Document and Entity Information
Document and Entity Information - USD ($) | 12 Months Ended | ||
Dec. 31, 2018 | Feb. 22, 2019 | Jun. 30, 2018 | |
Document Information [Line Items] | |||
Document Type | 10-K | ||
Amendment Flag | false | ||
Document Period End Date | Dec. 31, 2018 | ||
Document Fiscal Year Focus | 2,018 | ||
Document Fiscal Period Focus | FY | ||
Trading Symbol | MPW | ||
Entity Registrant Name | MEDICAL PROPERTIES TRUST INC | ||
Entity Central Index Key | 1,287,865 | ||
Current Fiscal Year End Date | --12-31 | ||
Entity Well-known Seasoned Issuer | Yes | ||
Entity Current Reporting Status | Yes | ||
Entity Voluntary Filers | No | ||
Entity Filer Category | Large Accelerated Filer | ||
Entity Shell Company | false | ||
Entity Small Business | false | ||
Entity Emerging Growth Company | false | ||
Entity Common Stock, Shares Outstanding | 381,077,933 | ||
Entity Public Float | $ 5,087,316,078 | ||
MPT Operating Partnership, L.P. [Member] | |||
Document Information [Line Items] | |||
Document Type | 10-K | ||
Amendment Flag | false | ||
Document Period End Date | Dec. 31, 2018 | ||
Document Fiscal Year Focus | 2,018 | ||
Document Fiscal Period Focus | FY | ||
Entity Registrant Name | MPT OPERATING PARTNERSHIP, L.P. | ||
Entity Central Index Key | 1,524,607 | ||
Current Fiscal Year End Date | --12-31 | ||
Entity Filer Category | Non-accelerated Filer | ||
Entity Shell Company | false | ||
Entity Small Business | false | ||
Entity Emerging Growth Company | false |
Consolidated Balance Sheets
Consolidated Balance Sheets - USD ($) $ in Thousands | Dec. 31, 2018 | Dec. 31, 2017 |
Real estate assets | ||
Land | $ 547,894 | $ 639,626 |
Buildings and improvements | 4,233,255 | 4,667,150 |
Construction in progress | 84,172 | 47,695 |
Intangible lease assets | 403,138 | 443,134 |
Real estate held for sale | 146,615 | |
Net investment in direct financing leases | 684,053 | 698,727 |
Mortgage loans | 1,213,322 | 1,778,316 |
Gross investment in real estate assets | 7,165,834 | 8,421,263 |
Accumulated depreciation | (414,331) | (406,855) |
Accumulated amortization | (50,653) | (48,857) |
Net investment in real estate assets | 6,700,850 | 7,965,551 |
Cash and cash equivalents | 820,868 | 171,472 |
Interest and rent receivables | 25,855 | 78,970 |
Straight-line rent receivables | 220,848 | 185,592 |
Other loans | 373,198 | 150,209 |
Other assets | 702,024 | 468,494 |
Total Assets | 8,843,643 | 9,020,288 |
Liabilities | ||
Debt, net | 4,037,389 | 4,898,667 |
Accounts payable and accrued expenses | 204,325 | 211,188 |
Deferred revenue | 13,467 | 18,178 |
Lease deposits and other obligations to tenants | 27,524 | 57,050 |
Total Liabilities | 4,282,705 | 5,185,083 |
Commitments and Contingencies | ||
Equity / Capital | ||
Preferred stock, $0.001 par value. Authorized 10,000 shares; no shares outstanding | ||
Common stock, $0.001 par value. Authorized 500,000 shares; issued and outstanding — 370,637 shares at December 31, 2018 and 364,424 shares at December 31, 2017 | 371 | 364 |
Limited Partners: | ||
Additional paid-in capital | 4,442,948 | 4,333,027 |
Retained earnings (deficit) | 162,768 | (485,932) |
Accumulated other comprehensive loss | (58,202) | (26,049) |
Treasury shares, at cost | (777) | (777) |
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital) | 4,547,108 | 3,820,633 |
Non-controlling interests | 13,830 | 14,572 |
Total Equity / Capital | 4,560,938 | 3,835,205 |
Total Liabilities and Equity / Capital | 8,843,643 | 9,020,288 |
Common Units [Member] | ||
Limited Partners: | ||
Total Equity / Capital | 371 | 364 |
MPT Operating Partnership, L.P. [Member] | ||
Real estate assets | ||
Land | 547,894 | 639,626 |
Buildings and improvements | 4,233,255 | 4,667,150 |
Construction in progress | 84,172 | 47,695 |
Intangible lease assets | 403,138 | 443,134 |
Real estate held for sale | 146,615 | |
Net investment in direct financing leases | 684,053 | 698,727 |
Mortgage loans | 1,213,322 | 1,778,316 |
Gross investment in real estate assets | 7,165,834 | 8,421,263 |
Accumulated depreciation | (414,331) | (406,855) |
Accumulated amortization | (50,653) | (48,857) |
Net investment in real estate assets | 6,700,850 | 7,965,551 |
Cash and cash equivalents | 820,868 | 171,472 |
Interest and rent receivables | 25,855 | 78,970 |
Straight-line rent receivables | 220,848 | 185,592 |
Other loans | 373,198 | 150,209 |
Other assets | 702,024 | 468,494 |
Total Assets | 8,843,643 | 9,020,288 |
Liabilities | ||
Debt, net | 4,037,389 | 4,898,667 |
Accounts payable and accrued expenses | 108,574 | 121,465 |
Deferred revenue | 13,467 | 18,178 |
Lease deposits and other obligations to tenants | 27,524 | 57,050 |
Payable due to Medical Properties Trust, Inc. | 95,361 | 89,333 |
Total Liabilities | 4,282,315 | 5,184,693 |
Commitments and Contingencies | ||
Limited Partners: | ||
Accumulated other comprehensive loss | (58,202) | (26,049) |
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital) | 4,547,498 | 3,821,023 |
Non-controlling interests | 13,830 | 14,572 |
Total Equity / Capital | 4,561,328 | 3,835,595 |
Total Liabilities and Equity / Capital | 8,843,643 | 9,020,288 |
MPT Operating Partnership, L.P. [Member] | Common Units [Member] | ||
Limited Partners: | ||
Limited Partners Capital | 4,559,616 | 3,808,583 |
General Partner [Member] | MPT Operating Partnership, L.P. [Member] | ||
Limited Partners: | ||
Total Equity / Capital | 46,084 | 38,489 |
General partner — issued and outstanding — 3,706 units at December 31, 2018 and 3,644 units at December 31, 2017 | $ 46,084 | $ 38,489 |
Consolidated Balance Sheets (Pa
Consolidated Balance Sheets (Parenthetical) - $ / shares | Dec. 31, 2018 | Dec. 31, 2017 |
Preferred stock, par value | $ 0.001 | $ 0.001 |
Preferred stock, shares authorized | 10,000,000 | 10,000,000 |
Preferred stock, shares outstanding | 0 | 0 |
Common stock, par value | $ 0.001 | $ 0.001 |
Common stock, shares authorized | 500,000,000 | 500,000,000 |
Common stock, shares issued | 370,637,000 | 364,424,000 |
Common stock, shares outstanding | 370,637,000 | 364,424,000 |
MPT Operating Partnership, L.P. [Member] | Common Units [Member] | ||
Limited Partners, units issued | 366,931,000 | 360,780,000 |
Limited Partners, units outstanding | 366,931,000 | 360,780,000 |
General Partner [Member] | MPT Operating Partnership, L.P. [Member] | ||
General partner, units issued | 3,706,000 | 3,644,000 |
General partner, units outstanding | 3,706,000 | 3,644,000 |
LTIP Units [Member] | MPT Operating Partnership, L.P. [Member] | ||
LTIP Units, shares issued | 232,000 | 292,000 |
LTIP Units, shares outstanding | 232,000 | 292,000 |
Consolidated Statements of Net
Consolidated Statements of Net Income - USD ($) shares in Thousands, $ in Thousands | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Revenues | |||
Rent billed | $ 473,343 | $ 435,782 | $ 327,269 |
Straight-line rent | 74,741 | 65,468 | 41,067 |
Income from direct financing leases | 73,983 | 74,495 | 64,307 |
Interest and fee income | 162,455 | 129,000 | 108,494 |
Total revenues | 784,522 | 704,745 | 541,137 |
Expenses | |||
Interest | 223,274 | 176,954 | 159,597 |
Real estate depreciation and amortization | 133,083 | 125,106 | 94,374 |
Property-related | 9,237 | 5,811 | 2,712 |
General and administrative | 80,086 | 58,599 | 48,911 |
Acquisition costs | 917 | 29,645 | 46,273 |
Total expenses | 446,597 | 396,115 | 351,867 |
Other income (expense) | |||
Gain on sale of real estate and other, net | 719,392 | 7,431 | 61,224 |
Impairment charges | (48,007) | (7,229) | |
Debt refinancing costs | (32,574) | (22,539) | |
Other | 10,094 | 10,432 | (1,619) |
Total other income (expense) | 681,479 | (14,711) | 29,837 |
Income before income tax | 1,019,404 | 293,919 | 219,107 |
Income tax (expense) benefit | (927) | (2,681) | 6,830 |
Net income | 1,018,477 | 291,238 | 225,937 |
Net income attributable to non-controlling interests | (1,792) | (1,445) | (889) |
Net income attributable to MPT common stockholders (Operating Partnership partners) | $ 1,016,685 | $ 289,793 | $ 225,048 |
Earnings per share — basic | |||
Net income attributable to MPT common stockholders (Operating Partnership partners) | $ 2.77 | $ 0.82 | $ 0.86 |
Weighted average shares outstanding — basic | 365,364 | 349,902 | 260,414 |
Earnings per share — diluted | |||
Net income attributable to MPT common stockholders (Operating Partnership partners) | $ 2.76 | $ 0.82 | $ 0.86 |
Weighted average shares outstanding — diluted | 366,271 | 350,441 | 261,072 |
MPT Operating Partnership, L.P. [Member] | |||
Revenues | |||
Rent billed | $ 473,343 | $ 435,782 | $ 327,269 |
Straight-line rent | 74,741 | 65,468 | 41,067 |
Income from direct financing leases | 73,983 | 74,495 | 64,307 |
Interest and fee income | 162,455 | 129,000 | 108,494 |
Total revenues | 784,522 | 704,745 | 541,137 |
Expenses | |||
Interest | 223,274 | 176,954 | 159,597 |
Real estate depreciation and amortization | 133,083 | 125,106 | 94,374 |
Property-related | 9,237 | 5,811 | 2,712 |
General and administrative | 80,086 | 58,599 | 48,911 |
Acquisition costs | 917 | 29,645 | 46,273 |
Total expenses | 446,597 | 396,115 | 351,867 |
Other income (expense) | |||
Gain on sale of real estate and other, net | 719,392 | 7,431 | 61,224 |
Impairment charges | (48,007) | (7,229) | |
Debt refinancing costs | (32,574) | (22,539) | |
Other | 10,094 | 10,432 | (1,619) |
Total other income (expense) | 681,479 | (14,711) | 29,837 |
Income before income tax | 1,019,404 | 293,919 | 219,107 |
Income tax (expense) benefit | (927) | (2,681) | 6,830 |
Net income | 1,018,477 | 291,238 | 225,937 |
Net income attributable to non-controlling interests | (1,792) | (1,445) | (889) |
Net income attributable to MPT common stockholders (Operating Partnership partners) | $ 1,016,685 | $ 289,793 | $ 225,048 |
Earnings per share — basic | |||
Net income attributable to MPT common stockholders (Operating Partnership partners) | $ 2.77 | $ 0.82 | $ 0.86 |
Weighted average shares outstanding — basic | 365,364 | 349,902 | 260,414 |
Earnings per share — diluted | |||
Net income attributable to MPT common stockholders (Operating Partnership partners) | $ 2.76 | $ 0.82 | $ 0.86 |
Weighted average shares outstanding — diluted | 366,271 | 350,441 | 261,072 |
Consolidated Statements of Comp
Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Net income | $ 1,018,477 | $ 291,238 | $ 225,937 |
Other comprehensive income (loss): | |||
Unrealized (loss) gain on interest rate swap | (3,317) | 2,904 | |
Foreign currency translation (loss) gain | (28,836) | 66,854 | (22,923) |
Total comprehensive income | 986,324 | 358,092 | 205,918 |
Comprehensive income attributable to non-controlling interests | (1,792) | (1,445) | (889) |
Comprehensive income attributable to MPT common stockholders (Operating Partnership Partners) | 984,532 | 356,647 | 205,029 |
MPT Operating Partnership, L.P. [Member] | |||
Net income | 1,018,477 | 291,238 | 225,937 |
Other comprehensive income (loss): | |||
Unrealized (loss) gain on interest rate swap | (3,317) | 2,904 | |
Foreign currency translation (loss) gain | (28,836) | 66,854 | (22,923) |
Total comprehensive income | 986,324 | 358,092 | 205,918 |
Comprehensive income attributable to non-controlling interests | (1,792) | (1,445) | (889) |
Comprehensive income attributable to MPT common stockholders (Operating Partnership Partners) | $ 984,532 | $ 356,647 | $ 205,029 |
Consolidated Statements of Equi
Consolidated Statements of Equity / Capital - USD ($) shares in Thousands, $ in Thousands | Total | MPT Operating Partnership, L.P. [Member] | MPT Operating Partnership, L.P. [Member]General Partner [Member] | Common Par Value [Member] | Common Par Value [Member]MPT Operating Partnership, L.P. [Member]Limited Partner [Member] | Additional Paid-in Capital [Member] | Retained Earnings (Deficit) [Member] | Accumulated Other Comprehensive Loss [Member] | Accumulated Other Comprehensive Loss [Member]MPT Operating Partnership, L.P. [Member] | Treasury Shares [Member] | Non-Controlling Interests [Member] | Non-Controlling Interests [Member]MPT Operating Partnership, L.P. [Member] | Long Term Incentive Plan [Member]MPT Operating Partnership, L.P. [Member]Limited Partner [Member] |
Beginning balance at Dec. 31, 2015 | $ 2,107,265 | $ 2,107,655 | $ 21,773 | $ 237 | $ 2,153,769 | $ 2,593,827 | $ (418,650) | $ (72,884) | $ (72,884) | $ (262) | $ 4,997 | $ 4,997 | |
Beginning balance (in shares) at Dec. 31, 2015 | 2,363 | 236,744 | 234,381 | 292 | |||||||||
Net income | 225,937 | 225,937 | $ 2,251 | $ 222,797 | 225,048 | 889 | 889 | ||||||
Unrealized (loss) gain on interest rate swap | 2,904 | 2,904 | 2,904 | 2,904 | |||||||||
Foreign currency translation (loss) gain | (22,923) | (22,923) | (22,923) | (22,923) | |||||||||
Stock (Unit) vesting and amortization of stock (unit)-based compensation | 7,942 | 7,942 | $ 80 | $ 1 | $ 7,862 | 7,941 | |||||||
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares) | 10 | 1,021 | 1,011 | ||||||||||
Distributions to non-controlling interests | (1,036) | (1,036) | (1,036) | (1,036) | |||||||||
Proceeds from offering (net of offering costs) | 1,173,651 | 1,173,651 | $ 11,737 | $ 83 | $ 1,161,914 | 1,173,568 | |||||||
Proceeds from offering (net of offering costs) (shares) | 831 | 82,749 | 81,918 | ||||||||||
Dividends (Distributions) declared ($0.91 in 2016, 0.96 in 2017 and 1.00 in 2018 per common share/ unit) | (240,512) | (240,512) | $ (2,405) | $ (238,107) | (240,512) | ||||||||
Ending balance at Dec. 31, 2016 | 3,253,228 | 3,253,618 | $ 33,436 | $ 321 | $ 3,308,235 | 3,775,336 | (434,114) | (92,903) | (92,903) | (262) | 4,850 | 4,850 | |
Ending balance (in shares) at Dec. 31, 2016 | 3,204 | 320,514 | 317,310 | 292 | |||||||||
Net income | 291,238 | 291,238 | $ 2,898 | $ 286,895 | 289,793 | 1,445 | 1,445 | ||||||
Sale of non-controlling interests | 10,000 | 10,000 | |||||||||||
Foreign currency translation (loss) gain | 66,854 | 66,854 | 66,854 | 66,854 | |||||||||
Stock (Unit) vesting and amortization of stock (unit)-based compensation | 9,949 | 9,949 | $ 99 | $ 9,850 | 9,949 | ||||||||
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares) | 9 | 785 | 776 | ||||||||||
Treasury shares acquired (41,270 shares) | (515) | (515) | |||||||||||
Treasury units acquired (41,270 units) | (515) | $ (6) | $ (509) | ||||||||||
Distributions to non-controlling interests | (1,723) | (1,723) | (1,723) | (1,723) | |||||||||
Proceeds from offering (net of offering costs) | 547,785 | 547,785 | $ 5,478 | $ 43 | $ 542,307 | 547,742 | |||||||
Proceeds from offering (net of offering costs) (shares) | 431 | 43,125 | 42,694 | ||||||||||
Dividends (Distributions) declared ($0.91 in 2016, 0.96 in 2017 and 1.00 in 2018 per common share/ unit) | (341,611) | (341,611) | $ (3,416) | $ (338,195) | (341,611) | ||||||||
Ending balance at Dec. 31, 2017 | 3,835,205 | 3,835,595 | $ 38,489 | $ 364 | $ 3,808,583 | 4,333,027 | (485,932) | (26,049) | (26,049) | (777) | 14,572 | 14,572 | |
Ending balance (in shares) at Dec. 31, 2017 | 3,644 | 364,424 | 360,780 | 292 | |||||||||
Sale of non-controlling interests | 10,000 | 10,000 | |||||||||||
Net income | 1,018,477 | 1,018,477 | $ 10,167 | $ 1,006,518 | 1,016,685 | 1,792 | 1,792 | ||||||
Cumulative effect of change in accounting principles | 1,938 | 1,938 | 19 | 1,919 | 1,938 | ||||||||
Unrealized (loss) gain on interest rate swap | (3,317) | (3,317) | (3,317) | (3,317) | |||||||||
Foreign currency translation (loss) gain | (28,836) | (28,836) | (28,836) | (28,836) | |||||||||
Stock (Unit) vesting and amortization of stock (unit)-based compensation | 16,505 | 16,505 | $ 165 | $ 1 | $ 16,340 | 16,504 | |||||||
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares) | 6 | 599 | 593 | ||||||||||
Conversion of LTIP units to common units (shares) | 60 | (60) | |||||||||||
Redemption of common units | (816) | (816) | $ (816) | (816) | |||||||||
Redemption of common units (shares) | (60) | ||||||||||||
Distributions to non-controlling interests | (2,534) | (2,534) | (2,534) | (2,534) | |||||||||
Proceeds from offering (net of offering costs) | 94,239 | 94,239 | $ 942 | $ 6 | $ 93,297 | 94,233 | |||||||
Proceeds from offering (net of offering costs) (shares) | 56 | 5,614 | 5,558 | ||||||||||
Dividends (Distributions) declared ($0.91 in 2016, 0.96 in 2017 and 1.00 in 2018 per common share/ unit) | (369,923) | (369,923) | $ (3,698) | $ (366,225) | (369,923) | ||||||||
Ending balance at Dec. 31, 2018 | $ 4,560,938 | $ 4,561,328 | $ 46,084 | $ 371 | $ 4,559,616 | $ 4,442,948 | $ 162,768 | $ (58,202) | $ (58,202) | $ (777) | $ 13,830 | $ 13,830 | |
Ending balance (in shares) at Dec. 31, 2018 | 3,706 | 370,637 | 366,931 | 232 |
Consolidated Statements of Eq_2
Consolidated Statements of Equity / Capital (Parenthetical) - $ / shares shares in Thousands | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Treasury shares acquired (shares) | 41,270 | ||
Dividends (Distributions) declared per common share / unit | $ 1 | $ 0.96 | $ 0.91 |
MPT Operating Partnership, L.P. [Member] | |||
Treasury shares acquired (shares) | 41,270 | ||
Dividends (Distributions) declared per common share / unit | 1 | $ 0.96 | 0.91 |
MPT Operating Partnership, L.P. [Member] | General Partner [Member] | |||
Treasury shares acquired (shares) | 41,270 | ||
Dividends (Distributions) declared per common share / unit | 1 | $ 0.96 | 0.91 |
Retained Earnings (Deficit) [Member] | |||
Dividends (Distributions) declared per common share / unit | 1 | $ 0.96 | 0.91 |
Treasury Shares [Member] | |||
Treasury shares acquired (shares) | 41,270 | ||
Common Par Value [Member] | MPT Operating Partnership, L.P. [Member] | Limited Partner [Member] | |||
Treasury shares acquired (shares) | 41,270 | ||
Dividends (Distributions) declared per common share / unit | $ 1 | $ 0.96 | $ 0.91 |
Consolidated Statements of Cash
Consolidated Statements of Cash Flows $ in Thousands | 12 Months Ended | ||
Dec. 31, 2018USD ($) | Dec. 31, 2017USD ($) | Dec. 31, 2016USD ($) | |
Operating activities | |||
Net income | $ 1,018,477 | $ 291,238 | $ 225,937 |
Adjustments to reconcile net income to net cash provided by operating activities: | |||
Depreciation and amortization | 141,492 | 131,979 | 97,601 |
Amortization of deferred financing costs and debt discount | 7,363 | 6,521 | 7,613 |
Direct financing lease interest accretion | (9,783) | (9,933) | (9,120) |
Straight-line rent revenue | (90,811) | (70,808) | (41,567) |
Share / (Unit)-based compensation expense | 16,505 | 9,949 | 7,942 |
Gain from sale of real estate and other, net | (719,392) | (7,431) | (61,224) |
Impairment charges | 48,007 | 7,229 | |
Straight-line rent and other write-off | 18,002 | 5,340 | 3,063 |
Debt refinancing costs | 32,574 | 22,539 | |
Other adjustments | (3,768) | (1,204) | 3,563 |
Changes in: | |||
Interest and rent receivables | 46,498 | (21,116) | (13,247) |
Other assets | (18,051) | (5,318) | (19,202) |
Accounts payable and accrued expenses | (5,596) | 2,494 | 41,583 |
Deferred revenue | 145 | (2,050) | (8,872) |
Net cash provided by operating activities | 449,088 | 362,235 | 263,838 |
Investing activities | |||
Cash paid for acquisitions and other related investments | (1,430,995) | (2,246,788) | (1,682,409) |
Net proceeds from sale of real estate | 1,513,666 | 64,362 | 198,767 |
Principal received on loans receivable | 885,917 | 8,480 | 906,757 |
Investment in loans receivable | (212,002) | (19,338) | (109,027) |
Construction in progress and other | (53,967) | (73,812) | (171,209) |
Investment in unsecured senior notes | (50,000) | ||
Proceeds from sale of unsecured notes | 50,000 | ||
Other investments, net | (138,441) | (94,970) | (69,423) |
Net cash provided by (used for) investing activities | 564,178 | (2,362,066) | (926,544) |
Financing activities | |||
Proceeds from term debt | 759,735 | 2,355,280 | 1,000,000 |
Payments of term debt | (1,038,221) | (575,299) | |
Payment of deferred financing costs | (32,794) | (15,468) | |
Revolving credit facilities, net | (811,718) | 550,415 | (810,000) |
Distributions paid | (363,906) | (326,729) | (218,393) |
Lease deposits and other obligations to tenants | (20,606) | 27,525 | 14,557 |
Proceeds from sale of common shares, net of offering costs | 94,239 | 547,785 | 1,173,651 |
Other financing activities | (3,614) | (12,984) | (16,485) |
Net cash (used for) provided by financing activities | (345,870) | 2,070,277 | 552,563 |
Increase (decrease) in cash, cash equivalents, and restricted cash for the year | 667,396 | 70,446 | (110,143) |
Effect of exchange rate changes | (17,218) | 16,920 | (3,003) |
Cash, cash equivalents and restricted cash at beginning of year | 172,247 | 84,881 | 198,027 |
Cash, cash equivalents, and restricted cash at end of year | 822,425 | 172,247 | 84,881 |
Interest paid, including capitalized interest of $1,480 in 2018, $840 in 2017, and $2,320 in 2016 | 221,779 | 149,798 | 138,770 |
Supplemental schedule of non-cash financing activities: | |||
Dividends declared, not paid | 95,419 | 89,403 | 74,521 |
Cash, cash equivalents and restricted cash are comprised of the following: | |||
Cash and cash equivalents at beginning of period | 171,472 | 83,240 | 195,541 |
Restricted cash, included in Other assets at beginning of period | $ 775 | $ 1,641 | $ 2,486 |
Restricted cash and cash equivalents, noncurrent, asset, statement of financial position [Extensible List] | us-gaap:OtherAssets | us-gaap:OtherAssets | us-gaap:OtherAssets |
Cash, cash equivalents and restricted cash at beginning of year | $ 172,247 | $ 84,881 | $ 198,027 |
Cash and cash equivalents at end of period | 820,868 | 171,472 | 83,240 |
Restricted cash, included in Other assets at end of period | 1,557 | 775 | 1,641 |
Cash, cash equivalents, and restricted cash at end of year | 822,425 | 172,247 | 84,881 |
MPT Operating Partnership, L.P. [Member] | |||
Operating activities | |||
Net income | 1,018,477 | 291,238 | 225,937 |
Adjustments to reconcile net income to net cash provided by operating activities: | |||
Depreciation and amortization | 141,492 | 131,979 | 97,601 |
Amortization of deferred financing costs and debt discount | 7,363 | 6,521 | 7,613 |
Direct financing lease interest accretion | (9,783) | (9,933) | (9,120) |
Straight-line rent revenue | (90,811) | (70,808) | (41,567) |
Share / (Unit)-based compensation expense | 16,505 | 9,949 | 7,942 |
Gain from sale of real estate and other, net | (719,392) | (7,431) | (61,224) |
Impairment charges | 48,007 | 7,229 | |
Straight-line rent and other write-off | 18,002 | 5,340 | 3,063 |
Debt refinancing costs | 32,574 | 22,539 | |
Other adjustments | (3,768) | (1,204) | 3,563 |
Changes in: | |||
Interest and rent receivables | 46,498 | (21,116) | (13,247) |
Other assets | (18,051) | (5,318) | (19,202) |
Accounts payable and accrued expenses | (5,596) | 2,494 | 41,583 |
Deferred revenue | 145 | (2,050) | (8,872) |
Net cash provided by operating activities | 449,088 | 362,235 | 263,838 |
Investing activities | |||
Cash paid for acquisitions and other related investments | (1,430,995) | (2,246,788) | (1,682,409) |
Net proceeds from sale of real estate | 1,513,666 | 64,362 | 198,767 |
Principal received on loans receivable | 885,917 | 8,480 | 906,757 |
Investment in loans receivable | (212,002) | (19,338) | (109,027) |
Construction in progress and other | (53,967) | (73,812) | (171,209) |
Investment in unsecured senior notes | (50,000) | ||
Proceeds from sale of unsecured notes | 50,000 | ||
Other investments, net | (138,441) | (94,970) | (69,423) |
Net cash provided by (used for) investing activities | 564,178 | (2,362,066) | (926,544) |
Financing activities | |||
Proceeds from term debt | 759,735 | 2,355,280 | 1,000,000 |
Payments of term debt | (1,038,221) | (575,299) | |
Payment of deferred financing costs | (32,794) | (15,468) | |
Revolving credit facilities, net | (811,718) | 550,415 | (810,000) |
Distributions paid | (363,906) | (326,729) | (218,393) |
Lease deposits and other obligations to tenants | (20,606) | 27,525 | 14,557 |
Proceeds from sale of common shares, net of offering costs | 94,239 | 547,785 | 1,173,651 |
Other financing activities | (3,614) | (12,984) | (16,485) |
Net cash (used for) provided by financing activities | (345,870) | 2,070,277 | 552,563 |
Increase (decrease) in cash, cash equivalents, and restricted cash for the year | 667,396 | 70,446 | (110,143) |
Effect of exchange rate changes | (17,218) | 16,920 | (3,003) |
Cash, cash equivalents and restricted cash at beginning of year | 172,247 | 84,881 | 198,027 |
Cash, cash equivalents, and restricted cash at end of year | 822,425 | 172,247 | 84,881 |
Interest paid, including capitalized interest of $1,480 in 2018, $840 in 2017, and $2,320 in 2016 | 221,779 | 149,798 | 138,770 |
Supplemental schedule of non-cash financing activities: | |||
Dividends declared, not paid | 95,419 | 89,403 | 74,521 |
Cash, cash equivalents and restricted cash are comprised of the following: | |||
Cash and cash equivalents at beginning of period | 171,472 | 83,240 | 195,541 |
Restricted cash, included in Other assets at beginning of period | $ 775 | $ 1,641 | $ 2,486 |
Restricted cash and cash equivalents, noncurrent, asset, statement of financial position [Extensible List] | us-gaap:OtherAssets | us-gaap:OtherAssets | us-gaap:OtherAssets |
Cash, cash equivalents and restricted cash at beginning of year | $ 172,247 | $ 84,881 | $ 198,027 |
Cash and cash equivalents at end of period | 820,868 | 171,472 | 83,240 |
Restricted cash, included in Other assets at end of period | 1,557 | 775 | 1,641 |
Cash, cash equivalents, and restricted cash at end of year | $ 822,425 | $ 172,247 | $ 84,881 |
Consolidated Statements of Ca_2
Consolidated Statements of Cash Flows (Parenthetical) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Interest paid, capitalized | $ 1,480 | $ 840 | $ 2,320 |
MPT Operating Partnership, L.P. [Member] | |||
Interest paid, capitalized | $ 1,480 | $ 840 | $ 2,320 |
Organization
Organization | 12 Months Ended |
Dec. 31, 2018 | |
Accounting Policies [Abstract] | |
Organization | 1. Organization Medical Properties Trust, Inc., a Maryland corporation, was formed on August 27, 2003, under the General Corporation Law of Maryland for the purpose of engaging in the business of investing in, owning, and leasing healthcare real estate. Our operating partnership subsidiary, MPT Operating Partnership, L.P., through which we conduct all of our operations, was formed in September 2003. Through another wholly-owned subsidiary, Medical Properties Trust, LLC, we are the sole general partner of the Operating Partnership. At present, we directly own substantially all of the limited partnership interests in the Operating Partnership and have elected to report our required disclosures and that of the Operating Partnership on a combined basis, except where material differences exist. We have operated as a real estate investment trust (“REIT”) since April 6, 2004, and accordingly, elected REIT status upon the filing in September 2005 of the calendar year 2004 federal income tax return. Accordingly, we will generally not be subject to United States (“U.S.”) federal income tax, provided that we continue to qualify as a REIT and our distributions to our stockholders equal or exceed our taxable income. Our primary business strategy is to acquire and develop real estate and improvements, primarily for long-term lease to providers of healthcare services such as operators of general acute care hospitals, inpatient physical rehabilitation hospitals, long-term acute care hospitals, surgery centers, centers for treatment of specific conditions such as cardiac, pulmonary, cancer, and neurological hospitals, and other healthcare-oriented facilities. We also make mortgage and other loans to operators of similar facilities. In addition, we may obtain profits or equity interests in our tenants, from time to time, in order to enhance our overall return. We manage our business as a single business segment. All of our properties are located in the U.S. and Europe. |
Summary of Significant Accounti
Summary of Significant Accounting Policies | 12 Months Ended |
Dec. 31, 2018 | |
Accounting Policies [Abstract] | |
Summary of Significant Accounting Policies | 2. Summary of Significant Accounting Policies Use of Estimates: The preparation of financial statements in conformity with accounting principles generally accepted in the U.S. requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. Principles of Consolidation: Property holding entities and other subsidiaries of which we own 100% of the equity or have a controlling financial interest evidenced by ownership of a majority voting interest are consolidated. All inter-company balances and transactions are eliminated. For entities in which we own less than 100% of the equity interest, we consolidate the property if we have the direct or indirect ability to control the entities’ activities based upon the terms of the respective entities’ ownership agreements. For these entities, we record a non-controlling interest representing equity held by non-controlling interests. We continually evaluate all of our transactions and investments to determine if they represent variable interests in a variable interest entity (“VIE”). If we determine that we have a variable interest in a VIE, we then evaluate if we are the primary beneficiary of the VIE. The evaluation is a qualitative assessment as to whether we have the ability to direct the activities of a VIE that most significantly impact the entity’s economic performance. We consolidate each VIE in which we, by virtue of or transactions with our investments in the entity, are considered to be the primary beneficiary. At December 31, 2018, we had loans and/or equity investments in certain VIEs, which are also tenants of our facilities. We have determined that we are not the primary beneficiary of these VIEs. The carrying value and classification of the related assets and maximum exposure to loss as a result of our involvement with these VIEs are presented below at December 31, 2018 (in thousands): VIE Type Maximum Loss Exposure(1) Asset Type Classification Carrying Amount(2) Equity investments $ 17,187 Other assets $ — (1) Our maximum loss exposure related to our equity investment in VIEs represent the current carrying values of such investment plus any other related assets (such as rent receivables) less any liabilities. (2) Carrying amount reflects the net book value of our equity interest only in the VIE. For the VIE types above, we do not consolidate the VIE because we do not have the ability to control the activities (such as the day-to-day healthcare operations of our borrowers or investees) that most significantly impact the VIE’s economic performance. As of December 31, 2018, we were not required to provide financial support through a liquidity arrangement or otherwise to our unconsolidated VIEs, including circumstances in which it could be exposed to further losses (e.g., cash short falls). Typically, our loans are collateralized by assets of the borrower (some assets of which are on the premises of facilities owned by us) and further supported by limited guarantees made by certain principals of the borrower. Investments in Unconsolidated Entities: Investments in entities in which we have the ability to significantly influence (but not control) are accounted for by the equity method, such as our joint venture with Primotop as discuss in Note 3. Under the equity method of accounting, our share of the investee’s earnings or losses are included in the other income line of our consolidated statements of net income. Except for our joint venture with Primotop, we have elected to record our share of such investee’s earnings or losses on a 90-day lag basis. The initial carrying value of investments in unconsolidated entities is based on the amount paid to purchase the interest in the investee entity. Subsequently, our investments are increased/decreased by our share in the investees’ earnings/losses and decreased by cash distributions from our investees. To the extent that our cost basis is different from the basis reflected at the investee entity level, the basis difference is generally amortized over the lives of the related assets and liabilities, and such amortization is included in our share of equity in earnings of the investee. We evaluate our equity method investments for impairment based upon a comparison of the fair value of the equity method investment to its carrying value, when impairment indicators exist. If we determine a decline in the fair value of an investment in an unconsolidated investee entity below its carrying value is other-than-temporary, and impairment is recorded. Investments in entities in which we do not control nor do we have the ability to significantly influence and for which there is no readily determinable fair value (such as our investments in Steward Health Care System LLC (“Steward”) and Median Kliniken S.á.r.l. (“MEDIAN”)) are accounted for at cost, less any impairment, plus or minus changes resulting from observable price changes in orderly transactions involving the investee. Cash and Cash Equivalents: Certificates of deposit, short-term investments with original maturities of three months or less and money-market mutual funds are considered cash equivalents. The majority of our cash and cash equivalents are held at major commercial banks, which at times may exceed the Federal Deposit Insurance Corporation limit. We have not experienced any losses to date on our invested cash. Cash and cash equivalents which have been restricted as to its use are recorded in other assets. Revenue Recognition: We receive income from operating leases based on the fixed, minimum required rents (base rents) per the lease agreements. Rent revenue from base rents is recorded on the straight-line method over the terms of the related lease agreements for new leases and the remaining terms of existing leases for those acquired as part of a property acquisition. The straight-line method records the periodic average amount of base rent earned over the term of a lease, taking into account contractual rent increases over the lease term. The straight-line method typically has the effect of recording more rent revenue from a lease than a tenant is required to pay early in the term of the lease. During the later parts of a lease term, this effect reverses with less rent revenue recorded than a tenant is required to pay. Rent revenue, as recorded on the straight-line method, in the consolidated statements of net income is presented as two amounts: rent billed and straight-line revenue. Rent billed revenue is the amount of base rent actually billed to our tenants each period as required by the lease. Straight-line rent revenue is the difference between rent revenue earned based on the straight-line method and the amount recorded as rent billed revenue. We record the difference between base rent revenues earned and amounts due per the respective lease agreements, as applicable, as an increase or decrease to straight-line rent receivable. We also receive additional rent (contingent rent) under some leases based on increases in the consumer price index (“CPI”) or when CPI exceeds the annual minimum percentage increase as stipulated in the lease. Contingent rents are recorded as rent billed revenue in the period earned. Rental payments received prior to their recognition as income are classified as deferred revenue. We use direct financial lease (“DFL”) accounting to record rent on certain leases deemed to be financing leases, per accounting rules, rather than operating leases. For leases accounted for as DFLs, the future minimum lease payments are recorded as a receivable. The difference between the future minimum lease payments and the estimated residual values less the cost of the properties is recorded as unearned income. Unearned income is deferred and amortized to income over the lease terms to provide a constant yield when collectability of the lease payments is reasonably assured. Investments in DFLs are presented net of unearned income. We begin recording base rent income from our development projects when the lessee takes physical possession of the facility, which may be different from the stated start date of the lease. Also, during construction of our development projects, we may be entitled to accrue rent based on the cost paid during the construction period (construction period rent). We accrue construction period rent as a receivable with a corresponding offset to deferred revenue during the construction period. When the lessee takes physical possession of the facility, we begin recognizing the deferred construction period revenue on the straight-line method over the term of the lease. We receive interest income from our tenants/borrowers on mortgage loans, working capital loans, and other long-term loans. Interest income from these loans is recognized as earned based upon the principal outstanding and terms of the loans. Commitment fees received from lessees for development and leasing services are initially recorded as deferred revenue and recognized as income over the initial term of a lease to produce a constant effective yield on the lease (interest method). Commitment and origination fees from lending services are also recorded as deferred revenue initially and recognized as income over the life of the loan using the interest method. Tenant payments for certain taxes, insurance, and other operating expenses related to our facilities (most of which are paid directly by our tenants to the government or appropriate third party vendor) are recorded net of the respective expense as generally our leases are “triple-net” leases, with terms requiring such expenses to be paid by our tenants. Failure on the part of our tenants to pay such expense or to pay late would result in a violation of the lease agreement, which could lead to an event of default, if not cured. In regards to property disposals, starting January 1, 2018, we account for such transactions pursuant to ASU No. 2014-09, “Revenue from Contracts with Customers,” (“ASU 2014-09”). Under this guidance, we recognize a sale of real estate when control has been transferred to the buyer and collection of the sales price is probable. Prior to 2018, we could not recognize a sale if we had continuing involvement in the real estate. Upon adoption of the new accounting guidance, we recorded a $2 million adjustment to retained earnings to fully recognize a gain on real estate sold in prior years that was required to be deferred under old accounting guidance. Acquired Real Estate Purchase Price Allocation: Since January 1, 2018 with adoption of ASU No. 2017-01, “Clarifying the Definition of a Business” (“ASU 2017-01”), all of our property acquisitions have been accounted for as asset acquisitions. Prior to 2018, properties acquired for leasing purposes were accounted for using business combination accounting rules. The primary impact to us from this change in accounting is the capitalization of third party transaction costs that are directly related to the acquisition as these costs were expensed under business combination accounting rules. Under either accounting method, we allocate the purchase price of acquired properties to tangible and identified intangible assets acquired based on their fair values. In making estimates of fair values for purposes of allocating purchase prices of acquired real estate, we may utilize a number of sources, from time to time, including available real estate broker data, independent appraisals that may be obtained in connection with the acquisition or financing of the respective property, internal data from previous acquisitions or developments, and other market data. We also consider information obtained about each property as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the tangible and intangible assets acquired. We measure the aggregate value of lease intangible assets acquired based on the difference between (i) the property valued with new or in-place leases adjusted to market rental rates and (ii) the property valued as if vacant. Management’s estimates of value are made using methods similar to those used by independent appraisers (e.g., discounted cash flow analysis). Factors considered by management in our analysis include an estimate of carrying costs during hypothetical expected lease-up periods, considering current market conditions, and costs to execute similar leases. We also consider information obtained about each targeted facility as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the intangible assets acquired. In estimating carrying costs, management includes real estate taxes, insurance and other operating expenses and estimates of lost rentals at market rates during the expected lease-up periods, which we expect to be about six months depending on specific local market conditions. Management also estimates costs to execute similar leases including leasing commissions, legal costs, and other related expenses to the extent that such costs are not already incurred in connection with a new lease origination as part of the transaction. We record above-market and below-market in-place lease values, if any, for our facilities, which are based on the present value of the difference between (i) the contractual amounts to be paid pursuant to the in-place leases and (ii) management’s estimate of fair market lease rates for the corresponding in-place leases, measured over a period equal to the remaining non-cancelable term of the lease. We amortize any resulting capitalized above-market lease values as a reduction of rental income over the lease term. We amortize any resulting capitalized below-market lease values as an increase to rental income over the lease term. Other intangible assets acquired may include customer relationship intangible values which are based on management’s evaluation of the specific characteristics of each prospective tenant’s lease and our overall relationship with that tenant. Characteristics to be considered by management in allocating these values include the nature and extent of our existing business relationships with the tenant, growth prospects for developing new business with the tenant, the tenant’s credit quality and expectations of lease renewals, including those existing under the terms of the lease agreement, among other factors. We amortize the value of these intangible assets to expense over the term of the respective leases. If a lease is terminated early, the unamortized portion of the lease intangibles are charged to expense. Real Estate and Depreciation: Real estate, consisting of land, buildings and improvements, are maintained at cost. Although typically paid by our tenants, any expenditure for ordinary maintenance and repairs that we pay are expensed to operations as incurred. Significant renovations and improvements which improve and/or extend the useful life of the asset are capitalized and depreciated over their estimated useful lives. We record impairment losses on long-lived assets used in operations when events and circumstances indicate that the assets might be impaired and the undiscounted cash flows estimated to be generated by those assets, including an estimated liquidation amount, during the expected holding periods are less than the carrying amounts of those assets. Impairment losses are measured as the difference between carrying value and fair value of the assets. For assets held for sale, we cease recording depreciation expense and adjust the assets’ value to the lower of its carrying value or fair value, less cost of disposal. Fair value is based on estimated cash flows discounted at a risk-adjusted rate of interest. We classify real estate assets as held for sale when we have commenced an active program to sell the assets, and in the opinion of management, it is probable the asset will be sold within the next 12 months. Construction in progress includes the cost of land, the cost of construction of buildings, improvements and fixed equipment, and costs for design and engineering. Other costs, such as interest, legal, property taxes and corporate project supervision, which can be directly associated with the project during construction, are also included in construction in progress. We commence capitalization of costs associated with a development project when the development of the future asset is probable and activities necessary to get the underlying property ready for its intended use have been initiated. We stop the capitalization of costs when the property is substantially complete and ready for its intended use. Depreciation is calculated on the straight-line method over the estimated useful lives of the related real estate and other assets. Our weighted average useful lives at December 31, 2018 are as follows: Buildings and improvements 39.2 years Tenant lease intangibles 26.0 years Leasehold improvements 16.4 years Furniture, equipment and other 9.8 years Losses from Rent Receivables: For all leases, we continuously monitor the performance of our existing tenants including, but not limited to: admission levels and surgery/procedure volumes by type; current operating margins; ratio of our tenants’ operating margins both to facility rent and to facility rent plus other fixed costs; trends in cash collections; trends in revenue and patient mix; and the effect of evolving healthcare regulations on tenants’ profitability and liquidity. Losses from Operating Lease Receivables: Losses on DFL Receivables: Loans: Loans consist of mortgage loans, working capital loans and other long-term loans. Mortgage loans are collateralized by interests in real property. Working capital and other long-term loans are generally collateralized by interests in receivables and corporate and individual guarantees. We record loans at cost. We evaluate the collectability of both interest and principal on a loan-by-loan basis (using the same process as we do for assessing the collectability of rents) to determine whether they are impaired. A loan is considered impaired when, based on current information and events, it is probable that we will be unable to collect all amounts due according to the existing contractual terms. When a loan is considered to be impaired, the amount of the allowance is calculated by comparing the recorded investment to either the value determined by discounting the expected future cash flows using the loan’s effective interest rate or to the fair value of the collateral, if the loan is collateral dependent. If a loan is deemed to be impaired, we generally place the loan on non-accrual status and record interest income only upon receipt of cash. Earnings Per Share/Units: Basic earnings per common share/unit is computed by dividing net income applicable to common shares/units by the weighted number of shares/units of common stock/units outstanding during the period. Diluted earnings per common share/units is calculated by including the effect of dilutive securities. Our unvested restricted stock/unit awards contain non-forfeitable rights to dividends, and accordingly, these awards are deemed to be participating securities. These participating securities are included in the earnings allocation in computing both basic and diluted earnings per common share/unit. Income Taxes: We conduct our business as a REIT under Sections 856 through 860 of the Internal Revenue Code of 1986, as amended (“the Code”). To qualify as a REIT, we must meet certain organizational and operational requirements, including a requirement to distribute to stockholders at least 90% of our REIT’s ordinary taxable income. As a REIT, we generally pay little U.S. federal and state income tax because of the dividends paid deduction that we are allowed to take. If we fail to qualify as a REIT in any taxable year, we will then be subject to U.S. federal income taxes on our taxable income at regular corporate rates and will not be permitted to qualify for treatment as a REIT for federal income tax purposes for four years following the year during which qualification is lost, unless the Internal Revenue Service grants us relief under certain statutory provisions. Such an event could materially adversely affect our net income and net cash available for distribution to stockholders. However, we intend to operate in such a manner so that we will remain qualified as a REIT for U.S. federal income tax purposes. Our financial statements include the operations of a taxable REIT subsidiary (“TRS”), MPT Development Services, Inc. (“MDS”), and with many other entities, which are single member LLCs that are disregarded for tax purposes and are reflected in the tax returns of MDS. MDS is not entitled to a dividends paid deduction and is subject to U.S. federal, state, and local income taxes. MDS is authorized to provide property development, leasing, and management services for third-party owned properties, and we will make non-mortgage loans to and/or investments in our lessees through this entity. With the property acquisitions and investments in Europe, we are subject to income taxes internationally. However, we do not expect to incur any additional income taxes in the U.S. as such income from our international properties flows through our REIT income tax returns. For our TRS and international subsidiaries, we determine deferred tax assets and liabilities based on the differences between the financial reporting and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Any increase or decrease in our deferred tax assets/liabilities that results from a change in circumstances and that causes us to change our judgment about expected future tax consequences of events, is reflected in our tax provision when such changes occur. Deferred income taxes also reflect the impact of operating loss carryforwards. A valuation allowance is provided if we believe it is more likely than not that all or some portion of our deferred tax assets will not be realized. Any increase or decrease in the valuation allowance that results from a change in circumstances, and that causes us to change our judgment about our ability to realize the related deferred tax asset, is reflected in our tax provision when such changes occur. The calculation of our income taxes involves dealing with uncertainties in the application of complex tax laws and regulations in a multitude of jurisdictions across our global operations. An income tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, on the basis of technical merits. However, if a more likely than not position cannot be reached, we record a liability as an off-set to the tax benefit and adjust the liabilities when our judgment changes as a result of the evaluation of new information not previously available. Because of the complexity of some of these uncertainties, the ultimate resolution may result in a payment that is materially different from our current estimate of the uncertain tax position liabilities. These differences will be reflected as increases or decreases to income tax expense in the period in which new information is available. Stock-Based Compensation: We adopted the 2013 Equity Incentive Plan (the “Equity Incentive Plan”) during the second quarter of 2013. Awards of restricted stock, stock options and other equity-based awards with service conditions are amortized to compensation expense over the vesting periods (typically three years), using the straight-line method. Awards that contain market conditions are amortized to compensation expense over the derived vesting periods, which correspond to the periods over which we estimate the awards will be earned, which generally range from three to five years, using the straight-line method. Awards with performance conditions are amortized using the straight-line method over the service period in which the performance conditions