Universal Health Realty Income Trust (UHT) 10-Q 7 May 21 2021 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2021	Apr. 30, 2021
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2021
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q1
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		13,772,112
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
		Mar. 31, 2021	Mar. 31, 2020
Revenues:
Revenues, Total		$ 20,699	$ 19,207
Expenses:
Depreciation and amortization		6,787	6,380
Other operating expenses		5,602	5,383
Costs and Expenses, Total		13,451	12,779
Income before equity in income of unconsolidated limited liability companies ("LLCs"), interest expense and gains on sales		7,248	6,428
Equity in income of unconsolidated LLCs		471	435
Interest expense, net		(2,133)	(2,309)
Net income		$ 5,586	$ 4,554
Basic earnings per share		$ 0.41	$ 0.33
Diluted earnings per share		$ 0.41	$ 0.33
Weighted average number of shares outstanding - Basic		13,750	13,736
Weighted average number of shares outstanding - Diluted		13,771	13,758
Non-Related Parties
Revenues:
Lease revenue		$ 13,092	$ 12,842
Other
Revenues:
Other revenue		249	270
Management Service
Expenses:
Advisory fees to UHS		1,062	1,016
UHS Facilities
Revenues:
Lease revenue	[1]	7,132	5,881
UHS Facilities | Other
Revenues:
Other revenue		$ 226	$ 214
[1]	Includes bonus rental on UHS hospital facilities of $1,695 and $1,380 for the three-month periods ended March 31, 2021 and 2020, respectively.

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Income (Parenthetical) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
UHS Hospital Facilities
Bonus rental	$ 1,695	$ 1,380

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Statement Of Income And Comprehensive Income [Abstract]
Net income	$ 5,586	$ 4,554
Other comprehensive gain/(loss):
Unrealized derivative gains/(losses) on cash flow hedges	3,348	(4,671)
Total other comprehensive gain/(loss):	3,348	(4,671)
Total comprehensive income/(loss)	$ 8,934	$ (117)

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2021		Dec. 31, 2020
Real Estate Investments:
Buildings and improvements and construction in progress	$ 608,366		$ 605,292
Accumulated depreciation	(222,521)		(216,648)
Real Estate Investment Property, Net, Total	385,845		388,644
Land	55,157		55,157
Net Real Estate Investments	441,002		443,801
Investments in limited liability companies ("LLCs")	9,087		4,278
Other Assets:
Cash and cash equivalents	6,171		5,742
Lease and other receivables from UHS	3,252		3,199
Lease receivable - other	7,780		7,504
Intangible assets (net of accumulated amortization of $19.0 million and $19.5 million, respectively)	11,013		11,742
Right-of-use land assets, net	8,907		8,914
Deferred charges and other assets, net	8,582		8,829
Total Assets	495,794		494,009
Liabilities:
Line of credit borrowings	247,650		236,200
Mortgage notes payable, non-recourse to us, net	58,403	[1]	58,895
Accrued interest	346		351
Accrued expenses and other liabilities	11,375		19,802
Ground lease liabilities, net	8,907		8,914
Tenant reserves, deposits and deferred and prepaid rents	10,446		10,842
Total Liabilities	337,127		335,004
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: 2021 - 13,772,095; 2020 - 13,771,287	138		138
Capital in excess of par value	267,667		267,368
Cumulative net income	686,313		680,727
Cumulative dividends	(794,984)		(785,413)
Accumulated other comprehensive (loss)/income	(467)		(3,815)
Total Equity	158,667		159,005
Total Liabilities and Equity	$ 495,794		$ 494,009
[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	Mar. 31, 2021	Dec. 31, 2020
Statement Of Financial Position [Abstract]
Intangible assets, accumulated amortization	$ 19	$ 19.5
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	13,772,095	13,771,287
Common shares, outstanding	13,772,095	13,771,287

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Changes in Equity - USD ($) shares in Thousands, $ in Thousands	Total	Common stock	Common stock	Cumulative net income	Common stock	Accumulated other comprehensive income/(loss)
January 1, 2021 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	50		50
Issued (in shares)		1
Restricted stock-based compensation expense	197		197
Dividends	(9,424)				(9,424)
Comprehensive income:
Net income	4,554			4,554
Unrealized net gain(loss) on cash flow hedges	(4,671)					(4,671)
Subtotal - comprehensive income	(117)			4,554		(4,671)
Balance at Mar. 31, 2020	172,440	$ 138	266,970	665,834	(756,841)	(3,661)
Balance, Shares at Mar. 31, 2020		13,758
January 1, 2021 at Dec. 31, 2020	159,005	$ 138	267,368	680,727	(785,413)	(3,815)
Balance, Shares at Dec. 31, 2020		13,771
Shares of Beneficial Interest:
Issued	57		57
Issued (in shares)		1
Restricted stock-based compensation expense	242		242
Dividends	(9,571)				(9,571)
Comprehensive income:
Net income	5,586			5,586
Unrealized net gain(loss) on cash flow hedges	3,348					3,348
Subtotal - comprehensive income	8,934			5,586		3,348
Balance at Mar. 31, 2021	$ 158,667	$ 138	$ 267,667	$ 686,313	$ (794,984)	$ (467)
Balance, Shares at Mar. 31, 2021		13,772

Condensed Consolidated Statem_5

Condensed Consolidated Statements of Changes in Equity (Parenthetical) - $ / shares	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Statement Of Stockholders Equity [Abstract]
Dividend, per share	$ 0.695	$ 0.685

Condensed Consolidated Statem_6

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Cash flows from operating activities:
Net income	$ 5,586	$ 4,554
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	6,787	6,380
Amortization related to above/below market leases, net	(45)	(46)
Amortization of debt premium	(12)	(13)
Amortization of deferred financing costs	216	157
Stock-based compensation expense	242	197
Changes in assets and liabilities:
Lease receivable	(329)	181
Accrued expenses and other liabilities	(633)	(867)
Tenant reserves, deposits and deferred and prepaid rents	(396)	65
Accrued interest	(5)	(25)
Leasing costs paid	(365)	(182)
Other, net	204	(264)
Net cash provided by operating activities	11,250	10,137
Cash flows from investing activities:
Investments in LLCs	(1,544)	(1,468)
Advance made to LLC	(3,500)
Additions to real estate investments, net	(6,974)	(5,521)
Deposit on real estate assets	(200)
Net cash used in investing activities	(12,218)	(6,989)
Cash flows from financing activities:
Net borrowings on line of credit	11,450	6,250
Repayments of mortgage notes payable	(510)	(432)
Financing costs paid	(35)	(35)
Dividends paid	(9,564)	(9,424)
Issuance of shares of beneficial interest, net	56	50
Net cash provided by/(used in) financing activities	1,397	(3,591)
Increase/(decrease) in cash and cash equivalents	429	(443)
Cash and cash equivalents, beginning of period	5,742	6,110
Cash and cash equivalents, end of period	6,171	5,667
Supplemental disclosures of cash flow information:
Interest paid	1,935	2,190
Invoices accrued for construction and improvements	$ 468	$ 3,151

