, during the second quarter of 2019, which were paid on July 2, 2019. During the six-month period ended June 30, 2020, we declared dividend and dividend equivalents of approximately $18.9 million, or $1.375 per share and we paid dividends of $18.9 million, or $1.375 per share. During the six-month period ended June 30, 2019, we declared dividends of $18.6 million, or $1.355 per share, $9.4 million of which was paid on July 2, 2019. Dividend equivalents which were accrued during the three and six-month period of 2020 will be paid out upon the vesting of the related restricted stock award. Equity Issuance Program: During the second quarter of 2020, we commenced an at-the-market (“ATM”) equity issuance program, pursuant to the terms of which we may sell, from time-to-time, common shares of our beneficial interest up to an aggregate sales price of $100 million to or through BofA Securities, Inc., Credit Agricole Securities (USA) Inc., Fifth Third Securities, Inc., SunTrust Robinson Humphrey, Inc. and Wells Fargo Securities, LLC (collectively, the Agents). The common shares will be offered pursuant to the Registration Statement filed with the Securities and Exchange Commission, which became effective in June 2020. During the second quarter of 2020 and since inception, we have issued 2,704 shares at an average price of $101.30 per share, which generated approximately $270,000 of net proceeds (net of approximately $4,000, consisting of compensation to BofA Securities, Inc.). Additionally, we paid or incurred approximately $435,000 in various fees and expenses related to the commencement of our ATM program.

New Construction, Acquisitions

New Construction, Acquisitions and Dispositions	6 Months Ended
	Jun. 30, 2020
Business Combinations [Abstract]
New Construction, Acquisitions and Dispositions	(4) New Construction, Acquisitions and Dispositions Six Months Ended June 30, 2020: New Construction: In September, 2019, we entered into an agreement whereby we will own a 95% non-controlling ownership interest in Grayson Properties II L.P., which will develop, construct, own and operate the Texoma Medical Plaza II, an MOB located in Denison, Texas. This MOB, which is scheduled to be completed in late 2020, will be located on the campus of Texoma Medical Center, a hospital that is owned and operated by a wholly-owned subsidiary of UHS. A 10-year master flex lease was executed with the wholly-owned subsidiary of UHS for 40,000 rentable square feet, representing over 50% of the rentable square feet of the MOB. The master flex lease commitment is subject to reduction upon the execution of third-party leases on up to 20,000 rentable square feet of the first and second floors of the three-story MOB, and 20,000 rentable square feet on the third floor. In April, 2020, a new, 122-month lease was fully executed with a third-party tenant for approximately 26,000 rentable square feet on the first floor of the MOB. As a result, the master flex lease commitment was reduced to 20,000 of rentable square feet on the third floor of the MOB. After giving effect to this new lease, 61% of the rentable square feet of the MOB is under lease agreements (including the remaining master lease space). Effective June 1, 2020, a $13.1 million third-party construction loan (non-recourse to us) was obtained by the LP, which is scheduled to mature on June 1, 2025 and has an outstanding loan balance of $7.1 million as of June 30, 2020. Additionally, we have committed to invest up to $4.8 million in equity or member loans in the development and construction of this MOB, none of which has been invested as of June 30, 2020. In July, 2019, Des Moines Medical Properties, LLC, a wholly-owned subsidiary of ours, entered into an agreement to build and lease a newly constructed behavioral health care hospital located in Clive, Iowa. The lease on this facility, which is triple net and has an initial term of 20-years with five 10-year renewal options, was executed with Clive Behavioral Health, LLC, a joint venture between UHS and Catholic Health Initiatives - Iowa, Corp. (d/b/a Mercy One Des Moines Medical Center). Construction of this hospital, for which we have engaged a wholly-owned subsidiary of UHS to act as project manager for an aggregate fee of approximately $750,000, is expected to be completed in late 2020 or early 2021. The hospital lease will commence upon issuance of the certificate of occupancy. The approximate cost of the project is estimated to be $37.5 million and the initial annual rent is estimated to be approximately $2.7 million. We have invested approximately $17.4 million for land and the development and construction costs of this hospital as of June 30, 2020 (including accrued costs at June 30, 2020). Acquisitions: There were no acquisitions during the first six months of 2020. Dispositions: There were no dispositions during the first six months of 2020. Six Months Ended June 30, 2019: Acquisitions: There were no acquisitions during the first six months of 2019. Dispositions: There were no dispositions during the first six months of 2019.

