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Document and Entity Information - USD ($)	12 Months Ended
Document and Entity Information - USD ($)	Dec. 31, 2016	Feb. 24, 2017	Jun. 30, 2016
Document Information [Line Items]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2016
Document Fiscal Year Focus	2016
Document Fiscal Period Focus	FY
Trading Symbol	MPW
Entity Registrant Name	MEDICAL PROPERTIES TRUST INC
Entity Central Index Key	0001287865
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 Common Stock, Shares Outstanding		320,934,225
Entity Public Float			$ 3,598,495,723
MPT Operating Partnership, L.P. [Member]
Document Information [Line Items]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2016
Document Fiscal Year Focus	2016
Document Fiscal Period Focus	FY
Entity Registrant Name	MPT OPERATING PARTNERSHIP, L.P.
Entity Central Index Key	0001524607
Current Fiscal Year End Date	--12-31
Entity Filer Category	Non-accelerated Filer

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Real estate assets
Land	$ 417,368	$ 315,787
Buildings and improvements	3,550,674	2,675,803
Construction in progress and other	53,648	49,165
Intangible lease assets	296,176	256,950
Net investment in direct financing leases	648,102	626,996
Mortgage loans	1,060,400	757,581
Gross investment in real estate assets	6,026,368	4,682,282
Accumulated depreciation	(292,786)	(232,675)
Accumulated amortization	(32,339)	(25,253)
Net investment in real estate assets	5,701,243	4,424,354
Cash and cash equivalents	83,240	195,541
Interest and rent receivables	57,698	46,939
Straight-line rent receivables	116,861	82,155
Other loans	155,721	664,822
Other assets	303,773	195,540
Total Assets	6,418,536	5,609,351
Liabilities
Debt, net	2,909,341	3,322,541
Accounts payable and accrued expenses	207,711	137,356
Deferred revenue	19,933	29,358
Lease deposits and other obligations to tenants	28,323	12,831
Total Liabilities	3,165,308	3,502,086
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 - 320,514 shares at December 31, 2016 and 236,744 shares at December 31, 2015	321	237
Limited Partners:
Additional paid-in capital	3,775,336	2,593,827
Distributions in excess of net income	(434,114)	(418,650)
Accumulated other comprehensive loss	(92,903)	(72,884)
Treasury shares, at cost	(262)	(262)
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital)	3,248,378	2,102,268
Non-controlling interests	4,850	4,997
Total Equity / Capital	3,253,228	2,107,265
Total Liabilities and Equity / Capital	6,418,536	5,609,351
Common Units [Member]
Limited Partners:
Total Equity / Capital	321	237
MPT Operating Partnership, L.P. [Member]
Real estate assets
Land	417,368	315,787
Buildings and improvements	3,550,674	2,675,803
Construction in progress and other	53,648	49,165
Intangible lease assets	296,176	256,950
Net investment in direct financing leases	648,102	626,996
Mortgage loans	1,060,400	757,581
Gross investment in real estate assets	6,026,368	4,682,282
Accumulated depreciation	(292,786)	(232,675)
Accumulated amortization	(32,339)	(25,253)
Net investment in real estate assets	5,701,243	4,424,354
Cash and cash equivalents	83,240	195,541
Interest and rent receivables	57,698	46,939
Straight-line rent receivables	116,861	82,155
Other loans	155,721	664,822
Other assets	303,773	195,540
Total Assets	6,418,536	5,609,351
Liabilities
Debt, net	2,909,341	3,322,541
Accounts payable and accrued expenses	132,868	84,628
Deferred revenue	19,933	29,358
Lease deposits and other obligations to tenants	28,323	12,831
Payable due to Medical Properties Trust, Inc.	74,453	52,338
Total Liabilities	3,164,918	3,501,696
Commitments and Contingencies
Limited Partners:
Accumulated other comprehensive loss	(92,903)	(72,884)
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital)	3,248,768	2,102,658
Non-controlling interests	4,850	4,997
Total Equity / Capital	3,253,618	2,107,655
Total Liabilities and Equity / Capital	6,418,536	5,609,351
MPT Operating Partnership, L.P. [Member] \| General Partner [Member]
Equity / Capital
General partner - issued and outstanding - 3,204 units at December 31, 2016 and 2,363 units at December 31, 2015	33,436	21,773
Limited Partners:
Total Equity / Capital	33,436	21,773
MPT Operating Partnership, L.P. [Member] \| Common Units [Member]
Limited Partners:
Limited Partners Capital	$ 3,308,235	$ 2,153,769

Consolidated Balance Sheets (Parenthetical) - $ / shares	Dec. 31, 2016	Dec. 31, 2015
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	320,514,000	236,744,000
Common stock, shares outstanding	320,514,000	236,744,000
MPT Operating Partnership, L.P. [Member] \| Common Units [Member]
Limited Partners, units issued	317,310,000	234,381,000
Limited Partners, units outstanding	317,310,000	234,381,000
General Partner [Member] \| MPT Operating Partnership, L.P. [Member]
General partner, units issued	3,204,000	2,363,000
General partner, units outstanding	3,204,000	2,363,000
LTIP Units [Member] \| MPT Operating Partnership, L.P. [Member]
LTIP Units, shares issued	292,000	292,000
LTIP Units, shares outstanding	292,000	292,000

Consolidated Statements of Net Income - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Revenues
Rent billed	$ 327,269	$ 247,604	$ 187,018
Straight-line rent	41,067	23,375	13,507
Income from direct financing leases	64,307	58,715	49,155
Interest and fee income	108,494	112,184	62,852
Total revenues	541,137	441,878	312,532
Expenses
Real estate depreciation and amortization	94,374	69,867	53,938
Impairment charges	7,229		50,128
Property-related	2,712	3,792	1,851
Acquisition expenses	46,273	61,342	26,389
General and administrative	48,911	43,639	37,274
Total operating expenses	199,499	178,640	169,580
Operating income	341,638	263,238	142,952
Other income (expense)
Interest expense	(159,597)	(120,884)	(98,156)
Gain on sale of real estate and other asset dispositions, net	61,224	3,268	2,857
Earnings from equity and other interests	(1,116)	2,849	2,559
Unutilized financing fees/ debt refinancing costs	(22,539)	(4,367)	(1,698)
Other income (expense)	(502)	(2,674)	2,624
Income tax benefit (expense)	6,830	(1,503)	(340)
Net other expenses	(115,700)	(123,311)	(92,154)
Income from continuing operations	225,938	139,927	50,798
Loss from discontinued operations	(1)		(2)
Net income	225,937	139,927	50,796
Net income attributable to non-controlling interests	(889)	(329)	(274)
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 225,048	$ 139,598	$ 50,522
Earnings per share - basic
Income from continuing operations attributable to MPT common stockholders (Operating Partnership partners)	$ 0.86	$ 0.64	$ 0.29
Income from discontinued operations attributable to MPT common stockholders (Operating Partnership partners)	0	0	0
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.86	$ 0.64	$ 0.29
Weighted average shares outstanding - basic	260,414	217,997	169,999
Earnings per share - diluted
Income from continuing operations attributable to MPT common stockholders (Operating Partnership partners)	$ 0.86	$ 0.63	$ 0.29
Income from discontinued operations attributable to MPT common stockholders (Operating Partnership partners)	0	0	0
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.86	$ 0.63	$ 0.29
Weighted average shares outstanding - diluted	261,072	218,304	170,540
MPT Operating Partnership, L.P. [Member]
Revenues
Rent billed	$ 327,269	$ 247,604	$ 187,018
Straight-line rent	41,067	23,375	13,507
Income from direct financing leases	64,307	58,715	49,155
Interest and fee income	108,494	112,184	62,852
Total revenues	541,137	441,878	312,532
Expenses
Real estate depreciation and amortization	94,374	69,867	53,938
Impairment charges	7,229		50,128
Property-related	2,712	3,792	1,851
Acquisition expenses	46,273	61,342	26,389
General and administrative	48,911	43,639	37,274
Total operating expenses	199,499	178,640	169,580
Operating income	341,638	263,238	142,952
Other income (expense)
Interest expense	(159,597)	(120,884)	(98,156)
Gain on sale of real estate and other asset dispositions, net	61,224	3,268	2,857
Earnings from equity and other interests	(1,116)	2,849	2,559
Unutilized financing fees/ debt refinancing costs	(22,539)	(4,367)	(1,698)
Other income (expense)	(502)	(2,674)	2,624
Income tax benefit (expense)	6,830	(1,503)	(340)
Net other expenses	(115,700)	(123,311)	(92,154)
Income from continuing operations	225,938	139,927	50,798
Loss from discontinued operations	(1)		(2)
Net income	225,937	139,927	50,796
Net income attributable to non-controlling interests	(889)	(329)	(274)
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 225,048	$ 139,598	$ 50,522
Earnings per share - basic
Income from continuing operations attributable to MPT common stockholders (Operating Partnership partners)	$ 0.86	$ 0.64	$ 0.29
Income from discontinued operations attributable to MPT common stockholders (Operating Partnership partners)	0	0	0
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.86	$ 0.64	$ 0.29
Weighted average shares outstanding - basic	260,414	217,997	169,999
Earnings per share - diluted
Income from continuing operations attributable to MPT common stockholders (Operating Partnership partners)	$ 0.86	$ 0.63	$ 0.29
Income from discontinued operations attributable to MPT common stockholders (Operating Partnership partners)	0	0	0
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.86	$ 0.63	$ 0.29
Weighted average shares outstanding - diluted	261,072	218,304	170,540

Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Net income	$ 225,937	$ 139,927	$ 50,796
Other comprehensive income (loss):
Unrealized gain on interest rate swap	2,904	3,139	2,964
Foreign currency translation loss	(22,923)	(54,109)	(15,937)
Total comprehensive income	205,918	88,957	37,823
Comprehensive income attributable to non-controlling interests	(889)	(329)	(274)
Comprehensive income attributable to MPT common stockholders (Operating Partnership partners)	205,029	88,628	37,549
MPT Operating Partnership, L.P. [Member]
Net income	225,937	139,927	50,796
Other comprehensive income (loss):
Unrealized gain on interest rate swap	2,904	3,139	2,964
Foreign currency translation loss	(22,923)	(54,109)	(15,937)
Total comprehensive income	205,918	88,957	37,823
Comprehensive income attributable to non-controlling interests	(889)	(329)	(274)
Comprehensive income attributable to MPT common stockholders (Operating Partnership partners)	$ 205,029	$ 88,628	$ 37,549

Consolidated Statements of Equity / Capital - USD ($) shares in Thousands, $ in Thousands	Total	Additional Paid-in Capital [Member]	Distributions in Excess of Net Income [Member]	Treasury Stock [Member]	Common Par Value [Member]	Accumulated Other Comprehensive Loss [Member]	Non- Controlling Interests [Member]	MPT Operating Partnership, L.P. [Member]	MPT Operating Partnership, L.P. [Member] Accumulated Other Comprehensive Loss [Member]	MPT Operating Partnership, L.P. [Member] Non- Controlling Interests [Member]	MPT Operating Partnership, L.P. [Member] General Partner [Member]	MPT Operating Partnership, L.P. [Member] Limited Partner [Member] Common Par Value [Member]	MPT Operating Partnership, L.P. [Member] Limited Partner [Member] Long Term Incentive Plan [Member]
Beginning balance at Dec. 31, 2013	$ 1,344,208	$ 1,618,054	$ (264,804)	$ (262)	$ 161	$ (8,941)		$ 1,344,598	$ (8,941)		$ 13,541	$ 1,339,998
Beginning balance (in shares) at Dec. 31, 2013					161,310						1,608	159,702	292
Net income	50,796		50,522				$ 274	50,796		$ 274	$ 508	$ 49,769	$ 245
Unrealized gain on interest rate swap	2,964					2,964		2,964	2,964
Foreign currency translation gain (loss)	(15,937)					(15,937)		(15,937)	(15,937)
Stock (Unit) vesting and amortization of stock (unit)-based compensation	9,165	9,165						9,165			$ 92	$ 9,073
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)					777						8	769
Distributions to non-controlling interests	(274)						(274)	(274)		(274)
Proceeds from offering (net of offering costs)	138,173	138,162			$ 11			138,173			$ 1,382	$ 136,791
Proceeds from offering (net of offering costs) (shares)					10,656						106	10,550
Dividends (Distributions) declared ($0.84 in 2014, 0.88 in 2015 and 0.91 in 2016 per common share/ unit)	(147,048)		(147,048)					(147,048)			$ (1,468)	$ (145,335)	$ (245)
Ending balance at Dec. 31, 2014	1,382,047	1,765,381	(361,330)	(262)	$ 172	(21,914)		1,382,437	(21,914)		$ 14,055	$ 1,390,296
Ending balance (in shares) at Dec. 31, 2014					172,743						1,722	171,021	292
Net income	139,927		139,598				329	139,927		329	$ 1,399	$ 138,199
Sale of non-controlling interests	5,000						5,000
Sale of non-controlling interests								5,000		5,000
Unrealized gain on interest rate swap	3,139					3,139		3,139	3,139
Foreign currency translation gain (loss)	(54,109)					(54,109)		(54,109)	(54,109)
Stock (Unit) vesting and amortization of stock (unit)-based compensation	11,122	11,120			$ 2			11,122			$ 111	$ 11,011
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)					751						8	743
Distributions to non-controlling interests	(332)						(332)	(332)		(332)
Proceeds from offering (net of offering costs)	817,389	817,326			$ 63			817,389			$ 8,175	$ 809,214
Proceeds from offering (net of offering costs) (shares)					63,250						633	62,617
Dividends (Distributions) declared ($0.84 in 2014, 0.88 in 2015 and 0.91 in 2016 per common share/ unit)	(196,918)		(196,918)					(196,918)			$ (1,967)	$ (194,951)
Ending balance at Dec. 31, 2015	2,107,265	2,593,827	(418,650)	(262)	$ 237	(72,884)	4,997	2,107,655	(72,884)	4,997	$ 21,773	$ 2,153,769
Ending balance (in shares) at Dec. 31, 2015					236,744						2,363	234,381	292
Net income	225,937		225,048				889	225,937		889	$ 2,251	$ 222,797
Unrealized gain on interest rate swap	2,904					2,904		2,904	2,904
Foreign currency translation gain (loss)	(22,923)					(22,923)		(22,923)	(22,923)
Stock (Unit) vesting and amortization of stock (unit)-based compensation	7,942	7,941			$ 1			7,942			$ 80	$ 7,862
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)					1,021						10	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	1,173,568			$ 83			1,173,651			$ 11,737	$ 1,161,914
Proceeds from offering (net of offering costs) (shares)					82,749						831	81,918
Dividends (Distributions) declared ($0.84 in 2014, 0.88 in 2015 and 0.91 in 2016 per common share/ unit)	(240,512)		(240,512)					(240,512)			$ (2,405)	$ (238,107)
Ending balance at Dec. 31, 2016	$ 3,253,228	$ 3,775,336	$ (434,114)	$ (262)	$ 321	$ (92,903)	$ 4,850	$ 3,253,618	$ (92,903)	$ 4,850	$ 33,436	$ 3,308,235
Ending balance (in shares) at Dec. 31, 2016					320,514						3,204	317,310	292

Consolidated Statements of Equity / Capital (Parenthetical) - $ / shares	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Dividends (Distributions) declared per common share / unit	$ 0.91	$ 0.88	$ 0.84
MPT Operating Partnership, L.P. [Member]
Dividends (Distributions) declared per common share / unit	$ 0.91	$ 0.88	$ 0.84

Consolidated Statements of Cash Flows $ in Thousands	12 Months Ended
Consolidated Statements of Cash Flows $ in Thousands	Dec. 31, 2016 USD ($)	Dec. 31, 2015 USD ($)	Dec. 31, 2014 USD ($)
Operating activities
Net income	$ 225,937	$ 139,927	$ 50,796
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	97,601	71,827	55,162
Amortization of deferred financing costs and debt discount	7,613	6,085	5,105
Direct financing lease interest accretion	(9,120)	(8,032)	(6,701)
Straight-line rent revenue	(41,567)	(26,187)	(16,325)
Share / (Unit)-based compensation expense	7,942	11,122	9,165
Gain from sale of real estate and other asset dispositions, net	(61,224)	(3,268)	(2,857)
Impairment charges	7,229		50,128
Straight-line rent and other write-off	3,063	2,812	2,818
Unutilized financing fees/ debt refinancing costs	22,539	4,367	1,698
Other adjustments	3,563	(6,334)	(1,178)
Decrease (increase) in:
Interest and rent receivable	(13,247)	(5,599)	(3,856)
Other assets	(18,357)	(8,297)	764
Accounts payable and accrued expenses	41,583	26,540	6,209
Deferred revenue	(8,872)	2,033	(485)
Net cash provided by operating activities	264,683	206,996	150,443
Investing activities
Cash paid for acquisitions and other related investments	(1,682,409)	(2,218,869)	(767,696)
Net proceeds from sale of real estate	198,767	19,175	34,649
Principal received on loans receivable	906,757	771,785	11,265
Investment in loans receivable	(109,027)	(354,001)	(12,782)
Construction in progress and other	(171,209)	(146,372)	(102,333)
Investment in unsecured senior notes	(50,000)
Proceeds from sale of unsecured senior notes	50,000
Other investments, net	(69,423)	(17,339)	(13,126)
Net cash used for investing activities	(926,544)	(1,945,621)	(850,023)
Financing activities
Proceeds from term debt	1,000,000	681,000	425,000
Payments of term debt	(575,299)	(283)	(100,266)
Payment of deferred financing costs	(15,468)	(7,686)	(14,496)
Revolving credit facilities, net	(810,000)	509,415	490,625
Distributions paid	(218,393)	(182,980)	(144,365)
Lease deposits and other obligations to tenants	14,557	(10,839)	7,892
Proceeds from sale of common shares / units, net of offering costs	1,173,651	817,389	138,173
Other financing activities	(16,485)	(5,326)
Net cash provided by financing activities	552,563	1,800,690	802,563
Increase in cash and cash equivalents for the year	(109,298)	62,065	102,983
Effect of exchange rate changes	(3,003)	(11,065)	(4,421)
Cash and cash equivalents at beginning of year	195,541	144,541	45,979
Cash and cash equivalents at end of year	83,240	195,541	144,541
Interest paid, including capitalized interest of $2,320 in 2016, $1,425 in 2015, and $1,860 in 2014	138,770	107,228	91,890
Supplemental schedule of non-cash investing activities:
Mortgage loan issued from sale of real estate			12,500
Increase in development project construction costs incurred, not paid	15,857	2,684
Supplemental schedule of non-cash financing activities:
Dividends declared, not paid	74,521	52,402	38,461
MPT Operating Partnership, L.P. [Member]
Operating activities
Net income	225,937	139,927	50,796
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	97,601	71,827	55,162
Amortization of deferred financing costs and debt discount	7,613	6,085	5,105
Direct financing lease interest accretion	(9,120)	(8,032)	(6,701)
Straight-line rent revenue	(41,567)	(26,187)	(16,325)
Share / (Unit)-based compensation expense	7,942	11,122	9,165
Gain from sale of real estate and other asset dispositions, net	(61,224)	(3,268)	(2,857)
Impairment charges	7,229		50,128
Straight-line rent and other write-off	3,063	2,812	2,818
Unutilized financing fees/ debt refinancing costs	22,539	4,367	1,698
Other adjustments	3,563	(6,334)	(1,178)
Decrease (increase) in:
Interest and rent receivable	(13,247)	(5,599)	(3,856)
Other assets	(18,357)	(8,297)	764
Accounts payable and accrued expenses	41,583	26,540	6,209
Deferred revenue	(8,872)	2,033	(485)
Net cash provided by operating activities	264,683	206,996	150,443
Investing activities
Cash paid for acquisitions and other related investments	(1,682,409)	(2,218,869)	(767,696)
Net proceeds from sale of real estate	198,767	19,175	34,649
Principal received on loans receivable	906,757	771,785	11,265
Investment in loans receivable	(109,027)	(354,001)	(12,782)
Construction in progress and other	(171,209)	(146,372)	(102,333)
Investment in unsecured senior notes	(50,000)
Proceeds from sale of unsecured senior notes	50,000
Other investments, net	(69,423)	(17,339)	(13,126)
Net cash used for investing activities	(926,544)	(1,945,621)	(850,023)
Financing activities
Proceeds from term debt	1,000,000	681,000	425,000
Payments of term debt	(575,299)	(283)	(100,266)
Payment of deferred financing costs	(15,468)	(7,686)	(14,496)
Revolving credit facilities, net	(810,000)	509,415	490,625
Distributions paid	(218,393)	(182,980)	(144,365)
Lease deposits and other obligations to tenants	14,557	(10,839)	7,892
Proceeds from sale of common shares / units, net of offering costs	1,173,651	817,389	138,173
Other financing activities	(16,485)	(5,326)
Net cash provided by financing activities	552,563	1,800,690	802,563
Increase in cash and cash equivalents for the year	(109,298)	62,065	102,983
Effect of exchange rate changes	(3,003)	(11,065)	(4,421)
Cash and cash equivalents at beginning of year	195,541	144,541	45,979
Cash and cash equivalents at end of year	83,240	195,541	144,541
Interest paid, including capitalized interest of $2,320 in 2016, $1,425 in 2015, and $1,860 in 2014	138,770	107,228	91,890
Supplemental schedule of non-cash investing activities:
Mortgage loan issued from sale of real estate			12,500
Increase in development project construction costs incurred, not paid	15,857	2,684
Supplemental schedule of non-cash financing activities:
Dividends declared, not paid	$ 74,521	$ 52,402	$ 38,461

Consolidated Statements of Cash Flows (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Interest paid, capitalized	$ 2,320	$ 1,425	$ 1,860
MPT Operating Partnership, L.P. [Member]
Interest paid, capitalized	$ 2,320	$ 1,425	$ 1,860

Organization	12 Months Ended
Organization	Dec. 31, 2016
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 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 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 Accounting Policies

12 Months Ended

Dec. 31, 2016

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, 2016, we had loans and/or equity investments in certain VIEs, which are also tenants of our facilities, (including but not limited to Ernest and Vibra). 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, 2016 (in thousands):


VIE Type	Maximum Loss Exposure(1)		Asset Type Classification		Carrying Amount(2)
Loans, net	$	316,179		Mortgage and other loans	$	235,613
Equity investments	$	13,223		Other assets	$	140

(1)

Our maximum loss exposure related to loans with VIEs represents our current aggregate gross carrying value of the loan plus accrued interest and any other related assets (such as rent receivables), less any liabilities. 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 loan or 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, 2016, 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.