are measured, adjusted for the probability of achieving the performance conditions. Forfeitures of stock-based awards are recognized as they occur. Deferred Costs: Costs incurred that directly relate to the offerings of stock are deferred and netted against proceeds received from the offering. Leasing commissions and other leasing costs directly attributable to tenant leases are capitalized as deferred leasing costs and amortized on the straight-line method over the terms of the related lease agreements. Costs identifiable with loans made to borrowers are capitalized and recognized as a reduction in interest income over the life of the loan. Deferred Financing Costs: We generally capitalize financing costs incurred in connection with new financings and refinancings of debt. These costs are amortized over the lives of the related debt as an addition to interest expense. For debt with defined principal re-payment terms, the deferred costs are amortized to produce a constant effective yield on the debt (interest method) and are included within Debt, net on our consolidated balance sheets. For debt without defined principal repayment terms, such as our revolving credit facility, the deferred costs are amortized on the straight-line method over the term of the debt and are included as a component of Other assets on our consolidated balance sheets. Foreign Currency Translation and Transactions: Certain of our international subsidiaries’ functional currencies are the local currencies of their respective countries. We translate the results of operations of our foreign subsidiaries into U.S. dollars using average rates of exchange in effect during the period, and we translate balance sheet accounts using exchange rates in effect at the end of the period. We record resulting currency translation adjustments in accumulated other comprehensive income (loss), a component of stockholders’ equity on our consolidated balance sheets. Certain of our U.S. subsidiaries will enter into short-term and long-term transactions denominated in a foreign currency from time to time. Gains or losses resulting from these foreign currency transactions are translated into U.S. dollars at the rates of exchange prevailing at the dates of the transactions. The effects of transaction gains or losses on our short-term transactions are included in other income in the consolidated statements of income, while the translation effects on our long-term investments are recorded in accumulated other comprehensive income (loss) on our consolidated balance sheets. Derivative Financial Investments and Hedging Activities: During our normal course of business, we may use certain types of derivative instruments for the purpose of managing interest rate and/or foreign currency risk. We record our derivative and hedging instruments at fair value on the balance sheet. Changes in the estimated fair value of derivative instruments that are not designated as hedges or that do not meet the criteria for hedge accounting are recognized in earnings. For derivatives designated as cash flow hedges, the change in the estimated fair value of the effective portion of the derivative is recognized in accumulated other comprehensive income (loss) on our consolidated balance sheets, whereas the change in the estimated fair value of the ineffective portion is recognized in earnings. For derivatives designated as fair value hedges, the change in the estimated fair value of the effective portion of the derivatives offsets the change in the estimated fair value of the hedged item, whereas the change in the estimated fair value of the ineffective portion is recognized in earnings. To qualify for hedge accounting, we formally document all relationships between hedging instruments and hedged items, as well as our risk management objective and strategy for undertaking the hedge prior to entering into a derivative transaction. This process includes specific identification of the hedging instrument and the hedge transaction, the nature of the risk being hedged and how the hedging instrument’s effectiveness in hedging the exposure to the hedged transaction’s variability in cash flows attributable to the hedged risk will be assessed. Both at the inception of the hedge and on an ongoing basis, we assess whether the derivatives that are used in hedging transactions are highly effective in offsetting changes in cash flows or fair values of hedged items. In addition, for cash flow hedges, we assess whether the underlying forecasted transaction will occur. We discontinue hedge accounting if a derivative is not determined to be highly effective as a hedge or that it is probable that the underlying forecasted transaction will not occur. Fair Value Measurement: We measure and disclose the estimated fair value of financial assets and liabilities utilizing a hierarchy of valuation techniques based on whether the inputs to a fair value measurement are considered to be observable or unobservable in a marketplace. Observable inputs reflect market data obtained from independent sources, while unobservable inputs reflect our market assumptions. This hierarchy requires the use of observable market data when available. These inputs have created the following fair value hierarchy: • Level 1 — quoted prices for instruments in active markets; • Level 2 — quoted prices for instruments in active markets; quoted prices for identical or similar instruments in markets that are not active; and model-derived valuations in which significant inputs and significant value drivers are observable in active markets; and • Level 3 — fair value measurements derived from valuation techniques in which one or more significant inputs or significant value drivers are . We measure fair value using a set of standardized procedures that are outlined herein for all assets and liabilities which are required to be measured at their estimated fair value on either a recurring or non-recurring basis. When available, we utilize quoted market prices from an independent third party source to determine fair value and classify such items in Level 1. In some instances where a market price is available, but the instrument is in an inactive or over-the-counter market, we apply the dealer (market maker) pricing estimate and classify the asset or liability in Level 2. If quoted market prices or inputs are not available, fair value measurements are based upon valuation models that utilize current market or independently sourced market inputs, such as interest rates, option volatilities, credit spreads, market capitalization rates, etc. Items valued using such internally-generated valuation techniques are classified according to the lowest level input that is significant to the fair value measurement. As a result, the asset or liability could be classified in either Level 2 or 3 even though there may be some significant inputs that are readily observable. Internal fair value models and techniques used by us include discounted cash flow and Monte Carlo valuation models. We also consider our counterparty’s and own credit risk on derivatives and other liabilities measured at their estimated fair value. Fair Value Option Election: For our equity interest in Ernest along with any related loans (all of which other than the mortgage loans were sold or paid off on October 4, 2018 - see Note 3 for more details), we have elected to account for these investments at fair value due to the size of the investments and because we believe this method is more reflective of current values. We have not made a similar election for other equity interests or loans that existed at December 31, 2018. Reclassifications: Certain amounts in the consolidated financial statements for prior periods have been reclassified to conform to the current period presentation. Recent Accounting Developments: Leases In February 2016, the FASB issued ASU 2016-02, “Leases”, which sets out the principles for the recognition, measurement, presentation and disclosure of leases for both parties to a contract (i.e. lessees and lessors). The new standard requires lessees to apply a dual approach, classifying leases as either financing or operating leases based on the principle of whether or not the lease is effectively a finance |
Real Estate Activities
Real Estate Activities | 12 Months Ended |
Dec. 31, 2018 | |
Text Block [Abstract] | |
Real Estate Activities | 3. Real Estate Activities Acquisitions For the years ended December 31, 2018, 2017, and 2016, we acquired the following assets: 2018 2017 2016 (in thousands) Assets Acquired Land $ 71,880 $ 240,993 $ 91,071 Building 686,739 985,219 655,324 Intangible lease assets — subject to amortization (weighted average useful life of 27.9 years in 2018, 27.7 years in 2017, and 28.5 years in 2016) 90,651 181,004 94,167 Net investments in direct financing leases — 40,450 178,000 Mortgage loans — 700,000 600,000 Other loans 336,458 — — Equity investments and other assets 245,267 100,000 70,166 Liabilities assumed — (878 ) (6,319 ) Total assets acquired $ 1,430,995 $ 2,246,788 $ 1,682,409 Loans repaid(1) (764,447 ) — (193,262 ) Total net assets acquired $ 666,548 $ 2,246,788 $ 1,489,147 (1) The 2018 column includes $0.8 billion of loans advanced to Steward in 2016 and repaid in 2018 as part of sale leaseback conversion described below. The 2016 column includes $93.3 million of loans advanced to Capella (2) Prime Healthcare Services, Inc. (“Prime”) (2) In 2018, LifePoint Health, Inc. (“LifePoint”) merged with RCCH, who acquired Capella Healthcare, Inc. (“Capella”) in 2016. Any reference to either LifePoint, RCCH, or Capella represent the same entity. 2018 Activity Joint Venture Transaction On August 31, 2018, we completed a joint venture arrangement with Primotop Holdings S.à.r.l. (“Primotop”) pursuant to which we contributed 71 of our post-acute hospitals in Germany, with an aggregate fair value of €1.635 billion, for a 50% interest, while Primotop contributed cash for its 50% interest in the joint venture. As part of the transaction, we received an aggregate amount of approximately €1.14 billion, from the proceeds of the cash contributed by Primotop and the secured debt financing placed on the joint venture’s real estate (as more fully discussed in Note 4), and we recognized an approximate €500 million gain on sale. Our interest in the joint venture is made up of a 50% equity investment valued at approximately €210 million, which is being accounted for under the equity method of accounting, and a €290 million shareholder loan (with terms identical to Primotop’s shareholder loan). Other Transactions On August 31, 2018, we acquired an acute care facility in Pasco, Washington for $17.5 million. The property is leased to RCCH, pursuant to the existing long-term master lease entered into with RCCH in April 2016. On August 28, 2018, we acquired three inpatient rehabilitation hospitals in Germany for €17.3 million (including real estate transfer taxes). These hospitals are part of a four-hospital portfolio that we agreed to purchase for an aggregate amount of €23 million (including real estate transfer taxes) in June 2018 – see Note 13 for an update on the final property in this portfolio. The properties are leased to MEDIAN, pursuant to a new 27-year master lease with annual escalators at the greater of 1% or 70% of the change in German CPI. During 2018, we acquired the fee simple real estate of five general acute care hospitals, four of which are located in Massachusetts and one located in Texas, from Steward Health Care System LLC (“Steward”) in exchange for the reduction of $764.4 million of mortgage loans made to Steward in October 2016 and March 2018, along with additional cash consideration. These properties are being leased to Steward pursuant to the original master lease from October 2016 that had an initial 15-year term with three five-year extension options, plus CPI increases. 2017 Activity Steward Transactions On September 29, 2017, we acquired, from IASIS Healthcare LLC (“IASIS”), a portfolio of ten acute care hospitals and one behavioral health facility, along with ancillary land and buildings, that are located in Arizona, Utah, Texas, and Arkansas. The portfolio is now operated by Steward which separately completed its acquisition of the operations of IASIS on September 29, 2017. Our investment in the portfolio includes the acquisition of eight acute care hospitals and one behavioral health facility for approximately $700 million, the making of $700 million in mortgage loans on two acute care hospitals, and a $100 million minority equity contribution in Steward, for a combined investment of approximately $1.5 billion. On May 1, 2017, we acquired eight hospitals previously affiliated with Community Health Systems, Inc. in Florida, Ohio, and Pennsylvania for an aggregate purchase price of $301.3 million. See “2016 Activity — Acquisition of Steward Portfolio” below for details of the master lease and mortgage loan terms. MEDIAN Transactions On November 29, 2017, we acquired three rehabilitation hospitals in Germany for an aggregate purchase price of €80 million. The facilities are leased to affiliates of MEDIAN, pursuant to a new long-term master lease. The lease began on November 30, 2017, and the term is for 27 years (ending in November 2044). The lease provides for increases in rent at the greater of one percent or 70% of the change in German CPI. During the third quarter of 2017, we acquired two rehabilitation hospitals in Germany for an aggregate purchase price of €39.2 million, in addition to 11 rehabilitation hospitals in Germany that we acquired in the second quarter of 2017 for an aggregate purchase price of €127 million. These 13 properties are leased to affiliates of MEDIAN, pursuant to a third master lease entered into in 2016. (See “2016 Activity” below for details of this master lease.) These acquisitions are the final properties of the portfolio of 20 properties in Germany that we agreed to acquire in July 2016 for €215.7 million, of which seven properties totaling €49.5 million closed in December 2016. On June 22, 2017, we acquired an acute care hospital in Germany for a purchase price of €19.4 million, of which €18.6 million was paid upon closing with the remainder being paid over four years. This property is leased to affiliates of MEDIAN, pursuant to an existing master lease agreement that ends in December 2042 with annual escalators at the greater of one percent or 70% of the change in German CPI. On January 30, 2017, we acquired an inpatient rehabilitation hospital in Germany for €8.4 million. This acquisition was the final property to close as part of the six hospital portfolio that we agreed to buy in September 2016 for an aggregate amount of €44.1 million. This property is leased to affiliates of MEDIAN pursuant to the original long-term master lease agreement reached with MEDIAN in 2015. Other Transactions On June 1, 2017, we acquired the real estate assets of Ohio Valley Medical Center, a 218-bed acute care hospital located in Wheeling, West Virginia, and the East Ohio Regional Hospital, a 139-bed acute care hospital in Martins Ferry, Ohio, from Ohio Valley Health Services, a not-for-profit entity in West Virginia, for an aggregate purchase price of approximately $40 million. We simultaneously leased the facilities to Alecto Healthcare Services LLC (“Alecto”), pursuant to a lease with a 15-year initial term with 2% annual minimum rent increases and three 5-year extension options. The facilities are cross-defaulted and cross-collateralized with our other hospitals currently operated by Alecto. With these acquisitions, we also obtained a 20% interest in the operator of these facilities. On May 1, 2017, we acquired the real estate of St. Joseph Regional Medical Center, a 145-bed acute care hospital in Lewiston, Idaho for $87.5 million. This facility is leased to RCCH, pursuant to the existing long-term master lease entered into with RCCH in April 2016. 2016 Activity Acquisition of Steward Portfolio On October 3, 2016, we closed on a portfolio of nine acute care hospitals in Massachusetts operated by Steward. Our investment in the portfolio included the acquisition of five hospitals for $600 million, the making of $600 million in mortgage loans on four facilities, and a $50 million minority equity contribution in Steward, for a combined investment of $1.25 billion. The five facilities acquired are being leased to Steward under a master lease agreement that has a 15-year term (ending October 31, 2031) with three 5-year extension options, plus annual inflation-based escalators. The terms of the mortgage loan are substantially similar to the master lease. Other Acquisitions From October 27, 2016 to December 31, 2016, we acquired 12 rehabilitation hospitals in Germany for an aggregate purchase price to us of €85.2 million. Of these acquisitions, five properties (totaling €35.6 million) are leased to affiliates of MEDIAN, pursuant to a master lease agreement reached with MEDIAN in 2015. The remaining seven properties (totaling €49.5 million) are leased to affiliates of MEDIAN, pursuant to a third master lease that has terms similar to the original master lease in 2015 with a fixed 27-year lease term ending in August 2043. On October 21, 2016, we acquired three general acute care hospitals and one free-standing emergency department and health center in New Jersey from Prime (as originally contemplated in the agreements) by reducing the $100 million mortgage loan made in September 2015 and advancing an additional $15 million. We are leasing these properties to Prime pursuant to a fifth master lease, which has a 15-year initial term (ending in May 2031) with three five-year extension options, plus consumer-price indexed increases. On July 22, 2016, we acquired an acute care facility in Olympia, Washington in exchange for a $93.3 million loan and an additional $7 million in cash, as contemplated in the initial Capella acquisition transaction in 2015. The terms of the Olympia lease are substantially similar to those of the master lease with Capella post lease amendment. See the Capella Disposal Transaction under the subheading “Disposals” below for further details on the terms of these leases. On June 22, 2016, we closed on the final property of the initial MEDIAN transaction that began in 2014 for a purchase price of €41.6 million. On May 2, 2016, we acquired an acute care hospital in Newark, New Jersey for an aggregate purchase price of $63 million leased to Prime pursuant to the fifth master lease. Furthermore, we committed to advance an additional $30 million to Prime over a three-year period to be used solely for capital additions to the real estate; any such addition will be added to the base upon which the lessee will pay us rents. None of the additional $30 million has been funded to date. Development Activities 2018 Activity During the year ended December 31, 2018, we completed the construction on Ernest Flagstaff. This $25.5 million inpatient rehabilitation facility located in Flagstaff, Arizona opened on March 1, 2018 and is being leased to Ernest pursuant to a stand-alone lease, with terms similar to the original master lease. 2017 Activity During 2017, we completed construction and began recording rental income on the following facilities: • Adeptus Health, Inc. (“Adeptus Health”) — We completed four acute care facilities for this tenant during 2017 totaling approximately $68 million in development costs. • IMED Group (“IMED”) — Our general acute facility located in Valencia, Spain opened on March 31, 2017, and is being leased to IMED pursuant to a 30-year lease that provides for quarterly fixed rent payments that started on October 1, 2017 with annual increases of 1% beginning April 1, 2020. Our ownership in this facility is effected through a joint venture between us and clients of AXA Real Estate, in which we own a 50% interest. Our share of the aggregate purchase and development cost of this facility is approximately €21 million. In April 2017, we completed the acquisition of the long leasehold interest of a development site in Birmingham, England from the Circle Health Group (“Circle”) (the tenant of our existing site in Bath, England) for a purchase price of £2.7 million. Simultaneously with the acquisition, we entered into contracts with the property landlord and Circle committing us to construct an acute care hospital on the site and have subsequently added a rehabilitation facility to the development. Our total development costs for both facilities are anticipated to be approximately £50 million. Circle is contracted to enter into a lease of the hospital following completion of construction for an initial 15-year term with rent to be calculated based on our total development costs. On December 19, 2017, we entered into an agreement to finance the development of and lease an acute care hospital in Idaho Falls, Idaho, for $113.5 million. This facility will be leased to Surgery Partners, Inc. (“Surgery Partners”) pursuant to a long-term lease upon completion. 2016 Activity During 2016, we completed construction and began recording rental income on the following facilities: • Adeptus Health — We completed 19 acute care facilities for this tenant during 2016 totaling $136.6 million. • Ernest Toledo — This $18.4 million inpatient rehabilitation facility located in Toledo, Ohio opened on April 1, 2016 and is being leased to Ernest pursuant to the original 2012 master lease. See table below for a status summary of our current development projects (in thousands): Property Commitment Costs Incurred as of December 31, 2018 Estimated Rent Commencement Date Circle Health (Birmingham, England) $ 43,288 $ 28,881 2Q 2019 Circle Health Rehabilitation (Birmingham, England) 21,505 9,081 3Q 2019 Surgery Partners (Idaho Falls, Idaho) 113,468 46,210 1Q 2020 $ 178,261 $ 84,172 Disposals 2018 Activity On October 4, 2018, we finalized a recapitalization agreement in which we sold our investment in the operations of Ernest and were repaid for our outstanding acquisition loans, working capital loans, and any unpaid interest. Total proceeds received from this transaction approximated $176 million. We retained ownership of the real estate and secured mortgage loans of our Ernest properties. On August 31, 2018, we completed the previously described joint venture arrangement with Primotop, in which we contributed the real estate of 71 of our post-acute hospitals in Germany, with a fair value of approximately €1.635 billion, resulting in a gain of approximately €500 million. See “2018 Activity” in this Note 3 for further details on this transaction. On August 31, 2018, we sold a general acute care hospital located in Houston, Texas that was leased and operated by North Cypress for $148 million. The transaction resulted in a gain on sale of $102.4 million, which was partially offset by a net $2.5 million non-cash charge to revenue to write-off related straight-line rent receivables. On June 4, 2018, we sold three long-term acute care hospitals located in California, Texas, and Oregon, that were leased and operated by Vibra Healthcare, LLC (“Vibra”), which included our equity investment in operations of the Texas facility. Total proceeds from the transaction were $53.3 million in cash, a mortgage loan in the amount of $18.3 million, and a $1.5 million working capital loan. The transaction resulted in a gain on real estate of $24.2 million, which was partially offset by a $5.1 million non-cash charge to revenue to write-off related straight-line rent receivables. On March 1, 2018, we sold the real estate of St. Joseph Medical Center in Houston, Texas, for approximately $148 million to Steward. In return, we received a mortgage loan equal to the purchase price, with such loan secured by the underlying real estate. The mortgage loan had terms consistent with the other mortgage loans in the Steward portfolio. This transaction resulted in a gain of $1.5 million, offset by a $1.7 million non-cash charge to revenue to write-off related straight-line rent receivables on this property. Summary of Operations for Disposed Assets in 2018 The properties sold during 2018 did not meet the definition of discontinued operations. However, the following represents the operating results (excluding the St. Joseph sale in March 2018) from these properties for the periods presented (in thousands): For the Year Ended December 31, 2018 2017 2016 Revenues $ 88,838 $ 132,039 $ 109,544 Real estate depreciation and amortization (15,849 ) (31,870 ) (26,410 ) Property-related expenses (531 ) (404 ) (45 ) Other income (expense) (1) 709,717 (14,168 ) (23,937 ) Income from real estate dispositions, net $ 782,175 $ 85,597 $ 59,152 (1) Includes approximately $720 million of gains on sale for the twelve months ended December 31, 2018. 2017 Activity On March 31, 2017, we sold the EASTAR Health System real estate located in Muskogee, Oklahoma, which was leased to RCCH. Total proceeds from this transaction were approximately $64 million resulting in a gain of $7.4 million, partially offset by a $0.6 million non-cash charge to revenue to write-off related straight-line rent receivables on this property. The sale of Muskogee facility was not a strategic shift in our operations and therefore the results of the Muskogee operations were not reclassified to discontinued operations. 2016 Activity Capella Disposal Transaction Effective April 30, 2016, our investment in the operator of Capella merged with RegionalCare Hospital Partners, Inc. (“RegionalCare”), an affiliate of certain funds managed by affiliates of Apollo Global Management, LLC (“Apollo”), to form RCCH. As part of the transaction, we received net proceeds of approximately $550 million including approximately $492 million for our equity investment and loans made as part of the original Capella acquisition that closed on August 31, 2015. In addition, we received $210 million in prepayment of two mortgage loans for hospitals in Russellville, Arkansas, and Lawton, Oklahoma that we made in connection with the original Capella transaction. We made a new $93.3 million loan for a hospital property in Olympia, Washington that was subsequently converted to real estate on July 22, 2016. Additionally, we and an Apollo affiliate invested $50 million each in unsecured senior notes issued by RegionalCare, which we sold to a large institution on June 20, 2016 at par. The proceeds from this transaction represented the recoverability of our investment in full, except for transaction costs incurred of $6.3 million. We maintained our ownership of five hospitals in Hot Springs, Arkansas; Camden, South Carolina; Hartsville, South Carolina; Muskogee, Oklahoma; and McMinnville, Oregon. Pursuant to the transaction described above, the underlying leases, one of which is a master lease covering all but one property was amended to shorten the initial fixed lease term (to 13.5 years for the master lease and 11.5 years for the other stand-alone lease) , increase the security deposit, and eliminate the lessees’ purchase option provisions. Due to this lease amendment, we reclassified the lease of the properties under the master lease from a DFL to an operating lease. This reclassification resulted in a write-off of $2.6 million of unbilled DFL rent receivables in 2016. Post Acute Transaction On May 23, 2016, we sold five properties (three of which were in Texas and two in Louisiana) that were leased and operated by Post Acute Medical. As part of this transaction, our outstanding loans of $4 million were paid in full, and we recovered our investment in the operations. Total proceeds from this transaction were $71 million, resulting in a net gain of approximately $15 million. Corinth Transaction On June 17, 2016, we sold the Atrium Medical Center real estate located in Corinth, Texas, which was leased and operated by Corinth Investor Holdings. Total proceeds from the transaction were $28 million, resulting in a gain on the sale of real estate of approximately $8 million. This gain on real estate was offset by approximately $9 million of non-cash charges that included the write-off of our investment in the operations of the facility, straight-line rent receivables, and a lease intangible. Encompass Health Transaction On July 20, 2016, we sold three inpatient rehabilitation hospitals located in Texas and operated by Encompass Health for $111.5 million, resulting in a net gain of approximately $45 million. Summary of Operations for Disposed Assets in 2016 The properties sold during 2016 did not meet the definition of discontinued operations. However, the following represents the operating results from these properties (excluding loans repaid in the Capella Disposal Transaction) for the periods presented (in thousands): For the Year Ended December 31, 2016 Revenues $ 8,350 Real estate depreciation and amortization (2,870 ) Property-related expenses (113 ) Other income(1) 60,283 Income from real estate dispositions, net $ 65,650 (1) Includes approximately $60 million of net gains on sale for the year ended December 31, 2016. Intangible Assets At December 31, 2018 and 2017, our intangible lease assets were $403.1 million ($352.5 million, net of accumulated amortization) and $443 million ($394 million, net of accumulated amortization), respectively. We recorded amortization expense related to intangible lease assets of $17.6 million, $15.8 million, and $13.4 million in 2018, 2017, and 2016, respectively, and expect to recognize amortization expense from existing lease intangible assets as follows (amounts in thousands): For the Year Ended December 31: 2019 $ 16,687 2020 16,507 2021 16,493 2022 16,479 2023 16,413 As of December 31, 2018, capitalized lease intangibles have a weighted average remaining life of 26.0 years. Leasing Operations At December 31, 2018, leases on two Alecto facilities, 15 Ernest facilities and ten Prime facilities are accounted for as DFLs. The components of our net investment in DFLs consisted of the following (in thousands): As of December 31, 2018 As of December 31, 2017 Minimum lease payments receivable $ 2,091,504 $ 2,294,081 Estimated residual values 424,719 448,339 Less unearned income (1,832,170 ) (2,043,693 ) Net investment in direct financing leases $ 684,053 $ 698,727 Minimum rental payments due to us over the remaining lease term under operating leases and DFLs at December 31, 2018, are as follows (amounts in thousands): Total Under Operating Leases Total Under DFLs Total 2019 $ 433,542 $ 64,971 $ 498,513 2020 437,025 66,270 503,295 2021 445,598 67,595 513,193 2022 450,592 68,947 519,539 2023 457,732 70,326 528,058 Thereafter 9,612,430 1,544,035 11,156,465 $ 11,836,919 $ 1,882,144 $ 13,719,063 Adeptus Health – Transition Properties 2018 Activity As noted in previous filings, effective October 2, 2017, we had 16 properties transitioning away from Adeptus Health in stages over a two year period as part of Adeptus Health’s confirmed plan of reorganization under Chapter 11 of the Bankruptcy Code. Through December 31, 2018, Adeptus Health vacated and stopped making rent payments on 14 properties. As a result of the shortening of our lease term on these properties, we accelerated the amortization of the straight-line rent receivables resulting in a reduction of straight-line rent revenue by $6.1 million in 2018. Of the other two properties, one will be transitioned away from Adeptus Health on October 1, 2019 and one has been re-leased by Adeptus Health. In August and early October 2018, we re-leased three of the vacant facilities in the Houston market and five in the San Antonio market, respectively, to Steward at rates consistent with that of the previous Adeptus Health lease. At December 31, 2018, our investment in the remaining seven transition facilities (that have not been re-leased) approximates less than 0.5% of our total assets. Although we expect to re-tenant and/or sell the remaining seven facilities in the near future, we lowered the carrying value of the six remaining vacant facilities by $18 million to fair value during 2018, based on market data received during the year. 2017 Activity On December 7, 2017, we announced that UCHealth Partners LLC (“UCHealth”), an affiliate of University of Colorado Hospital, had acquired all of Adeptus Health’s Colorado joint venture interests, assuming the existing master lease of 11 of our free standing emergency facilities. The 11 facilities that are now master leased to UCHealth affiliates had a gross investment of approximately $60 million. The master lease was amended to provide a new 15-year initial term effective January 1, 2018 with three five-year renewal options, while retaining annual escalation provisions of the increase in the CPI with a 2% minimum. On April 4, 2017, we announced that our Louisiana freestanding emergency facilities then-operated by Adeptus Health (with a total budgeted investment of approximately $25 million) had been re-leased to Ochsner Clinic Foundation (“Ochsner”), a health care system in the New Orleans area. We incurred a non-cash charge of $0.5 million to write-off the straight-line rent receivables associated with the previous Adeptus Health lease on these properties. On October 18, 2017, Ochsner agreed to an amended and restated lease that provided for initial terms of 15 years with a 9.2% average minimum lease rate based on our total development and construction cost, as well as the addition of three five-year renewal options. Gilbert and Florence Facilities In the first quarter of 2018, we terminated the lease at our Gilbert and Florence, Arizona facilities due to the tenant not meeting its rent obligations pursuant to the lease. As a result of the lease terminating, we recorded a charge of $1.1 million to reserve against the straight-line rent receivables in February 2018. On April 25, 2018, this former tenant filed for involuntary bankruptcy. On December 14, 2018, the Florence facility was re-leased to Steward pursuant to our original master lease with them with a term to begin in the first quarter of 2019. At December 31, 2018, any outstanding receivables on Florence and Gilbert were completely reserved. Although no assurances can be made that we will not have any impairment charges in the future, we believe our investment in the Gilbert facility (less than 0.2% of total assets at December 31, 2018) is fully recoverable. Alecto Healthcare facilities At December 31, 2018, we own four acute care facilities that are leased to Alecto and have a mortgage loan on a fifth property. With the continued softening in the markets and the overall decline in the operating results of the facility tenant, we lowered the carrying value of the four owned properties by $30 million to fair value. At December 31, 2018, our total investment in these properties is less than 1 % of our total assets. Loans The following is a summary of our loans ($ amounts in thousands): As of December 31, 2018 As of December 31, 2017 Balance Weighted Average Interest Rate Balance Weighted Average Interest Rate Mortgage loans $ 1,213,322 8.8 % $ 1,778,316 8.3 % Acquisition loans 3,454 10.8 % 118,448 13.8 % Working capital and other loans 369,744 5.4 % 31,760 7.6 % $ 1,586,520 $ 1,928,524 Our mortgage loans cover 10 of our properties with four operators. The decrease in mortgage loans relates to the use of Steward mortgage loans to fund the acquisition of the related fee simple real estate as more fully described in this note under sub-caption “Acquisitions”. Upon the finalization of the Ernest recapitalization agreement on October 4, 2018, we sold our investment in the operations of Ernest, and all outstanding acquisition loans and unpaid interest with Ernest were repaid (which made up the majority of the acquisition loan balance in 2017). The remaining acquisition loan balance is our outstanding loan with Vibra, which will mature in 2020. Other loans consist of loans to our tenants for acquisitions and working capital purposes and includes our shareholder loan made to the joint venture with Primotop on August 31, 2018 (as more fully described above in this Note 3) in the amount of €290 million. Concentration of Credit Risks We monitor concentration risk in several ways due to the nature of our real estate assets that are vital to the communities in which they are located and given our history of being able to replace inefficient operators of our facilities if needed, with more effective operators: 1) Facility concentration – At December 31, 2018, we had no investment of any single property greater than 4.2% of our total assets, which is consistent with December 31, 2017. 2) Operator concentration – For the year ended December 31, 2018, revenue from Steward, Prime, MEDIAN, and Ernest represented 39%, 16%, 13% and 8%, respectively. In comparison, these operators represented 27%, 18%, 14% and 10%, respectively, for the year ended December 31, 2017. 3) Geographic concentration – At December 31, 2018, investments in the U.S. and Europe represented approximately 80% and 20%, respectively, of our total assets, which is consistent with December 31, 2017. 4) Facility type concentration – For the year ended December 31, 2018, approximately 76% of our revenues are from our general acute care facilities, while rehabilitation and long-term acute care facilities make up 20% and 4%, respectively. In comparison, general acute care, rehabilitation, and long –term acute care facilities made up 69%, 25%, and 6%, respectively, for the year ended December 31, 2017. Related Party Transactions Lease and interest revenue earned from tenants in which we have or had an equity interest in during the year were $501.4 million, $422.4 million, and $282.9 million in 2018, 2017, and 2016, respectively. |
Debt
Debt | 12 Months Ended |
Dec. 31, 2018 | |
Debt Disclosure [Abstract] | |
Debt | 4. Debt The following is a summary of debt ($ amounts in thousands): As of December 31, 2018 As of December 31, 2017 Revolving credit facility(A) $ 28,059 $ 840,810 Term loans 200,000 200,000 4.000% Senior Unsecured Notes due 2022(B) 573,350 600,250 5.500% Senior Unsecured Notes due 2024 300,000 300,000 6.375% Senior Unsecured Notes due 2024 500,000 500,000 3.325% Senior Unsecured Notes due 2025(B) 573,350 600,250 5.250% Senior Unsecured Notes due 2026 500,000 500,000 5.000% Senior Unsecured Notes due 2027 1,400,000 1,400,000 $ 4,074,759 $ 4,941,310 Debt issue costs, net (37,370 ) (42,643 ) $ 4,037,389 $ 4,898,667 (A) Includes £22 million and £8 million of GBP-denominated borrowings that reflect the exchange rate at December 31, 2018 and December 31, 2017, respectively. (B) These notes are Euro-denominated and reflect the exchange rate at December 31, 2018 and December 31, 2017, respectively. As of December 31, 2018, principal payments due on our debt (which exclude the effects of any discounts, premiums, or debt issue costs recorded) are as follows ($ amounts in thousands): 2019 $ — 2020 — 2021 28,059 2022 773,350 2023 — Thereafter 3,273,350 Total $ 4,074,759 Credit Facility On February 1, 2017, we replaced our previous unsecured credit facility (which we had entered into in 2014 and amended in 2015) with a new revolving credit and term loan agreement (the “Credit Facility”). The new agreement included a $1.3 billion unsecured revolving loan facility (same amount as the previous revolving loan facility), a $200 million unsecured term loan facility ($50 million lower than the previous term loan facility), and a new €200 million unsecured term loan facility. The new unsecured revolving loan facility matures in February 2021 and can be extended for an additional 12 months at our option. The $200 million unsecured term loan facility matures on February 1, 2022, and the €200 million unsecured term loan facility had a maturity date of January 31, 2020; however, it was paid off on March 30, 2017 — see below. The term loan and/or revolving loan commitments may be increased in an aggregate amount not to exceed $500 million. At our election, loans under the Credit Facility may be made as either ABR Loans or Eurodollar Loans. The applicable margin for term loans that are ABR Loans is adjustable on a sliding scale from 0.00% to 0.95% based on our current credit rating. The applicable margin for term loans that are Eurodollar Loans is adjustable on a sliding scale from 0.90% to 1.95% based on our current credit rating. The applicable margin for revolving loans that are ABR Loans is adjustable on a sliding scale from 0.00% to 0.65% based on our current credit rating. The applicable margin for revolving loans that are Eurodollar Loans is adjustable on a sliding scale from 0.875% to 1.65% based on our current credit rating. The commitment fee is adjustable on a sliding scale from 0.125% to 0.30% based on our current credit rating and is payable on the revolving loan facility. At December 31, 2018 and 2017, we had $28.1 million and $840.8 million, respectively, outstanding on the revolving credit facility. At December 31, 2018, our availability under our revolving credit facility was $1.27 billion. The weighted average interest rate on this facility was 2.7% and 2.4% for 2018 and 2017, respectively. At December 31, 2018 and 2017, the interest rate in effect on our term loan was 3.89% and 2.98%, respectively. 4.000% Senior Unsecured Notes due 2022 On August 19, 2015, we completed a €500 million senior unsecured notes offering (“4.000% Senior Unsecured Notes due 2022”). Interest on the notes is payable annually on August 19 of each year. The notes pay interest in cash at a rate of 4.000% per year. The notes mature on August 19, 2022. We may redeem some or all of the 4.000% Senior Unsecured Notes due 2022 at any time. If the notes are redeemed prior to 90 days before maturity, the redemption price will be 100% of their principal amount, plus a make-whole premium, plus accrued and unpaid interest to, but excluding, the applicable redemption date. Within the period beginning on or after 90 days before maturity, the notes may be redeemed, in whole or in part, at a redemption price equal to 100% of their principal amount, plus accrued and unpaid interest to, but excluding, the applicable redemption date. The 4.000% Senior Unsecured Notes due 2022 are fully and unconditionally guaranteed on an unsecured basis by us. In the event of a change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of the purchase. 5.500% Senior Unsecured Notes due 2024 On April 17, 2014, we completed a $300 million senior unsecured notes offering (“5.500% Senior Unsecured Notes due 2024”). Interest on the notes is payable semi-annually on May 1 and November 1 of each year. The notes pay interest in cash at a rate of 5.500% per year. The notes mature on May 1, 2024. We may redeem some or all of the notes at any time prior to May 1, 2019 at a “make-whole” redemption price. On or after May 1, 2019, we may redeem some or all of the notes at a premium that will decrease over time. In the event of a change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase. 6.375% Senior Unsecured Notes due 2024 On February 22, 2016, we completed a $500 million senior unsecured notes offering (“6.375% Senior Unsecured Notes due 2024”). Interest on the notes is payable on March 1 and September 1 of each year. Interest on the notes is paid in cash at a rate of 6.375% per year. The notes mature on March 1, 2024. We may redeem some or all of the notes at any time prior to March 1, 2019 at a “make whole” redemption price. On or after March 1, 2019, we may redeem some or all of the notes at a premium that will decrease over time. In addition, at any time prior to March 1, 2019, we may redeem up to 35% of the notes at a redemption price equal to 106.375% of the aggregate principal amount thereof, plus accrued and unpaid interest thereon, using proceeds from one or more equity offerings. In the event of a change in control, each holder of the notes may require us to repurchase some or all of the notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase. 3.325% Senior Unsecured Notes due 2025 On March 24, 2017, we completed a €500 million senior unsecured notes offering (“3.325% Senior Unsecured Notes due 2025”). Interest on the notes is payable annually on March 24 of each year. The notes pay interest in cash at a rate of 3.325% per year. The notes mature on March 24, 2025. We may redeem some or all of the 3.325% Senior Unsecured Notes due 2025 at any time. If the notes are redeemed prior to 90 days before maturity, the redemption price will be equal to 100% of their principal amount, plus a make-whole premium, plus accrued and unpaid interest up to, but excluding, the applicable redemption date. Within the period beginning on or after 90 days before maturity, the notes may be redeemed, in whole or in part, at a redemption price equal to 100% of their principal amount, plus accrued and unpaid interest to, but excluding, the applicable redemption date. The 3.325% Senior Unsecured Notes due 2025 are fully and unconditionally guaranteed on a senior unsecured basis by us. In the event of a change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest up to, but excluding, the date of the purchase. 5.250% Senior Unsecured Notes due 2026 On July 22, 2016, we completed a $500 million senior unsecured notes offering (“5.250% Senior Unsecured Notes due 2026”). Interest on the notes is payable on February 1 and August 1 of each year. Interest on the notes is to be paid in cash at a rate of 5.250% per year. The notes mature on August 1, 2026. We may redeem some or all of the notes at any time prior to August 1, 2021 at a “make whole” redemption price. On or after August 1, 2021, we may redeem some or all of the notes at a premium that will decrease over time. In addition, at any time prior to August 1, 2019, we may redeem up to 35% of the notes at a redemption price equal to 105.250% of the aggregate principal amount thereof, plus accrued and unpaid interest thereon, using proceeds from one or more equity offerings. In the event of a change in control, each holder of the notes may require us to repurchase some or all of the notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase. 5.000% Senior Unsecured Notes due 2027 On September 7, 2017, we completed a $1.4 billion senior unsecured notes offering (“5.000% Senior Unsecured Notes due 2027”). Interest on the notes is payable on April 15 and October 15 of each year. The notes pay interest in cash at a rate of 5.000% per year. The notes mature on October 15, 2027. We may redeem some or all of the notes at any time prior to October 15, 2022 at a “make whole” redemption price. On or after October 15, 2022, we may redeem some or all of the notes at a premium that will decrease over time. In addition, at any time prior to October 15, 2020, we may redeem up to 40% of the notes at a redemption price equal to 105% of the aggregate principal amount thereof, plus accrued and unpaid interest thereon, using proceeds from one or more equity offerings. In the event of a change in control, each holder of the notes may require us to repurchase some or all of the notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase. With the completion of the 5.000% Senior Unsecured Notes due 2027 offering in 2017, we canceled a $1.0 billion term loan facility commitment from J.P. Morgan Chase Bank, N.A. that we received to assist in funding the September 2017 Steward Transaction. Other Activity 2018 In preparation of the joint venture with Primotop described under “2018 Activity” in Note 3, we issued secured debt on August 3, 2018, resulting in gross proceeds of €655 million. Provisions of the secured debt included a term of seven years and a swapped fixed rate of approximately 2.3%. Subsequently, on August 31, 2018, the secured debt was contributed along with the related real estate of 71 properties to form the joint venture. 2017 In connection with our acquisition of the Northland LTACH Hospital on February 14, 2011, we assumed a $14.6 million mortgage. The Northland mortgage loan required monthly principal and interest payments based on a 30-year amortization period. The Northland mortgage loan had a fixed interest rate of 6.2%, a maturity date of January 1, 2018 and could be prepaid, without penalty within 120 days of the term of the loan. On September 29, 2017, we prepaid the principal amount of this mortgage loan at par in the amount of $12.9 million. On February 17, 2012, we completed a $200 million offering of senior unsecured notes (“6.375% Senior Unsecured Notes due 2022”), and on August 20, 2013, we completed a $150 million tack on to the notes. These 6.375% Senior Unsecured Notes due 2022 accrued interest at a fixed rate of 6.375% per year and had a maturity date of February 15, 2022. The 2013 tack on offering, was issued at a premium (price of 102%), resulting in an effective rate of 5.998%. On October 7, 2017, we redeemed these notes and incurred an $11.2 million redemption premium. On October 10, 2013, we completed a €200 million offering of senior unsecured notes (“5.750% Senior Unsecured Notes due 2020”). The 5.750% Senior Unsecured Notes due 2020 paid interest in cash at a rate of 5.750% per year. The notes had a maturity date of October 1, 2020. On March 4, 2017, we redeemed the €200 million aggregate principal amount of our 5.750% Senior Unsecured Notes due 2020 and incurred a redemption premium of approximately $9 million. Debt Refinancing Costs 2017 With the replacement of our previous credit facility, the early redemption of the 5.750% Senior Unsecured Notes due 2020 and the 6.375% Senior Unsecured Notes due 2022, the payoff of our €200 million euro term loan, the cancellation of the $1.0 billion term loan facility commitment, and the payment of our $12.9 million mortgage loan, we incurred a charge of $32.6 million (including redemption premiums and accelerated amortization of deferred debt issuance cost and commitment fees) during the year ended December 31, 2017. 2016 On July 22, 2016, we used the net proceeds from the 5.250% Senior Unsecured Notes due 2026 offering to redeem $450 million of senior unsecured notes that had an original maturity date in 2021. This redemption resulted in a $22.5 million debt refinancing charge, consisting of a $15.5 million redemption premium and the write-off of deferred debt issuance costs. Covenants Our debt facilities impose certain restrictions on us, including restrictions on our ability to: incur debts; create or incur liens; provide guarantees in respect of obligations of any other entity; make redemptions and repurchases of our capital stock; prepay, redeem or repurchase debt; engage in mergers or consolidations; enter into affiliated transactions; dispose of real estate or other assets; and change our business. In addition, the credit agreements governing our Credit Facility limit the amount of dividends we can pay as a percentage of normalized adjusted funds from operations (“NAFFO”), as defined in the agreements, on a rolling four quarter basis. Through 2018, the dividend restriction was 95% of NAFFO. The indentures governing our senior unsecured notes also limit the amount of dividends we can pay based on the sum of 95% of NAFFO, proceeds of equity issuances and certain other net cash proceeds. Finally, our senior unsecured notes require us to maintain total unencumbered assets (as defined in the related indenture) of not less than 150% of our unsecured indebtedness. In addition to these restrictions, the Credit Facility contains customary financial and operating covenants, including covenants relating to our total leverage ratio, fixed charge coverage ratio, secured leverage ratio, consolidated adjusted net worth, unsecured leverage ratio, and unsecured interest coverage ratio. This Credit Facility also contains customary events of default, including among others, nonpayment of principal or interest, material inaccuracy of representations and failure to comply with our covenants. If an event of default occurs and is continuing under the Credit Facility, the entire outstanding balance may become immediately due and payable. At December 31, 2018, we were in compliance with all such financial and operating covenants. |