Summarized Financial Informatio

Summarized Financial Information of Equity Affiliates	6 Months Ended
	Jun. 30, 2020
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 represent 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, 2020, we have non-controlling equity investments or commitments in five jointly-owned LLCs/LPs which own MOBs (including one currently under construction which is scheduled to be completed in late 2020). As of June 30, 2020, we accounted for these LLCs/LPs on an unconsolidated basis pursuant to the 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 five LLCs/LPs in which we own a non-controlling interest (including one that is currently under construction) and were accounted for under the equity method as of June 30, 2020: Name of LLC/LP Ownership Property Owned by LLC/LP Suburban Properties 33 % St. Matthews Medical Plaza II Brunswick Associates (a.)(e.) 74 % Mid Coast Hospital MOB Grayson Properties (b.)(f.) 95 % Texoma Medical Plaza FTX MOB Phase II (c.) 95 % Forney Medical Plaza II Grayson Properties II (d.)(f.) 95 % Texoma Medical Plaza II (a.) This LLC has a third-party term loan of $8.0 million, which is non-recourse to us, outstanding as of June 30, 2020. (b.) This building is on the campus of a UHS hospital and has tenants that include subsidiaries of UHS. This LP has a third-party term loan, which is non-recourse to us, of $13.5 million, outstanding as of June 30, 2020. (c.) We have committed to invest up to $2.5 million in equity and debt financing, of which $2.1 million has been funded as of June 30, 2020. This LP has a third-party term loan, which is non-recourse to us, of $4.9 million, outstanding as of June 30, 2020. (d.) This MOB, currently under construction, will be 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 $ 4.8 million in equity and debt financing , no ne of which has been funded as of June 30, 2020 . This LP entered into a $ 13.1 million third-party construction loan, which is non-recourse to us and has an outstanding balance of $ 7.1 million as of June 30, 2020 . The L P will develop, construct, own and operate the Texoma Medical Plaza II which is expected to open in late 2020 . (e.) The LLC is the lessee with a third party lessor under a ground lease for land. (f.) The LPs are the lessee, or have committed to a lease, 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 (excluding one that owns an MOB that is currently under construction) accounted for under the equity method at June 30, 2020 and 2019. Three Months Ended June 30, Six Months Ended June 30, 2020 2019 2020 2019 (amounts in thousands) (amounts in thousands) Revenues $ 2,497 $ 2,531 $ 5,013 $ 4,991 Operating expenses 1,019 994 2,047 2,006 Depreciation and amortization 447 485 889 883 Interest, net 316 322 634 644 Net income $ 715 $ 730 $ 1,443 $ 1,458 Our share of net income $ 419 $ 454 $ 854 $ 884 Below are the condensed combined balance sheets (unaudited) for the five above-mentioned LLCs/LPs (including one LP that currently owns an MOB under construction) that were accounted for under the equity method as of June 30, 2020 and December 31, 2019: June 30, 2020 December 31, 2019 (amounts in thousands) Net property, including construction in progress $ 37,313 $ 33,207 Other assets (a.) 7,590 7,452 Total assets $ 44,903 $ 40,659 Other liabilities (a.) $ 6,138 $ 6,785 Mortgage notes payable, non-recourse to us 33,428 26,650 Equity 5,337 7,224 Total liabilities and equity $ 44,903 $ 40,659 Investments in LLCs before amounts included in accrued expenses and other liabilities $ 4,408 $ 6,918 Amounts included in accrued expenses and other liabilities (1,655 ) (1,856 ) Our share of equity in LLCs, net $ 2,753 $ 5,062 (a.) Other assets and other liabilities as of both June 30, 2020 and December 31, 2019 includes approximately $3.7 million 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 of June 3 0 , 20 20 , and December 31, 20 19 , 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 6/30/2020 12/31/2019 Maturity Date FTX MOB Phase II (5.00% fixed rate mortgage loan) (b.) $ 4,852 $ 4,926 October, 2020 Grayson Properties (5.034% fixed rate mortgage loan) 13,515 13,658 September, 2021 Brunswick Associates (3.64% fixed rate mortgage loan) 7,967 8,066 December, 2024 Grayson Properties II (3.70% fixed rate construction loan) (c.) 7,094 - June, 2025 $ 33,428 $ 26,650 (a.) All mortgage loans require monthly principal payments through maturity and include a balloon principal payment upon maturity. (b.) This loan is scheduled to mature within the next twelve months, at which time the venture intends to refinance pursuant to a new mortgage loan. (c.) This construction loan has a maximum balance of $13.1 million and requires unpaid interest on the outstanding principal balance to be paid on a monthly basis through December 1, 2022. Principal and accrued interest monthly payments will commence on January 1, 2023. Pursuant to the operating and/or partnership agreements of the five LLCs/LPs in which we continue to hold non-controlling ownership interests, the third-party member and/or 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, 2020
Accounting Policies [Abstract]
Recent Accounting Pronouncements	(6) Recent Accounting Pronouncements Accounting for Lease Concessions Granted in Connection with the COVID-19 Outbreak On April 8, 2020, the Financial Accounting Standards Board ("FASB") held a public meeting and shortly afterwards issued a question-and-answer ("Q&A") document which was intended to provide accounting relief for lease concessions related to the COVID-19 pandemic. The accounting relief permits an entity to choose to forgo the evaluation of the enforceable rights and obligations of a lease contract, which is a requirement of Accounting Standards Codification Topic 842, Leases, as long as the total rent payments after the lease concessions are substantially the same, or less than, the total payments previously required by the lease. An entity may account for COVID-19 related lease concessions either (i) as if they were part of the enforceable rights and obligations of the parties under the existing lease contract; or (ii) as a lease modification. To the extent that a rent concession is granted as a deferral of payments, but the total lease payments are substantially the same, lessors are allowed to account for the concession as if no change had been made to the original lease contract. Based on the Q&A, an entity is not required to account for all lease concessions related to the effects of the COVID-19 pandemic under one elected option, however, the entity is required to apply the elected option consistently to leases with similar characteristics and in similar circumstances. The COVID-19 pandemic did not start to adversely impact the economic conditions in the United States until late March 2020 and did not have a material effect on our operations or financial results during the three or six months ended June 30, 2020. We have received short-term rent deferral requests from a portion of tenants under lease at our MOBs. These requests are under review on a request-by-request basis based upon each tenant’s specific circumstances as well as consideration of potential economic benefit available and received by tenants through governmental assistance programs. At this time, we cannot estimate the magnitude of short-term rent deferral requests that we may ultimately agree to provide, or the magnitude of additional short-term rent deferral requests that we may receive in the future. 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. We will evaluate the impact of the guidance and may apply elections as applicable as additional changes in the market occur. Financial Instruments – Credit Losses In June 2016, the FASB issued ASU 2016-13, "Financial Instruments - Credit Losses," which introduced new guidance for an approach based on expected losses to estimate credit losses on certain types of financial instruments. Instruments in scope include loans, held-to-maturity debt securities, and net investments in leases as well as reinsurance and trade receivables. In November 2018, the FASB issued ASU 2018-19, which clarifies that operating lease receivables are outside the scope of the new standard. The standard was effective for us in fiscal years beginning after December 15, 2019. The adoption of this guidance did not have a material impact on our consolidated financial statements.

Lease Accounting

Lease Accounting	6 Months Ended
	Jun. 30, 2020
Leases [Abstract]
Lease Accounting	(7) Lease Accounting As Lessor: We lease our operating properties to customers under agreements that are classified as operating leases. We recognize the total minimum lease payments provided for under the 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 as our leases qualify as operating leases, we accounted for and presented rental revenue and tenant reimbursements as a single component under Lease revenue in our condensed consolidated statements of income for the three and six months ended June 30, 2020 and 2019. 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, 2020 and 2019 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 lease term. 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, 2020 2019 2020 2019 UHS facilities: Base rents $ 4,294 $ 4,115 $ 8,538 $ 8,289 Bonus rents 1,417 1,352 2,797 2,746 Tenant reimbursements 270 184 527 409 Lease revenue - UHS facilities $ 5,981 $ 5,651 $ 11,862 $ 11,444 Non-related parties: Base rents 10,387 10,660 20,765 21,020 Tenant reimbursements 2,456 2,518 4,920 4,889 Lease revenue - Non-related parties $ 12,843 $ 13,178 $ 25,685 $ 25,909 As Lessee: We are the lessee with various third parties, including subsidiaries of UHS, in connection with ground leases for land at fourteen 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, in determining the present value of lease payments. As of June 30, 2020, our condensed consolidated balance sheet includes right-of-use land assets of approximately $8.9 million and ground lease liabilities of approximately $8.9 million. There were no newly leased assets for which a right-of-use asset was recorded in exchange for a new lease liability during the six months ended June 30, 2020.