See Note 3 and 10 for additional description of the nature, purpose and activities of some of our VIEs and interests therein.

Investments in Unconsolidated Entities: Investments in entities in which we have the ability to influence (but not control) are typically accounted for by the equity method. Under the equity method of accounting, our share of the investee’s earnings or losses are included in our consolidated statements of net income, and 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 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.

Investments in entities in which we do not control nor do we have the ability to influence (such as our investments in Steward and MEDIAN) are accounted for using the cost method. The initial carrying value of such investments is based on the amount paid to purchase the interest in the investee entity. No income is recorded on our cost method investments until distributions are received.

We evaluate our equity and cost 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, an impairment is recorded.

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 the customer 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.

Certain leases may provide for additional rents contingent upon a percentage of the tenant’s revenue in excess of specified base amounts/thresholds (percentage rents). Percentage rents are recognized in the period in which revenue thresholds are met. Rental payments received prior to their recognition as income are classified as deferred revenue. We also receive additional rent (contingent rent) under some leases based on increases in the CPI or when the CPI exceeds the annual minimum percentage increase in the lease. Contingent rents are recorded as rent billed revenue in the period earned.

We use 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.

In instances where we have a profits or equity interest in our tenants’ operations, we record income equal to our percentage interest of the tenants’ profits, as defined in the lease or tenants’ operating agreements, once annual thresholds, if any, are met.

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 are generally 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 remaining 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.

Acquired Real Estate Purchase Price Allocation: For existing properties acquired for leasing purposes, we account for such acquisitions based on business combination accounting rules. We allocate the purchase price of acquired properties to net 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.

Goodwill: Goodwill is deemed to have an indefinite economic life and is not subject to amortization. Goodwill is tested annually for impairment and is tested for impairment more frequently if events and circumstances indicate that the asset might be impaired. The impairment testing involves a two-step approach. The first step determines if goodwill is impaired by comparing the fair value of the reporting unit as a whole to its book value. If a deficiency exists, the second step measures the amount of the impairment loss as the difference between the implied fair value of goodwill and its carrying value.

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, 2016 are as follows:


Buildings and improvements			38.8 years
Tenant lease intangibles			23.9 years
Leasehold improvements			17.9 years
Furniture, equipment and other			9.5 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: We utilize the information above along with the tenant’s payment and default history in evaluating (on a property-by-property basis) whether or not a provision for losses on outstanding rent receivables is needed. A provision for losses on rent receivables (including straight-line rent receivables) is ultimately recorded when it becomes probable that the receivable will not be collected in full. The provision is an amount which reduces the receivable to its estimated net realizable value based on a determination of the eventual amounts to be collected either from the debtor or from existing collateral, if any.

Losses on DFL Receivables: Allowances are established for DFLs based upon an estimate of probable losses on a property-by-property basis. DFLs are impaired when it is deemed probable that we will be unable to collect all amounts due in accordance with the contractual terms of the lease. Like operating lease receivables, the need for an allowance is based upon our assessment of the lessee’s overall financial condition; economic resources and payment record; the prospects for support from any financially responsible guarantors; and, if appropriate, the realizable value of any collateral. These estimates consider all available evidence including the expected future cash flows discounted at the DFL’s effective interest rate, fair value of collateral, and other relevant factors, as appropriate. DFLs are placed on non-accrual status when we determine that the collectability of contractual amounts is not reasonably assured. If on non-accrual status, we generally account for the DFLs on a cash basis, in which income is recognized only upon receipt of cash.

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 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 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 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 IRS 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 federal income tax purposes.

Our financial statements include the operations of TRSs, including MPT Development Services, Inc. (“MDS”), along with many other entities, which are single member LLCs that are disregarded for tax purposes and are reflected in the tax returns of MDS. Our TRS entities are not entitled to a dividends paid deduction and are subject to federal, state, and local income taxes. Our TRS entities are authorized to provide property development, leasing, and management services for third-party owned properties, and they may make loans to and/or investments in our lessees.

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 will flow 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 receivables/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 the realizability of the related deferred tax asset, is reflected in our tax provision when such changes occur.

The calculation of our tax liabilities involve dealing with uncertainties in the application of complex tax laws and regulations in a multitude of jurisdictions across our global operations. A 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 recognized as a reduction in interest income over the life of the loan.

Deferred Financing Costs: We amortize deferred financing costs incurred in connection with anticipated 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 revolving credit agreements, 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), 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 identical instruments in active markets;

•

Level 2 — quoted prices for similar 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 unobservable.

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 (as more fully described in Note 3 and 10), 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. Other than the Capella equity investment held at December 31, 2015, we have not made a similar election for other existing equity interest or loans.

Recent Accounting Developments:

Revenue from Contracts with Customers

In May 2014, the FASB issued Accounting Standards Update (“ASU”) No. 2014-09, “Revenue from Contracts with Customers.” Under the new standard, revenue is recognized at the time a good or service is transferred to a customer for the amount of consideration received for that specific good or service. Entities may use a full retrospective approach or report the cumulative effect as of the date of adoption. On April 1, 2015, the FASB proposed deferring the effective date of this standard by one year to December 15, 2017, for annual reporting periods beginning after that date. The FASB also proposed permitting early adoption of the standard, but not before the original effective date of December 15, 2016. We do not expect this standard to have a significant impact on our financial results, as a substantial portion of our revenue consists of rental income from leasing arrangements, which are specifically excluded from ASU No. 2014-09.

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 finance 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 of 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 new 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. The ASU is not effective for us until January 1, 2019, with early adoption permitted. We are continuing to evaluate this standard and the impact to us from both a lessor and lessee perspective.

Measurement of Credit Losses on Financial Instruments

In June 2016, the FASB issued ASU 2016-13, “Measurement of Credit Losses on Financial Instruments”, which is intended to improve financial reporting by requiring timely recording of credit losses on loans and other financial instruments held by financial institutions and other organizations. The ASU requires the measurement of all expected credit losses for financial assets not recorded at fair value based on historical experience, current conditions, and reasonable and supportable forecasts. The ASU will be required to be implemented through a cumulative-effect adjustment to retained earnings as of the beginning of the first reporting period in which the amendments are effective. The ASU is not effective for us until January 1, 2019. We do not expect the adoption of this ASU to have a significant impact on our consolidated financial statements.

Classification of Certain Cash Receipts and Cash Payments

In August 2016, the FASB issued ASU No. 2016-15, “Classification of Certain Cash Receipts and Cash Payments”, which clarifies the classification within the statement of cash flows for certain transactions, including debt extinguishment costs, zero-coupon debt, contingent consideration related to business combinations, insurance proceeds, equity method distributions and beneficial interests in securitizations. The standard also clarifies that cash flows with aspects of multiple classes of cash flows or that cannot be separated by source or use should be classified based on the activity that is likely to be the predominant source or use of cash flows for the item. This guidance is effective for us starting January 1, 2018; however, we believe our current cash flow presentation is generally consistent with this standard.

Clarifying the Definition of a Business

In January 2017, the FASB issued ASU No. 2017-01, “Clarifying the Definition of a Business” (“ASU 2017-01”). The amendments in ASU 2017-01 provide an initial screen to determine if substantially all of the fair value of the gross assets acquired is concentrated in a single identifiable asset or a group of similar identifiable assets, in which case, the transaction would be accounted for as an asset acquisition. In addition, ASU 2017-01 clarifies the requirements for a set of activities to be considered a business and narrows the definition of an output. ASU 2017-01 is effective for fiscal years, and interim periods within, beginning after December 15, 2017. Early adoption is permitted. A reporting entity must apply the amendments in ASU 2017-01 using a prospective approach. Upon adoption of ASU 2017-01, we expect to recognize a majority of our real estate acquisitions as asset transactions rather than business combinations which will result in the capitalization of related third party transaction costs.

Reclassifications and Revisions:

Certain amounts in the consolidated financial statements for prior periods have been reclassified to conform to the current period presentation.

Real Estate and Loans Receivable

12 Months Ended

Dec. 31, 2016

Text Block [Abstract]

Real Estate and Loans Receivable

3. Real Estate and Loans Receivable

Acquisitions

We acquired the following assets:


	2016			2015			2014
	(in thousands)
Assets Acquired
Land	$	91,176		$	120,746		$	22,569
Building		654,772			741,935			241,242
Intangible lease assets — subject to amortization (weighted average useful life of 28.5 years in 2016, 30.0 years in 2015 and 18.2 years in 2014)		94,614			176,383			22,513
Net investments in direct financing leases		178,000			174,801			—
Mortgage loans		600,000			380,000			—
Other loans		—			523,605			447,664
Equity investments and other assets		70,166			101,716			33,708
Liabilities assumed		(6,319	)		(317	)		—

Total assets acquired	$	1,682,409		$	2,218,869		$	767,696
Loans repaid(1)		(193,262	)		(385,851	)		—

Total net assets acquired	$	1,489,147		$	1,833,018		$	767,696

(1)

$93.3 million loans advanced to Capella in 2015 and repaid in 2016 as a part of the Capella transaction, and $100.0 million loans advanced to Prime in 2015 and repaid in 2016 as part of the sale leaseback conversion of four properties in New Jersey. $385.9 million loans advanced to MEDIAN in 2014 and repaid in 2015 as a part of the MEDIAN transaction.

Purchase price allocations attributable to acquisitions made during the 2016 fourth quarter are preliminary. When all relevant information is obtained, resulting changes, if any, to our provisional purchase price allocation will be adjusted to reflect new information obtained about the facts and circumstances that existed as of the respective acquisition dates that, if known, would have affected the measurement of the amounts recognized as of those dates.

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 includes 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 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 €35.7 million) are leased to affiliates of MEDIAN, pursuant to a master lease agreement reached with MEDIAN in 2015. (See “2015 Activity” below for further details of this master lease). 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.

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 term 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 the Capella 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. See “2015 and 2014 Activity” for a description of the initial MEDIAN Transaction.

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 basis upon which the lessee will pay us rents.

From the respective acquisition dates in 2016 through year-end, the properties acquired during the year ended December 31, 2016, contributed $37.4 million and $31.7 million of revenue and income (excluding related acquisition expenses), respectively, for the year ended December 31, 2016. In addition, we incurred $12.1 million of acquisition-related costs on the 2016 acquisitions for the year ended December 31, 2016.

2015 Activity

Acquisition of Capella Portfolio

In July 2015, we entered into definitive agreements to acquire a portfolio of seven acute care hospitals owned and operated by Capella for a combined purchase price and investment of approximately $900 million, adjusted for any cash on hand. The transaction included our investments in seven acute care hospitals (two of which were in the form of mortgage loans) for an aggregate investment of approximately $600 million, an acquisition loan for approximately $290 million and a 49% equity interest in the ongoing operator of the facilities.

In conjunction with the acquisition, MPT Camaro Opco, LLC, a wholly-owned subsidiary of MDS, formed a joint venture limited liability company, Capella Health Holdings, LLC (“Capella Holdings”), with an entity affiliated with the senior management of Capella (“ManageCo”). MPT Camaro Opco, LLC held 49% of the equity interests in Capella Holdings and the ManageCo held the remaining 51%. Capella and its operating subsidiaries were managed and operated by ManageCo pursuant to the terms of one or more management agreements, the terms of which included base management fees payable to ManageCo and incentive payments tied to agreed benchmarks. Pursuant to the limited liability company agreement of Capella Holdings, ManageCo and MPT Camaro Opco, LLC shared profits and distributions from Capella Holdings according to a distribution waterfall under which, if certain benchmarks were met, after taking into account interest paid on the acquisition loan, ManageCo and MPT Camaro Opco, LLC shared in cash generated by Capella Holdings in a ratio of 35% to ManageCo and 65% to MPT Camaro Opco, LLC. The limited liability company agreement provided that ManageCo managed Capella Holdings and MPT Camaro Opco, LLC had no management authority or control except for certain protective rights consistent with a passive ownership interest, such as a limited right to approve certain components of the annual budgets and the right to approve extraordinary transactions.

On August 31, 2015, we closed on six of the seven Capella properties, two of which were in the form of mortgage loans. We closed on the seventh property on July 22, 2016 (as discussed above). We entered into a master lease, a stand-alone lease, and mortgage loans for the acquired properties providing for 15-year terms with four 5-year extension options, plus consumer price-indexed increases, limited to a 2% floor and a 4% ceiling annually. The acquisition loan had a 15-year term and carried a fixed interest rate of 8%.

On October 30, 2015, we acquired an additional acute hospital in Camden, South Carolina for an aggregate purchase price of $25.8 million. We leased this hospital to Capella pursuant to the 2015 master lease. In connection with the transaction, we funded an additional acquisition loan to Capella of $9.2 million.

See the Capella Disposal Transaction under the subheading “Disposals” below for an update to this transaction.

MEDIAN Transaction

During early 2015, we made additional loans (as part of the initial MEDIAN transaction discussed below under “2014 Activity”) of approximately € 240 million on behalf of MEDIAN, to complete step one of a two step process to acquire the healthcare real estate of MEDIAN. On April 29, 2015, we entered into a series of definitive agreements with MEDIAN to complete step two, which involved the acquisition of the real estate assets of 32 hospitals owned by MEDIAN for an aggregate purchase price of approximately € 688 million. Upon acquisition, each property became subject to a master lease between us and MEDIAN providing for the leaseback of the property to MEDIAN. The master lease had an initial term of 27 years and provided for annual escalations of rent at the greater of one percent or 70% of the German consumer price index.

At each closing, the purchase price for each facility was reduced and offset against the interim loans made to affiliates of Waterland and MEDIAN and against the amount of any debt assumed or repaid by us in connection with the closing. As part of this transaction, we incurred approximately $37 million of real estate transfer tax in 2015. As of December 31, 2015, we had closed on 31 of the 32 properties for an aggregate amount of € 646 million, and we had no loans outstanding to MEDIAN.

Other Acquisitions

On December 3, 2015, we acquired a 266-bed outpatient rehabilitation clinic located in Hannover, Germany from MEDIAN (formally RHM) for €18.7 million. Upon acquisition, the facility was leased back under the initial master lease with MEDIAN in 2013, providing for a remaining term of 25 years at that time and annual rent increases of 2.0% in 2017 and 0.5% thereafter. On December 31, 2020 and every three years thereafter, rent will also be increased to reflect 70% of cumulative increases in the German CPI.

On November 18, 2015, we acquired seven acute care hospitals and a freestanding clinic in northern Italy for an aggregate purchase price to us of approximately €90 million. The acquisition was effected through a newly-formed joint venture between us and affiliates of AXA Real Estate, in which we own a 50% interest. The facilities are leased to an Italian acute care hospital operator, pursuant to a long-term master lease. We are accounting for our 50% interest in this joint venture under the equity method.

On September 30, 2015, we provided a $100 million mortgage financing to Prime for three general acute care hospitals and one free-standing emergency department and health center in New Jersey. The loan had a five-year term and provided for consumer-priced indexed interest increases, subject to a floor. As previously noted above, we acquired these facilities in October 2016 by reducing the mortgage loan and advancing an additional $15 million.

On September 9, 2015, we acquired the real estate of a general acute care hospital under development located in Valencia, Spain. The acquisition was effected through a newly-formed joint venture between us and clients of AXA Real Estate, in which we will own a 50% interest. Our expected share of the aggregate purchase and development price is €21.4 million. Upon completion, the facility will be leased to a Spanish operator of acute care hospitals, pursuant to a long-term lease. We expect construction to be complete on this facility in the second quarter of 2017.

On August 31, 2015, we closed on a $30 million mortgage loan transaction with Prime for the acquisition of Lake Huron Medical Center, a 144-bed general acute care hospital located in Port Huron, Michigan. The loan provided for consumer-priced indexed interest increases, subject to a floor. The mortgage loan had a five-year term with conversion rights to our standard sale leaseback agreement, which we exercised on December 31, 2015, when we acquired the real estate of Lake Huron Medical Center for $20 million, which reduced the mortgage loan accordingly. The facility is being leased to Prime under our master lease agreement.

On June 16, 2015, we acquired the real estate of two facilities in Lubbock, Texas, a 60-bed inpatient rehabilitation hospital and a 37-bed LTACH, for an aggregate purchase price of $31.5 million. We entered into a 20-year lease with Ernest for the rehabilitation hospital, which provides for three five-year extension options, and separately entered into a lease with Ernest for the long-term acute care hospital that has a final term ending December 31, 2034. In connection with the transaction, we funded an acquisition loan to Ernest of approximately $12.0 million. Ernest operates the rehabilitation hospital in a joint venture with Covenant Health System. Effective July 18, 2016, we amended the lease of the rehabilitation hospital to include the long-term acute care hospital. Ernest’s plans are to convert the long-term acute care facility into a rehabilitation facility by the second quarter of 2017.

On February 27, 2015, we acquired an inpatient rehabilitation hospital in Weslaco, Texas for $10.7 million. We have leased this hospital to Ernest pursuant to the 2012 master lease, which had a remaining 17-year fixed term at that time and three extension options of five years each. This lease provides for consumer-priced-indexed annual rent increases, subject to a floor and a cap. In addition, we funded an acquisition loan in the amount of $5 million.

On February 13, 2015, we acquired two general acute care hospitals in the Kansas City area for $110 million. Prime is the tenant and operator pursuant to a new master lease that has similar terms and security enhancements as the other master lease agreements entered into in 2013. This master lease has a 10-year initial fixed term with two extension options of five years each. The lease provides for consumer-price-indexed annual rent increases, subject to a specified floor. In addition, we funded a mortgage loan in the amount of $40 million, which has a 10-year term.

From the respective acquisition dates in 2015 through that year end, the properties and mortgage loans acquired in 2015 contributed $102.7 million and $87.7 million of revenue and income (excluding related acquisition expenses), respectively, for the year ended December 31, 2015. In addition, we incurred $58 million of acquisition related costs on the 2015 acquisitions for the year ended December 31, 2015.

2014 Activity

MEDIAN Transaction

On October 15, 2014, we entered into definitive agreements pursuant to which we would acquire substantially all the real estate assets of MEDIAN. The transaction was structured using a two step process in partnership with affiliates of Waterland. In the first step, an affiliate of Waterland acquired 94.9% of the outstanding equity interest in MEDIAN pursuant to a stock purchase agreement with MEDIAN’s current owners. We indirectly acquired the remaining 5.1% of the outstanding equity interest and provided or committed to provide interim acquisition loans to Waterland and MEDIAN in aggregate amounts of approximately €425 million, of which €349 million had been advanced at December 31, 2014. These interim loans bore interest at a rate similar to the initial lease rate under the planned sale and leaseback transactions. See “2015 and 2016 Activity” for an update on the second step of this transaction — the sale-leaseback of the real estate.