Income Taxes
Income Taxes | 12 Months Ended |
Dec. 31, 2018 | |
Income Tax Disclosure [Abstract] | |
Income Taxes | 5. Income Taxes Medical Properties Trust, Inc. We have maintained and intend to maintain our election as a REIT under the Code. To qualify as a REIT, we must meet a number of organizational and operational requirements, including a requirement to distribute at least 90% of our taxable income to our stockholders. As a REIT, we generally will not be subject to U.S. federal income tax if we distribute 100% of our taxable income to our stockholders and satisfy certain other requirements; instead, income tax is paid directly by our stockholders on the dividends distributed to them. If our taxable income exceeds our dividends in a tax year, REIT tax rules allow us to designate dividends from the subsequent tax year in order to avoid current taxation on undistributed income. If we fail to qualify as a REIT in any taxable year, we will be subject to federal income taxes at regular corporate rates, including any applicable alternative minimum tax. Taxable income from non-REIT activities managed through our TRS is subject to applicable U.S. federal, state and local income taxes. Our international subsidiaries are also subject to income taxes in the jurisdictions in which they operate. From our TRS and our foreign operations, income tax expense (benefit) were as follows (in thousands): For the Years Ended December 31, 2018 2017 2016 Current income tax (benefit) expense: Domestic $ (125 ) $ (41 ) $ 42 Foreign 3,294 3,062 1,856 3,169 3,021 1,898 Deferred income tax (benefit) expense: Domestic (3,713 ) (233 ) 147 Foreign 1,471 (107 ) (8,875 ) (2,242 ) (340 ) (8,728 ) Income tax expense (benefit) $ 927 $ 2,681 $ (6,830 ) A reconciliation of the income tax expense (benefit) at the statutory income tax rate and the effective tax rate for income before income taxes for the years ended December 31, 2018, 2017, and 2016 is as follows (in thousands): 2018 2017 2016 Income before income tax $ 1,019,404 $ 293,919 $ 219,107 Income tax at the U.S. statutory federal rate (21% in 2018 and 35% in 2017 and 2016) 214,075 102,872 76,687 Increase (decrease) resulting from: Foreign rate differential (2,643 ) (2,326 ) 1,434 State income taxes, net of federal benefit 379 — 66 U.S. earnings not subject to federal income tax (208,472 ) (98,026 ) (84,927 ) Equity investments (46 ) 3,293 4,297 Change in valuation allowance (2,668 ) (5,391 ) (6,104 ) Other items, net 302 2,259 1,717 Total income tax expense (benefit) $ 927 $ 2,681 $ (6,830 ) The foreign provision (benefit) for income taxes is based on foreign profit before income taxes of $18.6 million in 2018 as compared with foreign losses before income taxes of $(0.1) million in 2017, and $(23.5) million in 2016. The domestic provision (benefit) for income taxes is based on income before income taxes of $8.0 million in 2018 from our TRS as compared with income before income taxes of $13.9 million in 2017, and a loss before income taxes of $(1.4) million in 2016. At December 31, 2018 and 2017, components of our deferred tax assets and liabilities were as follows (in thousands): 2018 2017 Deferred tax assets: Operating loss and interest deduction carry forwards $ 21,984 $ 24,580 Other 277 504 Total deferred tax assets 22,261 25,084 Valuation allowance (3,444 ) (11,101 ) Total net deferred tax assets $ 18,817 $ 13,983 Deferred tax liabilities: Property and equipment $ (12,359 ) $ (4,336 ) Net unbilled revenue (1,633 ) (6,113 ) Partnership investments — (2,099 ) Other (300 ) (1,320 ) Total deferred tax liabilities (14,292 ) (13,868 ) Net deferred tax asset (liability) $ 4,525 $ 115 At December 31, 2018, our U.S. net operating losses (“NOLs”) consisted of $78.3 million of federal NOLs and $99.9 million of state NOLs available as offsets to future years’ taxable income. The NOLs primarily expire between 2022 and 2036. We have alternative minimum tax credits of $0.1 million as of December 31, 2018. To the extent these alternative minimum tax credits exceed regular tax liability in tax years 2019 through 2021, 50% of the excess credit are refundable. Any remaining alternative minimum tax credit will be refunded in 2022. At December 31, 2018, we had foreign NOLs of $8.6 million that may be carried forward indefinitely. Valuation Allowance The valuation allowance disclosed in the table above relates to foreign and domestic net operating loss carryforwards and other net deferred tax assets that may not be realized. As of each reporting date, we consider all new evidence that could impact the future realization of our deferred tax assets. In the evaluation of the need for a valuation allowance on our deferred income tax assets, we consider all available positive and negative evidence, including scheduled reversals of deferred income tax liabilities, carryback of future period losses to prior periods, projected future taxable income, tax planning strategies and recent financial performance. During the fourth quarter of 2018, we released $4.4 million of valuation allowances previously recorded against our U.S. federal and state net deferred tax assets. We now expect these domestic deferred tax assets will be fully utilized to offset taxable income in future years. The decision to reverse the valuation allowance was due to improved operating income in our TRS resulting in a three-year cumulative income position at the end of 2018 and future year taxable income projected in our forecasts. We also evaluated the need for a valuation allowance on our foreign deferred income tax assets. In doing so, we considered all available evidence to determine whether it is more likely than not that the foreign deferred income tax assets will be realized. Based on our review of all positive and negative evidence, we concluded that a partial valuation allowance should remain against certain foreign deferred income tax assets that are not expected to be realized through future sources of taxable income generated from scheduled reversals of deferred income tax liabilities and forecasted taxable income from operating activity. We have no material uncertain tax position liabilities and related interest or penalties recorded at December 31, 2018. REIT Status We have met the annual REIT distribution requirements by payment of at least 90% of our taxable income in 2018, 2017, and 2016. Earnings and profits, which determine the taxability of such distributions, will differ from net income reported for financial reporting purposes due primarily to differences in cost basis, differences in the estimated useful lives used to compute depreciation, and differences between the allocation of our net income and loss for financial reporting purposes and for tax reporting purposes. A schedule of per share distributions we paid and reported to our stockholders is set forth in the following: For the Years Ended December 31, 2018 2017 2016 Common share distribution $ 0.990000 $ 0.950000 $ 0.900000 Ordinary income 0.438792 0.655535 0.619368 Capital gains(1) 0.551208 0.021022 0.102552 Unrecaptured Sec. 1250 gain 0.132280 0.004647 0.045432 Section 19A Dividends 0.438792 — — Return of capital — 0.273443 0.178080 (1) Capital gains include unrecaptured Sec. 1250 gains. MPT Operating Partnership, L.P. As a partnership, the allocated share of income of the Operating Partnership is included in the income tax returns of the general and limited partners. Accordingly, no accounting for income taxes is generally required for such income of the Operating Partnership. However, the Operating Partnership has formed a TRS on behalf of Medical Properties Trust, Inc., which is subject to U.S. federal, state and local income taxes at regular corporate rates, and its international subsidiaries are subject to income taxes in the jurisdictions in which they operate. See discussion above under Medical Properties Trust, Inc. for more details of income taxes associated with our TRS and international operations. |
Earnings Per Share_Unit
Earnings Per Share/Unit | 12 Months Ended |
Dec. 31, 2018 | |
Earnings Per Share [Abstract] | |
Earnings Per Share/Unit | 6. Earnings Per Share/Unit Medical Properties Trust, Inc. Our earnings per share were calculated based on the following (amounts in thousands): For the Years Ended December 31, 2018 2017 2016 Numerator: Net income $ 1,018,477 $ 291,238 $ 225,937 Non-controlling interests’ share in earnings (1,792 ) (1,445 ) (889 ) Participating securities’ share in earnings (3,685 ) (1,409 ) (559 ) Net income, less participating securities’ share in earnings $ 1,013,000 $ 288,384 $ 224,489 Denominator: Basic weighted average common shares 365,364 349,902 260,414 Dilutive potential common shares 907 539 658 Diluted weighted average common shares 366,271 350,441 261,072 MPT Operating Partnership, L.P. Our earnings per unit were calculated based on the following (amounts in thousands): For the Years Ended December 31, 2018 2017 2016 Numerator: Net income $ 1,018,477 $ 291,238 $ 225,937 Non-controlling interests’ share in earnings (1,792 ) (1,445 ) (889 ) Participating securities’ share in earnings (3,685 ) (1,409 ) (559 ) Net income, less participating securities’ share in earnings $ 1,013,000 $ 288,384 $ 224,489 Denominator: Basic weighted average units 365,364 349,902 260,414 Dilutive potential units 907 539 658 Diluted weighted average units 366,271 350,441 261,072 |
Stock Awards
Stock Awards | 12 Months Ended |
Dec. 31, 2018 | |
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract] | |
Stock Awards | 7. Stock Awards Stock Awards Our Equity Incentive Plan authorizes the issuance of common stock options, restricted stock, restricted stock units, deferred stock units, stock appreciation rights, performance units and awards of interests in our Operating Partnership. Our Equity Incentive Plan is administered by the Compensation Committee of the Board of Directors. We have reserved 8,196,770 shares of common stock for awards under the Equity Incentive Plan and 976,073 shares remain available for future stock awards as of December 31, 2018. The Equity Incentive Plan contains a limit of 5,000,000 shares as the maximum number of shares of common stock that may be awarded to an individual in any fiscal year. Awards under the Equity Incentive Plan are subject to forfeiture due to termination of employment prior to vesting and/or from not achieving the respective performance/market conditions on performance-based awards. In the event of a change in control, outstanding and unvested options will immediately vest, unless otherwise provided in the participant’s award or employment agreement, and restricted stock, restricted stock units, deferred stock units and other stock-based awards will vest if so provided in the participant’s award agreement. The term of the awards is set by the Compensation Committee, though Incentive Stock Options may not have terms of more than ten years. Forfeited awards are returned to the Equity Incentive Plan and are then available to be re-issued as future awards. For each share of common stock issued by Medical Properties Trust, Inc. pursuant to its Equity Incentive Plan, the Operating Partnership issues a corresponding number of Operating Partnership units. The following awards have been granted pursuant to our Equity Incentive Plan: Restricted Equity Awards These stock-based awards are in the form of service-based awards and performance awards based on either company-specific performance hurdles or certain market conditions. Service-Based Awards The service-based awards vest as the employee provides the required service (typically three years). Service based awards are valued at the average price per share of common stock on the date of grant. Dividends are generally paid on these awards prior to vesting. See table below for a summary of activity involving service-based awards. Performance-Based Awards In 2018, 2017, and 2016, the Compensation Committee granted performance-based awards to employees. Generally, dividends are not paid on performance awards until the award is earned. See below for details of such performance award grants: 2018 performance awards — The 2018 performance awards were granted in three parts: 1) Certain 2018 performance awards (target number) were granted based on the achievement of specific performance thresholds as set by our compensation committee. However, more or less shares than the target number of shares were allowed to be earned based on our performance. The pre-established performance thresholds for 2018 were as follows: a) Approximately 40% of the target shares can be earned based on our return on equity (“ROE”), as defined by our compensation committee, over the period from January 1, 2018 through December 31, 2020, with the opportunity to earn one-third of the award in any one year. If our ROE was 12.5% or less for the performance period, 50% of these shares would be earned; if our ROE was at least equal to 13.0%, 100% of these shares would be earned; and, if our ROE was greater than or equal to 13.5%, 200% of these shares would be earned. The fair value of this award was based on the average price per share of common stock on the date of grant with the number of shares adjusted as needed based on the probability of such performance hurdles being met. Based on performance in 2018, one-third of the target shares was earned at 200%. b) Approximately 40% of the target shares can be earned based on our earnings before interest expense, taxes, depreciation and amortization all in accordance with GAAP adjusted for other certain items (or “EBITDA”) as defined by our compensation committee, for the year ending December 31, 2020, with the opportunity to earn one-third of the award in any one year. If our EBITDA is at least equal to $720 million for either of the 2018 or 2019 years, or $775 million for 2020, 50% of these shares would be earned; if our EBITDA is at least equal to $740 million for either of the 2018 or 2019 years or $800 million for 2020, 100% of these shares would be earned; and, if our EBITDA is at least equal to $760 million for either of the 2018 or 2019 years or $825 million for 2020, 200% of these shares would be earned. The fair value of this award was based on the average price per share of common stock on the date of grant with the number of shares adjusted as needed based on the probability of such performance hurdles being met. Based on performance, one-third of the target shares was earned at 200%. c) Approximately 20% of the target shares can be earned based on our completed acquisitions ("Acquisitions") as defined by our compensation committee, over the period from January 1, 2018 through December 31, 2020, with the opportunity to earn one-third of the award in any one year. If our Acquisitions were at least equal to $500 million for either of the 2018 or 2019 years or $1.5 billion for the cumulative three-year period; 50% of these shares would be earned; if our Acquisitions were at least equal to $750 million for either of the 2018 or 2019 years or $2.25 billion for the cumulative three-year period, 100% of these shares would be earned; and, if our Acquisitions were at least equal to $1.0 billion for either the 2018 or 2019 years or $3.0 billion for the cumulative three-year period, 200% of these shares would be earned. The fair value of this award was based on the average price per share of common stock on the date of grant with the number of shares adjusted as needed based on the probability of such performance hurdles being met. Based on performance, 73% of the target shares available in the first year of the measurement period was earned. At the end of each of the performance periods, any earned shares during such period will vest on January 1 of the following calendar year. 2) Certain 2018 performance awards were subject to a modifier (which increases or decreases the actual shares earned in each performance period) based on how our total shareholder return compared to the SNL U.S. REIT Healthcare Index (“SNL Index”). If our total shareholder return is in the 75 th th th th In 2018, 508,566 shares were earned but not vested, and 2,000 shares were forfeited. At December 31, 2018, we have 1,238,748 of 2018 performance awards remaining to be earned. 2017 performance awards — The 2017 performance awards were granted in three parts: 1) Certain 2017 performance awards (target number) were granted based on the achievement of specific performance thresholds as set by our compensation committee for the one-year performance period of 2017. However, more or less shares than the target number of shares were allowed to be earned based on our performance. The pre-established performance thresholds for 2017 were as follows: a) Approximately 42% of the target shares were earned based on the achievement of a one-year total shareholder return as compared to the SNL Index over the period from January 1, 2017 through December 31, 2017. If the shareholder return was equal to the SNL Index minus 3% for the one-year period, 50% of these shares would be earned; while, if shareholder return was greater than or equal to the SNL Index plus 3%, 200% of these target shares would be earned. The fair value of this award was estimated on the grant date using a Monte Carlo valuation model that assumed the following: risk free interest rate of 1%; expected volatility of 25%; expected dividend yield of 6.9%; and expected service period of three years. b) Approximately 47% of the target shares were earned based on our return on equity (“ROE”), as defined by our compensation committee, over the period from January 1, 2017 through December 31, 2017. If our ROE was at least equal to 12.5% for the one-year period, 50% of these shares would be earned; and, if our ROE was greater than or equal to 13.5%, 200% of these shares would be earned. The fair value of this award was based on the average price per share of common stock on the date of grant with the number of shares adjusted as needed based on the probability of such performance hurdles being met. For this performance hurdle, 200% of the target shares was earned. c) Approximately 11% of the target shares were earned based on general and administrative expenses (“G&A”) as a percentage of revenue, as defined by our compensation committee, over the period from January 1, 2017 through December 31, 2017. If our G&A as a percentage of revenue was no more than 10% for the one-year period, 50% of these shares would be earned; while, if our G&A as a percentage of revenue was 9% or less, 200% of these shares would be earned. The fair value of this award was based on the average price per share of common stock on the date of grant with the number of shares adjusted as needed based on the probability of such performance hurdles being met. For this performance hurdle, 200% of the target shares was earned. At the end of the one-year performance period, all earned shares will vest in equal annual amounts on January 1, 2018, 2019, and 2020. 2) Certain other 2017 performance awards were based on the achievement of a multi-year cumulative total shareholder return as compared to pre-established returns set by our compensation committee. If the cumulative shareholder return from January 1, 2017 through December 31, 2019 is 27% or greater, then 30% of these shares will be earned (“2019 award”). If the cumulative shareholder return from January 1, 2017 through December 31, 2020 is 36% or greater, then 30% of these shares may be earned (“2020 award”). However, the maximum percentage cumulatively earned in connection with both the 2019 award and the 2020 award shall not exceed 30% of the total award. If the cumulative shareholder return from January 1, 2017 through December 31, 2021 is 45% or greater, then all remaining shares will be earned. At the end of each of the performance periods, any earned shares during such period will vest on January 1 of the following calendar year. The fair value of this award was estimated on the grant date using a Monte Carlo valuation model that assumed the following: risk free interest rate of 1.9%; expected volatility of 25%; expected dividend yield of 6.9%; and expected service period of 5 years. 3) The final portion of our 2017 performance awards will be earned if our total shareholder return outpaces that of the SNL Index over the cumulative period from January 1, 2017 to December 31, 2019. Our total shareholder return must be within 3% of the SNL Index to earn the minimum number of shares under this award; while, it must exceed the SNL Index by 3% to earn 100% of the award. If any shares are earned from this award, the shares will vest in equal annual amounts on January 1, 2020, 2021, and 2022. The fair value of this award was estimated on the grant date using a Monte Carlo valuation model that assumed the following: risk free interest rate of 1.5%; expected volatility of 25%; expected dividend yield of 6.9%; and expected service period of 3 years. In 2018, 396,142 shares were earned but not vested, and 3,750 performance awards were forfeited. In 2017, 596,472 shares were earned but not vested, and 14,000 performance awards were forfeited. 2016 performance awards — The 2016 performance awards were granted in two parts: 1) One-half of the 2016 performance awards were based on us achieving a cumulative total shareholder return from January 1, 2016 to December 31, 2018. The minimum total shareholder return needed to earn a portion of this award was 27.0% with 100% of the award earned if our total shareholder return reached 35.0%. Shares earned from this award vest in equal annual amounts on January 1, 2019, 2020, and 2021. The fair value of this award was estimated on the dates of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 1.0%; expected volatility of 24.4%; expected dividend yield of 7.0%; and expected service period of 5 years. 2) The remainder of the 2016 performance awards were to be earned if our total shareholder return outpaced that of the MSCI U.S. REIT Index (“MSCI Index”) over the cumulative period from January 1, 2016 to December 31, 2018. Our total shareholder return needed to be within 3% of the MSCI Index to earn the minimum number of shares under this award, while it had to exceed the MSCI Index by 3% to earn 100% of the award. Shares earned from this award vest in equal annual amounts on January 1, 2019, 2020, and 2021. The fair value of this award was estimated on the dates of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 1.0%; expected volatility of 24.4%; expected dividend yield of 7.0%; and expected service period of 5 years. In 2018, 779,004 shares were earned but not vested, while no shares were forfeited. In 2017 and 2016, no shares were earned and vested, while 16,000 and 2,400 awards were forfeited in 2017 and 2016, respectively. The following summarizes restricted equity award activity in 2018 and 2017 (which includes awards granted in 2018, 2017, 2016, and any applicable prior years), respectively: For the Year Ended December 31, 2018: Vesting Based on Service Vesting Based on Market/Performance Conditions Shares Weighted Average Value at Award Date Shares Weighted Average Value at Award Date Nonvested awards at beginning of the year 276,280 $ 12.68 2,676,755 $ 7.86 Awarded 958,480 $ 14.31 1,750,834 $ 11.61 Vested (307,275 ) $ 12.92 (288,404 ) $ 11.25 Forfeited (3,637 ) $ 13.05 (5,750 ) $ 9.35 Nonvested awards at end of year 923,848 $ 14.29 4,133,435 $ 9.21 For the Year Ended December 31, 2017: Vesting Based on Service Vesting Based on Market/Performance Conditions Shares Weighted Average Value at Award Date Shares Weighted Average Value at Award Date Nonvested awards at beginning of the year 347,128 $ 13.35 1,811,675 $ 6.78 Awarded 249,841 $ 12.40 1,741,003 $ 8.21 Vested (304,613 ) $ 12.86 (491,071 ) $ 6.84 Forfeited (16,076 ) $ 12.75 (384,852 ) $ 5.65 Nonvested awards at end of year 276,280 $ 12.68 2,676,755 $ 7.86 The value of stock-based awards is charged to compensation expense over the service periods. For the years ended December 31, 2018, 2017, and 2016, we recorded $16.5 million, $9.9 million, and $7.9 million, respectively, of non-cash compensation expense. The remaining unrecognized cost from restricted equity awards at December 31, 2018, is $34.9 million, which will be recognized over a weighted average period of 2.1 years. Restricted equity awards that vested in 2018, 2017, and 2016, had a value of $8.4 million, $10.4 million, and $12.7 million, respectively. |
Commitments and Contingencies
Commitments and Contingencies | 12 Months Ended |
Dec. 31, 2018 | |
Commitments And Contingencies Disclosure [Abstract] | |
Commitments and Contingencies | 8. Commitments and Contingencies Commitments Operating leases, in which we are the lessee, primarily consist of ground leases on which certain of our facilities or other related property reside along with corporate office and equipment leases. The ground leases are long-term leases (almost all having terms of 30 years or more), some of which contain escalation provisions and one contains a purchase option. Properties subject to these ground leases are subleased to our tenants except for three Adeptus transition properties. Lease and rental expense (which is recorded on the straight-line method) for 2018, 2017, and 2016 was $9.4 million, $9.8 million, and $6.8 million, respectively, which was offset by sublease rental income of $4.3 million, $6.6 million, and $4.2 million, for 2018, 2017, and 2016, respectively. Fixed minimum payments due over the remaining lease term under non-cancelable operating leases of more than one year and amounts to be received in the future from non-cancelable subleases over their remaining lease term at December 31, 2018 are as follows: (amounts in thousands) Fixed minimum payments Amounts to be received from subleases Net payments 2019 $ 6,602 $ (3,284 ) $ 3,318 2020 6,903 (3,458 ) 3,445 2021 6,841 (3,551 ) 3,290 2022 6,838 (3,632 ) 3,206 2023 6,861 (3,636 ) 3,225 Thereafter 198,932 (93,586 ) 105,346 (1) $ 232,977 $ (111,147 ) $ 121,830 (1) Reflects certain ground leases, in which we are the lessee, that have longer initial fixed terms than our existing sublease to our tenants. However, we would expect to either renew the related sublease, enter into a lease with a new tenant or early terminate the ground lease to reduce or avoid any significant impact from such ground leases. Contingencies We are a party to various legal proceedings incidental to our business. In the opinion of management, after consultation with legal counsel, the ultimate liability, if any, with respect to these proceedings is not presently expected to materially affect our financial position, results of operations or cash flows. |
Common Stock_Partner's Capital
Common Stock/Partner's Capital | 12 Months Ended |
Dec. 31, 2018 | |
Equity [Abstract] | |
Common Stock/Partner's Capital | 9. Common Stock/Partner’s Capital Medical Properties Trust, Inc. 2018 Activity In the 2018 fourth quarter, we sold 5.6 million shares of common stock under our at-the-market equity offering program, resulting in net proceeds of approximately $95 million. 2017 Activity On May 1, 2017, we completed an underwritten public offering of 43.1 million shares (including the exercise of the underwriters’ 30-day option to purchase an additional 5.6 million shares) of our common stock, resulting in net proceeds of approximately $548 million, after deducting offering expenses. On November 13, 2017, we entered into a new at-the-market equity offering program, which gives us the ability to sell up to $750 million of stock with a commission rate up to 2.0%. During 2017, we did not sell any shares of our common stock under this program. 2016 Activity On October 7, 2016, we sold 10.3 million shares of common stock in a private placement to an affiliate of Cerberus, the controlling member of Steward, and certain members of Steward management. We sold these shares at a price per share of $14.50, equal to the public offering price of our September 2016 equity offering, generating total proceeds of $150 million. On September 30, 2016, we completed an underwritten public offering of 57.5 million shares (including the exercise of the underwriters’ 30-day option to purchase an additional 7.5 million shares) of our common stock, resulting in net proceeds of $799.5 million, after deducting estimated offering expenses. During 2016, we sold approximately 15 million shares of our common stock under a previously existing at-the-market equity offering program (that ended in 2016), resulting in net proceeds of approximately $224 million, after deducting approximately $2.8 million of commissions. MPT Operating Partnership, L.P. At December 31, 2018 the Operating Partnership is made up of a general partner, Medical Properties Trust, LLC (“General Partner”) and limited partners, including the Company (which owns 100% of the General Partner) and two other partners. By virtue of its ownership of the General Partner, the Company has a 99.9% ownership interest in Operating Partnership via its ownership of all the common units. The remaining ownership interest is held by the two employees via their ownership of LTIP units. These LTIP units were issued pursuant to the 2007 Multi-Year Incentive Plan, which is now part of the Equity Incentive Plan discussed in Note 7 and once vested in accordance with their award agreement, may be converted to common units per the Second Amended and Restated Agreement of Limited Partnership of MPT Operating Partnership, L.P. (“Operating Partnership Agreement”). In regards to distributions, the Operating Partnership shall distribute cash at such times and in such amounts as are determined by the General Partner in its sole and absolute discretion, to common unit holders who are common unit holders on the record date. However, per the Operating Partnership Agreement, the General Partner shall use its reasonable efforts to cause the Operating Partnership to distribute amounts sufficient to enable the Company to pay stockholder dividends that will allow the Company to (i) meet its distribution requirement for qualification as a REIT and (ii) avoid any U.S. federal income or excise tax liability imposed by the Code, other than to the extent the Company elects to retain and pay income tax on its net capital gain. In accordance with the Operating Partnership Agreement, LTIP units are treated as common units for distribution purposes. The Operating Partnership’s net income will generally be allocated first to the General Partner to the extent of any cumulative losses and then to the limited partners in accordance with their respective percentage interests in the common units issued by the Operating Partnership. Any losses of the Operating Partnership will generally be allocated first to the limited partners until their capital account is zero and then to the General Partner. In accordance with the Operating Partnership Agreement, LTIP units are treated as common units for purposes of income and loss allocations. Limited partners have the right to require the Operating Partnership to redeem part or all of their common units. It is at the Operating Partnership’s discretion to redeem such common units for cash based on the fair market value of an equivalent number of shares of the Company’s common stock at the time of redemption or, alternatively, redeem the common units for shares of the Company’s common stock on a one-for-one basis, subject to adjustment in the event of stock splits, stock dividends, or similar events. LTIP units must wait two years from the issuance of the LTIP units to be redeemed, and then converted to common units. In 2018, approximately 60 thousand LTIP units were converted to common units and then redeemed for approximately $0.8 million of cash. For each share of common stock issued by Medical Properties Trust, Inc., the Operating Partnership issues a corresponding number of operating partnership units. |
Fair Value of Financial Instrum
Fair Value of Financial Instruments | 12 Months Ended |
Dec. 31, 2018 | |
Fair Value Disclosures [Abstract] | |
Fair Value of Financial Instruments | 10. Fair Value of Financial Instruments We have various assets and liabilities that are considered financial instruments. We estimate that the carrying value of cash and cash equivalents, and accounts payable and accrued expenses approximate their fair values. We estimate the fair value of our interest and rent receivables using Level 2 inputs such as discounting the estimated future cash flows using the current rates at which similar receivables would be made to others with similar credit ratings and for the same remaining maturities. The fair value of our mortgage and working capital loans are estimated by using Level 2 inputs such as discounting the estimated future cash flows using the current rates which similar loans would be made to borrowers with similar credit ratings and for the same remaining maturities. We determine the fair value of our senior unsecured notes, using Level 2 inputs such as quotes from securities dealers and market makers. We estimate the fair value of our revolving credit facility and term loans using Level 2 inputs based on the present value of future payments, discounted at a rate which we consider appropriate for such debt. Fair value estimates are made at a specific point in time, are subjective in nature, and involve uncertainties and matters of significant judgment. Settlement of such fair value amounts may not be possible and may not be a prudent management decision. The following table summarizes fair value estimates for our financial instruments (in thousands): December 31, 2018 December 31, 2017 Asset (Liability) Book Value Fair Value Book Value Fair Value Interest and rent receivables $ 25,855 $ 24,942 $ 78,970 $ 78,028 Loans(1) 1,471,520 1,490,758 1,698,471 1,722,101 Debt, net (4,037,389 ) (3,947,795 ) (4,898,667 ) (5,073,707 ) (1) Excludes loans to Ernest that are recorded at fair value – see below for further details. Items Measured at Fair Value on a Recurring Basis Our equity interest in Ernest and related loans, which we sold or were repaid in full (other than our mortgage loans) on October 4, 2018, were measured at fair value on a recurring basis as we elected to account for these investments using the fair value option method. We elected to account for these investments at fair value due to the size of the investments and because we believe this method is more reflective of current values. We have not made a similar election for other equity interests or loans existing at December 31, 2018 or December 31, 2017. At December 31, 2018 and 2017, the amounts recorded under the fair value option method were as follows (in thousands): As of December 31, 2018 As of December 31, 2017 Asset Type Asset (Liability) Fair Value Original Cost Fair Value Original Cost Classification Mortgage loans $ 115,000 $ 115,000 $ 115,000 $ 115,000 Mortgage loans Equity investment and other loans — — 114,554 118,354 Other loans/other assets $ 115,000 $ 115,000 $ 229,554 $ 233,354 Our mortgage and other loans (for 2017 only) with Ernest are recorded at fair value based on Level 2 inputs by discounting the estimated cash flows using the market rates which similar loans would be made to borrowers with similar credit ratings and the same remaining maturities. Our equity investment in Ernest was recorded at fair value based on Level 3 inputs, by using a discounted cash flow model, which requires significant estimates of our investee such as projected revenue and expenses and appropriate consideration of the underlying risk profile of the forecasted assumptions associated with the investee. We classified the equity investment as Level 3, as we used certain unobservable inputs to the valuation methodology that were significant to the fair value measurement, and the valuation required management judgment due to the absence of quoted market prices. For these cash flow models, our observable inputs included use of a capitalization rate, discount rate (which is based on a weighted average cost of capital), and market interest rates, and our unobservable input included an adjustment for a marketability discount (“DLOM”) on our equity investment of 40% at December 31, 2018. In arriving at the DLOM, we started with a DLOM range based on the results of studies supporting valuation discounts for other transactions or structures without a public market. To select the appropriate DLOM within the range, we then considered many qualitative factors including the percent of control, the nature of the underlying investee’s business along with our rights as an investor pursuant to the operating agreement, the size of investment, expected holding period, number of shareholders, access to capital marketplace, etc. Because the fair value of Ernest investments noted above was below our original cost, we recognized an unrealized loss during 2018 (before selling our investment) and 2017. We did not recognize any unrealized gains/losses on the Ernest investments in 2016. |
Other Assets
Other Assets | 12 Months Ended |
Dec. 31, 2018 | |
Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract] | |
Other Assets | 11. Other Assets The following is a summary of our other assets (in thousands): At December 31, 2018 2017 Debt issue costs, net(1) $ 4,793 $ 7,093 Equity investments 520,058 288,398 Other corporate assets 115,416 117,827 Prepaids and other assets 61,757 55,176 Total other assets $ 702,024 $ 468,494 (1) Relates to revolving credit facility Equity investments have increased over the prior year primarily due to our €210 million joint venture arrangement with Primotop — see Note 3 for further details. Other corporate assets include leasehold improvements associated with our corporate offices, furniture and fixtures, equipment, software, deposits, etc. Included in prepaids and other assets is prepaid insurance, prepaid taxes, goodwill (2017 only), deferred income tax assets (net of valuation allowances, if any), and lease inducements made to tenants, among other items. Summarized Financial Information for Significant Investees The following table presents financial information as of and for the year ended December 31, 2018 for the joint venture arrangement with Primotop in which we made an equity method investment in and advances to on August 31, 2018 (in thousands): 2018 Revenue $ 42,526 Net income $ 6,009 Assets $ 2,018,496 Liabilities $ 1,553,191 |
Quarterly Financial Data (unaud
Quarterly Financial Data (unaudited) | 12 Months Ended |
Dec. 31, 2018 | |
Quarterly Financial Information Disclosure [Abstract] | |
Quarterly Financial Data (unaudited) | 12. Quarterly Financial Data (unaudited) Medical Properties Trust, Inc. The following is a summary of the unaudited quarterly financial information for the years ended December 31, 2018 and 2017: (amounts in thousands, except for per share data) For the Three Month Periods in 2018 Ended March 31 June 30 September 30 December 31 Revenues $ 205,046 $ 201,902 $ 196,996 $ 180,578 Net income 91,043 112,017 736,476 78,941 Net income attributable to MPT common stockholders 90,601 111,567 736,034 78,483 Net income attributable to MPT common stockholders per share — basic $ 0.25 $ 0.30 $ 2.01 $ 0.21 Weighted average shares outstanding — basic 364,882 364,897 365,024 366,655 Net income attributable to MPT common stockholders per share — diluted $ 0.25 $ 0.30 $ 2.00 $ 0.21 Weighted average shares outstanding — diluted 365,343 365,541 366,467 367,732 For the Three Month Periods in 2017 Ended March 31 June 30 September 30 December 31 Revenues $ 156,397 $ 166,807 $ 176,580 $ 204,961 Net income 68,185 73,796 76,881 72,376 Net income attributable to MPT common stockholders 67,970 73,415 76,464 71,944 Net income attributable to MPT common stockholders per share — basic $ 0.21 $ 0.21 $ 0.21 $ 0.19 Weighted average shares outstanding — basic 321,057 349,856 364,315 364,382 Net income attributable to MPT common stockholders per share —diluted $ 0.21 $ 0.21 $ 0.21 $ 0.19 Weighted average shares outstanding — diluted 321,423 350,319 365,046 364,977 MPT Operating Partnership, L.P. The following is a summary of the unaudited quarterly financial information for the years ended December 31, 2018 and 2017: (amounts in thousands, except for per unit data) For the Three Month Periods in 2018 Ended March 31 June 30 September 30 December 31 Revenues $ 205,046 $ 201,902 $ 196,996 $ 180,578 Net income 91,043 112,017 736,476 78,941 Net income attributable to MPT Operating Partnership partners 90,601 111,567 736,034 78,483 Net income attributable to MPT Operating Partnership partners per unit — basic $ 0.25 $ 0.30 $ 2.01 $ 0.21 Weighted average units outstanding — basic 364,882 364,897 365,024 366,655 Net income attributable to MPT Operating Partnership partners per unit — diluted $ 0.25 $ 0.30 $ 2.00 $ 0.21 Weighted average units outstanding — diluted 365,343 365,541 366,467 367,732 For the Three Month Periods in 2017 Ended March 31 June 30 September 30 December 31 Revenues $ 156,397 $ 166,807 $ 176,580 $ 204,961 Net income 68,185 73,796 76,881 72,376 Net income attributable to MPT Operating Partnership partners 67,970 73,415 76,464 71,944 Net income attributable to MPT Operating Partnership partners per unit — basic $ 0.21 $ 0.21 $ 0.21 $ 0.19 Weighted average units outstanding — basic 321,057 349,856 364,315 364,382 Net income attributable to MPT Operating Partnership partners per unit — diluted $ 0.21 $ 0.21 $ 0.21 $ 0.19 Weighted average units outstanding — diluted 321,423 350,319 365,046 364,977 |
Subsequent Events
Subsequent Events | 12 Months Ended |
Dec. 31, 2018 | |
Subsequent Events [Abstract] | |
Subsequent Events | 13. Subsequent Events On January 31, 2019, we entered into definitive agreements to acquire a portfolio of eleven Australian hospitals currently operated by Healthscope Ltd. (“Healthscope”) for an aggregate purchase price of approximately $859 million. Upon closing, these facilities will be leased to Healthscope pursuant to master lease agreements that have an average initial term of 20 years with annual fixed escalations and multiple extension options. In a related transaction, Brookfield Business Partners L.P. together with its institutional partners (“Brookfield”) has agreed to acquire up to 100% of Healthscope’s outstanding shares. Closing of our acquisition, which is expected to be completed in the second quarter of 2019, is subject to Healthscope shareholder approval, customary real estate and regulatory approvals, the successful completion of the Brookfield transactions, and other closing conditions. As discussed in Note 3, in June 2018, we agreed to purchase a four-hospital portfolio from MEDIAN for an aggregate amount of €23 million (including real estate transfer taxes) for which we closed on three of the properties in 2018. The properties are leased to affiliates of MEDIAN. On February 6, 2019, we closed on the last of the four inpatient rehabilitation hospitals in Germany for €5.8 million (including real estate transfer taxes). |
Schedule II_ Valuation and Qual
Schedule II: Valuation and Qualifying Accounts | 12 Months Ended |
Dec. 31, 2018 | |
Valuation And Qualifying Accounts [Abstract] | |
Schedule II: Valuation and Qualifying Accounts | Medical Properties Trust, Inc. and MPT Operating Partnership, L.P. December 31, 2018 Additions Deductions Year Ended December 31, Balance at Beginning of Year(1) Charged Against Operations(1) Net Recoveries/ Write-offs(1) Balance at End of Year(1) (In thousands) 2018 $ 16,397 $ 57,285 (2) $ (7,551 ) (3) $ 66,131 2017 $ 18,852 $ 2,525 (4) $ (4,980 ) (5) $ 16,397 2016 $ 27,384 $ 2,722 (6) $ (11,254 ) (7) $ 18,852 (1) Includes allowance for doubtful accounts, straight-line rent reserves, allowance for loan losses, tax valuation allowances and other reserves. (2) Represents $48 million increase to real estate impairment reserve and $9.3 million increases in accounts receivable reserves during 2018. (3) Includes $7.7 million decrease in valuation allowance (which includes the $4.4 million release of domestic valuation allowances in the 2018 fourth quarter) that was originally recorded to reserve against our net deferred tax assets. ( 4 ) Represents increases in accounts receivable reserves during 2017. ( 5 ) Includes $4.9 million decrease in valuation allowance that was originally recorded to reserve against our net deferred tax assets. ( 6 ) Includes $1.9 million of rent reserves related to our Twelve Oaks facility and $0.8 million of rent reserves related to our Corinth facility. ( 7 ) Includes write-offs of $3.3 million related to payment of rent, late fees, and loans for our Twelve Oaks facility; $0.8 million of write-offs for rent and interest reserves related to the sale of the Corinth facility; $0.1 million of write-offs related to the McLeod Healthcare loan; and $6.1 million decrease in valuation allowances (which includes the $4 million release of foreign valuation allowances in the 2016 fourth quarter) that was originally recorded to reserve against our net deferred tax assets. |
SCHEDULE III - REAL ESTATE INVE
SCHEDULE III - REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION | 12 Months Ended |
Dec. 31, 2018 | |
Real Estate And Accumulated Depreciation Disclosure [Abstract] | |