General

General	3 Months Ended
	Mar. 31, 2021
Organization Consolidation And Presentation Of Financial Statements [Abstract]
General	(1) General This Quarterly Report on Form 10-Q is for the quarter ended March 31, 2021. 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 March 31, 2021, we had investments in five jointly-owned LLCs/LPs. 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, 2020. 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	3 Months Ended
	Mar. 31, 2021
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 wholly-owned 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 wholly-owned subsidiaries of UHS are unconditionally guaranteed by UHS and are cross-defaulted with one another. The combined revenues generated from the leases on the three acute care hospital facilities leased to wholly-owned subsidiaries of UHS accounted for approximately 22% of our consolidated revenues for each of the three months ended March 31, 2021 and 2020. In addition to these three UHS hospital facilities, one of our hospital facilities is leased to a joint venture between a subsidiary of UHS and a third party, and we have eighteen medical office buildings (“MOBs”) or free-standing emergency departments (“FEDs”), that are either wholly or jointly-owned by us that include tenants which are subsidiaries or joint ventures of UHS. The aggregate revenues generated from UHS-related tenants comprised approximately 36% and 32% of our consolidated revenues during the three-month periods ended March 31, 2021 and 2020, 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 the three acute care hospitals with wholly-owned subsidiaries of UHS, as reflected below, UHS has the option, among other things, to renew the leases at the lease terms described below by providing notice to us at least 90 days prior to the termination of the then current term. UHS also has the right to purchase the respective leased facilities from us at their appraised fair market value upon any of the following: (i) at the end of the lease terms or any renewal terms; (ii) upon one month’s notice should a change of control of the Trust occur, or; (iii) within the time period as specified in the lease in the event that UHS provides notice to us of their intent to offer a substitution property/properties in exchange for one (or more) of the three hospital facilities leased from us, should we be unable to reach an agreement with UHS on the properties to be substituted. Additionally, UHS has rights of first refusal to: (i) purchase the respective leased facilities during and for 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 As previously disclosed, a wholly-owned subsidiary of UHS has notified us that it is planning to terminate the existing lease on Southwest Healthcare System, Inland Valley Campus, upon the scheduled expiration of the current lease term on December 31, 2021. As permitted pursuant to the terms of the lease, UHS has the right to purchase the leased property at its appraised fair market value at the end of the existing lease term. However, UHS has proposed exchanging potential substitution properties, with an aggregate fair market value substantially equal to that of Southwest Healthcare System, Inland Valley Campus, in return for the real estate assets of the Inland Valley Campus. The proposed substitution properties consist of one acute care hospital (including a behavioral health pavilion) and a newly constructed behavioral health hospital. The Independent Trustees of the Board have approved the proposed property substitution subject to satisfactory due diligence and completion of definitive agreements. The effective date of the property substitution is expected to coincide with the scheduled lease maturity date of December 31, 2021. Pursuant to the terms of the lease on the Inland Valley Campus, we earned $1.1 million of lease revenue during the three-month period ended March 31, 2021 ($662,000 in base rental and $454,000 in bonus rental) and $4.4 million of lease revenue during the year ended December 31, 2020 ($2.6 million in base rental and $1.8 million in bonus rental). In September 2019, we entered into an agreement whereby we own a 95% non-controlling ownership interest in Grayson Properties II L.P., which developed, constructed, owns and operates the Texoma Medical Plaza II, an MOB located in Denison, Texas. This MOB, which was substantially completed in December 2020, is 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 over 50% of the rentable square feet of the MOB and commenced in December 2020 upon the issuance of the certificate of occupancy. We account for this LP on an unconsolidated basis pursuant to the equity method since it is not a variable interest entity and we do not have a controlling voting interest. In late July 2019, Des Moines Medical Properties, LLC, a wholly-owned subsidiary of ours, entered into an agreement to build and lease a newly constructed UHS-related 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 a wholly-owned subsidiary of UHS and Catholic Health Initiatives - Iowa, Corp (“JV”). Construction of this hospital, for which we engaged a wholly-owned subsidiary of UHS to act as project manager for an aggregate fee of approximately $750,000, was substantially completed in December 2020 and the property received a temporary certificate of occupancy on December 31, 2020. The hospital lease commenced upon the issuance of the temporary certificate of occupancy. Pursuant to the lease on this facility, the JV has the option to, among other things, renew the lease at the terms specified in the lease agreement by providing notice to us at least 270 days prior to the termination of the then current term. The JV also has the right to purchase the leased facility from us at its appraised fair market value upon either of the following: (i) by providing notice at least 270 days prior to the end of the lease terms or any renewal terms, or; (ii) upon 30 days’ notice anytime within 12 months of a change of control of the Trust (UHS also has this right should the JV decline to exercise its purchase right). Additionally, the JV has rights of first offer to purchase the facility prior to any third-party sale. 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 twelve 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 28 years to approximately 78 years. The annual aggregate lease payments on these properties are approximately $508,000 for the year ended 2021 and $508,000 for each of the years ended 2022 , 2023 , 2024 and 202 5 , and an aggregate of $ million thereafter . See Note 7 for further disclosure around our lease accounting . Officers and Employees: Our officers are all employees of a wholly-owned subsidiary of UHS and although as of March 31, 2021 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 months ended March 31, 2021 and 2020, 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 2021, 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 $1.1 million and $1.0 million for the three months ended March 31, 2021 and 2020, and were based upon average invested real estate assets of $607 million and $581 million, respectively. Share Ownership: As of March 31, 2021 and December 31, 2020, 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 36% and 32% of our consolidated revenues during the three-month periods ended March 31, 2021 and 2020, 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	3 Months Ended
	Mar. 31, 2021
Equity [Abstract]
Dividends and Equity Issuance Program	(3) Dividends and Equity Issuance Program Dividends and dividend equivalents: During the first quarter of 2021, we declared and paid dividends of approximately $9.6 million, or $.695 per share. We declared and paid dividends of approximately $9.4 million, or $.685 per share, during the first quarter of 2020. Dividend equivalents, which were applicable to shares of unvested restricted stock, were accrued during the first quarter of 2021 and will be paid upon vesting of the restricted stock. 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 our agent banks. The common shares will be offered pursuant to the Registration Statement filed with the Securities and Exchange Commission, which became effective in June 2020. No shares were issued pursuant to this ATM equity program during the first quarter of 2021. Pursuant to this ATM program, since the program commenced in the second quarter of 2020, 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, as of March 31, 2021, we have paid or incurred approximately $507,000 in various fees and expenses related to the commencement of our ATM program.

