Universal Health Realty Income Trust (UHT) 10-Q 8 Nov 22 2022 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2022	Oct. 31, 2022
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2022
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	Q3
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		13,802,208
Entity Current Reporting Status	Yes
Entity Shell Company	false
Entity File Number	1-9321
Entity Tax Identification Number	23-6858580
Entity Address, Address Line One	UNIVERSAL CORPORATE CENTER
Entity Address, Address Line Two	367 SOUTH GULPH ROAD
Entity Address, City or Town	KING OF PRUSSIA
Entity Address, State or Province	PA
Entity Address, Postal Zip Code	19406-0958
City Area Code	610
Local Phone Number	265-0688
Entity Interactive Data Current	Yes
Title of 12(b) Security	Shares of beneficial interest, $0.01 par value
Trading Symbol	UHT
Security Exchange Name	NYSE
Entity Incorporation, State or Country Code	MD
Document Quarterly Report	true
Document Transition Report	false

Condensed Consolidated Statemen

Condensed Consolidated Statements of Income - USD ($) $ in Thousands		3 Months Ended		9 Months Ended
		Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Revenues:
Revenues, Total		$ 22,151	$ 21,205	$ 66,497	$ 62,780
Expenses:
Depreciation and amortization		6,658	6,813	20,046	20,551
Other operating expenses		6,875	5,980	20,728	17,485
Costs and Expenses, Total		14,830	13,914	44,561	41,308
Income before equity in income of unconsolidated limited liability companies ("LLCs"), gain on sale and interest expense		7,321	7,291	21,936	21,472
Equity in income of unconsolidated LLCs		346	303	943	1,341
Gain on sale of real estate assets					1,304
Interest expense, net		(2,819)	(2,250)	(7,408)	(6,566)
Net income		$ 4,848	$ 5,344	$ 15,471	$ 17,551
Basic earnings per share		$ 0.35	$ 0.39	$ 1.12	$ 1.28
Diluted earnings per share		$ 0.35	$ 0.39	$ 1.12	$ 1.27
Weighted average number of shares outstanding - Basic		13,776	13,762	13,769	13,755
Weighted average number of shares outstanding - Diluted		13,801	13,783	13,792	13,777
Non-Related Parties
Revenues:
Lease revenue		$ 12,836	$ 13,115	$ 38,664	$ 39,324
Other | Non-Related Parties
Revenues:
Other revenue		221	280	718	816
Management Service
Expenses:
Advisory fees to UHS		1,297	1,121	3,787	3,272
Universal Health Services Inc
Revenues:
Lease revenue	[1]	7,471	7,574	22,291	21,971
Interest income on financing leases		1,368		4,107
Universal Health Services Inc | Other
Revenues:
Other revenue		$ 255	$ 236	$ 717	$ 669
[1]Includes bonus rental on McAllen Medical Center, a UHS acute care hospital facility of $727 and $2,048 for the three and nine-month periods ended September 30, 2022, respectively, and includes bonus rental on three UHS acute care hospital facilities of $1,828 and $5,171 for the three and nine-month periods ended September 30, 2021, respectively

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Income (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
UHS Hospital Facilities | McAllen Medical Center
Bonus rental	$ 727	$ 1,828	$ 2,048	$ 5,171

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Statement Of Income And Comprehensive Income [Abstract]
Net income	$ 4,848	$ 5,344	$ 15,471	$ 17,551
Other comprehensive gain:
Unrealized derivative gains on cash flow hedges	3,728	471	11,417	3,259
Total other comprehensive gains:	3,728	471	11,417	3,259
Total comprehensive income	$ 8,576	$ 5,815	$ 26,888	$ 20,810

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Real Estate Investments:
Buildings and improvements and construction in progress	$ 636,320	$ 608,836
Accumulated depreciation	(243,079)	(225,584)
Real Estate Investment Property, Net, Total	393,241	383,252
Land	56,631	54,897
Net Real Estate Investments	449,872	438,149
Financing receivable from UHS	83,651	82,439
Net Real Estate Investments and Financing receivable	533,523	520,588
Investments in and advances to limited liability companies ("LLCs")	9,661	10,139
Other Assets:
Cash and cash equivalents	8,102	22,504
Lease and other receivables from UHS	5,083	4,641
Lease receivable - other	8,233	7,109
Intangible assets (net of accumulated amortization of $14.9 million and $14.2 million, respectively)	9,936	9,972
Right-of-use land assets, net	11,467	11,495
Deferred charges and other assets, net	23,303	11,971
Total Assets	609,308	598,419
Liabilities:
Line of credit borrowings	290,100	271,900
Mortgage notes payable, non-recourse to us, net	50,251	56,866
Accrued interest	346	346
Accrued expenses and other liabilities	13,606	12,157
Ground lease liabilities, net	11,467	11,495
Tenant reserves, deposits and deferred and prepaid rents	9,911	10,328
Total Liabilities	375,681	363,092
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: 2022 - 13,802,200; 2021 - 13,785,345	138	138
Capital in excess of par value	269,241	268,515
Cumulative net income	805,030	789,559
Cumulative dividends	(853,312)	(823,998)
Accumulated other comprehensive income	12,530	1,113
Total Equity	233,627	235,327
Total Liabilities and Equity	$ 609,308	$ 598,419

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Millions	Sep. 30, 2022	Dec. 31, 2021
Statement Of Financial Position [Abstract]
Intangible assets, accumulated amortization	$ 14.9	$ 14.2
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	13,802,200	13,785,345
Common shares, outstanding	13,802,200	13,785,345

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Changes in Equity - USD ($) $ in Thousands	Total	Common Stock	Capital in excess of par value	Cumulative net income	Cumulative dividends	Accumulated other comprehensive income/(loss)
Balance at Dec. 31, 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, net	161		161
Issued, net (in shares)		13
Repurchased	(16)		(16)
Restricted stock-based compensation expense	719		719
Dividends	(28,868)				(28,868)
Comprehensive income:
Net income	17,551			17,551
Unrealized net gain on cash flow hedges	3,259					3,259
Subtotal - comprehensive income	20,810			17,551		3,259
Balance at Sep. 30, 2021	151,811	$ 138	268,232	698,278	(814,281)	(556)
Balance, Shares at Sep. 30, 2021		13,784
Balance at Jun. 30, 2021	155,364	$ 138	267,951	692,934	(804,632)	(1,027)
Balance, Shares at Jun. 30, 2021		13,783
Shares of Beneficial Interest:
Issued, net	55		55
Issued, net (in shares)		1
Restricted stock-based compensation expense	226		226
Dividends	(9,649)				(9,649)
Comprehensive income:
Net income	5,344			5,344
Unrealized net gain on cash flow hedges	471					471
Subtotal - comprehensive income	5,815			5,344		471
Balance at Sep. 30, 2021	151,811	$ 138	268,232	698,278	(814,281)	(556)
Balance, Shares at Sep. 30, 2021		13,784
Balance at Dec. 31, 2021	235,327	$ 138	268,515	789,559	(823,998)	1,113
Balance, Shares at Dec. 31, 2021		13,785
Shares of Beneficial Interest:
Issued, net	135		135
Issued, net (in shares)		17
Restricted stock-based compensation expense	591		591
Dividends	(29,314)				(29,314)
Comprehensive income:
Net income	15,471			15,471
Unrealized net gain on cash flow hedges	11,417					11,417
Subtotal - comprehensive income	26,888			15,471		11,417
Balance at Sep. 30, 2022	233,627	$ 138	269,241	805,030	(853,312)	12,530
Balance, Shares at Sep. 30, 2022		13,802
Balance at Jun. 30, 2022	234,646	$ 138	269,039	800,182	(843,515)	8,802
Balance, Shares at Jun. 30, 2022		13,801
Shares of Beneficial Interest:
Issued, net	42		42
Issued, net (in shares)		1
Restricted stock-based compensation expense	160		160
Dividends	(9,797)				(9,797)
Comprehensive income:
Net income	4,848			4,848
Unrealized net gain on cash flow hedges	3,728					3,728
Subtotal - comprehensive income	8,576			4,848		3,728
Balance at Sep. 30, 2022	$ 233,627	$ 138	$ 269,241	$ 805,030	$ (853,312)	$ 12,530
Balance, Shares at Sep. 30, 2022		13,802

Condensed Consolidated Statem_5

Condensed Consolidated Statements of Changes in Equity (Parenthetical) - $ / shares	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Statement Of Stockholders Equity [Abstract]
Dividends, per share	$ 0.71	$ 0.70	$ 2.125	$ 2.095

Condensed Consolidated Statem_6

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Cash flows from operating activities:
Net income	$ 15,471	$ 17,551
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	20,046	20,551
Amortization related to above/below market leases, net	(108)	(139)
Amortization of debt premium	(38)	(38)
Amortization of deferred financing costs	536	609
Stock-based compensation expense	591	719
Gain on sale of real estate assets		(1,304)
Changes in assets and liabilities:
Lease receivable	(1,566)	(457)
Accrued expenses and other liabilities	977	201
Tenant reserves, deposits and deferred and prepaid rents	(417)	272
Accrued interest		1
Leasing costs paid	(1,421)	(1,250)
Other, net	445	(522)
Net cash provided by operating activities	34,516	36,194
Cash flows from investing activities:
Investments in LLCs	(94)	(16,138)
Cash distributions from LLCs	516
Advance made to LLC		(3,500)
Additions to real estate investments, net	(16,698)	(11,537)
Deposit on real estate assets		(200)
Cash paid for acquisition of properties	(13,620)	(12,989)
Cash proceeds received from divestiture of property, net		3,209
Net cash paid as part of asset exchange transaction	(1,346)
Net cash used in investing activities	(31,242)	(41,155)
Cash flows from financing activities:
Net borrowings on the line of credit	18,200	40,600
Repayments of mortgage notes payable	(6,660)	(1,550)
Financing costs paid	(26)	(1,813)
Dividends paid	(29,326)	(28,830)
Issuance of shares of beneficial interest, net	136	159
Net cash (used in)/provided by financing activities	(17,676)	8,566
(Decrease)/increase in cash and cash equivalents	(14,402)	3,605
Cash and cash equivalents, beginning of period	22,504	5,742
Cash and cash equivalents, end of period	8,102	9,347
Supplemental disclosures of cash flow information:
Interest paid	7,050	5,995
Invoices accrued for construction and improvements	$ 2,334	$ 151