Debt and Financial Instruments

Debt and Financial Instruments	6 Months Ended
	Jun. 30, 2020
Debt Disclosure [Abstract]
Debt and Financial Instruments	(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 $350 million 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 additional equity issuances pursuant to our ATM equity issuance program. 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. In June 2020, we entered into the first amendment (the “First Amendment”) to the revolving credit agreement (“Credit Agreement”), pursuant to which, among other things, an additional tranche of revolving credit commitments in the amount of $50 million, designated as the “Revolving B Facility”, was established thereby increasing the aggregate revolving credit commitment to $350 million from $300 million. The Credit Agreement, as amended, which is scheduled to mature in March 2022, provides for a revolving credit facility in an aggregate principal amount of $350 million, including a $40 million sublimit for letters of credit and a $30 million sublimit for swingline/short-term loans. The Credit Agreement also provides for options to extend the maturity date for two additional six month periods. Borrowings under the Credit Agreement are guaranteed by certain subsidiaries of the Trust. In addition, borrowings under the Credit Agreement are secured by first priority security interests in and liens on all equity interests in certain of the Trust’s wholly-owned subsidiaries. The remainder of the revolving credit commitments provided under the Credit Agreement that were in effect prior to giving effect to the First Amendment, has been designated as the “Revolving A Facility”. Borrowings made pursuant to the Revolving A Facility will bear interest, at our option, at one, two, three, or six-month LIBOR plus an applicable margin ranging from 1.10% to 1.35% or at the Base Rate plus an applicable margin ranging from 0.10% to 0.35%. The Credit Agreement defines “Base Rate” as the greater of: (a) the administrative agent’s prime rate; (b) the federal funds effective rate plus 1/2 Borrowings made pursuant to the Revolving B Facility will bear interest, at our option, at one, two, three, or six months LIBOR plus an applicable margin ranging from 1.85% to 2.10% or at the Base Rate plus an applicable margin ranging from 0.85% to 1.10%. The Credit Agreement defines “Base Rate” as the greatest of (a) the Administrative Agent’s prime rate, (b) the federal funds effective rate plus 1/2 1.95 %, the margin over the Base Rate was 0.95 % and the facility fee was 0.20%. At June 30, 2020, we had $221.3 million of outstanding borrowings and $5.6 million of letters of credit outstanding under our Credit Agreement. We had $123.1 million of available borrowing capacity, net of the outstanding borrowings and letters of credit outstanding as of June 30, 2020. There are no compensating balance requirements. At December 31, 2019, we had $213.0 million of outstanding borrowings outstanding against our revolving credit agreement and $87.0 million of available borrowing capacity. 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 outstanding under the Credit Agreement. We are in compliance with all of the covenants at June 30, 2020 and December 31, 2019. 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, 2020 December 31, 2019 Tangible net worth > =$125,000 $ 153,292 $ 167,181 Total leverage < 60% 43.6 % 42.3 % Secured leverage < 30% 9.0 % 9.1 % Unencumbered leverage < 60% 40.2 % 38.5 % Fixed charge coverage > 1.50x 4.3x 4.0x 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, 2020 (amounts in thousands): Outstanding Balance (in Interest Rate Maturity Date 700 Shadow Lane and Goldring MOBs fixed rate mortgage loan $ 5,547 4.54 % June, 2022 BRB Medical Office Building fixed rate mortgage loan 5,614 4.27 % December, 2022 Desert Valley Medical Center fixed rate mortgage loan 4,587 3.62 % January, 2023 2704 North Tenaya Way fixed rate mortgage loan 6,653 4.95 % November, 2023 Summerlin Hospital Medical Office Building III fixed rate mortgage loan 13,158 4.03 % April, 2024 Tuscan Professional Building fixed rate mortgage loan 3,216 5.56 % June, 2025 Phoenix Children’s East Valley Care Center fixed rate mortgage loan 8,841 3.95 % January, 2030 Rosenberg Children's Medical Plaza fixed rate mortgage loan 12,621 4.42 % September, 2033 Total, excluding net debt premium and net financing fees 60,237 Less net financing fees (533 ) Plus net debt premium 167 Total mortgages notes payable, non-recourse to us, net $ 59,871 (a.) All mortgage loans require monthly principal payments through maturity and either fully amortize or include a balloon principal payment upon maturity. 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, 2020 had a combined fair value of approximately $62.4 million. At December 31, 2019, we had various mortgages, all of which were non-recourse to us, included in our condensed consolidated balance sheet. The combined outstanding balance of these various mortgages was $61.1 million and had a combined fair value of approximately $63.1 million. The fair value of our debt was 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 March 2020, we entered into an In January 2020, we entered into an During the third quarter of 2019, we entered into an the one-month LIBOR is less than 1.144 %, we pay the counterparty, the difference between the fixed rate of 1.144 % and one-month LIBOR. 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, 2020, the fair value of our interest rate swaps was a net liability of $4.9 million which is included in accrued expenses and other liabilities on the accompanying condensed consolidated balance sheet. During the second quarter of 2020, we paid or accrued approximately $182,000 in net payments made to the counterparty by us, adjusted for the previous quarter accrual, pursuant to the terms of the swaps (consisting of approximately $201,000 in payments, adjusted for the previous quarter accrual, or accruals made to the counterparty by us, offset by approximately $19,000 paid to us by the counterparty). During the first six months of 2020, we paid or accrued approximately $131,000 in net payments made to the counterparty by us, adjusted for the previous quarter accrual, pursuant to the terms of the swaps (consisting of approximately $222,000 in payments, adjusted for the previous quarter accrual, or accruals made to the counterparty by us, offset by approximately $91,000 of payments paid to us by the counterparty). From inception of the swap agreements through June 30, 2020 we paid or accrued approximately $23,000 in net payments made to the counterparty by us pursuant to the terms of the swap (consisting of approximately $199,000 in payments or accruals made to us by the counterparty, offset by approximately $222,000 of payments due to the counterparty from us). 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 classified from AOCI to the income statement in the period or periods the hedged transaction affects earnings. During the third quarter of 2016, we entered into an March, 2019 During the second quarter of 2016, we entered into an March 2019

Segment Reporting

Segment Reporting	6 Months Ended
	Jun. 30, 2020
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 segment.

Recent Accounting Pronounceme_2

Recent Accounting Pronouncements (Policies)	6 Months Ended
	Jun. 30, 2020
Accounting Policies [Abstract]
Recent Accounting Pronouncements	Accounting for Lease Concessions Granted in Connection with the COVID-19 Outbreak On April 8, 2020, the Financial Accounting Standards Board ("FASB") held a public meeting and shortly afterwards issued a question-and-answer ("Q&A") document which was intended to provide accounting relief for lease concessions related to the COVID-19 pandemic. The accounting relief permits an entity to choose to forgo the evaluation of the enforceable rights and obligations of a lease contract, which is a requirement of Accounting Standards Codification Topic 842, Leases, as long as the total rent payments after the lease concessions are substantially the same, or less than, the total payments previously required by the lease. An entity may account for COVID-19 related lease concessions either (i) as if they were part of the enforceable rights and obligations of the parties under the existing lease contract; or (ii) as a lease modification. To the extent that a rent concession is granted as a deferral of payments, but the total lease payments are substantially the same, lessors are allowed to account for the concession as if no change had been made to the original lease contract. Based on the Q&A, an entity is not required to account for all lease concessions related to the effects of the COVID-19 pandemic under one elected option, however, the entity is required to apply the elected option consistently to leases with similar characteristics and in similar circumstances. The COVID-19 pandemic did not start to adversely impact the economic conditions in the United States until late March 2020 and did not have a material effect on our operations or financial results during the three or six months ended June 30, 2020. We have received short-term rent deferral requests from a portion of tenants under lease at our MOBs. These requests are under review on a request-by-request basis based upon each tenant’s specific circumstances as well as consideration of potential economic benefit available and received by tenants through governmental assistance programs. At this time, we cannot estimate the magnitude of short-term rent deferral requests that we may ultimately agree to provide, or the magnitude of additional short-term rent deferral requests that we may receive in the future. 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. We will evaluate the impact of the guidance and may apply elections as applicable as additional changes in the market occur. Financial Instruments – Credit Losses In June 2016, the FASB issued ASU 2016-13, "Financial Instruments - Credit Losses," which introduced new guidance for an approach based on expected losses to estimate credit losses on certain types of financial instruments. Instruments in scope include loans, held-to-maturity debt securities, and net investments in leases as well as reinsurance and trade receivables. In November 2018, the FASB issued ASU 2018-19, which clarifies that operating lease receivables are outside the scope of the new standard. The standard was effective for us in fiscal years beginning after December 15, 2019. The adoption of this guidance did not have a material impact on our consolidated financial statements.