Acquisitions and Dispositions

Acquisitions and Dispositions	3 Months Ended
	Mar. 31, 2021
Business Combinations [Abstract]
Acquisitions and Dispositions	(4) Acquisitions and Dispositions Three Months Ended March 31, 2021: Acquisitions: There were no acquisitions during the first three months of 2021. Dispositions: There were no dispositions during the first three months of 2021. Three Months Ended March 31, 2020: Acquisitions: There were no acquisitions during the first three months of 2020. Dispositions: There were no dispositions during the first three months of 2020.

Summarized Financial Informatio

Summarized Financial Information of Equity Affiliates	3 Months Ended
	Mar. 31, 2021
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 March 31, 2021, we have non-controlling equity investments or commitments in five jointly-owned LLCs/LPs which own MOBs. We account 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 and were accounted for under the equity method as of March 31, 2021: 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 $9.2 million, which is non-recourse to us, outstanding as of March 31, 2021. (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 of $13.3 million, which is non-recourse to us, outstanding as of March 31, 2021. (c.) We have committed to invest up to $2.5 million in equity and debt financing, of which $2.4 million has been funded as of March 31, 2021. During the first quarter of 2021, this LP paid off its $4.7 million mortgage loan, upon maturity, utilizing pro rata equity contributions from the limited partners as well as a $3.5 million member loan from us to the LP which was funded utilizing borrowings from our revolving credit agreement. (d.) Construction on this MOB , which is located in Denison, Texas on the campus of a hospital owned and operated by a wholly-owned subsidiary of UHS , was substantially completed in December 2020. We have committed to invest up to $ 4.8 million in equity and debt financing , no ne of which has been funded as of March 31, 202 1 . This LP entered into a $ 13.1 million third-party construction loan commitment, which is non-recourse to us , which has an outstanding balance of $ million as of March 3 1 , 202 1 . (e.) The LLC is the lessee with a third-party lessor under a ground lease for land. (f.) These LPs are the lessees with UHS-related parties for the land related to these properties. Below are the condensed combined statements of income (unaudited) for the four LLCs/LPs accounted for under the equity method at March 31, 2021 and 2020. Three Months Ended March 31, 2021 2020 (amounts in thousands) Revenues $ 2,788 $ 2,516 Operating expenses 1,107 1,028 Depreciation and amortization 521 442 Interest, net 431 318 Net income $ 729 $ 728 Our share of net income $ 471 $ 435 Below are the condensed combined balance sheets (unaudited) for the five above-mentioned LLCs/LPs that were accounted for under the equity method as of March 31, 2021 and December 31, 2020: March 31, 2021 December 31, 2020 (amounts in thousands) Net property, including construction in progress $ 41,822 $ 42,374 Other assets (a.) 8,817 8,818 Total assets $ 50,639 $ 51,192 Other liabilities (a.) $ 8,543 $ 9,402 Mortgage notes payable, non-recourse to us 34,896 39,735 Advances payable to us (b.) 3,500 - Equity 3,700 2,055 Total liabilities and equity $ 50,639 $ 51,192 Investments in LLCs before amounts included in accrued expenses and other liabilities $ 9,087 $ 4,278 Amounts included in accrued expenses and other liabilities (2,700 ) (3,020 ) Our share of equity in LLCs, net $ 6,387 $ 1,258 (a.) Other assets and other liabilities as of both March 31, 2021 and December 31, 2020 include approximately $4.3 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. (b.) Consists of a 7.25% member loan to FTX MOB Phase II, LP with a maturity date of March 1, 2023. As of March 31, 2021, and December 31, 2020, 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 3/31/2021 12/31/2020 Maturity Date FTX MOB Phase II (5.00% fixed rate mortgage loan) (b.) $ - $ 4,777 Repaid in Feb., 2021 Grayson Properties (5.034% fixed rate mortgage loan) (c.) 13,295 13,372 September, 2021 Brunswick Associates (3.64% fixed rate mortgage loan) 9,185 9,250 December, 2024 Grayson Properties II (3.70% fixed rate construction loan) (d.) 12,416 12,336 June, 2025 $ 34,896 $ 39,735 (a.) All mortgage loans require monthly principal payments through maturity and include a balloon principal payment upon maturity. (b.) Upon maturity in February, 2021 this LP paid off this mortgage loan utilizing pro rata equity contributions from the limited partners as well as a $3.5 million member loan from us to the LP which was funded utilizing borrowings from our revolving credit agreement. (c.) This loan is scheduled to mature within the next twelve months, at which time the entity intends to refinance pursuant to a new mortgage loan. (d.) This construction loan has a maximum commitment of $13.1 million and requires interest on the outstanding principal balance to be paid on a monthly basis through December 1, 2022. Monthly principal and interest payments are scheduled to 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	3 Months Ended
	Mar. 31, 2021
Accounting Policies [Abstract]
Recent Accounting Pronouncements	(6) Recent Accounting Pronouncements Accounting for Lease Concessions Granted in Connection with the COVID-19 Pandemic 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, which we adopted on January 1, 2019, 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 months ended March 31, 2021 or the year ended December 31, 2020. 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.