General

General	9 Months Ended
	Sep. 30, 2022
Organization Consolidation And Presentation Of Financial Statements [Abstract]
General	(1) General This Quarterly Report on Form 10-Q is for the quarter ended September 30, 2022. 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 September 30, 2022, we had investments in four jointly-owned LLCs/LPs. We currently account for our share of the income/loss from these investments by the equity method (see Note 5). 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, 2021. 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	9 Months Ended
	Sep. 30, 2022
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. The base rentals and lease and renewal terms for each of the hospitals leased to subsidiaries of UHS as of September 30, 2022 are provided below. The base rents are paid monthly. The lease on McAllen Medical Center also provides for bonus rent which is paid quarterly based upon a computation that compares the hospital’s current quarter revenue to a corresponding quarter in the base year. The hospital leases with subsidiaries of UHS, with the exception of the lease on Clive Behavioral Health Hospital (which is operated by UHS in a joint venture with an unrelated third party), are unconditionally guaranteed by UHS and are cross-defaulted with one another. The lease for the Clive facility is guaranteed on a several basis by UHS (52%) and Catholic Health Initiatives-Iowa (48%). As previously disclosed on Form 8-K as filed on January 4, 2022, on December 31, 2021, we entered into an asset purchase and sale agreement with UHS and certain of its affiliates. Pursuant to the terms of the asset purchase and sale agreement, which was amended during the first quarter of 2022, a wholly-owned subsidiary of UHS purchased from us the real estate assets of the Inland Valley Campus of Southwest Healthcare System (at its fair market value of $79.6 million), and two wholly-owned subsidiaries of UHS transferred to us the real estate assets of Aiken Regional Medical Center (at its fair market value of $57.7 million) and Canyon Creek Behavioral Health (at its fair market value of $26.0 million). In connection with this transaction, since the $83.7 million aggregate fair market value of Aiken Regional Medical Center (“Aiken”) located in Aiken, South Carolina, and Canyon Creek Behavioral Health (“Canyon Creek”) located in Temple, Texas, exceeded the $79.6 million fair market value of Inland Valley Campus of Southwest Healthcare System, we paid approximately $4.1 million in cash to UHS. Aiken Regional Medical Center includes an acute care hospital and a behavioral health pavilion. The properties acquired by us in connection with this asset purchase and sale agreement with UHS were accounted for as financing arrangements and our consolidated balance sheets as of September 30, 2022 and December 31, 2021 include financing receivables related to this transaction amounting to $83.7 million and $82.4 million, respectively. Pursuant to the leases, as amended during the first quarter of 2022, the aggregate annual rental during 2022 on the acquired properties, which is payable to us on a monthly basis, amounts to approximately $5.7 million ($3.9 million related to Aiken and $1.8 million related to Canyon Creek). The portion of the lease payments that will be included in our consolidated statements of income, and reflected as interest income on financing leases, is expected to be approximately $5.5 million during the full year of 2022. Pursuant to the terms of the previous lease on the Inland Valley Campus of Southwest Healthcare System, we earned $4.5 million of lease revenue during the year ended December 31, 2021 ($2.6 million in base rental and $1.9 million in bonus rental). The combined revenues generated from the leases on the three acute care and three behavioral health care hospital facilities leased to subsidiaries of UHS at September 30, 2022, accounted for approximately 27% of our consolidated revenues for each of the three and nine months ended September 30, 2022, respectively. The combined revenues generated from the leases on the three acute care and one behavioral health care hospital facilities leased to subsidiaries of UHS at September 30, 2021 accounted for approximately 26% of our consolidated revenues for each of the three and nine month periods ended September 30, 2021. In addition to the six UHS hospital facilities, we have twenty properties consisting of MOBs (including one under construction) and FEDs that are either wholly or jointly-owned by us that include, or will include, tenants which are subsidiaries of UHS. The aggregate revenues generated from UHS-related tenants comprised approximately 41% and 37% of our consolidated revenues during the three-month periods ended September 30, 2022 and 2021, respectively, and approximately 41% and 36% of our consolidated revenues during the nine-month periods ended September 30, 2022 and 2021, respectively. Pursuant to the terms of the two master leases by and among us and certain subsidiaries of UHS, dated December 24, 1986 and December 31, 2021 (the “Master Leases”), which govern the leases of McAllen Medical Center, Wellington Regional Medical Center (governed by the Master Lease dated December 24, 1986), Aiken Regional Medical Center and Canyon Creek Behavioral Health (governed by the Master Lease dated December 31, 2021), all of which are hospital properties that are wholly-owned subsidiaries of UHS, UHS has the option, among other things, to renew the leases at the lease terms described below by providing notice to us at least 90 days prior to the termination of the then current term. UHS also has the right to purchase the respective leased facilities from us at their appraised fair market value upon any of the following: (i) at the end of the lease terms or any renewal terms; (ii) upon one month’s notice should a change of control of the Trust occur, or; (iii) within the time period as specified in the leases in the event that UHS provides notice to us of their intent to offer a substitution property/properties in exchange for one (or more) of the four wholly-owned UHS hospital facilities leased from us, should we be unable to reach an agreement with UHS on the properties to be substituted. Additionally, UHS has rights of first refusal to: (i) purchase the respective leased facilities during and for 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. In addition, a wholly-owned subsidiary of UHS is the managing, majority member in a joint-venture with an unrelated third-party that operates, and leases from us, Clive Behavioral Health. This 100-bed behavioral health care facility is located in Clive, Iowa and was completed and opened in late December, 2020 and the hospital lease commenced on December 31, 2020. The lease on this facility is a triple net lease and has an initial term of 20 years with five 10-year renewal options. B st The table below details the existing lease terms and renewal options for each of the hospital leases that are related to UHS as of September 30, 2022, consisting of three acute care hospitals and three behavioral health hospitals: 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 $ 6,319,000 December, 2026 5 (b) Aiken Regional Medical Center/Aurora Pavilion Behavioral Health Services $ 3,895,000 December, 2033 35 (c) Canyon Creek Behavioral Health $ 1,670,000 December, 2033 35 (c) Clive Behavioral Health Hospital $ 2,628,000 December, 2040 50 (d) (a) UHS has one (b) UHS has one (c) UHS has seven (d) The UHS-related joint venture has five Upon the December 31, 2021 expiration of the lease on Wellington Regional Medical Center located in West Palm Beach, Florida, a wholly-owned subsidiary of UHS exercised its fair market value renewal option and renewed the lease for a 5-year term scheduled to expire on December 31, 2026. Effective January 1, 2022, the annual fair market value lease rate for this hospital, which is payable to us monthly, is $6.3 million (there is no longer a bonus rental component of the lease payment). Beginning on January 1, 2023, and thereafter on each January 1 st Management cannot predict whether the leases with wholly-owned subsidiaries of UHS, which have renewal options at existing lease rates or fair market value lease rates, or any of our other leases, will be renewed at the end of their lease term. If the leases are not renewed at their current rates or the fair market value lease rates, we would be required to find other operators for those facilities and/or enter into leases on terms potentially less favorable to us than the current leases. In addition, if subsidiaries of UHS exercise their options to purchase the respective leased hospital or FED facilities upon expiration of the lease terms, our future revenues could decrease if we were unable to earn a favorable rate of return on the sale proceeds received, as compared to the rental revenue currently earned pursuant to these leases. In January, 2022, we entered into a ground lease and master flex-lease agreement with a wholly-owned subsidiary of UHS with the intent to develop, construct and own the real property of Sierra Medical Plaza I, an MOB located in Reno, Nevada, consisting of approximately 86,000 rentable square feet. This MOB will be located on the campus of the Northern Nevada Sierra Medical Center, a newly constructed hospital that is owned and operated by a wholly-owned subsidiary of UHS, which was completed and opened during April of 2022. Construction of this MOB, for which we have engaged a non-related third party to act as construction manager, commenced in January, 2022 and is anticipated to be completed and opened during the first quarter of 2023. The cost of the MOB is estimated to be approximately $34.6 million, $16.9 million of which has been incurred as of September 30, 2022. The master flex lease agreement, which is subject to reduction based upon the execution of third-party leases, is for approximately 68% of the rentable square feet of the MOB at an initial minimum rent of $1.3 million annually. During the fourth quarter of 2021, we purchased the 5% minority ownership interest held by a third-party member in Grayson Properties, LP which owns the Texoma Medical Plaza, an MOB located in Denison, Texas for approximately $3.1 million. The MOB is located on the campus of Texoma Medical Center, a hospital that is owned and operated by a wholly-owned subsidiary of UHS. A third-party appraisal was completed to determine the fair value of the property. As a result of this minority ownership purchase during the fourth quarter of 2021, we own 100% of the LP and are therefore consolidating this LP effective with the purchase date. We do not expect a material impact on our net income as a result of the consolidation of this LP subsequent to the transaction. Please see Note 5 for additional disclosure surrounding this transaction. In May, 2021, we acquired the Fire Mesa office building located in Las Vegas, Nevada for a purchase price of approximately $12.9 million. The building is 100% leased under the terms of a triple net lease by a wholly-owned subsidiary of UHS. The initial lease is scheduled to expire on August 31, 2027 and has two five-year renewal options. As discussed in Note 4, t he acquisition of this office building wa s part of a series of planned tax deferred like-kind exchange transactions pursuant to Section 1031 of the Internal Revenue Code , as amended . 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 27 years to approximately 76 years. The annual aggregate lease payments on these properties are approximately $508,000 during each of the years ended 2022 through 2026, and an aggregate of $28.0 million thereafter. See Note 7 for additional lease accounting disclosure. Officers and Employees: Our officers are all employees of a wholly-owned subsidiary of UHS and although as of September 30, 2022 we had no salaried employees, our officers do typically receive annual stock-based compensation awards in the form of restricted stock. In special circumstances, if warranted and deemed appropriate by the Compensation Committee of the Board of Trustees, our officers may also receive one-time special compensation awards in the form of restricted stock and/or cash bonuses. Advisory Agreement: UHS of Delaware, Inc. (the “Advisor”), a wholly-owned subsidiary of UHS, serves as Advisor to us under an advisory agreement dated December 24, 1986, and as amended and restated as of January 1, 2019 (the “Advisory Agreement”). Pursuant to the Advisory Agreement, the Advisor is obligated to present an investment program to us, to use its best efforts to obtain investments suitable for such program (although it is not obligated to present any particular investment opportunity to us), to provide administrative services to us and to conduct our day-to-day affairs. All transactions between us and UHS must be approved by the Trustees who are unaffiliated with UHS (the “Independent Trustees”). In performing its services under the Advisory Agreement, the Advisor may utilize independent professional services, including accounting, legal, tax and other services, for which the Advisor is reimbursed directly by us. The Advisory Agreement may be terminated for any reason upon sixty days written notice by us or the Advisor. The Advisory Agreement expires on December 31 of each year; however, it is renewable by us, subject to a determination by the Independent Trustees, that the Advisor’s performance has been satisfactory. The Advisory Agreement was renewed for 2022 with the same terms as the Advisory Agreement in place during 2021 and 2020. Our advisory fee for the three and nine months ended September 30, 2022 and 2021, 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 2022, 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 $1.3 million and $1.1 million for the three months ended September 30, 2022 and 2021, respectively, and were based upon average invested real estate assets of $741 million and $641 million, respectively. Advisory fees incurred and paid (or payable) to UHS were approximately $3.8 million and $3.3 million for the nine months ended September 30, 2022 and 2021, respectively, and were based upon average invested real estate assets of $721 million and $623 million, respectively. Share Ownership: As of September 30, 2022 and December 31, 2021, 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 approximately 41% and 37% of our consolidated revenues during the three-month periods ended September 30, 2022 and 2021, respectively, and 41% and 36% of our consolidated revenues during the nine-month periods ended September 30, 2022 and 2021, 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	9 Months Ended
	Sep. 30, 2022
Equity [Abstract]
Dividends and Equity Issuance Program	(3) Dividends and Equity Issuance Program Dividends and dividend equivalents: During the third quarter of 2022, we declared and paid dividends of approximately $9.8 million, or $.71 per share. We declared and paid dividends of approximately $9.6 million, or $.70 per share, during the third quarter of 2021. During the nine-month period ended September 30, 2022, we declared and paid dividends of approximately $29.3 million (including accrued dividends that were paid related to the vesting of restricted stock), or $2.125 per share. During the nine-month period ended September 30, 2021, we declared and paid dividends of approximately $28.8 million, or $2.095 per share. Dividend equivalents, which are applicable to shares of unvested restricted stock, were accrued during the first nine months of 2022 and 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 nine months of 2022. 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 September 30, 2022, we have paid or incurred approximately $508,000 in various fees and expenses related to the commencement of our ATM program.