Relationship with Universal H_2

Relationship with Universal Health Services, Inc. ("UHS") and Related Party Transactions (Tables)	6 Months Ended
	Jun. 30, 2020
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 our three Hospital Name Annual Minimum Rent End of Lease Term Renewal Term (years) McAllen Medical Center $ 5,485,000 December, 2026 5 (a.) Wellington Regional Medical Center $ 3,030,000 December, 2021 10 (b.) Southwest Healthcare System, Inland Valley Campus $ 2,648,000 December, 2021 10 (b.) (a . ) UHS has one (b . ) UHS has two

Summarized Financial Informat_2

Summarized Financial Information of Equity Affiliates (Tables)	6 Months Ended
	Jun. 30, 2020
Equity Method Investments And Joint Ventures [Abstract]
Limited Liability Companies Accounted for Under Equity Method	The following property table represents the five LLCs/LPs in which we own a non-controlling interest (including one that is currently under construction) and were accounted for under the equity method as of June 30, 2020: Name of LLC/LP Ownership Property Owned by LLC/LP Suburban Properties 33 % St. Matthews Medical Plaza II Brunswick Associates (a.)(e.) 74 % Mid Coast Hospital MOB Grayson Properties (b.)(f.) 95 % Texoma Medical Plaza FTX MOB Phase II (c.) 95 % Forney Medical Plaza II Grayson Properties II (d.)(f.) 95 % Texoma Medical Plaza II (a.) This LLC has a third-party term loan of $8.0 million, which is non-recourse to us, outstanding as of June 30, 2020. (b.) This building is on the campus of a UHS hospital and has tenants that include subsidiaries of UHS. This LP has a third-party term loan, which is non-recourse to us, of $13.5 million, outstanding as of June 30, 2020. (c.) We have committed to invest up to $2.5 million in equity and debt financing, of which $2.1 million has been funded as of June 30, 2020. This LP has a third-party term loan, which is non-recourse to us, of $4.9 million, outstanding as of June 30, 2020. (d.) This MOB, currently under construction, will be 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 $ 4.8 million in equity and debt financing , no ne of which has been funded as of June 30, 2020 . This LP entered into a $ 13.1 million third-party construction loan, which is non-recourse to us and has an outstanding balance of $ 7.1 million as of June 30, 2020 . The L P will develop, construct, own and operate the Texoma Medical Plaza II which is expected to open in late 2020 . (e.) The LLC is the lessee with a third party lessor under a ground lease for land. (f.) The LPs are the lessee, or have committed to a lease, 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 (excluding one that owns an MOB that is currently under construction) accounted for under the equity method at June 30, 2020 and 2019. Three Months Ended June 30, Six Months Ended June 30, 2020 2019 2020 2019 (amounts in thousands) (amounts in thousands) Revenues $ 2,497 $ 2,531 $ 5,013 $ 4,991 Operating expenses 1,019 994 2,047 2,006 Depreciation and amortization 447 485 889 883 Interest, net 316 322 634 644 Net income $ 715 $ 730 $ 1,443 $ 1,458 Our share of net income $ 419 $ 454 $ 854 $ 884
Condensed Combined Balance Sheets (Unaudited) for LLCs/LPs Accounted Under Equity Method	Below are the condensed combined balance sheets (unaudited) for the five above-mentioned LLCs/LPs (including one LP that currently owns an MOB under construction) that were accounted for under the equity method as of June 30, 2020 and December 31, 2019: June 30, 2020 December 31, 2019 (amounts in thousands) Net property, including construction in progress $ 37,313 $ 33,207 Other assets (a.) 7,590 7,452 Total assets $ 44,903 $ 40,659 Other liabilities (a.) $ 6,138 $ 6,785 Mortgage notes payable, non-recourse to us 33,428 26,650 Equity 5,337 7,224 Total liabilities and equity $ 44,903 $ 40,659 Investments in LLCs before amounts included in accrued expenses and other liabilities $ 4,408 $ 6,918 Amounts included in accrued expenses and other liabilities (1,655 ) (1,856 ) Our share of equity in LLCs, net $ 2,753 $ 5,062 (a.) Other assets and other liabilities as of both June 30, 2020 and December 31, 2019 includes approximately $3.7 million 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 and Construction Notes Payable by Unconsolidated LLC's/LPs Accounted Under Equity Method	Mortgage Loan Balance (a.) Name of LLC/LP 6/30/2020 12/31/2019 Maturity Date FTX MOB Phase II (5.00% fixed rate mortgage loan) (b.) $ 4,852 $ 4,926 October, 2020 Grayson Properties (5.034% fixed rate mortgage loan) 13,515 13,658 September, 2021 Brunswick Associates (3.64% fixed rate mortgage loan) 7,967 8,066 December, 2024 Grayson Properties II (3.70% fixed rate construction loan) (c.) 7,094 - June, 2025 $ 33,428 $ 26,650 (a.) All mortgage loans require monthly principal payments through maturity and include a balloon principal payment upon maturity. (b.) This loan is scheduled to mature within the next twelve months, at which time the venture intends to refinance pursuant to a new mortgage loan. (c.) This construction loan has a maximum balance of $13.1 million and requires unpaid interest on the outstanding principal balance to be paid on a monthly basis through December 1, 2022. Principal and accrued interest monthly payments will commence on January 1, 2023.

Lease Accounting (Tables)

Lease Accounting (Tables)	6 Months Ended
	Jun. 30, 2020
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, 2020 and 2019 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 lease term. 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, 2020 2019 2020 2019 UHS facilities: Base rents $ 4,294 $ 4,115 $ 8,538 $ 8,289 Bonus rents 1,417 1,352 2,797 2,746 Tenant reimbursements 270 184 527 409 Lease revenue - UHS facilities $ 5,981 $ 5,651 $ 11,862 $ 11,444 Non-related parties: Base rents 10,387 10,660 20,765 21,020 Tenant reimbursements 2,456 2,518 4,920 4,889 Lease revenue - Non-related parties $ 12,843 $ 13,178 $ 25,685 $ 25,909

Debt and Financial Instruments

Debt and Financial Instruments (Tables)	6 Months Ended
	Jun. 30, 2020
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, 2020 December 31, 2019 Tangible net worth > =$125,000 $ 153,292 $ 167,181 Total leverage < 60% 43.6 % 42.3 % Secured leverage < 30% 9.0 % 9.1 % Unencumbered leverage < 60% 40.2 % 38.5 % Fixed charge coverage > 1.50x 4.3x 4.0x
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, 2020 (amounts in thousands): Outstanding Balance (in Interest Rate Maturity Date 700 Shadow Lane and Goldring MOBs fixed rate mortgage loan $ 5,547 4.54 % June, 2022 BRB Medical Office Building fixed rate mortgage loan 5,614 4.27 % December, 2022 Desert Valley Medical Center fixed rate mortgage loan 4,587 3.62 % January, 2023 2704 North Tenaya Way fixed rate mortgage loan 6,653 4.95 % November, 2023 Summerlin Hospital Medical Office Building III fixed rate mortgage loan 13,158 4.03 % April, 2024 Tuscan Professional Building fixed rate mortgage loan 3,216 5.56 % June, 2025 Phoenix Children’s East Valley Care Center fixed rate mortgage loan 8,841 3.95 % January, 2030 Rosenberg Children's Medical Plaza fixed rate mortgage loan 12,621 4.42 % September, 2033 Total, excluding net debt premium and net financing fees 60,237 Less net financing fees (533 ) Plus net debt premium 167 Total mortgages notes payable, non-recourse to us, net $ 59,871 (a.) All mortgage loans require monthly principal payments through maturity and either fully amortize or include a balloon principal payment upon maturity.