Lease Accounting

Lease Accounting	3 Months Ended
	Mar. 31, 2021
Leases [Abstract]
Lease Accounting	(7) Lease Accounting We adopted the new lease standard on January 1, 2019 and applied it to leases that were in place on the effective date as both a lessor and lessee. We adopted ASC 842 effective January 1, 2019 under the modified retrospective approach and elected the optional transition method to apply the provisions of ASC 842 as of the adoption date, rather than the earliest period presented. We elected to apply certain adoption related practical expedients for all leases that commenced prior to the election date. 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. 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. 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 consolidated statements of income for the three months ended March 31, 2021 and 2020. The components of the “Lease revenue – UHS facilities” and “Lease revenue – Non-related parties” captions for the three month periods ended March 31, 2021 and 2020 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 March 31, 2021 2020 UHS facilities: Base rents $ 5,146 $ 4,244 Bonus rents 1,695 1,380 Tenant reimbursements 291 257 Lease revenue - UHS facilities $ 7,132 $ 5,881 Non-related parties: Base rents 10,505 10,378 Tenant reimbursements 2,587 2,464 Lease revenue - Non-related parties $ 13,092 $ 12,842 Disclosures Related to Certain Hospital Facilities: Southwest Healthcare System, Inland Valley Campus: As previously disclosed, a wholly-owned subsidiary of UHS has notified us that it is planning to terminate the existing lease on Southwest Healthcare System, Inland Valley Campus, upon the scheduled expiration of the current lease term on December 31, 2021. As permitted pursuant to the terms of the lease, UHS has the right to purchase the leased property at its appraised fair market value at the end of the existing lease term. However, UHS has proposed exchanging potential substitution properties, with an aggregate fair market value substantially equal to that of Southwest Healthcare System, Inland Valley Campus, in return for the real estate assets of the Inland Valley Campus. The proposed substitution properties consist of one acute care hospital (including a behavioral health pavilion) and a newly constructed behavioral health hospital. The Independent Trustees of the Board have approved the proposed property substitution subject to satisfactory due diligence and completion of definitive agreements. The effective date of the property substitution is expected to coincide with the scheduled lease maturity date of December 31, 2021. Pursuant to the terms of the lease on the Inland Valley Campus, we earned $1.1 million of lease revenue during the three-month period ended March 31, 2021 ($662,000 in base rental and $454,000 in bonus rental) and $4.4 million of lease revenue during the year ended December 31, 2020 ($2.6 million in base rental and $1.8 million in bonus rental). Kindred Hospital Chicago Central: The existing lease on Kindred Hospital Chicago Central, a 95-bed specialty hospital located in Chicago, Illinois, is scheduled to expire on December 31, 2021. The tenant of the facility has recently notified us that they do not intend to renew the lease upon its scheduled expiration. We have begun marketing this property to potential new tenants. However, should this property be vacant for an extended period of time, or should we experience a decrease in the lease rate on a future lease as compared to the current lease, or incur substantial renovation costs to make the property suitable for another operator/tenant, our future results of operations could be unfavorably impacted. Pursuant to the terms of the lease, we earned approximately $390,000 of lease revenue during the three-month period ended March 31, 2021 and $1.6 million of lease revenue during the twelve-month period ended December 31, 2020. Vacancies - Evansville, Indiana and Corpus Christi, Texas: The leases on two hospital facilities, located in Evansville, Indiana, and Corpus Christi, Texas, expired on May 31, 2019 and June 1, 2019, respectively. The former tenant of the hospital located in Evansville, Indiana, entered into a short-term lease with us, which covered the period of June 1, 2019 through September 30, 2019. The hospital located in Evansville, Indiana, has remained vacant since September 30, 2019 and the hospital located in Corpus Christi, Texas, has remained vacant since June 1, 2019. We continue to market each property for lease to new tenants. However, should these properties continue to remain owned and vacant for an extended period of time, or should we experience decreased lease rates on future leases, as compared to prior/expired lease rates, or incur substantial renovation costs to make the properties suitable for other operators/tenants, our future results of operations could be materially unfavorably impacted. 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 March 31, 2021, 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 three months ended March 31, 2021.

Debt and Financial Instruments

Debt and Financial Instruments	3 Months Ended
	Mar. 31, 2021
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. 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 of 1%, and; (c) one month LIBOR plus 1 %. A facility fee of 0.15 % to 0.35 % will be charged on the total commitment of the Revolving A Facility of the Credit Agreement. The margins over LIBOR, Base Rate and the facility fee are based upon our total leverage ratio. At March 3 1 , 20 2 1 , the applicable margin over the LIBOR rate was 1.20 %, the margin over the Base Rate was 0.20 %, and the facility fee was 0.20 %. The Credit Agreement also provides for options to extend the maturity date and borrowing availability for two additional six-month periods for the Revolving A Facility. 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 %, the margin over the Base Rate was % and the facility fee was 0.20%. At March 31, 2021, we had $247.7 million of outstanding borrowings and $5.6 million of letters of credit outstanding under our Credit Agreement. We had $96.7 million of available borrowing capacity, net of the outstanding borrowings and letters of credit outstanding as of March 31, 2021. There are no compensating balance requirements. At December 31, 2020, we had $236.2 million of outstanding borrowings outstanding against our revolving credit agreement and $108.2 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 March 31, 2021 and December 31, 2020. 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 March 31, 2021 December 31, 2020 Tangible net worth > =$125,000 $ 147,654 $ 147,263 Total leverage < 60% 45.3 % 44.8 % Secured leverage < 30% 8.5 % 8.6 % Unencumbered leverage < 60% 43.3 % 41.4 % Fixed charge coverage > 1.50x 4.8x 4.7x 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 March 31, 2021 (amounts in thousands): Facility Name Outstanding Balance (in Interest Rate Maturity Date 700 Shadow Lane and Goldring MOBs fixed rate mortgage loan $ 5,381 4.54 % June, 2022 BRB Medical Office Building fixed rate mortgage loan 5,449 4.27 % December, 2022 Desert Valley Medical Center fixed rate mortgage loan 4,474 3.62 % January, 2023 2704 North Tenaya Way fixed rate mortgage loan 6,538 4.95 % November, 2023 Summerlin Hospital Medical Office Building III fixed rate mortgage loan 12,984 4.03 % April, 2024 Tuscan Professional Building fixed rate mortgage loan 2,789 5.56 % June, 2025 Phoenix Children’s East Valley Care Center fixed rate mortgage loan 8,656 3.95 % January, 2030 Rosenberg Children's Medical Plaza fixed rate mortgage loan 12,450 4.42 % September, 2033 Total, excluding net debt premium and net financing fees 58,721 Less net financing fees (447 ) Plus net debt premium 129 Total mortgages notes payable, non-recourse to us, net $ 58,403 (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 March 31, 2021 had a combined fair value of approximately $61.6 million. At December 31, 2020, 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 at December 31, 2020 was $59.2 million and had a combined fair value of approximately $62.0 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 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 March 31, 2021, the fair value of our interest rate swaps was a net liability of $467,000 which is included in accrued expenses and other liabilities on the accompanying condensed consolidated balance sheet. During the first quarter of 2021, we paid or accrued approximately $305,000 to the counterparty by us, adjusted for the previous quarter accrual, pursuant to the terms of the swaps. From inception of the swap agreements through March 31, 2021 we paid or accrued approximately $931,000 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 $1.1 million 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.