Acquisitions and Divestitures

Acquisitions and Divestitures	9 Months Ended
	Sep. 30, 2022
Business Combinations [Abstract]
Acquisitions and Divestitures	(4) Acquisitions and Divestitures During the nine-month periods ended September 30, 2022 and 2021, we completed various transactions, as described below, utilizing qualified third-party intermediaries as part of a series of planned tax-deferred like-kind exchange transactions pursuant to Section 1031 of the Internal Revenue Code, as amended. Nine Months Ended September 30, 2022: Acquisitions: In March, 2022, we acquired the Beaumont Heart and Vascular Center, a medical office building located in Dearborn, Michigan for a purchase price of approximately $5.4 million. The building, which has approximately 17,621 rentable square feet, is 100% leased to a single tenant under the terms of a triple-net lease that is scheduled to expire on November 30, 2026 and has lease escalations of 2.5% per year commencing on December 1, 2022. In January, 2022, we acquired the 140 Thomas Johnson Drive medical office building located in Frederick, Maryland for a purchase price of approximately $8.0 million. The building, which has approximately 20,146 rentable square feet, is 100% leased to three tenants under the terms of triple-net leases. Approximately 72% of the rentable square feet of this MOB is leased pursuant to a 15-year lease, with a remaining lease term of approximately 14 years at the time of purchase, with three, five-year Divestitures: There were no divestitures during the first nine months of 2022. Nine Months Ended September 30, 2021: Acquisitions: In May, 2021, we acquired the Fire Mesa office building located in Las Vegas, Nevada for a purchase price of approximately $12.9 million. The building, which has approximately 44,000 rentable square feet, is 100% leased under the terms of a triple net lease with a wholly-owned subsidiary of UHS. The lease on this building is scheduled to expire on August 31, 2027 and has two five-year renewal options. Divestitures: In June, 2021, we sold the Children’s Clinic at Springdale, a medical office building located in Springdale, AR for a sale price of approximately $3.2 million, net of closing costs. This divestiture resulted in a gain of approximately $1.3 million which is included in our consolidated statement of income for the nine-month period ended September 30, 2021.

Summarized Financial Informatio

Summarized Financial Information of Equity Affiliates	9 Months Ended
	Sep. 30, 2022
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 September 30, 2022, we have non-controlling equity investments or commitments in four jointly-owned LLCs/LPs which own MOBs. As of September 30, 2022 we accounted for these LLCs/LPs on an unconsolidated basis pursuant to the equity method since they are not variable interest entities which we are the primary beneficiary nor do we have a controlling voting interest. The majority of these entities are joint-ventures between us and non-related parties that hold minority ownership interests in the entities. Each entity is generally self-sustained from a cash flow perspective and generates sufficient cash flow to meet its operating cash flow requirements and service the third-party debt (if applicable) that is non-recourse to us. Although there is typically no ongoing financial support required from us to these entities since they are cash-flow sufficient, we may, from time to time, provide funding for certain purposes such as, but not limited to, significant capital expenditures, leasehold improvements and debt financing. Although we are not obligated to do so, if approved by us at our sole discretion, additional cash funding is typically advanced as equity or member loans. These entities maintain property insurance on the properties. During the fourth quarter of 2021, we purchased the 5% minority ownership interest, held by the third-party member in Grayson Properties, LP which owns the Texoma Medical Plaza, in which we previously held a noncontrolling majority ownership interest. As a result of this minority ownership purchase, we now own 100% of the LP and began to account for it on a consolidated basis effective November 1, 2021. Prior to November 1, 2021, the LP was accounted for on an unconsolidated basis pursuant to the equity method. The following property table represents the four LLCs/LPs in which we owned a non-controlling interest and were accounted for under the equity method as of September 30, 2022: Name of LLC/LP Ownership Property Owned by LLC/LP Suburban Properties 33 % St. Matthews Medical Plaza II Brunswick Associates (a.)(b.) 74 % Mid Coast Hospital MOB FTX MOB Phase II (c.) 95 % Forney Medical Plaza II Grayson Properties II (d.)(e.) 95 % Texoma Medical Plaza II (a.) This LLC has a third-party term loan of $8.8 million, which is non-recourse to us, outstanding as of September 30, 2022. (b.) We are the lessee with a third party on a ground lease for land. (c.) During the first quarter of 2021, this LP paid off its $4.7 million mortgage loan upon maturity, utilizing pro rata equity contributions from the limited partners as well as a $3.5 million member loan from us to the LP which was funded utilizing borrowings from our revolving credit agreement. (d.) Construction of this MOB was substantially completed in December, 2020. This MOB is located in Denison, Texas on the campus of a hospital owned and operated by a wholly-owned subsidiary of UHS. We have committed to invest up to $4.8 million in equity and debt financing, $1.8 million of which has been funded as of September 30, 2022. 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 $13.1 million as of September 30, 2022. The LP developed, constructed, owns and operates the Texoma II Medical Plaza. (e.) We are the lessee with a UHS-related party for the land related to this property. Below are the condensed combined statements of income (unaudited) for the four LLCs/LPs accounted for under the equity method at September 30, 2022 and the five LLCs/LPs accounted for under the equity method at September 30, 2021. The data for the three and nine months ended September 30, 2021 includes financial results for the above-mentioned Texoma Medical Plaza in which we purchased the minority ownership interest during the fourth quarter of 2021. Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 (amounts in thousands) (amounts in thousands) Revenues $ 2,129 $ 2,736 $ 6,108 $ 8,373 Operating expenses 826 1,184 2,289 3,356 Depreciation and amortization 463 627 1,386 1,684 Interest, net 264 388 795 1,260 Net income $ 576 $ 537 $ 1,638 $ 2,073 Our share of net income $ 346 $ 303 $ 943 $ 1,341 Below are the condensed combined balance sheets (unaudited) for the four above-mentioned LLCs/LPs that were accounted for under the equity method as of September 30, 2022 and December 31, 2021: September 30, 2022 December 31, 2021 (amounts in thousands) Net property, including construction in progress $ 29,831 $ 30,983 Other assets (a.) 5,010 4,574 Total assets $ 34,841 $ 35,557 Other liabilities (a.) $ 2,794 $ 2,797 Mortgage notes payable, non-recourse to us 21,869 22,068 Advances payable to us (b.) 3,500 3,500 Equity 6,678 7,192 Total liabilities and equity $ 34,841 $ 35,557 Investments in and advances to LLCs before amounts included in accrued expenses and other liabilities $ 9,661 $ 10,139 Amounts included in accrued expenses and other liabilities (1,728 ) (1,784 ) Our share of equity in LLCs, net $ 7,933 $ 8,355 (a.) Other assets and other liabilities as of September 30, 2022 and December 31, 2021 include approximately $655,000 and $656,000, respectively, of right-of-use land assets and right-of-use land liabilities related to ground leases whereby the LLC/LP is the lessee, with third party lessors, including subsidiaries of UHS. (b.) Consists of a 7.25% member loan to FTX MOB Phase II, LP with a maturity date of March 1, 2023. As of September 30, 2022, and December 31, 2021, 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 9/30/2022 12/31/2021 Maturity Date Brunswick Associates (2.80% fixed rate mortgage loan) 8,794 8,993 December, 2030 Grayson Properties II (3.70% fixed rate construction loan) (b.) 13,075 13,075 June, 2025 $ 21,869 $ 22,068 (a.) All mortgage loans require monthly principal payments through maturity and include a balloon principal payment upon maturity. (b.) 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 four LLCs/LPs in which we continue to hold non-controlling ownership interests, the third-party member and the Trust, at any time, potentially subject to certain conditions, have the right to make an offer (“Offering Member”) to the other member(s) (“Non-Offering Member”) in which it either agrees to: (i) sell the entire ownership interest of the Offering Member to the Non-Offering Member (“Offer to Sell”) at a price as determined by the Offering Member (“Transfer Price”), or; (ii) purchase the entire ownership interest of the Non-Offering Member (“Offer to Purchase”) at the equivalent proportionate Transfer Price. The Non-Offering Member has 60 to 90 days to either: (i) purchase the entire ownership interest of the Offering Member at the Transfer Price, or; (ii) sell its entire ownership interest to the Offering Member at the equivalent proportionate Transfer Price. The closing of the transfer must occur within 60 to 90 days of the acceptance by the Non-Offering Member.