Other Acquisitions

In the fourth quarter of 2014, we acquired three RHM (now MEDIAN) rehabilitation facilities in Germany for an aggregate purchase price of € 63.6 million (approximately $81 million based on currency exchange rates at that time) including approximately € 3.0 million (or approximately $3.6 million) of transfer and other taxes that have been expensed as acquisition costs. These facilities included: Bad Mergentheim (211 beds), Bad Tolz (248 beds), and Bad Liebenstein (271 beds). All three properties are included under our initial master lease agreement with MEDIAN in 2013.

On October 31, 2014, we acquired a 237-bed acute care hospital, associated medical office buildings, and a behavioral health facility in Sherman, Texas for $32.5 million. Alecto is the tenant and operator pursuant to a 15-year lease agreement with three five-year extension options. In addition, we funded a working capital loan of $7.5 million, and we obtained a 20% interest in the operator of the facility.

On September 19, 2014, we acquired an acute care hospital in Fairmont, West Virginia for an aggregate purchase price of $15 million from Alecto. The facility was simultaneously leased back to the seller under a 15-year initial term with three five-year extension options. In addition, we made a $5 million working capital loan to the tenant with a five year term and a commitment to fund up to $5 million in capital improvements. Finally, we obtained a 20% interest in the operator of this facility.

On July 1, 2014, we acquired an acute care hospital in Peasedown St. John, United Kingdom from Circle Health Ltd. (“Circle”), through its subsidiary Circle Hospital (Bath) Ltd. The sale/leaseback transaction, excluding any transfer taxes, was valued at approximately £28.3 million (or approximately $48.0 million based on exchange rates at that time). The lease has an initial term of 15-years with a tenant option to extend the lease for an additional 15 years. The lease includes annual rent increases, which will equal the year-over-year change in the retail price index with a floor of 2% and a cap of 5%. With the transaction, we incurred approximately £1.1 million (approximately $1.9 million) of transfer and other taxes that have been expensed as acquisition costs.

On March 31, 2014, we acquired a general acute care hospital and an adjacent parcel of land for an aggregate purchase price of $115 million from a joint venture of LHP Hospital Group, Inc. and Hackensack University Medical Center Mountainside. The facility was simultaneously leased back to the seller under a lease with a 15-year initial term with a 3-year extension option, followed by a further 12-year extension option at fair market value. The lease provides for consumer price-indexed annual rent increases, subject to a specified floor and ceiling. The lease includes a customary right of first refusal with respect to a subsequent proposed sale of the facility.

From the respective acquisition dates in 2014 through that year end, the 2014 acquisitions contributed $12.4 million and $8.7 million of revenue and income (excluding related acquisition and financing expenses) for the period ended December 31, 2014. In addition, we incurred $26.4 million of acquisition related expenses in 2014, of which $25.2 million (including $5.8 million in transfer taxes as part of our MEDIAN and Circle transactions) related to acquisitions consummated as of December 31, 2014.

Pro Forma Information

The following unaudited supplemental pro forma operating data is presented below as if each acquisition was completed on January 1, 2015 and January 1, 2014 for the year ended December 31, 2016 and 2015, respectively. The unaudited supplemental pro forma operating data is not necessarily indicative of what the actual would have been assuming the transactions had been completed as set forth above, nor do they purport to represent our results of operations for future periods (in thousands, except per share/unit amounts).


	For the Year Ended December 31, (Unaudited)
	2016		2015
Total revenues	$	627,583	$	624,443
Net income		310,019		306,756
Net income per share/unit	$	0.97	$	0.96

Development Activities

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. These facilities are leased pursuant to the master leases entered into in both 2014 and 2015 and are cross-defaulted with each other and with the original master lease executed in 2013.

•

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.

On August 23, 2016, we entered into an agreement to finance the development of and lease an inpatient rehabilitation facility in Flagstaff, Arizona, for $28.1 million, which will be leased to Ernest pursuant to a stand-alone lease, which has terms generally similar to the original master lease. The facility is expected to be completed in the third quarter of 2017.

2015 Activity

During 2015, we completed construction and began recording rental income on the following facilities:

•

Adeptus Health — We completed 17 acute care facilities for this tenant during 2015 totaling $102.6 million. Fourteen of these facilities are leased pursuant to the master lease entered into in 2014 and are cross-defaulted with the original master lease executed with Adeptus Health in 2013. Three properties are leased pursuant to the master lease entered into in 2015 and are cross-defaulted with the master leases entered into in 2014 and 2013.

•

UAB Medical West — This $8.6 million acute care facility and medical office building located in Birmingham, Alabama is leased to Medical West, an affiliate of The University of Alabama at Birmingham, for 15 years and contains four renewal options of five years each. The rent increases 2% annually.

In April 2015, we executed an agreement with Adeptus Health that provides for the acquisition and development of general acute care hospitals and free standing emergency facilities with an aggregate commitment of $250 million. These facilities will be leased to Adeptus Health pursuant to the terms of the 2014 and 2015 master lease agreements that have a 15-year initial term with three extension options of five years each that provide for annual rent increases based on changes in the CPI with a 2% minimum. With this commitment, along with similar agreements entered into in 2014 and 2013, we have committed to fund up to $500 million in acute care facilities with Adeptus Health. At December 31, 2016, we have 54 completed and open facilities and five still under construction. See table below for an update on our remaining commitments to Adeptus Health.

2014 Activity

During 2014, we completed construction and began recording rental income on the following facilities:

•

Northern Utah Rehabilitation Hospital — This $19 million inpatient rehabilitation facility located in South Ogden, Utah is leased to Ernest pursuant to the 2012 master lease.

•

Oakleaf Surgical Hospital — This approximately $30 million acute care facility located in Altoona, Wisconsin. This facility is leased to National Surgical Hospitals for 15 years and contains two renewal options of five years each plus an additional option for nearly another five years, and the rent increases annually based on changes in the consumer price-index.

•

Adeptus Health — We completed 17 acute care facilities for this tenant during 2014 totaling approximately $83.0 million. These facilities are leased pursuant to the master lease entered into in 2013.

See table below for a status update on our current development projects (in thousands):


Operator	Commitment		Costs Incurred as of 12/31/16		Estimated Completion Date
Adeptus Health	$	5,848	$	2,710		1Q 2017
Adeptus Health		67,185		44,948		2Q 2017
Ernest Health		28,067		4,342		4Q 2017
Adeptus Health		7,804		1,648		1Q 2018
Adeptus Health		53,866		—		Various

	$	162,770	$	53,648

Disposals

2016 Activity

Capella Disposal Transaction

On March 21, 2016, we entered into definitive agreements with RegionalCare, an affiliate of certain funds managed by affiliates of Apollo Global Management, LLC (together with its consolidated subsidiaries, “Apollo”), under which our investment in the operations of Capella would be merged with RegionalCare, forming RCCH.

On April 29, 2016, this transaction closed and funded, effective April 30, 2016. 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 to subsidiaries of Capella in connection with the Capella transaction on August 31, 2015. We made a new $93.3 million loan for a hospital property in Olympia, Washington (which was subsequently converted to real estate on July 22, 2016 as previously disclosed). 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 Capella 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 in unbilled DFL rent in the 2016 second quarter.

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. 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.

HealthSouth Transaction

On July 20, 2016, we sold three inpatient rehabilitation hospitals located in Texas and operated by HealthSouth 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 (excluding gain on sale, transaction costs, and impairment or other non-cash charges) from these properties (excluding loans repaid in the Capella Disposal Transaction) for the periods presented (in thousands):


	For the Year Ended December 31,
	2016			2015			2014
Revenues	$	7,851		$	18,112		$	18,225
Real estate depreciation and amortization		(1,754	)		(3,795	)		(3,789	)
Property-related expenses		(114	)		(121	)		(60	)
Other income (expense)		(23	)		1,079			462

Income from real estate dispositions, net	$	5,960		$	15,275		$	14,838

2015 Activity

On July 30, 2015, we sold a long-term acute care facility in Luling, Texas for approximately $9.7 million, resulting in a gain of $1.5 million. Due to this sale, we wrote off $0.9 million of straight-line receivables. On August 5, 2015, we sold six wellness centers in the U.S. for total proceeds of approximately $9.5 million (of which $1.5 million is in the form of a promissory note), resulting in a gain of $1.7 million. Due to this sale, we wrote off $0.9 million of billed rent receivables. With these disposals, we accelerated the amortization of the related lease intangible assets resulting in approximately $0.7 million of additional expense.

The sale of the Luling facility and the six wellness centers were not strategic shifts in our operations, and therefore the results of operations related to these facilities were not reclassified as discontinued operations.

2014 Activity

On December 31, 2014, we sold our La Palma facility for $12.5 million, resulting in a gain of $2.9 million. Due to this sale, we wrote-off $1.3 million of straight-line rent receivables.

On May 20, 2014, the tenant of our Bucks facility gave notice of their intent to exercise the lease’s purchase option. Pursuant to this purchase option, the tenant acquired the facility on August 6, 2014 for $35 million. We wrote down this facility to fair market value less cost to sell, resulting in a $3.1 million real estate impairment charge in the 2014 second quarter.

The sale of the Bucks and La Palma facilities was not a strategic shift in our operations, and therefore the results of the Bucks and La Palma operations were not reclassified as discontinued operations.

Intangible Assets

At December 31, 2016 and 2015, our intangible lease assets were $296.2 million ($263.8 million, net of accumulated amortization) and $257.0 million ($231.7 million, net of accumulated amortization), respectively.

We recorded amortization expense related to intangible lease assets of $13.4 million, $9.1 million, and $7.0 million in 2016, 2015, and 2014, respectively, and expect to recognize amortization expense from existing lease intangible assets as follows (amounts in thousands):


For the Year Ended December 31:
2017	$	22,130
2018		22,069
2019		22,021
2020		21,818
2021		21,751

As of December 31, 2016, capitalized lease intangibles have a weighted average remaining life of 22.1 years.

Leasing Operations

All of our leases are accounted for as operating leases, except we are accounting for 15 Ernest facilities and ten Prime facilities as DFLs. The components of our net investment in DFLs consisted of the following (in thousands):


	As of December 31, 2016			As of December 31, 2015
Minimum lease payments receivable	$	2,207,625		$	2,587,912
Estimated residual values		407,647			393,097
Less unearned income		(1,967,170	)		(2,354,013	)

Net investment in direct financing leases	$	648,102		$	626,996

Minimum rental payments due to us in future periods under operating leases and DFLs, which have non-cancelable terms extending beyond one year at December 31, 2016, are as follows (amounts in thousands):


	Total Under Operating Leases		Total Under DFLs		Total
2017	$	386,058	$	62,419	$	448,477
2018		388,808		63,668		452,476
2019		392,577		64,941		457,518
2020		395,339		66,240		461,579
2021		400,607		67,565		468,172
Thereafter		7,077,794		1,673,600		8,751,394

	$	9,041,183	$	1,998,433	$	11,039,616

Adeptus Health

On November 1, 2016, Adeptus Health announced their 2016 third quarter results showing a decline in net income over the prior year and disclosing collection issues associated with a third party billing agent among other things. At December 31, 2016, we have no outstanding receivables due from this tenant. Furthermore, Adeptus Health is current on its rent obligations to us through February 2017. In addition, we currently hold letters of credit approximating $12.4 million. At December 31, 2016, we have approximately $400 million invested in 59 properties (including five properties still under development) that are leased, pursuant to master lease agreements, to Adeptus Health, along with additional funding commitments as disclosed earlier. This investment represents approximately 7% of our total assets at December 31, 2016. At December 31, 2016, we believe this investment is fully recoverable; however, no assurances can be made that we will not have any impairment charges related to this investment in the future.

Hoboken Facility

In the 2015 third quarter, a subsidiary of the operator of our Hoboken facility acquired 10% of our subsidiary that owns the real estate for $5 million, which is reflected in the non-controlling interest line of our consolidated balance sheets.

Twelve Oaks Facility

In the third quarter of 2015, we sent notice of termination of the lease to the tenant at our Twelve Oaks facility. As a result of the lease terminating, we recorded a charge of $1.9 million to reserve against the straight-line rent receivables. In addition, we accelerated the amortization of the related lease intangible asset resulting in $0.5 million of additional expense during 2015. This former tenant has continued to occupy the facility. During the third quarter of 2016, the tenant paid us approximately $2.5 million representing substantially all of amounts owed to us and agreed to general terms of a new lease, which we expect to execute in 2017. The tenant is current on all of its obligations to us through February 2017. Although no assurances can be made that we will not have any impairment charges in the future, we believe our real estate investment in Twelve Oaks at December 31, 2016 is fully recoverable.

Monroe Facility

During 2014, the previous operator of our Monroe facility continued to underperform and became further behind on payments to us as required by the real estate lease agreement and working capital loan agreement. In August 2014, this operator filed for bankruptcy. Based on these developments and the fair value of our real estate and the underlying collateral of our loan (using Level 2 inputs), we recorded a $47.0 million impairment charge in 2014. Effective December 31, 2014, the bankruptcy court approved the purchase by Prime of the assets of the prior operator. Prime leases the facility from us pursuant to terms under an existing master lease. Prime has been current on its rent since lease inception. At December 31, 2016, our investment in Monroe is approximately $36 million, which we believe is fully recoverable.

Loans

The following is a summary of our loans ($ amounts in thousands):


	As of December 31, 2016					As of December 31, 2015
	Balance		Weighted Average Interest Rate			Balance		Weighted Average Interest Rate
Mortgage loans	$	1,060,400		8.8	%	$	757,581		9.5	%
Acquisition loans		121,464		13.7	%		610,469		9.1	%
Working capital and other loans		34,257		9.0	%		54,353		10.2	%

	$	1,216,121				$	1,422,403

Our mortgage loans cover 12 of our properties with four operators. The increase in mortgage loans relates to the loans made to Steward totaling $600 million for four properties in October 2016, partially offset by the repayment of two loans for $210 million by RCCH (formally Capella) and the conversion of a $100 million mortgage loan to Prime into a sale/leaseback of the property — See “2016 Activity” under the Disposal and Acquisition sections for more details.

Other loans typically consist of loans to our tenants for acquisitions and working capital purposes. At December 31, 2016, acquisition loans include our $115 million of loans to Ernest. The Capella acquisition loans of approximately $489 million at December 31, 2015 were paid in full during 2016 — See “2016 Activity” under the Disposal section for more details.

On March 1, 2012, pursuant to our convertible note agreement, we converted $1.7 million of our $5.0 million convertible note into a 9.9% equity interest in the operator of our Hoboken University Medical Center facility. On October 1, 2016, we converted the remaining $3.3 million of our convertible note into a 15.1% of equity interest in the operator for a total 25% equity interest in the operator.

Concentration of Credit Risks

Revenue by Operator

(Dollar amounts in thousands)


	For the Years Ended December 31,
	2016					2015
Operators (A)	Total Revenue		Percentage of Total Revenue			Total Revenue		Percentage of Total Revenue
Prime	$	120,558		22.3	%	$	104,325		23.6	%
MEDIAN		93,425		17.3	%		78,540		17.8	%
Ernest		67,742		12.5	%		61,988		14.0	%
RCCH		52,720		9.7	%		28,567		6.4	%
Other operators		206,692		38.2	%		168,458		38.2	%

Total	$	541,137		100.0	%	$	441,878		100.0	%

(A) Steward is not included herein as the Steward transaction closed on October 3, 2016.

Revenue by U.S. State and Country

(Dollar amounts in thousands)


	For the Years Ended December 31,
	2016					2015
U.S. States and Other Countries	Total Revenue		Percentage of Total Revenue			Total Revenue		Percentage of Total Revenue
Texas	$	96,992		17.9	%	$	87,541		19.8	%
California		66,197		12.2	%		66,120		15.0	%
New Jersey		39,084		7.2	%		27,688		6.3	%
Massachusetts		26,098		4.8	%		69		0.0	%
Arizona		23,798		4.4	%		21,188		4.8	%
Other States		187,363		34.7	%		156,256		35.3	%

Total U.S.	$	439,532		81.2	%	$	358,862		81.2	%

Germany	$	97,382		18.0	%	$	78,540		17.8	%
United Kingdom, Italy, and Spain		4,223		0.8	%		4,476		1.0	%

Total International	$	101,605		18.8	%	$	83,016		18.8	%

Total	$	541,137		100.0	%	$	441,878		100.0	%

From an asset perspective, approximately 80% of our total assets are in the U.S., while 20% reside in Europe (primarily Germany) as of December 31, 2016, consistent with December 31, 2015.

Related Party Transactions

Lease and interest revenue earned from tenants in which we have an equity interest in were $282.9 million, $215.4 million and $101.8 million in 2016, 2015 and 2014, respectively.

Debt

12 Months Ended

Dec. 31, 2016

Debt Disclosure [Abstract]

Debt

4. Debt

The following is a summary of debt ($ amounts in thousands):


	As of December 31,
	2016			2015
Revolving credit facility	$	290,000		$	1,100,000
Term loans		263,101			263,400
Senior Unsecured Notes due 2016		—			125,000
6.875% Senior Unsecured Notes due 2021		—			450,000
6.375% Senior Unsecured Notes due 2022:
Principal amount		350,000			350,000
Unamortized premium		1,814			2,168

		351,814			352,168
5.750% Senior Unsecured Notes due 2020 (A)		210,340			217,240
4.000% Senior Unsecured Notes due 2022 (A)		525,850			543,100
5.500% Senior Unsecured Notes due 2024		300,000			300,000
6.375% Senior Unsecured Notes due 2024		500,000			—
5.250% Senior Unsecured Notes due 2026		500,000			—

	$	2,941,105		$	3,350,908
Debt issue costs, net		(31,764	)		(28,367	)

	$	2,909,341		$	3,322,541

As of December 31, 2016, 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):


2017	$	320
2018		302,781
2019		250,000
2020		210,340
2021		—
Thereafter		2,175,850

Total	$	2,939,291

(A)	These notes are Euro-denominated and reflect the exchange rates at December 31, 2016 and 2015, respectively.

Revolving Credit Facility

On June 19, 2014, we closed on the Credit Facility for $900 million. The Credit Facility was comprised of a $775 million senior unsecured revolving credit facility (the “Revolving credit facility”) and a $125 million senior unsecured term loan facility (the “Term Loan”). The Credit Facility had an accordion feature that allowed us to expand the size of the facility by up to $250 million through increases to the Revolving credit facility, Term Loan, both or as a separate term loan tranche. The Credit Facility replaced our previous $400 million unsecured revolving credit facility and $100 million unsecured term loan. This transaction resulted in a refinancing charge of approximately $0.3 million in the 2014 second quarter.

On October 17, 2014, we entered into an amendment to our Credit Facility to exercise the $250 million accordion on the Revolving credit facility. This amendment increased the Credit Facility to $1.15 billion and added a new accordion feature that allowed us to expand our credit facility by another $400 million.

On August 4, 2015, we entered into an amendment to our Revolving credit facility and Term Loan agreement to further increase the current aggregate committed size to $1.25 billion and amend certain covenants in order to permit us to consummate and finance the acquisition of Capella.

On September 30, 2015, we further amended our Credit Facility to, among other things, increase the aggregate commitment under our Revolving credit facility to $1.3 billion and increase the Term Loan portion to $250 million. In addition, this amendment included a new accordion feature that allowed us to expand the Credit Facility by another $400 million for a total commitment of $1.95 billion. This amendment resulted in a $0.1 million expense in the 2015 third quarter.

The Revolving credit facility matures in June 2018 and can be extended for an additional 12 months at our option. The Revolving credit facility’s interest rate was originally set as (1) the higher of the “prime rate”, federal funds rate plus 0.50%, or Eurodollar rate plus 1.00%, plus a spread that was adjustable from 0.70% to 1.25% based on current total leverage, or (2) LIBOR plus a spread that was adjustable from 1.70% to 2.25% based on current total leverage. In addition to interest expense, we were required to pay a quarterly commitment fee on the undrawn portion of the revolving credit facility, ranging from 0.25% to 0.35% per year.