Segment Reporting

Segment Reporting	3 Months Ended
	Mar. 31, 2021
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)	3 Months Ended
	Mar. 31, 2021
Accounting Policies [Abstract]
Recent Accounting Pronouncements	Accounting for Lease Concessions Granted in Connection with the COVID-19 Pandemic 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, which we adopted on January 1, 2019, 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 months ended March 31, 2021 or the year ended December 31, 2020. 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.

Relationship with Universal H_2

Relationship with Universal Health Services, Inc. ("UHS") and Related Party Transactions (Tables)	3 Months Ended
	Mar. 31, 2021
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)	3 Months Ended
	Mar. 31, 2021
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 and were accounted for under the equity method as of March 31, 2021: 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 $9.2 million, which is non-recourse to us, outstanding as of March 31, 2021. (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 of $13.3 million, which is non-recourse to us, outstanding as of March 31, 2021. (c.) We have committed to invest up to $2.5 million in equity and debt financing, of which $2.4 million has been funded as of March 31, 2021. During the first quarter of 2021, this LP paid off its $4.7 million mortgage loan, upon maturity, utilizing pro rata equity contributions from the limited partners as well as a $3.5 million member loan from us to the LP which was funded utilizing borrowings from our revolving credit agreement. (d.) Construction on this MOB , which is located in Denison, Texas on the campus of a hospital owned and operated by a wholly-owned subsidiary of UHS , was substantially completed in December 2020. We have committed to invest up to $ 4.8 million in equity and debt financing , no ne of which has been funded as of March 31, 202 1 . This LP entered into a $ 13.1 million third-party construction loan commitment, which is non-recourse to us , which has an outstanding balance of $ million as of March 3 1 , 202 1 . (e.) The LLC is the lessee with a third-party lessor under a ground lease for land. (f.) These LPs are the lessees with UHS-related parties for the land related to these properties.
Condensed Combined Statements of Income (Unaudited) for LLCs/LPs Accounted Under Equity Method	Below are the condensed combined statements of income (unaudited) for the four LLCs/LPs accounted for under the equity method at March 31, 2021 and 2020. Three Months Ended March 31, 2021 2020 (amounts in thousands) Revenues $ 2,788 $ 2,516 Operating expenses 1,107 1,028 Depreciation and amortization 521 442 Interest, net 431 318 Net income $ 729 $ 728 Our share of net income $ 471 $ 435
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 that were accounted for under the equity method as of March 31, 2021 and December 31, 2020: March 31, 2021 December 31, 2020 (amounts in thousands) Net property, including construction in progress $ 41,822 $ 42,374 Other assets (a.) 8,817 8,818 Total assets $ 50,639 $ 51,192 Other liabilities (a.) $ 8,543 $ 9,402 Mortgage notes payable, non-recourse to us 34,896 39,735 Advances payable to us (b.) 3,500 - Equity 3,700 2,055 Total liabilities and equity $ 50,639 $ 51,192 Investments in LLCs before amounts included in accrued expenses and other liabilities $ 9,087 $ 4,278 Amounts included in accrued expenses and other liabilities (2,700 ) (3,020 ) Our share of equity in LLCs, net $ 6,387 $ 1,258 (a.) Other assets and other liabilities as of both March 31, 2021 and December 31, 2020 include approximately $4.3 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. (b.) Consists of a 7.25% member loan to FTX MOB Phase II, LP with a maturity date of March 1, 2023.
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 3/31/2021 12/31/2020 Maturity Date FTX MOB Phase II (5.00% fixed rate mortgage loan) (b.) $ - $ 4,777 Repaid in Feb., 2021 Grayson Properties (5.034% fixed rate mortgage loan) (c.) 13,295 13,372 September, 2021 Brunswick Associates (3.64% fixed rate mortgage loan) 9,185 9,250 December, 2024 Grayson Properties II (3.70% fixed rate construction loan) (d.) 12,416 12,336 June, 2025 $ 34,896 $ 39,735 (a.) All mortgage loans require monthly principal payments through maturity and include a balloon principal payment upon maturity. (b.) Upon maturity in February, 2021 this LP paid off this mortgage loan utilizing pro rata equity contributions from the limited partners as well as a $3.5 million member loan from us to the LP which was funded utilizing borrowings from our revolving credit agreement. (c.) This loan is scheduled to mature within the next twelve months, at which time the entity intends to refinance pursuant to a new mortgage loan. (d.) This construction loan has a maximum commitment of $13.1 million and requires interest on the outstanding principal balance to be paid on a monthly basis through December 1, 2022. Monthly principal and interest payments are scheduled to commence on January 1, 2023.

Lease Accounting (Tables)

Lease Accounting (Tables)	3 Months Ended
	Mar. 31, 2021
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 month periods ended March 31, 2021 and 2020 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 March 31, 2021 2020 UHS facilities: Base rents $ 5,146 $ 4,244 Bonus rents 1,695 1,380 Tenant reimbursements 291 257 Lease revenue - UHS facilities $ 7,132 $ 5,881 Non-related parties: Base rents 10,505 10,378 Tenant reimbursements 2,587 2,464 Lease revenue - Non-related parties $ 13,092 $ 12,842