SCHEDULE III - REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION | December 31, 2018 Initial Costs Additions Subsequent to Acquisition Cost at December 31, 2018(1) Accumulated Life on which depreciation in latest income statements is Location Type of Property Land Buildings Improve- ments Carrying Costs Land Buildings Total Depreciation Encum- brances Date of Construction Date Acquired computed (Years) (Dollar amounts in thousands) Bath, UK Acute care general hospital $ 1,512 $ 31,334 $ — $ — $ 1,512 $ 31,334 $ 32,846 $ 3,526 $ — 2008, 2009 July 1, 2014 40 Braunfels, Germany Acute care general hospital 2,202 14,073 57 — 2,259 14,073 16,332 1,245 — 1977 June 30, 2015 40 Heidelberg, Germany Rehabilitation hospital 6,404 37,006 75 — 6,479 37,006 43,485 2,325 — 1885, 1991 June 22, 2016 40 Cologne, Germany Acute care general hospital 4,494 15,545 104 — 4,598 15,545 20,143 593 — 2011 June 23, 2017 40 Bad Salzuflen, Germany Rehabilitation hospital 9,972 27,611 939 — 10,911 27,611 38,522 816 — 1974, 2016 November 30, 2017 40 Bad Salzuflen, Germany Rehabilitation hospital 7,062 24,283 353 — 7,415 24,283 31,698 683 — 1989, 2016 November 30, 2017 40 Bad Oeynhausen, Germany Rehabilitation hospital 1,042 2,859 127 — 1,169 2,859 4,028 87 — 1973, 2010 November 30, 2017 40 Dormagen, Germany Rehabilitation hospital 1,843 5,848 140 — 1,983 5,848 7,831 52 — 1993, 2006 August 28, 2018 40 Grefath, Germany Rehabilitation hospital 1,145 3,127 102 — 1,247 3,127 4,374 28 — 1886, 1983 August 28, 2018 40 Remscheid, Germany Rehabilitation hospital 1,029 2,614 60 — 1,089 2,614 3,703 23 — 1951, 1983 August 28, 2018 40 Houston, TX Acute care general hospital 3,501 34,530 8,477 16,589 3,274 59,823 63,097 12,943 — 1960 August 10, 2007 40 Allen, TX Freestanding ER 1,550 866 — — 1,550 866 2,416 441 — 2014 July 14, 2014 40 San Diego, CA Acute care general hospital 12,663 52,431 — — 12,663 52,431 65,094 10,377 — 1973 February 9, 2011 40 Alvin, TX Freestanding ER 105 4,087 — — 105 4,087 4,192 462 — 2014 March 19, 2014 40 Houston, TX Freestanding ER 950 3,996 — — 950 3,996 4,946 225 — 2016 September 26, 2016 40 Aurora, CO Freestanding ER — 4,812 — — — 4,812 4,812 391 — 2015 September 17, 2015 40 Ft. Worth, TX Freestanding ER — 4,392 — — — 4,392 4,392 412 — 2015 March 27, 2015 40 Ayer, MA Acute care general hospital 9,048 77,913 1,603 — 9,048 79,516 88,564 911 — 1970-2013 June 27, 2018 47 Bayonne, NJ Acute care general hospital 2,003 51,495 — — 2,003 51,495 53,498 20,383 — 1918 February 4, 2011 20 Bennettsville, SC Acute care general hospital 794 15,772 — — 794 15,772 16,566 4,157 — 1984 April 1, 2008 42 Blue Springs, MO Acute care general hospital 4,347 23,494 — — 4,347 23,494 27,841 2,417 — 1980 February 13, 2015 40 Boise, ID Long term acute care hospital 1,558 11,027 — — 1,558 11,027 12,585 173 — 2008 February 29, 2012 50 Bossier City, LA Long term acute care hospital 900 17,818 628 — 900 18,446 19,346 4,786 — 1982 April 1, 2008 40 Brighton, MA Acute care general hospital 18,540 146,490 11,176 — 18,540 157,666 176,206 8,304 — 1917-2009 October 3, 2016 41 Brockton, MA Acute care general hospital 18,328 67,248 4,296 — 18,328 71,544 89,872 4,798 — 1965-2010 October 3, 2016 41 Austin, TX Freestanding ER 1,140 1,777 — — 1,140 1,777 2,917 441 — 2014 May 29, 2014 40 Broomfield, CO Freestanding ER 825 3,895 — — 825 3,895 4,720 438 — 2014 July 3, 2014 40 Glendale, AZ Freestanding ER 1,144 6,087 — — 1,144 6,087 7,231 330 — 2016 October 21, 2016 40 New Orleans, LA Freestanding ER 2,850 6,125 — — 2,850 6,125 8,975 346 — 2016 September 23, 2016 40 Carrollton, TX Acute care general hospital 729 34,342 — — 729 34,342 35,071 2,933 — 2015 July 17, 2015 40 Cedar Hill. TX Freestanding ER 1,122 3,644 — — 1,122 3,644 4,766 410 — 2014 June 23, 2014 40 Spring, TX Freestanding ER 1,310 3,639 — — 1,310 3,639 4,949 409 — 2014 July 15, 2014 40 Initial Costs Additions Subsequent to Acquisition Cost at December 31, 2018(1) Accumulated Life on which depreciation in latest income statements is Location Type of Property Land Buildings Improve- ments Carrying Costs Land Buildings Total Depreciation Encum- brances Date of Construction Date Acquired computed (Years) (Dollar amounts in thousands) Chandler, AZ Freestanding ER — 4,783 — — — 4,783 4,783 438 — 2015 April 24, 2015 40 Chandler, AZ Freestanding ER 750 3,852 0 — 750 3,852 4,602 313 — 2015 October 7, 2015 40 Cheraw, SC Acute care general hospital 657 19,576 — — 657 19,576 20,233 5,158 — 1982 April 1, 2008 42 Katy, TX Freestanding ER — 3,873 — — — 3,873 3,873 307 — 2015 October 21, 2015 40 Webster, TX Long term acute care hospital 663 33,751 — — 663 33,751 34,414 6,750 — 2004 December 21, 2010 40 Commerce City, TX Freestanding ER 707 4,248 — — 707 4,248 4,955 434 — 2014 December 11, 2014 40 Conroe, TX Freestanding ER 1,338 3,712 — — 1,338 3,712 5,050 317 — 2015 July 29, 2015 40 Converse, TX Freestanding ER 750 4,423 — — 750 4,423 5,173 415 — 2015 April 10, 2015 40 The Woodlands, TX Freestanding ER — 4,524 — — — 4,524 4,524 311 — 2016 March 28, 2016 40 Houston, TX Freestanding ER — 4,267 — — — 4,267 4,267 203 — 2017 May 8, 2017 35 Dallas, TX Long term acute care hospital 1,000 13,589 — 368 1,421 13,536 14,957 4,173 — 2006 September 5, 2006 40 Denver, CO Freestanding ER — 4,276 — — — 4,276 4,276 383 — 2015 June 8, 2015 40 DeSoto, TX Freestanding ER 750 4,234 — — 750 4,234 4,984 273 — 2016 May 23, 2016 40 Detroit, MI Long term acute care hospital 1,220 8,687 — (365 ) 1,220 8,322 9,542 2,274 — 1956 May 22, 2008 40 San Antonio, TX Freestanding ER — 4,801 — — — 4,801 4,801 250 — 2016 December 9, 2016 40 Dorchester, MA Acute care general hospital 14,428 219,575 5,394 — 14,428 224,969 239,397 1,371 — 1953-2015 October 15, 2018 42 Dulles, TX Freestanding ER 1,076 3,784 — — 1,076 3,784 4,860 410 — 2014 September 12, 2014 40 Easton, PA Acute care general hospital 13,898 40,245 2,921 — 13,898 43,166 57,064 1,786 — 1930-2005 May 1, 2017 41 Houston, TX Freestanding ER 1,345 3,678 — — 1,345 3,678 5,023 414 — 2014 June 20, 2014 40 Fairmont, CA Acute care general hospital 1,000 6,072 5,278 — 1,277 11,073 12,350 1,798 — 1939, 1972, 1985 September 19, 2014 40 Fall River, MA Acute care general hospital 3,526 82,358 22,205 — 3,525 104,564 108,089 4,977 — 1950-2012 October 3, 2016 41 Firestone, TX Freestanding ER 495 3,963 — — 495 3,963 4,458 454 — 2014 June 6, 2014 40 Flagstaff, AZ Rehabilitation hospital 3,049 22,464 — — 3,049 22,464 25,513 468 — 2016 August 23, 2016 40 Florence, AZ Acute care general hospital 900 28,462 105 — 900 28,567 29,467 4,817 — 2012 February 7, 2012 40 Fort Lauderdale, FL Rehabilitation hospital 3,499 21,939 — 1 3,499 21,940 25,439 5,862 — 1985 April 22, 2008 40 Fountain, CO Freestanding ER 1,508 4,131 — — 1,508 4,131 5,639 456 — 2014 July 31, 2014 40 Frisco, TX Freestanding ER — 1,806 — — — 1,806 1,806 336 — 2016 March 4, 2016 40 Frisco, TX Freestanding ER 2,441 185 — — 2,441 185 2,626 354 — 2015 November 13, 2015 40 Frisco, TX Freestanding ER 1,500 3,863 27 (89 ) 1,411 3,890 5,301 446 — 2014 June 13, 2014 40 Garden Grove, CA Acute care general hospital 5,502 10,748 — 51 5,502 10,799 16,301 2,736 — 1982 November 25, 2008 40 Garland, TX Freestanding ER — 4,647 — — — 4,647 4,647 252 — 2016 November 15, 2016 40 Garden Grove, CA Medical Office Building 862 7,888 — 28 862 7,916 8,778 1,999 — 1982 November 25, 2008 40 Gilbert, AZ Acute care general hospital 150 15,553 — — 150 15,553 15,703 3,111 — 2005 January 4, 2011 40 Gilbert, AZ Freestanding ER 1,517 4,660 — — 1,517 4,660 6,177 398 — 2015 July 22, 2015 40 Glendale, AZ Freestanding ER — 4,046 — — — 4,046 4,046 362 — 2015 June 5, 2015 40 Goodyear, AZ Freestanding ER 1,800 4,713 — — 1,800 4,713 6,513 324 — 2016 April 4, 2016 40 Hartsville, SC Acute care general hospital 2,050 43,970 — — 2,050 43,970 46,020 3,827 — 1999 August 31, 2015 34 Hausman, TX Acute care general hospital 1,500 8,957 — — 1,500 8,957 10,457 1,284 — 2013 March 1, 2013 40 Haverhill, MA Acute care general hospital 5,651 105,848 1,888 — 5,651 107,736 113,387 936 — 1982-2005 August 31, 2018 40 Helotes, TX Freestanding ER 1,900 5,115 — — 1,900 5,115 7,015 362 — 2016 March 10, 2016 40 Initial Costs Additions Subsequent to Acquisition Cost at December 31, 2018(1) Accumulated Life on which depreciation in latest income statements is Location Type of Property Land Buildings Improve- ments Carrying Costs Land Buildings Total Depreciation Encum- brances Date of Construction Date Acquired computed (Years) (Dollar amounts in thousands) Highland Village, TX Freestanding ER — 1,551 — — — 1,551 1,551 326 — 2015 September 22, 2015 40 Hill County, TX Acute care general hospital 1,120 17,882 — — 1,120 17,882 19,002 9,890 — 1980 September 17, 2010 15 Warren, OH Rehabilitation hospital 2,417 15,857 35 — 2,417 15,892 18,309 891 — 1922-2000 May 1, 2017 46 Hoboken, NJ Acute care general hospital 1,387 44,351 — — 1,387 44,351 45,738 15,838 — 1863 November 4, 2011 20 Hoover, AL Freestanding ER — 7,581 — — — 7,581 7,581 812 — 2015 May 1, 2015 34 Hoover, AL Medical Office Building — 1,034 — — — 1,034 1,034 111 — 2015 May 1, 2015 34 Hope, AR Acute care general hospital 1,651 3,359 373 — 1,651 3,732 5,383 223 — 1984-2001 September 29, 2017 41 Hot Springs, AR Acute care general hospital 7,100 59,432 21,221 — 7,100 80,653 87,753 6,795 — 1985 August 31, 2015 40 Houston, TX Acute care general hospital 28,687 104,028 5,999 — 28,687 110,027 138,714 878 — 1940-1950 September 29, 2017 41 Highlands Ranch, CO Freestanding ER 4,200 4,779 — — 4,200 4,779 8,979 289 — 2016 July 25, 2016 40 Idaho Falls, ID Acute care general hospital 1,822 37,467 441 4,665 1,822 42,573 44,395 11,201 — 2002 April 1, 2008 40 Kansas City, MO Acute care general hospital 10,497 64,419 — — 10,497 64,419 74,916 6,429 — 1978 February 13, 2015 40 Katy, TX Freestanding ER — 4,174 — — — 4,174 4,174 235 — 2016 October 10, 2016 40 Camden, SC Acute care general hospital — 22,739 — — — 22,739 22,739 1,555 — 1954-2004 October 30, 2015 39 Lafayette, IN Rehabilitation hospital 800 14,968 (25 ) — 800 14,943 15,743 2,198 — 2013 February 1, 2013 40 Lehi, UT Acute care general hospital 13,403 29,950 156 (35 ) 13,368 30,106 43,474 1,108 — 2015 September 29, 2017 45 Lewiston, ID Acute care general hospital 5,389 75,435 — — 5,389 75,435 80,824 4,251 — 1922 May 1, 2017 40 Little Elm, TX Freestanding ER 1,241 3,491 — — 1,241 3,491 4,732 441 — 2013 December 1, 2013 40 Longmont, CO Freestanding ER — 4,181 — — — 4,181 4,181 305 — 2016 February 10, 2016 40 Lubbock, TX Rehabilitation hospital 1,376 28,292 3,648 — 1,376 31,940 33,316 2,657 — 2008 June 16, 2015 40 Mandeville, LA Freestanding ER 2,800 5,370 — — 2,800 5,370 8,170 291 — 2016 October 28, 2016 40 Marrero, LA Freestanding ER — 5,801 — — — 5,801 5,801 364 — 2016 July 15, 2016 40 McKinney, TX Freestanding ER — 4,060 — — — 4,060 4,060 466 — 2015 July 31, 2015 30 McMinnville, OR Acute care general hospital 5,000 97,900 — — 5,000 97,900 102,900 6,652 — 1996 August 31, 2015 41 Melbourne, FL Acute care general hospital 5,642 17,087 2,282 — 5,642 19,369 25,011 922 — 2002 May 1, 2017 42 Mesa, AZ Acute care general hospital 6,534 100,042 289 — 6,533 100,332 106,865 13,819 — 2007 September 26, 2013 40 Phoenix, AZ Acute care general hospital 5,576 45,782 — — 5,576 45,782 51,358 2,194 — 2017 February 10, 2017 40 Methuen, MA Acute care general hospital 23,809 89,505 5,698 — 23,809 95,203 119,012 5,766 — 1950-2011 October 3, 2016 41 Bloomington, IN Acute care general hospital 2,392 28,212 5,000 408 2,392 33,620 36,012 10,377 — 2006 August 8, 2006 40 Montclair, NJ Acute care general hospital 7,900 99,640 577 — 8,477 99,640 108,117 12,211 — 1920-2000 April 1, 2014 40 San Antonio, TX Freestanding ER 351 3,952 — — 351 3,952 4,303 468 — 2014 January 1, 2014 40 Colorado Springs, CO Freestanding ER 600 4,231 — — 600 4,231 4,831 485 — 2014 June 5, 2014 40 Northland, MO Long term acute care hospital 834 17,182 — — 834 17,182 18,016 3,401 — 2007 February 14, 2011 40 Norwood, MA Acute care general hospital 7,073 154,496 7,745 — 7,073 162,241 169,314 1,781 — 1926-2001 June 27, 2018 46 Altoona, WI Acute care general hospital — 29,062 — — — 29,062 29,062 3,148 — 2014 August 31, 2014 40 Odessa, TX Acute care general hospital 6,535 123,518 254 — 6,535 123,772 130,307 3,950 — 1973-2004 September 29, 2017 41 Ogden, UT Rehabilitation hospital 1,759 16,414 — — 1,759 16,414 18,173 1,971 — 2014 March 1, 2014 40 Olympia, WA Acute care general hospital 7,220 89,348 15,930 — 7,220 105,278 112,498 6,138 — 1984 July 22, 2016 40 Overlook, TX Acute care general hospital 2,452 9,666 7 — 2,452 9,673 12,125 1,411 — 2012 February 1, 2013 40 San Diego, CA Acute care general hospital 6,550 15,653 — 77 6,550 15,730 22,280 4,586 — 1964 May 9, 2007 40 Initial Costs Additions Subsequent to Acquisition Cost at December 31, 2018(1) Accumulated Life on which depreciation in latest income statements is Location Type of Property Land Buildings Improve- ments Carrying Costs Land Buildings Total Depreciation Encum- brances Date of Construction Date Acquired computed (Years) (Dollar amounts in thousands) Parker, CO Freestanding ER 1,300 4,448 — — 1,300 4,448 5,748 352 — 2015 November 6, 2015 40 Pasco, WA Acute care general hospital 2,594 13,195 — — 2,594 13,195 15,789 150 — 1920 August 31, 2018 30 Pearland, TX Freestanding ER 1,075 3,577 — — 1,075 3,577 4,652 388 — 2014 September 8, 2014 40 Petersburg, VA Rehabilitation hospital 1,302 9,121 — — 1,302 9,121 10,423 2,394 — 2006 July 1, 2008 40 Phoenix, AZ Acute care general hospital 2,396 26,521 2,931 — 2,396 29,452 31,848 817 — 1979 September 29, 2017 42 Phoenix, AZ Acute care general hospital 12,695 73,774 2,432 — 12,695 76,206 88,901 2,502 — 1968-1976 September 29, 2017 43 Plano, TX Freestanding ER — 2,492 — — — 2,492 2,492 272 — 2016 September 30, 2016 40 Poplar Bluff, MO Acute care general hospital 2,660 38,693 — 1 2,660 38,694 41,354 10,339 — 1980 April 22, 2008 40 Port Arthur, TX Acute care general hospital 12,972 78,051 859 — 12,972 78,910 91,882 10,155 — 2005 September 26, 2013 40 Port Huron, MI Acute care general hospital 3,029 14,622 — — 3,029 14,622 17,651 1,498 — 1953, 1973-1983 December 31, 2015 30 Post Falls, ID Rehabilitation hospital 417 12,175 1,905 — 767 13,730 14,497 1,725 — 2013 December 31, 2013 40 San Antonio, TX Freestanding ER — 4,253 — — — 4,253 4,253 230 — 2016 October 27, 2016 40 Redding, CA Acute care general hospital 1,555 53,863 — 13 1,555 53,876 55,431 15,387 — 1974 August 10, 2007 40 Austin, TX Freestanding ER — 4,200 — — — 4,200 4,200 231 — 2017 March 2, 2017 40 Rockledge, FL Acute care general hospital 13,919 23,282 1,831 — 13,919 25,113 39,032 1,460 — 1950, 1970 May 1, 2017 42 Rosenberg, TX Freestanding ER — 4,505 — — — 4,505 4,505 338 — 2016 January 15, 2016 40 Columbus, OH Freestanding ER 1,726 — — — 1,726 — 1,726 — — 2016 August 30, 2016 - Salt Lake City, UT Acute care general hospital 13,590 101,915 726 — 13,590 102,641 116,231 3,178 — 1906-1987 September 29, 2017 41 San Antonio, TX Acute care general hospital 8,053 29,333 675 — 8,053 30,008 38,061 1,024 — 1978-2002 September 29, 2017 41 San Dimas, CA Acute care general hospital 6,160 6,839 — 34 6,160 6,873 13,033 1,735 — 1972 November 25, 2008 40 San Dimas, CA Medical Office Building 1,915 5,085 — 18 1,915 5,103 7,018 1,289 — 1979 November 25, 2008 40 Phoenix, AZ Freestanding ER 1,132 5,052 — — 1,132 5,052 6,184 221 — 2017 April 13, 2017 40 Sebastian, FL Acute care general hospital 5,733 49,136 16,829 — 5,733 65,965 71,698 2,288 — 1974 May 1, 2017 41 Sharon, PA Acute care general hospital 6,179 9,066 1,808 — 6,179 10,874 17,053 1,096 — 1950-1980 May 1, 2017 41 Sherman, TX Acute care general hospital 4,493 11,081 — — 4,493 11,081 15,574 2,703 — 1913, 1960-2010 October 31, 2014 40 Sienna, TX Freestanding ER 1,000 3,591 — — 1,000 3,591 4,591 389 — 2014 August 20, 2014 40 Spartanburg, SC Rehabilitation hospital 1,135 15,717 — — 1,135 15,717 16,852 2,112 — 2013 August 1, 2013 40 Houston, TX Freestanding ER 1,423 3,772 — — 1,423 3,772 5,195 361 — 2015 February 18, 2015 40 Taunton, MA Acute care general hospital 4,428 73,228 2,951 — 4,428 76,179 80,607 4,400 — 1940-2015 October 3, 2016 41 Tempe, AZ Acute care general hospital 6,050 10,986 871 — 6,050 11,857 17,907 476 — 1940 September 29, 2017 41 Texarkana, TX Acute care general hospital 14,562 — — — 14,562 — 14,562 — — 2017 September 29, 2017 - Thornton, CO Freestanding ER 1,350 4,259 — — 1,350 4,259 5,609 461 — 2014 August 29, 2014 40 Toledo, OH Rehabilitation hospital — 17,740 — — — 17,740 17,740 1,220 — 2016 April 1, 2016 40 Tomball, TX Long term acute care hospital 1,299 23,982 — — 1,299 23,982 25,281 4,796 — 2005 December 21, 2010 40 Houston, TX Acute care general hospital 4,047 36,862 — — 4,047 36,862 40,909 2,304 — 2016 July 7, 2016 40 League City, TX Freestanding ER — 3,901 — — — 3,901 3,901 341 — 2015 June 19, 2015 40 Anaheim, CA Acute care general hospital 1,875 21,813 — 10 1,875 21,823 23,698 6,638 — 1964 November 8, 2006 40 Warren, OH Acute care general hospital 5,385 47,588 5,142 — 5,385 52,730 58,115 2,509 — 1982 May 1, 2017 41 West Monroe, LA Acute care general hospital 12,000 69,433 11,013 — 12,552 79,894 92,446 9,746 — 1962 September 26, 2013 40 San Antonio, TX Acute care general hospital 2,248 5,880 — — 2,248 5,880 8,128 904 — 2012 October 2, 2012 40 West Valley City, UT Acute care general hospital 5,516 58,314 2,478 (114 ) 5,402 60,792 66,194 15,762 — 1980 April 22, 2008 40 Wichita, KS Rehabilitation hospital 1,019 18,373 — 1 1,019 18,374 19,393 4,937 — 1992 April 4, 2008 40 Youngstown, OH Acute care general hospital 4,335 3,565 604 — 4,334 4,170 8,504 965 — 1929-2003 May 1, 2017 41 $ 544,228 $ 4,026,620 $ 188,640 $ 21,661 $ 547,894 $ 4,233,255 $ 4,781,149 $ 414,331 $ — (1) The aggregate cost for federal income tax purposes is $4,873,085. The changes in total real estate assets (excluding construction in progress, intangible lease assets, investment in direct financing leases, and mortgage loans) are as follows for the years ended (in thousands): December 31, 2018 December 31, 2017 December 31, 2016 COST Balance at beginning of period $ 5,438,148 $ 3,968,042 $ 2,991,590 Acquisitions 758,619 1,256,245 745,948 Transfers from construction in progress 25,513 74,441 163,080 Additions 96,775 36,828 33,279 Dispositions (1,318,238 ) (53,372 ) (138,886 ) Other (219,668 ) (2) 155,964 (2) 173,031 Balance at end of period $ 4,781,149 $ 5,438,148 (3) $ 3,968,042 The changes in accumulated depreciation are as follows for the years ended (in thousands): December 31, 2018 December 31, 2017 December 31, 2016 ACCUMULATED DEPRECIATION Balance at beginning of period $ 407,349 $ 292,786 $ 232,675 Depreciation 115,497 109,307 81,010 Depreciation on disposed property (101,967 ) (1,438 ) (19,086 ) Other (6,548 ) 6,694 (1,813 ) Balance at end of period $ 414,331 $ 407,349 (4) $ 292,786 (2) Represents foreign currency fluctuations and purchase price allocation adjustments. (3) Includes $131.4 million of land and building cost reflected in real estate held for sale at December 31, 2017. Excludes intangible lease assets that are included in real estate held for sale of $15.8 million at December 31, 2017. (4) Includes $0.5 million of accumulated depreciation reflected in real estate held for sale at December 31, 2017. Excludes accumulated amortization related to intangible lease assets that are included in real estate held for sale of $0.1 million at December 31, 2017. |
SCHEDULE IV - MORTGAGE LOANS ON
SCHEDULE IV - MORTGAGE LOANS ON REAL ESTATE | 12 Months Ended |
Dec. 31, 2018 | |
Mortgage Loans On Real Estate [Abstract] | |
SCHEDULE IV - MORTGAGE LOANS ON REAL ESTATE | MEDICAL PROPERTIES TRUST, INC. AND MPT OPERATING PARTNERSHIP, L.P. Column A Column B Column C Column D Column E Column F Column G(3) Column H Description Interest Rate Final Maturity Date Periodic Payment Terms Prior Liens Face Amount of Mortgages Carrying Amount of Mortgages Principal Amount of Loans Subject to Delinquent Principal or Interest (Dollar amounts in thousands) Long-term first mortgage loan: Payable in monthly installments of interest plus principal payable in full at maturity Desert Valley Hospital 11.0 % 2022 (1 ) $ 70,000 $ 70,000 (2 ) Desert Valley Hospital 12.2 % 2022 (1 ) 20,000 20,000 (2 ) Desert Valley Hospital 11.0 % 2020 (1 ) 12,500 12,500 (2 ) Chino Valley Medical Center 11.0 % 2022 (1 ) 50,000 50,000 (2 ) Paradise Valley Hospital 11.0 % 2022 (1 ) 25,000 25,000 (2 ) Ernest Mortgage Loan(4) 10.0 % 2032 (1 ) 115,000 115,000 (2 ) Centinela Hospital Medical Center 11.6 % 2022 (1 ) 100,000 100,000 (2 ) Olympia Medical Center 10.7 % 2024 (1 ) 25,000 25,000 (2 ) St. Joseph Medical Center 9.0 % 2025 (1 ) 30,000 30,000 (2 ) St. Mary’s Medical Center 9.0 % 2025 (1 ) 10,000 10,000 (2 ) Lake Huron Medical Center 9.0 % 2020 (1 ) 10,000 10,000 (2 ) Steward Mortgage Loan(6) 7.5 % 2031 (1 ) 727,508 727,508 (2 ) Vibra Mortgage Loan 11.5 % 2024 (1 ) 18,275 18,275 (2 ) $ 1,213,283 $ 1,213,283 (5 ) (1) There were no prior liens on loans as of December 31, 2018. (2) The mortgage loan was not delinquent with respect to principal or interest. (3) The aggregate cost for federal income tax purposes is $1,213,283. (4) Mortgage loans covering four properties in two tranches. Interest rate is weighted average of both tranches. (5) Excludes unamortized loan issue costs of $0.04 million at December 31, 2018. (6) Mortgage loans covering two properties. Changes in mortgage loans (excluding unamortized loan issue costs) for the years ended December 31, 2018, 2017, and 2016 are summarized as follows: Year Ended December 31, 2018 2017 2016 (Dollar amounts in thousands) Balance at beginning of year $ 1,778,264 $ 1,060,336 $ 757,500 Additions during year: New mortgage loans and additional advances on existing loans 50,783 717,928 612,836 1,829,047 1,778,264 1,370,336 Deductions during year: Collection of principal (615,764 ) — (310,000 ) (615,764 ) — (310,000 ) Balance at end of year $ 1,213,283 $ 1,778,264 $ 1,060,336 |
Summary of Significant Accoun_2
Summary of Significant Accounting Policies (Policies) | 12 Months Ended |
Dec. 31, 2018 | |
Accounting Policies [Abstract] | |
Use of Estimates | Use of Estimates: The preparation of financial statements in conformity with accounting principles generally accepted in the U.S. requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. |
Principles of Consolidation | Principles of Consolidation: Property holding entities and other subsidiaries of which we own 100% of the equity or have a controlling financial interest evidenced by ownership of a majority voting interest are consolidated. All inter-company balances and transactions are eliminated. For entities in which we own less than 100% of the equity interest, we consolidate the property if we have the direct or indirect ability to control the entities’ activities based upon the terms of the respective entities’ ownership agreements. For these entities, we record a non-controlling interest representing equity held by non-controlling interests. We continually evaluate all of our transactions and investments to determine if they represent variable interests in a variable interest entity (“VIE”). If we determine that we have a variable interest in a VIE, we then evaluate if we are the primary beneficiary of the VIE. The evaluation is a qualitative assessment as to whether we have the ability to direct the activities of a VIE that most significantly impact the entity’s economic performance. We consolidate each VIE in which we, by virtue of or transactions with our investments in the entity, are considered to be the primary beneficiary. At December 31, 2018, we had loans and/or equity investments in certain VIEs, which are also tenants of our facilities. We have determined that we are not the primary beneficiary of these VIEs. The carrying value and classification of the related assets and maximum exposure to loss as a result of our involvement with these VIEs are presented below at December 31, 2018 (in thousands): VIE Type Maximum Loss Exposure(1) Asset Type Classification Carrying Amount(2) Equity investments $ 17,187 Other assets $ — (1) Our maximum loss exposure related to our equity investment in VIEs represent the current carrying values of such investment plus any other related assets (such as rent receivables) less any liabilities. (2) Carrying amount reflects the net book value of our equity interest only in the VIE. For the VIE types above, we do not consolidate the VIE because we do not have the ability to control the activities (such as the day-to-day healthcare operations of our borrowers or investees) that most significantly impact the VIE’s economic performance. As of December 31, 2018, we were not required to provide financial support through a liquidity arrangement or otherwise to our unconsolidated VIEs, including circumstances in which it could be exposed to further losses (e.g., cash short falls). Typically, our loans are collateralized by assets of the borrower (some assets of which are on the premises of facilities owned by us) and further supported by limited guarantees made by certain principals of the borrower. |
Investments in Unconsolidated Entities | Investments in Unconsolidated Entities: Investments in entities in which we have the ability to significantly influence (but not control) are accounted for by the equity method, such as our joint venture with Primotop as discuss in Note 3. Under the equity method of accounting, our share of the investee’s earnings or losses are included in the other income line of our consolidated statements of net income. Except for our joint venture with Primotop, we have elected to record our share of such investee’s earnings or losses on a 90-day lag basis. The initial carrying value of investments in unconsolidated entities is based on the amount paid to purchase the interest in the investee entity. Subsequently, our investments are increased/decreased by our share in the investees’ earnings/losses and decreased by cash distributions from our investees. To the extent that our cost basis is different from the basis reflected at the investee entity level, the basis difference is generally amortized over the lives of the related assets and liabilities, and such amortization is included in our share of equity in earnings of the investee. We evaluate our equity method investments for impairment based upon a comparison of the fair value of the equity method investment to its carrying value, when impairment indicators exist. If we determine a decline in the fair value of an investment in an unconsolidated investee entity below its carrying value is other-than-temporary, and impairment is recorded. Investments in entities in which we do not control nor do we have the ability to significantly influence and for which there is no readily determinable fair value (such as our investments in Steward Health Care System LLC (“Steward”) and Median Kliniken S.á.r.l. (“MEDIAN”)) are accounted for at cost, less any impairment, plus or minus changes resulting from observable price changes in orderly transactions involving the investee. |
Cash and Cash Equivalents | Cash and Cash Equivalents: Certificates of deposit, short-term investments with original maturities of three months or less and money-market mutual funds are considered cash equivalents. The majority of our cash and cash equivalents are held at major commercial banks, which at times may exceed the Federal Deposit Insurance Corporation limit. We have not experienced any losses to date on our invested cash. Cash and cash equivalents which have been restricted as to its use are recorded in other assets. |
Revenue Recognition | Revenue Recognition: We receive income from operating leases based on the fixed, minimum required rents (base rents) per the lease agreements. Rent revenue from base rents is recorded on the straight-line method over the terms of the related lease agreements for new leases and the remaining terms of existing leases for those acquired as part of a property acquisition. The straight-line method records the periodic average amount of base rent earned over the term of a lease, taking into account contractual rent increases over the lease term. The straight-line method typically has the effect of recording more rent revenue from a lease than a tenant is required to pay early in the term of the lease. During the later parts of a lease term, this effect reverses with less rent revenue recorded than a tenant is required to pay. Rent revenue, as recorded on the straight-line method, in the consolidated statements of net income is presented as two amounts: rent billed and straight-line revenue. Rent billed revenue is the amount of base rent actually billed to our tenants each period as required by the lease. Straight-line rent revenue is the difference between rent revenue earned based on the straight-line method and the amount recorded as rent billed revenue. We record the difference between base rent revenues earned and amounts due per the respective lease agreements, as applicable, as an increase or decrease to straight-line rent receivable. We also receive additional rent (contingent rent) under some leases based on increases in the consumer price index (“CPI”) or when CPI exceeds the annual minimum percentage increase as stipulated in the lease. Contingent rents are recorded as rent billed revenue in the period earned. Rental payments received prior to their recognition as income are classified as deferred revenue. We use direct financial lease (“DFL”) accounting to record rent on certain leases deemed to be financing leases, per accounting rules, rather than operating leases. For leases accounted for as DFLs, the future minimum lease payments are recorded as a receivable. The difference between the future minimum lease payments and the estimated residual values less the cost of the properties is recorded as unearned income. Unearned income is deferred and amortized to income over the lease terms to provide a constant yield when collectability of the lease payments is reasonably assured. Investments in DFLs are presented net of unearned income. We begin recording base rent income from our development projects when the lessee takes physical possession of the facility, which may be different from the stated start date of the lease. Also, during construction of our development projects, we may be entitled to accrue rent based on the cost paid during the construction period (construction period rent). We accrue construction period rent as a receivable with a corresponding offset to deferred revenue during the construction period. When the lessee takes physical possession of the facility, we begin recognizing the deferred construction period revenue on the straight-line method over the term of the lease. We receive interest income from our tenants/borrowers on mortgage loans, working capital loans, and other long-term loans. Interest income from these loans is recognized as earned based upon the principal outstanding and terms of the loans. Commitment fees received from lessees for development and leasing services are initially recorded as deferred revenue and recognized as income over the initial term of a lease to produce a constant effective yield on the lease (interest method). Commitment and origination fees from lending services are also recorded as deferred revenue initially and recognized as income over the life of the loan using the interest method. Tenant payments for certain taxes, insurance, and other operating expenses related to our facilities (most of which are paid directly by our tenants to the government or appropriate third party vendor) are recorded net of the respective expense as generally our leases are “triple-net” leases, with terms requiring such expenses to be paid by our tenants. Failure on the part of our tenants to pay such expense or to pay late would result in a violation of the lease agreement, which could lead to an event of default, if not cured. In regards to property disposals, starting January 1, 2018, we account for such transactions pursuant to ASU No. 2014-09, “Revenue from Contracts with Customers,” (“ASU 2014-09”). Under this guidance, we recognize a sale of real estate when control has been transferred to the buyer and collection of the sales price is probable. Prior to 2018, we could not recognize a sale if we had continuing involvement in the real estate. Upon adoption of the new accounting guidance, we recorded a $2 million adjustment to retained earnings to fully recognize a gain on real estate sold in prior years that was required to be deferred under old accounting guidance. |
Acquired Real Estate Purchase Price Allocation | Acquired Real Estate Purchase Price Allocation: Since January 1, 2018 with adoption of ASU No. 2017-01, “Clarifying the Definition of a Business” (“ASU 2017-01”), all of our property acquisitions have been accounted for as asset acquisitions. Prior to 2018, properties acquired for leasing purposes were accounted for using business combination accounting rules. The primary impact to us from this change in accounting is the capitalization of third party transaction costs that are directly related to the acquisition as these costs were expensed under business combination accounting rules. Under either accounting method, we allocate the purchase price of acquired properties to tangible and identified intangible assets acquired based on their fair values. In making estimates of fair values for purposes of allocating purchase prices of acquired real estate, we may utilize a number of sources, from time to time, including available real estate broker data, independent appraisals that may be obtained in connection with the acquisition or financing of the respective property, internal data from previous acquisitions or developments, and other market data. We also consider information obtained about each property as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the tangible and intangible assets acquired. We measure the aggregate value of lease intangible assets acquired based on the difference between (i) the property valued with new or in-place leases adjusted to market rental rates and (ii) the property valued as if vacant. Management’s estimates of value are made using methods similar to those used by independent appraisers (e.g., discounted cash flow analysis). Factors considered by management in our analysis include an estimate of carrying costs during hypothetical expected lease-up periods, considering current market conditions, and costs to execute similar leases. We also consider information obtained about each targeted facility as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the intangible assets acquired. In estimating carrying costs, management includes real estate taxes, insurance and other operating expenses and estimates of lost rentals at market rates during the expected lease-up periods, which we expect to be about six months depending on specific local market conditions. Management also estimates costs to execute similar leases including leasing commissions, legal costs, and other related expenses to the extent that such costs are not already incurred in connection with a new lease origination as part of the transaction. We record above-market and below-market in-place lease values, if any, for our facilities, which are based on the present value of the difference between (i) the contractual amounts to be paid pursuant to the in-place leases and (ii) management’s estimate of fair market lease rates for the corresponding in-place leases, measured over a period equal to the remaining non-cancelable term of the lease. We amortize any resulting capitalized above-market lease values as a reduction of rental income over the lease term. We amortize any resulting capitalized below-market lease values as an increase to rental income over the lease term. Other intangible assets acquired may include customer relationship intangible values which are based on management’s evaluation of the specific characteristics of each prospective tenant’s lease and our overall relationship with that tenant. Characteristics to be considered by management in allocating these values include the nature and extent of our existing business relationships with the tenant, growth prospects for developing new business with the tenant, the tenant’s credit quality and expectations of lease renewals, including those existing under the terms of the lease agreement, among other factors. We amortize the value of these intangible assets to expense over the term of the respective leases. If a lease is terminated early, the unamortized portion of the lease intangibles are charged to expense. |
Real Estate and Depreciation | Real Estate and Depreciation: Real estate, consisting of land, buildings and improvements, are maintained at cost. Although typically paid by our tenants, any expenditure for ordinary maintenance and repairs that we pay are expensed to operations as incurred. Significant renovations and improvements which improve and/or extend the useful life of the asset are capitalized and depreciated over their estimated useful lives. We record impairment losses on long-lived assets used in operations when events and circumstances indicate that the assets might be impaired and the undiscounted cash flows estimated to be generated by those assets, including an estimated liquidation amount, during the expected holding periods are less than the carrying amounts of those assets. Impairment losses are measured as the difference between carrying value and fair value of the assets. For assets held for sale, we cease recording depreciation expense and adjust the assets’ value to the lower of its carrying value or fair value, less cost of disposal. Fair value is based on estimated cash flows discounted at a risk-adjusted rate of interest. We classify real estate assets as held for sale when we have commenced an active program to sell the assets, and in the opinion of management, it is probable the asset will be sold within the next 12 months. Construction in progress includes the cost of land, the cost of construction of buildings, improvements and fixed equipment, and costs for design and engineering. Other costs, such as interest, legal, property taxes and corporate project supervision, which can be directly associated with the project during construction, are also included in construction in progress. We commence capitalization of costs associated with a development project when the development of the future asset is probable and activities necessary to get the underlying property ready for its intended use have been initiated. We stop the capitalization of costs when the property is substantially complete and ready for its intended use. Depreciation is calculated on the straight-line method over the estimated useful lives of the related real estate and other assets. Our weighted average useful lives at December 31, 2018 are as follows: Buildings and improvements 39.2 years Tenant lease intangibles 26.0 years Leasehold improvements 16.4 years Furniture, equipment and other 9.8 years |
Losses from Rent Receivables | Losses from Rent Receivables: For all leases, we continuously monitor the performance of our existing tenants including, but not limited to: admission levels and surgery/procedure volumes by type; current operating margins; ratio of our tenants’ operating margins both to facility rent and to facility rent plus other fixed costs; trends in cash collections; trends in revenue and patient mix; and the effect of evolving healthcare regulations on tenants’ profitability and liquidity. Losses from Operating Lease Receivables: Losses on DFL Receivables: |
Loans | Loans: Loans consist of mortgage loans, working capital loans and other long-term loans. Mortgage loans are collateralized by interests in real property. Working capital and other long-term loans are generally collateralized by interests in receivables and corporate and individual guarantees. We record loans at cost. We evaluate the collectability of both interest and principal on a loan-by-loan basis (using the same process as we do for assessing the collectability of rents) to determine whether they are impaired. A loan is considered impaired when, based on current information and events, it is probable that we will be unable to collect all amounts due according to the existing contractual terms. When a loan is considered to be impaired, the amount of the allowance is calculated by comparing the recorded investment to either the value determined by discounting the expected future cash flows using the loan’s effective interest rate or to the fair value of the collateral, if the loan is collateral dependent. If a loan is deemed to be impaired, we generally place the loan on non-accrual status and record interest income only upon receipt of cash. |
Earnings Per Share/Units | Earnings Per Share/Units: Basic earnings per common share/unit is computed by dividing net income applicable to common shares/units by the weighted number of shares/units of common stock/units outstanding during the period. Diluted earnings per common share/units is calculated by including the effect of dilutive securities. Our unvested restricted stock/unit awards contain non-forfeitable rights to dividends, and accordingly, these awards are deemed to be participating securities. These participating securities are included in the earnings allocation in computing both basic and diluted earnings per common share/unit. |
Income Taxes | Income Taxes: We conduct our business as a REIT under Sections 856 through 860 of the Internal Revenue Code of 1986, as amended (“the Code”). To qualify as a REIT, we must meet certain organizational and operational requirements, including a requirement to distribute to stockholders at least 90% of our REIT’s ordinary taxable income. As a REIT, we generally pay little U.S. federal and state income tax because of the dividends paid deduction that we are allowed to take. If we fail to qualify as a REIT in any taxable year, we will then be subject to U.S. federal income taxes on our taxable income at regular corporate rates and will not be permitted to qualify for treatment as a REIT for federal income tax purposes for four years following the year during which qualification is lost, unless the Internal Revenue Service grants us relief under certain statutory provisions. Such an event could materially adversely affect our net income and net cash available for distribution to stockholders. However, we intend to operate in such a manner so that we will remain qualified as a REIT for U.S. federal income tax purposes. Our financial statements include the operations of a taxable REIT subsidiary (“TRS”), MPT Development Services, Inc. (“MDS”), and with many other entities, which are single member LLCs that are disregarded for tax purposes and are reflected in the tax returns of MDS. MDS is not entitled to a dividends paid deduction and is subject to U.S. federal, state, and local income taxes. MDS is authorized to provide property development, leasing, and management services for third-party owned properties, and we will make non-mortgage loans to and/or investments in our lessees through this entity. With the property acquisitions and investments in Europe, we are subject to income taxes internationally. However, we do not expect to incur any additional income taxes in the U.S. as such income from our international properties flows through our REIT income tax returns. For our TRS and international subsidiaries, we determine deferred tax assets and liabilities based on the differences between the financial reporting and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Any increase or decrease in our deferred tax assets/liabilities that results from a change in circumstances and that causes us to change our judgment about expected future tax consequences of events, is reflected in our tax provision when such changes occur. Deferred income taxes also reflect the impact of operating loss carryforwards. A valuation allowance is provided if we believe it is more likely than not that all or some portion of our deferred tax assets will not be realized. Any increase or decrease in the valuation allowance that results from a change in circumstances, and that causes us to change our judgment about our ability to realize the related deferred tax asset, is reflected in our tax provision when such changes occur. The calculation of our income taxes involves dealing with uncertainties in the application of complex tax laws and regulations in a multitude of jurisdictions across our global operations. An income tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, on the basis of technical merits. However, if a more likely than not position cannot be reached, we record a liability as an off-set to the tax benefit and adjust the liabilities when our judgment changes as a result of the evaluation of new information not previously available. Because of the complexity of some of these uncertainties, the ultimate resolution may result in a payment that is materially different from our current estimate of the uncertain tax position liabilities. These differences will be reflected as increases or decreases to income tax expense in the period in which new information is available. |
Stock-Based Compensation | Stock-Based Compensation: We adopted the 2013 Equity Incentive Plan (the “Equity Incentive Plan”) during the second quarter of 2013. Awards of restricted stock, stock options and other equity-based awards with service conditions are amortized to compensation expense over the vesting periods (typically three years), using the straight-line method. Awards that contain market conditions are amortized to compensation expense over the derived vesting periods, which correspond to the periods over which we estimate the awards will be earned, which generally range from three to five years, using the straight-line method. Awards with performance conditions are amortized using the straight-line method over the service period in which the performance conditions are measured, adjusted for the probability of achieving the performance conditions. Forfeitures of stock-based awards are recognized as they occur. |
Deferred Costs | Deferred Costs: Costs incurred that directly relate to the offerings of stock are deferred and netted against proceeds received from the offering. Leasing commissions and other leasing costs directly attributable to tenant leases are capitalized as deferred leasing costs and amortized on the straight-line method over the terms of the related lease agreements. Costs identifiable with loans made to borrowers are capitalized and recognized as a reduction in interest income over the life of the loan. |
Deferred Financing Costs | Deferred Financing Costs: We generally capitalize financing costs incurred in connection with new financings and refinancings of debt. These costs are amortized over the lives of the related debt as an addition to interest expense. For debt with defined principal re-payment terms, the deferred costs are amortized to produce a constant effective yield on the debt (interest method) and are included within Debt, net on our consolidated balance sheets. For debt without defined principal repayment terms, such as our revolving credit facility, the deferred costs are amortized on the straight-line method over the term of the debt and are included as a component of Other assets on our consolidated balance sheets. |
Foreign Currency Translation and Transactions | Foreign Currency Translation and Transactions: Certain of our international subsidiaries’ functional currencies are the local currencies of their respective countries. We translate the results of operations of our foreign subsidiaries into U.S. dollars using average rates of exchange in effect during the period, and we translate balance sheet accounts using exchange rates in effect at the end of the period. We record resulting currency translation adjustments in accumulated other comprehensive income (loss), a component of stockholders’ equity on our consolidated balance sheets. Certain of our U.S. subsidiaries will enter into short-term and long-term transactions denominated in a foreign currency from time to time. Gains or losses resulting from these foreign currency transactions are translated into U.S. dollars at the rates of exchange prevailing at the dates of the transactions. The effects of transaction gains or losses on our short-term transactions are included in other income in the consolidated statements of income, while the translation effects on our long-term investments are recorded in accumulated other comprehensive income (loss) on our consolidated balance sheets. |
Derivative Financial Investments and Hedging Activities | Derivative Financial Investments and Hedging Activities: During our normal course of business, we may use certain types of derivative instruments for the purpose of managing interest rate and/or foreign currency risk. We record our derivative and hedging instruments at fair value on the balance sheet. Changes in the estimated fair value of derivative instruments that are not designated as hedges or that do not meet the criteria for hedge accounting are recognized in earnings. For derivatives designated as cash flow hedges, the change in the estimated fair value of the effective portion of the derivative is recognized in accumulated other comprehensive income (loss) on our consolidated balance sheets, whereas the change in the estimated fair value of the ineffective portion is recognized in earnings. For derivatives designated as fair value hedges, the change in the estimated fair value of the effective portion of the derivatives offsets the change in the estimated fair value of the hedged item, whereas the change in the estimated fair value of the ineffective portion is recognized in earnings. To qualify for hedge accounting, we formally document all relationships between hedging instruments and hedged items, as well as our risk management objective and strategy for undertaking the hedge prior to entering into a derivative transaction. This process includes specific identification of the hedging instrument and the hedge transaction, the nature of the risk being hedged and how the hedging instrument’s effectiveness in hedging the exposure to the hedged transaction’s variability in cash flows attributable to the hedged risk will be assessed. Both at the inception of the hedge and on an ongoing basis, we assess whether the derivatives that are used in hedging transactions are highly effective in offsetting changes in cash flows or fair values of hedged items. In addition, for cash flow hedges, we assess whether the underlying forecasted transaction will occur. We discontinue hedge accounting if a derivative is not determined to be highly effective as a hedge or that it is probable that the underlying forecasted transaction will not occur. |
Fair Value Measurement | Fair Value Measurement: We measure and disclose the estimated fair value of financial assets and liabilities utilizing a hierarchy of valuation techniques based on whether the inputs to a fair value measurement are considered to be observable or unobservable in a marketplace. Observable inputs reflect market data obtained from independent sources, while unobservable inputs reflect our market assumptions. This hierarchy requires the use of observable market data when available. These inputs have created the following fair value hierarchy: • Level 1 — quoted prices for instruments in active markets; • Level 2 — quoted prices for instruments in active markets; quoted prices for identical or similar instruments in markets that are not active; and model-derived valuations in which significant inputs and significant value drivers are observable in active markets; and • Level 3 — fair value measurements derived from valuation techniques in which one or more significant inputs or significant value drivers are . We measure fair value using a set of standardized procedures that are outlined herein for all assets and liabilities which are required to be measured at their estimated fair value on either a recurring or non-recurring basis. When available, we utilize quoted market prices from an independent third party source to determine fair value and classify such items in Level 1. In some instances where a market price is available, but the instrument is in an inactive or over-the-counter market, we apply the dealer (market maker) pricing estimate and classify the asset or liability in Level 2. If quoted market prices or inputs are not available, fair value measurements are based upon valuation models that utilize current market or independently sourced market inputs, such as interest rates, option volatilities, credit spreads, market capitalization rates, etc. Items valued using such internally-generated valuation techniques are classified according to the lowest level input that is significant to the fair value measurement. As a result, the asset or liability could be classified in either Level 2 or 3 even though there may be some significant inputs that are readily observable. Internal fair value models and techniques used by us include discounted cash flow and Monte Carlo valuation models. We also consider our counterparty’s and own credit risk on derivatives and other liabilities measured at their estimated fair value. Fair Value Option Election: For our equity interest in Ernest along with any related loans (all of which other than the mortgage loans were sold or paid off on October 4, 2018 - see Note 3 for more details), we have elected to account for these investments at fair value due to the size of the investments and because we believe this method is more reflective of current values. We have not made a similar election for other equity interests or loans that existed at December 31, 2018. |
Reclassification | Reclassifications: Certain amounts in the consolidated financial statements for prior periods have been reclassified to conform to the current period presentation. |
Recent Accounting Developments | Recent Accounting Developments: Leases In February 2016, the FASB issued ASU 2016-02, “Leases”, which sets out the principles for the recognition, measurement, presentation and disclosure of leases for both parties to a contract (i.e. lessees and lessors). The new standard requires lessees to apply a dual approach, classifying leases as either financing or operating leases based on the principle of whether or not the lease is effectively a financed purchase by the lessee. This classification will determine whether lease expense is recognized based on an effective interest method or on a straight-line basis over the term of the lease. A lessee is also required to record a right-of-use asset and a lease liability for all leases with a term greater than 12 months regardless of their classification. Leases with a term of 12 months or less will be accounted for similar to existing guidance for operating leases today. The standard requires lessors to account for leases using an approach that is substantially equivalent to existing guidance for sales-type leases, direct financing leases and operating leases. In July 2018, the FASB issued ASU 2018-11, “Leases (Topic 842): Targeted Improvements” (“ASU 2018-11”), allowing companies to record a cumulative adjustment to retained earnings in the period of adoption rather than requiring the restatement of prior periods. This standard is effective for us on January 1, 2019. We do have leases in which we are the lessee, including ground leases, on which certain of our facilities reside, along with corporate office and equipment leases. Although we do not expect any change in the current operating lease classification of these leases, we will record a right-of-use asset and a lease liability on our balance sheet upon adoption of this standard, which we estimate to be between $80 million to $90 million with any difference recorded as a cumulative adjustment in equity. From a lessor perspective, we do not expect any change in the current classification and accounting of our existing leases. However, we do expect certain non-lease components (such as certain operating expenses that we pay and our tenants reimburse us for pursuant to our “triple-net” leases) to be recorded gross versus net of the respective expenses upon adoption of this standard in 2019 in accordance with ASU No. 2014-09, “Revenue from Contracts with Customers (Topic 606)”. For those operating expenses that our tenants pay directly to third parties pursuant to our leases, we will continue to present on a net basis. |
Summary of Significant Accoun_3
Summary of Significant Accounting Policies (Tables) | 12 Months Ended |
Dec. 31, 2018 | |
Accounting Policies [Abstract] | |
Carrying Value and Classification of Related Assets and Maximum Exposure to Loss | The carrying value and classification of the related assets and maximum exposure to loss as a result of our involvement with these VIEs are presented below at December 31, 2018 (in thousands): VIE Type Maximum Loss Exposure(1) Asset Type Classification Carrying Amount(2) Equity investments $ 17,187 Other assets $ — (1) Our maximum loss exposure related to our equity investment in VIEs represent the current carrying values of such investment plus any other related assets (such as rent receivables) less any liabilities. (2) Carrying amount reflects the net book value of our equity interest only in the VIE. |
Estimated Useful Lives of Related Real Estate and Other Assets | Depreciation is calculated on the straight-line method over the estimated useful lives of the related real estate and other assets. Our weighted average useful lives at December 31, 2018 are as follows: Buildings and improvements 39.2 years Tenant lease intangibles 26.0 years Leasehold improvements 16.4 years Furniture, equipment and other 9.8 years |
Real Estate Activities (Tables)
Real Estate Activities (Tables) | 12 Months Ended |
Dec. 31, 2018 | |
Schedule of Revenue by Operator | Error extracting Word content |
Schedule of Revenue from External Customers by Geographic Areas | Error extracting Word content |