General - Additional Informatio

General - Additional Information (Detail)	Jun. 30, 2020PropertyHospital
Preschool And Childcare Center
Organization Consolidation And Presentation Of Financial Statements [Line Items]
Number of acute care hospitals	4
COVID-19
Organization Consolidation And Presentation Of Financial Statements [Line Items]
Number of acute care hospitals | Hospital	3
4 Unconsolidated Limited Liability Companies / Limited Partner | Minimum
Organization Consolidation And Presentation Of Financial Statements [Line Items]
Non-controlling equity interest, ownership percentage	33.00%
4 Unconsolidated Limited Liability Companies / Limited Partner | Maximum
Organization Consolidation And Presentation Of Financial Statements [Line Items]
Non-controlling equity interest, ownership percentage	95.00%
Limited Liability Companies
Organization Consolidation And Presentation Of Financial Statements [Line Items]
Number of real estate investments	5

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
	Jun. 30, 2020USD ($)PropertyTimeLease	Jun. 30, 2019USD ($)	Jun. 30, 2020USD ($)PropertyTimeLease	Jun. 30, 2019USD ($)	Dec. 31, 2019
Related Party Transaction [Line Items]
Annual advisory fee as percentage of average invested real estate assets	0.70%	0.70%	0.70%	0.70%
Universal Health Services, Inc
Related Party Transaction [Line Items]
Number of term renewal options | Time	6		6
Additional renewal terms			5 years
Number of medical office buildings and free standing emergency departments | Property			17
Option to renew lease, notice period prior to termination date of current term			90 days
Period to purchase respective leased facilities at same price after lease terms			180 days
Renewal period of respective leased facilities at same price after lease terms			180 days
Number of renewal options at existing lease rate | Time			3
Number of ground leases | Lease	11		11
Aggregate lease payments for 2020	$ 482,000		$ 482,000
Aggregate lease payments for 2021	482,000		482,000
Aggregate lease payments for 2022	482,000		482,000
Aggregate lease payments for 2023	482,000		482,000
Aggregate lease payments for 2024	482,000		482,000
Aggregate lease payments for thereafter	$ 27,600,000		$ 27,600,000
Percentage ownership of outstanding shares	5.70%		5.70%		5.70%
Universal Health Services, Inc | Customer Concentration Risk | Revenues
Related Party Transaction [Line Items]
Percentage of revenues generated from leases and tenants	22.00%	21.00%	22.00%	22.00%
Universal Health Services, Inc | Customer Concentration Risk | Revenues | Tenants
Related Party Transaction [Line Items]
Percentage of revenues generated from leases and tenants	32.00%	30.00%	32.00%	31.00%
Universal Health Services, Inc | Hospital Facilities Leased
Related Party Transaction [Line Items]
Number of acute care hospitals | Property	3		3
Universal Health Services, Inc | Minimum
Related Party Transaction [Line Items]
Initial lease terms			13 years
Remaining lease terms on ground leases			29 years
Universal Health Services, Inc | Maximum
Related Party Transaction [Line Items]
Initial lease terms			15 years
Remaining lease terms on ground leases			79 years
Universal Health Services of Delaware Inc
Related Party Transaction [Line Items]
Advisory fee	$ 1,000,000	$ 982,000,000,000	$ 2,000,000	$ 2,000,000
Cost, Product and Service [Extensible List]	us-gaap:ManagementServiceMember	us-gaap:ManagementServiceMember	us-gaap:ManagementServiceMember	us-gaap:ManagementServiceMember
Average invested real estate assets	$ 587,000,000	$ 561,000,000	$ 584,000,000	$ 558,000,000

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, 2020USD ($)
McAllen Medical Center
Operating Leased Assets [Line Items]
Annual Minimum Rent	$ 5,485,000
End of Lease Term	2026-12
Renewal Term (years)	5 years	[1]
Wellington Regional Medical Center
Operating Leased Assets [Line Items]
Annual Minimum Rent	$ 3,030,000
End of Lease Term	2021-12
Renewal Term (years)	10 years	[2]
Southwest Healthcare System, Inland Valley Campus
Operating Leased Assets [Line Items]
Annual Minimum Rent	$ 2,648,000
End of Lease Term	2021-12
Renewal Term (years)	10 years	[2]
[1]	UHS has one
[2]	UHS has two

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, 2020TimeRenewalOption
Operating Leased Assets [Line Items]
Number of renewal option at existing lease rate	3
McAllen Medical Center
Operating Leased Assets [Line Items]
Number of renewal option at existing lease rate	1
Renewal option term at existing lease rate	5 years
Renewal option at existing lease rate expiration year	2031
Wellington Regional Medical Center And Southwest Healthcare System
Operating Leased Assets [Line Items]
Number of renewal options at fair market value lease rates | RenewalOption	2
Renewal options term at fair market value lease rates	5 years
Wellington Regional Medical Center And Southwest Healthcare System | Minimum
Operating Leased Assets [Line Items]
Renewal options at fair market value lease rates expiration year	2022
Wellington Regional Medical Center And Southwest Healthcare System | Maximum
Operating Leased Assets [Line Items]
Renewal options at fair market value lease rates expiration year	2031

Dividends and Equity Issuance_2

Dividends and Equity Issuance Program - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	Jul. 02, 2019	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Dividends and Equity Issuance [Line Items]
Dividends declared		$ 9,501	$ 9,354	$ 18,925	$ 18,633
Declared dividends, per share		$ 0.69		$ 1.375	$ 1.355
Dividends payable, date to be paid		Jun. 30, 2020	Jul. 2, 2019		Jul. 2, 2019
Dividends declared and paid	$ 9,400	$ 9,500	$ 9,400	$ 18,917	$ 9,279
Declared and paid dividends, per share		$ 0.69	$ 0.68	$ 1.375
At-The-Market Equity Issuance Program (ATM)
Dividends and Equity Issuance [Line Items]
Aggregate sales of threshold amount		$ 100,000		$ 100,000
Issued (in shares)		2,704
Average sale price per share		$ 101.30
Net cash proceeds from stock issued		$ 270,000
Payment of stock issuance cost		4,000
At-The-Market Equity Issuance Program (ATM) | Other Expenses
Dividends and Equity Issuance [Line Items]
Payments for stock issuance		$ 435,000