Debt and Financial Instruments

Debt and Financial Instruments (Tables)	3 Months Ended
	Mar. 31, 2021
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 March 31, 2021 December 31, 2020 Tangible net worth > =$125,000 $ 147,654 $ 147,263 Total leverage < 60% 45.3 % 44.8 % Secured leverage < 30% 8.5 % 8.6 % Unencumbered leverage < 60% 43.3 % 41.4 % Fixed charge coverage > 1.50x 4.8x 4.7x
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 March 31, 2021 (amounts in thousands): Facility Name Outstanding Balance (in Interest Rate Maturity Date 700 Shadow Lane and Goldring MOBs fixed rate mortgage loan $ 5,381 4.54 % June, 2022 BRB Medical Office Building fixed rate mortgage loan 5,449 4.27 % December, 2022 Desert Valley Medical Center fixed rate mortgage loan 4,474 3.62 % January, 2023 2704 North Tenaya Way fixed rate mortgage loan 6,538 4.95 % November, 2023 Summerlin Hospital Medical Office Building III fixed rate mortgage loan 12,984 4.03 % April, 2024 Tuscan Professional Building fixed rate mortgage loan 2,789 5.56 % June, 2025 Phoenix Children’s East Valley Care Center fixed rate mortgage loan 8,656 3.95 % January, 2030 Rosenberg Children's Medical Plaza fixed rate mortgage loan 12,450 4.42 % September, 2033 Total, excluding net debt premium and net financing fees 58,721 Less net financing fees (447 ) Plus net debt premium 129 Total mortgages notes payable, non-recourse to us, net $ 58,403 (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)	Mar. 31, 2021Property
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)		1 Months Ended		3 Months Ended		12 Months Ended
		Sep. 30, 2019	Jul. 31, 2019USD ($)Time	Mar. 31, 2021USD ($)PropertyTimeLease	Mar. 31, 2020USD ($)	Dec. 31, 2020USD ($)
Related Party Transaction [Line Items]
Annual advisory fee as percentage of average invested real estate assets				0.70%	0.70%
Grayson Properties Two L P | Denison Texas
Related Party Transaction [Line Items]
Non-controlling equity interest, ownership percentage		95.00%
Universal Health Services, Inc
Related Party Transaction [Line Items]
Number of term renewal options | Time				6
Additional renewal terms				5 years
Number of medical office buildings and free standing emergency departments | Property				18
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
Lease revenue	[1]			$ 7,132,000	$ 5,881,000
Master flex lease term		10 years
Percentage of rentable square feet		50.00%
Number of ground leases | Lease				12
Aggregate lease payments for 2021				$ 508,000
Aggregate lease payments for 2022				508,000
Aggregate lease payments for 2023				508,000
Aggregate lease payments for 2024				508,000
Aggregate lease payments for 2025				508,000
Aggregate lease payments for thereafter				$ 29,000,000
Percentage ownership of outstanding shares				5.70%		5.70%
Universal Health Services, Inc | Southwest Healthcare System, Inland Valley Campus
Related Party Transaction [Line Items]
Lease expiration date				Dec. 31, 2021
Lease revenue				$ 1,100,000		$ 4,400,000
Universal Health Services, Inc | Base Rents
Related Party Transaction [Line Items]
Lease revenue				5,146,000	4,244,000
Universal Health Services, Inc | Base Rents | Southwest Healthcare System, Inland Valley Campus
Related Party Transaction [Line Items]
Lease revenue				662,000		2,600,000
Universal Health Services, Inc | Bonus Rents
Related Party Transaction [Line Items]
Lease revenue				1,695,000	$ 1,380,000
Universal Health Services, Inc | Bonus Rents | Southwest Healthcare System, Inland Valley Campus
Related Party Transaction [Line Items]
Lease revenue				$ 454,000		$ 1,800,000
Universal Health Services, Inc | Customer Concentration Risk | Revenues
Related Party Transaction [Line Items]
Percentage of revenues generated from leases and tenants				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				36.00%	32.00%
Universal Health Services, Inc | Hospital Facilities Leased
Related Party Transaction [Line Items]
Number of hospital facilities leased | Property				3
Universal Health Services, Inc | Minimum
Related Party Transaction [Line Items]
Initial lease terms				13 years
Remaining lease terms on ground leases				28 years
Universal Health Services, Inc | Maximum
Related Party Transaction [Line Items]
Initial lease terms				15 years
Remaining lease terms on ground leases				78 years
Universal Health Services Inc And Catholic Health Initiatives
Related Party Transaction [Line Items]
Number of term renewal options | Time			5
Option to renew lease, notice period prior to termination date of current term			270 days
Renewal period of respective leased facilities at same price after lease terms			270 days
Triple net lease agreement period			20 years
Renewal option term			10 years
Project manager's aggregate fee			$ 750,000
Change in control of trust notice, description			upon 30 days’ notice anytime within 12 months of a change of control of the Trust (UHS also has this right should the JV decline to exercise its purchase right)
Universal Health Services of Delaware Inc
Related Party Transaction [Line Items]
Advisory fee				$ 1,100,000	$ 1,000,000
Cost, Product and Service [Extensible List]				Management Service	Management Service
Average invested real estate assets				$ 607,000,000	$ 581,000,000
[1]	Includes bonus rental on UHS hospital facilities of $1,695 and $1,380 for the three-month periods ended March 31, 2021 and 2020, respectively.

Existing Lease Terms and Renewa

Existing Lease Terms and Renewal Options for Each of UHS Hospital Facilities (Detail) - Universal Health Services, Inc	3 Months Ended
	Mar. 31, 2021USD ($)
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	3 Months Ended
	Mar. 31, 2021TimeRenewalOption
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	3 Months Ended
	Mar. 31, 2021	Jun. 30, 2020	Mar. 31, 2020
Dividends and Equity Issuance [Line Items]
Dividends declared and paid	$ 9,564		$ 9,424
Declared and paid dividends, per share	$ 0.695		$ 0.685
At-The-Market Equity Issuance Program (ATM)
Dividends and Equity Issuance [Line Items]
Aggregate sales of threshold amount		$ 100,000
Issued (in shares)	0	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	$ 507,000

Acquisitions and Dispositions -

Acquisitions and Dispositions - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2021AcquisitionDisposition	Mar. 31, 2020AcquisitionDisposition
Business Combinations [Abstract]
Number of acquisitions | Acquisition	0	0
Number of dispositions | Disposition	0	0

Summarized Financial Informat_3

Summarized Financial Information of Equity Affiliates - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2021Property
Limited Liability Companies | Medical office buildings
Schedule Of Equity Method Investments [Line Items]
Number of real estate investments	5
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	3 Months Ended
	Mar. 31, 2021
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 LP
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 $9.2 million, which is non-recourse to us, outstanding as of March 31, 2021.
[3]	These LPs are the lessees with UHS-related parties for the land related to these properties.
[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 of $13.3 million, which is non-recourse to us, outstanding as of March 31, 2021.
[5]	We have committed to invest up to $2.5 million in equity and debt financing, of which $2.4 million has been funded as of March 31, 2021. During the first quarter of 2021, this LP paid off its $4.7 million mortgage loan, upon maturity, utilizing pro rata equity contributions from the limited partners as well as a $3.5 million member loan from us to the LP which was funded utilizing borrowings from our revolving credit agreement.
[6]	Construction on this MOB , which is located in Denison, Texas on the campus of a hospital owned and operated by a wholly-owned subsidiary of UHS , was substantially completed in December 2020. We have committed to invest up to $ 4.8 million in equity and debt financing , no ne of which has been funded as of March 31, 202 1 . This LP entered into a $ 13.1 million third-party construction loan commitment, which is non-recourse to us , which has an outstanding balance of $ million as of March 3 1 , 202 1 .