Assets Acquired | For the years ended December 31, 2018, 2017, and 2016, we acquired the following assets: 2018 2017 2016 (in thousands) Assets Acquired Land $ 71,880 $ 240,993 $ 91,071 Building 686,739 985,219 655,324 Intangible lease assets — subject to amortization (weighted average useful life of 27.9 years in 2018, 27.7 years in 2017, and 28.5 years in 2016) 90,651 181,004 94,167 Net investments in direct financing leases — 40,450 178,000 Mortgage loans — 700,000 600,000 Other loans 336,458 — — Equity investments and other assets 245,267 100,000 70,166 Liabilities assumed — (878 ) (6,319 ) Total assets acquired $ 1,430,995 $ 2,246,788 $ 1,682,409 Loans repaid(1) (764,447 ) — (193,262 ) Total net assets acquired $ 666,548 $ 2,246,788 $ 1,489,147 (1) The 2018 column includes $0.8 billion of loans advanced to Steward in 2016 and repaid in 2018 as part of sale leaseback conversion described below. The 2016 column includes $93.3 million of loans advanced to Capella (2) Prime Healthcare Services, Inc. (“Prime”) (2) In 2018, LifePoint Health, Inc. (“LifePoint”) merged with RCCH, who acquired Capella Healthcare, Inc. (“Capella”) in 2016. Any reference to either LifePoint, RCCH, or Capella represent the same entity. |
Summary of Status on Current Development Projects | See table below for a status summary of our current development projects (in thousands): Property Commitment Costs Incurred as of December 31, 2018 Estimated Rent Commencement Date Circle Health (Birmingham, England) $ 43,288 $ 28,881 2Q 2019 Circle Health Rehabilitation (Birmingham, England) 21,505 9,081 3Q 2019 Surgery Partners (Idaho Falls, Idaho) 113,468 46,210 1Q 2020 $ 178,261 $ 84,172 |
Amortization Expense from Existing Lease Intangible Assets | We recorded amortization expense related to intangible lease assets of $17.6 million, $15.8 million, and $13.4 million in 2018, 2017, and 2016, respectively, and expect to recognize amortization expense from existing lease intangible assets as follows (amounts in thousands): For the Year Ended December 31: 2019 $ 16,687 2020 16,507 2021 16,493 2022 16,479 2023 16,413 |
Components of Net Investment in Direct Financing Leases | The components of our net investment in DFLs consisted of the following (in thousands): As of December 31, 2018 As of December 31, 2017 Minimum lease payments receivable $ 2,091,504 $ 2,294,081 Estimated residual values 424,719 448,339 Less unearned income (1,832,170 ) (2,043,693 ) Net investment in direct financing leases $ 684,053 $ 698,727 |
Minimum Rental Payments Due over the Remaining Lease Term under Operating Leases | Minimum rental payments due to us over the remaining lease term under operating leases and DFLs at December 31, 2018, are as follows (amounts in thousands): Total Under Operating Leases Total Under DFLs Total 2019 $ 433,542 $ 64,971 $ 498,513 2020 437,025 66,270 503,295 2021 445,598 67,595 513,193 2022 450,592 68,947 519,539 2023 457,732 70,326 528,058 Thereafter 9,612,430 1,544,035 11,156,465 $ 11,836,919 $ 1,882,144 $ 13,719,063 |
Summary of Loans | The following is a summary of our loans ($ amounts in thousands): As of December 31, 2018 As of December 31, 2017 Balance Weighted Average Interest Rate Balance Weighted Average Interest Rate Mortgage loans $ 1,213,322 8.8 % $ 1,778,316 8.3 % Acquisition loans 3,454 10.8 % 118,448 13.8 % Working capital and other loans 369,744 5.4 % 31,760 7.6 % $ 1,586,520 $ 1,928,524 |
2018 [Member] | |
Summary of Operations for Disposed Assets | The properties sold during 2018 did not meet the definition of discontinued operations. However, the following represents the operating results (excluding the St. Joseph sale in March 2018) from these properties for the periods presented (in thousands): For the Year Ended December 31, 2018 2017 2016 Revenues $ 88,838 $ 132,039 $ 109,544 Real estate depreciation and amortization (15,849 ) (31,870 ) (26,410 ) Property-related expenses (531 ) (404 ) (45 ) Other income (expense) (1) 709,717 (14,168 ) (23,937 ) Income from real estate dispositions, net $ 782,175 $ 85,597 $ 59,152 (1) Includes approximately $720 million of gains on sale for the twelve months ended December 31, 2018. |
2016 [Member] | |
Summary of Operations for Disposed Assets | The properties sold during 2016 did not meet the definition of discontinued operations. However, the following represents the operating results from these properties (excluding loans repaid in the Capella Disposal Transaction) for the periods presented (in thousands): For the Year Ended December 31, 2016 Revenues $ 8,350 Real estate depreciation and amortization (2,870 ) Property-related expenses (113 ) Other income(1) 60,283 Income from real estate dispositions, net $ 65,650 (1) Includes approximately $60 million of net gains on sale for the year ended December 31, 2016. |
Debt (Tables)
Debt (Tables) | 12 Months Ended |
Dec. 31, 2018 | |
Debt Disclosure [Abstract] | |
Summary of Debt | The following is a summary of debt ($ amounts in thousands): As of December 31, 2018 As of December 31, 2017 Revolving credit facility(A) $ 28,059 $ 840,810 Term loans 200,000 200,000 4.000% Senior Unsecured Notes due 2022(B) 573,350 600,250 5.500% Senior Unsecured Notes due 2024 300,000 300,000 6.375% Senior Unsecured Notes due 2024 500,000 500,000 3.325% Senior Unsecured Notes due 2025(B) 573,350 600,250 5.250% Senior Unsecured Notes due 2026 500,000 500,000 5.000% Senior Unsecured Notes due 2027 1,400,000 1,400,000 $ 4,074,759 $ 4,941,310 Debt issue costs, net (37,370 ) (42,643 ) $ 4,037,389 $ 4,898,667 (A) Includes £22 million and £8 million of GBP-denominated borrowings that reflect the exchange rate at December 31, 2018 and December 31, 2017, respectively. (B) These notes are Euro-denominated and reflect the exchange rate at December 31, 2018 and December 31, 2017, respectively. |
Principal Payments Due on Debt | As of December 31, 2018, principal payments due on our debt (which exclude the effects of any discounts, premiums, or debt issue costs recorded) are as follows ($ amounts in thousands): 2019 $ — 2020 — 2021 28,059 2022 773,350 2023 — Thereafter 3,273,350 Total $ 4,074,759 |
Income Taxes (Tables)
Income Taxes (Tables) | 12 Months Ended |
Dec. 31, 2018 | |
Income Tax Disclosure [Abstract] | |
Schedule of Income Tax Expense (Benefit) | From our TRS and our foreign operations, income tax expense (benefit) were as follows (in thousands): For the Years Ended December 31, 2018 2017 2016 Current income tax (benefit) expense: Domestic $ (125 ) $ (41 ) $ 42 Foreign 3,294 3,062 1,856 3,169 3,021 1,898 Deferred income tax (benefit) expense: Domestic (3,713 ) (233 ) 147 Foreign 1,471 (107 ) (8,875 ) (2,242 ) (340 ) (8,728 ) Income tax expense (benefit) $ 927 $ 2,681 $ (6,830 ) |
Summary of Reconciliation of the Income Tax Expense (Benefit) at the Statutory Income Tax Rate and the Effective Tax Rate for Income before Income Taxes | A reconciliation of the income tax expense (benefit) at the statutory income tax rate and the effective tax rate for income before income taxes for the years ended December 31, 2018, 2017, and 2016 is as follows (in thousands): 2018 2017 2016 Income before income tax $ 1,019,404 $ 293,919 $ 219,107 Income tax at the U.S. statutory federal rate (21% in 2018 and 35% in 2017 and 2016) 214,075 102,872 76,687 Increase (decrease) resulting from: Foreign rate differential (2,643 ) (2,326 ) 1,434 State income taxes, net of federal benefit 379 — 66 U.S. earnings not subject to federal income tax (208,472 ) (98,026 ) (84,927 ) Equity investments (46 ) 3,293 4,297 Change in valuation allowance (2,668 ) (5,391 ) (6,104 ) Other items, net 302 2,259 1,717 Total income tax expense (benefit) $ 927 $ 2,681 $ (6,830 ) |
Schedule of Deferred Tax Assets and Liabilities | At December 31, 2018 and 2017, components of our deferred tax assets and liabilities were as follows (in thousands): 2018 2017 Deferred tax assets: Operating loss and interest deduction carry forwards $ 21,984 $ 24,580 Other 277 504 Total deferred tax assets 22,261 25,084 Valuation allowance (3,444 ) (11,101 ) Total net deferred tax assets $ 18,817 $ 13,983 Deferred tax liabilities: Property and equipment $ (12,359 ) $ (4,336 ) Net unbilled revenue (1,633 ) (6,113 ) Partnership investments — (2,099 ) Other (300 ) (1,320 ) Total deferred tax liabilities (14,292 ) (13,868 ) Net deferred tax asset (liability) $ 4,525 $ 115 |
Schedule of Per Share Distributions to Stockholders | A schedule of per share distributions we paid and reported to our stockholders is set forth in the following: For the Years Ended December 31, 2018 2017 2016 Common share distribution $ 0.990000 $ 0.950000 $ 0.900000 Ordinary income 0.438792 0.655535 0.619368 Capital gains(1) 0.551208 0.021022 0.102552 Unrecaptured Sec. 1250 gain 0.132280 0.004647 0.045432 Section 19A Dividends 0.438792 — — Return of capital — 0.273443 0.178080 (1) Capital gains include unrecaptured Sec. 1250 gains. |
Earnings Per Share_Unit (Tables
Earnings Per Share/Unit (Tables) | 12 Months Ended |
Dec. 31, 2018 | |
Earnings Per Share [Abstract] | |
Calculation of Earnings Per Share | Medical Properties Trust, Inc. Our earnings per share were calculated based on the following (amounts in thousands): For the Years Ended December 31, 2018 2017 2016 Numerator: Net income $ 1,018,477 $ 291,238 $ 225,937 Non-controlling interests’ share in earnings (1,792 ) (1,445 ) (889 ) Participating securities’ share in earnings (3,685 ) (1,409 ) (559 ) Net income, less participating securities’ share in earnings $ 1,013,000 $ 288,384 $ 224,489 Denominator: Basic weighted average common shares 365,364 349,902 260,414 Dilutive potential common shares 907 539 658 Diluted weighted average common shares 366,271 350,441 261,072 MPT Operating Partnership, L.P. Our earnings per unit were calculated based on the following (amounts in thousands): For the Years Ended December 31, 2018 2017 2016 Numerator: Net income $ 1,018,477 $ 291,238 $ 225,937 Non-controlling interests’ share in earnings (1,792 ) (1,445 ) (889 ) Participating securities’ share in earnings (3,685 ) (1,409 ) (559 ) Net income, less participating securities’ share in earnings $ 1,013,000 $ 288,384 $ 224,489 Denominator: Basic weighted average units 365,364 349,902 260,414 Dilutive potential units 907 539 658 Diluted weighted average units 366,271 350,441 261,072 |
Stock Awards (Tables)
Stock Awards (Tables) | 12 Months Ended |
Dec. 31, 2018 | |
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract] | |
Restricted Equity Awards Activity | The following summarizes restricted equity award activity in 2018 and 2017 (which includes awards granted in 2018, 2017, 2016, and any applicable prior years), respectively: For the Year Ended December 31, 2018: Vesting Based on Service Vesting Based on Market/Performance Conditions Shares Weighted Average Value at Award Date Shares Weighted Average Value at Award Date Nonvested awards at beginning of the year 276,280 $ 12.68 2,676,755 $ 7.86 Awarded 958,480 $ 14.31 1,750,834 $ 11.61 Vested (307,275 ) $ 12.92 (288,404 ) $ 11.25 Forfeited (3,637 ) $ 13.05 (5,750 ) $ 9.35 Nonvested awards at end of year 923,848 $ 14.29 4,133,435 $ 9.21 For the Year Ended December 31, 2017: Vesting Based on Service Vesting Based on Market/Performance Conditions Shares Weighted Average Value at Award Date Shares Weighted Average Value at Award Date Nonvested awards at beginning of the year 347,128 $ 13.35 1,811,675 $ 6.78 Awarded 249,841 $ 12.40 1,741,003 $ 8.21 Vested (304,613 ) $ 12.86 (491,071 ) $ 6.84 Forfeited (16,076 ) $ 12.75 (384,852 ) $ 5.65 Nonvested awards at end of year 276,280 $ 12.68 2,676,755 $ 7.86 |
Commitments and Contingencies (
Commitments and Contingencies (Tables) | 12 Months Ended |
Dec. 31, 2018 | |
Commitments And Contingencies Disclosure [Abstract] | |
Fixed Minimum Rental Payable under Operating Leases Sublease Receivable And Net Payments Due with Non-cancelable Terms | Fixed minimum payments due over the remaining lease term under non-cancelable operating leases of more than one year and amounts to be received in the future from non-cancelable subleases over their remaining lease term at December 31, 2018 are as follows: (amounts in thousands) Fixed minimum payments Amounts to be received from subleases Net payments 2019 $ 6,602 $ (3,284 ) $ 3,318 2020 6,903 (3,458 ) 3,445 2021 6,841 (3,551 ) 3,290 2022 6,838 (3,632 ) 3,206 2023 6,861 (3,636 ) 3,225 Thereafter 198,932 (93,586 ) 105,346 (1) $ 232,977 $ (111,147 ) $ 121,830 (1) Reflects certain ground leases, in which we are the lessee, that have longer initial fixed terms than our existing sublease to our tenants. However, we would expect to either renew the related sublease, enter into a lease with a new tenant or early terminate the ground lease to reduce or avoid any significant impact from such ground leases. |
Fair Value of Financial Instr_2
Fair Value of Financial Instruments (Tables) | 12 Months Ended |
Dec. 31, 2018 | |
Fair Value Disclosures [Abstract] | |
Summary of Fair Value Information of Financial Instruments | The following table summarizes fair value estimates for our financial instruments (in thousands): December 31, 2018 December 31, 2017 Asset (Liability) Book Value Fair Value Book Value Fair Value Interest and rent receivables $ 25,855 $ 24,942 $ 78,970 $ 78,028 Loans(1) 1,471,520 1,490,758 1,698,471 1,722,101 Debt, net (4,037,389 ) (3,947,795 ) (4,898,667 ) (5,073,707 ) (1) Excludes loans to Ernest that are recorded at fair value – see below for further details. |
Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis | At December 31, 2018 and 2017, the amounts recorded under the fair value option method were as follows (in thousands): As of December 31, 2018 As of December 31, 2017 Asset Type Asset (Liability) Fair Value Original Cost Fair Value Original Cost Classification Mortgage loans $ 115,000 $ 115,000 $ 115,000 $ 115,000 Mortgage loans Equity investment and other loans — — 114,554 118,354 Other loans/other assets $ 115,000 $ 115,000 $ 229,554 $ 233,354 |
Other Assets (Tables)
Other Assets (Tables) | 12 Months Ended |
Dec. 31, 2018 | |
Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract] | |
Summary of Other Assets | The following is a summary of our other assets (in thousands): At December 31, 2018 2017 Debt issue costs, net(1) $ 4,793 $ 7,093 Equity investments 520,058 288,398 Other corporate assets 115,416 117,827 Prepaids and other assets 61,757 55,176 Total other assets $ 702,024 $ 468,494 (1) Relates to revolving credit facility |
Summary of Financial Information for Investees | The following table presents financial information as of and for the year ended December 31, 2018 for the joint venture arrangement with Primotop in which we made an equity method investment in and advances to on August 31, 2018 (in thousands): 2018 Revenue $ 42,526 Net income $ 6,009 Assets $ 2,018,496 Liabilities $ 1,553,191 |
Quarterly Financial Data (una_2
Quarterly Financial Data (unaudited) (Tables) | 12 Months Ended |
Dec. 31, 2018 | |
Medical Properties Trust, Inc. [Member] | |
Unaudited Quarterly Financial Information | The following is a summary of the unaudited quarterly financial information for the years ended December 31, 2018 and 2017: (amounts in thousands, except for per share data) For the Three Month Periods in 2018 Ended March 31 June 30 September 30 December 31 Revenues $ 205,046 $ 201,902 $ 196,996 $ 180,578 Net income 91,043 112,017 736,476 78,941 Net income attributable to MPT common stockholders 90,601 111,567 736,034 78,483 Net income attributable to MPT common stockholders per share — basic $ 0.25 $ 0.30 $ 2.01 $ 0.21 Weighted average shares outstanding — basic 364,882 364,897 365,024 366,655 Net income attributable to MPT common stockholders per share — diluted $ 0.25 $ 0.30 $ 2.00 $ 0.21 Weighted average shares outstanding — diluted 365,343 365,541 366,467 367,732 For the Three Month Periods in 2017 Ended March 31 June 30 September 30 December 31 Revenues $ 156,397 $ 166,807 $ 176,580 $ 204,961 Net income 68,185 73,796 76,881 72,376 Net income attributable to MPT common stockholders 67,970 73,415 76,464 71,944 Net income attributable to MPT common stockholders per share — basic $ 0.21 $ 0.21 $ 0.21 $ 0.19 Weighted average shares outstanding — basic 321,057 349,856 364,315 364,382 Net income attributable to MPT common stockholders per share —diluted $ 0.21 $ 0.21 $ 0.21 $ 0.19 Weighted average shares outstanding — diluted 321,423 350,319 365,046 364,977 |
MPT Operating Partnership, L.P. [Member] | |
Unaudited Quarterly Financial Information | The following is a summary of the unaudited quarterly financial information for the years ended December 31, 2018 and 2017: (amounts in thousands, except for per unit data) For the Three Month Periods in 2018 Ended March 31 June 30 September 30 December 31 Revenues $ 205,046 $ 201,902 $ 196,996 $ 180,578 Net income 91,043 112,017 736,476 78,941 Net income attributable to MPT Operating Partnership partners 90,601 111,567 736,034 78,483 Net income attributable to MPT Operating Partnership partners per unit — basic $ 0.25 $ 0.30 $ 2.01 $ 0.21 Weighted average units outstanding — basic 364,882 364,897 365,024 366,655 Net income attributable to MPT Operating Partnership partners per unit — diluted $ 0.25 $ 0.30 $ 2.00 $ 0.21 Weighted average units outstanding — diluted 365,343 365,541 366,467 367,732 For the Three Month Periods in 2017 Ended March 31 June 30 September 30 December 31 Revenues $ 156,397 $ 166,807 $ 176,580 $ 204,961 Net income 68,185 73,796 76,881 72,376 Net income attributable to MPT Operating Partnership partners 67,970 73,415 76,464 71,944 Net income attributable to MPT Operating Partnership partners per unit — basic $ 0.21 $ 0.21 $ 0.21 $ 0.19 Weighted average units outstanding — basic 321,057 349,856 364,315 364,382 Net income attributable to MPT Operating Partnership partners per unit — diluted $ 0.21 $ 0.21 $ 0.21 $ 0.19 Weighted average units outstanding — diluted 321,423 350,319 365,046 364,977 |
Summary of Significant Accoun_4
Summary of Significant Accounting Policies - Additional Information (Detail) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Significant Accounting Policies [Line Items] | |||
Threshold ownership percentage for inter company balances and transactions elimination | 100.00% | ||
Cumulative effect of change in accounting principles | $ 1,938 | ||
Expected lease-up periods for estimating lost rentals, in months | 6 months | ||
Percentage of ordinary taxable income to be distributed for real estate investment trust qualification | 90.00% | 90.00% | 90.00% |
Number of years of federal income tax at corporate rates on failure to qualify as REIT | 4 years | ||
Minimum [Member] | |||
Significant Accounting Policies [Line Items] | |||
Operating lease, right-of-use asset | $ 80,000 | ||
Operating lease, liability | $ 80,000 | ||
Maximum [Member] | |||
Significant Accounting Policies [Line Items] | |||
Stock award vesting period in years | 10 years | ||
Operating lease, right-of-use asset | $ 90,000 | ||
Operating lease, liability | $ 90,000 | ||
Time-Based Awards [Member] | |||
Significant Accounting Policies [Line Items] | |||
Stock award vesting period in years | 3 years | ||
Market Conditions Based Awards [Member] | Minimum [Member] | |||
Significant Accounting Policies [Line Items] | |||
Stock award vesting period in years | 3 years | ||
Market Conditions Based Awards [Member] | Maximum [Member] | |||
Significant Accounting Policies [Line Items] | |||
Stock award vesting period in years | 5 years | ||
Accounting Standards Update 2014-09 [Member] | |||
Significant Accounting Policies [Line Items] | |||
Cumulative effect of change in accounting principles | $ 2,000 |
Summary of Significant Accoun_5
Summary of Significant Accounting Policies - Carrying Value and Classification of Related Assets and Maximum Exposure to Loss (Detail) | Dec. 31, 2018USD ($) |
Equity investments [Member] | |
Variable Interest Entity [Line Items] | |
Maximum Loss Exposure | $ 17,187,000 |
Summary of Significant Accoun_6
Summary of Significant Accounting Policies - Estimated Useful Lives of Related Real Estate and Other Assets (Detail) | 12 Months Ended |
Dec. 31, 2018 | |
Buildings and improvements [Member] | |
Property, Plant and Equipment [Line Items] | |
Weighted average useful lives of related real estate and other assets | 39 years 2 months 12 days |
Tenant lease intangibles [Member] | |
Property, Plant and Equipment [Line Items] | |
Weighted average useful lives of related real estate and other assets | 26 years |
Leasehold improvements [Member] | |
Property, Plant and Equipment [Line Items] | |
Weighted average useful lives of related real estate and other assets | 16 years 4 months 24 days |
Furniture, equipment and other [Member] | |
Property, Plant and Equipment [Line Items] | |
Weighted average useful lives of related real estate and other assets | 9 years 9 months 18 days |
Real Estate Activities - Assets
Real Estate Activities - Assets Acquired (Detail) - USD ($) $ in Thousands | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Business Acquisition [Line Items] | ||||
Total assets acquired | $ 1,430,995 | $ 2,246,788 | $ 1,682,409 | |
Equity investments and other assets | 245,267 | 100,000 | 70,166 | |
Liabilities assumed | (878) | (6,319) | ||
Loans repaid | [1] | (764,447) | (193,262) | |
Total net assets acquired | 666,548 | 2,246,788 | 1,489,147 | |
Land [Member] | ||||
Business Acquisition [Line Items] | ||||
Total assets acquired | 71,880 | 240,993 | 91,071 | |
Building [Member] | ||||
Business Acquisition [Line Items] | ||||
Total assets acquired | 686,739 | 985,219 | 655,324 | |
Intangible Lease Assets - Subject to Amortization [Member] | ||||
Business Acquisition [Line Items] | ||||
Total assets acquired | 90,651 | 181,004 | 94,167 | |
Net Investments in Direct Financing Leases [Member] | ||||
Business Acquisition [Line Items] | ||||
Total assets acquired | 40,450 | 178,000 | ||
Mortgage Loans [Member] | ||||
Business Acquisition [Line Items] | ||||
Total assets acquired | $ 700,000 | $ 600,000 | ||
Other Loans [Member] | ||||
Business Acquisition [Line Items] | ||||
Total assets acquired | $ 336,458 | |||
[1] | The 2018 column includes $0.8 billion of loans advanced to Steward in 2016 and repaid in 2018 as part of sale leaseback conversion described below. The 2016 column includes $93.3 million of loans advanced to Capella(2) in 2015 and repaid in 2016 as a part of the Capella transaction (2), along with $100.0 million of loans advanced to Prime Healthcare Services, Inc. (“Prime”) in 2015 and repaid in 2016 as part of the sale leaseback conversion of four properties in New Jersey. |
Real Estate Activities - Asse_2
Real Estate Activities - Assets Acquired (Parenthetical) (Detail) $ in Thousands | 12 Months Ended | |||
Dec. 31, 2018USD ($) | Dec. 31, 2017Hospital | Dec. 31, 2016USD ($) | ||
Business Acquisition [Line Items] | ||||
Weighted average useful life of acquired intangible lease assets (in years) | 26 years | |||
Loans repaid | [1] | $ 764,447 | $ 193,262 | |
Number of sale leaseback conversion properties | Hospital | 4 | |||
Steward [Member] | ||||
Business Acquisition [Line Items] | ||||
Loans repaid | $ 800,000 | |||
Capella [Member] | ||||
Business Acquisition [Line Items] | ||||
Loans repaid | 93,300 | |||
Prime Healthcare Services, Inc [Member] | ||||
Business Acquisition [Line Items] | ||||
Loans repaid | $ 100,000 | |||
Intangible Lease Assets - Subject to Amortization [Member] | ||||
Business Acquisition [Line Items] | ||||
Weighted average useful life of acquired intangible lease assets (in years) | 27 years 10 months 24 days | 27 years 8 months 12 days | 28 years 6 months | |
[1] | The 2018 column includes $0.8 billion of loans advanced to Steward in 2016 and repaid in 2018 as part of sale leaseback conversion described below. The 2016 column includes $93.3 million of loans advanced to Capella(2) in 2015 and repaid in 2016 as a part of the Capella transaction (2), along with $100.0 million of loans advanced to Prime Healthcare Services, Inc. (“Prime”) in 2015 and repaid in 2016 as part of the sale leaseback conversion of four properties in New Jersey. |
Real Estate Activities - 2018 A
Real Estate Activities - 2018 Activity - Additional Information (Detail) $ in Thousands, € in Millions | Aug. 31, 2018USD ($) | Aug. 28, 2018EUR (€)Hospital | Mar. 31, 2017USD ($) | Aug. 31, 2018USD ($)Hospital | Aug. 31, 2018EUR (€)Hospital | Jun. 30, 2018EUR (€)Hospital | Mar. 31, 2018USD ($) | Oct. 31, 2016USD ($)RenewalOption | Dec. 31, 2018EUR (€)Hospital | Dec. 31, 2018USD ($)Hospital | Dec. 31, 2017USD ($) | Dec. 31, 2016USD ($) |
Business Acquisition [Line Items] | ||||||||||||
Ownership interest in joint venture under the equity method value included in other assets | $ | $ 520,058 | $ 288,398 | ||||||||||
Gain on sale of real estate | $ | $ 7,400 | |||||||||||
Mortgage financing | $ | $ 50,783 | $ 717,928 | $ 612,836 | |||||||||
Germany [Member] | Rehabilitation Hospital with Covenant Health System [Member] | ||||||||||||
Business Acquisition [Line Items] | ||||||||||||
Number of facilities acquired | Hospital | 3 | |||||||||||
Primotop Holdings S.a.r.l. [Member] | Germany [Member] | Acute Care Hospital [Member] | ||||||||||||
Business Acquisition [Line Items] | ||||||||||||
Gain on sale of real estate | $ | $ 500 | |||||||||||
2018 [Member] | General Acute Care Hospital and Healthcare System [Member] | ||||||||||||
Business Acquisition [Line Items] | ||||||||||||
Number of facilities acquired | Hospital | 5 | |||||||||||
Term of lease | 15 years | |||||||||||
Mortgage financing | $ | $ 764,400 | $ 764,400 | ||||||||||
Number of lease extension options | RenewalOption | 3 | |||||||||||
Term of lease extension, years | 5 years | |||||||||||
2018 [Member] | Germany [Member] | Acute Care Hospital [Member] | ||||||||||||
Business Acquisition [Line Items] | ||||||||||||
Ownership interest in joint venture under the equity method | 50.00% | |||||||||||
Ownership interest in joint venture under the equity method value included in other assets | € | € 210 | |||||||||||
Shareholder loan to joint venture | € | 290 | |||||||||||
Gain on sale of real estate | 500 | $ 720,000 | ||||||||||
2018 [Member] | Germany [Member] | Rehabilitation Hospital with Covenant Health System [Member] | ||||||||||||
Business Acquisition [Line Items] | ||||||||||||
Number of facilities acquired | Hospital | 3 | 4 | 4 | |||||||||
Purchase price of acquisition | € | € 17.3 | € 23 | € 23 | |||||||||
2018 [Member] | Germany [Member] | Rehabilitation Hospital with Covenant Health System [Member] | MEDIAN [Member] | ||||||||||||
Business Acquisition [Line Items] | ||||||||||||
Term of lease | 27 years | |||||||||||
Lease rent increase percentage | 70.00% | |||||||||||
Lease rate | 1.00% | |||||||||||
2018 [Member] | Germany [Member] | Fair Value [Member] | Acute Care Hospital [Member] | ||||||||||||
Business Acquisition [Line Items] | ||||||||||||
Aggregate fair value of ownership interest | € | € 1,635 | |||||||||||
2018 [Member] | Pasco, Washington [Member] | Acute Care Hospital [Member] | ||||||||||||
Business Acquisition [Line Items] | ||||||||||||
Purchase price of acquisition | $ | $ 17,500 | |||||||||||
2018 [Member] | Massachusetts [Member] | General Acute Care Hospital and Healthcare System [Member] | ||||||||||||
Business Acquisition [Line Items] | ||||||||||||
Number of facilities acquired | Hospital | 4 | |||||||||||
2018 [Member] | Texas [Member] | General Acute Care Hospital and Healthcare System [Member] | Steward Health Care System LLC [Member] | ||||||||||||
Business Acquisition [Line Items] | ||||||||||||
Number of facilities acquired | Hospital | 1 | |||||||||||
2018 [Member] | Primotop Holdings S.a.r.l. [Member] | Germany [Member] | Acute Care Hospital [Member] | ||||||||||||
Business Acquisition [Line Items] | ||||||||||||
Ownership interest in joint venture under the equity method | 50.00% | |||||||||||
Number of facilities acquired | Hospital | 71 | 71 | ||||||||||
Proceeds from joint venture | € | € 1,140 |
Real Estate Activities - 2017 A
Real Estate Activities - 2017 Activity - Additional Information (Detail) $ in Thousands, € in Millions | Nov. 29, 2017EUR (€)Hospital | Sep. 29, 2017USD ($)HospitalHealth_Center | Jun. 22, 2017EUR (€) | Jun. 01, 2017USD ($)RenewalOptionBed | May 01, 2017USD ($)HospitalBed | Jan. 30, 2017EUR (€) | Dec. 31, 2016EUR (€)Property | Jul. 31, 2016EUR (€)Hospital | Sep. 30, 2017EUR (€)Hospital | Jun. 30, 2017EUR (€)Hospital | Jan. 30, 2017EUR (€)Hospital | Dec. 31, 2018USD ($)Hospital | Dec. 31, 2017USD ($) | Dec. 31, 2016USD ($) |
Business Acquisition [Line Items] | ||||||||||||||
Amount of mortgage loan | $ | $ 50,783 | $ 717,928 | $ 612,836 | |||||||||||
2017 [Member] | Subsidiaries [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Amount of mortgage loan | $ | $ 700,000 | |||||||||||||
Number of mortgage facilities | Hospital | 2 | |||||||||||||
Equity interest acquired | $ | $ 100,000 | $ 210,000 | ||||||||||||
Combined purchase price and investment amount | $ | 1,500,000 | |||||||||||||
2017 [Member] | Subsidiaries [Member] | IASIS Healthcare [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Purchase price of acquisition | $ | $ 700,000 | |||||||||||||
Acute Care Hospital [Member] | 2017 [Member] | Germany [Member] | MEDIAN [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Purchase price of acquisition | € | € 19.4 | |||||||||||||
Lease agreement, end date | 2042-12 | |||||||||||||
Lease rate | 1.00% | |||||||||||||
Lease rent increase percentage | 70.00% | |||||||||||||
Purchase price of acquisition funded | € | € 18.6 | |||||||||||||
Remaining payment period | 4 years | |||||||||||||
Acute Care Hospital [Member] | 2017 [Member] | West Virginia and Ohio [Member] | Alecto Healthcare Services [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Purchase price of acquisition | $ | $ 40,000 | |||||||||||||
Term of lease | 15 years | |||||||||||||
Percentage of increase in annual rent | 2.00% | |||||||||||||
Number of lease extension options | RenewalOption | 3 | |||||||||||||
Term of lease extension, years | 5 years | |||||||||||||
Ownership interest percentage in operator facility | 20.00% | |||||||||||||
Acute Care Hospital [Member] | 2017 [Member] | IDAHO, Lewiston | St. Joseph Regional Medical Center [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Purchase price of acquisition | $ | $ 87,500 | |||||||||||||
Number of beds acquired | Bed | 145 | |||||||||||||
Acute Care Hospital [Member] | 2017 [Member] | IASIS Healthcare [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities closed | Hospital | 10 | |||||||||||||
Acute Care Hospital [Member] | 2017 [Member] | Ohio Valley Medical Center [Member] | Alecto Healthcare Services [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of beds acquired | Bed | 218 | |||||||||||||
Acute Care Hospital [Member] | 2017 [Member] | East Ohio Regional Hospital [Member] | Alecto Healthcare Services [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of beds acquired | Bed | 139 | |||||||||||||
Acute Care Hospital [Member] | 2017 [Member] | Subsidiaries [Member] | IASIS Healthcare [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities acquired | Hospital | 8 | |||||||||||||
Behavioral Health Care Facility [Member] | 2017 [Member] | IASIS Healthcare [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities closed | Health_Center | 1 | |||||||||||||
Behavioral Health Care Facility [Member] | 2017 [Member] | Subsidiaries [Member] | IASIS Healthcare [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities acquired | Health_Center | 1 | |||||||||||||
Community Health Systems, Inc. [Member] | 2017 [Member] | Florida, Ohio, and Pennsylvania [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities acquired | Hospital | 8 | |||||||||||||
Purchase price of acquisition | $ | $ 301,300 | |||||||||||||
Rehabilitation Hospital with Covenant Health System [Member] | Germany [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities acquired | Hospital | 3 | |||||||||||||
Rehabilitation Hospital with Covenant Health System [Member] | 2017 [Member] | Germany [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities acquired | Hospital | 6 | |||||||||||||
Purchase price of acquisition | € | € 8.4 | € 44.1 | ||||||||||||
Rehabilitation Hospital with Covenant Health System [Member] | 2017 [Member] | Germany [Member] | Third Master Lease [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities acquired | Hospital | 20 | 2 | 11 | |||||||||||
Acquisition costs | € | € 215.7 | € 39.2 | € 127 | |||||||||||
Number of properties closed | Property | 7 | |||||||||||||
Amount of properties closed | € | € 49.5 | |||||||||||||
Rehabilitation Hospital with Covenant Health System [Member] | 2017 [Member] | Germany [Member] | MEDIAN [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities acquired | Hospital | 3 | |||||||||||||
Acquisition costs | € | € 80 | |||||||||||||
Term of lease | 27 years | |||||||||||||
Lease agreement, end date | 2044-11 | |||||||||||||
Lease rate | 1.00% | |||||||||||||
Lease rent increase percentage | 70.00% |
Real Estate Activities - 2016 A
Real Estate Activities - 2016 Activity - Additional Information (Detail) $ in Thousands, € in Millions | Oct. 21, 2016USD ($)HospitalRenewalOption | Oct. 03, 2016USD ($)HospitalRenewalOptionFacility | Jul. 22, 2016USD ($) | May 02, 2016USD ($) | Sep. 30, 2015USD ($) | Dec. 31, 2018USD ($)Hospital | Dec. 31, 2017USD ($) | Dec. 31, 2016USD ($)Hospital | Dec. 31, 2016EUR (€)Hospital | Jun. 22, 2016EUR (€) | |
Business Acquisition [Line Items] | |||||||||||
Loans repaid | [1] | $ 764,447 | $ 193,262 | ||||||||
Mortgage financing | 50,783 | $ 717,928 | 612,836 | ||||||||
Mortgage financing funded | $ 615,764 | 310,000 | |||||||||
Capella [Member] | |||||||||||
Business Acquisition [Line Items] | |||||||||||
Loans repaid | $ 93,300 | ||||||||||
Rehabilitation Hospital with Covenant Health System [Member] | Germany [Member] | |||||||||||
Business Acquisition [Line Items] | |||||||||||
Number of facilities acquired | Hospital | 3 | ||||||||||
2016 [Member] | Olympia, Washington [Member] | Capella [Member] | |||||||||||
Business Acquisition [Line Items] | |||||||||||
Cash paid for acquisition transaction | $ 7,000 | ||||||||||
Loans repaid | $ 93,300 | ||||||||||
2016 [Member] | New Jersey [Member] | Acute Care Hospital [Member] | |||||||||||
Business Acquisition [Line Items] | |||||||||||
Acquisition costs | $ 63,000 | ||||||||||
Commitment to advance an additional amount for capital additions | $ 30,000 | ||||||||||
Commitment period to advance an additional amount for capital additions | 3 years | ||||||||||
2016 [Member] | Rehabilitation Hospital with Covenant Health System [Member] | Germany [Member] | |||||||||||
Business Acquisition [Line Items] | |||||||||||
Number of facilities acquired | Hospital | 12 | 12 | |||||||||
Acquisition costs | € | € 85.2 | ||||||||||
2016 [Member] | General Acute Care Hospital and Healthcare System [Member] | |||||||||||
Business Acquisition [Line Items] | |||||||||||
Term of lease, years | 15 years | ||||||||||
Number of lease extension options | RenewalOption | 3 | ||||||||||
Number of facilities acquired | Hospital | 3 | ||||||||||
Lease agreement, end date | 2031-05 | ||||||||||
Number of free-standing emergency department and health center | Hospital | 1 | ||||||||||
Mortgage financing | $ 100,000 | ||||||||||
Mortgage financing funded | $ 15,000 | ||||||||||
2016 [Member] | 2015 Master Lease [Member] | Rehabilitation Hospital with Covenant Health System [Member] | Germany [Member] | |||||||||||
Business Acquisition [Line Items] | |||||||||||
Number of facilities acquired | Hospital | 5 | 5 | |||||||||
Acquisition costs | € | € 35.6 | ||||||||||
2016 [Member] | Third Master Lease [Member] | Rehabilitation Hospital with Covenant Health System [Member] | Germany [Member] | |||||||||||
Business Acquisition [Line Items] | |||||||||||
Number of facilities acquired | Hospital | 7 | 7 | |||||||||
Acquisition costs | € | € 49.5 | ||||||||||
Lease agreement, end date | 2043-08 | 2043-08 | |||||||||
Term of lease | 27 years | ||||||||||
2016 [Member] | Steward [Member] | |||||||||||
Business Acquisition [Line Items] | |||||||||||
Number of hospitals closed | Hospital | 9 | ||||||||||
Combined purchase price and investment amount | $ 1,250,000 | ||||||||||
Number of licensed hospitals | Hospital | 5 | ||||||||||
Cash paid for acquisition transaction | $ 600,000 | ||||||||||
Loans repaid | 600,000 | ||||||||||
Equity interest acquired | $ 50,000 | ||||||||||
Term of lease, years | 15 years | ||||||||||
Number of lease extension options | RenewalOption | 3 | ||||||||||
Number of facilities for making mortgage loans | Facility | 4 | ||||||||||
Lease expiration date | Oct. 31, 2031 | ||||||||||
2016 [Member] | MEDIAN [Member] | |||||||||||
Business Acquisition [Line Items] | |||||||||||
Value of properties closed | € | € 41.6 | ||||||||||
[1] | The 2018 column includes $0.8 billion of loans advanced to Steward in 2016 and repaid in 2018 as part of sale leaseback conversion described below. The 2016 column includes $93.3 million of loans advanced to Capella(2) in 2015 and repaid in 2016 as a part of the Capella transaction (2), along with $100.0 million of loans advanced to Prime Healthcare Services, Inc. (“Prime”) in 2015 and repaid in 2016 as part of the sale leaseback conversion of four properties in New Jersey. |
Real Estate Activities - Develo
Real Estate Activities - Development Activities - Additional Information (Detail) € in Millions, £ in Millions, $ in Millions | Dec. 19, 2017USD ($) | Apr. 30, 2017GBP (£) | Dec. 31, 2018USD ($) | Dec. 31, 2017USD ($)Facility | Dec. 31, 2017EUR (€)Facility | Dec. 31, 2016USD ($)Facility |
Birmingham, England [Member] | ||||||
Business Acquisition [Line Items] | ||||||
Term of lease, years | 15 years | |||||
Purchase price of acquisition | £ | £ 2.7 | |||||
Total development costs anticipated | £ | £ 50 | |||||
Acute Care Hospital [Member] | Idaho Falls, ID [Member] | ||||||
Business Acquisition [Line Items] | ||||||
Estimated total development cost | $ 113.5 | |||||
Development Activities [Member] | Acute Care Facilities [Member] | ||||||
Business Acquisition [Line Items] | ||||||
Number of facilities constructed | Facility | 19 | |||||
Acquisition costs | $ 136.6 | |||||
Ernest [Member] | Development Activities [Member] | ||||||
Business Acquisition [Line Items] | ||||||
Estimated total development cost | $ 25.5 | $ 18.4 | ||||
Adeptus Health [Member] | Development Activities [Member] | Acute Care Facilities [Member] | ||||||
Business Acquisition [Line Items] | ||||||
Number of facilities constructed | Facility | 4 | 4 | ||||
Acquisition costs | $ 68 | |||||
IMED [Member] | Development Activities [Member] | Acute Care Facilities [Member] | Spain [Member] | ||||||
Business Acquisition [Line Items] | ||||||
Acquisition costs | € | € 21 | |||||
Lessor direct financing lease description | Quarterly fixed rent payments that started on October 1, 2017 with annual increases of 1% beginning April 1, 2020. | |||||
Lease rent increase percentage | 1.00% | 1.00% | ||||
Ownership interests acquired | 50.00% | 50.00% | ||||
Term of lease, years | 30 years | 30 years |
Real Estate Activities - Summar
Real Estate Activities - Summary of Status on Current Development Projects (Detail) $ in Thousands | 12 Months Ended |
Dec. 31, 2018USD ($) | |
Business Acquisition [Line Items] | |
Commitment | $ 178,261 |
Costs Incurred as of December 31, 2018 | 84,172 |
Circle Health [Member] | Birmingham, England [Member] | |
Business Acquisition [Line Items] | |
Commitment | 43,288 |
Costs Incurred as of December 31, 2018 | $ 28,881 |
Estimated Rent Commencement Date | 2Q 2019 |
Circle Health Rehabilitation [Member] | Birmingham, England [Member] | |
Business Acquisition [Line Items] | |
Commitment | $ 21,505 |
Costs Incurred as of December 31, 2018 | $ 9,081 |
Estimated Rent Commencement Date | 3Q 2019 |
Surgery Partners [Member] | Idaho Falls, ID [Member] | |
Business Acquisition [Line Items] | |
Commitment | $ 113,468 |
Costs Incurred as of December 31, 2018 | $ 46,210 |
Estimated Rent Commencement Date | 1Q 2020 |
Real Estate Activities - Dispos
Real Estate Activities - Disposals - Additional Information (Detail) $ in Thousands, € in Millions | Oct. 04, 2018USD ($) | Aug. 31, 2018USD ($)Hospital | Aug. 31, 2018EUR (€)Hospital | Jun. 04, 2018USD ($)Hospital | Mar. 01, 2018USD ($) | Mar. 31, 2017USD ($) | Dec. 31, 2018USD ($) | Dec. 31, 2017USD ($) | Dec. 31, 2016USD ($) |
Debt Instrument [Line Items] | |||||||||
Proceeds from sale of facilities | $ 64,000 | ||||||||
Gain on real estate dispositions | 7,400 | ||||||||
Gain offset by non-cash charges | $ 600 | ||||||||
Loans, Balance | $ 1,586,520 | $ 1,928,524 | |||||||
Net proceeds from sale of real estate | 1,513,666 | 64,362 | $ 198,767 | ||||||
Working Capital Loans [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Loans, Balance | 369,744 | 31,760 | |||||||
Mortgage Loans [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Loans, Balance | $ 1,213,322 | $ 1,778,316 | |||||||
Houston, Texas [Member] | Steward Health Care System LLC [Member] | St. Joseph Medical Center [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Gain on real estate dispositions | $ 1,500 | ||||||||
Gain offset by non-cash charges | 1,700 | ||||||||
Net proceeds from sale of real estate | $ 148,000 | ||||||||
Primotop Holdings S.a.r.l. [Member] | Germany [Member] | Acute Care Hospital [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Proceeds from sale of facilities | € | € 1,635 | ||||||||
Number of properties sold | Hospital | 71 | 71 | |||||||
Gain on real estate dispositions | $ 500 | ||||||||
Ernest [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Proceeds from sale of facilities | $ 176,000 | ||||||||
North Cypress [Member] | Houston, Texas [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Proceeds from sale of facilities | 148,000 | ||||||||
Gain on real estate dispositions | 102,400 | ||||||||
Gain offset by non-cash charges | $ 2,500 | ||||||||
North Cypress [Member] | General Acute Care Hospital and Healthcare System [Member] | Houston, Texas [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Number of properties sold | Hospital | 1 | 1 | |||||||
Vibra Healthcare, LLC [Member] | California, Texas, and Oregon [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Proceeds from sale of facilities | $ 53,300 | ||||||||
Gain on real estate dispositions | 24,200 | ||||||||
Gain offset by non-cash charges | 5,100 | ||||||||
Vibra Healthcare, LLC [Member] | California, Texas, and Oregon [Member] | Working Capital Loans [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Loans, Balance | 1,500 | ||||||||
Vibra Healthcare, LLC [Member] | California, Texas, and Oregon [Member] | Mortgage Loans [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Loans, Balance | $ 18,300 | ||||||||
Vibra Healthcare, LLC [Member] | California, Texas, and Oregon [Member] | Long-term Acute Care Hospital [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Number of properties sold | Hospital | 3 |
Real Estate Activities - Summ_2
Real Estate Activities - Summary of Operations for Disposed Assets (Detail) - USD ($) $ in Thousands | 12 Months Ended | |||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | ||
2018 [Member] | ||||
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items] | ||||
Revenues | $ 88,838 | $ 132,039 | $ 109,544 | |
Real estate depreciation and amortization | (15,849) | (31,870) | (26,410) | |
Property-related expenses | (531) | (404) | (45) | |
Other income (expense) | [1] | 709,717 | (14,168) | (23,937) |
Income from real estate dispositions, net | $ 782,175 | $ 85,597 | 59,152 | |
2016 [Member] | ||||
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items] | ||||
Revenues | 8,350 | |||
Real estate depreciation and amortization | (2,870) | |||
Property-related expenses | (113) | |||
Other income (expense) | [2] | 60,283 | ||
Income from real estate dispositions, net | $ 65,650 | |||
[1] | Includes approximately $720 million of gains on sale for the twelve months ended December 31, 2018. | |||
[2] | Includes approximately $60 million of net gains on sale for the year ended December 31, 2016. |
Real Estate Activities - Summ_3
Real Estate Activities - Summary of Operations for Disposed Assets (Parenthetical) (Detail) € in Millions, $ in Millions | Mar. 31, 2017USD ($) | Aug. 31, 2018EUR (€) | Dec. 31, 2018USD ($) | Dec. 31, 2016USD ($) |
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items] | ||||
Gain on sale of real estate | $ 7.4 | |||
2018 [Member] | Germany [Member] | Acute Care Hospital [Member] | ||||
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items] | ||||
Gain on sale of real estate | € 500 | $ 720 | ||
2016 [Member] | ||||
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items] | ||||
Gain on sale of real estate | $ 60 |
Real Estate Activities - Capell
Real Estate Activities - Capella Transaction - Additional Information (Detail) $ in Thousands | Apr. 30, 2016USD ($)Hospital | Dec. 31, 2018USD ($) | Dec. 31, 2017USD ($) | Dec. 31, 2016USD ($) |
Business Acquisition [Line Items] | ||||
New loan for hospital property | $ 50,783 | $ 717,928 | $ 612,836 | |
Capella [Member] | ||||
Business Acquisition [Line Items] | ||||
Net proceeds from transaction | $ 550,000 | |||
Net proceeds from equity investment and loans | 492,000 | |||
Proceeds from prepayment of mortgage loans | 210,000 | |||
New loan for hospital property | 93,300 | |||
Investment on unsecured senior notes | 50,000 | |||
Transaction costs incurred | $ 6,300 | |||
Number of hospital owned | Hospital | 5 | |||
Write off of unbilled direct finance lease rent | $ 2,600 | |||
Capella [Member] | Master Lease [Member] | ||||
Business Acquisition [Line Items] | ||||
Term of lease, years | 13 years 6 months | |||
Capella [Member] | Other Stand-Alone Lease [Member] | ||||
Business Acquisition [Line Items] | ||||
Term of lease, years | 11 years 6 months |
Real Estate Activities - Post A
Real Estate Activities - Post Acute Transaction - Additional Information (Detail) $ in Millions | Mar. 31, 2017USD ($) | Jun. 17, 2016USD ($) | May 23, 2016USD ($)Property |
Business Acquisition [Line Items] | |||
Proceeds from sale of real estate | $ 64 | ||
Gain on real estate dispositions | $ 7.4 | ||
Post Acute [Member] | |||
Business Acquisition [Line Items] | |||
Number of properties sold | Property | 5 | ||
Outstanding loans paid in full | $ 4 | ||
Proceeds from sale of real estate | $ 28 | 71 | |
Gain on real estate dispositions | $ 15 | ||
Post Acute [Member] | Texas [Member] | |||
Business Acquisition [Line Items] | |||
Number of properties sold | Property | 3 | ||
Post Acute [Member] | Louisiana [Member] | |||
Business Acquisition [Line Items] | |||
Number of properties sold | Property | 2 |
Real Estate Activities - Corint
Real Estate Activities - Corinth Transaction - Additional Information (Detail) - USD ($) $ in Millions | Mar. 31, 2017 | Jun. 17, 2016 | May 23, 2016 |
Proceeds from sale of real estate | $ 64 | ||
Gain offset by non-cash charges | $ 0.6 | ||
Post Acute [Member] | |||
Proceeds from sale of real estate | $ 28 | $ 71 | |
Gain on sale of real estate | 8 | ||
Post Acute [Member] | Texas [Member] | |||
Gain offset by non-cash charges | $ 9 |
Real Estate Activities - Health
Real Estate Activities - HealthSouth Transaction - Additional Information (Detail) $ in Millions | Mar. 31, 2017USD ($) | Jul. 20, 2016USD ($)Hospital |
Proceeds from sale of facilities | $ 64 | |
Gain on real estate dispositions | $ 7.4 | |
Encompass Health [Member] | ||
Proceeds from sale of facilities | $ 111.5 | |
Gain on real estate dispositions | $ 45 | |
Encompass Health [Member] | Texas [Member] | ||
Number of hospitals sold | Hospital | 3 |
Real Estate Activities - Intang
Real Estate Activities - Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Business Combinations [Abstract] | |||
Intangible lease assets | $ 403,138 | $ 443,134 | |
Accumulated amortization, net | 352,500 | 394,000 | |
Amortization expense related to intangible lease assets | $ 17,600 | $ 15,800 | $ 13,400 |
Capitalized lease intangibles, weighted average life (in years) | 26 years |
Real Estate Activities - Amorti
Real Estate Activities - Amortization Expense from Existing Lease Intangible Assets (Detail) $ in Thousands | Dec. 31, 2018USD ($) |
Business Combinations [Abstract] | |
2,019 | $ 16,687 |
2,020 | 16,507 |
2,021 | 16,493 |
2,022 | 16,479 |
2,023 | $ 16,413 |
Real Estate Activities - Leasin
Real Estate Activities - Leasing Operations - Additional Information (Detail) | 12 Months Ended |
Dec. 31, 2018Lease | |
Alecto Healthcare Services [Member] | |
Business Acquisition [Line Items] | |
Number of direct financing leases | 2 |
Ernest [Member] | |
Business Acquisition [Line Items] | |
Number of direct financing leases | 15 |
Prime Facilities [Member] | |
Business Acquisition [Line Items] | |
Number of direct financing leases | 10 |
Real Estate Activities - Compon
Real Estate Activities - Components of Net Investment in Direct Financing Leases (Detail) - USD ($) $ in Thousands | Dec. 31, 2018 | Dec. 31, 2017 |
Business Combinations [Abstract] | ||
Minimum lease payments receivable | $ 2,091,504 | $ 2,294,081 |
Estimated residual values | 424,719 | 448,339 |
Less unearned income | (1,832,170) | (2,043,693) |
Net investment in direct financing leases | $ 684,053 | $ 698,727 |
Real Estate Activities - Minimu
Real Estate Activities - Minimum Rental Payments Due over the Remaining Lease Term under Operating Leases (Detail) $ in Thousands | Dec. 31, 2018USD ($) |
Leases User Charges And Commitments [Line Items] | |
2,019 | $ 6,602 |
2,020 | 6,903 |
2,021 | 6,841 |
2,022 | 6,838 |
2,023 | 6,861 |
Thereafter | 198,932 |
Minimum rental payments, total | 232,977 |
Minimum [Member] | |
Leases User Charges And Commitments [Line Items] | |
2,019 | 498,513 |
2,020 | 503,295 |
2,021 | 513,193 |
2,022 | 519,539 |
2,023 | 528,058 |
Thereafter | 11,156,465 |
Minimum rental payments, total | 13,719,063 |
Minimum [Member] | Operating Leases [Member] | |
Leases User Charges And Commitments [Line Items] | |
2,019 | 433,542 |
2,020 | 437,025 |
2,021 | 445,598 |
2,022 | 450,592 |
2,023 | 457,732 |
Thereafter | 9,612,430 |
Minimum rental payments, total | 11,836,919 |
Minimum [Member] | Direct Financing Leases [Member] | |
Leases User Charges And Commitments [Line Items] | |
2,019 | 64,971 |
2,020 | 66,270 |
2,021 | 67,595 |
2,022 | 68,947 |
2,023 | 70,326 |
Thereafter | 1,544,035 |
Minimum rental payments, total | $ 1,882,144 |
Real Estate Activities - Adeptu
Real Estate Activities - Adeptus Health - Additional Information (Detail) $ in Thousands | Dec. 31, 2018Property | Dec. 07, 2017USD ($)Lease | Oct. 18, 2017RenewalOption | Oct. 02, 2017Facility | Mar. 31, 2017USD ($) | Oct. 31, 2018Facility | Aug. 31, 2018Facility | Dec. 31, 2018USD ($)Facility | Dec. 31, 2017USD ($) | Dec. 31, 2016USD ($) | Apr. 04, 2017USD ($) |
Business Acquisition [Line Items] | |||||||||||
Real estate impairment charge | $ 18,002 | $ 5,340 | $ 3,063 | ||||||||
Gain offset by non-cash charges | $ 600 | ||||||||||
Colorado [Member] | University of Colorado Hospital [Member] | |||||||||||
Business Acquisition [Line Items] | |||||||||||
Number of leased properties | Lease | 11 | ||||||||||
Total budgeted investment | $ 60,000 | ||||||||||
Term of lease, years | 15 years | ||||||||||
Number of lease extension options | Lease | 3 | ||||||||||
Term of lease extension, years | 5 years | ||||||||||
Lease rent increase percentage | 2.00% | ||||||||||
Louisiana [Member] | Ochsner [Member] | |||||||||||
Business Acquisition [Line Items] | |||||||||||
Total budgeted investment | $ 25,000 | ||||||||||
Term of lease, years | 15 years | ||||||||||