In November 2014, we received an upgrade to our credit rating resulting in an improvement in our interest rate spreads and commitment fee rates. Effective December 10, 2014, the Revolving credit facility’s interest rate is (1) the higher of the “prime rate”, federal funds rate plus 0.50%, or Eurodollar rate plus 1.00% plus a fixed spread of 0.40% or (2) LIBOR plus a fixed spread of 1.40%. In regards to commitment fees, we now pay based on the total facility at a rate of 0.30% per year.

At December 31, 2016 and 2015, we had $290 million and $1.1 billion, respectively, outstanding on the Revolving credit facility.

At December 31, 2016, our availability under our Revolving credit facility was $1 billion. The weighted average interest rate on this facility was 2.0% and 1.7% for 2016 and 2015, respectively.

See Note 13 for subsequent event activity impacting our Credit Facility.

Term Loans

As noted above in the Revolving Credit Facility section, we closed on the Term Loan for $125 million in the second quarter of 2014. Furthermore, as noted above, we amended the credit facility to increase the Term Loan portion to $250 million in the third quarter of 2015. The Term Loan matures in June 2019. The Term Loan’s initial interest rate was (1) the higher of the “prime rate”, federal funds rate plus 0.50%, or Eurodollar rate plus 1.00%, plus a spread that was adjustable from 0.60% to 1.20% based on current total leverage, or (2) LIBOR plus a spread that was adjustable from 1.60% to 2.20% based on current total leverage. With the upgrade to our credit rating as discussed above, the Term Loan’s interest rate, effective December 10, 2014, improved to (1) the higher of the “prime rate”, federal funds rate plus 0.50%, or Euro dollar rate plus 1.00% plus a fixed spread of 0.65%, or (2) LIBOR plus a fixed spread of 1.65%. At December 31, 2016 and 2015, the interest rate in effect on the Term Loan was 2.36% and 2.05%, respectively.

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 requires monthly principal and interest payments based on a 30-year amortization period. The Northland mortgage loan has a fixed interest rate of 6.2%, matures on January 1, 2018 and can be prepaid, subject to a certain prepayment premium. At December 31, 2016, the remaining balance on this term loan was $13.1 million. The loan is collateralized by the real estate of the Northland LTACH Hospital, which had a net book value of $16.4 million and $16.9 million at December 31, 2016 and 2015, respectively.

See Note 13 for subsequent activity impacting our Credit Facility.

Senior Unsecured Notes due 2016

During 2006, we issued $125.0 million of senior unsecured notes (the “Senior Unsecured Notes due 2016”). One of the issuances of the Senior Unsecured Notes due 2016 totaling $65.0 million paid interest quarterly at a floating annual rate of three-month LIBOR plus 2.30% and could be called at par value by us at any time. This portion of the Senior Unsecured Notes due 2016 matured in July 2016. The remaining issuances of Senior Unsecured Notes due 2016 paid interest quarterly at a floating annual rate of three-month LIBOR plus 2.30% and could also be called at par value by us at any time. These remaining notes matured in October 2016.

During the second quarter 2010, we entered into an interest rate swap to manage our exposure to variable interest rates by fixing $65 million of our $125 million Senior Unsecured Notes due 2016, which started July 31, 2011 (date on which the interest rate turned variable) through maturity date (or July 2016), at a rate of 5.507%. We also entered into an interest rate swap to fix $60 million of our Senior Unsecured Notes due 2016 which started October 31, 2011 (date on which the related interest rate turned variable) through the maturity date (or October 2016) at a rate of 5.675%. At December 31, 2015, the fair value of the interest rate swaps was $2.9 million, which is reflected in accounts payable and accrued expenses on the consolidated balance sheets. These interest rate swaps expired in 2016 in connection with the maturity of the related notes. We accounted for our interest rate swaps as cash flow hedges. We did not have any hedge ineffectiveness from inception of our interest rate swaps through their expiration in 2016; and therefore, there was no income statement effect recorded during the years ended December 31, 2016, 2015, and 2014.

6.875% Senior Unsecured Notes due 2021

On April 26, 2011, we closed on a private placement of $450 million senior notes (the “6.875% Senior Unsecured Notes due 2021”) to qualified institutional buyers in reliance on Rule 144A under the Securities Act. The notes were subsequently registered under the Securities Act pursuant to an exchange offer. Interest on the notes was payable semi-annually on May 1 and November 1 of each year. The notes paid interest in cash at a rate of 6.875% per year, would have matured on May 1, 2021, and offered a redemption option to redeem some or all of the notes at a premium, plus accrued and unpaid interest to, but not including, the redemption date.

On July 22, 2016, we used the net proceeds from the 5.250% Senior Unsecured Notes due 2026 offering (see discussion below for further details on these notes) to redeem our $450 million 6.875% Senior Unsecured Notes due 2021. This redemption resulted in a $22.5 million debt refinancing charge during the 2016 third quarter, consisting of a $15.5 million redemption premium along with the write-off of deferred debt issuance costs associated with the redeemed notes.

6.375% Senior Unsecured Notes due 2022

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 accrue interest at a fixed rate of 6.375% per year and mature on February 15, 2022. The 2013 tack on offering, was issued at a premium (price of 102%), resulting in an effective rate of 5.998%. Interest on these notes is payable semi-annually on February 15 and August 15 of each year. We may redeem some or all of the notes at a premium that will decrease over time, plus accrued and unpaid interest to, but not including, the redemption date. In the event of a change of control, each holder of the 6.375% Senior Unsecured Notes due 2022 may require us to repurchase some or all of its notes at a repurchase price equal to 101% of the aggregate principal amount plus accrued and unpaid interest to the date of purchase.

5.750% Senior Unsecured Notes due 2020

On October 10, 2013, we completed a €200 million offering of senior unsecured notes (“5.750% Senior Unsecured Notes due 2020”). Interest on the notes is payable semi-annually on April 1 and October 1 of each year. The 5.750% Senior Unsecured Notes due 2020 pay interest in cash at a rate of 5.750% per year. The notes mature on October 1, 2020. We may redeem some or all of the notes at any time at a “make-whole” redemption price 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. See Note 13 for subsequent event activity related to these notes.

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 4.00% 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 5.50% 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 addition, at any time prior to May 1, 2017, we may redeem up to 35% of the aggregate principal amount of the notes using the proceeds of one or more equity offerings. 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.

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, commencing on February 1, 2017. Interest on the notes is to be paid in cash at a rate of 5.25% 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 105.25% 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.

Other Financing

On July 27, 2015, we received a commitment to provide a senior unsecured bridge loan facility in the original principal amount of $1.0 billion to fund the acquisition of Capella pursuant to a commitment letter from JPMorgan Chase Bank, N.A. and Goldman, Sachs & Co. Funding under the bridge facility was not necessary as we funded the acquisition through a combination of an equity issuance and other borrowings. We incurred and expensed certain customary structuring and underwriting fees of $3.9 million in the 2015 third quarter related to the bridge commitment.

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, as defined in the agreements, on a rolling four quarter basis. Through 2016, the dividend restriction was 95% of normalized adjusted FFO. The indentures governing our senior unsecured notes also limit the amount of dividends we can pay based on the sum of 95% of FFO, 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, 2016, we were in compliance with all such financial and operating covenants.

Income Taxes

12 Months Ended

Dec. 31, 2016

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 of 1986, as amended. 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. 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 TRSs 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 TRSs and our foreign operations, income tax (benefit) expense were as follows (in thousands):


	For the years ended December 31,
	2016			2015			2014
Current income tax expense:
Domestic	$	42		$	147		$	114
Foreign		1,856			1,614			225

		1,898			1,761			339
Deferred income tax (benefit) expense:
Domestic		147			(360	)		(23	)
Foreign		(8,875	)		102			24

		(8,728	)		(258	)		1

Income tax (benefit) expense	$	(6,830	)	$	1,503		$	340

The foreign provision (benefit) for income taxes is based on foreign loss before income taxes of $23.5 million in 2016 as compared with foreign loss before income taxes of $29.4 million in 2015, and foreign loss before income taxes of $7.5 million in 2014.

The domestic provision (benefit) for income taxes is based on a loss before income taxes of $1.4 million in 2016 from our taxable REIT subsidiaries as compared with income before income taxes of $7.1 million in 2015, and a loss before income taxes of $20.9 million in 2014.

At December 31, 2016 and 2015, components of our deferred tax assets and liabilities were as follows (in thousands):


	2016			2015
Deferred tax liabilities:
Property and equipment	$	(3,781	)	$	(1,636	)
Unbilled rent		(7,045	)		(4,495	)
Partnership investments		(5,103	)		(3,362	)
Other		(6,757	)		(6,141	)

Total deferred tax liabilities	$	(22,686	)	$	(15,634	)
Deferred tax assets:
Operating loss and interest deduction carry forwards	$	28,289		$	19,016
Other		10,085			10,314

Total deferred tax assets		38,374			29,330
Valuation allowance		(15,975	)		(23,005	)

Total net deferred tax assets	$	22,399		$	6,325

Net deferred tax (liability)	$	(287	)	$	(9,309	)

At December 31, 2016, our U.S. net operating losses (“NOLs”) consisted of $60 million of federal NOLs and $113.5 million of state NOLs available as offsets to future years’ taxable income. We have federal and state capital loss carryforwards of $8.1 million. The NOLs primarily expire between 2021 and 2035 and the capital loss carryforward expires in 2022. We have alternative minimum tax credits of $0.3 million as of December 31, 2016, which may be carried forward indefinitely. At December 31, 2016, we had foreign NOLs of $13.3 million that may be carried forward indefinitely.

In the evaluation of the need for a valuation allowance on the U.S. deferred income tax assets, we considered 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. Based on our review of all positive and negative evidence, including a three year U.S. cumulative pre-tax loss, we concluded that a valuation allowance should remain against those 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. As a result, a valuation allowance continues to be recorded to reflect the portion of the U.S. federal and state deferred income tax assets that are not likely to be realized based upon all available evidence. If we later determine that we will more likely than not realize all, or a portion, of the deferred income tax assets, we will reverse the valuation allowance in a future period. All future reversals of the valuation allowance would result in a tax benefit in the period recognized.

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. When comparing 2016 results to prior periods, we noted a significant increase in positive evidence, which included a strong positive trend in foreign earnings and forecasted foreign income projections in 2017 and future periods. For instance, several of our initial foreign subsidiaries achieved a cumulative pre-tax income position as of the 2016 fourth quarter, and we expect the majority of our remaining foreign subsidiaries to be in a cumulative pre-tax income position within the next 12-18 months. Current year earnings resulted in the use of $2 million of beginning of the year valuation allowances on deferred tax assets which offset corresponding current tax expense. The positive evidence noted above resulted in our conclusion to make a one-time release of $4 million of the valuation allowance on our foreign deferred income tax assets in the 2016 fourth quarter. We also noted that sufficient objective positive evidence did not exist for a portion of foreign deferred income tax assets at December 31, 2016 due to the lack of future sources of taxable income to utilize these deferred income tax assets. A valuation allowance of $2.2 million has remained to reserve against these foreign deferred tax assets.

We have no uncertain tax position liabilities and related interest or penalties recorded at December 31, 2016.

A reconciliation of the income tax (benefit) expense at the statutory income tax rate and the effective tax rate for income from continuing operations before income taxes for the years ended December 31, 2016, 2015, and 2014 is as follows (in thousands):


	2016			2015			2014
Income from continuing operations (before-tax)	$	219,108		$	141,430		$	51,138
Income tax at the US statutory federal rate (35%)		76,688			49,501			17,898
Increase (decrease) resulting from:
Rate differential		1,434			5,047			1,145
State income taxes, net of federal benefit		66			(601	)		(337	)
Dividends paid deduction		(84,927	)		(57,109	)		(27,873	)
Equity investments		4,297			—			—
Change in valuation allowance		(6,104	)		6,174			8,988
Other items, net		1,716			(1,509	)		519

Total income tax (benefit) expense	$	(6,830	)	$	1,503		$	340

We have met the annual REIT distribution requirements by payment of at least 90% of our estimated taxable income in 2016, 2015, and 2014. 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,
	2016		2015		2014
Common share distribution	$	0.900000	$	0.870000	$	0.840000
Ordinary income		0.619368		0.769535		0.520692
Capital gains(1)		0.102552		—		0.000276
Unrecaptured Sec. 1250 gain		0.045432		—		0.000276
Return of capital		0.178080		0.100465		0.319032

(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 TRSs on behalf of Medical Properties Trust, Inc., which are subject to 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 TRSs and international operations.

Earnings Per Share/Unit

12 Months Ended

Dec. 31, 2016

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,
	2016			2015			2014
Numerator:
Income from continuing operations	$	225,938		$	139,927		$	50,798
Non-controlling interests’ share in continuing operations		(889	)		(329	)		(274	)
Participating securities’ share in earnings		(559	)		(1,029	)		(894	)

Income from continuing operations, less participating securities’ share in earnings		224,490			138,569			49,630
Income (loss) from discontinued operations attributable to MPT common stockholders		(1	)		—			(2	)

Net income, less participating securities’ share in earnings	$	224,489		$	138,569		$	49,628

Denominator:
Basic weighted-average common shares		260,414			217,997			169,999
Dilutive potential common shares		658			307			541

Diluted weighted-average common shares		261,072			218,304			170,540

MPT Operating Partnership, L.P.

Our earnings per unit were calculated based on the following (amounts in thousands):


	For the Years Ended December 31,
	2016			2015			2014
Numerator:
Income from continuing operations	$	225,938		$	139,927		$	50,798
Non-controlling interests’ share in continuing operations		(889	)		(329	)		(274	)
Participating securities’ share in earnings		(559	)		(1,029	)		(894	)

Income from continuing operations, less participating securities’ share in earnings		224,490			138,569			49,630
Income (loss) from discontinued operations attributable to MPT Operating Partnership partners		(1	)		—			(2	)

Net income, less participating securities’ share in earnings	$	224,489		$	138,569		$	49,628

Denominator:
Basic weighted-average units		260,414			217,997			169,999
Dilutive potential units		658			307			541

Diluted weighted-average units		261,072			218,304			170,540

Stock Awards

12 Months Ended

Dec. 31, 2016

Disclosure of Compensation Related Costs, Share-based 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 5,265,916 shares remain available for future stock awards as of December 31, 2016. 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. 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 (and its predecessor plan):

Restricted Equity Awards

These stock-based awards are in the form of service-based awards and performance awards based on certain market conditions. The service-based awards vest as the employee provides the required service (typically three to five years). Service based awards are valued at the average price per share of common stock on the date of grant. In 2016, 2015, and 2014, the Compensation Committee granted performance — based awards to employees which vest based on us achieving certain total shareholder returns or comparisons of our total shareholder returns to peer total return indices. Generally, dividends are not paid on performance awards until the award is earned. See below for details of such performance award grants:

2016 performance awards — The 2016 performance awards were granted in two parts:

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 is 27.0% with 100% of the award earned if our total shareholder return reaches 35.0%. If any shares are earned from this award, the shares will 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 rates of 1.0%; expected volatility of 24.4%; expected dividend yield of 7.0%; and expected service period of 5 years.

The remainder of the 2016 performance awards will be earned if our total shareholder return outpaces that of the MSCI U.S. REIT Index (“Index”) over the cumulative period from January 1, 2016 to December 31, 2018. Our total shareholder return must be within 3% of the Index to earn the minimum number of shares under this award, while it must exceed the 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, 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.

No 2016 performance awards were earned and vested in 2016, and 2,400 performance awards were forfeited in 2016. At December 31, 2016, we have 797,404 of 2016 performance awards remaining to be earned.

2015 performance awards — The 2015 performance awards were granted in three parts:

Approximately 40% of the 2015 performance awards were based on us achieving a simple 9.0% annual total shareholder return. For the three-year period from January 1, 2015 through December 31, 2017, one-third of the awards will be earned annually (until the award is fully earned) if a 9.0% total shareholder return is achieved. If total shareholder return does not reach 9.0% in a particular year, shares for that year can be earned in a future period (during the three-year period) if the cumulative total shareholder return is equal to or greater than a 9.0% annual return for such cumulative period. The fair value of this award was estimated on the date of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 1.1%; expected volatility of 20%; expected dividend yield of 7.2%; and expected service period of 3 years.

Approximately 30% of the 2015 performance awards were based on us achieving a cumulative total shareholder return from January 1, 2015 to December 31, 2017. The minimum total shareholder return needed to earn a portion of this award is 27.0% with 100% of the award earned if our total shareholder return reaches 35.0%. If any shares are earned from this award, the shares will vest in equal annual amounts on December 31, 2017, 2018, and 2019. The fair value of this award was estimated on the date of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 1.1%; expected volatility of 20%; expected dividend yield of 7.2%; and expected service period of 5 years.

The remainder of the 2015 performance awards will be earned if our total shareholder return outpaces the Index over the cumulative period from January 1, 2015 to December 31, 2017. Our total shareholder return must exceed that of the Index to earn the minimum number of shares under this award, while it must exceed the Index by 6% to earn 100% of the award. If any shares are earned from this award, the shares will vest in equal annual amounts on December 31, 2017, 2018, and 2019. The fair value of this award was estimated on the date of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 1.1%; expected volatility of 20%; expected dividend yield of 7.2%; and expected service period of 5 years.

In 2016, 98,526 shares were earned and vested, and 66,792 performance awards were forfeited in 2016. No 2015 performance awards were earned and vested in 2015, and 4,500 performance awards were forfeited in 2015. At December 31, 2016, we have 702,070 of 2015 performance awards remaining to be earned.

2014 performance awards — The 2014 performance awards were granted in three parts:

Approximately 40% of the 2014 performance awards were based on us achieving a simple 9.0% annual total shareholder return. For the five-year period from January 1, 2014 through December 31, 2018, one-third of the awards will be earned annually (until the award is fully earned) if a 9.0% total shareholder return is achieved. If total shareholder return does not reach 9.0% in a particular year, shares for that year can be earned in a future period (during the five-year period) if the cumulative total shareholder return is equal to or greater than a 9.0% annual return for such cumulative period. The fair value of this award was estimated on the date of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 1.7%; expected volatility of 27%; expected dividend yield of 8.0%; and expected service period of 3 years.

Approximately 30% of the 2014 performance awards were based on us achieving a cumulative total shareholder return from January 1, 2014 to December 31, 2016. The minimum total shareholder return needed to earn a portion of this award is 27.0% with 100% of the award earned if our total shareholder return reaches 35.0%. If any shares are earned from this award, the shares will vest in equal annual amounts on December 31, 2016, 2017, and 2018. The fair value of this award was estimated on the date of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 0.8%; expected volatility of 27%; expected dividend yield of 8.0%; and expected service period of 5 years.

The remainder of the 2014 performance awards were to be earned if our total shareholder return outpaced that of the Index over the cumulative period from January 1, 2014 to December 31, 2016. Our total shareholder return must exceed that of the Index to earn the minimum number of shares under this award, while it must exceed the Index by 6% to earn 100% of the award. If any shares are earned from this award, the shares will vest in equal annual amounts on December 31, 2016, 2017, and 2018. The fair value of this award was estimated on the date of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 0.8%; expected volatility of 27%; expected dividend yield of 8.0%; and expected service period of 5 years.

In 2014 and 2016, 108,261 and 99,959 shares were earned and vested under the 2014 performance awards, respectively. No such awards were earned and vested in 2015. In 2016, 500,000 shares, which related to the latter two parts of the award as described above, were forfeited as the three-year cumulative total shareholder return hurdles from January 1, 2014 to December 31, 2016 were not met. An additional 72,003 performance shares were forfeited prior to the measurement date in 2016. At December 31, 2016, we have 99,935 of 2014 performance awards remaining to be earned.

The following summarizes restricted equity award activity in 2016 and 2015 (which includes awards granted in 2016, 2015, 2014, and any applicable prior years), respectively:

For the Year Ended December 31, 2016:


	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		509,634		$	13.25		2,331,152		$	6.38
Awarded		254,574		$	13.07		799,804		$	7.30
Vested		(349,356	)	$	13.07		(671,983	)	$	6.50
Forfeited		(67,724	)	$	13.06		(647,298	)	$	6.28

Nonvested awards at end of year		347,128		$	13.35		1,811,675		$	6.78

For the Year Ended December 31, 2015:


	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		452,263		$	12.11		2,428,518		$	5.81
Awarded		407,969		$	13.94		871,888		$	6.62
Vested		(343,904	)	$	12.56		(406,970	)	$	4.94
Forfeited		(6,694	)	$	13.08		(562,284	)	$	5.33

Nonvested awards at end of year		509,634		$	13.25		2,331,152		$	6.38

The value of stock-based awards is charged to compensation expense over the vesting periods. In the years ended December 31, 2016, 2015, and 2014, we recorded $7.9 million, $11.1 million, and $9.2 million, respectively, of non-cash compensation expense. The remaining unrecognized cost from restricted equity awards at December 31, 2016, is $12.4 million, which will be recognized over a weighted average period of 2.78 years. Restricted equity awards that vested in 2016, 2015, and 2014 had a value of $12.7 million, $10.2 million, and $10.2 million, respectively.