New Construction, Acquisition_2

New Construction, Acquisitions and Dispositions - Additional Information (Detail)	1 Months Ended			6 Months Ended
	Apr. 30, 2020ft²	Sep. 30, 2019USD ($)ft²	Jul. 31, 2019USD ($)Time	Jun. 30, 2020USD ($)TimeAcquisitionDisposition	Jun. 30, 2019AcquisitionDisposition
Business Acquisitions And Dispositions [Line Items]
Outstanding Loan Balance		$ 7,100
Construction Loans Scheduled Maturity		Jun. 1, 2025
Number of acquisitions | Acquisition				0	0
Number of dispositions | Disposition				0	0
Medical Office Buildings Third Floor
Business Acquisitions And Dispositions [Line Items]
Rentable square feet reduced in master flex lease commitment | ft²	20,000
Medical office buildings
Business Acquisitions And Dispositions [Line Items]
Third-party tenant lease term	122 months
Medical Office Buildings First Floor
Business Acquisitions And Dispositions [Line Items]
Percentage of rentable square feet	61.00%
Universal Health Services, Inc
Business Acquisitions And Dispositions [Line Items]
Master flex lease term		10 years
Rentable square feet | ft²		40,000
Percentage of rentable square feet		50.00%
Number of term renewal options | Time				6
Universal Health Services, Inc | Medical Office Buildings Third Floor
Business Acquisitions And Dispositions [Line Items]
Rentable square feet | ft²		20,000
Universal Health Services, Inc | Maximum | Medical Office Buildings First and Second Floor
Business Acquisitions And Dispositions [Line Items]
Rentable square feet | ft²		20,000
Third-Party Tenant
Business Acquisitions And Dispositions [Line Items]
Construction Loan		$ 13,100
Third-Party Tenant | Medical Office Buildings First Floor
Business Acquisitions And Dispositions [Line Items]
Rentable square feet | ft²	26,000
Universal Health Services, Inc and Catholic Health Initiatives
Business Acquisitions And Dispositions [Line Items]
Triple net lease agreement period			20 years
Number of term renewal options | Time			5
Renewal option term			10 years
Project manager's aggregate fee			$ 750,000
Estimated approximate project cost			37,500,000
Estimated initial annual rent			$ 2,700,000
Des Moines Medical Properties, LLC
Business Acquisitions And Dispositions [Line Items]
Land and development and construction costs				$ 17,400,000
Grayson Properties II LP | Medical office buildings
Business Acquisitions And Dispositions [Line Items]
Committed investment in equity or member loans		0
Grayson Properties II LP | Maximum | Medical office buildings
Business Acquisitions And Dispositions [Line Items]
Commitment to investment		$ 4,800
Grayson Properties II LP | Denison, Texas
Business Acquisitions And Dispositions [Line Items]
Non-controlling equity interest, ownership percentage		95.00%

Summarized Financial Informat_3

Summarized Financial Information of Equity Affiliates - Additional Information (Detail)	6 Months Ended
	Jun. 30, 2020Property
Limited Liability Companies | Medical office buildings
Schedule Of Equity Method Investments [Line Items]
Number of real estate investments	5
Number of real estate investments under construction	1
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	33.00%
4 Unconsolidated Limited Liability Companies / Limited Partner | Maximum
Schedule Of Equity Method Investments [Line Items]
Non-controlling equity interest, ownership percentage	95.00%

Limited Liability Companies Acc

Limited Liability Companies Accounted for Under Equity Method (Detail) - Equity Method Investments	6 Months Ended
	Jun. 30, 2020
Suburban Properties
Schedule Of Equity Method Investments [Line Items]
Ownership	33.00%
Property Owned by LLC/LP	St. Matthews Medical Plaza II
Brunswick Associates
Schedule Of Equity Method Investments [Line Items]
Ownership	74.00%	[1],[2]
Property Owned by LLC/LP	Mid Coast Hospital MOB	[1],[2]
Grayson Properties
Schedule Of Equity Method Investments [Line Items]
Ownership	95.00%	[3],[4]
Property Owned by LLC/LP	Texoma Medical Plaza	[3],[4]
FTX MOB Phase II limited partnership
Schedule Of Equity Method Investments [Line Items]
Ownership	95.00%	[5]
Property Owned by LLC/LP	Forney Medical Plaza II	[5]
Grayson Properties II
Schedule Of Equity Method Investments [Line Items]
Ownership	95.00%	[3],[6]
Property Owned by LLC/LP	Texoma Medical Plaza II	[3],[6]
[1]	The LLC is the lessee with a third party lessor under a ground lease for land.
[2]	This LLC has a third-party term loan of $8.0 million, which is non-recourse to us, outstanding as of June 30, 2020.
[3]	The LPs are the lessee, or have committed to a lease, with a UHS-related party for the land related to this property.
[4]	This building is on the campus of a UHS hospital and has tenants that include subsidiaries of UHS. This LP has a third-party term loan, which is non-recourse to us, of $13.5 million, outstanding as of June 30, 2020.
[5]	We have committed to invest up to $2.5 million in equity and debt financing, of which $2.1 million has been funded as of June 30, 2020.  This LP has a third-party term loan, which is non-recourse to us, of $4.9 million, outstanding as of June 30, 2020.
[6]	This MOB, currently under construction, will be 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 $ 4.8 million in equity and debt financing , no ne of which has been funded as of June 30, 2020 . This LP entered into a $ 13.1 million third-party construction loan, which is non-recourse to us and has an outstanding balance of $ 7.1 million as of June 30, 2020 . The L P will develop, construct, own and operate the Texoma Medical Plaza II which is expected to open in late 2020 .

Limited Liability Companies A_2

Limited Liability Companies Accounted for Under Equity Method (Parenthetical) (Detail)	Jun. 30, 2020USD ($)
Brunswick Associates
Schedule Of Equity Method Investments [Line Items]
Third-party term loan	$ 8,000,000
Grayson Properties II
Schedule Of Equity Method Investments [Line Items]
Construction Loan	13,100,000
Construction loan outstanding balance	7,100,000
Grayson Properties II | Denison, Texas
Schedule Of Equity Method Investments [Line Items]
Committed investment in equity and debt financing, funded	0
Grayson Properties II | Maximum | Denison, Texas
Schedule Of Equity Method Investments [Line Items]
Commitment to investment	4,800,000
Grayson Properties
Schedule Of Equity Method Investments [Line Items]
Third-party term loan	13,500,000
FTX MOB Phase II limited partnership
Schedule Of Equity Method Investments [Line Items]
Third-party term loan	4,900,000
Committed investment in equity and debt financing, funded	2,100,000
FTX MOB Phase II limited partnership | Maximum
Schedule Of Equity Method Investments [Line Items]
Commitment to investment	$ 2,500,000

Condensed Combined Statement of

Condensed Combined Statement of Income for LLCs/LPs Accounted Under Equity Method (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Schedule Of Equity Method Investments [Line Items]
Revenues	$ 19,281	$ 19,326	$ 38,488	$ 38,438
Net income			9,254	8,473
Our share of net income	419	454	854	884
Equity Method Investment, Nonconsolidated Investee or Group of Investees
Schedule Of Equity Method Investments [Line Items]
Revenues	2,497	2,531	5,013	4,991
Operating expenses	1,019	994	2,047	2,006
Depreciation and amortization	447	485	889	883
Interest, net	316	322	634	644
Net income	715	730	1,443	1,458
Our share of net income	$ 419	$ 454	$ 854	$ 884