Recent Accounting Pronouncement

Recent Accounting Pronouncements	9 Months Ended
	Sep. 30, 2022
Accounting Policies [Abstract]
Recent Accounting Pronouncements	(6) Recent Accounting Pronouncements 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	9 Months Ended
	Sep. 30, 2022
Leases [Abstract]
Lease Accounting	(7) Lease Accounting We adopted the lease standard ASC 842 on January 1, 2019 and applied it to leases that were in place on the effective date as both a lessor and lessee. Our results for reporting periods beginning January 1, 2019 are presented under the ASC 842 lease standard. 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 most of our operating properties to customers under agreements that are typically classified as operating leases (as noted below, two of our leases are accounted for as financing arrangements effective on December 31, 2021). We recognize the total minimum lease payments provided for under the operating leases on a straight-line basis over the lease term. Generally, under the terms of our leases, the majority of our rental expenses, including common area maintenance, real estate taxes and insurance, are recovered from our customers. We record amounts reimbursed by customers in the period that the applicable expenses are incurred, which is generally ratably throughout the term of the lease. We have elected the package of practical expedients that allows lessors to not separate lease and non-lease components by class of underlying asset. This practical expedient allowed us to not separate expenses reimbursed by our customers (“tenant reimbursements”) from the associated rental revenue if certain criteria were met. We assessed these criteria and concluded that the timing and pattern of transfer for rental revenue and the associated tenant reimbursements are the same, and for the leases that qualify as operating leases, we accounted for and presented rental revenue and tenant reimbursements as a single component under Lease revenue in our consolidated statements of income for the three and nine months ended September 30, 2022 and 2021. On December 31, 2021, as a result of the asset purchase and sale transaction with UHS, as amended during the first quarter of 2022, the real estate assets of two wholly-owned subsidiaries of UHS were transferred to us (Aiken and Canyon Creek). As discussed in Note 2, these assets are accounted for as financing arrangements and our consolidated balance sheets at September 30, 2022 and December 31, 2021 reflect financing receivables related to this transaction amounting to $83.7 million and $82.4 million, respectively. Pursuant to the leases, as amended during the first quarter of 2022, the aggregate annual rental during 2022 on the acquired properties, which is payable to us on a monthly basis, amounts to approximately $5.7 million ($3.9 million related to Aiken and $1.8 million related to Canyon Creek). The portion of these lease payments that will be included in our consolidated statements of income, and reflected as interest income on financing leases, is expected to be approximately $5.5 million during the full year of 2022. Lease revenue will not be impacted by the lease payments received related to these two properties. The components of the “Lease revenue – UHS facilities” and “Lease revenue – Non-related parties” captions for the three and nine month periods ended September 30, 2022 and 2021 are disaggregated below (in thousands). Base rents are primarily stated rent amounts provided for under the leases that are recognized on a straight-line basis over the term of the lease. Bonus rents and tenant reimbursements represent amounts where tenants are contractually obligated to pay an amount that is variable in nature. Three Months Ended Nine Months Ended September 30, September 30, 2022 2021 2022 2021 UHS facilities: Base rents $ 6,102 $ 5,392 $ 18,303 $ 15,820 Bonus rents (a.) 727 1,828 2,048 5,171 Tenant reimbursements 642 354 1,940 980 Lease revenue - UHS facilities $ 7,471 $ 7,574 $ 22,291 $ 21,971 Non-related parties: Base rents 10,108 10,421 30,352 31,425 Tenant reimbursements 2,728 2,694 8,312 7,899 Lease revenue - Non-related parties $ 12,836 $ 13,115 $ 38,664 $ 39,324 (a.) Includes bonus rental on McAllen Medical Center, a UHS acute care hospital facility of $727 and $2,048 for the three and nine-month periods ended September 30, 2022, respectively, and includes bonus rental on three UHS acute care hospital facilities of $1,828 and $5,171 for the three and nine-month periods ended September 30, 2021, respectively. Please see disclosure above surrounding the December 31, 2021 asset purchase and sale transaction with UHS. Disclosures Related to Vacant Facilities : Vacancies – Specialty Hospitals: As previously disclosed, the lease on the specialty hospital located in Chicago, Illinois, expired on December 31, 2021 and the facility is currently vacant. During the three and nine-month periods ended September 30, 2021, we earned $390,000 and $1.2 million, respectively, of lease revenue in connection with this property. The operating expenses incurred by us in connection with this facility during the three and nine-month periods ended September 30, 2022 were $240,000 and $1.1 million, respectively. Prior to 2022, the former tenant was responsible for the operating expenses on this facility. Pursuant to the terms of the lease that expired in December, 2021, we earned approximately $1.6 million of lease revenue during the 2021 full year. The leases on two specialty hospital facilities, located in Evansville, Indiana, and Corpus Christi, Texas, expired on May 31, 2019 and June 1, 2019, respectively. 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 estimate that the aggregate operating expenses for the three vacant specialty facilities, including the facility located in Chicago, Illinois, as well as the facilities located in Evansville, Indiana, and Corpus Christi, Texas, will approximate $900,000 during the remaining three months of 2022. Future operating expenses related to these facilities will be incurred by us during the time they remain owned and vacant. We continue to market these specialty facilities to potential interested parties. However, should these properties continue to remain vacant for an extended period of time, or should we incur substantial renovation or demolition costs to make the properties suitable for other operators/tenants/buyers, 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 September 30, 2022, our condensed consolidated balance sheet includes right-of-use land assets of approximately $11.5 million and ground lease liabilities of approximately $11.5 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 and nine months ended September 30, 2022.

Debt and Financial Instruments

Debt and Financial Instruments	9 Months Ended
	Sep. 30, 2022
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 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. On July 2, 2021, we entered into an amended and restated revolving credit agreement (“Credit Agreement”) to amend and restate the previously existing $350 million credit agreement, as amended and dated June 5, 2020 (“Prior Credit Agreement”). Among other things, under the Credit Agreement, our aggregate revolving credit commitment was increased to $375 million from $350 million. The Credit Agreement, which is scheduled to mature on July 2, 2025, provides for a revolving credit facility in an aggregate principal amount of $375 million, including a $40 million sublimit for letters of credit and a $30 million sublimit for swingline/short-term loans. Under the terms of the Credit Agreement, we may request that the revolving line of credit be increased by up to an additional $50 million. Borrowings under the new facility are guaranteed by certain subsidiaries of the Trust. In addition, borrowings under the new facility are secured by first priority security interests in and liens on all equity interests in most of the Trust’s wholly-owned subsidiaries. Borrowings under the Credit Agreement will bear interest annually at a rate equal to, at our option, at either LIBOR (for one, three, or six months) or the Base Rate, plus in either case, a specified margin depending on our ratio of debt to total capital, as determined by the formula set forth in the Credit Agreement. The applicable margin ranges from 1.10% to 1.35% for LIBOR loans and 0.10% to 0.35% for Base Rate loans. The initial applicable margin was 1.25% for LIBOR loans and 0.25% for Base Rate loans. 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 margins over LIBOR, Base Rate and the facility fee are based upon our total leverage ratio. At September 30, 2022, the applicable margin over the LIBOR rate was %, the margin over the Base Rate was % and the facility fee was 0.20%. At September 30, 2022, we had $290.1 million of outstanding borrowings and $3.1 million of letters of credit outstanding under our Credit Agreement. We had $81.8 million of available borrowing capacity, net of the outstanding borrowings and letters of credit outstanding as of September 30, 2022. There are no compensating balance requirements. The Credit Agreement contains customary affirmative and negative covenants, including limitations on certain indebtedness, liens, acquisitions and other investments, fundamental changes, asset dispositions and dividends and other distributions. The Credit Agreement also contains restrictive covenants regarding the Trust’s ratio of total debt to total assets, the fixed charge coverage ratio, the ratio of total secured debt to total asset value, the ratio of total unsecured debt to total unencumbered asset value, and minimum tangible net worth, as well as customary events of default, the occurrence of which may trigger an acceleration of amounts then outstanding under the Credit Agreement. We are in compliance with all of the covenants in the Credit Agreement at September 30, 2022 and were in compliance with all of the covenants in the Credit Agreement at December 31, 2021. 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 September 30, 2022 December 31, 2021 Tangible net worth > =$125,000 $ 223,691 $ 225,355 Total leverage < 60% 42.8 % 43.1 % Secured leverage < 30% 6.3 % 7.4 % Unencumbered leverage < 60% 41.6 % 41.9 % Fixed charge coverage > 1.50x 4.6x 4.8x 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 September 30, 2022 (amounts in thousands): Facility Name Outstanding Balance (in Interest Rate Maturity Date BRB Medical Office Building fixed rate mortgage loan (b.) $ 5,104 4.27 % December, 2022 Desert Valley Medical Center fixed rate mortgage loan (c.) 4,235 3.62 % January, 2023 2704 North Tenaya Way fixed rate mortgage loan 6,294 4.95 % November, 2023 Summerlin Hospital Medical Office Building III fixed rate mortgage loan 12,621 4.03 % April, 2024 Tuscan Professional Building fixed rate mortgage loan 1,879 5.56 % June, 2025 Phoenix Children’s East Valley Care Center fixed rate mortgage loan 8,269 3.95 % January, 2030 Rosenberg Children's Medical Plaza fixed rate mortgage loan 12,090 4.42 % September, 2033 Total, excluding net debt premium and net financing fees 50,492 Less net financing fees (293 ) Plus net debt premium 52 Total mortgages notes payable, non-recourse to us, net $ 50,251 (a.) All mortgage loans require monthly principal payments through maturity and either fully amortize or include a balloon principal payment upon maturity. (b.) This loan is scheduled to mature within the next twelve months. We intend to repay this loan in full utilizing borrowings under our Credit Agreement. (c.) This loan is scheduled to mature within the next twelve months. We intend to refinance this loan prior to the maturity date. On June 1, 2022, the $5.1 million fixed rate mortgage loan on 700 Shadow Lane and Goldring MOBs was fully repaid utilizing borrowings under our Credit Agreement. The mortgages are secured by the real property of the buildings as well as property leases and rents. The mortgages outstanding as of September 30, 2022 had a combined fair value of approximately $48.3 million. At December 31, 2021, 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, 2021 was $57.2 million and had a combined fair value of approximately $59.4 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 September 30, 2022, the fair value of our interest rate swaps was a net asset of $12.5 million which is included in deferred charges and other assets on the accompanying condensed consolidated balance sheet. During the third quarter of 2022, we paid or accrued approximately $3,000 to the counterparty by us, offset by $428,000 in receipts from the counterparty, adjusted for the previous quarter accrual, pursuant to the terms of the swaps. During the fi r st nine months of 2022, we paid or accrued approximately $ to the counterparty by us, offset by $ in receipts from the counterparty and adjusted for the previous quarter accrual, pursuant to the terms of the swaps. Fro m inception of the swap agreement s through September 30 , 20 2 2 we pai d or accrued approximately $ 1.8 million in net payments made to the counterparty by us pursuant to the terms of the swap (consisting of approximately $ in payments or accruals made to us by the counterparty, offset by approximately $ 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. We do not expect any gains or losses on our interest rate swaps to be reclassified to earnings in the next twelve months.

Segment Reporting

Segment Reporting	9 Months Ended
	Sep. 30, 2022
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.