Number of lease extension options | RenewalOption | 3 | ||||||||||
Term of lease extension, years | 5 years | ||||||||||
Gain offset by non-cash charges | 500 | ||||||||||
Average minimum lease rate on development and construction cost | 9.20% | ||||||||||
Adeptus Health [Member] | |||||||||||
Business Acquisition [Line Items] | |||||||||||
Number of properties closed | Property | 14 | ||||||||||
Amortization of straight line rent receivables, reduction in rent revenue | $ 6,100 | ||||||||||
Number of facilities transitioned | Facility | 16 | ||||||||||
Number of properties re-leased | Facility | 5 | 3 | |||||||||
Number of transitioned facilities not re-leased | Facility | 7 | ||||||||||
Percentage of investment in remaining transition facilities on total assets | 0.50% | ||||||||||
Real estate impairment charge | $ 18,000 |
Real Estate Activities - Gilber
Real Estate Activities - Gilbert and Florence Facilities - Additional Information (Detail) - USD ($) $ in Millions | Mar. 31, 2017 | Dec. 31, 2018 |
Business Acquisition [Line Items] | ||
Gain offset by non-cash charges | $ 0.6 | |
Gilbert and Florence Facilities [Member] | ||
Business Acquisition [Line Items] | ||
Gain offset by non-cash charges | $ 1.1 | |
Gilbert and Florence Facilities [Member] | Total Gross Assets [Member] | Credit Concentration Risk [Member] | ||
Business Acquisition [Line Items] | ||
Percentage of Total Gross Assets | 0.20% |
Real Estate Activities - Alecto
Real Estate Activities - Alecto Healthcare facilities - Additional Information (Detail) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2018USD ($)Property | Dec. 31, 2017USD ($) | Dec. 31, 2016USD ($) | |
Business Acquisition [Line Items] | |||
Real estate impairment charge | $ 18,002 | $ 5,340 | $ 3,063 |
Alecto Healthcare Services [Member] | |||
Business Acquisition [Line Items] | |||
Number of leased properties | Property | 4 | ||
Real estate impairment charge | $ 30,000 | ||
Alecto Healthcare Services [Member] | Total Gross Assets [Member] | Customer Concentration Risk | |||
Business Acquisition [Line Items] | |||
Percentage of Total Gross Assets | 1.00% |
Real Estate Activities - Summ_4
Real Estate Activities - Summary of Loans (Detail) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2018 | Dec. 31, 2017 | |
Loans [Line Items] | ||
Loans, Balance | $ 1,586,520 | $ 1,928,524 |
Mortgage Loans [Member] | ||
Loans [Line Items] | ||
Loans, Balance | $ 1,213,322 | $ 1,778,316 |
Loans, Weighted Average Interest Rate | 8.80% | 8.30% |
Acquisition Loans [Member] | ||
Loans [Line Items] | ||
Loans, Balance | $ 3,454 | $ 118,448 |
Loans, Weighted Average Interest Rate | 10.80% | 13.80% |
Working Capital and Other Loans [Member] | ||
Loans [Line Items] | ||
Loans, Balance | $ 369,744 | $ 31,760 |
Loans, Weighted Average Interest Rate | 5.40% | 7.60% |
Real Estate Activities - Loans
Real Estate Activities - Loans - Additional Information (Detail) $ in Thousands | Dec. 31, 2018USD ($)PropertyOperator |
Primotop Holdings S.a.r.l. [Member] | |
Business Acquisition [Line Items] | |
Shareholder loan to joint venture | $ | $ 290 |
Mortgage Loans [Member] | Steward [Member] | |
Business Acquisition [Line Items] | |
Number of Real Estate Properties | Property | 10 |
Number Of Operators | Operator | 4 |
Real Estate Activities - Concen
Real Estate Activities - Concentration of Credit Risks and Related Party Transactions - Additional Information (Detail) $ in Millions | 12 Months Ended | ||
Dec. 31, 2018USD ($)Investment | Dec. 31, 2017USD ($)Investment | Dec. 31, 2016USD ($) | |
Related Party Transactions [Member] | |||
Business Acquisition [Line Items] | |||
Lease and interest revenue earned from tenants | $ | $ 501.4 | $ 422.4 | $ 282.9 |
Total Gross Assets [Member] | Geographic Concentration [Member] | U.S. [Member] | |||
Business Acquisition [Line Items] | |||
Percentage of revenue from affiliates of total revenue | 80.00% | 80.00% | |
Total Gross Assets [Member] | Geographic Concentration [Member] | Europe [Member] | |||
Business Acquisition [Line Items] | |||
Percentage of revenue from affiliates of total revenue | 20.00% | 20.00% | |
Revenue [Member] | Credit Concentration Risk [Member] | Steward [Member] | |||
Business Acquisition [Line Items] | |||
Percentage of revenue from affiliates of total revenue | 39.00% | 27.00% | |
Revenue [Member] | Credit Concentration Risk [Member] | Prime [Member] | |||
Business Acquisition [Line Items] | |||
Percentage of revenue from affiliates of total revenue | 16.00% | 18.00% | |
Revenue [Member] | Credit Concentration Risk [Member] | MEDIAN [Member] | |||
Business Acquisition [Line Items] | |||
Percentage of revenue from affiliates of total revenue | 13.00% | 14.00% | |
Revenue [Member] | Credit Concentration Risk [Member] | Ernest [Member] | |||
Business Acquisition [Line Items] | |||
Percentage of revenue from affiliates of total revenue | 8.00% | 10.00% | |
Revenue [Member] | Customer Concentration Risk [Member] | General Acute Care Hospital and Healthcare System [Member] | |||
Business Acquisition [Line Items] | |||
Percentage of revenue from affiliates of total revenue | 76.00% | 69.00% | |
Revenue [Member] | Customer Concentration Risk [Member] | Rehabilitation Hospital with Covenant Health System [Member] | |||
Business Acquisition [Line Items] | |||
Percentage of revenue from affiliates of total revenue | 20.00% | 25.00% | |
Revenue [Member] | Customer Concentration Risk [Member] | Long-term Acute Care Hospital [Member] | |||
Business Acquisition [Line Items] | |||
Percentage of revenue from affiliates of total revenue | 4.00% | 6.00% | |
Pro Forma [Member] | Total Gross Assets [Member] | Customer Concentration Risk [Member] | |||
Business Acquisition [Line Items] | |||
Number of investment in property | Investment | 0 | 0 | |
Maximum percentage of entity's assets invested on single property | 4.20% | 4.20% |
Debt - Summary of Debt (Detail)
Debt - Summary of Debt (Detail) - USD ($) $ in Thousands | Dec. 31, 2018 | Dec. 31, 2017 | |
Debt Instrument [Line Items] | |||
Debt | $ 4,074,759 | ||
Debt issue costs, net | (37,370) | $ (42,643) | |
Debt, net | 4,037,389 | 4,898,667 | |
Revolving Credit Facility [Member] | |||
Debt Instrument [Line Items] | |||
Debt | [1] | 28,059 | 840,810 |
Term Loans [Member] | |||
Debt Instrument [Line Items] | |||
Debt | 200,000 | 200,000 | |
4.000% Senior Unsecured Notes due 2022 [Member] | |||
Debt Instrument [Line Items] | |||
Debt | [2] | 573,350 | 600,250 |
5.500% Senior Unsecured Notes Due 2024 [Member] | |||
Debt Instrument [Line Items] | |||
Debt | 300,000 | 300,000 | |
6.375% Senior Unsecured Notes due 2024 [Member] | |||
Debt Instrument [Line Items] | |||
Debt | 500,000 | 500,000 | |
3.325% Senior Unsecured Notes Due 2025 [Member] | |||
Debt Instrument [Line Items] | |||
Debt | [2] | 573,350 | 600,250 |
5.250% Senior Unsecured Notes Due 2026 [Member] | |||
Debt Instrument [Line Items] | |||
Debt | 500,000 | 500,000 | |
5.000% Senior Unsecured Notes Due 2027 [Member] | |||
Debt Instrument [Line Items] | |||
Debt | 1,400,000 | 1,400,000 | |
Senior Unsecured Debt [Member] | |||
Debt Instrument [Line Items] | |||
Debt | $ 4,074,759 | $ 4,941,310 | |
[1] | Includes £22 million and £8 million of GBP-denominated borrowings that reflect the exchange rate at December 31, 2018 and December 31, 2017, respectively. | ||
[2] | These notes are Euro-denominated and reflect the exchange rate at December 31, 2018 and December 31, 2017, respectively. |
Debt - Summary of Debt (Parenth
Debt - Summary of Debt (Parenthetical) (Detail) $ in Thousands, £ in Millions | Dec. 31, 2018USD ($) | Dec. 31, 2018GBP (£) | Dec. 31, 2017USD ($) | Dec. 31, 2017GBP (£) | Sep. 07, 2017 | Mar. 24, 2017 | Apr. 17, 2014 | |
Debt Instrument [Line Items] | ||||||||
Debt | $ 4,074,759 | |||||||
4.000% Senior Unsecured Notes due 2022 [Member] | ||||||||
Debt Instrument [Line Items] | ||||||||
Senior unsecured notes, interest rate | 4.00% | 4.00% | 4.00% | 4.00% | ||||
Debt | [1] | $ 573,350 | $ 600,250 | |||||
5.500% Senior Unsecured Notes Due 2024 [Member] | ||||||||
Debt Instrument [Line Items] | ||||||||
Senior unsecured notes, interest rate | 5.50% | 5.50% | 5.50% | 5.50% | 5.50% | |||
Debt | $ 300,000 | $ 300,000 | ||||||
6.375% Senior Unsecured Notes due 2024 [Member] | ||||||||
Debt Instrument [Line Items] | ||||||||
Senior unsecured notes, interest rate | 6.375% | 6.375% | 6.375% | 6.375% | ||||
Debt | $ 500,000 | $ 500,000 | ||||||
3.325% Senior Unsecured Notes Due 2025 [Member] | ||||||||
Debt Instrument [Line Items] | ||||||||
Senior unsecured notes, interest rate | 3.325% | 3.325% | 3.325% | 3.325% | 3.325% | |||
Debt | [1] | $ 573,350 | $ 600,250 | |||||
5.250% Senior Unsecured Notes Due 2026 [Member] | ||||||||
Debt Instrument [Line Items] | ||||||||
Senior unsecured notes, interest rate | 5.25% | 5.25% | 5.25% | 5.25% | ||||
Debt | $ 500,000 | $ 500,000 | ||||||
5.000% Senior Unsecured Notes Due 2027 [Member] | ||||||||
Debt Instrument [Line Items] | ||||||||
Senior unsecured notes, interest rate | 5.00% | 5.00% | 5.00% | 5.00% | 5.00% | |||
Debt | $ 1,400,000 | $ 1,400,000 | ||||||
GBP-denominated Borrowings [Member] | ||||||||
Debt Instrument [Line Items] | ||||||||
Debt | £ | £ 22 | £ 8 | ||||||
[1] | These notes are Euro-denominated and reflect the exchange rate at December 31, 2018 and December 31, 2017, respectively. |
Debt - Principal Payments Due f
Debt - Principal Payments Due for Debt (Detail) $ in Thousands | Dec. 31, 2018USD ($) |
Debt Disclosure [Abstract] | |
2,019 | $ 0 |
2,020 | 0 |
2,021 | 28,059 |
2,022 | 773,350 |
2,023 | 0 |
Thereafter | 3,273,350 |
Total | $ 4,074,759 |
Debt - Credit Facility - Additi
Debt - Credit Facility - Additional Information (Detail) € in Millions | Feb. 01, 2017USD ($) | Dec. 31, 2018USD ($) | Dec. 31, 2017USD ($) | Feb. 01, 2017EUR (€) |
Debt Instrument [Line Items] | ||||
Aggregate committed amount of credit facility | $ 500,000,000 | |||
Minimum [Member] | ||||
Debt Instrument [Line Items] | ||||
Commitment fee | 0.125% | |||
Maximum [Member] | ||||
Debt Instrument [Line Items] | ||||
Commitment fee | 0.30% | |||
Unsecured Revolving Credit Facility [Member] | ||||
Debt Instrument [Line Items] | ||||
Amount of senior unsecured debt | $ 1,300,000,000 | |||
Debt instrument, maturity date | Feb. 28, 2021 | |||
Aggregate committed amount of credit facility | $ 1,270,000,000 | |||
Credit facilities, amount outstanding | $ 28,100,000 | $ 840,800,000 | ||
Credit facilities, weighted average interest rate | 2.70% | 2.40% | ||
Term Loans [Member] | ||||
Debt Instrument [Line Items] | ||||
Amount of senior unsecured debt | $ 200,000,000 | € 200 | ||
Debt instrument, maturity date | Feb. 1, 2022 | |||
Decrease in unsecured debt from previous facility | $ 50,000,000 | |||
Aggregate committed amount of credit facility | $ 1,000,000,000 | |||
Interest rate at end of period | 3.89% | 2.98% | ||
Alternate Base Rate [Member] | Minimum [Member] | ||||
Debt Instrument [Line Items] | ||||
Applicable margin | 0.00% | |||
Applicable margin for revolving loans | 0.00% | |||
Alternate Base Rate [Member] | Maximum [Member] | ||||
Debt Instrument [Line Items] | ||||
Applicable margin | 0.95% | |||
Applicable margin for revolving loans | 0.65% | |||
Eurodollar Loans [Member] | Minimum [Member] | ||||
Debt Instrument [Line Items] | ||||
Applicable margin | 0.90% | |||
Applicable margin for revolving loans | 0.875% | |||
Eurodollar Loans [Member] | Maximum [Member] | ||||
Debt Instrument [Line Items] | ||||
Applicable margin | 1.95% | |||
Applicable margin for revolving loans | 1.65% | |||
Euro [Member] | Term Loans [Member] | ||||
Debt Instrument [Line Items] | ||||
Debt instrument, maturity date | Jan. 31, 2020 |
Debt - 4.000% Senior Unsecured
Debt - 4.000% Senior Unsecured Notes Due 2022 - Additional Information (Detail) - 4.000% Senior Unsecured Notes Due 2022 [Member] - EUR (€) | Aug. 19, 2015 | Dec. 31, 2018 |
Debt Instrument [Line Items] | ||
Senior unsecured notes face amount | € 500,000,000 | |
Senior unsecured notes, interest rate | 4.00% | |
Senior unsecured notes, payable term | Interest on the notes is payable annually on August 19 of each year. | |
Senior unsecured notes, maturity date | Aug. 19, 2022 | |
Senior unsecured notes, redemption period | 90 days | |
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest | 101.00% | |
Senior unsecured notes, redemption description | Notes are redeemed prior to 90 days before maturity, the redemption price will be 100% of their principal amount, plus a make-whole premium, plus accrued and unpaid interest to, but excluding, the applicable redemption date. Within the period beginning on or after 90 days before maturity, the notes may be redeemed, in whole or in part, at a redemption price equal to 100% of their principal amount, plus accrued and unpaid interest to, but excluding, the applicable redemption date. The 4.000% Senior Unsecured Notes due 2022 are fully and unconditionally guaranteed on an unsecured basis by us. In the event of a change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of the purchase. | |
Redeemed Prior to 90 Days [Member] | ||
Debt Instrument [Line Items] | ||
Senior unsecured notes, redemption price percentage | 100.00% | |
Redeemed Beginning on or After 90 Days [Member] | ||
Debt Instrument [Line Items] | ||
Senior unsecured notes, redemption price percentage | 100.00% |
Debt - 5.500% Senior Unsecured
Debt - 5.500% Senior Unsecured Notes Due 2024 - Additional Information (Detail) - 5.500% Senior Unsecured Notes Due 2024 [Member] - USD ($) | Apr. 17, 2014 | Dec. 31, 2018 | Dec. 31, 2017 |
Debt Instrument [Line Items] | |||
Senior unsecured notes face amount | $ 300,000,000 | ||
Senior unsecured notes, interest rate | 5.50% | 5.50% | 5.50% |
Senior unsecured notes, payable term | Interest on the notes is payable semi-annually on May 1 and November 1 of each year. | ||
Senior unsecured notes, maturity date | May 1, 2024 | ||
Senior notes, earliest redemption date | May 1, 2019 | ||
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest | 101.00% | ||
Senior unsecured notes, redemption description | We may redeem some or all of the notes at any time prior to May 1, 2019 at a “make-whole” redemption price. On or after May 1, 2019, we may redeem some or all of the notes at a premium that will decrease over time. In the event of a change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase. |
Debt - 6.375% Senior Unsecured
Debt - 6.375% Senior Unsecured Notes Due 2024 - Additional Information (Detail) - 6.375% Senior Unsecured Notes due 2024 [Member] - USD ($) | Feb. 22, 2016 | Dec. 31, 2018 | Dec. 31, 2017 |
Debt Instrument [Line Items] | |||
Senior unsecured notes, interest rate | 6.375% | 6.375% | |
Revolving Credit Facility [Member] | |||
Debt Instrument [Line Items] | |||
Senior unsecured notes face amount | $ 500,000,000 | ||
Senior unsecured notes, maturity date | Mar. 1, 2024 | ||
Senior unsecured notes, interest rate | 6.375% | ||
Debt instrument, redemption price percentage | 106.375% | ||
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest | 101.00% | ||
Senior unsecured notes, payable term | Interest on the notes is payable on March 1 and September 1 of each year. | ||
Senior notes, earliest redemption date | Mar. 1, 2019 | ||
Senior unsecured notes, redemption description | We may redeem up to 35% of the notes at a redemption price equal to 106.375% of the aggregate principal amount thereof, plus accrued and unpaid interest thereon, using proceeds from one or more equity offerings. In the event of a change in control, each holder of the notes may require us to repurchase some or all of the notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase. | ||
Maximum [Member] | Revolving Credit Facility [Member] | |||
Debt Instrument [Line Items] | |||
Senior unsecured notes, redemption percentage on principal amount | 35.00% |
Debt - 3.325% Senior Unsecured
Debt - 3.325% Senior Unsecured Notes Due 2025 - Additional Information (Detail) - 3.325% Senior Unsecured Notes Due 2025 [Member] - EUR (€) | Mar. 24, 2017 | Dec. 31, 2018 | Dec. 31, 2017 |
Debt Instrument [Line Items] | |||
Senior unsecured notes face amount | € 500,000,000 | ||
Senior unsecured notes, interest rate | 3.325% | 3.325% | 3.325% |
Senior unsecured notes, payable term | Interest on the notes is payable annually on March 24 of each year. | ||
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest | 101.00% | ||
Senior unsecured notes, maturity date | Mar. 24, 2025 | ||
Senior unsecured notes, redemption period | 90 days | ||
Senior unsecured notes, redemption description | Notes are redeemed prior to 90 days before maturity, the redemption price will be equal to 100% of their principal amount, plus a make-whole premium, plus accrued and unpaid interest up to, but excluding, the applicable redemption date. Within the period beginning on or after 90 days before maturity, the notes may be redeemed, in whole or in part, at a redemption price equal to 100% of their principal amount, plus accrued and unpaid interest to, but excluding, the applicable redemption date. The 3.325% Senior Unsecured Notes due 2025 are fully and unconditionally guaranteed on a senior unsecured basis by us. In the event of a change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest up to, but excluding, the date of the purchase. | ||
Redeemed Prior to 90 Days [Member] | |||
Debt Instrument [Line Items] | |||
Senior unsecured notes, redemption price percentage | 100.00% | ||
Redeemed Beginning on or After 90 Days [Member] | |||
Debt Instrument [Line Items] | |||
Senior unsecured notes, redemption price percentage | 100.00% |
Debt - 5.250% Senior Unsecured
Debt - 5.250% Senior Unsecured Notes Due 2026 - Additional Information (Detail) - 5.250% Senior Unsecured Notes Due 2026 [Member] - USD ($) | Jul. 22, 2016 | Dec. 31, 2018 | Dec. 31, 2017 |
Debt Instrument [Line Items] | |||
Senior unsecured notes, interest rate | 5.25% | 5.25% | |
Revolving Credit Facility [Member] | |||
Debt Instrument [Line Items] | |||
Senior unsecured notes face amount | $ 500,000,000 | ||
Senior unsecured notes, payable term | Interest on the notes is payable on February 1 and August 1 of each year. | ||
Senior unsecured notes, interest rate | 5.25% | ||
Senior unsecured notes, maturity date | Aug. 1, 2026 | ||
Senior notes, earliest redemption date | Aug. 1, 2021 | ||
Senior unsecured notes, redemption description | We may redeem some or all of the notes at any time prior to August 1, 2021 at a “make whole” redemption price. On or after August 1, 2021, we may redeem some or all of the notes at a premium that will decrease over time. In addition, at any time prior to August 1, 2019, we may redeem up to 35% of the notes at a redemption price equal to 105.250% of the aggregate principal amount thereof, plus accrued and unpaid interest thereon, using proceeds from one or more equity offerings. In the event of a change in control, each holder of the notes may require us to repurchase some or all of the notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase. | ||
Debt instrument, redemption price percentage | 105.25% | ||
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest | 101.00% | ||
Revolving Credit Facility [Member] | Maximum [Member] | |||
Debt Instrument [Line Items] | |||
Senior unsecured notes, redemption percentage on principal amount | 35.00% |
Debt - 5.000% Senior Unsecured
Debt - 5.000% Senior Unsecured Notes Due 2027 - Additional Information (Detail) - USD ($) | Sep. 07, 2017 | Feb. 01, 2017 | Jul. 22, 2016 | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 |
Debt Instrument [Line Items] | ||||||
Debt refinancing costs | $ 32,574,000 | $ 22,539,000 | ||||
Aggregate committed amount of credit facility | $ 500,000,000 | |||||
Term Loans [Member] | ||||||
Debt Instrument [Line Items] | ||||||
Senior unsecured notes, maturity date | Feb. 1, 2022 | |||||
Debt refinancing costs | 32,600,000 | |||||
Aggregate committed amount of credit facility | $ 1,000,000,000 | |||||
Term Loans [Member] | J P Morgan Chase Bank [Member] | ||||||
Debt Instrument [Line Items] | ||||||
Cancellation of loan | $ 1,000,000,000 | |||||
5.000% Senior Unsecured Notes Due 2027 [Member] | ||||||
Debt Instrument [Line Items] | ||||||
Senior unsecured notes face amount | $ 1,400,000,000 | |||||
Senior unsecured notes, payable term | Interest on the notes is payable on April 15 and October 15 of each year | |||||
Senior unsecured notes, interest rate | 5.00% | 5.00% | 5.00% | |||
Senior unsecured notes, maturity date | Oct. 15, 2027 | |||||
Senior notes, earliest redemption date | Oct. 15, 2022 | |||||
Senior unsecured notes, redemption description | We may redeem up to 40% of the notes at a redemption price equal to 105% of the aggregate principal amount thereof, plus accrued and unpaid interest thereon, using proceeds from one or more equity offerings. In the event of a change in control, each holder of the notes may require us to repurchase some or all of the notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase. | |||||
Debt instrument, redemption price percentage | 105.00% | |||||
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest | 101.00% | |||||
5.000% Senior Unsecured Notes Due 2027 [Member] | Maximum [Member] | ||||||
Debt Instrument [Line Items] | ||||||
Senior unsecured notes, redemption percentage on principal amount | 40.00% | |||||
6.875% Senior Unsecured Notes Due 2021 [Member] | ||||||
Debt Instrument [Line Items] | ||||||
Debt refinancing costs | $ 22,500,000 | |||||
Note redeemed | 450,000,000 | |||||
Redemption Premium | $ 15,500,000 |
Debt - Additional Information (
Debt - Additional Information (Detail) - Primotop Holdings S.a.r.l. [Member] - Germany [Member] - Acute Care Hospital [Member] € in Millions | Aug. 31, 2018Hospital | Aug. 03, 2018EUR (€) |
Debt Instrument [Line Items] | ||
Proceeds from issuance of new secured debt | € | € 655 | |
Secured Debt [Member] | ||
Debt Instrument [Line Items] | ||
Number of facilities acquired | Hospital | 71 | |
Debt instrument term | 7 years | |
Debt instrument swapped fixed rate | 2.30% |
Debt - Term Loan - Northland Mo
Debt - Term Loan - Northland Mortgage - Additional Information (Detail) - Mortgage Loans [Member] - Northland LTACH Hospital [Member] - USD ($) $ in Millions | Sep. 29, 2017 | Feb. 14, 2011 | Dec. 31, 2018 |
Debt Instrument [Line Items] | |||
Liabilities acquired | $ 14.6 | ||
Amortization period | 30 years | ||
Interest rate | 6.20% | ||
Debt instrument, maturity date | Jan. 1, 2018 | ||
Term of loan to pay without penalty | 120 days | ||
Prepayment of mortgage loans | $ 12.9 |
Debt - 6.375% Senior Unsecure_2
Debt - 6.375% Senior Unsecured Notes Due 2022 - Additional Information (Detail) - 6.375% Senior Unsecured Notes Due 2022 [Member] - USD ($) | Oct. 07, 2017 | Aug. 20, 2013 | Feb. 17, 2012 |
Debt Instrument [Line Items] | |||
Senior unsecured notes face amount | $ 150,000,000 | $ 200,000,000 | |
Senior unsecured notes, interest rate | 6.375% | ||
Senior unsecured notes, maturity date | Feb. 15, 2022 | ||
Debt instrument redemption price | 102.00% | ||
Debt instrument effective rate | 5.998% | ||
Redemption Premium | $ 11,200,000 |
Debt - 5.750% Senior Unsecured
Debt - 5.750% Senior Unsecured Notes Due 2020 - Additional Information (Detail) - 5.750% Senior Unsecured Notes Due 2020 [Member] € in Millions, $ in Millions | Mar. 04, 2017USD ($) | Mar. 04, 2017EUR (€) | Oct. 10, 2013EUR (€) | Dec. 31, 2018 |
Debt Instrument [Line Items] | ||||
Senior unsecured notes, value of offering | € 200 | |||
Senior unsecured notes, interest rate | 5.75% | 5.75% | 5.75% | |
Debt instrument, maturity date | Oct. 1, 2020 | |||
Senior notes, redemption date | Mar. 4, 2017 | Mar. 4, 2017 | ||
Amount of senior unsecured debt redeemed | € 200 | |||
Senior unsecured notes, redemption description | We redeemed the €200 million aggregate principal amount of our 5.750% Senior Unsecured Notes due 2020 and incurred a redemption premium of approximately $9 million. | |||
Redemption Premium | $ | $ 9 |
Debt - Other - Additional Infor
Debt - Other - Additional Information (Detail) - USD ($) | 12 Months Ended | ||
Dec. 31, 2017 | Dec. 31, 2016 | Feb. 01, 2017 | |
Debt Instrument [Line Items] | |||
Aggregate committed amount of credit facility | $ 500,000,000 | ||
Debt refinancing costs | $ 32,574,000 | $ 22,539,000 | |
Term Loans [Member] | |||
Debt Instrument [Line Items] | |||
Aggregate committed amount of credit facility | 1,000,000,000 | ||
Debt refinancing costs | $ 32,600,000 |
Debt - Covenants - Additional I
Debt - Covenants - Additional Information (Detail) | 12 Months Ended |
Dec. 31, 2018 | |
Debt Disclosure [Abstract] | |
Percentage of dividends which could be paid from adjusted operating funds | 95.00% |
Percentage of dividends which could be paid from operation funds | 95.00% |
Maximum percentage of total unencumbered assets | 150.00% |
Income Taxes - Additional Infor
Income Taxes - Additional Information (Detail) - USD ($) | 3 Months Ended | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Income Taxes [Line Items] | ||||
Percentage of ordinary taxable income to be distributed for real estate investment trust qualification | 90.00% | 90.00% | 90.00% | |
Percentage of taxable income to be distributed for federal income tax assumption | 100.00% | |||
Amount of foreign income (loss) before income taxes | $ 18,600,000 | $ (100,000) | $ (23,500,000) | |
Amount of domestic income (loss) before income taxes | 8,000,000 | $ 13,900,000 | $ (1,400,000) | |
U.S federal NOLs | $ 78,300,000 | 78,300,000 | ||
U.S. state NOLs | 99,900,000 | 99,900,000 | ||
U.S federal alternative minimum tax credits carry forward | 100,000 | $ 100,000 | ||
Tax credit description | Alternative minimum tax credits exceed regular tax liability in tax years 2019 through 2021 | |||
Percentage of credit refundable | 50.00% | |||
Foreign NOLs | $ 8,600,000 | $ 8,600,000 | ||
Cumulative pre-tax loss position period | 3 years | |||
Valuation allowance not expected to be realized | $ 4,400,000 | |||
Uncertain tax position liabilities and related interest or penalties | $ 0 | $ 0 | ||
Maximum [Member] | ||||
Income Taxes [Line Items] | ||||
U.S. federal and state NOLs, expiration period | 2,036 | |||
Minimum [Member] | ||||
Income Taxes [Line Items] | ||||
U.S. federal and state NOLs, expiration period | 2,022 |
Income Taxes - Schedule of Inco
Income Taxes - Schedule of Income Tax Expense (Benefit) (Detail) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Current income tax (benefit) expense: | |||
Domestic | $ (125) | $ (41) | $ 42 |
Foreign | 3,294 | 3,062 | 1,856 |
Total income tax expense | 3,169 | 3,021 | 1,898 |
Deferred income tax (benefit) expense: | |||
Domestic | (3,713) | (233) | 147 |
Foreign | 1,471 | (107) | (8,875) |
Total income tax expense | (2,242) | (340) | (8,728) |
Income tax expense (benefit) | $ 927 | $ 2,681 | $ (6,830) |
Income Taxes - Summary of Recon
Income Taxes - Summary of Reconciliation of the Income Tax Expense (Benefit) at the Statutory Income Tax Rate and the Effective Tax Rate for Income before Income Taxes (Detail) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Income Tax Disclosure [Abstract] | |||
Income before income tax | $ 1,019,404 | $ 293,919 | $ 219,107 |
Income tax at the U.S. statutory federal rate (21% in 2018 and 35% in 2017 and 2016) | 214,075 | 102,872 | 76,687 |
Increase (decrease) resulting from: | |||
Foreign rate differential | (2,643) | (2,326) | 1,434 |
State income taxes, net of federal benefit | 379 | 66 | |
U.S. earnings not subject to federal income tax | (208,472) | (98,026) | (84,927) |
Equity investments | (46) | 3,293 | 4,297 |
Change in valuation allowance | (2,668) | (5,391) | (6,104) |
Other items, net | 302 | 2,259 | 1,717 |
Income tax expense (benefit) | $ 927 | $ 2,681 | $ (6,830) |
Income Taxes - Summary of Rec_2
Income Taxes - Summary of Reconciliation of the Income Tax Expense (Benefit) at the Statutory Income Tax Rate and the Effective Tax Rate for Income before Income Taxes (Parenthetical) (Detail) | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Income Tax Disclosure [Abstract] | |||
Income tax at the US statutory federal rate | 21.00% | 35.00% | 35.00% |
Income Taxes - Schedule of Defe
Income Taxes - Schedule of Deferred Tax Assets and liabilities (Detail) - USD ($) $ in Thousands | Dec. 31, 2018 | Dec. 31, 2017 |
Income Tax Disclosure [Abstract] | ||
Operating loss and interest deduction carry forwards | $ 21,984 | $ 24,580 |
Other | 277 | 504 |
Total deferred tax assets | 22,261 | 25,084 |
Valuation allowance | (3,444) | (11,101) |
Total net deferred tax assets | 18,817 | 13,983 |
Property and equipment | (12,359) | (4,336) |
Net unbilled revenue | (1,633) | (6,113) |
Partnership investments | (2,099) | |
Other | (300) | (1,320) |
Total deferred tax liabilities | (14,292) | (13,868) |
Net deferred tax asset (liability) | $ 4,525 | $ 115 |
Income Taxes - Schedule of Per
Income Taxes - Schedule of Per Share Distributions to Stockholders (Detail) - $ / shares | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Income Tax Disclosure [Abstract] | |||
Common share distribution | $ 0.990000 | $ 0.950000 | $ 0.900000 |
Ordinary income | 0.438792 | 0.655535 | 0.619368 |
Capital gains | 0.551208 | 0.021022 | 0.102552 |
Unrecaptured Sec. 1250 gain | 0.132280 | 0.004647 | 0.045432 |
Section 19A Dividends | $ 0.438792 | ||
Return of capital | $ 0.273443 | $ 0.178080 |
Earnings Per Share_Unit - Calcu
Earnings Per Share/Unit - Calculation of Earnings Per Share (Detail) - USD ($) shares in Thousands, $ in Thousands | 3 Months Ended | 12 Months Ended | |||||||||
Dec. 31, 2018 | Sep. 30, 2018 | Jun. 30, 2018 | Mar. 31, 2018 | Dec. 31, 2017 | Sep. 30, 2017 | Jun. 30, 2017 | Mar. 31, 2017 | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items] | |||||||||||
Net income | $ 78,941 | $ 736,476 | $ 112,017 | $ 91,043 | $ 72,376 | $ 76,881 | $ 73,796 | $ 68,185 | $ 1,018,477 | $ 291,238 | $ 225,937 |
Net income attributable to non-controlling interests | (1,792) | (1,445) | (889) | ||||||||
Participating securities’ share in earnings | (3,685) | (1,409) | (559) | ||||||||
Net income, less participating securities’ share in earnings | $ 1,013,000 | $ 288,384 | $ 224,489 | ||||||||
Weighted average shares outstanding — basic | 366,655 | 365,024 | 364,897 | 364,882 | 364,382 | 364,315 | 349,856 | 321,057 | 365,364 | 349,902 | 260,414 |
Dilutive potential common shares | 907 | 539 | 658 | ||||||||
Diluted weighted average common shares | 367,732 | 366,467 | 365,541 | 365,343 | 364,977 | 365,046 | 350,319 | 321,423 | 366,271 | 350,441 | 261,072 |
MPT Operating Partnership, L.P. [Member] | |||||||||||
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items] | |||||||||||
Net income | $ 78,941 | $ 736,476 | $ 112,017 | $ 91,043 | $ 72,376 | $ 76,881 | $ 73,796 | $ 68,185 | $ 1,018,477 | $ 291,238 | $ 225,937 |
Net income attributable to non-controlling interests | (1,792) | (1,445) | (889) | ||||||||
Participating securities’ share in earnings | (3,685) | (1,409) | (559) | ||||||||
Net income, less participating securities’ share in earnings | $ 1,013,000 | $ 288,384 | $ 224,489 | ||||||||
Weighted average shares outstanding — basic | 366,655 | 365,024 | 364,897 | 364,882 | 364,382 | 364,315 | 349,856 | 321,057 | 365,364 | 349,902 | 260,414 |
Dilutive potential common shares | 907 | 539 | 658 | ||||||||
Diluted weighted average common shares | 367,732 | 366,467 | 365,541 | 365,343 | 364,977 | 365,046 | 350,319 | 321,423 | 366,271 | 350,441 | 261,072 |
Stock Awards - Additional Infor
Stock Awards - Additional Information (Detail) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Share / (Unit)-based compensation expense | $ 16,505 | $ 9,949 | $ 7,942 |
Stock-based compensation expense, unrecognized cost | $ 34,900 | ||
Stock-based compensation expense, unrecognized cost, reorganization period (in years) | 2 years 1 month 6 days | ||
Restricted equity awards, fair value | $ 8,400 | $ 10,400 | $ 12,700 |
Maximum [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Stock awards vesting period in years | 10 years | ||
Equity Incentive Plan [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Reserved shares of common stock for awards under the Equity Incentive Plan | 8,196,770,000 | ||
Common stock remaining for future stock awards transferred to the equity incentive plan | 976,073,000 | ||
Maximum number of shares of common stock that may be awarded | 5,000,000,000 | ||
Service-Based Awards [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Share-based compensation arrangement by share based payment award, expected service period (in years) | 3 years | ||
40% of 2018 Performance Awards [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Annual total shareholder return (in years) | 1 year | ||
Stock-based awards expiration date | Dec. 31, 2020 | ||
Percentage of performance award grant in period | 40.00% | ||
EBITDA achieving period | 1 year | ||
40% of 2018 Performance Awards [Member] | Return on Equity Equal to 12.5% [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of shareholder return to be earned | 12.50% | ||
40% of 2018 Performance Awards [Member] | Return on Equity Greater than or Equal to 13.5% [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of shareholder return to be earned | 13.50% | ||
Percentage of performance award to be earned of shareholder return reaches shareholder limit | 200.00% | ||
40% of 2018 Performance Awards [Member] | EBITDA Equal to $720 Million [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
EBITDA to be earned | $ 720,000 | ||
Percentage of performance award to be earned if EBITDA reaches limit | 50.00% | ||
40% of 2018 Performance Awards [Member] | EBITDA Equal to $775 Million [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
EBITDA to be earned | $ 775,000 | ||
Percentage of performance award to be earned if EBITDA reaches limit | 50.00% | ||
40% of 2018 Performance Awards [Member] | EBITDA Equal to $740 Million [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
EBITDA to be earned | $ 740,000 | ||
Percentage of performance award to be earned if EBITDA reaches limit | 100.00% | ||
40% of 2018 Performance Awards [Member] | EBITDA Equal to $800 Million [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
EBITDA to be earned | $ 800,000 | ||
Percentage of performance award to be earned if EBITDA reaches limit | 100.00% | ||
40% of 2018 Performance Awards [Member] | EBITDA Equal to $760 Million [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
EBITDA to be earned | $ 760,000 | ||
Percentage of performance award to be earned if EBITDA reaches limit | 200.00% | ||
40% of 2018 Performance Awards [Member] | EBITDA Equal to $825 Million [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
EBITDA to be earned | $ 825,000 | ||
Percentage of performance award to be earned if EBITDA reaches limit | 200.00% | ||
40% of 2018 Performance Awards [Member] | Maximum [Member] | Return on Equity Equal to 12.5% [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of performance award to be earned of shareholder return reaches shareholder limit | 100.00% | ||
40% of 2018 Performance Awards [Member] | Minimum [Member] | Return on Equity Equal to 12.5% [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of performance award to be earned of shareholder return reaches shareholder limit | 50.00% | ||
20% of 2018 Performance Awards [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Stock-based awards expiration date | Dec. 31, 2020 | ||
Percentage of performance award grant in period | 20.00% | ||
Acquisition achieving period | 1 year | ||
20% of 2018 Performance Awards [Member] | Acquisitions Equal to $500 Million [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Acquisitions | $ 500,000 | ||
Percentage of performance award to be earned if acquisitions reaches threshold limit | 50.00% | ||
20% of 2018 Performance Awards [Member] | Acquisitions Equal to $1.5 Billion [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Acquisitions | $ 1,500,000 | ||
Percentage of performance award to be earned if acquisitions reaches threshold limit | 50.00% | ||
20% of 2018 Performance Awards [Member] | Acquisitions Equal to $750 Million [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Acquisitions | $ 750,000 | ||
Percentage of performance award to be earned if acquisitions reaches threshold limit | 100.00% | ||
20% of 2018 Performance Awards [Member] | Acquisitions Equal to $2.25 Billion [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Acquisitions | $ 2,250,000 | ||
Percentage of performance award to be earned if acquisitions reaches threshold limit | 100.00% | ||
20% of 2018 Performance Awards [Member] | Acquisitions Equal to $1.0 Billion [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Acquisitions | $ 1,000,000 | ||
Percentage of performance award to be earned if acquisitions reaches threshold limit | 200.00% | ||
20% of 2018 Performance Awards [Member] | Acquisitions Equal to $3.0 Billion [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Acquisitions | $ 3,000,000 | ||
Percentage of performance award to be earned if acquisitions reaches threshold limit | 200.00% | ||
Final Portion of 2018 Performance Awards [Member] | SNL Index, Greater than Seventy Five Percent [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of shareholder return to be earned | 75.00% | ||
Increase (decrease) in percentage of performance award to be earned If shareholder return reaches shareholder limit | 25.00% | ||
Final Portion of 2018 Performance Awards [Member] | SNL Index, Greater than Fifty Five Percent [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of shareholder return to be earned | 55.00% | ||
Increase (decrease) in percentage of performance award to be earned If shareholder return reaches shareholder limit | 0.00% | ||
Final Portion of 2018 Performance Awards [Member] | SNL Index, Greater than Thirty Five Percent [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of shareholder return to be earned | 35.00% | ||
Increase (decrease) in percentage of performance award to be earned If shareholder return reaches shareholder limit | (25.00%) | ||
Final Portion of 2018 Performance Awards [Member] | SNL Index, Greater than Ninety Five Percent [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of shareholder return to be earned | 95.00% | ||
2018 Performance Awards [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Number of performance awards forfeited | 2,000 | ||
Number of performance awards earned and unvested | 508,566 | ||
Number of performance awards to be earned | 1,238,748 | ||
42% of 2017 Performance Awards [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Share-based compensation arrangement by share based payment award, expected service period (in years) | 3 years | ||
Annual total shareholder return (in years) | 1 year | ||
Stock-based awards expiration date | Dec. 31, 2017 | ||
Percentage of performance award grant in period | 42.00% | ||
Share based payment award, weighted average risk-free rate of return | 1.00% | ||
Share based payment award, expected volatility rate | 25.00% | ||
Common stock options awarded, dividend yield | 6.90% | ||
42% of 2017 Performance Awards [Member] | U.S. REIT Healthcare Index Minus 3% [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of shareholder return to be earned | 3.00% | ||
Percentage of performance award to be earned of shareholder return reaches shareholder limit | 50.00% | ||
42% of 2017 Performance Awards [Member] | U.S. REIT Healthcare Index Plus 3% [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of shareholder return to be earned | 3.00% | ||
Percentage of performance award to be earned of shareholder return reaches shareholder limit | 200.00% | ||
47% of 2017 Performance Awards [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Annual total shareholder return (in years) | 1 year | ||
Stock-based awards expiration date | Dec. 31, 2017 | ||
Percentage of performance award grant in period | 47.00% | ||
47% of 2017 Performance Awards [Member] | Return on Equity Equal to 12.5% [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of shareholder return to be earned | 12.50% | ||
Percentage of performance award to be earned of shareholder return reaches shareholder limit | 50.00% | ||
47% of 2017 Performance Awards [Member] | Return on Equity Greater than or Equal to 13.5% [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of shareholder return to be earned | 13.50% | ||
Percentage of performance award to be earned of shareholder return reaches shareholder limit | 200.00% | ||
11% of 2017 Performance Awards [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Annual total shareholder return (in years) | 1 year | ||
Stock-based awards expiration date | Dec. 31, 2017 | ||
Percentage of performance award to be earned of shareholder return reaches shareholder limit | 11.00% | ||
11% of 2017 Performance Awards [Member] | General and Administrative Expense to Revenue Ratio Equal to 10% [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of performance award to be earned if G&A stays at or below limit | 50.00% | ||
11% of 2017 Performance Awards [Member] | General and Administrative Expense to Revenue Ratio is Less Than Equal to 9% [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of performance award to be earned if G&A stays at or below limit | 200.00% | ||
G&A as a percentage of revenue threshold | 9.00% | ||
11% of 2017 Performance Awards [Member] | General and Administrative Expenses to Revenue Ratio Less Than Equal to Ten Percent [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
G&A as a percentage of revenue threshold | 10.00% | ||
65% of 2017 Performance Awards [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Share-based compensation arrangement by share based payment award, expected service period (in years) | 5 years | ||
Share based payment award, weighted average risk-free rate of return | 1.90% | ||
Share based payment award, expected volatility rate | 25.00% | ||
Common stock options awarded, dividend yield | 6.90% | ||
65% of 2017 Performance Awards [Member] | 2019 Award [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Stock-based awards expiration date | Dec. 31, 2019 | ||
Percentage of performance award to be earned of shareholder return reaches shareholder limit | 30.00% | ||
65% of 2017 Performance Awards [Member] | 2020 Award [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Stock-based awards expiration date | Dec. 31, 2020 | ||
Percentage of performance award to be earned of shareholder return reaches shareholder limit | 30.00% | ||
65% of 2017 Performance Awards [Member] | 2019 and 2020 Awards [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Stock-based awards expiration date | Dec. 31, 2021 | ||
65% of 2017 Performance Awards [Member] | Maximum [Member] | 2019 and 2020 Awards [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of performance award to be earned of shareholder return reaches shareholder limit | 30.00% | ||
65% of 2017 Performance Awards [Member] | Minimum [Member] | 2019 Award [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of shareholder return to be earned | 27.00% | ||
65% of 2017 Performance Awards [Member] | Minimum [Member] | 2020 Award [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of shareholder return to be earned | 36.00% | ||
65% of 2017 Performance Awards [Member] | Minimum [Member] | 2019 and 2020 Awards [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of shareholder return to be earned | 45.00% | ||
Final Portion of 2017 Performance Awards [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Share-based compensation arrangement by share based payment award, expected service period (in years) | 3 years | ||
Stock-based awards expiration date | Dec. 31, 2019 | ||
Share based payment award, weighted average risk-free rate of return | 1.50% | ||
Share based payment award, expected volatility rate | 25.00% | ||
Common stock options awarded, dividend yield | 6.90% | ||
Share-based compensation award vesting rights | Vest in equal annual amounts on January 1, 2020, 2021, and 2022. | ||
Final Portion of 2017 Performance Awards [Member] | SNL Index, Greater than Three Percent [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of shareholder return to be earned | 3.00% | ||
Percentage of performance award to be earned of shareholder return reaches shareholder limit | 100.00% | ||
2017 Performance Awards [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Number of performance awards forfeited | 3,750 | 14,000 | |
Number of performance awards earned and unvested | 396,142 | 596,472 | |
Number of performance awards to be earned | 1,125,281 | ||
50% of 2016 Performance Awards [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Share-based compensation arrangement by share based payment award, expected service period (in years) | 5 years | ||
Stock-based awards expiration date | Dec. 31, 2018 | ||
Percentage of performance award grant in period | 50.00% | ||
Percentage of performance award to be earned of shareholder return reaches shareholder limit | 100.00% | ||
Share based payment award, weighted average risk-free rate of return | 1.00% | ||
Share based payment award, expected volatility rate | 24.40% | ||
Common stock options awarded, dividend yield | 7.00% | ||
50% of 2016 Performance Awards [Member] | If Any Shares are Earned from this Award [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Share-based compensation award vesting rights | Vest in equal annual amounts on January 1, 2019, 2020, and 2021. | ||
50% of 2016 Performance Awards [Member] | Maximum [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of shareholder return to be earned | 35.00% | ||
50% of 2016 Performance Awards [Member] | Minimum [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of shareholder return to be earned | 27.00% | ||
Remaining % of 2016 Performance Awards [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Share-based compensation arrangement by share based payment award, expected service period (in years) | 5 years | ||
Stock-based awards expiration date | Dec. 31, 2018 | ||
Share based payment award, weighted average risk-free rate of return | 1.00% | ||
Share based payment award, expected volatility rate | 24.40% | ||
Common stock options awarded, dividend yield | 7.00% | ||
Remaining % of 2016 Performance Awards [Member] | If Any Shares are Earned from this Award [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Share-based compensation award vesting rights | Vest in equal annual amounts on January 1, 2019, 2020, and 2021. | ||
Remaining % of 2016 Performance Awards [Member] | Within Three Percent of MSCI Index [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of shareholder return to be earned | 3.00% | ||
Remaining % of 2016 Performance Awards [Member] | MSCI Index Plus Three Percent [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Percentage of shareholder return to be earned | 300.00% | ||
Percentage of performance award to be earned of shareholder return reaches shareholder limit | 100.00% | ||
2016 Performance Awards [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Number of performance awards forfeited | 0 | 16,000 | 2,400 |
Number of performance awards to be earned | 0 | 0 | |
Number of performance awards earned and unvested | 779,004 |
Stock Awards - Restricted Equit
Stock Awards - Restricted Equity Awards Activity (Detail) - $ / shares | 12 Months Ended | |
Dec. 31, 2018 | Dec. 31, 2017 | |
Vesting Based on Service [Member] | ||
Employee Restricted Equity Awards Vesting Activity [Line Items] | ||
Nonvested awards at beginning of the year, Shares | 276,280 | 347,128 |
Awarded, Shares | 958,480 | 249,841 |
Vested, Shares | (307,275) | (304,613) |
Forfeited, Shares | (3,637) | (16,076) |
Nonvested awards at end of year, Shares | 923,848 | 276,280 |
Nonvested awards at beginning of the year, Weighted Average Value at Award Date | $ 12.68 | $ 13.35 |
Awarded, Weighted Average Value at Award Date | 14.31 | 12.40 |
Vested, Weighted Average Value at Award Date | 12.92 | 12.86 |
Forfeited, Weighted Average Value at Award Date | 13.05 | 12.75 |
Nonvested awards at end of year, Weighted Average Value at Award Date | $ 14.29 | $ 12.68 |
Vesting Based on Market/Performance Conditions [Member] | ||
Employee Restricted Equity Awards Vesting Activity [Line Items] | ||
Nonvested awards at beginning of the year, Shares | 2,676,755 | 1,811,675 |
Awarded, Shares | 1,750,834 | 1,741,003 |
Vested, Shares | (288,404) | (491,071) |
Forfeited, Shares | (5,750) | (384,852) |
Nonvested awards at end of year, Shares | 4,133,435 | 2,676,755 |
Nonvested awards at beginning of the year, Weighted Average Value at Award Date | $ 7.86 | $ 6.78 |
Awarded, Weighted Average Value at Award Date | 11.61 | 8.21 |
Vested, Weighted Average Value at Award Date | 11.25 | 6.84 |
Forfeited, Weighted Average Value at Award Date | 9.35 | 5.65 |
Nonvested awards at end of year, Weighted Average Value at Award Date | $ 9.21 | $ 7.86 |
Commitments and Contingencies -
Commitments and Contingencies - Additional Information (Detail) - USD ($) $ in Millions | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Commitments And Contingencies Disclosure [Abstract] | |||
Term of lease period | 30 years or more | ||
Lease and Rental Expenses | $ 9.4 | $ 9.8 | $ 6.8 |
Sublease rental income | $ 4.3 | $ 6.6 | $ 4.2 |
Commitments and Contingencies_2
Commitments and Contingencies - Fixed Minimum Rental Payments Due under Operating Leases with Non-Cancelable Terms (Detail) $ in Thousands | Dec. 31, 2018USD ($) | |
Commitments And Contingencies Disclosure [Abstract] | ||
2,019 | $ 6,602 | |
2,020 | 6,903 | |
2,021 | 6,841 | |
2,022 | 6,838 | |
2,023 | 6,861 | |
Thereafter | 198,932 | |
Minimum rental payments, total | 232,977 | |
2,019 | (3,284) | |
2,020 | (3,458) | |
2,021 | (3,551) | |
2,022 | (3,632) | |
2,023 | (3,636) | |
Thereafter | (93,586) | |
Sub lease minimum rental payments receivable, total | (111,147) | |
2,019 | 3,318 | |
2,020 | 3,445 | |
2,021 | 3,290 | |
2,022 | 3,206 | |
2,023 | 3,225 | |
Thereafter | 105,346 | [1] |
Minimum rental payments, total | $ 121,830 | |
[1] | Reflects certain ground leases, in which we are the lessee, that have longer initial fixed terms than our existing sublease to our tenants. However, we would expect to either renew the related sublease, enter into a lease with a new tenant or early terminate the ground lease to reduce or avoid any significant impact from such ground leases. |
Common Stock_Partners' Capital
Common Stock/Partners' Capital - Additional Information (Detail) $ / shares in Units, $ in Thousands | Nov. 13, 2017USD ($) | May 01, 2017USD ($)shares | Oct. 07, 2016USD ($)$ / sharesshares | Sep. 30, 2016USD ($)shares | Dec. 31, 2018USD ($)shares | Dec. 31, 2018USD ($)PartnerEmployeeshares | Dec. 31, 2017USD ($)shares | Dec. 31, 2016USD ($)shares |
Class of Stock [Line Items] | ||||||||
Proceeds from sale of common shares / units, net of offering costs | $ 95 | $ 94,239 | $ 547,785 | $ 1,173,651 | ||||
Common stock, shares issued | shares | 370,637,000 | 370,637,000 | 364,424,000 | |||||
Redemption of common units | $ 816 | |||||||
Employee [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Number of partners shared remaining ownership percentage | Employee | 2 | |||||||
MPT Operating Partnership, L.P. [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Proceeds from sale of common shares / units, net of offering costs | $ 94,239 | $ 547,785 | 1,173,651 | |||||
Percentage of ownership of general partner | 100.00% | |||||||
Number of other partners | Partner | 2 | |||||||
Redemption of common units | $ 816 | |||||||
MPT Operating Partnership, L.P. [Member] | Medical Properties Trust, Inc. [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Ownership interest in equity | 99.90% | 99.90% | ||||||