- Definition

The entire disclosure for compensation-related costs for equity-based compensation, which may include disclosure of policies, compensation plan details, allocation of equity compensation, incentive distributions, equity-based arrangements to obtain goods and services, deferred compensation arrangements, employee stock ownership plan details and employee stock purchase plan details.

+ References + Details

Commitments and Contingencies

12 Months Ended

Dec. 31, 2016

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

8. Commitments and Contingencies

Commitments

On July 20, 2016, we entered into definitive agreements to acquire 20 rehabilitation hospitals in Germany for an aggregate purchase price to us of approximately €215.7 million. Upon closing, the facilities will be leased to affiliates of MEDIAN, pursuant to a new master lease with a term of approximately 27 years. Closing of the transaction, which began during the fourth quarter of 2016, is subject to customary real estate, regulatory and other closing conditions. As discussed in Note 3, we have closed seven of the 20 facilities in the amount of €49.5 million on December 31, 2016.

On September 9, 2016, we entered into definitive agreements to acquire six rehabilitation hospitals in Germany for an aggregate purchase price to us of approximately €44.1 million. Upon closing, the facilities will be leased to affiliates of MEDIAN, pursuant to the existing long-term master lease. Closing of the transaction, which began during the fourth quarter of 2016, is subject to customary real estate, regulatory and other closing conditions. As discussed in Note 3, we have closed on five of the six facilities in the amount of €35.7 million as of December 31, 2016. We closed on the final property on January 27, 2017, in the amount of €8.4 million.

On September 28, 2016, we entered into definitive agreements to acquire two acute care hospitals in Washington and Idaho for an aggregate purchase price to us of approximately $105 million. Upon closing, the facilities will be leased to RCCH, pursuant to the current master lease. Closing of the transaction, which is expected to be completed in the first half of 2017, is subject to customary real estate, regulatory and other closing conditions.

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. Lease and rental expense (which is recorded on the straight-line method) for 2016, 2015 and 2014, respectively, were $6.8 million, $4.6 million, and $2.3 million, which was offset by sublease rental income of $4.2 million, $2.3 million, and $0.3 million for 2016, 2015, and 2014, respectively.

Fixed minimum payments due under operating leases with non-cancelable terms of more than one year and amounts to be received in the future from non-cancelable subleases at December 31, 2016 are as follows: (amounts in thousands)


	Fixed minimum payments		Amounts to be received from subleases			Net payments
2017	$	7,328	$	(4,725	)	$	2,603
2018		7,249		(4,731	)		2,518
2019		6,925		(4,755	)		2,170
2020		6,944		(4,860	)		2,084
2021		6,024		(4,966	)		1,058
Thereafter		251,981		(249,662	)		2,319

	$	286,451	$	(273,699	)	$	12,752

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	12 Months Ended
Common Stock/Partner's Capital	Dec. 31, 2016
Equity [Abstract]
Common Stock/Partner's Capital	9. Common Stock/Partner’s Capital Medical Properties Trust, Inc. 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. On March 1, 2016, we updated our at-the-market equity offering program, which gave us the ability to sell up to $227 million of stock with a commission rate of 1.25%. During 2016, we sold approximately 15 million shares of our common stock under this program, resulting in net proceeds of approximately $224 million, after deducting approximately $2.8 million of commissions. We have no capacity to sell additional shares under this at-the-market equity offering program. 2015 Activity On August 11, 2015, we completed an underwritten public offering of 28.75 million shares (including the exercise of the underwriters’ 30-day option to purchase an additional 3.8 million shares) of our common stock, resulting in net proceeds of approximately $337 million, after deducting estimated offering expenses. On August 4, 2015, we filed Articles of Amendment to our charter with the Maryland State Department of Assessments and Taxation increasing the number of authorized shares of common stock, par value $0.001 per share available for issuance from 250,000,000 to 500,000,000. On January 14, 2015, we completed an underwritten public offering of 34.5 million shares (including the exercise of the underwriters’ 30-day option to purchase an additional 4.5 million shares) of our common stock, resulting in net proceeds of approximately $480 million, after deducting estimated offering expenses. MPT Operating Partnership, L.P. 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 three 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 and one director 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 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. In order for LTIP units to be redeemed, they must first be converted to common units and then must wait two years from the issuance of the LTIP units to be redeemed. 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 Instruments

12 Months Ended

Dec. 31, 2016

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. Included in our accounts payable and accrued expenses at December 31, 2015, were our interest rate swaps, which were recorded at fair value based on Level 2 observable market assumptions using standardized derivative pricing models. 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, 2016						December 31, 2015
Asset (Liability)	Book Value			Fair Value			Book Value			Fair Value
Interest and rent receivables	$	57,698		$	57,707		$	46,939		$	46,858
Loans(1)		986,987			1,017,428			508,851			543,859
Debt, net		(2,909,341	)		(2,966,759	)		(3,322,541	)		(3,372,773	)

(1)	Excludes loans related to Ernest and Capella (2015 only) since they are recorded at fair value as discussed below.

Items Measured at Fair Value on a Recurring Basis

Our equity interest in Ernest, Capella (2015 only) and related loans, as discussed in Note 2, are being measured at fair value on a recurring basis as we elected to account for these investments using the fair value option method. 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 in or prior to 2016.

At December 31, 2016, the amounts recorded under the fair value option method were as follows (in thousands):


Asset (Liability)	Fair Value		Cost		Asset Type Classification
Mortgage loan	$	112,836	$	112,836	Mortgage loans
Acquisition and other loans		116,298		116,298	Other loans
Equity investment		3,300		3,300	Other assets

	$	232,434	$	232,434

At December 31, 2015, the amounts recorded under the fair value option method were as follows (in thousands):


Asset (Liability)	Fair Value		Cost		Asset Type Classification
Mortgage loan	$	310,000	$	310,000		Mortgage loans
Acquisition and other loans		603,552		603,552		Other loans
Equity investment		7,349		7,349		Other assets

	$	920,901	$	920,901

Our mortgage and other loans with Ernest and Capella (2015 only) 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 investments in Ernest and Capella (2015 only) are 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 classify the equity investments as Level 3, as we use certain unobservable inputs to the valuation methodology that are significant to the fair value measurement, and the valuation requires management judgment due to the absence of quoted market prices. For these cash flow models, our observable inputs include 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 includes an adjustment for a DLOM on our equity investment of 40% at December 31, 2016.

In regards to the underlying projection of revenues and expenses used in the discounted cash flow model, such projections are provided by Ernest and Capella (2015 only), respectively. However, we will modify such projections (including underlying assumptions used) as needed based on our review and analysis of their historical results, meetings with key members of management, and our understanding of trends and developments within the healthcare industry.

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. To illustrate the effect of movements in the DLOM, we performed a sensitivity analysis below by using basis point variations (dollars in thousands):


Basis Point Change in Marketability Discount	Estimated Increase (Decrease) In Fair Value
+100 basis points	$	(49	)
- 100 basis points		49

Because the fair value of Ernest and Capella (2015 only) investments noted above approximate their original cost, we did not recognize any unrealized gains/losses during 2016, 2015, or 2014. To date, we have not received any distribution payments from our equity investment in Ernest. In regards to the Capella investment, we sold this investment in 2016 at our original cost (see Note 3 for further details of this disposal).

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Other Assets

12 Months Ended

Dec. 31, 2016

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,
	2016		2015
Debt issue costs, net(1)	$	4,478	$	7,628
Equity investments		177,430		129,337
Other corporate assets		77,580		31,547
Prepaids and other assets		44,285		27,028

Total other assets	$	303,773	$	195,540

(1)

Relates to Revolving credit facility

Equity investments have increased over the prior year primarily due to our new investment in Steward — see Note 3 for further details. Other corporate assets include leasehold improvements associated with our corporate office space, furniture and fixtures, equipment, software, deposits, etc. Included in prepaids and other assets is prepaid insurance, prepaid taxes, goodwill, deferred income tax assets (net of valuation allowances, if any), and lease inducements made to tenants, among other items.

Quarterly Financial Data (unaudited)

12 Months Ended

Dec. 31, 2016

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, 2016 and 2015: (amounts in thousands, except for per share data)


	For the Three Month Periods in 2016 Ended
	March 31		June 30		September 30		December 31
Revenues	$	134,999	$	126,300	$	126,555	$	153,283
Income from continuing operations		58,226		53,924		70,543		43,245
Net income		58,225		53,924		70,543		43,245
Net income attributable to MPT common stockholders		57,927		53,724		70,358		43,039
Net income attributable to MPT common stockholders per share — basic	$	0.24	$	0.23	$	0.29	$	0.13
Weighted average shares outstanding — basic		237,510		238,082		246,230		319,833
Net income attributable to MPT common stockholders per share — diluted	$	0.24	$	0.22	$	0.28	$	0.13
Weighted average shares outstanding — diluted		237,819		239,008		247,468		319,994


	For the Three Month Periods in 2015 Ended
	March 31		June 30		September 30		December 31
Revenues	$	95,961	$	99,801	$	114,570	$	131,546
Income from continuing operations		35,976		22,489		23,123		58,339
Net income		35,976		22,489		23,123		58,339
Net income attributable to MPT common stockholders		35,897		22,407		23,057		58,237
Net income attributable to MPT common stockholders per share — basic	$	0.18	$	0.11	$	0.10	$	0.24
Weighted average shares outstanding — basic		202,958		208,071		223,948		237,011
Net income attributable to MPT common stockholders per share —diluted	$	0.17	$	0.11	$	0.10	$	0.24
Weighted average shares outstanding — diluted		203,615		208,640		223,948		237,011

MPT Operating Partnership, L.P.

The following is a summary of the unaudited quarterly financial information for the years ended December 31, 2016 and 2015: (amounts in thousands, except for per unit data)


	For the Three Month Periods in 2016 Ended
	March 31		June 30		September 30		December 31
Revenues	$	134,999	$	126,300	$	126,555	$	153,283
Income from continuing operations		58,226		53,924		70,543		43,245
Net income		58,225		53,924		70,543		43,245
Net income attributable to MPT Operating Partnership partners		57,927		53,724		70,358		43,039
Net income attributable to MPT Operating Partnership partners per unit — basic	$	0.24	$	0.23	$	0.29	$	0.13
Weighted average units outstanding — basic		237,510		238,082		246,230		319,833
Net income attributable to MPT Operating Partnership partners per unit — diluted	$	0.24	$	0.22	$	0.28	$	0.13
Weighted average units outstanding — diluted		237,819		239,008		247,468		319,994


	For the Three Month Periods in 2015 Ended
	March 31		June 30		September 30		December 31
Revenues	$	95,961	$	99,801	$	114,570	$	131,546
Income from continuing operations		35,976		22,489		23,123		58,339
Net income		35,976		22,489		23,123		58,339
Net income attributable to MPT Operating Partnership partners		35,897		22,407		23,057		58,237
Net income attributable to MPT Operating Partnership partners per unit — basic	$	0.18	$	0.11	$	0.10	$	0.24
Weighted average units outstanding — basic		202,958		208,071		223,948		237,011
Net income attributable to MPT Operating Partnership partners per unit — diluted	$	0.17	$	0.11	$	0.10	$	0.24
Weighted average units outstanding — diluted		203,615		208,640		223,948		237,011

Subsequent Events	12 Months Ended
Subsequent Events	Dec. 31, 2016
Subsequent Events [Abstract]
Subsequent Events	13. Subsequent Events On February 1, 2017, we replaced our Credit Facility with a new revolving credit and term loan agreement. The new agreement includes a $1.3 billion unsecured revolving loan facility, a $200 million unsecured term loan facility, and a €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 matures on January 31, 2020, and can be extended for an additional 12 months at our option. The commitment fee on the total facility is paid at a rate of 0.25%. 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 new 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 facility 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. On February 2, 2017, we delivered an irrevocable notice of full redemption to the holders of the €200 million aggregate principal amount of our 5.750% Senior Notes due 2020 and set a redemption date of March 4, 2017. To fund such redemption, including any premium and accrued interest, we plan to use the proceeds of the new euro term loan together with cash on hand. With the new revolving credit facility and term loans along with the redemption of the 5.750% Senior Notes due 2020, we expect to incur a one-time debt refinancing charge of approximately $13 million in the 2017 first quarter (of which approximately $9 million relates to the redemption premium).

Schedule II: Valuation and Qualifying Accounts

12 Months Ended

Dec. 31, 2016

Valuation and Qualifying Accounts [Abstract]

Schedule II: Valuation and Qualifying Accounts

Medical Properties Trust, Inc. and MPT Operating Partnership, L.P.

Schedule II: Valuation and Qualifying Accounts

December 31, 2016


			Additions			Deductions
Year Ended December 31,	Balance at Beginning of Year(1)		Charged Against Operations(1)			Net Recoveries/ Writeoffs(1)			Balance at End of Year(1)
	(In thousands)
2016	$	27,384	$	2,722	(2)	$	(11,254	)(3)	$	18,852
2015	$	20,129	$	8,205	(4)	$	(950	)(5)	$	27,384
2014	$	41,573	$	65,512	(6)	$	(86,956	)(7)	$	20,129

(1)	Includes allowance for doubtful accounts, straight-line rent reserves, allowance for loan losses, tax valuation allowances and other reserves.

(2)	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.

(3)

Includes writeoffs of $3.3 million related to payment of rent, late fees, and loans for our Twelve Oaks facility; $0.8 million of writeoffs for rent and interest reserves related to the sale of the Corinth facility; $0.1 million of writeoffs related to the McLeod Healthcare loan; and $6.9 million decrease in valuation allowance to reserve our net deferred tax assets.

(4)	Includes $1.5 million of rent and late fee reserves related to our Twelve Oaks facility; $0.5 million of rent reserves related to our Healthtrax properties; and $6.2 million to fully reserve our net deferred tax assets.

(5)	Writeoffs of rent and interest reserves related to sale of Healthtrax properties.

(6)

Includes the $47 million of impairment charges related to the Monroe property, $9.5 million of rent and interest reserves primarily related to the Monroe property (prior to change in operators — see Note 3 to Item 8 of this Annual Report on Form 10-K for further details), and approximately $9 million increase in the valuation allowance to fully reserve our net deferred tax assets.

(7)	Writeoffs of loans and other receivables related to the Monroe facility due to change in operators.

SCHEDULE III - REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION

12 Months Ended

Dec. 31, 2016

SEC Schedule III, Real Estate and Accumulated Depreciation Disclosure [Abstract]