Relationship with Universal H_2

Relationship with Universal Health Services, Inc. ("UHS") and Related Party Transactions (Tables)	9 Months Ended
	Sep. 30, 2022
Related Party Transactions [Abstract]
Existing Lease Terms and Renewal Options for Each of UHS Hospital Facilities	The table below details the existing lease terms and renewal options for each of the hospital leases that are related to UHS as of September 30, 2022, consisting of three acute care hospitals and three behavioral health hospitals: 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 $ 6,319,000 December, 2026 5 (b) Aiken Regional Medical Center/Aurora Pavilion Behavioral Health Services $ 3,895,000 December, 2033 35 (c) Canyon Creek Behavioral Health $ 1,670,000 December, 2033 35 (c) Clive Behavioral Health Hospital $ 2,628,000 December, 2040 50 (d) (a) UHS has one (b) UHS has one (c) UHS has seven (d) The UHS-related joint venture has five

Summarized Financial Informat_2

Summarized Financial Information of Equity Affiliates (Tables)	9 Months Ended
	Sep. 30, 2022
Equity Method Investments And Joint Ventures [Abstract]
Limited Liability Companies Accounted for Under Equity Method	The following property table represents the four LLCs/LPs in which we owned a non-controlling interest and were accounted for under the equity method as of September 30, 2022: Name of LLC/LP Ownership Property Owned by LLC/LP Suburban Properties 33 % St. Matthews Medical Plaza II Brunswick Associates (a.)(b.) 74 % Mid Coast Hospital MOB FTX MOB Phase II (c.) 95 % Forney Medical Plaza II Grayson Properties II (d.)(e.) 95 % Texoma Medical Plaza II (a.) This LLC has a third-party term loan of $8.8 million, which is non-recourse to us, outstanding as of September 30, 2022. (b.) We are the lessee with a third party on a ground lease for land. (c.) During the first quarter of 2021, this LP paid off its $4.7 million mortgage loan upon maturity, utilizing pro rata equity contributions from the limited partners as well as a $3.5 million member loan from us to the LP which was funded utilizing borrowings from our revolving credit agreement. (d.) Construction of this MOB was substantially completed in December, 2020. This MOB is located in Denison, Texas on the campus of a hospital owned and operated by a wholly-owned subsidiary of UHS. We have committed to invest up to $4.8 million in equity and debt financing, $1.8 million of which has been funded as of September 30, 2022. 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 $13.1 million as of September 30, 2022. The LP developed, constructed, owns and operates the Texoma II Medical Plaza. (e.) We are the lessee with a UHS-related party for the land related to this property.
Condensed Combined Statements of Income (Unaudited) for LLCs/LPs Accounted Under Equity Method	Below are the condensed combined statements of income (unaudited) for the four LLCs/LPs accounted for under the equity method at September 30, 2022 and the five LLCs/LPs accounted for under the equity method at September 30, 2021. The data for the three and nine months ended September 30, 2021 includes financial results for the above-mentioned Texoma Medical Plaza in which we purchased the minority ownership interest during the fourth quarter of 2021. Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 (amounts in thousands) (amounts in thousands) Revenues $ 2,129 $ 2,736 $ 6,108 $ 8,373 Operating expenses 826 1,184 2,289 3,356 Depreciation and amortization 463 627 1,386 1,684 Interest, net 264 388 795 1,260 Net income $ 576 $ 537 $ 1,638 $ 2,073 Our share of net income $ 346 $ 303 $ 943 $ 1,341
Condensed Combined Balance Sheets (Unaudited) for LLCs/LPs Accounted Under Equity Method	Below are the condensed combined balance sheets (unaudited) for the four above-mentioned LLCs/LPs that were accounted for under the equity method as of September 30, 2022 and December 31, 2021: September 30, 2022 December 31, 2021 (amounts in thousands) Net property, including construction in progress $ 29,831 $ 30,983 Other assets (a.) 5,010 4,574 Total assets $ 34,841 $ 35,557 Other liabilities (a.) $ 2,794 $ 2,797 Mortgage notes payable, non-recourse to us 21,869 22,068 Advances payable to us (b.) 3,500 3,500 Equity 6,678 7,192 Total liabilities and equity $ 34,841 $ 35,557 Investments in and advances to LLCs before amounts included in accrued expenses and other liabilities $ 9,661 $ 10,139 Amounts included in accrued expenses and other liabilities (1,728 ) (1,784 ) Our share of equity in LLCs, net $ 7,933 $ 8,355 (a.) Other assets and other liabilities as of September 30, 2022 and December 31, 2021 include approximately $655,000 and $656,000, respectively, of right-of-use land assets and right-of-use land liabilities related to ground leases whereby the LLC/LP is the lessee, with third party lessors, including subsidiaries of UHS. (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 9/30/2022 12/31/2021 Maturity Date Brunswick Associates (2.80% fixed rate mortgage loan) 8,794 8,993 December, 2030 Grayson Properties II (3.70% fixed rate construction loan) (b.) 13,075 13,075 June, 2025 $ 21,869 $ 22,068 (a.) All mortgage loans require monthly principal payments through maturity and include a balloon principal payment upon maturity. (b.) 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)	9 Months Ended
	Sep. 30, 2022
Leases [Abstract]
Components of the "Lease Revenue - UHS facilities" and "Lease Revenue - Non-related Parties" Captions	The components of the “Lease revenue – UHS facilities” and “Lease revenue – Non-related parties” captions for the three and nine month periods ended September 30, 2022 and 2021 are disaggregated below (in thousands). Base rents are primarily stated rent amounts provided for under the leases that are recognized on a straight-line basis over the term of the lease. Bonus rents and tenant reimbursements represent amounts where tenants are contractually obligated to pay an amount that is variable in nature. Three Months Ended Nine Months Ended September 30, September 30, 2022 2021 2022 2021 UHS facilities: Base rents $ 6,102 $ 5,392 $ 18,303 $ 15,820 Bonus rents (a.) 727 1,828 2,048 5,171 Tenant reimbursements 642 354 1,940 980 Lease revenue - UHS facilities $ 7,471 $ 7,574 $ 22,291 $ 21,971 Non-related parties: Base rents 10,108 10,421 30,352 31,425 Tenant reimbursements 2,728 2,694 8,312 7,899 Lease revenue - Non-related parties $ 12,836 $ 13,115 $ 38,664 $ 39,324

Debt and Financial Instruments

Debt and Financial Instruments (Tables)	9 Months Ended
	Sep. 30, 2022
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 September 30, 2022 December 31, 2021 Tangible net worth > =$125,000 $ 223,691 $ 225,355 Total leverage < 60% 42.8 % 43.1 % Secured leverage < 30% 6.3 % 7.4 % Unencumbered leverage < 60% 41.6 % 41.9 % Fixed charge coverage > 1.50x 4.6x 4.8x
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 September 30, 2022 (amounts in thousands): Facility Name Outstanding Balance (in Interest Rate Maturity Date BRB Medical Office Building fixed rate mortgage loan (b.) $ 5,104 4.27 % December, 2022 Desert Valley Medical Center fixed rate mortgage loan (c.) 4,235 3.62 % January, 2023 2704 North Tenaya Way fixed rate mortgage loan 6,294 4.95 % November, 2023 Summerlin Hospital Medical Office Building III fixed rate mortgage loan 12,621 4.03 % April, 2024 Tuscan Professional Building fixed rate mortgage loan 1,879 5.56 % June, 2025 Phoenix Children’s East Valley Care Center fixed rate mortgage loan 8,269 3.95 % January, 2030 Rosenberg Children's Medical Plaza fixed rate mortgage loan 12,090 4.42 % September, 2033 Total, excluding net debt premium and net financing fees 50,492 Less net financing fees (293 ) Plus net debt premium 52 Total mortgages notes payable, non-recourse to us, net $ 50,251 (a.) All mortgage loans require monthly principal payments through maturity and either fully amortize or include a balloon principal payment upon maturity. (b.) This loan is scheduled to mature within the next twelve months. We intend to repay this loan in full utilizing borrowings under our Credit Agreement. (c.) This loan is scheduled to mature within the next twelve months. We intend to refinance this loan prior to the maturity date.

General - Additional Informatio

General - Additional Information (Detail)	Sep. 30, 2022 Property
Limited Liability Companies
Organization Consolidation And Presentation Of Financial Statements [Line Items]
Number of real estate investments	4
4 Unconsolidated Limited Liability Companies / Limited Partner | Minimum
Organization Consolidation And Presentation Of Financial Statements [Line Items]
Non-controlling equity interest, ownership percentage	33%
4 Unconsolidated Limited Liability Companies / Limited Partner | Maximum
Organization Consolidation And Presentation Of Financial Statements [Line Items]
Non-controlling equity interest, ownership percentage	95%