Limited Liability Companies A_2

Limited Liability Companies Accounted for Under Equity Method (Parenthetical) (Detail)	3 Months Ended
	Mar. 31, 2021USD ($)
Brunswick Associates
Schedule Of Equity Method Investments [Line Items]
Third-party term loan	$ 9,200,000
FTX MOB Phase II limited partnership
Schedule Of Equity Method Investments [Line Items]
Committed investment in equity and debt financing, funded	2,400,000
Member loan used to repay mortgage loan	3,500,000
Repayment of loan	4,700,000
FTX MOB Phase II limited partnership | Maximum
Schedule Of Equity Method Investments [Line Items]
Commitment to investment	2,500,000
Grayson Properties II LP
Schedule Of Equity Method Investments [Line Items]
Construction loan	13,100,000
Construction loan outstanding balance	12,400,000
Grayson Properties II LP | 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	$ 13,300,000

Condensed Combined Statement of

Condensed Combined Statement of Income for LLCs/LPs Accounted Under Equity Method (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Schedule Of Equity Method Investments [Line Items]
Revenues	$ 20,699	$ 19,207
Net income	5,586	4,554
Our share of net income	471	435
Equity Method Investment, Nonconsolidated Investee or Group of Investees
Schedule Of Equity Method Investments [Line Items]
Revenues	2,788	2,516
Operating expenses	1,107	1,028
Depreciation and amortization	521	442
Interest, net	431	318
Net income	729	728
Our share of net income	$ 471	$ 435

Condensed Combined Balance Shee

Condensed Combined Balance Sheets for LLCs/LPs Accounted Under Equity Method (Detail) - USD ($) $ in Thousands		Mar. 31, 2021	Dec. 31, 2020	Mar. 31, 2020	Dec. 31, 2019
Schedule Of Equity Method Investments [Line Items]
Total Assets		$ 495,794	$ 494,009
Equity		158,667	159,005	$ 172,440	$ 181,734
Total Liabilities and Equity		495,794	494,009
Investments in LLCs before amounts included in accrued expenses and other liabilities		9,087	4,278
Equity Method Investment, Nonconsolidated Investee or Group of Investees
Schedule Of Equity Method Investments [Line Items]
Net property, including construction in progress		41,822	42,374
Other assets	[1]	8,817	8,818
Total Assets		50,639	51,192
Other liabilities	[1]	8,543	9,402
Mortgage notes payable, non-recourse to us		34,896	39,735
Advances payable to us	[2]	3,500
Equity		3,700	2,055
Total Liabilities and Equity		50,639	51,192
Investments in LLCs before amounts included in accrued expenses and other liabilities		9,087	4,278
Amounts included in accrued expenses and other liabilities		(2,700)	(3,020)
Our share of equity in LLCs, net		$ 6,387	$ 1,258
[1]	Other assets and other liabilities as of both March 31, 2021 and December 31, 2020 include approximately $4.3 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.
[2]	Consists of a 7.25% member loan to FTX MOB Phase II, LP with a maturity date of March 1, 2023.

Condensed Combined Balance Sh_2

Condensed Combined Balance Sheets for LLCs/LPs Accounted Under Equity Method (Parenthetical) (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Dec. 31, 2020
Schedule Of Equity Method Investments [Line Items]
Right-of-use land assets	$ 8,907	$ 8,914
Right-of-use land liabilities	8,907	8,914
Limited Liability Companies
Schedule Of Equity Method Investments [Line Items]
Right-of-use land assets	4,300	4,300
Right-of-use land liabilities	$ 4,300	$ 4,300
FTX MOB Phase II limited partnership
Schedule Of Equity Method Investments [Line Items]
Debt Instrument Maturity Date	2023-03

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		3 Months Ended
		Mar. 31, 2021	Dec. 31, 2020
Schedule Of Equity Method Investments [Line Items]
Mortgage Loan Balance	[1]	$ 34,896	$ 39,735
FTX MOB Phase II
Schedule Of Equity Method Investments [Line Items]
Mortgage Loan Balance	[1],[2]		4,777
Debt Instrument Maturity Date	[2]	2021-02
Grayson Properties
Schedule Of Equity Method Investments [Line Items]
Mortgage Loan Balance	[1],[3]	$ 13,295	13,372
Debt Instrument Maturity Date	[3]	2021-09
Brunswick Associates
Schedule Of Equity Method Investments [Line Items]
Mortgage Loan Balance	[1]	$ 9,185	9,250
Debt Instrument Maturity Date		2024-12
Grayson Properties Two L P
Schedule Of Equity Method Investments [Line Items]
Mortgage Loan Balance	[1],[4]	$ 12,416	$ 12,336
Debt Instrument Maturity Date	[4]	2025-06
[1]	All mortgage loans require monthly principal payments through maturity and include a balloon principal payment upon maturity
[2]	Upon maturity in February, 2021 this LP paid off this mortgage loan utilizing pro rata equity contributions from the limited partners as well as a $3.5 million member loan from us to the LP which was funded utilizing borrowings from our revolving credit agreement.
[3]	This loan is scheduled to mature within the next twelve months, at which time the entity intends to refinance pursuant to a new mortgage loan.
[4]	This construction loan has a maximum commitment of $13.1 million and requires interest on the outstanding principal balance to be paid on a monthly basis through December 1, 2022.  Monthly principal and interest payments are scheduled to 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	Mar. 31, 2021USD ($)
Grayson Properties Two L P
Schedule Of Equity Method Investments [Line Items]
Construction loan	$ 13.1
FTX MOB Phase II limited partnership
Schedule Of Equity Method Investments [Line Items]
Member loan used to repay mortgage loan	$ 3.5

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
		Mar. 31, 2021	Mar. 31, 2020
Non-Related Parties
Leases Disclosure [Line Items]
Lease revenue		$ 13,092	$ 12,842
Non-Related Parties | Base Rents
Leases Disclosure [Line Items]
Lease revenue		10,505	10,378
Non-Related Parties | Tenant Reimbursements
Leases Disclosure [Line Items]
Lease revenue		2,587	2,464
Universal Health Services, Inc
Leases Disclosure [Line Items]
Lease revenue	[1]	7,132	5,881
Universal Health Services, Inc | Base Rents
Leases Disclosure [Line Items]
Lease revenue		5,146	4,244
Universal Health Services, Inc | Bonus Rents
Leases Disclosure [Line Items]
Lease revenue		1,695	1,380
Universal Health Services, Inc | Tenant Reimbursements
Leases Disclosure [Line Items]
Lease revenue		$ 291	$ 257
[1]	Includes bonus rental on UHS hospital facilities of $1,695 and $1,380 for the three-month periods ended March 31, 2021 and 2020, respectively.