SCHEDULE III - REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION

SCHEDULE III — REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION

December 31, 2016


		Initial Costs				Additions Subsequent to Acquisition						Cost at December 31, 2016(1)						Accumulated						Life on which depreciation in latest income statements is computed (Years)
Location	Type of Property	Land		Buildings		Improvements			Carrying Costs			Land		Buildings		Total		Depreciation		Encumbrances		Date of Construction	Date Acquired
	(Dollar amounts in thousands)
Bad Rappenau, Germany	Rehabilitation hospital	$	—	$	9,159	$	—		$	—		$	—	$	9,159	$	9,159	$	706	$	—	1994	November 30, 2013		40
Dahlen, Germany	Rehabilitation hospital		360		19,863		—			—			360		19,863		20,223		1,531		—	1996	November 30, 2013		40
Bad Dürkheim, Germany	Rehabilitation hospital		3,074		14,531		—			—			3,074		14,531		17,605		1,120		—	1960	November 30, 2013		40
Bad Liebenwerda, Germany	Rehabilitation hospital		335		17,307		—			—			335		17,307		17,642		1,334		—	1994	November 30, 2013		40
Ortenberg, Germany	Rehabilitation hospital		89		5,070		—			—			89		5,070		5,159		391		—	1981	November 30, 2013		40
Wiesbaden, Germany	Rehabilitation hospital		2,980		14,334		—			—			2,980		14,334		17,314		1,105		—	1977	November 30, 2013		40
Bad Dürkheim, Germany	Rehabilitation hospital		—		28,758		—			—			—		28,758		28,758		2,217		—	1992	November 30, 2013		40
Bad Liebenwerda, Germany	Rehabilitation hospital		522		14,469		—			—			522		14,469		14,991		1,115		—	1904, 1995	November 30, 2013		40
Bad Dürkheim, Germany	Rehabilitation hospital		705		6,337		—			—			705		6,337		7,042		488		—	1980	November 30, 2013		40
Bad Dürkheim, Germany	Rehabilitation hospital		5,649		15,597		—			—			5,649		15,597		21,246		1,202		—	1930	November 30, 2013		40
Bad Rappenau, Germany	Rehabilitation hospital		3,312		5,642		—			—			3,312		5,642		8,954		435		—	1986	November 30, 2013		40
Bad Tölz, Germany	Rehabilitation hospital		2,134		9,187		—			—			2,134		9,187		11,321		478		—	1974	November 19, 2014		40
Bad Liebenstein, Germany	Rehabilitation hospital		1,554		32,836		—			—			1,554		32,836		34,390		1,779		—	1954, 1992	November 5, 2014		40
Bad Mergentheim, Germany	Rehabilitation hospital		—		10,891		—			—			—		10,891		10,891		567		—	1988, 1995	December 11, 2014		40
Bath, UK	Acute care general hospital		1,463		30,316		—			—			1,463		30,316		31,779		1,895		—	2008, 2009	July 1, 2014		40
Ottenhöfen, Germany	Rehabilitation hospital		2,182		12,278		105			—			2,287		12,278		14,565		471		—	1956/1957	July 3, 2015		40
Bad Berka, Germany	Rehabilitation hospital		3,124		14,569		163			—			3,287		14,569		17,856		531		—	1997	July 22, 2015		40
Wiesbaden, Germany	Rehabilitation hospital		1,557		7,220		37			—			1,594		7,220		8,814		274		—	1974	June 30, 2015		40
Bad Lausick, Germany	Rehabilitation hospital		1,677		15,176		147			—			1,824		15,176		17,000		584		—	1993	June 30, 2015		40
Bad Sülze, Germany	Rehabilitation hospital		2,224		19,184		189			—			2,413		19,184		21,597		738		—	1993	June 30, 2015		40
Kurort Berggießhübel, Germany	Rehabilitation hospital		2,966		14,961		131			—			3,097		14,961		18,058		542		—	1993	July 21, 2015		40
Braunfels, Germany	Acute care general hospital		2,019		12,907		53			—			2,072		12,907		14,979		489		—	1977	June 30, 2015		40
Bernkastel-Kues, Germany	Rehabilitation hospital		3,386		14,709		42			—			3,428		14,709		18,137		525		—	1982	July 15, 2015		40
Flechtingen, Germany	Rehabilitation hospital		2,692		13,590		142			—			2,834		13,590		16,424		524		—	1993	June 30, 2015		40
Flechtingen, Germany	Rehabilitation hospital		2,692		21,291		210			—			2,902		21,291		24,193		819		—	1993-1995	June 30, 2015		40
Nordrach, Germany	Rehabilitation hospital		294		2,818		79			—			373		2,818		3,191		114		—	1960	July 7, 2015		40
Bad Gottleuba, Germany	Rehabilitation hospital		49		14,462		835			—			884		14,462		15,346		417		—	1913	December 16, 2015		40
Grünheide, Germany	Rehabilitation hospital		2,674		39,306		321			—			2,995		39,306		42,301		1,422		—	1994/2014	July 31, 2015		40
Baden-Baden, Germany	Rehabilitation hospital		1,230		8,652		121			—			1,351		8,652		10,003		337		—	1900/2002- 2003	June 30, 2015		40
Gyhum, Germany	Rehabilitation hospital		3,755		21,461		330			—			4,085		21,461		25,546		838		—	1994	June 30, 2015		40
Hannover, Germany	Rehabilitation hospital		3,081		14,562		300			—			3,381		14,562		17,943		416		—	1900 (renovations in 1997, 2000, 2009)	December 1, 2015		40
Heiligendamm, Germany	Rehabilitation hospital		4,049		25,235		200			—			4,249		25,235		29,484		966		—	1995	June 30, 2015		40
Bad Camberg, Germany	Rehabilitation hospital		1,961		14,956		252			—			2,213		14,956		17,169		586		—	1973	June 30, 2015		40
Hoppegarten, Germany	Rehabilitation hospital		3,770		23,351		231			—			4,001		23,351		27,352		849		—	1994	July 27, 2015		40
Ban Nauheim, Germany	Rehabilitation hospital		2,976		15,036		137			—			3,113		15,036		18,149		578		—	1977	June 30, 2015		40
Kalbe, Germany	Rehabilitation hospital		3,292		21,994		158			—			3,450		21,994		25,444		841		—	1995	July 6, 2015		40
Bad Soden-Salmünster, Germany	Rehabilitation hospital		904		6,276		116			—			1,020		6,276		7,296		247		—	1974	June 30, 2015		40
Berlin, Germany	Rehabilitation hospital		—		20,107		179			—			179		20,107		20,286		775		—	1998	July 16, 2015		40
Bad Lobenstein, Germany	Rehabilitation hospital		3,429		19,442		174			—			3,603		19,442		23,045		746		—	1994	June 30, 2015		40
Bernkastel-Kues, Germany	Rehabilitation hospital		757		10,926		126			—			883		10,926		11,809		422		—	1993	July 14, 2015		40
Magdeburg, Germany	Rehabilitation hospital		13,931		51,674		242			—			14,173		51,674		65,847		1,853		—	1999/2014	July 22, 2015		40
Schlangenbad, Germany	Rehabilitation hospital		1,015		3,302		258			—			1,273		3,302		4,575		150		—	1973	June 30, 2015		40
Bad Dürrheim, Germany	Rehabilitation hospital		1,346		11,038		221			—			1,567		11,038		12,605		412		—	1960-1970	July 24, 2015		40
Bad Krozingen, Germany	Rehabilitation hospital		1,425		10,392		110			—			1,535		10,392		11,927		378		—	2008	July 24, 2015		40
Bad Nauheim, Germany	Rehabilitation hospital		1,704		8,906		53			—			1,757		8,906		10,663		339		—	1972-1973	June 30, 2015		40
Bad Tennstedt, Germany	Rehabilitation hospital		3,560		26,396		195			—			3,755		26,396		30,151		1,009		—	1993	June 30, 2015		40
Wismar, Germany	Rehabilitation hospital		3,355		19,989		189			—			3,544		19,989		23,533		769		—	1996	June 30, 2015		40
Heidelberg, Germany	Rehabilitation hospital		5,757		33,689		438			—			6,195		33,689		39,884		436		—	1885/1991	June 22, 2016		40
Bad Kösen, Germany	Rehabilitation hospital		1,189		6,941		—			—			1,189		6,941		8,130		29		—	1992	October 27, 2016		40
Bad Kösen, Germany	Rehabilitation hospital		1,203		7,095		—			—			1,203		7,095		8,298		30		—	1996	October 27, 2016		40
Bad Kösen, Germany	Rehabilitation hospital		717		4,473		—			—			717		4,473		5,190		19		—	1997	October 27, 2016		40
Bad Salzdetfurth, Germany	Rehabilitation hospital		1,129		6,556		—			—			1,129		6,556		7,685		14		—	1987	November 23, 2016		40
Bad Bertrich, Germany	Rehabilitation hospital		631		3,787		—			—			631		3,787		4,418		8		—	1910,1980- 1985	November 30, 2016		40
Lübeck, Germany	Rehabilitation hospital		673		4,922		38			—			711		4,922		5,633		—		—	1900/2011	December 31, 2016		40
Vitense-Parber, Germany	Rehabilitation hospital		540		3,938		30			—			570		3,938		4,508		—		—	1800/1995	December 31, 2016		40
Breuberg-Sandbach, Germany	Rehabilitation hospital		1,554		11,485		88			—			1,642		11,485		13,127		—		—	1901/1984	December 31, 2016		40
Ravensrush, Germany	Rehabilitation hospital		407		3,199		25			—			432		3,199		3,631		—		—	1860/1992	December 31, 2016		40
Wildeck, Germany	Rehabilitation hospital		731		5,250		40			—			771		5,250		6,021		—		—	1600/2013	December 31, 2016		40
Römhild, Germany	Rehabilitation hospital		169		8,039		62			—			231		8,039		8,270		—		—	1902/2000	December 31, 2016		40
Bad Hersfield, Germany	Rehabilitation hospital		507		3,773		29			—			536		3,773		4,309		—		—	1930/2014	December 31, 2016		40
Houston, TX	Acute care general hospital		3,501		34,530		8,477			16,589			3,274		59,823		63,097		9,663		—	1960	August 10, 2007		40
Allen, TX	Freestanding ER		1,550		3,921		—			—			1,550		3,921		5,471		245		—	2014	July 14, 2014		40
San Diego, CA	Acute care general hospital		12,663		52,432		—			—			12,663		52,432		65,095		7,755		—	1973	February 9, 2011		40
Alvin, TX	Freestanding ER		105		4,087		—			—			105		4,087		4,192		258		—	2014	March 19, 2014		40
Houston, TX	Freestanding ER		950		4,576		—			—			950		4,576		5,526		29		—	2016	September 26, 2016		40
Aurora, CO	Freestanding ER		—		4,812		—			—			—		4,812		4,812		150		—	2015	September 17, 2015		40
Ft. Worth, TX	Freestanding ER		—		4,392		—			—			—		4,392		4,392		192		—	2015	March 27, 2015		40
Bayonne, NJ	Acute care general hospital		2,003		51,495		—			—			2,003		51,495		53,498		15,234		—	1918	February 4, 2011		20
Bennettsville, SC	Acute care general hospital		794		15,772		—			—			794		15,772		16,566		3,419		—	1984	April 1, 2008		40
Blue Springs, MO	Acute care general hospital		4,347		23,494		—			—			4,347		23,494		27,841		1,183		—	1980	February 13, 2015		40
Bossier City, LA	Long term acute care hospital		900		17,818		—			—			900		17,818		18,718		3,895		—	1982	April 1, 2008		40
Brighton, MA	Acute care general hospital		18,638		147,266		—			—			18,638		147,266		165,904		922		—	1917-2009	October 3, 2016		41
Brockton, MA	Acute care general hospital		18,141		66,562		—			—			18,141		66,562		84,703		526		—	1965-2010	October 3, 2016		41
Austin, TX	Freestanding ER		1,140		3,853		—			—			1,140		3,853		4,993		249		—	2014	May 29, 2014		40
Broomfield, CO	Freestanding ER		825		3,895		—			—			825		3,895		4,720		243		—	2014	July 3, 2014		40
Glendale, AZ	Freestanding ER		1,144		6,005		—			—			1,144		6,005		7,149		25		—	2016	October 21, 2016		40
New Orleans, LA	Freestanding ER		2,850		5,599		—			—			2,850		5,599		8,449		35		—	2016	September 23, 2016		40
Carrollton, TX	Acute care general hospital		729		34,342		—			—			729		34,342		35,071		1,216		—	2015	July 17, 2015		40
Cedar Hill. TX	Freestanding ER		1,122		3,644		—			—			1,122		3,644		4,766		228		—	2014	June 23, 2014		40
Spring, TX	Freestanding ER		1,310		4,203		—			—			1,310		4,203		5,513		263		—	2014	July 15, 2014		40
Chandler, AZ	Freestanding ER		—		4,783		—			—			—		4,783		4,783		199		—	2015	April 24, 2015		40
Chandler, AZ	Freestanding ER		750		3,852		—			—			750		3,852		4,602		120		—	2015	October 7, 2015		40
Cheraw, SC	Acute care general hospital		657		19,576		—			—			657		19,576		20,233		4,242		—	1982	April 1, 2008		40
Katy, TX	Freestanding ER		—		3,873		—			—			—		3,873		3,873		113		—	2015	October 21, 2015		40
Webster, TX	Long term acute care hospital		663		33,751		—			—			663		33,751		34,414		5,063		—	2004	December 21, 2010		40
Commerce City, TX	Freestanding ER		707		4,236		—			—			707		4,236		4,943		221		—	2014	December 11, 2014		40
Conroe, TX	Freestanding ER		1,338		3,712		—			—			1,338		3,712		5,050		131		—	2015	July 29, 2015		40
Converse, TX	Freestanding ER		750		4,423		—			—			750		4,423		5,173		194		—	2015	April 10, 2015		40
The Woodlands, TX	Freestanding ER		—		4,740		—			—			—		4,740		4,740		89		—	2016	March 28, 2016		40
Dallas, TX	Long term acute care hospital		1,000		13,589		—			368			1,421		13,536		14,957		3,496		—	2006	September 5, 2006		40
Denver, CO	Freestanding ER		—		4,276		—			—			—		4,276		4,276		169		—	2015	June 8, 2015		40
DeSoto, TX	Freestanding ER		750		4,569		—			—			750		4,569		5,319		67		—	2016	May 23, 2016		40
DeSoto, TX	Long term acute care hospital		1,067		10,701		86			8			1,161		10,701		11,862		1,476		—	2008	July 18, 2011		40
Detroit, MI	Long term acute care hospital		1,220		8,687		—			(365	)		1,220		8,322		9,542		1,862		—	1956	May 22, 2008		40
San Antonio, TX	Freestanding ER		—		5,157		—			—			—		5,157		5,157		11		—	2016	December 9, 2016		40
Dulles, TX	Freestanding ER		1,076		3,784		—			—			1,076		3,784		4,860		220		—	2014	September 12, 2014		40
Houston, TX	Freestanding ER		1,345		3,678		—			—			1,345		3,678		5,023		230		—	2014	June 20, 2014		40
Fairmont, CA	Acute care general hospital		1,000		12,301		3,928			—			1,277		15,952		17,229		857		—	1939,1972,1985	September 19, 2014		40
Fall River, MA	Acute care general hospital		2,406		82,358		—			—			2,406		82,358		84,764		526		—	1950-2012	October 3, 2016		41
Firestone, TX	Freestanding ER		495		3,963		—			—			495		3,963		4,458		256		—	2014	June 6, 2014		40
Florence, AZ	Acute care general hospital		900		28,462		105			—			900		28,567		29,467		3,388		—	2012	February 7, 2012		40
Fort Lauderdale, FL	Rehabilitation hospital		3,499		21,939		—			1			3,499		21,940		25,439		4,763		—	1985	April 22, 2008		40
Fountain, CO	Freestanding ER		1,508		4,131		—			—			1,508		4,131		5,639		250		—	2014	July 31, 2014		40
Frisco, TX	Freestanding ER		—		4,735		—			—			—		4,735		4,735		99		—	2016	March 4, 2016		40
Frisco, TX	Freestanding ER		2,441		4,474		—			—			2,441		4,474		6,915		130		—	2015	November 13, 2015		40
Frisco, TX	Freestanding ER		1,500		3,863		27			(89	)		1,411		3,890		5,301		251		—	2014	June 13, 2014		40
Garden Grove, CA	Acute care general hospital		5,502		10,748		—			51			5,502		10,799		16,301		2,196		—	1982	November 25, 2008		40
Garland, TX	Freestanding ER		—		4,954		—			—			—		4,954		4,954		21		—	2016	November 15, 2016		40
Garden Grove, CA	Medical Office Building		862		7,888		—			28			862		7,916		8,778		1,603		—	1982	November 25, 2008		40
Gilbert, AZ	Acute care general hospital		150		15,553		—			—			150		15,553		15,703		2,333		—	2005	January 4, 2011		40
Gilbert, AZ	Freestanding ER		1,518		4,660		—			—			1,518		4,660		6,178		165		—	2015	July 22, 2015		40
Glendale, AZ	Freestanding ER		—		4,046		—			—			—		4,046		4,046		160		—	2015	June 5, 2015		40
Goodyear, AZ	Freestanding ER		1,800		4,709		—			—			1,800		4,709		6,509		88		—	2016	April 4, 2016		40
Hartsville, SC	Acute care general hospital		2,050		43,970		—			—			2,050		43,970		46,020		957		—	1999	August 31, 2015		34
Hausman, TX	Acute care general hospital		1,500		8,958		—			—			1,500		8,958		10,458		835		—	2013	March 1, 2013		40
Helotes, TX	Freestanding ER		1,900		5,297		—			—			1,900		5,297		7,197		110		—	2016	March 10, 2016		40
Highland Village, TX	Freestanding ER		—		4,016		—			—			—		4,016		4,016		126		—	2015	September 22, 2015		40
Hill County, TX	Acute care general hospital		1,120		17,882		—			—			1,120		17,882		19,002		7,492		—	1980	September 17, 2010		40
Hoboken, NJ	Acute care general hospital		1,387		44,351		—			—			1,387		44,351		45,738		11,394		—	1863	November 4, 2011		20
Hoover, AL	Freestanding ER		—		7,581		—			—			—		7,581		7,581		369		—	2015	May 1, 2015		34
Hoover, AL	Medical Office Building		—		1,034		—			—			—		1,034		1,034		50		—	2015	May 1, 2015		34
Hot Springs, AR	Acute care general hospital		7,100		59,432		19,113			—			7,100		78,545		85,645		2,480		—	1985	August 31, 2015		40
Highlands Ranch, CO	Freestanding ER		4,200		4,763		—			—			4,200		4,763		8,963		50		—	2016	July 25, 2016		40
Idaho Falls, ID	Acute care general hospital		1,822		37,467		—			4,665			1,822		42,132		43,954		9,086		—	2002	April 1, 2008		40
Kansas City, MO	Acute care general hospital		10,497		64,419		—			—			10,497		64,419		74,916		3,146		—	1978	February 13, 2015		40
Katy, TX	Freestanding ER		—		4,671		—			—			—		4,671		4,671		29		—	2016	October 10, 2016		40
Camden, SC	Acute care general hospital		—		22,739		—			—			—		22,739		22,739		384		—	1954-2004	October 30, 2015		20
Lafayette, IN	Rehabilitation hospital		800		14,968		(25	)		—			800		14,943		15,743		1,450		—	2013	February 1, 2013		40
Little Elm, TX	Freestanding ER		1,241		3,491		—			—			1,241		3,491		4,732		266		—	2013	December 1, 2013		40
Longmont, CO	Freestanding ER		—		4,770		—			—			—		4,770		4,770		109		—	2016	February 10, 2016		40
Lubbock, TX	Rehabilitation hospital		1,376		28,292		705			—			1,376		28,997		30,373		1,072		—	2008	June 16, 2015		40
Mandeville, LA	Freestanding ER		2,800		5,004		—			—			2,800		5,004		7,804		21		—	2016	October 28, 2016		40
Marrero, LA	Freestanding ER		—		5,756		—			—			—		5,756		5,756		72		—	2016	July 15, 2016		40
McKinney, TX	Freestanding ER		—		4,060		—			—			—		4,060		4,060		193		—	2015	July 31, 2015		30
McMinnville, OR	Acute care general hospital		5,000		97,900		—			—			5,000		97,900		102,900		1,663		—	1996	August 31, 2015		41
Mesa, AZ	Acute care general hospital		4,900		97,980		2,242			—			7,142		97,980		105,122		8,576		—	2007	September 26, 2013		40
Methuen, MA	Acute general care hospital		23,809		89,505		—			—			23,809		89,505		113,314		638		—	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		8,483		—	2006	August 8, 2006		40
Montclair, NJ	Acute care general hospital		7,900		99,632		585			—			8,477		99,640		108,117		7,152		—	1920-2000	April 1, 2014		40
Muskogee, OK	Acute care general hospital		1,420		51,953		—			—			1,420		51,953		53,373		1,046		—	1959,2009	August 31, 2015		30
San Antonio, TX	Freestanding ER		351		3,952		—			—			351		3,952		4,303		271		—	2014	January 1, 2014		40
Houston, TX	Acute care general hospital		4,757		56,238		(37	)		1,259			5,427		56,790		62,217		14,270		—	2006	December 1, 2006		40
Colorado Springs, CO	Freestanding ER		600		4,231		—			—			600		4,231		4,831		274		—	2014	June 5, 2014		40
Northland, MO	Long term acute care hospital		834		17,182		—			—			834		17,182		18,016		2,542		13,101	2007	February 14, 2011		40
Altoona, WI	Acute care general hospital		—		29,062		—			—			—		29,062		29,062		1,695		—	2014	August 31, 2014		40
Ogden, UT	Rehabilitation hospital		1,759		16,414		—			—			1,759		16,414		18,173		1,150		—	2014	March 1, 2014		40
Olympia, WA	Acute care general hospital		7,220		89,348		—			—			7,220		89,348		96,568		993		—	1984	July 22, 2016		40
Overlook, TX	Acute care general hospital		2,452		9,666		7			—			2,452		9,673		12,125		926		—	2012	February 1, 2013		40
San Diego, CA	Acute care general hospital		6,550		15,653		—			77			6,550		15,730		22,280		3,799		—	1964	May 9, 2007		40
Parker, CO	Freestanding ER		1,301		4,448		—			—			1,301		4,448		5,749		130		—	2015	November 6, 2015		40
Pearland, TX	Freestanding ER		1,075		3,577		—			—			1,075		3,577		4,652		209		—	2014	September 8, 2014		40
Petersburg, VA	Rehabilitation hospital		1,302		9,121		—			—			1,302		9,121		10,423		1,938		—	2006	July 1, 2008		40
Plano, TX	Freestanding ER		—		5,060		—			—			—		5,060		5,060		32		—	2016	September 30, 2016		40
Poplar Bluff, MO	Acute care general hospital		2,659		38,694		—			1			2,660		38,694		41,354		8,400		—	1980	April 22, 2008		40
Port Arthur, TX	Acute care general hospital		3,000		72,341		1,062			—			4,062		72,341		76,403		6,071		—	2005	September 26, 2013		40
Port Huron, MI	Acute care general hospital		3,029		14,622		—			—			3,029		14,622		17,651		490		—	1953, 1973-1983	December 31, 2015		40
Portland, OR	Long term acute care hospital		3,085		17,859		—			2,559			3,071		20,432		23,503		4,897		—	1964	April 18, 2007		40
Post Falls, ID	Rehabilitation hospital		417		12,175		1,905			—			767		13,730		14,497		1,039		—	2013	December 31, 2013		40
San Antonio, TX	Freestanding ER		—		4,837		—			—			—		4,837		4,837		20		—	2016	October 27, 2016		40
Redding, CA	Acute care general hospital		1,555		53,863		—			13			1,555		53,876		55,431		12,692		—	1974	August 10, 2007		40
Redding, CA	Long term acute care hospital		—		19,952		—			4,360			1,629		22,683		24,312		6,406		—	1991	June 30, 2005		40
Rosenberg, TX	Freestanding ER		—		4,731		—			—			—		4,731		4,731		118		—	2016	January 15, 2016		40
San Dimas, CA	Acute care general hospital		6,160		6,839		—			34			6,160		6,873		13,033		1,390		—	1972	November 25, 2008		40
San Dimas, CA	Medical Office Building		1,915		5,085		—			18			1,915		5,103		7,018		1,033		—	1979	November 25, 2008		40
Sherman, TX	Acute care general hospital		4,491		24,802		—			—			4,491		24,802		29,293		1,418		—	1913, 1960- 2010	October 31, 2014		40
Sienna, TX	Freestanding ER		999		3,591		—			—			999		3,591		4,590		209		—	2014	August 20, 2014		40
Spartanburg, SC	Rehabilitation hospital		1,135		15,717		—			—			1,135		15,717		16,852		1,325		—	2013	August 1, 2013		40
Houston, TX	Freestanding ER		1,423		3,770		—			—			1,423		3,770		5,193		173		—	2015	February 18, 2015		40
Taunton, MA	Acute care general hospital		4,428		73,433		—			—			4,428		73,433		77,861		488		—	1940-2015	October 3, 2016		41
Thornton, CO	Freestanding ER		1,350		4,259		—			—			1,350		4,259		5,609		248		—	2014	August 29, 2014		40
Toledo, OH	Rehabilitation hospital		—		17,740		—			—			—		17,740		17,740		333		—	2016	April 1, 2016		40
Tomball, TX	Long term acute care hospital		1,299		23,982		—			—			1,299		23,982		25,281		3,597		—	2005	December 21, 2010		40
Houston, TX	Acute care general hospital		4,047		41,914		—			—			4,047		41,914		45,961		524		—	2016	July 7, 2016		40
League City, TX	Freestanding ER		—		3,901		—			—			—		3,901		3,901		146		—	2015	June 19, 2015		40
Anaheim, CA	Acute care general hospital		1,875		21,814		—			10			1,875		21,824		23,699		5,547		—	1964	November 8, 2006		40
West Monroe, LA	Acute care general hospital		12,000		69,433		552			—			12,552		69,433		81,985		5,822		—	1962	September 26, 2013		40
San Antonio, TX	Acute care general hospital		2,248		5,880		—			—			2,248		5,880		8,128		609		—	2012	October 2, 2012		40
West Valley City, UT	Acute care general hospital		5,516		58,314		2,036			(114	)		5,402		60,350		65,752		12,716		—	1980	April 22, 2008		40
Wichita, KS	Rehabilitation hospital		1,019		18,373		—			1			1,019		18,374		19,393		4,018		—	1992	April 4, 2008		40

		$	403,141	$	3,482,455	$	52,564		$	29,882		$	417,368	$	3,550,674	$	3,968,042	$	292,786	$	13,101

(1)	The aggregate cost for federal income tax purposes is $4,471,179.