Relationship with Universal H_3

Relationship with Universal Health Services, Inc. ("UHS") and Related Party Transactions - Additional Information (Detail)		1 Months Ended		3 Months Ended			9 Months Ended		12 Months Ended
		Jan. 31, 2022 USD ($) ft²	May 31, 2021 USD ($)	Sep. 30, 2022 USD ($) Hospital Time Lease	Mar. 31, 2022 USD ($) Subsidiary	Sep. 30, 2021 USD ($) Hospital	Sep. 30, 2022 USD ($) Property Subsidiary Hospital Bed Time RenewalOption Lease	Sep. 30, 2021 USD ($) Hospital	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Related Party Transaction [Line Items]
Number of bed facility | Bed							100
Annual advisory fee as percentage of average invested real estate assets				0.70%		0.70%	0.70%	0.70%
Grayson Properties Member
Related Party Transaction [Line Items]
Minority ownership interest held by a third-party										5%
Ownership percentage upon completion of the minority ownership purchase										100%
Minority ownership interest										$ 3,100,000
Aiken Regional Medical Center
Related Party Transaction [Line Items]
Monthly lease rent receivable					$ 3,900,000
Canyon Creek Behavioral Health
Related Party Transaction [Line Items]
Monthly lease rent receivable					1,800,000
Aiken Regional Medical Center and Canyon Creek Behavioral Health
Related Party Transaction [Line Items]
Fair market value of real estate assets received							$ 83,700,000			82,400,000
Monthly lease rent receivable					$ 5,700,000
Aiken Regional Medical Center and Canyon Creek Behavioral Health | Forecast
Related Party Transaction [Line Items]
Lease payments expected									$ 5,500,000
Aiken Regional Medical Center and Canyon Creek Behavioral Health | Southwest Healthcare System Inland Valley Campus
Related Party Transaction [Line Items]
Lease revenue										4,500,000
Aiken Regional Medical Center and Canyon Creek Behavioral Health | Southwest Healthcare System Inland Valley Campus | Base Rents
Related Party Transaction [Line Items]
Lease revenue										2,600,000
Aiken Regional Medical Center and Canyon Creek Behavioral Health | Southwest Healthcare System Inland Valley Campus | Bonus Rents
Related Party Transaction [Line Items]
Lease revenue										$ 1,900,000
Universal Health Services Inc
Related Party Transaction [Line Items]
Percentage of lease guaranteed							52%
Lease revenue	[1]			$ 7,471,000		$ 7,574,000	$ 22,291,000	$ 21,971,000
Number of acute care hospital leased | Hospital				3		3	3	3
Number of behavioral health care hospital leased | Hospital				3		1	3	1
Number of hospital facilities leased | Hospital							6
Number of medical office buildings and free standing emergency departments | Property							20
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 ground leases | Lease				12			12
Aggregate lease payments for 2022				$ 508,000			$ 508,000
Aggregate lease payments for 2023				508,000			508,000
Aggregate lease payments for 2024				508,000			508,000
Aggregate lease payments for 2025				508,000			508,000
Aggregate lease payments for 2026				508,000			508,000
Aggregate lease payments for thereafter				$ 28,000,000			$ 28,000,000
Percentage ownership of outstanding shares				5.70%			5.70%			5.70%
Universal Health Services Inc | Minimum
Related Party Transaction [Line Items]
Remaining lease terms on ground leases							27 years
Universal Health Services Inc | Maximum
Related Party Transaction [Line Items]
Remaining lease terms on ground leases							76 years
Universal Health Services Inc | Customer Concentration Risk | Revenues
Related Party Transaction [Line Items]
Percentage of revenues generated from leases and tenants				27%		26%	27%	26%
Universal Health Services Inc | Customer Concentration Risk | Revenues | Tenants
Related Party Transaction [Line Items]
Percentage of revenues generated from leases and tenants				41%		37%	41%	36%
Universal Health Services Inc | Base Rents
Related Party Transaction [Line Items]
Lease revenue				$ 6,102,000		$ 5,392,000	$ 18,303,000	$ 15,820,000
Universal Health Services Inc | Bonus Rents
Related Party Transaction [Line Items]
Lease revenue				$ 727,000		1,828,000	$ 2,048,000	5,171,000
Universal Health Services Inc | Acute Care Hospitals
Related Party Transaction [Line Items]
Number of hospitals operating lease terms of existing and renewal options | Hospital							3
Universal Health Services Inc | Behavioral Health Hospitals
Related Party Transaction [Line Items]
Number of hospitals operating lease terms of existing and renewal options | Hospital							3
Universal Health Services Inc | Wellington Regional Medical Center
Related Party Transaction [Line Items]
Renewal options term at fair market value lease rates							5 years
Renewal options at fair market value lease rates expiration year							2031
Universal Health Services Inc | Clive, Iowa | Clive Behavioral Health
Related Party Transaction [Line Items]
Option to renew lease, notice period prior to termination date of current term							270 days
Initial lease term on property							20 years
Lessee operating lease, existence of option to extend							true
Number of term renewal options | Time				5			5
Number of lease renewal option exercised | Time							3
Renewal option term							10 years
Percentage of annual rental increase on cumulative and compound basis							2.75%
Number of additional renewal options at fair market value lease rates | RenewalOption							2
Renewal options term at fair market value lease rates							10 years
Period to purchase respective leased facilities prior to end of lease term or renewal terms							270 days
Universal Health Services Inc | Clive, Iowa | Clive Behavioral Health | Minimum
Related Party Transaction [Line Items]
Renewal options at fair market value lease rates expiration year							2071
Universal Health Services Inc | Clive, Iowa | Clive Behavioral Health | Maximum
Related Party Transaction [Line Items]
Renewal options at fair market value lease rates expiration year							2090
Universal Health Services Inc | Palm Beach, Florida | Wellington Regional Medical Center
Related Party Transaction [Line Items]
Monthly lease rent receivable				$ 6,300,000			$ 6,300,000
Lease revenue										$ 5,500,000
Lessee operating lease, existence of option to extend							true
Percentage of annual rental increase on cumulative and compound basis							2.50%
Operating lease renewal term				5 years			5 years
Universal Health Services Inc | Palm Beach, Florida | Wellington Regional Medical Center | Base Rents
Related Party Transaction [Line Items]
Lease revenue										3,000,000
Universal Health Services Inc | Palm Beach, Florida | Wellington Regional Medical Center | Bonus Rents
Related Party Transaction [Line Items]
Lease revenue										2,500,000
Universal Health Services Inc | Subsidiary
Related Party Transaction [Line Items]
Number of wholly-owned subsidiaries | Subsidiary					2
Financing receivables				$ 83,700,000			$ 83,700,000
Universal Health Services Inc | Subsidiary | Aiken Regional Medical Center and Canyon Creek Behavioral Health
Related Party Transaction [Line Items]
Financing receivables										$ 82,400,000
Universal Health Services Inc | Asset Purchase and Sale Agreement | Subsidiary
Related Party Transaction [Line Items]
Cash received for sale of real estate asset					$ 4,100,000
Universal Health Services Inc | Asset Purchase and Sale Agreement | Subsidiary | Inland Valley Campus of Southwest Healthcare System | Wildomar, California
Related Party Transaction [Line Items]
Fair market value of real estate asset sold					79,600,000
Universal Health Services Inc | Asset Purchase and Sale Agreement | Subsidiary | Aiken Regional Medical Center | Aiken, South Carolina
Related Party Transaction [Line Items]
Fair market value of real estate assets received					57,700,000
Universal Health Services Inc | Asset Purchase and Sale Agreement | Subsidiary | Canyon Creek Behavioral Health | Temple, Texas
Related Party Transaction [Line Items]
Fair market value of real estate assets received					26,000,000
Universal Health Services Inc | Asset Purchase and Sale Agreement | Subsidiary | Aiken Regional Medical Center and Canyon Creek Behavioral Health
Related Party Transaction [Line Items]
Number of wholly-owned subsidiaries | Subsidiary							2
Fair market value of real estate assets received					$ 83,700,000
Universal Health Services Inc | Ground Lease and Master Flex-lease Agreement | Reno, Nevada | Sierra Medical Plaza I
Related Party Transaction [Line Items]
Rentable square feet | ft²		86,000
Cost of medical office building		$ 34,600,000
Cost Of Medical Office Building Incurred							$ 16,900,000
Percentage of rentable square feet		68%
Universal Health Services Inc | Ground Lease and Master Flex-lease Agreement | Reno, Nevada | Sierra Medical Plaza I | Minimum
Related Party Transaction [Line Items]
Initial rent		$ 1,300,000
Catholic Health Initiatives Iowa
Related Party Transaction [Line Items]
Percentage of lease guaranteed							48%
Fire Mesa Office Building [Member]
Related Party Transaction [Line Items]
Payment to acquire business			$ 12,900,000
Lease percentage			100%
Lease expiration date			Aug. 31, 2027
Universal Health Services of Delaware Inc
Related Party Transaction [Line Items]
Advisory fee				$ 1,300,000		$ 1,100,000	$ 3,800,000	$ 3,300,000
Cost, Product and Service [Extensible List]				Management Service		Management Service	Management Service	Management Service
Average invested real estate assets				$ 741,000,000		$ 641,000,000	$ 721,000,000	$ 623,000,000
[1]Includes bonus rental on McAllen Medical Center, a UHS acute care hospital facility of $727 and $2,048 for the three and nine-month periods ended September 30, 2022, respectively, and includes bonus rental on three UHS acute care hospital facilities of $1,828 and $5,171 for the three and nine-month periods ended September 30, 2021, respectively

Existing Lease Terms and Renewa

Existing Lease Terms and Renewal Options for Each of UHS Hospital Facilities (Detail) - Universal Health Services Inc	9 Months Ended
	Sep. 30, 2022 USD ($)
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	$ 6,319,000
End of Lease Term	2026-12
Renewal Term (years)	5 years	[2]
Aiken Regional Medical Center/Aurora Pavilion Behavioral Health Services
Operating Leased Assets [Line Items]
Annual Minimum Rent	$ 3,895,000
End of Lease Term	2033-12
Renewal Term (years)	35 years	[3]
Canyon Creek Behavioral Health
Operating Leased Assets [Line Items]
Annual Minimum Rent	$ 1,670,000
End of Lease Term	2033-12
Renewal Term (years)	35 years	[3]
Clive Behavioral Health Hospital
Operating Leased Assets [Line Items]
Annual Minimum Rent	$ 2,628,000
End of Lease Term	2040-12
Renewal Term (years)	50 years	[4]
[1]UHS has one one seven five

Existing Lease Terms and Rene_2

Existing Lease Terms and Renewal Options for Each of UHS Hospital Facilities (Parenthetical) (Detail) - Universal Health Services Inc	9 Months Ended
	Sep. 30, 2022 Time RenewalOption
McAllen Medical Center
Operating Leased Assets [Line Items]
Number of renewal option at existing lease rate | Time	1
Renewal option term at existing lease rate	5 years
Renewal option at existing lease rate expiration year	2031
Wellington Regional Medical Center
Operating Leased Assets [Line Items]
Number of renewal options at fair market value lease rates	1
Renewal options term at fair market value lease rates	5 years
Renewal options at fair market value lease rates expiration year	2031
Aiken Regional Medical Center and Canyon Creek Behavioral Health
Operating Leased Assets [Line Items]
Number of renewal options at fair market value lease rates	7
Renewal options term at fair market value lease rates	5 years
Aiken Regional Medical Center and Canyon Creek Behavioral Health | Minimum
Operating Leased Assets [Line Items]
Renewal options at fair market value lease rates expiration year	2034
Aiken Regional Medical Center and Canyon Creek Behavioral Health | Maximum
Operating Leased Assets [Line Items]
Renewal options at fair market value lease rates expiration year	2068
Clive Behavioral Health Hospital
Operating Leased Assets [Line Items]
Number of renewal options at fair market value lease rates	5
Renewal options term at fair market value lease rates	10 years
Clive Behavioral Health Hospital | Minimum | First Three Year Renewal Options
Operating Leased Assets [Line Items]
Renewal options at lease rate stipulated in lease expiration year	2041
Clive Behavioral Health Hospital | Minimum | Last Two Year Renewal Options
Operating Leased Assets [Line Items]
Renewal options at fair market value lease rates expiration year	2071
Clive Behavioral Health Hospital | Maximum | First Three Year Renewal Options
Operating Leased Assets [Line Items]
Renewal options at lease rate stipulated in lease expiration year	2070
Clive Behavioral Health Hospital | Maximum | Last Two Year Renewal Options
Operating Leased Assets [Line Items]
Renewal options at fair market value lease rates expiration year	2090

Dividends and Equity Issuance_2

Dividends and Equity Issuance Program - Additional Information (Detail) - USD ($)	3 Months Ended		6 Months Ended	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Jun. 30, 2020	Sep. 30, 2022	Sep. 30, 2021
Dividends and Equity Issuance [Line Items]
Dividends declared and paid	$ 9,800,000	$ 9,600,000		$ 29,326,000	$ 28,830,000
Declared and paid dividends, per share	$ 0.71	$ 0.70		$ 2.125	$ 2.095
At-The-Market Equity Issuance Program (ATM)
Dividends and Equity Issuance [Line Items]
Aggregate sales of threshold amount			$ 100,000,000
Share issued			2,704	0
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				$ 508,000