Condensed Combined Balance Shee

Condensed Combined Balance Sheets for LLCs/LPs Accounted Under Equity Method (Detail) - USD ($) $ in Thousands		Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018
Schedule Of Equity Method Investments [Line Items]
Total Assets		$ 486,606		$ 488,789
Equity		166,240	$ 172,440	181,734	$ 188,540	$ 193,627	$ 198,610
Total Liabilities and Equity		486,606		488,789
Investments in LLCs before amounts included in accrued expenses and other liabilities		4,408		6,918
Equity Method Investment, Nonconsolidated Investee or Group of Investees
Schedule Of Equity Method Investments [Line Items]
Net property, including construction in progress		37,313		33,207
Other assets	[1]	7,590		7,452
Total Assets		44,903		40,659
Other liabilities	[1]	6,138		6,785
Mortgage notes payable, non-recourse to us		33,428		26,650
Equity		5,337		7,224
Total Liabilities and Equity		44,903		40,659
Investments in LLCs before amounts included in accrued expenses and other liabilities		4,408		6,918
Amounts included in accrued expenses and other liabilities		(1,655)		(1,856)
Our share of equity in LLCs, net		$ 2,753		$ 5,062
[1]	Other assets and other liabilities as of both June 30, 2020 and December 31, 2019 includes approximately $3.7 million 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 ($) $ in Thousands	Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2019
Schedule Of Equity Method Investments [Line Items]
Right-of-use land assets	$ 8,929	$ 8,900	$ 8,944
Right-of-use land liabilities	8,929	$ 8,900	$ 8,944
Limited Liability Companies
Schedule Of Equity Method Investments [Line Items]
Right-of-use land assets	3,700
Right-of-use land liabilities	$ 3,700

Aggregate Principal Amounts due

Aggregate Principal Amounts due on Mortgage and Construction Notes Payable by Unconsolidated LLC's/LPs Accounted Under Equity Method (Detail) - Equity Method Investments - USD ($) $ in Thousands		6 Months Ended
		Jun. 30, 2020	Dec. 31, 2019
Schedule Of Equity Method Investments [Line Items]
Mortgage Loan Balance	[1]	$ 33,428	$ 26,650
FTX MOB Phase II
Schedule Of Equity Method Investments [Line Items]
Mortgage Loan Balance	[1],[2]	$ 4,852	4,926
Maturity Date	[2]	2020-10
Grayson Properties
Schedule Of Equity Method Investments [Line Items]
Mortgage Loan Balance	[1]	$ 13,515	13,658
Maturity Date		2021-09
Brunswick Associates
Schedule Of Equity Method Investments [Line Items]
Mortgage Loan Balance	[1]	$ 7,967	$ 8,066
Maturity Date		2024-12
Grayson Properties II
Schedule Of Equity Method Investments [Line Items]
Mortgage Loan Balance	[1],[3]	$ 7,094
Maturity Date	[3]	2025-06
[1]	All mortgage loans require monthly principal payments through maturity and include a balloon principal payment upon maturity
[2]	This loan is scheduled to mature within the next twelve months, at which time the venture intends to refinance pursuant to a new mortgage loan.
[3]	This construction loan has a maximum balance of $13.1 million and requires unpaid interest on the outstanding principal balance to be paid on a monthly basis through December 1, 2022.  Principal and accrued interest monthly payments will commence on January 1, 2023.

Aggregate Principal Amounts d_2

Aggregate Principal Amounts due on Mortgage and Construction Notes Payable by Unconsolidated LLC's/LPs Accounted Under Equity Method (Parenthetical) (Detail) $ in Millions	6 Months Ended
	Jun. 30, 2020USD ($)
Grayson Properties II LP
Schedule Of Equity Method Investments [Line Items]
Construction Loan	$ 13.1
Principal and accrued interest monthly payments	Jan. 1, 2023
5.00% Fixed Rate Mortgage Loan | FTX MOB Phase II
Schedule Of Equity Method Investments [Line Items]
Loan interest rate fixed percentage	5.00%
5.034% Fixed Rate Mortgage Loan | Grayson Properties
Schedule Of Equity Method Investments [Line Items]
Loan interest rate fixed percentage	5.034%
3.64% Fixed Rate Mortgage Loan | Brunswick Associates
Schedule Of Equity Method Investments [Line Items]
Loan interest rate fixed percentage	3.64%
3.70% Fixed Rate Mortgage Loan | Grayson Properties II LP
Schedule Of Equity Method Investments [Line Items]
Loan interest rate fixed percentage	3.70%

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, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Non-Related Parties
Leases Disclosure [Line Items]
Lease revenue		$ 12,843	$ 13,178	$ 25,685	$ 25,909
Non-Related Parties | Base Rents
Leases Disclosure [Line Items]
Lease revenue		10,387	10,660	20,765	21,020
Non-Related Parties | Tenant Reimbursements
Leases Disclosure [Line Items]
Lease revenue		2,456	2,518	4,920	4,889
Universal Health Services, Inc
Leases Disclosure [Line Items]
Lease revenue	[1]	5,981	5,651	11,862	11,444
Universal Health Services, Inc | Base Rents
Leases Disclosure [Line Items]
Lease revenue		4,294	4,115	8,538	8,289
Universal Health Services, Inc | Bonus Rents
Leases Disclosure [Line Items]
Lease revenue		1,417	1,352	2,797	2,746
Universal Health Services, Inc | Tenant Reimbursements
Leases Disclosure [Line Items]
Lease revenue		$ 270	$ 184	$ 527	$ 409
[1]	Includes bonus rental on UHS hospital facilities of $1,417 and $1,352 for the three-month periods ended June 30, 2020 and 2019, respectively, and $2,797 and $2,746 for the six-month periods ended June 30, 2020 and 2019, respectively.

Lease Accounting - Additional I

Lease Accounting - Additional Information (Detail) $ in Thousands	3 Months Ended
	Mar. 31, 2020USD ($)Land	Jun. 30, 2020USD ($)	Dec. 31, 2019USD ($)
Leases [Abstract]
Lessee in connection with ground leases for land | Land	14
Right-of-use land assets	$ 8,900	$ 8,929	$ 8,944
Ground lease liabilities	$ 8,900	$ 8,929	$ 8,944

Debt and Financial Instrument_2

Debt and Financial Instruments - Additional Information (Detail)

Mar. 27, 2018USD ($)Option

Mar. 31, 2020USD ($)Derivative

Jan. 31, 2020USD ($)Derivative

Jun. 30, 2020USD ($)

Sep. 30, 2019USD ($)Derivative

Mar. 31, 2019USD ($)

Sep. 30, 2016USD ($)Derivative

Jun. 30, 2016USD ($)Derivative

Jun. 30, 2020USD ($)

Dec. 31, 2018USD ($)

Mar. 31, 2019USD ($)

Mar. 31, 2019USD ($)

Dec. 31, 2019USD ($)

Debt Instrument [Line Items]