Market Equity Offering Program [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Proceeds from sale of common shares / units, net of offering costs | 224,000 | |||||||
Sales commissions, amount | $ 2,800 | |||||||
Market Equity Offering Program [Member] | Maximum [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Value of stock | $ 750,000 | |||||||
Sales commission percentage | 2.00% | |||||||
Public Offering [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Proceeds from sale of common shares / units, net of offering costs | $ 548,000 | $ 799,500 | ||||||
Common stock, shares issued | shares | 43,100,000 | 57,500,000 | ||||||
Additional shares purchased by underwriters | shares | 5,600,000 | 7,500,000 | ||||||
Common Units [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Number of share sold | shares | 5,600 | 5,614,000 | 43,125,000 | 82,749,000 | ||||
Common Units [Member] | MPT Operating Partnership, L.P. [Member] | Limited Partner [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Number of share sold | shares | 5,558,000 | 42,694,000 | 81,918,000 | |||||
Conversion of LTIP units to common units | shares | 60,000 | |||||||
Redemption of common units | $ 816 | |||||||
Common Units [Member] | Market Equity Offering Program [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Number of share sold | shares | 0 | 15,000,000 | ||||||
Common Units [Member] | Private Placement [Member] | Cerberus Capital Management [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Number of share sold | shares | 10,300,000 | |||||||
Proceeds from sale of common shares / units, net of offering costs | $ 150,000 | |||||||
Sale of Stock, price per share | $ / shares | $ 14.50 |
Fair Value of Financial Instr_3
Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Detail) - USD ($) $ in Thousands | Dec. 31, 2018 | Dec. 31, 2017 |
Fair Value Disclosures [Abstract] | ||
Interest and rent receivables, Book value | $ 25,855 | $ 78,970 |
Loans, Book value | 1,471,520 | 1,698,471 |
Debt, net Book value | (4,037,389) | (4,898,667) |
Interest and rent receivables, Fair value | 24,942 | 78,028 |
Loans, Fair value | 1,490,758 | 1,722,101 |
Debt, net Fair value | $ (3,947,795) | $ (5,073,707) |
Fair Value of Financial Instr_4
Fair Value of Financial Instruments - Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands | Dec. 31, 2018 | Dec. 31, 2017 |
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items] | ||
Fair Value | $ 115,000 | $ 229,554 |
Original Cost | 115,000 | 233,354 |
Fair Value Measurements, Recurring [Member] | Mortgage Loans [Member] | Mortgage Loans [Member] | ||
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items] | ||
Fair Value | 115,000 | 115,000 |
Original Cost | $ 115,000 | 115,000 |
Fair Value Measurements, Recurring [Member] | Equity Method Investment and Other Loans [Member] | Other Loans and Other Assets [Member] | ||
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items] | ||
Fair Value | 114,554 | |
Original Cost | $ 118,354 |
Fair Value of Financial Instr_5
Fair Value of Financial Instruments - Additional information (Detail) | 12 Months Ended | |
Dec. 31, 2016USD ($) | Dec. 31, 2018 | |
Ernest [Member] | ||
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items] | ||
Unrealized gains/losses on investments | $ 0 | |
Valuation Technique, Discounted Cash Flow [Member] | Measurement Input, Discount Rate [Member] | ||
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items] | ||
Adjustment for DLOM on our equity investment | 40 |
Other Assets - Summary of Other
Other Assets - Summary of Other Assets (Detail) - USD ($) $ in Thousands | Dec. 31, 2018 | Dec. 31, 2017 |
Other Assets [Abstract] | ||
Debt issue costs, net | $ 4,793 | $ 7,093 |
Equity investments | 520,058 | 288,398 |
Other corporate assets | 115,416 | 117,827 |
Prepaids and other assets | 61,757 | 55,176 |
Total other assets | $ 702,024 | $ 468,494 |
Other Assets - Additional Infor
Other Assets - Additional Information (Detail) - USD ($) $ in Millions | Sep. 29, 2017 | Dec. 31, 2018 |
2017 [Member] | Subsidiaries [Member] | ||
Other Assets [Line Items] | ||
Equity interest acquired | $ 100 | $ 210 |
Other Assets - Summary of Finan
Other Assets - Summary of Financial Information For Investees (Detail) - MEDIAN [Member] $ in Thousands | 12 Months Ended |
Dec. 31, 2018USD ($) | |
Other Assets [Line Items] | |
Revenue | $ 42,526 |
Net income | 6,009 |
Assets | 2,018,496 |
Liabilities | $ 1,553,191 |
Quarterly Financial Data (Una_3
Quarterly Financial Data (Unaudited) - Unaudited Quarterly Financial Information (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands | 3 Months Ended | 12 Months Ended | |||||||||
Dec. 31, 2018 | Sep. 30, 2018 | Jun. 30, 2018 | Mar. 31, 2018 | Dec. 31, 2017 | Sep. 30, 2017 | Jun. 30, 2017 | Mar. 31, 2017 | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Quarterly Financial Information [Line Items] | |||||||||||
Revenues | $ 180,578 | $ 196,996 | $ 201,902 | $ 205,046 | $ 204,961 | $ 176,580 | $ 166,807 | $ 156,397 | $ 784,522 | $ 704,745 | $ 541,137 |
Net income | 78,941 | 736,476 | 112,017 | 91,043 | 72,376 | 76,881 | 73,796 | 68,185 | 1,018,477 | 291,238 | 225,937 |
Net income attributable to MPT common stockholders | $ 78,483 | $ 736,034 | $ 111,567 | $ 90,601 | $ 71,944 | $ 76,464 | $ 73,415 | $ 67,970 | $ 1,016,685 | $ 289,793 | $ 225,048 |
Net income attributable to MPT common stockholders (Operating Partnership partners) | $ 0.21 | $ 2.01 | $ 0.30 | $ 0.25 | $ 0.19 | $ 0.21 | $ 0.21 | $ 0.21 | $ 2.77 | $ 0.82 | $ 0.86 |
Weighted average shares outstanding — basic | 366,655 | 365,024 | 364,897 | 364,882 | 364,382 | 364,315 | 349,856 | 321,057 | 365,364 | 349,902 | 260,414 |
Net income attributable to MPT common stockholders (Operating Partnership partners) | $ 0.21 | $ 2 | $ 0.30 | $ 0.25 | $ 0.19 | $ 0.21 | $ 0.21 | $ 0.21 | $ 2.76 | $ 0.82 | $ 0.86 |
Weighted average shares outstanding — diluted | 367,732 | 366,467 | 365,541 | 365,343 | 364,977 | 365,046 | 350,319 | 321,423 | 366,271 | 350,441 | 261,072 |
MPT Operating Partnership, L.P. [Member] | |||||||||||
Quarterly Financial Information [Line Items] | |||||||||||
Revenues | $ 180,578 | $ 196,996 | $ 201,902 | $ 205,046 | $ 204,961 | $ 176,580 | $ 166,807 | $ 156,397 | $ 784,522 | $ 704,745 | $ 541,137 |
Net income | 78,941 | 736,476 | 112,017 | 91,043 | 72,376 | 76,881 | 73,796 | 68,185 | 1,018,477 | 291,238 | 225,937 |
Net income attributable to MPT common stockholders | $ 78,483 | $ 736,034 | $ 111,567 | $ 90,601 | $ 71,944 | $ 76,464 | $ 73,415 | $ 67,970 | $ 1,016,685 | $ 289,793 | $ 225,048 |
Net income attributable to MPT common stockholders (Operating Partnership partners) | $ 0.21 | $ 2.01 | $ 0.30 | $ 0.25 | $ 0.19 | $ 0.21 | $ 0.21 | $ 0.21 | $ 2.77 | $ 0.82 | $ 0.86 |
Weighted average shares outstanding — basic | 366,655 | 365,024 | 364,897 | 364,882 | 364,382 | 364,315 | 349,856 | 321,057 | 365,364 | 349,902 | 260,414 |
Net income attributable to MPT common stockholders (Operating Partnership partners) | $ 0.21 | $ 2 | $ 0.30 | $ 0.25 | $ 0.19 | $ 0.21 | $ 0.21 | $ 0.21 | $ 2.76 | $ 0.82 | $ 0.86 |
Weighted average shares outstanding — diluted | 367,732 | 366,467 | 365,541 | 365,343 | 364,977 | 365,046 | 350,319 | 321,423 | 366,271 | 350,441 | 261,072 |
Subsequent Events - Additional
Subsequent Events - Additional Information (Detail) € in Millions, $ in Millions | Feb. 06, 2019EUR (€)Hospital | Jan. 31, 2019USD ($)Hospital | Aug. 28, 2018EUR (€)Hospital | Jun. 30, 2018EUR (€)Hospital | Dec. 31, 2018EUR (€)Hospital | Dec. 31, 2018Hospital |
Germany [Member] | Rehabilitation Hospital with Covenant Health System [Member] | ||||||
Subsequent Event [Line Items] | ||||||
Number of facilities acquired | 3 | |||||
Subsequent Event [Member] | Germany [Member] | Rehabilitation Hospital with Covenant Health System [Member] | ||||||
Subsequent Event [Line Items] | ||||||
Number of facilities acquired | 4 | |||||
Purchase price of acquisition | € | € 5.8 | |||||
2018 [Member] | Germany [Member] | Rehabilitation Hospital with Covenant Health System [Member] | ||||||
Subsequent Event [Line Items] | ||||||
Number of facilities acquired | 3 | 4 | 4 | |||
Purchase price of acquisition | € | € 17.3 | € 23 | € 23 | |||
Healthscope [Member] | Subsequent Event [Member] | ||||||
Subsequent Event [Line Items] | ||||||
Number of facilities acquired | 11 | |||||
Purchase price of acquisition | $ | $ 859 | |||||
Term of lease | 20 years | |||||
Healthscope [Member] | Subsequent Event [Member] | Maximum [Member] | ||||||
Subsequent Event [Line Items] | ||||||
Ownership interests acquired | 100.00% |
Schedule II - Schedule of Valua
Schedule II - Schedule of Valuation and Qualifying Accounts (Detail) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Valuation And Qualifying Accounts [Abstract] | |||
Balance at Beginning of Year | $ 16,397 | $ 18,852 | $ 27,384 |
Additions charged against operations | 57,285 | 2,525 | 2,722 |
Deductions,Net recoveries/write offs | (7,551) | (4,980) | (11,254) |
Balance at end of year | $ 66,131 | $ 16,397 | $ 18,852 |
Schedule II - Schedule of Val_2
Schedule II - Schedule of Valuation and Qualifying Accounts (Parenthetical) (Detail) - USD ($) $ in Millions | 3 Months Ended | 12 Months Ended | |||
Dec. 31, 2018 | Dec. 31, 2016 | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Increase in real estate impairment reserve | $ 48 | ||||
Increase in accounts receivable reserve | 9.3 | ||||
Increase (decrease) in valuation allowance | $ (7.7) | $ (4.9) | $ (6.1) | ||
Domestic Valuation Allowances [Member] | |||||
Increase (decrease) in valuation allowance | $ (4.4) | ||||
Foreign Valuation Allowances [Member] | |||||
Increase (decrease) in valuation allowance | $ (4) | ||||
Twelve Oaks Facility [Member] | |||||
Rent reserves | 1.9 | 1.9 | |||
Write offs related to payment of rent, late fees, and loans | 3.3 | 3.3 | |||
Corinth Facility [Member] | |||||
Rent reserves | 0.8 | 0.8 | |||
Write offs for rent and interest reserves | 0.8 | 0.8 | |||
M/C Healthcare Loan [Member] | |||||
Write offs related to loan | $ 0.1 | $ 0.1 |
Schedule III - Real Estate In_2
Schedule III - Real Estate Investments and Accumulated Depreciation (Detail) - USD ($) $ in Thousands | 12 Months Ended | ||||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | ||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Initial costs, land | $ 544,228 | ||||
Initial costs, buildings | 4,026,620 | ||||
Additions subsequent to acquisition, Improvements | 188,640 | ||||
Additions subsequent to acquisition, carrying costs | 21,661 | ||||
Land at cost | 547,894 | ||||
Buildings at cost | 4,233,255 | ||||
Total at cost | 4,781,149 | $ 5,438,148 | [1] | $ 3,968,042 | $ 2,991,590 |
Accumulated Depreciation | 414,331 | $ 406,855 | |||
Encumbrances | $ 0 | ||||
2008 [Member] | Bath, UK [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 1,512 | ||||
Initial costs, buildings | 31,334 | ||||
Land at cost | 1,512 | ||||
Buildings at cost | 31,334 | ||||
Total at cost | 32,846 | ||||
Accumulated Depreciation | 3,526 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,008 | ||||
Date Acquired | Jul. 1, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2008 [Member] | Boise, ID [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Long term acute care hospital | ||||
Initial costs, land | $ 1,558 | ||||
Initial costs, buildings | 11,027 | ||||
Land at cost | 1,558 | ||||
Buildings at cost | 11,027 | ||||
Total at cost | 12,585 | ||||
Accumulated Depreciation | 173 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,008 | ||||
Date Acquired | Feb. 29, 2012 | ||||
Life on which depreciation in latest income statements is computed (Years) | 50 years | ||||
2008 [Member] | Lubbock, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 1,376 | ||||
Initial costs, buildings | 28,292 | ||||
Additions subsequent to acquisition, Improvements | 3,648 | ||||
Land at cost | 1,376 | ||||
Buildings at cost | 31,940 | ||||
Total at cost | 33,316 | ||||
Accumulated Depreciation | 2,657 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,008 | ||||
Date Acquired | Jun. 16, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2009 [Member] | Bath, UK [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 1,512 | ||||
Initial costs, buildings | 31,334 | ||||
Land at cost | 1,512 | ||||
Buildings at cost | 31,334 | ||||
Total at cost | 32,846 | ||||
Accumulated Depreciation | 3,526 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,009 | ||||
Date Acquired | Jul. 1, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2009 [Member] | Brighton, MA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 18,540 | ||||
Initial costs, buildings | 146,490 | ||||
Additions subsequent to acquisition, Improvements | 11,176 | ||||
Land at cost | 18,540 | ||||
Buildings at cost | 157,666 | ||||
Total at cost | 176,206 | ||||
Accumulated Depreciation | 8,304 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,009 | ||||
Date Acquired | Oct. 3, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
1977 [Member] | Braunfels, Germany [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 2,202 | ||||
Initial costs, buildings | 14,073 | ||||
Additions subsequent to acquisition, Improvements | 57 | ||||
Land at cost | 2,259 | ||||
Buildings at cost | 14,073 | ||||
Total at cost | 16,332 | ||||
Accumulated Depreciation | 1,245 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,977 | ||||
Date Acquired | Jun. 30, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1885 [Member] | Heidelberg, Germany [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 6,404 | ||||
Initial costs, buildings | 37,006 | ||||
Additions subsequent to acquisition, Improvements | 75 | ||||
Land at cost | 6,479 | ||||
Buildings at cost | 37,006 | ||||
Total at cost | 43,485 | ||||
Accumulated Depreciation | 2,325 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,885 | ||||
Date Acquired | Jun. 22, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1991 [Member] | Heidelberg, Germany [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 6,404 | ||||
Initial costs, buildings | 37,006 | ||||
Additions subsequent to acquisition, Improvements | 75 | ||||
Land at cost | 6,479 | ||||
Buildings at cost | 37,006 | ||||
Total at cost | 43,485 | ||||
Accumulated Depreciation | 2,325 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,991 | ||||
Date Acquired | Jun. 22, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2011 [Member] | Cologne, Germany [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 4,494 | ||||
Initial costs, buildings | 15,545 | ||||
Additions subsequent to acquisition, Improvements | 104 | ||||
Land at cost | 4,598 | ||||
Buildings at cost | 15,545 | ||||
Total at cost | 20,143 | ||||
Accumulated Depreciation | 593 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,011 | ||||
Date Acquired | Jun. 23, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2011 [Member] | Methuen, MA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 23,809 | ||||
Initial costs, buildings | 89,505 | ||||
Additions subsequent to acquisition, Improvements | 5,698 | ||||
Land at cost | 23,809 | ||||
Buildings at cost | 95,203 | ||||
Total at cost | 119,012 | ||||
Accumulated Depreciation | 5,766 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,011 | ||||
Date Acquired | Oct. 3, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
1974 [Member] | Bad Salzuflen, Germany [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 9,972 | ||||
Initial costs, buildings | 27,611 | ||||
Additions subsequent to acquisition, Improvements | 939 | ||||
Land at cost | 10,911 | ||||
Buildings at cost | 27,611 | ||||
Total at cost | 38,522 | ||||
Accumulated Depreciation | 816 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,974 | ||||
Date Acquired | Nov. 30, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1974 [Member] | Redding, CA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 1,555 | ||||
Initial costs, buildings | 53,863 | ||||
Additions subsequent to acquisition, carrying costs | 13 | ||||
Land at cost | 1,555 | ||||
Buildings at cost | 53,876 | ||||
Total at cost | 55,431 | ||||
Accumulated Depreciation | 15,387 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,974 | ||||
Date Acquired | Aug. 10, 2007 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1974 [Member] | Sebastian, FL [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 5,733 | ||||
Initial costs, buildings | 49,136 | ||||
Additions subsequent to acquisition, Improvements | 16,829 | ||||
Land at cost | 5,733 | ||||
Buildings at cost | 65,965 | ||||
Total at cost | 71,698 | ||||
Accumulated Depreciation | 2,288 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,974 | ||||
Date Acquired | May 1, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
2016 [Member] | Bad Salzuflen, Germany [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 9,972 | ||||
Initial costs, buildings | 27,611 | ||||
Additions subsequent to acquisition, Improvements | 939 | ||||
Land at cost | 10,911 | ||||
Buildings at cost | 27,611 | ||||
Total at cost | 38,522 | ||||
Accumulated Depreciation | 816 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Nov. 30, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2016 [Member] | Houston, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 950 | ||||
Initial costs, buildings | 3,996 | ||||
Land at cost | 950 | ||||
Buildings at cost | 3,996 | ||||
Total at cost | 4,946 | ||||
Accumulated Depreciation | 225 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Sep. 26, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2016 [Member] | Glendale, AZ [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 1,144 | ||||
Initial costs, buildings | 6,087 | ||||
Land at cost | 1,144 | ||||
Buildings at cost | 6,087 | ||||
Total at cost | 7,231 | ||||
Accumulated Depreciation | 330 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Oct. 21, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2016 [Member] | New Orleans, LA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 2,850 | ||||
Initial costs, buildings | 6,125 | ||||
Land at cost | 2,850 | ||||
Buildings at cost | 6,125 | ||||
Total at cost | 8,975 | ||||
Accumulated Depreciation | 346 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Sep. 23, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2016 [Member] | Katy, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, buildings | $ 4,174 | ||||
Buildings at cost | 4,174 | ||||
Total at cost | 4,174 | ||||
Accumulated Depreciation | 235 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Oct. 10, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2016 [Member] | The Woodlands, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, buildings | $ 4,524 | ||||
Buildings at cost | 4,524 | ||||
Total at cost | 4,524 | ||||
Accumulated Depreciation | 311 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Mar. 28, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2016 [Member] | DeSoto, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 750 | ||||
Initial costs, buildings | 4,234 | ||||
Land at cost | 750 | ||||
Buildings at cost | 4,234 | ||||
Total at cost | 4,984 | ||||
Accumulated Depreciation | 273 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | May 23, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2016 [Member] | San Antonio, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, buildings | $ 4,801 | ||||
Buildings at cost | 4,801 | ||||
Total at cost | 4,801 | ||||
Accumulated Depreciation | 250 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Dec. 9, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2016 [Member] | Flagstaff, AZ [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 3,049 | ||||
Initial costs, buildings | 22,464 | ||||
Land at cost | 3,049 | ||||
Buildings at cost | 22,464 | ||||
Total at cost | 25,513 | ||||
Accumulated Depreciation | 468 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Aug. 23, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2016 [Member] | Frisco, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, buildings | $ 1,806 | ||||
Buildings at cost | 1,806 | ||||
Total at cost | 1,806 | ||||
Accumulated Depreciation | 336 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Mar. 4, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2016 [Member] | Garland, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, buildings | $ 4,647 | ||||
Buildings at cost | 4,647 | ||||
Total at cost | 4,647 | ||||
Accumulated Depreciation | 252 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Nov. 15, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2016 [Member] | Goodyear, AZ [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 1,800 | ||||
Initial costs, buildings | 4,713 | ||||
Land at cost | 1,800 | ||||
Buildings at cost | 4,713 | ||||
Total at cost | 6,513 | ||||
Accumulated Depreciation | 324 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Apr. 4, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2016 [Member] | Helotes, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 1,900 | ||||
Initial costs, buildings | 5,115 | ||||
Land at cost | 1,900 | ||||
Buildings at cost | 5,115 | ||||
Total at cost | 7,015 | ||||
Accumulated Depreciation | 362 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Mar. 10, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2016 [Member] | Highlands Ranch, CO [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 4,200 | ||||
Initial costs, buildings | 4,779 | ||||
Land at cost | 4,200 | ||||
Buildings at cost | 4,779 | ||||
Total at cost | 8,979 | ||||
Accumulated Depreciation | 289 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Jul. 25, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2016 [Member] | Longmont, CO [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, buildings | $ 4,181 | ||||
Buildings at cost | 4,181 | ||||
Total at cost | 4,181 | ||||
Accumulated Depreciation | 305 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Feb. 10, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2016 [Member] | Mandeville, LA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 2,800 | ||||
Initial costs, buildings | 5,370 | ||||
Land at cost | 2,800 | ||||
Buildings at cost | 5,370 | ||||
Total at cost | 8,170 | ||||
Accumulated Depreciation | 291 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Oct. 28, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2016 [Member] | Marrero, LA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, buildings | $ 5,801 | ||||
Buildings at cost | 5,801 | ||||
Total at cost | 5,801 | ||||
Accumulated Depreciation | 364 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Jul. 15, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2016 [Member] | Plano, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, buildings | $ 2,492 | ||||
Buildings at cost | 2,492 | ||||
Total at cost | 2,492 | ||||
Accumulated Depreciation | 272 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Sep. 30, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2016 [Member] | San Antonio, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, buildings | $ 4,253 | ||||
Buildings at cost | 4,253 | ||||
Total at cost | 4,253 | ||||
Accumulated Depreciation | 230 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Oct. 27, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2016 [Member] | Rosenberg, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, buildings | $ 4,505 | ||||
Buildings at cost | 4,505 | ||||
Total at cost | 4,505 | ||||
Accumulated Depreciation | 338 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Jan. 15, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2016 [Member] | Columbus, OH [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 1,726 | ||||
Land at cost | 1,726 | ||||
Total at cost | 1,726 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Aug. 30, 2016 | ||||
2016 [Member] | Toledo, OH [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, buildings | $ 17,740 | ||||
Buildings at cost | 17,740 | ||||
Total at cost | 17,740 | ||||
Accumulated Depreciation | 1,220 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Apr. 1, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1989 [Member] | Bad Salzuflen, Germany [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 7,062 | ||||
Initial costs, buildings | 24,283 | ||||
Additions subsequent to acquisition, Improvements | 353 | ||||
Land at cost | 7,415 | ||||
Buildings at cost | 24,283 | ||||
Total at cost | 31,698 | ||||
Accumulated Depreciation | 683 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,989 | ||||
Date Acquired | Nov. 30, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2016 One [Member] | Bad Salzuflen, Germany [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 7,062 | ||||
Initial costs, buildings | 24,283 | ||||
Additions subsequent to acquisition, Improvements | 353 | ||||
Land at cost | 7,415 | ||||
Buildings at cost | 24,283 | ||||
Total at cost | 31,698 | ||||
Accumulated Depreciation | 683 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Nov. 30, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2016 One [Member] | Houston, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 4,047 | ||||
Initial costs, buildings | 36,862 | ||||
Land at cost | 4,047 | ||||
Buildings at cost | 36,862 | ||||
Total at cost | 40,909 | ||||
Accumulated Depreciation | 2,304 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,016 | ||||
Date Acquired | Jul. 7, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1960 [Member] | Houston, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 3,501 | ||||
Initial costs, buildings | 34,530 | ||||
Additions subsequent to acquisition, Improvements | 8,477 | ||||
Additions subsequent to acquisition, carrying costs | 16,589 | ||||
Land at cost | 3,274 | ||||
Buildings at cost | 59,823 | ||||
Total at cost | 63,097 | ||||
Accumulated Depreciation | 12,943 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,960 | ||||
Date Acquired | Aug. 10, 2007 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1960 [Member] | Sherman, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 4,493 | ||||
Initial costs, buildings | 11,081 | ||||
Land at cost | 4,493 | ||||
Buildings at cost | 11,081 | ||||
Total at cost | 15,574 | ||||
Accumulated Depreciation | 2,703 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,960 | ||||
Date Acquired | Oct. 31, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1973 [Member] | Bad Oeynhausen, Germany [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 1,042 | ||||
Initial costs, buildings | 2,859 | ||||
Additions subsequent to acquisition, Improvements | 127 | ||||
Land at cost | 1,169 | ||||
Buildings at cost | 2,859 | ||||
Total at cost | 4,028 | ||||
Accumulated Depreciation | 87 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,973 | ||||
Date Acquired | Nov. 30, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1973 [Member] | San Diego, CA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 12,663 | ||||
Initial costs, buildings | 52,431 | ||||
Land at cost | 12,663 | ||||
Buildings at cost | 52,431 | ||||
Total at cost | 65,094 | ||||
Accumulated Depreciation | 10,377 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,973 | ||||
Date Acquired | Feb. 9, 2011 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1973 [Member] | Odessa, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 6,535 | ||||
Initial costs, buildings | 123,518 | ||||
Additions subsequent to acquisition, Improvements | 254 | ||||
Land at cost | 6,535 | ||||
Buildings at cost | 123,772 | ||||
Total at cost | 130,307 | ||||
Accumulated Depreciation | 3,950 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,973 | ||||
Date Acquired | Sep. 29, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
1973 [Member] | Port Huron, MI [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 3,029 | ||||
Initial costs, buildings | 14,622 | ||||
Land at cost | 3,029 | ||||
Buildings at cost | 14,622 | ||||
Total at cost | 17,651 | ||||
Accumulated Depreciation | 1,498 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,973 | ||||
Date Acquired | Dec. 31, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 30 years | ||||
2010 [Member] | Bad Oeynhausen, Germany [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 1,042 | ||||
Initial costs, buildings | 2,859 | ||||
Additions subsequent to acquisition, Improvements | 127 | ||||
Land at cost | 1,169 | ||||
Buildings at cost | 2,859 | ||||
Total at cost | 4,028 | ||||
Accumulated Depreciation | 87 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,010 | ||||
Date Acquired | Nov. 30, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2010 [Member] | Brockton, MA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 18,328 | ||||
Initial costs, buildings | 67,248 | ||||
Additions subsequent to acquisition, Improvements | 4,296 | ||||
Land at cost | 18,328 | ||||
Buildings at cost | 71,544 | ||||
Total at cost | 89,872 | ||||
Accumulated Depreciation | 4,798 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,010 | ||||
Date Acquired | Oct. 3, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
2010 [Member] | Sherman, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 4,493 | ||||
Initial costs, buildings | 11,081 | ||||
Land at cost | 4,493 | ||||
Buildings at cost | 11,081 | ||||
Total at cost | 15,574 | ||||
Accumulated Depreciation | 2,703 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,010 | ||||
Date Acquired | Oct. 31, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1993 [Member] | Dormagen, Germany [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 1,843 | ||||
Initial costs, buildings | 5,848 | ||||
Additions subsequent to acquisition, Improvements | 140 | ||||
Land at cost | 1,983 | ||||
Buildings at cost | 5,848 | ||||
Total at cost | 7,831 | ||||
Accumulated Depreciation | 52 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,993 | ||||
Date Acquired | Aug. 28, 2018 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2006 [Member] | Dormagen, Germany [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 1,843 | ||||
Initial costs, buildings | 5,848 | ||||
Additions subsequent to acquisition, Improvements | 140 | ||||
Land at cost | 1,983 | ||||
Buildings at cost | 5,848 | ||||
Total at cost | 7,831 | ||||
Accumulated Depreciation | 52 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,006 | ||||
Date Acquired | Aug. 28, 2018 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2006 [Member] | Dallas, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Long term acute care hospital | ||||
Initial costs, land | $ 1,000 | ||||
Initial costs, buildings | 13,589 | ||||
Additions subsequent to acquisition, carrying costs | 368 | ||||
Land at cost | 1,421 | ||||
Buildings at cost | 13,536 | ||||
Total at cost | 14,957 | ||||
Accumulated Depreciation | 4,173 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,006 | ||||
Date Acquired | Sep. 5, 2006 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2006 [Member] | Bloomington, IN [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 2,392 | ||||
Initial costs, buildings | 28,212 | ||||
Additions subsequent to acquisition, Improvements | 5,000 | ||||
Additions subsequent to acquisition, carrying costs | 408 | ||||
Land at cost | 2,392 | ||||
Buildings at cost | 33,620 | ||||
Total at cost | 36,012 | ||||
Accumulated Depreciation | 10,377 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,006 | ||||
Date Acquired | Aug. 8, 2006 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2006 [Member] | Petersburg, VA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 1,302 | ||||
Initial costs, buildings | 9,121 | ||||
Land at cost | 1,302 | ||||
Buildings at cost | 9,121 | ||||
Total at cost | 10,423 | ||||
Accumulated Depreciation | 2,394 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,006 | ||||
Date Acquired | Jul. 1, 2008 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1886 [Member] | Grefath, Germany [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 1,145 | ||||
Initial costs, buildings | 3,127 | ||||
Additions subsequent to acquisition, Improvements | 102 | ||||
Land at cost | 1,247 | ||||
Buildings at cost | 3,127 | ||||
Total at cost | 4,374 | ||||
Accumulated Depreciation | 28 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,886 | ||||
Date Acquired | Aug. 28, 2018 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1983 [Member] | Grefath, Germany [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 1,145 | ||||
Initial costs, buildings | 3,127 | ||||
Additions subsequent to acquisition, Improvements | 102 | ||||
Land at cost | 1,247 | ||||
Buildings at cost | 3,127 | ||||
Total at cost | 4,374 | ||||
Accumulated Depreciation | 28 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,983 | ||||
Date Acquired | Aug. 28, 2018 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1983 [Member] | Remscheid, Germany [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 1,029 | ||||
Initial costs, buildings | 2,614 | ||||
Additions subsequent to acquisition, Improvements | 60 | ||||
Land at cost | 1,089 | ||||
Buildings at cost | 2,614 | ||||
Total at cost | 3,703 | ||||
Accumulated Depreciation | 23 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,983 | ||||
Date Acquired | Aug. 28, 2018 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1983 [Member] | Port Huron, MI [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 3,029 | ||||
Initial costs, buildings | 14,622 | ||||
Land at cost | 3,029 | ||||
Buildings at cost | 14,622 | ||||
Total at cost | 17,651 | ||||
Accumulated Depreciation | 1,498 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,983 | ||||
Date Acquired | Dec. 31, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 30 years | ||||
1951 [Member] | Remscheid, Germany [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 1,029 | ||||
Initial costs, buildings | 2,614 | ||||
Additions subsequent to acquisition, Improvements | 60 | ||||
Land at cost | 1,089 | ||||
Buildings at cost | 2,614 | ||||
Total at cost | 3,703 | ||||
Accumulated Depreciation | 23 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,951 | ||||
Date Acquired | Aug. 28, 2018 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2014 [Member] | Houston, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 1,345 | ||||
Initial costs, buildings | 3,678 | ||||
Land at cost | 1,345 | ||||
Buildings at cost | 3,678 | ||||
Total at cost | 5,023 | ||||
Accumulated Depreciation | 414 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,014 | ||||
Date Acquired | Jun. 20, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2014 [Member] | Allen, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 1,550 | ||||
Initial costs, buildings | 866 | ||||
Land at cost | 1,550 | ||||
Buildings at cost | 866 | ||||
Total at cost | 2,416 | ||||
Accumulated Depreciation | 441 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,014 | ||||
Date Acquired | Jul. 14, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2014 [Member] | Alvin, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 105 | ||||
Initial costs, buildings | 4,087 | ||||
Land at cost | 105 | ||||
Buildings at cost | 4,087 | ||||
Total at cost | 4,192 | ||||
Accumulated Depreciation | 462 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,014 | ||||
Date Acquired | Mar. 19, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2014 [Member] | Austin, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 1,140 | ||||
Initial costs, buildings | 1,777 | ||||
Land at cost | 1,140 | ||||
Buildings at cost | 1,777 | ||||
Total at cost | 2,917 | ||||
Accumulated Depreciation | 441 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,014 | ||||
Date Acquired | May 29, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2014 [Member] | Broomfield, CO [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 825 | ||||
Initial costs, buildings | 3,895 | ||||
Land at cost | 825 | ||||
Buildings at cost | 3,895 | ||||
Total at cost | 4,720 | ||||
Accumulated Depreciation | 438 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,014 | ||||
Date Acquired | Jul. 3, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2014 [Member] | Cedar Hill. TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 1,122 | ||||
Initial costs, buildings | 3,644 | ||||
Land at cost | 1,122 | ||||
Buildings at cost | 3,644 | ||||
Total at cost | 4,766 | ||||
Accumulated Depreciation | 410 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,014 | ||||
Date Acquired | Jun. 23, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2014 [Member] | Spring, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 1,310 | ||||
Initial costs, buildings | 3,639 | ||||
Land at cost | 1,310 | ||||
Buildings at cost | 3,639 | ||||
Total at cost | 4,949 | ||||
Accumulated Depreciation | 409 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,014 | ||||
Date Acquired | Jul. 15, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2014 [Member] | Commerce City, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 707 | ||||
Initial costs, buildings | 4,248 | ||||
Land at cost | 707 | ||||
Buildings at cost | 4,248 | ||||
Total at cost | 4,955 | ||||
Accumulated Depreciation | 434 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,014 | ||||
Date Acquired | Dec. 11, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2014 [Member] | Dulles, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 1,076 | ||||
Initial costs, buildings | 3,784 | ||||
Land at cost | 1,076 | ||||
Buildings at cost | 3,784 | ||||
Total at cost | 4,860 | ||||
Accumulated Depreciation | 410 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,014 | ||||
Date Acquired | Sep. 12, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2014 [Member] | Firestone, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 495 | ||||
Initial costs, buildings | 3,963 | ||||
Land at cost | 495 | ||||
Buildings at cost | 3,963 | ||||
Total at cost | 4,458 | ||||
Accumulated Depreciation | 454 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,014 | ||||
Date Acquired | Jun. 6, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2014 [Member] | Fountain, CO [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 1,508 | ||||
Initial costs, buildings | 4,131 | ||||
Land at cost | 1,508 | ||||
Buildings at cost | 4,131 | ||||
Total at cost | 5,639 | ||||
Accumulated Depreciation | 456 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,014 | ||||
Date Acquired | Jul. 31, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2014 [Member] | Frisco, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 1,500 | ||||
Initial costs, buildings | 3,863 | ||||
Additions subsequent to acquisition, Improvements | 27 | ||||
Additions subsequent to acquisition, carrying costs | (89) | ||||
Land at cost | 1,411 | ||||
Buildings at cost | 3,890 | ||||
Total at cost | 5,301 | ||||
Accumulated Depreciation | 446 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,014 | ||||
Date Acquired | Jun. 13, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2014 [Member] | San Antonio, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 351 | ||||
Initial costs, buildings | 3,952 | ||||
Land at cost | 351 | ||||
Buildings at cost | 3,952 | ||||
Total at cost | 4,303 | ||||
Accumulated Depreciation | 468 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,014 | ||||
Date Acquired | Jan. 1, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2014 [Member] | Colorado Springs, CO [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 600 | ||||
Initial costs, buildings | 4,231 | ||||
Land at cost | 600 | ||||
Buildings at cost | 4,231 | ||||
Total at cost | 4,831 | ||||
Accumulated Depreciation | 485 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,014 | ||||
Date Acquired | Jun. 5, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2014 [Member] | Altoona, WI [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, buildings | $ 29,062 | ||||
Buildings at cost | 29,062 | ||||
Total at cost | 29,062 | ||||
Accumulated Depreciation | 3,148 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,014 | ||||
Date Acquired | Aug. 31, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2014 [Member] | Ogden, UT [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 1,759 | ||||
Initial costs, buildings | 16,414 | ||||
Land at cost | 1,759 | ||||
Buildings at cost | 16,414 | ||||
Total at cost | 18,173 | ||||
Accumulated Depreciation | 1,971 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,014 | ||||
Date Acquired | Mar. 1, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2014 [Member] | Pearland, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 1,075 | ||||
Initial costs, buildings | 3,577 | ||||
Land at cost | 1,075 | ||||
Buildings at cost | 3,577 | ||||
Total at cost | 4,652 | ||||
Accumulated Depreciation | 388 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,014 | ||||
Date Acquired | Sep. 8, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2014 [Member] | Sienna, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 1,000 | ||||
Initial costs, buildings | 3,591 | ||||
Land at cost | 1,000 | ||||
Buildings at cost | 3,591 | ||||
Total at cost | 4,591 | ||||
Accumulated Depreciation | 389 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,014 | ||||
Date Acquired | Aug. 20, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2014 [Member] | Thornton, CO [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 1,350 | ||||
Initial costs, buildings | 4,259 | ||||
Land at cost | 1,350 | ||||
Buildings at cost | 4,259 | ||||
Total at cost | 5,609 | ||||
Accumulated Depreciation | 461 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,014 | ||||
Date Acquired | Aug. 29, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2015 [Member] | Houston, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 1,423 | ||||
Initial costs, buildings | 3,772 | ||||
Land at cost | 1,423 | ||||
Buildings at cost | 3,772 | ||||
Total at cost | 5,195 | ||||
Accumulated Depreciation | 361 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,015 | ||||
Date Acquired | Feb. 18, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2015 [Member] | Aurora, CO [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, buildings | $ 4,812 | ||||
Buildings at cost | 4,812 | ||||
Total at cost | 4,812 | ||||
Accumulated Depreciation | 391 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,015 | ||||
Date Acquired | Sep. 17, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2015 [Member] | Ft. Worth, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, buildings | $ 4,392 | ||||
Buildings at cost | 4,392 | ||||
Total at cost | 4,392 | ||||
Accumulated Depreciation | 412 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,015 | ||||
Date Acquired | Mar. 27, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2015 [Member] | Glendale, AZ [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, buildings | $ 4,046 | ||||
Buildings at cost | 4,046 | ||||
Total at cost | 4,046 | ||||
Accumulated Depreciation | 362 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,015 | ||||
Date Acquired | Jun. 5, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2015 [Member] | Carrollton, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 729 | ||||
Initial costs, buildings | 34,342 | ||||
Land at cost | 729 | ||||
Buildings at cost | 34,342 | ||||
Total at cost | 35,071 | ||||
Accumulated Depreciation | 2,933 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,015 | ||||
Date Acquired | Jul. 17, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2015 [Member] | Chandler, AZ [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, buildings | $ 4,783 | ||||
Buildings at cost | 4,783 | ||||
Total at cost | 4,783 | ||||
Accumulated Depreciation | 438 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,015 | ||||
Date Acquired | Apr. 24, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2015 [Member] | Katy, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, buildings | $ 3,873 | ||||
Buildings at cost | 3,873 | ||||
Total at cost | 3,873 | ||||
Accumulated Depreciation | 307 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,015 | ||||
Date Acquired | Oct. 21, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2015 [Member] | Conroe, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 1,338 | ||||
Initial costs, buildings | 3,712 | ||||
Land at cost | 1,338 | ||||
Buildings at cost | 3,712 | ||||
Total at cost | 5,050 | ||||
Accumulated Depreciation | 317 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,015 | ||||
Date Acquired | Jul. 29, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2015 [Member] | Converse, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 750 | ||||
Initial costs, buildings | 4,423 | ||||
Land at cost | 750 | ||||
Buildings at cost | 4,423 | ||||
Total at cost | 5,173 | ||||
Accumulated Depreciation | 415 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,015 | ||||
Date Acquired | Apr. 10, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2015 [Member] | Denver, CO [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, buildings | $ 4,276 | ||||
Buildings at cost | 4,276 | ||||
Total at cost | 4,276 | ||||
Accumulated Depreciation | 383 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,015 | ||||
Date Acquired | Jun. 8, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2015 [Member] | Dorchester, MA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 14,428 | ||||
Initial costs, buildings | 219,575 | ||||
Additions subsequent to acquisition, Improvements | 5,394 | ||||
Land at cost | 14,428 | ||||
Buildings at cost | 224,969 | ||||
Total at cost | 239,397 | ||||
Accumulated Depreciation | 1,371 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,015 | ||||
Date Acquired | Oct. 15, 2018 | ||||
Life on which depreciation in latest income statements is computed (Years) | 42 years | ||||
2015 [Member] | Frisco, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 2,441 | ||||
Initial costs, buildings | 185 | ||||
Land at cost | 2,441 | ||||
Buildings at cost | 185 | ||||
Total at cost | 2,626 | ||||
Accumulated Depreciation | 354 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,015 | ||||
Date Acquired | Nov. 13, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2015 [Member] | Gilbert, AZ [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 1,517 | ||||
Initial costs, buildings | 4,660 | ||||
Land at cost | 1,517 | ||||
Buildings at cost | 4,660 | ||||
Total at cost | 6,177 | ||||
Accumulated Depreciation | 398 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,015 | ||||
Date Acquired | Jul. 22, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2015 [Member] | Highland Village, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, buildings | $ 1,551 | ||||
Buildings at cost | 1,551 | ||||
Total at cost | 1,551 | ||||
Accumulated Depreciation | 326 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,015 | ||||
Date Acquired | Sep. 22, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2015 [Member] | Hoover, AL [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, buildings | $ 7,581 | ||||
Buildings at cost | 7,581 | ||||
Total at cost | 7,581 | ||||
Accumulated Depreciation | 812 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,015 | ||||
Date Acquired | May 1, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 34 years | ||||
2015 [Member] | Lehi, UT [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 13,403 | ||||
Initial costs, buildings | 29,950 | ||||
Additions subsequent to acquisition, Improvements | 156 | ||||
Additions subsequent to acquisition, carrying costs | (35) | ||||
Land at cost | 13,368 | ||||
Buildings at cost | 30,106 | ||||
Total at cost | 43,474 | ||||
Accumulated Depreciation | 1,108 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,015 | ||||
Date Acquired | Sep. 29, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 45 years | ||||
2015 [Member] | McKinney, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, buildings | $ 4,060 | ||||
Buildings at cost | 4,060 | ||||
Total at cost | 4,060 | ||||
Accumulated Depreciation | 466 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,015 | ||||
Date Acquired | Jul. 31, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 30 years | ||||
2015 [Member] | Parker, CO [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 1,300 | ||||
Initial costs, buildings | 4,448 | ||||
Land at cost | 1,300 | ||||
Buildings at cost | 4,448 | ||||
Total at cost | 5,748 | ||||
Accumulated Depreciation | 352 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,015 | ||||
Date Acquired | Nov. 6, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2015 [Member] | Taunton, MA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 4,428 | ||||
Initial costs, buildings | 73,228 | ||||
Additions subsequent to acquisition, Improvements | 2,951 | ||||
Land at cost | 4,428 | ||||
Buildings at cost | 76,179 | ||||
Total at cost | 80,607 | ||||
Accumulated Depreciation | 4,400 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,015 | ||||
Date Acquired | Oct. 3, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
2015 [Member] | League City, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, buildings | $ 3,901 | ||||
Buildings at cost | 3,901 | ||||
Total at cost | 3,901 | ||||
Accumulated Depreciation | 341 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,015 | ||||
Date Acquired | Jun. 19, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1970 [Member] | Ayer, MA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 9,048 | ||||
Initial costs, buildings | 77,913 | ||||
Additions subsequent to acquisition, Improvements | 1,603 | ||||
Land at cost | 9,048 | ||||
Buildings at cost | 79,516 | ||||
Total at cost | 88,564 | ||||
Accumulated Depreciation | 911 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,970 | ||||
Date Acquired | Jun. 27, 2018 | ||||
Life on which depreciation in latest income statements is computed (Years) | 47 years | ||||
1970 [Member] | Rockledge, FL [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 13,919 | ||||
Initial costs, buildings | 23,282 | ||||
Additions subsequent to acquisition, Improvements | 1,831 | ||||
Land at cost | 13,919 | ||||
Buildings at cost | 25,113 | ||||
Total at cost | 39,032 | ||||
Accumulated Depreciation | 1,460 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,970 | ||||
Date Acquired | May 1, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 42 years | ||||
2013 [Member] | Ayer, MA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 9,048 | ||||
Initial costs, buildings | 77,913 | ||||
Additions subsequent to acquisition, Improvements | 1,603 | ||||
Land at cost | 9,048 | ||||
Buildings at cost | 79,516 | ||||
Total at cost | 88,564 | ||||
Accumulated Depreciation | 911 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,013 | ||||
Date Acquired | Jun. 27, 2018 | ||||
Life on which depreciation in latest income statements is computed (Years) | 47 years | ||||
2013 [Member] | Hausman, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 1,500 | ||||
Initial costs, buildings | 8,957 | ||||
Land at cost | 1,500 | ||||
Buildings at cost | 8,957 | ||||
Total at cost | 10,457 | ||||
Accumulated Depreciation | 1,284 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,013 | ||||
Date Acquired | Mar. 1, 2013 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2013 [Member] | Lafayette, IN [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 800 | ||||
Initial costs, buildings | 14,968 | ||||
Additions subsequent to acquisition, Improvements | (25) | ||||
Land at cost | 800 | ||||
Buildings at cost | 14,943 | ||||
Total at cost | 15,743 | ||||
Accumulated Depreciation | 2,198 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,013 | ||||