Lease Accounting - Additional I

Lease Accounting - Additional Information (Detail)		3 Months Ended		12 Months Ended
		Mar. 31, 2021USD ($)BedLand	Mar. 31, 2020USD ($)	Dec. 31, 2020USD ($)
Leases Disclosure [Line Items]
Lessee in connection with ground leases for land | Land		14
Right-of-use land assets		$ 8,907,000		$ 8,914,000
Ground lease liabilities		$ 8,907,000		8,914,000
Kindred Chicago Central Hospital Central Chicago, Illinois
Leases Disclosure [Line Items]
Lease expiration date		Dec. 31, 2021
Lease revenue		$ 390,000		1,600,000
Number of beds in specialty hospital | Bed		95
Evansville Rehabilitation Hospital Evansville, Indiana
Leases Disclosure [Line Items]
Lease expiration date		May 31, 2019
Corpus Christi Corpus Christi Texas
Leases Disclosure [Line Items]
Lease expiration date		Jun. 1, 2019
Universal Health Services, Inc
Leases Disclosure [Line Items]
Lease revenue	[1]	$ 7,132,000	$ 5,881,000
Universal Health Services, Inc | Southwest Healthcare System, Inland Valley Campus
Leases Disclosure [Line Items]
Lease expiration date		Dec. 31, 2021
Lease revenue		$ 1,100,000		4,400,000
Universal Health Services, Inc | Base Rents
Leases Disclosure [Line Items]
Lease revenue		5,146,000	4,244,000
Universal Health Services, Inc | Base Rents | Southwest Healthcare System, Inland Valley Campus
Leases Disclosure [Line Items]
Lease revenue		662,000		2,600,000
Universal Health Services, Inc | Bonus Rents
Leases Disclosure [Line Items]
Lease revenue		1,695,000	$ 1,380,000
Universal Health Services, Inc | Bonus Rents | Southwest Healthcare System, Inland Valley Campus
Leases Disclosure [Line Items]
Lease revenue		$ 454,000		$ 1,800,000
[1]	Includes bonus rental on UHS hospital facilities of $1,695 and $1,380 for the three-month periods ended March 31, 2021 and 2020, respectively.

Debt and Financial Instrument_2

Debt and Financial Instruments - Additional Information (Detail)	Mar. 27, 2018USD ($)Option	Mar. 31, 2020USD ($)Derivative	Jan. 31, 2020USD ($)Derivative	Mar. 31, 2021USD ($)	Mar. 31, 2020USD ($)Derivative	Sep. 30, 2019USD ($)Derivative	Jun. 30, 2020USD ($)	Dec. 31, 2020USD ($)
Debt Instrument [Line Items]
Proceeds from lines of credit				$ 11,450,000	$ 6,250,000
Outstanding borrowings under revolving credit agreement				247,650,000				$ 236,200,000
Letters of credit outstanding				5,600
Available borrowing capacity				96,700,000				108,200,000
Compensating balance				0
Interest Rate Swap | Cash Flow Hedge
Debt Instrument [Line Items]
Number of interest rate cap agreements | Derivative		1	1		1	1
Derivative instruments, fixed rate		0.565%	1.4975%		0.565%	1.144%
Notional amount		$ 55,000,000	$ 35,000,000		$ 55,000,000	$ 50,000,000
Expiration date of interest rate		Mar. 25, 2027	Sep. 16, 2024			Sep. 16, 2024
Level 2
Debt Instrument [Line Items]
Mortgage loan fair value				61,600,000				62,000,000
Mortgage debt								$ 59,200,000
Derivative interest rate cap, net payment received or accrued from counterparties				931,000
Derivative interest rate cap, payment received or accrued from counterparties				199,000
Derivative interest rate cap, offset due to counterparties				1,100,000
Level 2 | Interest Rate Swap
Debt Instrument [Line Items]
Liability derivatives, fair value				467,000,000,000
Derivative interest rate cap, net payment received or accrued from counterparties				305,000
Credit Agreement
Debt Instrument [Line Items]
Outstanding borrowing				$ 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
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	3 Months Ended
	Mar. 31, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
Covenant, Tangible net worth	$ 125,000
Tangible net worth	$ 147,654	$ 147,263
Total leverage	45.30%	44.80%
Secured leverage	8.50%	8.60%
Unencumbered leverage	43.30%	41.40%
Fixed charge coverage	4.80%	4.70%
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		3 Months Ended
		Mar. 31, 2021		Dec. 31, 2020
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 58,721
Less net financing fees	[1]	(447)
Plus net debt premium	[1]	129
Total mortgages notes payable, non-recourse to us, net		58,403	[1]	$ 58,895
700 Shadow Lane and Goldring MOBs Fixed Rate Mortgage Loan
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 5,381
Debt Instrument Interest Rate Stated Percentage		4.54%
Debt Instrument Maturity Date		2022-06
BRB Medical Office Building Fixed Rate Mortgage Loan
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 5,449
Debt Instrument Interest Rate Stated Percentage		4.27%
Debt Instrument Maturity Date		2022-12
Desert Valley Medical Center Fixed Rate Mortgage Loan
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 4,474
Debt Instrument Interest Rate Stated Percentage		3.62%
Debt Instrument Maturity Date		2023-01
2704 North Tenaya Way Fixed Rate Mortgage Loan
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 6,538
Debt Instrument Interest Rate Stated Percentage		4.95%
Debt Instrument Maturity Date		2023-11
Summerlin Hospital Medical Office Building III Fixed Rate Mortgage Loan
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 12,984
Debt Instrument Interest Rate Stated Percentage		4.03%
Debt Instrument Maturity Date		2024-04
Tuscan Professional Building Fixed Rate Mortgage Loan
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 2,789
Debt Instrument Interest Rate Stated Percentage		5.56%
Debt Instrument Maturity Date		2025-06
Phoenix Children East Valley Care Center Fixed Rate Mortgage Loan
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 8,656
Debt Instrument Interest Rate Stated Percentage		3.95%
Debt Instrument Maturity Date		2030-01
Rosenberg Children's Medical Plaza Fixed Rate Mortgage Loan
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 12,450
Debt Instrument Interest Rate Stated Percentage		4.42%
Debt Instrument 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)	3 Months Ended
	Mar. 31, 2021Segment
Segment Reporting [Abstract]
Number of reportable segments	1