Acquisitions and Divestitures -

Acquisitions and Divestitures - Additional Information (Detail) $ in Thousands	1 Months Ended				9 Months Ended
	Mar. 31, 2022 USD ($) ft²	Jan. 31, 2022 USD ($) ft² Time Tenant	Jun. 30, 2021 USD ($)	May 31, 2021 USD ($) ft²	Sep. 30, 2022 Disposition	Sep. 30, 2021 USD ($)
Business Acquisitions And Dispositions [Line Items]
Number of dispositions | Disposition					0
Gain on sale of real estate assets						$ 1,304
Medical Office Buildings
Business Acquisitions And Dispositions [Line Items]
Sale price net of closing costs			$ 3,200
Gain on sale of real estate assets						$ 1,300
Fire Mesa Office Building [Member]
Business Acquisitions And Dispositions [Line Items]
Rentable square feet | ft²				44,000
Lease expiration date				Aug. 31, 2027
Payment to acquire business				$ 12,900
Lease percentage				100%
Beaumont Heart And Vascular Center | Dearborn Michigan
Business Acquisitions And Dispositions [Line Items]
Total purchase price	$ 5,400
Percentage of building area leased	100%
Rentable square feet | ft²	17,621
Lease expiration date	Nov. 30, 2026
Lease commencing date	Dec. 01, 2022
Percentage of lease escalations	2.5
140 Thomas Johnson Drive Medical Office Building | Frederick, Maryland
Business Acquisitions And Dispositions [Line Items]
Rentable square feet | ft²		20,146
Payment to acquire business		$ 8,000
Percentage of lease		100%
Number of tenants | Tenant		3
Percentage of rentable square feet		72%
Term of lease		15 years
Remaining lease term		14 years
Number of term renewal options | Time		3
Renewal Term (years)		5 years

Summarized Financial Informat_3

Summarized Financial Information of Equity Affiliates - Additional Information (Detail) - Property	9 Months Ended
	Sep. 30, 2022	Dec. 31, 2021
Grayson Properties Member
Schedule Of Equity Method Investments [Line Items]
Minority ownership interest held by a third-party		5%
Ownership percentage upon completion of the minority ownership purchase		100%
Limited Liability Companies | Medical office buildings
Schedule Of Equity Method Investments [Line Items]
Number of real estate investments	4
Minimum
Schedule Of Equity Method Investments [Line Items]
Number of days for Non-Offering Member either to purchase or sell its entire ownership interest to or from Offering Member	60 days
Maximum
Schedule Of Equity Method Investments [Line Items]
Number of days for Non-Offering Member either to purchase or sell its entire ownership interest to or from Offering Member	90 days
4 Unconsolidated Limited Liability Companies / Limited Partner | Minimum
Schedule Of Equity Method Investments [Line Items]
Non-controlling equity interest, ownership percentage	33%
4 Unconsolidated Limited Liability Companies / Limited Partner | Maximum
Schedule Of Equity Method Investments [Line Items]
Non-controlling equity interest, ownership percentage	95%

Limited Liability Companies Acc

Limited Liability Companies Accounted for Under Equity Method (Detail)	9 Months Ended
	Sep. 30, 2022
Suburban Properties
Schedule Of Equity Method Investments [Line Items]
Ownership	33%
Property Owned by LLC/LP	St. Matthews Medical Plaza II
Brunswick Associates
Schedule Of Equity Method Investments [Line Items]
Ownership	74%	[1],[2]
Property Owned by LLC/LP	Mid Coast Hospital MOB	[1],[2]
FTX MOB Phase II limited partnership
Schedule Of Equity Method Investments [Line Items]
Ownership	95%	[3]
Property Owned by LLC/LP	Forney Medical Plaza II	[3]
Grayson Properties Two L P
Schedule Of Equity Method Investments [Line Items]
Ownership	95%	[4],[5]
Property Owned by LLC/LP	Texoma Medical Plaza II	[4],[5]
[1]This LLC has a third-party term loan of $8.8 million, which is non-recourse to us, outstanding as of September 30, 2022.[2]We are the lessee with a third party on a ground lease for land[3] 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. Construction of this MOB was substantially completed in December, 2020. This MOB is located in Denison, Texas on the campus of a hospital owned and operated by a wholly-owned subsidiary of UHS. We have committed to invest up to $4.8 million in equity and debt financing, $1.8 million of which has been funded as of September 30, 2022. 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 $13.1 million as of September 30, 2022. The LP developed, constructed, owns and operates the Texoma II Medical Plaza. We are the lessee with a UHS-related party for the land related to this property.

Limited Liability Companies A_2

Limited Liability Companies Accounted for Under Equity Method (Parenthetical) (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Sep. 30, 2022
Brunswick Associates
Schedule Of Equity Method Investments [Line Items]
Third-party term loan		$ 8.8
Grayson Properties Member | Denison Texas
Schedule Of Equity Method Investments [Line Items]
Commitment to investment		1.8
FTX MOB Phase II limited partnership
Schedule Of Equity Method Investments [Line Items]
Member loan used to repay mortgage loan	$ 3.5
Repayment of loan	$ 4.7
Grayson Properties II LP
Schedule Of Equity Method Investments [Line Items]
Construction loan		13.1
Construction loan outstanding balance		13.1
Grayson Properties II LP | Maximum | Denison Texas
Schedule Of Equity Method Investments [Line Items]
Commitment to investment		$ 4.8

Condensed Combined Statement of

Condensed Combined Statement of Income for LLCs/LPs Accounted Under Equity Method (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Schedule Of Equity Method Investments [Line Items]
Revenues	$ 22,151	$ 21,205	$ 66,497	$ 62,780
Net income			15,471	17,551
Our share of net income	346	303	943	1,341
Equity Method Investment, Nonconsolidated Investee or Group of Investees
Schedule Of Equity Method Investments [Line Items]
Revenues	2,129	2,736	6,108	8,373
Operating expenses	826	1,184	2,289	3,356
Depreciation and amortization	463	627	1,386	1,684
Interest, net	264	388	795	1,260
Net income	576	537	1,638	2,073
Equity Method Investment, Nonconsolidated Investee or Group of Investees
Schedule Of Equity Method Investments [Line Items]
Our share of net income	$ 346	$ 303	$ 943	$ 1,341

Condensed Combined Balance Shee

Condensed Combined Balance Sheets for LLCs/LPs Accounted Under Equity Method (Detail) - USD ($) $ in Thousands		Sep. 30, 2022	Jun. 30, 2022	Dec. 31, 2021	Sep. 30, 2021	Jun. 30, 2021	Dec. 31, 2020
Schedule Of Equity Method Investments [Line Items]
Total Assets		$ 609,308		$ 598,419
Equity		233,627	$ 234,646	235,327	$ 151,811	$ 155,364	$ 159,005
Total Liabilities and Equity		609,308		598,419
Investments in LLCs before amounts included in accrued expenses and other liabilities		9,661		10,139
Equity Method Investment, Nonconsolidated Investee or Group of Investees
Schedule Of Equity Method Investments [Line Items]
Net property, including construction in progress		29,831		30,983
Other assets	[1]	5,010		4,574
Total Assets		34,841		35,557
Other liabilities	[1]	2,794		2,797
Mortgage notes payable, non-recourse to us		21,869		22,068
Advances payable to us	[2]	3,500		3,500
Equity		6,678		7,192
Total Liabilities and Equity		34,841		35,557
Investments in LLCs before amounts included in accrued expenses and other liabilities		9,661		10,139
Amounts included in accrued expenses and other liabilities		(1,728)		(1,784)
Equity Method Investment, Nonconsolidated Investee or Group of Investees
Schedule Of Equity Method Investments [Line Items]
Our share of equity in LLCs, net		$ 7,933		$ 8,355
[1]Other assets and other liabilities as of September 30, 2022 and December 31, 2021 include approximately $655,000 and $656,000, respectively, of right-of-use land assets and right-of-use land liabilities related to ground leases whereby the LLC/LP is the lessee, with third party lessors, including subsidiaries of UHS.[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 ($)	9 Months Ended
	Sep. 30, 2022	Dec. 31, 2021
Schedule Of Equity Method Investments [Line Items]
Right-of-use land assets	$ 11,467,000	$ 11,495,000
Right-of-use land liabilities	11,467,000	11,495,000
Limited Liability Companies
Schedule Of Equity Method Investments [Line Items]
Right-of-use land assets	655,000	656,000
Right-of-use land liabilities	$ 655,000	$ 656,000
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		9 Months Ended
		Sep. 30, 2022	Dec. 31, 2021
Schedule Of Equity Method Investments [Line Items]
Mortgage Loan Balance	[1]	$ 21,869	$ 22,068
Grayson Properties II LP
Schedule Of Equity Method Investments [Line Items]
Mortgage Loan Balance	[1],[2]	$ 13,075	13,075
Debt Instrument Maturity Date	[2]	2025-06
Brunswick Associates
Schedule Of Equity Method Investments [Line Items]
Mortgage Loan Balance	[1]	$ 8,794	$ 8,993
Debt Instrument Maturity Date		2030-12
[1]All mortgage loans require monthly principal payments through maturity and include a balloon principal payment upon maturity[2] 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	Sep. 30, 2022 USD ($)
Grayson Properties Two L P
Schedule Of Equity Method Investments [Line Items]
Construction loan	$ 13.1