Date Acquired | Feb. 1, 2013 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2013 [Member] | Lehi, UT [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 1,241 | ||||
Initial costs, buildings | 3,491 | ||||
Land at cost | 1,241 | ||||
Buildings at cost | 3,491 | ||||
Total at cost | 4,732 | ||||
Accumulated Depreciation | 441 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,013 | ||||
Date Acquired | Dec. 1, 2013 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2013 [Member] | Post Falls, ID [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 417 | ||||
Initial costs, buildings | 12,175 | ||||
Additions subsequent to acquisition, Improvements | 1,905 | ||||
Land at cost | 767 | ||||
Buildings at cost | 13,730 | ||||
Total at cost | 14,497 | ||||
Accumulated Depreciation | 1,725 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,013 | ||||
Date Acquired | Dec. 31, 2013 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2013 [Member] | Spartanburg, SC [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 1,135 | ||||
Initial costs, buildings | 15,717 | ||||
Land at cost | 1,135 | ||||
Buildings at cost | 15,717 | ||||
Total at cost | 16,852 | ||||
Accumulated Depreciation | 2,112 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,013 | ||||
Date Acquired | Aug. 1, 2013 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1918 [Member] | Bayonne, NJ [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 2,003 | ||||
Initial costs, buildings | 51,495 | ||||
Land at cost | 2,003 | ||||
Buildings at cost | 51,495 | ||||
Total at cost | 53,498 | ||||
Accumulated Depreciation | 20,383 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,918 | ||||
Date Acquired | Feb. 4, 2011 | ||||
Life on which depreciation in latest income statements is computed (Years) | 20 years | ||||
1984 [Member] | Bennettsville, SC [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 794 | ||||
Initial costs, buildings | 15,772 | ||||
Land at cost | 794 | ||||
Buildings at cost | 15,772 | ||||
Total at cost | 16,566 | ||||
Accumulated Depreciation | 4,157 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,984 | ||||
Date Acquired | Apr. 1, 2008 | ||||
Life on which depreciation in latest income statements is computed (Years) | 42 years | ||||
1984 [Member] | Hope, AR [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 1,651 | ||||
Initial costs, buildings | 3,359 | ||||
Additions subsequent to acquisition, Improvements | 373 | ||||
Land at cost | 1,651 | ||||
Buildings at cost | 3,732 | ||||
Total at cost | 5,383 | ||||
Accumulated Depreciation | 223 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,984 | ||||
Date Acquired | Sep. 29, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
1984 [Member] | Olympia, Washington [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 7,220 | ||||
Initial costs, buildings | 89,348 | ||||
Additions subsequent to acquisition, Improvements | 15,930 | ||||
Land at cost | 7,220 | ||||
Buildings at cost | 105,278 | ||||
Total at cost | 112,498 | ||||
Accumulated Depreciation | 6,138 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,984 | ||||
Date Acquired | Jul. 22, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1980 [Member] | Blue Springs, MO [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 4,347 | ||||
Initial costs, buildings | 23,494 | ||||
Land at cost | 4,347 | ||||
Buildings at cost | 23,494 | ||||
Total at cost | 27,841 | ||||
Accumulated Depreciation | 2,417 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,980 | ||||
Date Acquired | Feb. 13, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1980 [Member] | Hill County, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 1,120 | ||||
Initial costs, buildings | 17,882 | ||||
Land at cost | 1,120 | ||||
Buildings at cost | 17,882 | ||||
Total at cost | 19,002 | ||||
Accumulated Depreciation | 9,890 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,980 | ||||
Date Acquired | Sep. 17, 2010 | ||||
Life on which depreciation in latest income statements is computed (Years) | 15 years | ||||
1980 [Member] | Poplar Bluff, MO [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 2,660 | ||||
Initial costs, buildings | 38,693 | ||||
Additions subsequent to acquisition, carrying costs | 1 | ||||
Land at cost | 2,660 | ||||
Buildings at cost | 38,694 | ||||
Total at cost | 41,354 | ||||
Accumulated Depreciation | 10,339 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,980 | ||||
Date Acquired | Apr. 22, 2008 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1980 [Member] | Sharon, PA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 6,179 | ||||
Initial costs, buildings | 9,066 | ||||
Additions subsequent to acquisition, Improvements | 1,808 | ||||
Land at cost | 6,179 | ||||
Buildings at cost | 10,874 | ||||
Total at cost | 17,053 | ||||
Accumulated Depreciation | 1,096 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,980 | ||||
Date Acquired | May 1, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
1980 [Member] | West Valley City, UT [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 5,516 | ||||
Initial costs, buildings | 58,314 | ||||
Additions subsequent to acquisition, Improvements | 2,478 | ||||
Additions subsequent to acquisition, carrying costs | (114) | ||||
Land at cost | 5,402 | ||||
Buildings at cost | 60,792 | ||||
Total at cost | 66,194 | ||||
Accumulated Depreciation | 15,762 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,980 | ||||
Date Acquired | Apr. 22, 2008 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1982 [Member] | Bossier City, LA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Long term acute care hospital | ||||
Initial costs, land | $ 900 | ||||
Initial costs, buildings | 17,818 | ||||
Additions subsequent to acquisition, Improvements | 628 | ||||
Land at cost | 900 | ||||
Buildings at cost | 18,446 | ||||
Total at cost | 19,346 | ||||
Accumulated Depreciation | 4,786 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,982 | ||||
Date Acquired | Apr. 1, 2008 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1982 [Member] | Cheraw, SC [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 657 | ||||
Initial costs, buildings | 19,576 | ||||
Land at cost | 657 | ||||
Buildings at cost | 19,576 | ||||
Total at cost | 20,233 | ||||
Accumulated Depreciation | 5,158 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,982 | ||||
Date Acquired | Apr. 1, 2008 | ||||
Life on which depreciation in latest income statements is computed (Years) | 42 years | ||||
1982 [Member] | Garden Grove, CA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 5,502 | ||||
Initial costs, buildings | 10,748 | ||||
Additions subsequent to acquisition, carrying costs | 51 | ||||
Land at cost | 5,502 | ||||
Buildings at cost | 10,799 | ||||
Total at cost | 16,301 | ||||
Accumulated Depreciation | 2,736 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,982 | ||||
Date Acquired | Nov. 25, 2008 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1982 [Member] | Haverhill, MA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 5,651 | ||||
Initial costs, buildings | 105,848 | ||||
Additions subsequent to acquisition, Improvements | 1,888 | ||||
Land at cost | 5,651 | ||||
Buildings at cost | 107,736 | ||||
Total at cost | 113,387 | ||||
Accumulated Depreciation | 936 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,982 | ||||
Date Acquired | Aug. 31, 2018 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1982 [Member] | Warren, OH [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 5,385 | ||||
Initial costs, buildings | 47,588 | ||||
Additions subsequent to acquisition, Improvements | 5,142 | ||||
Land at cost | 5,385 | ||||
Buildings at cost | 52,730 | ||||
Total at cost | 58,115 | ||||
Accumulated Depreciation | 2,509 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,982 | ||||
Date Acquired | May 1, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
1917 [Member] | Brighton, MA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 18,540 | ||||
Initial costs, buildings | 146,490 | ||||
Additions subsequent to acquisition, Improvements | 11,176 | ||||
Land at cost | 18,540 | ||||
Buildings at cost | 157,666 | ||||
Total at cost | 176,206 | ||||
Accumulated Depreciation | 8,304 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,917 | ||||
Date Acquired | Oct. 3, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
1965 [Member] | Brockton, MA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 18,328 | ||||
Initial costs, buildings | 67,248 | ||||
Additions subsequent to acquisition, Improvements | 4,296 | ||||
Land at cost | 18,328 | ||||
Buildings at cost | 71,544 | ||||
Total at cost | 89,872 | ||||
Accumulated Depreciation | 4,798 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,965 | ||||
Date Acquired | Oct. 3, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
2015 One [Member] | Chandler, AZ [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 750 | ||||
Initial costs, buildings | 3,852 | ||||
Additions subsequent to acquisition, Improvements | 0 | ||||
Land at cost | 750 | ||||
Buildings at cost | 3,852 | ||||
Total at cost | 4,602 | ||||
Accumulated Depreciation | 313 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,015 | ||||
Date Acquired | Oct. 7, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2015 One [Member] | Hoover, AL [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Medical Office Building | ||||
Initial costs, buildings | $ 1,034 | ||||
Buildings at cost | 1,034 | ||||
Total at cost | 1,034 | ||||
Accumulated Depreciation | 111 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,015 | ||||
Date Acquired | May 1, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 34 years | ||||
2004 [Member] | Webster, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Long term acute care hospital | ||||
Initial costs, land | $ 663 | ||||
Initial costs, buildings | 33,751 | ||||
Land at cost | 663 | ||||
Buildings at cost | 33,751 | ||||
Total at cost | 34,414 | ||||
Accumulated Depreciation | 6,750 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,004 | ||||
Date Acquired | Dec. 21, 2010 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2004 [Member] | Camden, SC [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, buildings | $ 22,739 | ||||
Buildings at cost | 22,739 | ||||
Total at cost | 22,739 | ||||
Accumulated Depreciation | 1,555 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,004 | ||||
Date Acquired | Oct. 30, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 39 years | ||||
2004 [Member] | Odessa, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 6,535 | ||||
Initial costs, buildings | 123,518 | ||||
Additions subsequent to acquisition, Improvements | 254 | ||||
Land at cost | 6,535 | ||||
Buildings at cost | 123,772 | ||||
Total at cost | 130,307 | ||||
Accumulated Depreciation | 3,950 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,004 | ||||
Date Acquired | Sep. 29, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
2017 [Member] | Houston, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, buildings | $ 4,267 | ||||
Buildings at cost | 4,267 | ||||
Total at cost | 4,267 | ||||
Accumulated Depreciation | 203 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,017 | ||||
Date Acquired | May 8, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 35 years | ||||
2017 [Member] | Austin, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, buildings | $ 4,200 | ||||
Buildings at cost | 4,200 | ||||
Total at cost | 4,200 | ||||
Accumulated Depreciation | 231 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,017 | ||||
Date Acquired | Mar. 2, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2017 [Member] | Phoenix, AZ [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 5,576 | ||||
Initial costs, buildings | 45,782 | ||||
Land at cost | 5,576 | ||||
Buildings at cost | 45,782 | ||||
Total at cost | 51,358 | ||||
Accumulated Depreciation | 2,194 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,017 | ||||
Date Acquired | Feb. 10, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2017 [Member] | Texarkana, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 14,562 | ||||
Land at cost | 14,562 | ||||
Total at cost | 14,562 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,017 | ||||
Date Acquired | Sep. 29, 2017 | ||||
1956 [Member] | Detroit, MI [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Long term acute care hospital | ||||
Initial costs, land | $ 1,220 | ||||
Initial costs, buildings | 8,687 | ||||
Additions subsequent to acquisition, carrying costs | (365) | ||||
Land at cost | 1,220 | ||||
Buildings at cost | 8,322 | ||||
Total at cost | 9,542 | ||||
Accumulated Depreciation | 2,274 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,956 | ||||
Date Acquired | May 22, 2008 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1953 [Member] | Dorchester, MA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 14,428 | ||||
Initial costs, buildings | 219,575 | ||||
Additions subsequent to acquisition, Improvements | 5,394 | ||||
Land at cost | 14,428 | ||||
Buildings at cost | 224,969 | ||||
Total at cost | 239,397 | ||||
Accumulated Depreciation | 1,371 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,953 | ||||
Date Acquired | Oct. 15, 2018 | ||||
Life on which depreciation in latest income statements is computed (Years) | 42 years | ||||
1953 [Member] | Port Huron, MI [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 3,029 | ||||
Initial costs, buildings | 14,622 | ||||
Land at cost | 3,029 | ||||
Buildings at cost | 14,622 | ||||
Total at cost | 17,651 | ||||
Accumulated Depreciation | 1,498 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,953 | ||||
Date Acquired | Dec. 31, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 30 years | ||||
1930 [Member] | Easton, PA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 13,898 | ||||
Initial costs, buildings | 40,245 | ||||
Additions subsequent to acquisition, Improvements | 2,921 | ||||
Land at cost | 13,898 | ||||
Buildings at cost | 43,166 | ||||
Total at cost | 57,064 | ||||
Accumulated Depreciation | 1,786 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,930 | ||||
Date Acquired | May 1, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
2005 [Member] | Easton, PA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 13,898 | ||||
Initial costs, buildings | 40,245 | ||||
Additions subsequent to acquisition, Improvements | 2,921 | ||||
Land at cost | 13,898 | ||||
Buildings at cost | 43,166 | ||||
Total at cost | 57,064 | ||||
Accumulated Depreciation | 1,786 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,005 | ||||
Date Acquired | May 1, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
2005 [Member] | Gilbert, AZ [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 150 | ||||
Initial costs, buildings | 15,553 | ||||
Land at cost | 150 | ||||
Buildings at cost | 15,553 | ||||
Total at cost | 15,703 | ||||
Accumulated Depreciation | 3,111 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,005 | ||||
Date Acquired | Jan. 4, 2011 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2005 [Member] | Haverhill, MA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 5,651 | ||||
Initial costs, buildings | 105,848 | ||||
Additions subsequent to acquisition, Improvements | 1,888 | ||||
Land at cost | 5,651 | ||||
Buildings at cost | 107,736 | ||||
Total at cost | 113,387 | ||||
Accumulated Depreciation | 936 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,005 | ||||
Date Acquired | Aug. 31, 2018 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2005 [Member] | Port Arthur, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 12,972 | ||||
Initial costs, buildings | 78,051 | ||||
Additions subsequent to acquisition, Improvements | 859 | ||||
Land at cost | 12,972 | ||||
Buildings at cost | 78,910 | ||||
Total at cost | 91,882 | ||||
Accumulated Depreciation | 10,155 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,005 | ||||
Date Acquired | Sep. 26, 2013 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2005 [Member] | Tomball, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Long term acute care hospital | ||||
Initial costs, land | $ 1,299 | ||||
Initial costs, buildings | 23,982 | ||||
Land at cost | 1,299 | ||||
Buildings at cost | 23,982 | ||||
Total at cost | 25,281 | ||||
Accumulated Depreciation | 4,796 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,005 | ||||
Date Acquired | Dec. 21, 2010 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1939 [Member] | Fairmont, CA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 1,000 | ||||
Initial costs, buildings | 6,072 | ||||
Additions subsequent to acquisition, Improvements | 5,278 | ||||
Land at cost | 1,277 | ||||
Buildings at cost | 11,073 | ||||
Total at cost | 12,350 | ||||
Accumulated Depreciation | 1,798 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,939 | ||||
Date Acquired | Sep. 19, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1950 [Member] | Houston, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 28,687 | ||||
Initial costs, buildings | 104,028 | ||||
Additions subsequent to acquisition, Improvements | 5,999 | ||||
Land at cost | 28,687 | ||||
Buildings at cost | 110,027 | ||||
Total at cost | 138,714 | ||||
Accumulated Depreciation | 878 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,950 | ||||
Date Acquired | Sep. 29, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
1950 [Member] | Fall River, MA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 3,526 | ||||
Initial costs, buildings | 82,358 | ||||
Additions subsequent to acquisition, Improvements | 22,205 | ||||
Land at cost | 3,525 | ||||
Buildings at cost | 104,564 | ||||
Total at cost | 108,089 | ||||
Accumulated Depreciation | 4,977 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,950 | ||||
Date Acquired | Oct. 3, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
1950 [Member] | Methuen, MA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 23,809 | ||||
Initial costs, buildings | 89,505 | ||||
Additions subsequent to acquisition, Improvements | 5,698 | ||||
Land at cost | 23,809 | ||||
Buildings at cost | 95,203 | ||||
Total at cost | 119,012 | ||||
Accumulated Depreciation | 5,766 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,950 | ||||
Date Acquired | Oct. 3, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
1950 [Member] | Rockledge, FL [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 13,919 | ||||
Initial costs, buildings | 23,282 | ||||
Additions subsequent to acquisition, Improvements | 1,831 | ||||
Land at cost | 13,919 | ||||
Buildings at cost | 25,113 | ||||
Total at cost | 39,032 | ||||
Accumulated Depreciation | 1,460 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,950 | ||||
Date Acquired | May 1, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 42 years | ||||
1950 [Member] | Sharon, PA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 6,179 | ||||
Initial costs, buildings | 9,066 | ||||
Additions subsequent to acquisition, Improvements | 1,808 | ||||
Land at cost | 6,179 | ||||
Buildings at cost | 10,874 | ||||
Total at cost | 17,053 | ||||
Accumulated Depreciation | 1,096 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,950 | ||||
Date Acquired | May 1, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
1972 [Member] | Fairmont, CA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 1,000 | ||||
Initial costs, buildings | 6,072 | ||||
Additions subsequent to acquisition, Improvements | 5,278 | ||||
Land at cost | 1,277 | ||||
Buildings at cost | 11,073 | ||||
Total at cost | 12,350 | ||||
Accumulated Depreciation | 1,798 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,972 | ||||
Date Acquired | Sep. 19, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1972 [Member] | San Dimas, CA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 6,160 | ||||
Initial costs, buildings | 6,839 | ||||
Additions subsequent to acquisition, carrying costs | 34 | ||||
Land at cost | 6,160 | ||||
Buildings at cost | 6,873 | ||||
Total at cost | 13,033 | ||||
Accumulated Depreciation | 1,735 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,972 | ||||
Date Acquired | Nov. 25, 2008 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1985 [Member] | Fairmont, CA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 1,000 | ||||
Initial costs, buildings | 6,072 | ||||
Additions subsequent to acquisition, Improvements | 5,278 | ||||
Land at cost | 1,277 | ||||
Buildings at cost | 11,073 | ||||
Total at cost | 12,350 | ||||
Accumulated Depreciation | 1,798 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,985 | ||||
Date Acquired | Sep. 19, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1985 [Member] | Fort Lauderdale, FL [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 3,499 | ||||
Initial costs, buildings | 21,939 | ||||
Additions subsequent to acquisition, carrying costs | 1 | ||||
Land at cost | 3,499 | ||||
Buildings at cost | 21,940 | ||||
Total at cost | 25,439 | ||||
Accumulated Depreciation | 5,862 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,985 | ||||
Date Acquired | Apr. 22, 2008 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1985 [Member] | Hot Springs, AR [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 7,100 | ||||
Initial costs, buildings | 59,432 | ||||
Additions subsequent to acquisition, Improvements | 21,221 | ||||
Land at cost | 7,100 | ||||
Buildings at cost | 80,653 | ||||
Total at cost | 87,753 | ||||
Accumulated Depreciation | 6,795 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,985 | ||||
Date Acquired | Aug. 31, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
Two Thousand Twelve | San Antonio, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 2,248 | ||||
Initial costs, buildings | 5,880 | ||||
Land at cost | 2,248 | ||||
Buildings at cost | 5,880 | ||||
Total at cost | 8,128 | ||||
Accumulated Depreciation | 904 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,012 | ||||
Date Acquired | Oct. 2, 2012 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
Two Thousand Twelve | Fall River, MA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 3,526 | ||||
Initial costs, buildings | 82,358 | ||||
Additions subsequent to acquisition, Improvements | 22,205 | ||||
Land at cost | 3,525 | ||||
Buildings at cost | 104,564 | ||||
Total at cost | 108,089 | ||||
Accumulated Depreciation | 4,977 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,012 | ||||
Date Acquired | Oct. 3, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
Two Thousand Twelve | Florence, AZ [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 900 | ||||
Initial costs, buildings | 28,462 | ||||
Additions subsequent to acquisition, Improvements | 105 | ||||
Land at cost | 900 | ||||
Buildings at cost | 28,567 | ||||
Total at cost | 29,467 | ||||
Accumulated Depreciation | 4,817 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,012 | ||||
Date Acquired | Feb. 7, 2012 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
Two Thousand Twelve | Overlook, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 2,452 | ||||
Initial costs, buildings | 9,666 | ||||
Additions subsequent to acquisition, Improvements | 7 | ||||
Land at cost | 2,452 | ||||
Buildings at cost | 9,673 | ||||
Total at cost | 12,125 | ||||
Accumulated Depreciation | 1,411 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,012 | ||||
Date Acquired | Feb. 1, 2013 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1982 One [Member] | Garden Grove, CA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Medical Office Building | ||||
Initial costs, land | $ 862 | ||||
Initial costs, buildings | 7,888 | ||||
Additions subsequent to acquisition, carrying costs | 28 | ||||
Land at cost | 862 | ||||
Buildings at cost | 7,916 | ||||
Total at cost | 8,778 | ||||
Accumulated Depreciation | 1,999 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,982 | ||||
Date Acquired | Nov. 25, 2008 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
Nineteen Ninety Nine | Hartsville, SC [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 2,050 | ||||
Initial costs, buildings | 43,970 | ||||
Land at cost | 2,050 | ||||
Buildings at cost | 43,970 | ||||
Total at cost | 46,020 | ||||
Accumulated Depreciation | 3,827 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,999 | ||||
Date Acquired | Aug. 31, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 34 years | ||||
1922 [Member] | Warren, OH [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 2,417 | ||||
Initial costs, buildings | 15,857 | ||||
Additions subsequent to acquisition, Improvements | 35 | ||||
Land at cost | 2,417 | ||||
Buildings at cost | 15,892 | ||||
Total at cost | 18,309 | ||||
Accumulated Depreciation | 891 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,922 | ||||
Date Acquired | May 1, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 46 years | ||||
1922 [Member] | Lewiston, ID [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 5,389 | ||||
Initial costs, buildings | 75,435 | ||||
Land at cost | 5,389 | ||||
Buildings at cost | 75,435 | ||||
Total at cost | 80,824 | ||||
Accumulated Depreciation | 4,251 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,922 | ||||
Date Acquired | May 1, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2000 [Member] | Warren, OH [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 2,417 | ||||
Initial costs, buildings | 15,857 | ||||
Additions subsequent to acquisition, Improvements | 35 | ||||
Land at cost | 2,417 | ||||
Buildings at cost | 15,892 | ||||
Total at cost | 18,309 | ||||
Accumulated Depreciation | 891 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,000 | ||||
Date Acquired | May 1, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 46 years | ||||
2000 [Member] | Montclair, NJ [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 7,900 | ||||
Initial costs, buildings | 99,640 | ||||
Additions subsequent to acquisition, Improvements | 577 | ||||
Land at cost | 8,477 | ||||
Buildings at cost | 99,640 | ||||
Total at cost | 108,117 | ||||
Accumulated Depreciation | 12,211 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,000 | ||||
Date Acquired | Apr. 1, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1863 [Member] | Hoboken, NJ [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 1,387 | ||||
Initial costs, buildings | 44,351 | ||||
Land at cost | 1,387 | ||||
Buildings at cost | 44,351 | ||||
Total at cost | 45,738 | ||||
Accumulated Depreciation | 15,838 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,863 | ||||
Date Acquired | Nov. 4, 2011 | ||||
Life on which depreciation in latest income statements is computed (Years) | 20 years | ||||
2001 [Member] | Hope, AR [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 1,651 | ||||
Initial costs, buildings | 3,359 | ||||
Additions subsequent to acquisition, Improvements | 373 | ||||
Land at cost | 1,651 | ||||
Buildings at cost | 3,732 | ||||
Total at cost | 5,383 | ||||
Accumulated Depreciation | 223 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,001 | ||||
Date Acquired | Sep. 29, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
2001 [Member] | Norwood, MA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 7,073 | ||||
Initial costs, buildings | 154,496 | ||||
Additions subsequent to acquisition, Improvements | 7,745 | ||||
Land at cost | 7,073 | ||||
Buildings at cost | 162,241 | ||||
Total at cost | 169,314 | ||||
Accumulated Depreciation | 1,781 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,001 | ||||
Date Acquired | Jun. 27, 2018 | ||||
Life on which depreciation in latest income statements is computed (Years) | 46 years | ||||
1940 [Member] | Houston, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 28,687 | ||||
Initial costs, buildings | 104,028 | ||||
Additions subsequent to acquisition, Improvements | 5,999 | ||||
Land at cost | 28,687 | ||||
Buildings at cost | 110,027 | ||||
Total at cost | 138,714 | ||||
Accumulated Depreciation | 878 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,940 | ||||
Date Acquired | Sep. 29, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
1940 [Member] | Taunton, MA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 4,428 | ||||
Initial costs, buildings | 73,228 | ||||
Additions subsequent to acquisition, Improvements | 2,951 | ||||
Land at cost | 4,428 | ||||
Buildings at cost | 76,179 | ||||
Total at cost | 80,607 | ||||
Accumulated Depreciation | 4,400 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,940 | ||||
Date Acquired | Oct. 3, 2016 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
1940 [Member] | Tempe, AZ [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 6,050 | ||||
Initial costs, buildings | 10,986 | ||||
Additions subsequent to acquisition, Improvements | 871 | ||||
Land at cost | 6,050 | ||||
Buildings at cost | 11,857 | ||||
Total at cost | 17,907 | ||||
Accumulated Depreciation | 476 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,940 | ||||
Date Acquired | Sep. 29, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
2002 [Member] | San Antonio, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 8,053 | ||||
Initial costs, buildings | 29,333 | ||||
Additions subsequent to acquisition, Improvements | 675 | ||||
Land at cost | 8,053 | ||||
Buildings at cost | 30,008 | ||||
Total at cost | 38,061 | ||||
Accumulated Depreciation | 1,024 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,002 | ||||
Date Acquired | Sep. 29, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
2002 [Member] | Idaho Falls, ID [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 1,822 | ||||
Initial costs, buildings | 37,467 | ||||
Additions subsequent to acquisition, Improvements | 441 | ||||
Additions subsequent to acquisition, carrying costs | 4,665 | ||||
Land at cost | 1,822 | ||||
Buildings at cost | 42,573 | ||||
Total at cost | 44,395 | ||||
Accumulated Depreciation | 11,201 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,002 | ||||
Date Acquired | Apr. 1, 2008 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2002 [Member] | Melbourne, FL [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 5,642 | ||||
Initial costs, buildings | 17,087 | ||||
Additions subsequent to acquisition, Improvements | 2,282 | ||||
Land at cost | 5,642 | ||||
Buildings at cost | 19,369 | ||||
Total at cost | 25,011 | ||||
Accumulated Depreciation | 922 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,002 | ||||
Date Acquired | May 1, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 42 years | ||||
1978 [Member] | San Antonio, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 8,053 | ||||
Initial costs, buildings | 29,333 | ||||
Additions subsequent to acquisition, Improvements | 675 | ||||
Land at cost | 8,053 | ||||
Buildings at cost | 30,008 | ||||
Total at cost | 38,061 | ||||
Accumulated Depreciation | 1,024 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,978 | ||||
Date Acquired | Sep. 29, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
1978 [Member] | Kansas City, MO [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 10,497 | ||||
Initial costs, buildings | 64,419 | ||||
Land at cost | 10,497 | ||||
Buildings at cost | 64,419 | ||||
Total at cost | 74,916 | ||||
Accumulated Depreciation | 6,429 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,978 | ||||
Date Acquired | Feb. 13, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1954 [Member] | Camden, SC [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, buildings | $ 22,739 | ||||
Buildings at cost | 22,739 | ||||
Total at cost | 22,739 | ||||
Accumulated Depreciation | 1,555 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,954 | ||||
Date Acquired | Oct. 30, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 39 years | ||||
1996 [Member] | McMinnville, OR [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 5,000 | ||||
Initial costs, buildings | 97,900 | ||||
Land at cost | 5,000 | ||||
Buildings at cost | 97,900 | ||||
Total at cost | 102,900 | ||||
Accumulated Depreciation | 6,652 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,996 | ||||
Date Acquired | Aug. 31, 2015 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
2007 [Member] | Mesa, AZ [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 6,534 | ||||
Initial costs, buildings | 100,042 | ||||
Additions subsequent to acquisition, Improvements | 289 | ||||
Land at cost | 6,533 | ||||
Buildings at cost | 100,332 | ||||
Total at cost | 106,865 | ||||
Accumulated Depreciation | 13,819 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,007 | ||||
Date Acquired | Sep. 26, 2013 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
2007 [Member] | Northland, MO [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Long term acute care hospital | ||||
Initial costs, land | $ 834 | ||||
Initial costs, buildings | 17,182 | ||||
Land at cost | 834 | ||||
Buildings at cost | 17,182 | ||||
Total at cost | 18,016 | ||||
Accumulated Depreciation | 3,401 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,007 | ||||
Date Acquired | Feb. 14, 2011 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1920 [Member] | Montclair, NJ [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 7,900 | ||||
Initial costs, buildings | 99,640 | ||||
Additions subsequent to acquisition, Improvements | 577 | ||||
Land at cost | 8,477 | ||||
Buildings at cost | 99,640 | ||||
Total at cost | 108,117 | ||||
Accumulated Depreciation | 12,211 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,920 | ||||
Date Acquired | Apr. 1, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1920 [Member] | Pasco, WA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 2,594 | ||||
Initial costs, buildings | 13,195 | ||||
Land at cost | 2,594 | ||||
Buildings at cost | 13,195 | ||||
Total at cost | 15,789 | ||||
Accumulated Depreciation | 150 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,920 | ||||
Date Acquired | Aug. 31, 2018 | ||||
Life on which depreciation in latest income statements is computed (Years) | 30 years | ||||
1926 [Member] | Norwood, MA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 7,073 | ||||
Initial costs, buildings | 154,496 | ||||
Additions subsequent to acquisition, Improvements | 7,745 | ||||
Land at cost | 7,073 | ||||
Buildings at cost | 162,241 | ||||
Total at cost | 169,314 | ||||
Accumulated Depreciation | 1,781 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,926 | ||||
Date Acquired | Jun. 27, 2018 | ||||
Life on which depreciation in latest income statements is computed (Years) | 46 years | ||||
1964 [Member] | San Diego, CA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 6,550 | ||||
Initial costs, buildings | 15,653 | ||||
Additions subsequent to acquisition, carrying costs | 77 | ||||
Land at cost | 6,550 | ||||
Buildings at cost | 15,730 | ||||
Total at cost | 22,280 | ||||
Accumulated Depreciation | 4,586 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,964 | ||||
Date Acquired | May 9, 2007 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1964 [Member] | Anaheim, CA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 1,875 | ||||
Initial costs, buildings | 21,813 | ||||
Additions subsequent to acquisition, carrying costs | 10 | ||||
Land at cost | 1,875 | ||||
Buildings at cost | 21,823 | ||||
Total at cost | 23,698 | ||||
Accumulated Depreciation | 6,638 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,964 | ||||
Date Acquired | Nov. 8, 2006 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1979 [Member] | Phoenix, AZ [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 2,396 | ||||
Initial costs, buildings | 26,521 | ||||
Additions subsequent to acquisition, Improvements | 2,931 | ||||
Land at cost | 2,396 | ||||
Buildings at cost | 29,452 | ||||
Total at cost | 31,848 | ||||
Accumulated Depreciation | 817 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,979 | ||||
Date Acquired | Sep. 29, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 42 years | ||||
1979 [Member] | San Dimas, CA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Medical Office Building | ||||
Initial costs, land | $ 1,915 | ||||
Initial costs, buildings | 5,085 | ||||
Additions subsequent to acquisition, carrying costs | 18 | ||||
Land at cost | 1,915 | ||||
Buildings at cost | 5,103 | ||||
Total at cost | 7,018 | ||||
Accumulated Depreciation | 1,289 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,979 | ||||
Date Acquired | Nov. 25, 2008 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1968 [Member] | Phoenix, AZ [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 12,695 | ||||
Initial costs, buildings | 73,774 | ||||
Additions subsequent to acquisition, Improvements | 2,432 | ||||
Land at cost | 12,695 | ||||
Buildings at cost | 76,206 | ||||
Total at cost | 88,901 | ||||
Accumulated Depreciation | 2,502 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,968 | ||||
Date Acquired | Sep. 29, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 43 years | ||||
1976 [Member] | Phoenix, AZ [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 12,695 | ||||
Initial costs, buildings | 73,774 | ||||
Additions subsequent to acquisition, Improvements | 2,432 | ||||
Land at cost | 12,695 | ||||
Buildings at cost | 76,206 | ||||
Total at cost | 88,901 | ||||
Accumulated Depreciation | 2,502 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,976 | ||||
Date Acquired | Sep. 29, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 43 years | ||||
1906 [Member] | San Antonio, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 13,590 | ||||
Initial costs, buildings | 101,915 | ||||
Additions subsequent to acquisition, Improvements | 726 | ||||
Land at cost | 13,590 | ||||
Buildings at cost | 102,641 | ||||
Total at cost | 116,231 | ||||
Accumulated Depreciation | 3,178 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,906 | ||||
Date Acquired | Sep. 29, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
1987 [Member] | San Antonio, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 13,590 | ||||
Initial costs, buildings | 101,915 | ||||
Additions subsequent to acquisition, Improvements | 726 | ||||
Land at cost | 13,590 | ||||
Buildings at cost | 102,641 | ||||
Total at cost | 116,231 | ||||
Accumulated Depreciation | 3,178 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,987 | ||||
Date Acquired | Sep. 29, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
2017 One [Member] | Phoenix, AZ [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Freestanding ER | ||||
Initial costs, land | $ 1,132 | ||||
Initial costs, buildings | 5,052 | ||||
Land at cost | 1,132 | ||||
Buildings at cost | 5,052 | ||||
Total at cost | 6,184 | ||||
Accumulated Depreciation | 221 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,017 | ||||
Date Acquired | Apr. 13, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1913 [Member] | Sherman, TX [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 4,493 | ||||
Initial costs, buildings | 11,081 | ||||
Land at cost | 4,493 | ||||
Buildings at cost | 11,081 | ||||
Total at cost | 15,574 | ||||
Accumulated Depreciation | 2,703 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,913 | ||||
Date Acquired | Oct. 31, 2014 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1962 [Member] | West Monroe, LA [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 12,000 | ||||
Initial costs, buildings | 69,433 | ||||
Additions subsequent to acquisition, Improvements | 11,013 | ||||
Land at cost | 12,552 | ||||
Buildings at cost | 79,894 | ||||
Total at cost | 92,446 | ||||
Accumulated Depreciation | 9,746 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,962 | ||||
Date Acquired | Sep. 26, 2013 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1992 [Member] | Wichita, KS [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Rehabilitation hospital | ||||
Initial costs, land | $ 1,019 | ||||
Initial costs, buildings | 18,373 | ||||
Additions subsequent to acquisition, carrying costs | 1 | ||||
Land at cost | 1,019 | ||||
Buildings at cost | 18,374 | ||||
Total at cost | 19,393 | ||||
Accumulated Depreciation | 4,937 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,992 | ||||
Date Acquired | Apr. 4, 2008 | ||||
Life on which depreciation in latest income statements is computed (Years) | 40 years | ||||
1929 [Member] | Youngstown, OH [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 4,335 | ||||
Initial costs, buildings | 3,565 | ||||
Additions subsequent to acquisition, Improvements | 604 | ||||
Land at cost | 4,334 | ||||
Buildings at cost | 4,170 | ||||
Total at cost | 8,504 | ||||
Accumulated Depreciation | 965 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 1,929 | ||||
Date Acquired | May 1, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
2003 [Member] | Youngstown, OH [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Type of property | Acute care general hospital | ||||
Initial costs, land | $ 4,335 | ||||
Initial costs, buildings | 3,565 | ||||
Additions subsequent to acquisition, Improvements | 604 | ||||
Land at cost | 4,334 | ||||
Buildings at cost | 4,170 | ||||
Total at cost | 8,504 | ||||
Accumulated Depreciation | 965 | ||||
Encumbrances | $ 0 | ||||
Date of Construction | 2,003 | ||||
Date Acquired | May 1, 2017 | ||||
Life on which depreciation in latest income statements is computed (Years) | 41 years | ||||
[1] | Includes $131.4 million of land and building cost reflected in real estate held for sale at December 31, 2017. Excludes intangible lease assets that are included in real estate held for sale of $15.8 million at December 31, 2017. |
Schedule III - Real Estate In_3
Schedule III - Real Estate Investments and Accumulated Depreciation (Parenthetical) (Detail) $ in Thousands | Dec. 31, 2018USD ($) |
Real Estate And Accumulated Depreciation Disclosure [Abstract] | |
Aggregate cost for federal income tax purposes | $ 4,873,085 |
Schedule III - Changes in Total
Schedule III - Changes in Total Real Estate Assets (Detail) - USD ($) $ in Thousands | 12 Months Ended | ||||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |||
Real Estate And Accumulated Depreciation Disclosure [Abstract] | |||||
Balance at beginning of period | $ 5,438,148 | [1] | $ 3,968,042 | $ 2,991,590 | |
Acquisitions | 758,619 | 1,256,245 | 745,948 | ||
Transfers from construction in progress | 25,513 | 74,441 | 163,080 | ||
Additions | 96,775 | 36,828 | 33,279 | ||
Dispositions | (1,318,238) | (53,372) | (138,886) | ||
Other | (219,668) | [2] | 155,964 | [2] | 173,031 |
Balance at end of period | $ 4,781,149 | $ 5,438,148 | [1] | $ 3,968,042 | |
[1] | Includes $131.4 million of land and building cost reflected in real estate held for sale at December 31, 2017. Excludes intangible lease assets that are included in real estate held for sale of $15.8 million at December 31, 2017. | ||||
[2] | Represents foreign currency fluctuations and purchase price allocation adjustments. |
Schedule III - Changes in Accum
Schedule III - Changes in Accumulated Depreciation (Detail) - USD ($) $ in Thousands | 12 Months Ended | ||||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |||
Real Estate And Accumulated Depreciation Disclosure [Abstract] | |||||
Balance at beginning of period | $ 407,349 | [1] | $ 292,786 | $ 232,675 | |
Depreciation | 115,497 | 109,307 | 81,010 | ||
Depreciation on disposed property | (101,967) | (1,438) | (19,086) | ||
Other | (6,548) | 6,694 | (1,813) | ||
Balance at end of period | $ 414,331 | $ 407,349 | [1] | $ 292,786 | |
[1] | Includes $0.5 million of accumulated depreciation reflected in real estate held for sale at December 31, 2017. Excludes accumulated amortization related to intangible lease assets that are included in real estate held for sale of $0.1 million at December 31, 2017. |
Schedule III - Changes in Acc_2
Schedule III - Changes in Accumulated Depreciation (Parenthetical) (Detail) - USD ($) $ in Thousands | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | |
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Real estate held for sale | $ 146,615 | ||||
Intangible lease assets | $ 403,138 | 443,134 | |||
Accumulated Depreciation | 414,331 | 407,349 | [1] | $ 292,786 | $ 232,675 |
Accumulated amortization | $ 50,653 | 48,857 | |||
Real Estate Held For Sale [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Intangible lease assets | 15,800 | ||||
Accumulated Depreciation | 500 | ||||
Accumulated amortization | 100 | ||||
Real Estate Held For Sale [Member] | Land and Building [Member] | |||||
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items] | |||||
Real estate held for sale | $ 131,400 | ||||
[1] | Includes $0.5 million of accumulated depreciation reflected in real estate held for sale at December 31, 2017. Excludes accumulated amortization related to intangible lease assets that are included in real estate held for sale of $0.1 million at December 31, 2017. |
Schedule IV - Schedule of Mortg
Schedule IV - Schedule of Mortgage Loans on Real Estate (Detail) - USD ($) | 12 Months Ended | |||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | |
Mortgage Loans on Real Estate [Line Items] | ||||
Prior Liens | $ 0 | |||
Face Amount of Mortgages | 1,213,283,000 | |||
Carrying Amount of Mortgages | 1,213,283,000 | $ 1,778,264,000 | $ 1,060,336,000 | $ 757,500,000 |
Principal Amount of Loans Subject to Delinquent Principal or Interest | $ 0 | |||
Long-Term First Mortgage Loan [Member] | ||||
Mortgage Loans on Real Estate [Line Items] | ||||
Periodic Payment Terms | Payable in monthly installments of interest plus principal payable in full at maturity | |||
Long-Term First Mortgage Loan [Member] | Desert Valley Hospital [Member] | ||||
Mortgage Loans on Real Estate [Line Items] | ||||
Interest Rate | 11.00% | |||
Final Maturity Date | 2,022 | |||
Face Amount of Mortgages | $ 70,000,000 | |||
Carrying Amount of Mortgages | 70,000,000 | |||
Principal Amount of Loans Subject to Delinquent Principal or Interest | $ 0 | |||
Long-Term First Mortgage Loan [Member] | Desert Valley Hospital [Member] | ||||
Mortgage Loans on Real Estate [Line Items] | ||||
Interest Rate | 12.20% | |||
Final Maturity Date | 2,022 | |||
Face Amount of Mortgages | $ 20,000,000 | |||
Carrying Amount of Mortgages | 20,000,000 | |||
Principal Amount of Loans Subject to Delinquent Principal or Interest | $ 0 | |||
Long-Term First Mortgage Loan [Member] | Desert Valley Hospital [Member] | ||||
Mortgage Loans on Real Estate [Line Items] | ||||
Interest Rate | 11.00% | |||
Final Maturity Date | 2,020 | |||
Face Amount of Mortgages | $ 12,500,000 | |||
Carrying Amount of Mortgages | 12,500,000 | |||
Principal Amount of Loans Subject to Delinquent Principal or Interest | $ 0 | |||
Long-Term First Mortgage Loan [Member] | Chino Valley Medical Center [Member] | ||||
Mortgage Loans on Real Estate [Line Items] | ||||
Interest Rate | 11.00% | |||
Final Maturity Date | 2,022 | |||
Face Amount of Mortgages | $ 50,000,000 | |||
Carrying Amount of Mortgages | 50,000,000 | |||
Principal Amount of Loans Subject to Delinquent Principal or Interest | $ 0 | |||
Long-Term First Mortgage Loan [Member] | Paradise Valley Hospital [Member] | ||||
Mortgage Loans on Real Estate [Line Items] | ||||
Interest Rate | 11.00% | |||
Final Maturity Date | 2,022 | |||
Face Amount of Mortgages | $ 25,000,000 | |||
Carrying Amount of Mortgages | 25,000,000 | |||
Principal Amount of Loans Subject to Delinquent Principal or Interest | $ 0 | |||
Long-Term First Mortgage Loan [Member] | Ernest Mortgage Loan [Member] | ||||
Mortgage Loans on Real Estate [Line Items] | ||||
Interest Rate | 10.00% | |||
Final Maturity Date | 2,032 | |||
Face Amount of Mortgages | $ 115,000,000 | |||
Carrying Amount of Mortgages | 115,000,000 | |||
Principal Amount of Loans Subject to Delinquent Principal or Interest | $ 0 | |||
Long-Term First Mortgage Loan [Member] | Centinela Hospital Medical Center [Member] | ||||
Mortgage Loans on Real Estate [Line Items] | ||||
Interest Rate | 11.60% | |||
Final Maturity Date | 2,022 | |||
Face Amount of Mortgages | $ 100,000,000 | |||
Carrying Amount of Mortgages | 100,000,000 | |||
Principal Amount of Loans Subject to Delinquent Principal or Interest | $ 0 | |||
Long-Term First Mortgage Loan [Member] | Olympia Medical Center [Member] | ||||
Mortgage Loans on Real Estate [Line Items] | ||||
Interest Rate | 10.70% | |||
Final Maturity Date | 2,024 | |||
Face Amount of Mortgages | $ 25,000,000 | |||
Carrying Amount of Mortgages | 25,000,000 | |||
Principal Amount of Loans Subject to Delinquent Principal or Interest | $ 0 | |||
Long-Term First Mortgage Loan [Member] | St. Joseph Medical Center [Member] | ||||
Mortgage Loans on Real Estate [Line Items] | ||||
Interest Rate | 9.00% | |||
Final Maturity Date | 2,025 | |||
Face Amount of Mortgages | $ 30,000,000 | |||
Carrying Amount of Mortgages | 30,000,000 | |||
Principal Amount of Loans Subject to Delinquent Principal or Interest | $ 0 | |||
Long-Term First Mortgage Loan [Member] | St. Mary's Medical Center [Member] | ||||
Mortgage Loans on Real Estate [Line Items] | ||||
Interest Rate | 9.00% | |||
Final Maturity Date | 2,025 | |||
Face Amount of Mortgages | $ 10,000,000 | |||
Carrying Amount of Mortgages | 10,000,000 | |||
Principal Amount of Loans Subject to Delinquent Principal or Interest | $ 0 | |||
Long-Term First Mortgage Loan [Member] | Lake Huron Medical Center [Member] | ||||
Mortgage Loans on Real Estate [Line Items] | ||||
Interest Rate | 9.00% | |||
Final Maturity Date | 2,020 | |||
Face Amount of Mortgages | $ 10,000,000 | |||
Carrying Amount of Mortgages | 10,000,000 | |||
Principal Amount of Loans Subject to Delinquent Principal or Interest | $ 0 | |||
Long-Term First Mortgage Loan [Member] | Steward Mortgage Loan [Member] | ||||
Mortgage Loans on Real Estate [Line Items] | ||||
Interest Rate | 7.50% | |||
Final Maturity Date | 2,031 | |||
Face Amount of Mortgages | $ 727,508,000 | |||
Carrying Amount of Mortgages | 727,508,000 | |||
Principal Amount of Loans Subject to Delinquent Principal or Interest | $ 0 | |||
Long-Term First Mortgage Loan [Member] | Vibra Mortgage Loan [Member] | ||||
Mortgage Loans on Real Estate [Line Items] | ||||
Interest Rate | 11.50% | |||
Final Maturity Date | 2,024 | |||
Face Amount of Mortgages | $ 18,275,000 | |||
Carrying Amount of Mortgages | 18,275,000 | |||
Principal Amount of Loans Subject to Delinquent Principal or Interest | $ 0 |
Schedule IV - Schedule of Mor_2
Schedule IV - Schedule of Mortgage Loans on Real Estate (Parenthetical) (Detail) | Dec. 31, 2018USD ($)Property |
Mortgage Loans on Real Estate [Line Items] | |
Prior Liens | $ 0 |
Carrying amount of mortgages, federal income tax purposes | 1,213,283,000 |
Unamortized loan issue costs | $ 40,000 |
Ernest Mortgage Loan [Member] | Long-Term First Mortgage Loan [Member] | |
Mortgage Loans on Real Estate [Line Items] | |
Number of properties | Property | 4 |
Steward Mortgage Loan [Member] | Long-Term First Mortgage Loan [Member] | |
Mortgage Loans on Real Estate [Line Items] | |
Number of properties | Property | 2 |
Schedule IV - Changes in Mortga
Schedule IV - Changes in Mortgage Loans Excluding Unamortized Loan Issue Costs (Detail) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Mortgage Loans On Real Estate [Abstract] | |||
Balance at beginning of year | $ 1,778,264 | $ 1,060,336 | $ 757,500 |
New mortgage loans and additional advances on existing loans | 50,783 | 717,928 | 612,836 |
Mortgage loans on real estate including additions during year | 1,829,047 | 1,778,264 | 1,370,336 |
Collection of principal | (615,764) | (310,000) | |
Deductions during year | (615,764) | (310,000) | |
Balance at end of year | $ 1,213,283 | $ 1,778,264 | $ 1,060,336 |