Outstanding borrowings under revolving credit agreement

$ 221,250,000

$ 221,250,000

$ 212,950,000

Letters of credit outstanding

5,600

5,600

Available borrowing capacity

123,100,000

123,100,000

87,000,000

Compensating balance

0

0

Interest Rate Swap | Cash Flow Hedge

Debt Instrument [Line Items]

Number of interest rate cap agreements | Derivative

1

1

1

Derivative instruments, fixed rate

0.565%

1.4975%

1.144%

Notional amount

$ 55,000,000

$ 35,000,000

$ 50,000,000

Expiration date of interest rate

Mar. 25, 2027

Sep. 16, 2024

Sep. 16, 2024

Interest Rate Cap

Debt Instrument [Line Items]

Number of interest rate cap agreements | Derivative

1

1

Notional amount

$ 30,000,000

$ 30,000,000

Expiration date of interest rate

Mar. 31, 2019

Mar. 31, 2019

Derivative interest rate cap, payment received or accrued from counterparties

$ 61,000

$ 144,000

$ 205,000

$ 205,000

Premium paid

$ 55,000

$ 115,000

Level 2

Debt Instrument [Line Items]

Mortgage loan fair value

62,400,000

62,400,000

63,100,000

Mortgage debt

$ 61,100,000

Derivative interest rate cap, net payment received or accrued from counterparties

23,000

Derivative interest rate cap, payment received or accrued from counterparties

199,000

Derivative interest rate cap, offset due to counterparties

222,000

Level 2 | Interest Rate Swap

Debt Instrument [Line Items]

Liability derivatives, fair value

4,900,000

4,900,000

Derivative interest rate cap, net payment received or accrued from counterparties

182,000

131,000

Derivative interest rate cap, payment received or accrued from counterparties

201,000

222,000

Derivative interest rate cap, offset due to counterparties

19,000

91,000

LIBOR | Interest Rate Cap

Debt Instrument [Line Items]

Derivative instruments, LIBOR rate

1.50%

1.50%

Credit Agreement

Debt Instrument [Line Items]

Outstanding borrowing

350,000,000

350,000,000

Credit Agreement

Debt Instrument [Line Items]

Outstanding borrowing

$ 350,000,000

Unsecured revolving amended credit agreement terminated date

2022-03

Number of additional six month extension options | Option

2

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 B Facility

Debt Instrument [Line Items]

Outstanding borrowing

$ 300,000,000

300,000,000

Proceeds from lines of credit

50,000,000

Increase in borrowing capacity

$ 350,000,000

Credit facility, Interest Rate Terms

one, two, three, or six months LIBOR plus an applicable margin ranging from 1.85% to 2.10% or at the Base Rate plus an applicable margin ranging from 0.85% to 1.10%.

Base rate description

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 LIBOR plus 1%.

Facility fee payable on commitment

0.20%

Revolving B Facility | LIBOR

Debt Instrument [Line Items]

Margin points added to the reference rate

1.95%

1.95%

Revolving B Facility | Base Rate

Debt Instrument [Line Items]

Margin points added to the reference rate

0.95%

0.95%

Revolving B Facility | Minimum

Debt Instrument [Line Items]

Facility fee payable on commitment

0.15%

Revolving B Facility | Minimum | LIBOR

Debt Instrument [Line Items]

Margin points added to the reference rate

1.85%

Margin points added to the base rate

1.00%

Revolving B Facility | Minimum | Base Rate

Debt Instrument [Line Items]

Margin points added to the reference rate

0.85%

Revolving B Facility | Minimum | Federal Funds Effective Rate

Debt Instrument [Line Items]

Margin points added to the base rate

0.50%

Revolving B Facility | Maximum

Debt Instrument [Line Items]

Facility fee payable on commitment

0.35%

Revolving B Facility | Maximum | LIBOR

Debt Instrument [Line Items]

Margin points added to the reference rate

2.10%

Revolving B Facility | Maximum | Base Rate

Debt Instrument [Line Items]

Margin points added to the reference rate

1.10%

Revolving A Facility

Debt Instrument [Line Items]

Credit facility, Interest Rate Terms

one, two, three, or six-month LIBOR plus an applicable margin ranging from 1.10% to 1.35% or at the Base Rate plus an applicable margin ranging from 0.10% to 0.35%.

Base rate description

the greater of: (a) the administrative agent’s prime rate; (b) the federal funds effective rate plus 1/2 of 1%, and; (c) one month LIBOR plus 1%.

Facility fee payable on commitment

0.20%

Revolving A Facility | LIBOR

Debt Instrument [Line Items]

Margin points added to the reference rate

1.20%

Revolving A Facility | Base Rate

Debt Instrument [Line Items]

Margin points added to the reference rate

0.20%

Revolving A Facility | Minimum

Debt Instrument [Line Items]

Facility fee payable on commitment

0.15%

Revolving A Facility | Minimum | LIBOR

Debt Instrument [Line Items]

Margin points added to the reference rate

1.10%

Margin points added to the base rate

1.00%

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 | Maximum

Debt Instrument [Line Items]

Facility fee payable on commitment

0.35%

Revolving A Facility | Maximum | LIBOR

Debt Instrument [Line Items]

Margin points added to the reference rate

1.35%

Revolving A Facility | Maximum | Base Rate

Debt Instrument [Line Items]

Margin points added to the reference rate

0.35%

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, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Covenant, Tangible net worth	$ 125,000
Tangible net worth	$ 153,292	$ 167,181
Total leverage	43.60%	42.30%
Secured leverage	9.00%	9.10%
Unencumbered leverage	40.20%	38.50%
Fixed charge coverage	4.30%	4.00%
Maximum
Debt Instrument [Line Items]
Covenant, Total leverage	60.00%
Covenant, Secured leverage	30.00%
Covenant, Unencumbered leverage	60.00%
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, 2020		Dec. 31, 2019
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 60,237
Less net financing fees	[1]	(533)
Plus net debt premium	[1]	167
Total mortgages notes payable, non-recourse to us, net		59,871	[1]	$ 60,744
700 Shadow Lane and Goldring MOBs Fixed Rate Mortgage Loan
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 5,547
Interest Rate		4.54%
Maturity Date		2022-06
BRB Medical Office Building Fixed Rate Mortgage Loan
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 5,614
Interest Rate		4.27%
Maturity Date		2022-12
Desert Valley Medical Center Fixed Rate Mortgage Loan
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 4,587
Interest Rate		3.62%
Maturity Date		2023-01
2704 North Tenaya Way Fixed Rate Mortgage Loan
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 6,653
Interest Rate		4.95%
Maturity Date		2023-11
Summerlin Hospital Medical Office Building III Fixed Rate Mortgage Loan
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 13,158
Interest Rate		4.03%
Maturity Date		2024-04
Tuscan Professional Building Fixed Rate Mortgage Loan
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 3,216
Interest Rate		5.56%
Maturity Date		2025-06
Phoenix Children’s East Valley Care Center Fixed Rate Mortgage Loan
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 8,841
Interest Rate		3.95%
Maturity Date		2030-01
Rosenberg Children's Medical Plaza Fixed Rate Mortgage Loan
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 12,621
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.

Segment Reporting - Additional

Segment Reporting - Additional Information (Detail)	6 Months Ended
	Jun. 30, 2020Segment
Segment Reporting [Abstract]
Number of reportable segments	1