Lease Accounting - Additional I

Lease Accounting - Additional Information (Detail)		3 Months Ended			9 Months Ended		12 Months Ended
		Sep. 30, 2022 USD ($)	Mar. 31, 2022 USD ($) Subsidiary	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($) Property Subsidiary Lease Land	Sep. 30, 2021 USD ($)	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Leases Disclosure [Line Items]
Number of properties | Property					2
Lessee in connection with ground leases for land | Land					14
Right-of-use land assets		$ 11,467,000			$ 11,467,000			$ 11,495,000
Ground lease liabilities		11,467,000			11,467,000			11,495,000
Aiken Regional Medical Center and Canyon Creek Behavioral Health
Leases Disclosure [Line Items]
Fair market value of real estate assets received					83,700,000			82,400,000
Monthly lease rent receivable			$ 5,700,000
Aiken Regional Medical Center and Canyon Creek Behavioral Health | Forecast
Leases Disclosure [Line Items]
Lease payments expected							$ 5,500,000
Aiken Regional Medical Center
Leases Disclosure [Line Items]
Monthly lease rent receivable			3,900,000
Canyon Creek Behavioral Health
Leases Disclosure [Line Items]
Monthly lease rent receivable			$ 1,800,000
Universal Health Services Inc
Leases Disclosure [Line Items]
Lease revenue	[1]	7,471,000		$ 7,574,000	$ 22,291,000	$ 21,971,000
Universal Health Services Inc | Subsidiary
Leases Disclosure [Line Items]
Number of wholly-owned subsidiaries | Subsidiary			2
Asset Purchase and Sale Agreement | Universal Health Services Inc | Subsidiary | Aiken Regional Medical Center and Canyon Creek Behavioral Health
Leases Disclosure [Line Items]
Number of wholly-owned subsidiaries | Subsidiary					2
Fair market value of real estate assets received			$ 83,700,000
Kindred Chicago Central Hospital Central Chicago, Illinois
Leases Disclosure [Line Items]
Number of lease property | Lease					2
Chicago, Illinois
Leases Disclosure [Line Items]
Lease expiration date					Dec. 31, 2021
Lease revenue		240,000		$ 390,000	$ 1,100,000	$ 1,200,000		$ 1,600,000
Evansville Rehabilitation Hospital Evansville, Indiana
Leases Disclosure [Line Items]
Lease expiration date					May 31, 2019
Estimate operating expenses, remainder of fiscal year		900,000			$ 900,000
Corpus Christi Corpus Christi Texas
Leases Disclosure [Line Items]
Lease expiration date					Jun. 01, 2019
Estimate operating expenses, remainder of fiscal year		$ 900,000			$ 900,000
[1]Includes bonus rental on McAllen Medical Center, a UHS acute care hospital facility of $727 and $2,048 for the three and nine-month periods ended September 30, 2022, respectively, and includes bonus rental on three UHS acute care hospital facilities of $1,828 and $5,171 for the three and nine-month periods ended September 30, 2021, respectively

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		9 Months Ended
		Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Non-Related Parties
Leases Disclosure [Line Items]
Lease revenue		$ 12,836	$ 13,115	$ 38,664	$ 39,324
Non-Related Parties | Base Rents
Leases Disclosure [Line Items]
Lease revenue		10,108	10,421	30,352	31,425
Non-Related Parties | Tenant Reimbursements
Leases Disclosure [Line Items]
Lease revenue		2,728	2,694	8,312	7,899
Universal Health Services Inc
Leases Disclosure [Line Items]
Lease revenue	[1]	7,471	7,574	22,291	21,971
Universal Health Services Inc | Base Rents
Leases Disclosure [Line Items]
Lease revenue		6,102	5,392	18,303	15,820
Universal Health Services Inc | Tenant Reimbursements
Leases Disclosure [Line Items]
Lease revenue		642	354	1,940	980
Universal Health Services Inc | Bonus Rents
Leases Disclosure [Line Items]
Lease revenue		$ 727	$ 1,828	$ 2,048	$ 5,171
[1]Includes bonus rental on McAllen Medical Center, a UHS acute care hospital facility of $727 and $2,048 for the three and nine-month periods ended September 30, 2022, respectively, and includes bonus rental on three UHS acute care hospital facilities of $1,828 and $5,171 for the three and nine-month periods ended September 30, 2021, respectively

Lease Accounting - Components_2

Lease Accounting - Components of the "Lease Revenue - UHS facilities" and "Lease Revenue - Non-related Parties" Captions (Parenthetical) (Detail) - McAllen Medical Center - Bonus Rents $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022 USD ($)	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($) Hospital	Sep. 30, 2021 USD ($)
Leases Disclosure [Line Items]
Lease revenue | $	$ 727	$ 1,828	$ 2,048	$ 5,171
Number of hospital facilities | Hospital			3

Debt and Financial Instrument_2

Debt and Financial Instruments - Additional Information (Detail)				1 Months Ended		3 Months Ended		9 Months Ended
	Jun. 01, 2022 USD ($)	Jul. 02, 2021 USD ($)	Mar. 27, 2018 USD ($) Option	Mar. 31, 2020 USD ($) Derivative	Jan. 31, 2020 USD ($) Derivative	Sep. 30, 2022 USD ($)	Sep. 30, 2019 USD ($) Derivative	Sep. 30, 2022 USD ($)	Sep. 30, 2021 USD ($)	Dec. 31, 2021 USD ($)
Debt Instrument [Line Items]
Net borrowings on the line of credit								$ 18,200,000	$ 40,600,000
Proceeds from lines of credit								18,200,000	$ 40,600,000
Outstanding borrowings under revolving credit agreement						$ 290,100,000		290,100,000		$ 271,900,000
Letters Of Credit Outstanding Amount						3,100,000		3,100,000		3,200,000
Available borrowing capacity						81,800,000		81,800,000		99,900,000
Compensating Balance Amount						0		0
Interest Rate Swap
Debt Instrument [Line Items]
Derivative interest rate cap, net payment received or accrued from counterparties						3,000		414,000
Derivative interest rate cap, offset due to counterparties						428,000		463,000
Interest Rate Swap | Cash Flow Hedge
Debt Instrument [Line Items]
Number of interest rate cap agreements | Derivative				1	1		1
Derivative instruments, fixed rate				0.565%	1.4975%		1.144%
Notional amount				$ 55,000,000	$ 35,000,000		$ 50,000,000
Expiration date of interest rate				Mar. 25, 2027	Sep. 16, 2024		Sep. 16, 2024
Level 2
Debt Instrument [Line Items]
Mortgage loan fair value						48,300,000		48,300,000		59,400,000
Mortgage debt										$ 57,200,000
Derivative interest rate cap, net payment received or accrued from counterparties								1,800,000
Derivative interest rate cap, payment received or accrued from counterparties								662,000
Derivative interest rate cap, offset due to counterparties								2,500,000
Level 2 | Interest Rate Swap
Debt Instrument [Line Items]
Liability derivatives, fair value						$ 12,500,000		$ 12,500,000
Seven Hundred Shadow Lane And Goldring Medical Office Building Fixed Rate Mortgage Loan | Nonrecourse
Debt Instrument [Line Items]
Repayment of mortgage loan	$ 5,100,000
London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
Margin points added to the reference rate			1.25%
Base Rate
Debt Instrument [Line Items]
Margin points added to the reference rate			0.25%
Credit Agreement
Debt Instrument [Line Items]
Outstanding borrowing		$ 350,000,000	$ 375,000,000
Net borrowings on the line of credit		350,000,000	$ 50,000,000
Unsecured revolving amended credit agreement terminated date			Jul. 02, 2025
Proceeds from lines of credit		350,000,000	$ 50,000,000
Increase in borrowing capacity		$ 375,000,000
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 A Facility
Debt Instrument [Line Items]
Credit facility, Interest Rate Terms								Borrowings under the Credit Agreement will bear interest annually at a rate equal to, at our option, at either LIBOR (for one, three, or six months) or the Base Rate, plus in either case, a specified margin depending on our ratio of debt to total capital, as determined by the formula set forth in the Credit Agreement. The applicable margin ranges from 1.10% to 1.35% for LIBOR loans and 0.10% to 0.35% for Base Rate loans.
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%.
Revolving A Facility | Minimum
Debt Instrument [Line Items]
Facility fee payable on commitment			0.15%
Revolving A Facility | Minimum | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
Margin points added to the reference rate			1.10%
Margin points added to the base rate			1%
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 | London Interbank Offered Rate (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%
Revolving B Facility
Debt Instrument [Line Items]
Facility fee payable on commitment								0.20%
Revolving B Facility | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
Margin points added to the reference rate								1.20%
Revolving B Facility | Base Rate
Debt Instrument [Line Items]
Margin points added to the reference rate								0.20%

Summary of Required Compliance

Summary of Required Compliance Ratios in Connection with Terms of Credit Agreement (Detail) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Covenant, Tangible net worth	$ 125,000
Tangible net worth	$ 223,691	$ 225,355
Total leverage	42.80%	43.10%
Secured leverage	6.30%	7.40%
Unencumbered leverage	41.60%	41.90%
Fixed charge coverage	4.60%	4.80%
Maximum
Debt Instrument [Line Items]
Covenant, Total leverage	60%
Covenant, Secured leverage	30%
Covenant, Unencumbered leverage	60%
Minimum
Debt Instrument [Line Items]
Covenant, Fixed charge coverage	1.50%

Summary of Outstanding Mortgage

Summary of Outstanding Mortgages, Excluding Net Debt Premium (Detail) - USD ($) $ in Thousands		9 Months Ended
		Sep. 30, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Total mortgages notes payable, non-recourse to us, net		$ 50,251	$ 56,866
Nonrecourse
Debt Instrument [Line Items]
Outstanding Balance	[1]	50,492
Less net financing fees	[1]	(293)
Plus net debt premium	[1]	52
Total mortgages notes payable, non-recourse to us, net	[1]	50,251
BRB Medical Office Building Fixed Rate Mortgage Loan | Nonrecourse
Debt Instrument [Line Items]
Outstanding Balance	[1],[2]	$ 5,104
Debt Instrument Interest Rate Stated Percentage	[2]	4.27%
Debt Instrument Maturity Date	[2]	2022-12
Desert Valley Medical Center Fixed Rate Mortgage Loan | Nonrecourse
Debt Instrument [Line Items]
Outstanding Balance	[1],[2]	$ 4,235
Debt Instrument Interest Rate Stated Percentage	[2]	3.62%
Debt Instrument Maturity Date	[2]	2023-01
2704 North Tenaya Way Fixed Rate Mortgage Loan | Nonrecourse
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 6,294
Debt Instrument Interest Rate Stated Percentage		4.95%
Debt Instrument Maturity Date		2023-11
Summerlin Hospital Medical Office Building III Fixed Rate Mortgage Loan | Nonrecourse
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 12,621
Debt Instrument Interest Rate Stated Percentage		4.03%
Debt Instrument Maturity Date		2024-04
Tuscan Professional Building Fixed Rate Mortgage Loan | Nonrecourse
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 1,879
Debt Instrument Interest Rate Stated Percentage		5.56%
Debt Instrument Maturity Date		2025-06
Phoenix Children East Valley Care Center Fixed Rate Mortgage Loan | Nonrecourse
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 8,269
Debt Instrument Interest Rate Stated Percentage		3.95%
Debt Instrument Maturity Date		2030-01
Rosenberg Children's Medical Plaza Fixed Rate Mortgage Loan | Nonrecourse
Debt Instrument [Line Items]
Outstanding Balance	[1]	$ 12,090
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.[2]This loan is scheduled to mature within the next twelve months.  We intend to refinance this loan prior to the maturity date.

Segment Reporting - Additional

Segment Reporting - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2022 Segment
Segment Reporting [Abstract]
Number of reportable segments	1