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, 2016			December 31, 2015			December 31, 2014
COST
Balance at beginning of period	$	2,991,590		$	2,040,727		$	1,733,194
Acquisitions		745,948			975,239			263,811
Transfers from construction in progress		163,080			23,163			41,772
Additions		33,279			7,376			84,831
Dispositions		(138,886	)		(24,701	)		(56,590	)
Other		173,031			(30,214	)		(26,291	)

Balance at end of period	$	3,968,042		$	2,991,590		$	2,040,727

The changes in accumulated depreciation are as follows for the years ended (in thousands):


	December 31, 2016			December 31, 2015			December 31, 2014
ACCUMULATED DEPRECIATION
Balance at beginning of period	$	232,675		$	181,441		$	144,235
Depreciation		81,010			60,796			46,935
Depreciation on disposed property		(19,086	)		(8,887	)		(9,213	)
Other		(1,813	)		(675	)		(516	)

Balance at end of period	$	292,786		$	232,675		$	181,441

SCHEDULE IV - MORTGAGE LOANS ON REAL ESTATE

12 Months Ended

Dec. 31, 2016

Mortgage Loans on Real Estate [Abstract]

SCHEDULE IV - MORTGAGE LOANS ON REAL ESTATE

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		11.6	%		2022				(1)		20,000		20,000		(2)
Desert Valley Hospital		11.0	%		2022				(1)		12,500		12,500		(2)
Chino Valley Medical Center		11.0	%		2022				(1)		50,000		50,000		(2)
Paradise Valley Hospital		10.6	%		2022				(1)		25,000		25,000		(2)
Ernest Mortgage Loan(4)		9.6	%		2032				(1)		112,836		112,836		(2)
Centinela Hospital Medical Center		11.0	%		2022				(1)		100,000		100,000		(2)
Olympia Medical Center		11.2	%		2024				(1)		20,000		20,000		(2)
St. Joseph Medical Center		8.5	%		2025				(1)		30,000		30,000		(2)
St. Mary’s Medical Center		8.5	%		2025				(1)		10,000		10,000		(2)
Lake Huron Medical Center		8.5	%		2020				(1)		10,000		10,000		(2)
Steward Mortgage Loan(6)		7.5	%		2031				(1)		600,000		600,000		(2)

										$	1,060,336	$	1,060,336		(5)

(1)	There were no prior liens on loans as of December 31, 2016.

(2)	The mortgage loan was not delinquent with respect to principal or interest.

(3)	The aggregate cost for federal income tax purposes is $1,060,336.

(4)	Mortgage loans covering four properties in two tranches. Interest rate is weighted average of both tranches.

(5)	Excludes unamortized loan issue costs of $0.1 million at December 31, 2016.

(6)	Mortgage loans covering four properties.

Changes in mortgage loans (excluding unamortized loan issue costs) for the years ended December 31, 2016, 2015, and 2014 are summarized as follows:


	Year Ended December 31,
	2016			2015			2014
	(Dollar amounts in thousands)
Balance at beginning of year	$	757,500		$	397,500		$	388,650
Additions during year:
New mortgage loans and additional advances on existing loans		612,836			380,000			12,500

		1,370,336			777,500			401,150

Deductions during year:
Collection of principal		(310,000	)		(20,000	)		(3,650	)

		(310,000	)		(20,000	)		(3,650	)

Balance at end of year	$	1,060,336		$	757,500		$	397,500

Summary of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2016

Accounting Policies [Abstract]

Use of Estimates

Principles of Consolidation


VIE Type	Maximum Loss Exposure(1)		Asset Type Classification		Carrying Amount(2)
Loans, net	$	316,179		Mortgage and other loans	$	235,613
Equity investments	$	13,223		Other assets	$	140

(1)

(2)	Carrying amount reflects the net book value of our loan or equity interest only in the VIE.

See Note 3 and 10 for additional description of the nature, purpose and activities of some of our VIEs and interests therein.

Investments in Unconsolidated Entities

Cash and Cash Equivalents

Revenue Recognition

Acquired Real Estate Purchase Price Allocation

Goodwill

Real Estate and Depreciation


Buildings and improvements			38.8 years
Tenant lease intangibles			23.9 years
Leasehold improvements			17.9 years
Furniture, equipment and other			9.5 years

Losses from Rent Receivables

Loans

Earnings Per Share/Units

Income Taxes

Stock-Based Compensation

Deferred Costs

Deferred Financing Costs

Foreign Currency Translation and Transactions

Derivative Financial Investments and Hedging Activities

Fair Value Measurement

•

Level 1 — quoted prices for identical instruments in active markets;

•

Level 3 — fair value measurements derived from valuation techniques in which one or more significant inputs or significant value drivers are unobservable.

Recent Accounting Developments

Recent Accounting Developments:

Revenue from Contracts with Customers

Leases

Measurement of Credit Losses on Financial Instruments

Classification of Certain Cash Receipts and Cash Payments

Clarifying the Definition of a Business

Reclassifications and Revisions

Reclassifications and Revisions:

Certain amounts in the consolidated financial statements for prior periods have been reclassified to conform to the current period presentation.

Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2016

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, 2016 (in thousands):


VIE Type	Maximum Loss Exposure(1)		Asset Type Classification		Carrying Amount(2)
Loans, net	$	316,179		Mortgage and other loans	$	235,613
Equity investments	$	13,223		Other assets	$	140

(1)

(2)	Carrying amount reflects the net book value of our loan or equity interest only in the VIE.

Estimated Useful Lives of Related Real Estate and Other Assets


Buildings and improvements			38.8 years
Tenant lease intangibles			23.9 years
Leasehold improvements			17.9 years
Furniture, equipment and other			9.5 years

- Definition

Tabular disclosure of the significant judgments and assumptions made in determining whether a variable interest (as defined) held by the entity requires the variable interest entity (VIE) (as defined) to be consolidated and (or) disclose information about its involvement with the VIE, individually or in aggregate (as applicable); the nature of restrictions, if any, on the consolidated VIE's assets and on the settlement of its liabilities reported by an entity in its statement of financial position, including the carrying amounts of such assets and liabilities; the nature of, and changes in, the risks associated with involvement in the VIE; how involvement with the VIE affects the entity's financial position, financial performance, and cash flows; the lack of recourse if creditors (or beneficial interest holders) of the consolidated VIE have no recourse to the general credit of the primary beneficiary (if applicable); the terms of arrangements, giving consideration to both explicit arrangements and implicit variable interests, if any, that could require the entity to provide financial support to the VIE, including events or circumstances that could expose the entity to a loss; the methodology used by the entity for determining whether or not it is the primary beneficiary of the variable interest entity; the significant factors considered and judgments made in determining that the power to direct the activities of a VIE that most significantly impact the VIE's economic performance are shared (as defined); the carrying amounts and classification of assets and liabilities of the VIE included in the statement of financial position; the entity's maximum exposure to loss, if any, as a result of its involvement with the VIE, including how the maximum exposure is determined and significant sources of the entity's exposure to the VIE; a comparison of the carrying amounts of the assets and liabilities and the entity's maximum exposure to loss; information about any liquidity arrangements, guarantees, and (or) other commitments by third parties that may affect the fair value or risk of the entity's variable interest in the VIE; whether or not the entity has provided financial support or other support (explicitly or implicitly) to the VIE that it was not previously contractually required to provide or whether the entity intends to provide that support, including the type and amount of the support and the primary reasons for providing the support; and supplemental information the entity determines necessary to provide.

+ References + Details

Real Estate and Loans Receivable (Tables)

12 Months Ended

Dec. 31, 2016

Text Block [Abstract]

Assets Acquired

We acquired the following assets:


	2016			2015			2014
	(in thousands)
Assets Acquired
Land	$	91,176		$	120,746		$	22,569
Building		654,772			741,935			241,242
Intangible lease assets — subject to amortization (weighted average useful life of 28.5 years in 2016, 30.0 years in 2015 and 18.2 years in 2014)		94,614			176,383			22,513
Net investments in direct financing leases		178,000			174,801			—
Mortgage loans		600,000			380,000			—
Other loans		—			523,605			447,664
Equity investments and other assets		70,166			101,716			33,708
Liabilities assumed		(6,319	)		(317	)		—

Total assets acquired	$	1,682,409		$	2,218,869		$	767,696
Loans repaid(1)		(193,262	)		(385,851	)		—

Total net assets acquired	$	1,489,147		$	1,833,018		$	767,696

(1)

Schedule of Unaudited Supplemental Pro Forma Operating Data


	For the Year Ended December 31, (Unaudited)
	2016		2015
Total revenues	$	627,583	$	624,443
Net income		310,019		306,756
Net income per share/unit	$	0.97	$	0.96

Summary of Status Update on Current Development Projects

See table below for a status update on our current development projects (in thousands):


Operator	Commitment		Costs Incurred as of 12/31/16		Estimated Completion Date
Adeptus Health	$	5,848	$	2,710		1Q 2017
Adeptus Health		67,185		44,948		2Q 2017
Ernest Health		28,067		4,342		4Q 2017
Adeptus Health		7,804		1,648		1Q 2018
Adeptus Health		53,866		—		Various

	$	162,770	$	53,648

Summary of Operations for Disposed Assets in 2016


	For the Year Ended December 31,
	2016			2015			2014
Revenues	$	7,851		$	18,112		$	18,225
Real estate depreciation and amortization		(1,754	)		(3,795	)		(3,789	)
Property-related expenses		(114	)		(121	)		(60	)
Other income (expense)		(23	)		1,079			462

Income from real estate dispositions, net	$	5,960		$	15,275		$	14,838

Amortization Expense from Existing Lease Intangible Assets


For the Year Ended December 31:
2017	$	22,130
2018		22,069
2019		22,021
2020		21,818
2021		21,751

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, 2016			As of December 31, 2015
Minimum lease payments receivable	$	2,207,625		$	2,587,912
Estimated residual values		407,647			393,097
Less unearned income		(1,967,170	)		(2,354,013	)

Net investment in direct financing leases	$	648,102		$	626,996

Minimum Rental Payments Due under Operating Leases with Non-Cancelable Terms


	Total Under Operating Leases		Total Under DFLs		Total
2017	$	386,058	$	62,419	$	448,477
2018		388,808		63,668		452,476
2019		392,577		64,941		457,518
2020		395,339		66,240		461,579
2021		400,607		67,565		468,172
Thereafter		7,077,794		1,673,600		8,751,394

	$	9,041,183	$	1,998,433	$	11,039,616

Summary of Loans

The following is a summary of our loans ($ amounts in thousands):


	As of December 31, 2016					As of December 31, 2015
	Balance		Weighted Average Interest Rate			Balance		Weighted Average Interest Rate
Mortgage loans	$	1,060,400		8.8	%	$	757,581		9.5	%
Acquisition loans		121,464		13.7	%		610,469		9.1	%
Working capital and other loans		34,257		9.0	%		54,353		10.2	%

	$	1,216,121				$	1,422,403

Schedule of Revenue by Operator

Revenue by Operator

(Dollar amounts in thousands)


	For the Years Ended December 31,
	2016					2015
Operators (A)	Total Revenue		Percentage of Total Revenue			Total Revenue		Percentage of Total Revenue
Prime	$	120,558		22.3	%	$	104,325		23.6	%
MEDIAN		93,425		17.3	%		78,540		17.8	%
Ernest		67,742		12.5	%		61,988		14.0	%
RCCH		52,720		9.7	%		28,567		6.4	%
Other operators		206,692		38.2	%		168,458		38.2	%

Total	$	541,137		100.0	%	$	441,878		100.0	%

(A) Steward is not included herein as the Steward transaction closed on October 3, 2016.

Schedule of Revenue from External Customers by Geographic Areas

Revenue by U.S. State and Country

(Dollar amounts in thousands)


	For the Years Ended December 31,
	2016					2015
U.S. States and Other Countries	Total Revenue		Percentage of Total Revenue			Total Revenue		Percentage of Total Revenue
Texas	$	96,992		17.9	%	$	87,541		19.8	%
California		66,197		12.2	%		66,120		15.0	%
New Jersey		39,084		7.2	%		27,688		6.3	%
Massachusetts		26,098		4.8	%		69		0.0	%
Arizona		23,798		4.4	%		21,188		4.8	%
Other States		187,363		34.7	%		156,256		35.3	%

Total U.S.	$	439,532		81.2	%	$	358,862		81.2	%

Germany	$	97,382		18.0	%	$	78,540		17.8	%
United Kingdom, Italy, and Spain		4,223		0.8	%		4,476		1.0	%

Total International	$	101,605		18.8	%	$	83,016		18.8	%

Total	$	541,137		100.0	%	$	441,878		100.0	%

Debt (Tables)

12 Months Ended

Dec. 31, 2016

Debt Disclosure [Abstract]

Summary of Debt

The following is a summary of debt ($ amounts in thousands):


	As of December 31,
	2016			2015
Revolving credit facility	$	290,000		$	1,100,000
Term loans		263,101			263,400
Senior Unsecured Notes due 2016		—			125,000
6.875% Senior Unsecured Notes due 2021		—			450,000
6.375% Senior Unsecured Notes due 2022:
Principal amount		350,000			350,000
Unamortized premium		1,814			2,168

		351,814			352,168
5.750% Senior Unsecured Notes due 2020 (A)		210,340			217,240
4.000% Senior Unsecured Notes due 2022 (A)		525,850			543,100
5.500% Senior Unsecured Notes due 2024		300,000			300,000
6.375% Senior Unsecured Notes due 2024		500,000			—
5.250% Senior Unsecured Notes due 2026		500,000			—

	$	2,941,105		$	3,350,908
Debt issue costs, net		(31,764	)		(28,367	)

	$	2,909,341		$	3,322,541

Principal Payments Due on Debt

As of December 31, 2016, 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):


2017	$	320
2018		302,781
2019		250,000
2020		210,340
2021		—
Thereafter		2,175,850

Total	$	2,939,291

(A)	These notes are Euro-denominated and reflect the exchange rates at December 31, 2016 and 2015, respectively.

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2016

Income Tax Disclosure [Abstract]

Schedule of Income Tax (Benefit) Expense

From our TRSs and our foreign operations, income tax (benefit) expense were as follows (in thousands):


	For the years ended December 31,
	2016			2015			2014
Current income tax expense:
Domestic	$	42		$	147		$	114
Foreign		1,856			1,614			225

		1,898			1,761			339
Deferred income tax (benefit) expense:
Domestic		147			(360	)		(23	)
Foreign		(8,875	)		102			24

		(8,728	)		(258	)		1

Income tax (benefit) expense	$	(6,830	)	$	1,503		$	340

Schedule of Deferred Tax Assets and Liabilities

At December 31, 2016 and 2015, components of our deferred tax assets and liabilities were as follows (in thousands):


	2016			2015
Deferred tax liabilities:
Property and equipment	$	(3,781	)	$	(1,636	)
Unbilled rent		(7,045	)		(4,495	)
Partnership investments		(5,103	)		(3,362	)
Other		(6,757	)		(6,141	)

Total deferred tax liabilities	$	(22,686	)	$	(15,634	)
Deferred tax assets:
Operating loss and interest deduction carry forwards	$	28,289		$	19,016
Other		10,085			10,314

Total deferred tax assets		38,374			29,330
Valuation allowance		(15,975	)		(23,005	)

Total net deferred tax assets	$	22,399		$	6,325

Net deferred tax (liability)	$	(287	)	$	(9,309	)

Summary of Reconciliation of the Income Tax (Benefit) Expense at the Statutory Income Tax Rate and the Effective Tax Rate for Income from Continuing Operations before Income Taxes


	2016			2015			2014
Income from continuing operations (before-tax)	$	219,108		$	141,430		$	51,138
Income tax at the US statutory federal rate (35%)		76,688			49,501			17,898
Increase (decrease) resulting from:
Rate differential		1,434			5,047			1,145
State income taxes, net of federal benefit		66			(601	)		(337	)
Dividends paid deduction		(84,927	)		(57,109	)		(27,873	)
Equity investments		4,297			—			—
Change in valuation allowance		(6,104	)		6,174			8,988
Other items, net		1,716			(1,509	)		519

Total income tax (benefit) expense	$	(6,830	)	$	1,503		$	340

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,
	2016		2015		2014
Common share distribution	$	0.900000	$	0.870000	$	0.840000
Ordinary income		0.619368		0.769535		0.520692
Capital gains(1)		0.102552		—		0.000276
Unrecaptured Sec. 1250 gain		0.045432		—		0.000276
Return of capital		0.178080		0.100465		0.319032

(1)	Capital gains include unrecaptured Sec. 1250 gains.

Earnings Per Share/Unit (Tables)

12 Months Ended

Dec. 31, 2016

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,
	2016			2015			2014
Numerator:
Income from continuing operations	$	225,938		$	139,927		$	50,798
Non-controlling interests’ share in continuing operations		(889	)		(329	)		(274	)
Participating securities’ share in earnings		(559	)		(1,029	)		(894	)

Income from continuing operations, less participating securities’ share in earnings		224,490			138,569			49,630
Income (loss) from discontinued operations attributable to MPT common stockholders		(1	)		—			(2	)

Net income, less participating securities’ share in earnings	$	224,489		$	138,569		$	49,628

Denominator:
Basic weighted-average common shares		260,414			217,997			169,999
Dilutive potential common shares		658			307			541

Diluted weighted-average common shares		261,072			218,304			170,540

MPT Operating Partnership, L.P.

Our earnings per unit were calculated based on the following (amounts in thousands):


	For the Years Ended December 31,
	2016			2015			2014
Numerator:
Income from continuing operations	$	225,938		$	139,927		$	50,798
Non-controlling interests’ share in continuing operations		(889	)		(329	)		(274	)
Participating securities’ share in earnings		(559	)		(1,029	)		(894	)

Income from continuing operations, less participating securities’ share in earnings		224,490			138,569			49,630
Income (loss) from discontinued operations attributable to MPT Operating Partnership partners		(1	)		—			(2	)

Net income, less participating securities’ share in earnings	$	224,489		$	138,569		$	49,628

Denominator:
Basic weighted-average units		260,414			217,997			169,999
Dilutive potential units		658			307			541

Diluted weighted-average units		261,072			218,304			170,540

Stock Awards (Tables)

12 Months Ended

Dec. 31, 2016

Disclosure of Compensation Related Costs, Share-based Payments [Abstract]

Restricted Equity Awards Activity

The following summarizes restricted equity award activity in 2016 and 2015 (which includes awards granted in 2016, 2015, 2014, and any applicable prior years), respectively:

For the Year Ended December 31, 2016:


	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		509,634		$	13.25		2,331,152		$	6.38
Awarded		254,574		$	13.07		799,804		$	7.30
Vested		(349,356	)	$	13.07		(671,983	)	$	6.50
Forfeited		(67,724	)	$	13.06		(647,298	)	$	6.28

Nonvested awards at end of year		347,128		$	13.35		1,811,675		$	6.78

For the Year Ended December 31, 2015:


	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		452,263		$	12.11		2,428,518		$	5.81
Awarded		407,969		$	13.94		871,888		$	6.62
Vested		(343,904	)	$	12.56		(406,970	)	$	4.94
Forfeited		(6,694	)	$	13.08		(562,284	)	$	5.33

Nonvested awards at end of year		509,634		$	13.25		2,331,152		$	6.38

Commitments and Contingencies (Tables)

12 Months Ended

Dec. 31, 2016

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		Amounts to be received from subleases			Net payments
2017	$	7,328	$	(4,725	)	$	2,603
2018		7,249		(4,731	)		2,518
2019		6,925		(4,755	)		2,170
2020		6,944		(4,860	)		2,084
2021		6,024		(4,966	)		1,058
Thereafter		251,981		(249,662	)		2,319

	$	286,451	$	(273,699	)	$	12,752

Fair Value of Financial Instruments (Tables)

12 Months Ended

Dec. 31, 2016

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, 2016						December 31, 2015
Asset (Liability)	Book Value			Fair Value			Book Value			Fair Value
Interest and rent receivables	$	57,698		$	57,707		$	46,939		$	46,858
Loans(1)		986,987			1,017,428			508,851			543,859
Debt, net		(2,909,341	)		(2,966,759	)		(3,322,541	)		(3,372,773	)

(1)	Excludes loans related to Ernest and Capella (2015 only) since they are recorded at fair value as discussed below.

Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis

At December 31, 2016, the amounts recorded under the fair value option method were as follows (in thousands):


Asset (Liability)	Fair Value		Cost		Asset Type Classification
Mortgage loan	$	112,836	$	112,836	Mortgage loans
Acquisition and other loans		116,298		116,298	Other loans
Equity investment		3,300		3,300	Other assets

	$	232,434	$	232,434

At December 31, 2015, the amounts recorded under the fair value option method were as follows (in thousands):


Asset (Liability)	Fair Value		Cost		Asset Type Classification
Mortgage loan	$	310,000	$	310,000		Mortgage loans
Acquisition and other loans		603,552		603,552		Other loans
Equity investment		7,349		7,349		Other assets

	$	920,901	$	920,901

Summary Showing Sensitivity Analysis by Using Basis Point Variations

To illustrate the effect of movements in the DLOM, we performed a sensitivity analysis below by using basis point variations (dollars in thousands):


Basis Point Change in Marketability Discount	Estimated Increase (Decrease) In Fair Value
+100 basis points	$	(49	)
- 100 basis points		49

Other Assets (Tables)

12 Months Ended

Dec. 31, 2016

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,
	2016		2015
Debt issue costs, net(1)	$	4,478	$	7,628
Equity investments		177,430		129,337
Other corporate assets		77,580		31,547
Prepaids and other assets		44,285		27,028

Total other assets	$	303,773	$	195,540

(1)

Relates to Revolving credit facility

Quarterly Financial Data (unaudited) (Tables)

12 Months Ended

Dec. 31, 2016

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, 2016 and 2015: (amounts in thousands, except for per share data)


	For the Three Month Periods in 2016 Ended
	March 31		June 30		September 30		December 31
Revenues	$	134,999	$	126,300	$	126,555	$	153,283
Income from continuing operations		58,226		53,924		70,543		43,245
Net income		58,225		53,924		70,543		43,245
Net income attributable to MPT common stockholders		57,927		53,724		70,358		43,039
Net income attributable to MPT common stockholders per share — basic	$	0.24	$	0.23	$	0.29	$	0.13
Weighted average shares outstanding — basic		237,510		238,082		246,230		319,833
Net income attributable to MPT common stockholders per share — diluted	$	0.24	$	0.22	$	0.28	$	0.13
Weighted average shares outstanding — diluted		237,819		239,008		247,468		319,994


	For the Three Month Periods in 2015 Ended
	March 31		June 30		September 30		December 31
Revenues	$	95,961	$	99,801	$	114,570	$	131,546
Income from continuing operations		35,976		22,489		23,123		58,339
Net income		35,976		22,489		23,123		58,339
Net income attributable to MPT common stockholders		35,897		22,407		23,057		58,237
Net income attributable to MPT common stockholders per share — basic	$	0.18	$	0.11	$	0.10	$	0.24
Weighted average shares outstanding — basic		202,958		208,071		223,948		237,011
Net income attributable to MPT common stockholders per share —diluted	$	0.17	$	0.11	$	0.10	$	0.24
Weighted average shares outstanding — diluted		203,615		208,640		223,948		237,011

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, 2016 and 2015: (amounts in thousands, except for per unit data)


	For the Three Month Periods in 2016 Ended
	March 31		June 30		September 30		December 31
Revenues	$	134,999	$	126,300	$	126,555	$	153,283
Income from continuing operations		58,226		53,924		70,543		43,245
Net income		58,225		53,924		70,543		43,245
Net income attributable to MPT Operating Partnership partners		57,927		53,724		70,358		43,039
Net income attributable to MPT Operating Partnership partners per unit — basic	$	0.24	$	0.23	$	0.29	$	0.13
Weighted average units outstanding — basic		237,510		238,082		246,230		319,833
Net income attributable to MPT Operating Partnership partners per unit — diluted	$	0.24	$	0.22	$	0.28	$	0.13
Weighted average units outstanding — diluted		237,819		239,008		247,468		319,994


	For the Three Month Periods in 2015 Ended
	March 31		June 30		September 30		December 31
Revenues	$	95,961	$	99,801	$	114,570	$	131,546
Income from continuing operations		35,976		22,489		23,123		58,339
Net income		35,976		22,489		23,123		58,339
Net income attributable to MPT Operating Partnership partners		35,897		22,407		23,057		58,237
Net income attributable to MPT Operating Partnership partners per unit — basic	$	0.18	$	0.11	$	0.10	$	0.24
Weighted average units outstanding — basic		202,958		208,071		223,948		237,011
Net income attributable to MPT Operating Partnership partners per unit — diluted	$	0.17	$	0.11	$	0.10	$	0.24
Weighted average units outstanding — diluted		203,615		208,640		223,948		237,011

Summary of Significant Accounting Policies - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Summary Of Significant Accounting Policies [Line Items]
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
Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Stock award vesting period in years	10 years
Consolidated Entities [Member]
Summary Of Significant Accounting Policies [Line Items]
Equity method investment, ownership percentage	100.00%
Time-Based Awards [Member]
Summary Of Significant Accounting Policies [Line Items]
Stock award vesting period in years	3 years
Market Conditions Based Awards [Member] \| Minimum [Member]
Summary Of Significant Accounting Policies [Line Items]
Stock award vesting period in years	3 years
Market Conditions Based Awards [Member] \| Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Stock award vesting period in years	5 years

Summary of Significant Accounting Policies - Carrying Value and Classification of Related Assets and Maximum Exposure to Loss (Detail)	Dec. 31, 2016 USD ($)
Mortgage and other loans [Member]
Variable Interest Entity [Line Items]
Carrying Amount	$ 235,613,000
Loans, net [Member]
Variable Interest Entity [Line Items]
Maximum Loss Exposure	316,179,000
Other Assets [Member]
Variable Interest Entity [Line Items]
Carrying Amount	140,000
Equity investments [Member]
Variable Interest Entity [Line Items]
Maximum Loss Exposure	$ 13,223,000

Summary of Significant Accounting Policies - Estimated Useful Lives of Related Real Estate and Other Assets (Detail)	12 Months Ended
	Dec. 31, 2016
Buildings and improvements [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	38 years 9 months 18 days
Tenant lease intangibles [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	23 years 10 months 24 days
Leasehold improvements [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	17 years 10 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 6 months

Real Estate and Loans Receivable - Assets Acquired (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Business Acquisition [Line Items]
Equity investments and other assets	$ 70,166	$ 101,716	$ 33,708
Liabilities assumed	(6,319)	(317)
Total assets acquired	1,682,409	2,218,869	767,696
Loans repaid	(193,262)	(385,851)
Total net assets acquired	1,489,147	1,833,018	767,696
Land [Member]
Business Acquisition [Line Items]
Total assets acquired	91,176	120,746	22,569
Building [Member]
Business Acquisition [Line Items]
Total assets acquired	654,772	741,935	241,242
Intangible Lease Assets - Subject to Amortization [Member]
Business Acquisition [Line Items]
Total assets acquired	94,614	176,383	22,513
Net Investments in Direct Financing Leases [Member]
Business Acquisition [Line Items]
Total assets acquired	178,000	174,801
Other Loans [Member]
Business Acquisition [Line Items]
Total assets acquired		523,605	$ 447,664
Mortgage Loans [Member]
Business Acquisition [Line Items]
Total assets acquired	$ 600,000	$ 380,000

Real Estate and Loans Receivable - Assets Acquired (Parenthetical) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Business Acquisition [Line Items]
Loans repaid	$ 193,262	$ 385,851
Intangible Lease Assets - Subject to Amortization [Member]
Business Acquisition [Line Items]
Weighted average useful life of acquired intangible lease assets (in years)	28 years 6 months	30 years	18 years 2 months 12 days
Capella [Member]
Business Acquisition [Line Items]
Loans repaid	$ 93,300
Median [Member]
Business Acquisition [Line Items]
Loans repaid		$ 385,900
Prime [Member]
Business Acquisition [Line Items]
Loans repaid	$ 100,000

Real Estate and Loans Receivable - 2016 Activity - Additional Information (Detail) $ in Thousands, € in Millions					1 Months Ended	12 Months Ended
	Oct. 21, 2016 USD ($) RenewalOptions Hospital	Oct. 03, 2016 USD ($) RenewalOptions Facility Hospital	Jul. 22, 2016 USD ($)	May 02, 2016 USD ($)	Sep. 30, 2015 USD ($)	Dec. 31, 2016 USD ($) Hospital	Dec. 31, 2016 EUR (€) Hospital	Dec. 31, 2015 USD ($)	Dec. 31, 2014 USD ($)	Jun. 22, 2016 EUR (€)
Business Acquisition [Line Items]
Loans repaid						$ 193,262		$ 385,851
Mortgage financing						612,836		380,000	$ 12,500
Mortgage financing funded						310,000		20,000	3,650
Acquisition related costs						$ 46,273		61,342	$ 26,389
Median [Member]
Business Acquisition [Line Items]
Loans repaid								$ 385,900
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 \| RenewalOptions	3
Number of facilities acquired \| Hospital	3
Number of free-standing emergency department and health center \| Hospital	1
Mortgage financing					$ 100,000
Mortgage financing funded	$ 15,000
2016 [Member] \| Germany [Member] \| Rehabilitation Hospital with Covenant Health System [Member]
Business Acquisition [Line Items]
Number of facilities acquired \| Hospital						12	12
Acquisition costs \| €							€ 85.2
2016 [Member] \| Germany [Member] \| Rehabilitation Hospital with Covenant Health System [Member] \| 2015 Master Lease [Member]
Business Acquisition [Line Items]
Number of facilities acquired \| Hospital						5	5
Acquisition costs \| €							€ 35.7
2016 [Member] \| Germany [Member] \| Rehabilitation Hospital with Covenant Health System [Member] \| Third Master Lease [Member]
Business Acquisition [Line Items]
Number of facilities acquired \| Hospital						7	7
Acquisition costs \| €							€ 49.5
2016 [Member] \| Median [Member]
Business Acquisition [Line Items]
Value of properties closed \| €										€ 41.6
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 \| RenewalOptions		3
Number of facilities for making mortgage loans \| Facility		4
Acute Care Hospital [Member] \| 2016 [Member] \| New Jersey [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
Business Acquisitions [Member] \| 2016 [Member]
Business Acquisition [Line Items]
Revenue contributed by the acquired entity						$ 37,400
Income contributed by the acquired entity						31,700
Acquisition related costs						12,100
Capella [Member]
Business Acquisition [Line Items]
Loans repaid						$ 93,300
Capella [Member] \| 2016 [Member] \| Olympia, Washington [Member]
Business Acquisition [Line Items]
Cash paid for acquisition transaction			$ 7,000
Loans repaid			$ 93,300

Real Estate and Loans Receivable - 2015 Activity - Additional Information (Detail) $ in Thousands												1 Months Ended		12 Months Ended
	Dec. 31, 2015 USD ($) Property Hospital	Dec. 03, 2015 EUR (€) Bed	Nov. 18, 2015 EUR (€) Facility	Oct. 30, 2015 USD ($)	Sep. 30, 2015 USD ($) Hospital	Sep. 09, 2015 EUR (€)	Aug. 31, 2015 USD ($) Bed Investment	Jun. 16, 2015 USD ($) Bed RenewalOptions Property	Apr. 29, 2015 EUR (€) Hospital	Feb. 27, 2015 USD ($) RenewalOptions	Feb. 13, 2015 USD ($) RenewalOptions Facility	Aug. 31, 2015 Investment Property Leases	Jul. 31, 2015 USD ($) Investment	Dec. 31, 2016 USD ($)	Dec. 31, 2015 USD ($)	Dec. 31, 2014 USD ($)	Dec. 31, 2015 EUR (€)
Business Acquisition [Line Items]
Mortgage financing														$ 612,836	$ 380,000	$ 12,500
Mortgage financing funded														310,000	20,000	3,650
Acquisition related costs														$ 46,273	61,342	$ 26,389
2015 [Member] \| Lake Huron Medical Center [Member]
Business Acquisition [Line Items]
Acquisition costs															20,000
Mortgage financing							$ 30,000
Mortgage financing term							5 years
2015 [Member] \| Ernest [Member]
Business Acquisition [Line Items]
Acquisition costs								$ 31,500
Loans provided for acquisition								$ 12,000
Term of lease, years								20 years
Number of lease extension options \| RenewalOptions								3
Term of lease extension, years								5 years
Number of properties acquired \| Property								2
2015 [Member] \| AXA Real Estate [Member]
Business Acquisition [Line Items]
Ownership interest in joint venture under the equity method						50.00%
2015 [Member] \| Acute Care Hospital [Member]
Business Acquisition [Line Items]
Number of facilities acquired \| Facility			7
Purchase price of acquisition \| €			€ 90,000,000
2015 [Member] \| Acute Care Hospital [Member] \| Kansas [Member]
Business Acquisition [Line Items]
Term of lease, years											10 years
Number of lease extension options \| RenewalOptions											2
Term of lease extension, years											5 years
Number of facilities acquired \| Facility											2
Purchase price of acquisition											$ 110,000
Mortgage financing											$ 40,000
Mortgage financing term											10 years
2015 [Member] \| Acute Care Hospital [Member] \| Ernest [Member]
Business Acquisition [Line Items]
Number of beds acquired \| Bed								37
2015 [Member] \| Acute Care Hospital [Member] \| AXA Real Estate [Member]
Business Acquisition [Line Items]
Ownership interest in joint venture under the equity method			50.00%
Estimated total development cost \| €						€ 21,400,000
2015 [Member] \| RHM Rehabilitation Clinic [Member] \| Germany [Member]
Business Acquisition [Line Items]
Acquisition costs \| €		€ 18,700,000
Term of lease, years		25 years
Number of beds acquired \| Bed		266
Cumulative increases in the German consumer price index		70.00%
2015 [Member] \| RHM Rehabilitation Clinic [Member] \| Germany [Member] \| From 2015 through 2017 [Member]
Business Acquisition [Line Items]
Rent escalations percentage		2.00%
2015 [Member] \| RHM Rehabilitation Clinic [Member] \| Germany [Member] \| After 2017 [Member]
Business Acquisition [Line Items]
Rent escalations percentage		0.50%
2015 [Member] \| General Acute Care Hospital and Healthcare System [Member]
Business Acquisition [Line Items]
Mortgage financing					$ 100,000
Number of licensed hospitals \| Hospital					3
Number of free-standing emergency department and health center \| Hospital					1
Mortgage financing term					5 years
Mortgage financing funded					$ 15,000
2015 [Member] \| General Acute Care Hospital [Member] \| Lake Huron Medical Center [Member]
Business Acquisition [Line Items]
Number of beds acquired \| Bed							144
2015 [Member] \| Rehabilitation Hospital with Covenant Health System [Member] \| Ernest [Member]
Business Acquisition [Line Items]
Number of beds acquired \| Bed								60
2015 [Member] \| Inpatient Rehabilitation Hospital [Member] \| Ernest [Member] \| Weslaco Texas [Member]
Business Acquisition [Line Items]
Acquisition costs										$ 10,700
Term of lease, years										17 years
Number of lease extension options \| RenewalOptions										3
Term of lease extension, years										5 years
Payments to fund long-term loans to related parties										$ 5,000
2015 [Member] \| Median [Member]
Business Acquisition [Line Items]
Acquisition costs \| €									€ 688,000,000
Loans provided for acquisition \| €																	€ 240,000,000
Term of lease, years									27 years
Number of properties closed \| Property	31
Number of hospitals acquired \| Hospital	32								32
Lease rent increase percentage									70.00%
Value of properties closed \| €																	646,000,000
Real estate transfer tax	$ 37,000														37,000
Loan amount outstanding \| €																	€ 0
2015 [Member] \| Capella [Member]
Business Acquisition [Line Items]
Combined purchase price and investment amount													$ 900,000
Ownership interests acquired													49.00%
Acquisition costs				$ 25,800									$ 600,000
Loans provided for acquisition				$ 9,200									$ 290,000
Term of lease, years												15 years
Number of lease extension options \| Leases												4
Term of lease extension, years												5 years
Number of properties closed \| Property												6
Increase in consumer price-index, floor rate												2.00%
Increase in consumer price-index, ceiling rate												4.00%
2015 [Member] \| Capella [Member] \| MPT Camaro Opco [Member]
Business Acquisition [Line Items]
Ownership interests acquired													49.00%
2015 [Member] \| Capella [Member] \| Acute Care Hospital [Member]
Business Acquisition [Line Items]
Number of portfolio investments \| Investment							7					7	7
Number of investment in form of mortgage loan \| Investment							2					2	2
2015 [Member] \| Capella [Member] \| Joint Venture Partner [Member]
Business Acquisition [Line Items]
Fixed interest rate							8.00%					8.00%
2015 [Member] \| Capella [Member] \| Joint Venture Partner [Member] \| ManageCo [Member]
Business Acquisition [Line Items]
Ownership interests acquired													51.00%
2015 [Member] \| Business Acquisitions [Member]
Business Acquisition [Line Items]
Revenue contributed by the acquired entity															102,700
Income contributed by the acquired entity															87,700
Acquisition related costs															$ 58,000

Real Estate and Loans Receivable - 2014 Activity - Additional Information (Detail) $ in Thousands, € in Millions, £ in Millions							3 Months Ended	12 Months Ended
	Oct. 31, 2014 USD ($) Bed	Oct. 15, 2014 EUR (€)	Sep. 19, 2014 USD ($) RenewalOptions	Jul. 01, 2014 USD ($)	Jul. 01, 2014 GBP (£)	Mar. 31, 2014 USD ($)	Dec. 31, 2014 USD ($) Bed Facility	Dec. 31, 2016 USD ($)	Dec. 31, 2015 USD ($)	Dec. 31, 2014 USD ($) Bed	Dec. 31, 2014 EUR (€) Bed	Jul. 01, 2014 GBP (£)
Business Acquisition [Line Items]
Acquisition related costs								$ 46,273	$ 61,342	$ 26,389
Income contributed by the acquired entity								$ 310,019	$ 306,756
2014 [Member]
Business Acquisition [Line Items]
Acquired percentage of the outstanding equity interest		5.10%
2014 [Member] \| Circle Health Ltd. [Member]
Business Acquisition [Line Items]
Acquired facility, carrying value of sale/leaseback transaction				$ 48,000								£ 28.3
Sale/leaseback transaction, initial term period				15 years	15 years
Sale/leaseback transaction, additional term period				15 years	15 years
Percentage change in annual retail price index, floor rate				2.00%								2.00%
Percentage change in annual retail price index, cap rate				5.00%								5.00%
Acquisition related costs				$ 1,900	£ 1.1
2014 [Member] \| Acute Care Hospital [Member]
Business Acquisition [Line Items]
Acquisition costs						$ 115,000
Term of lease, years						15 years
Term of lease extension, years						3 years
2014 [Member] \| Acute Care Hospital [Member] \| Fair value market [Member]
Business Acquisition [Line Items]
Term of lease extension, years						12 years
2014 [Member] \| Acute Care Hospital [Member] \| Alecto Healthcare Services [Member] \| Fairmont West Virginia [Member]
Business Acquisition [Line Items]
Ownership interest, percentage			20.00%
Acquisition costs			$ 15,000
Term of lease, years			15 years
Term of lease extension, years			5 years
Number of lease extension options in current lease contract \| RenewalOptions			3
Working capital loan to the tenant			$ 5,000
Additional lease period			5 years
Additional fund committed to the tenant for capital improvements			$ 5,000
2014 [Member] \| Median and Waterland [Member]
Business Acquisition [Line Items]
Interim acquisition loans aggregate amount \| €		€ 425.0
Interim acquisition loans advanced \| €											€ 349.0
2014 [Member] \| Median [Member] \| Waterland [Member]
Business Acquisition [Line Items]
Acquired percentage of the outstanding equity interest		94.90%
2014 [Member] \| Business Acquisitions [Member]
Business Acquisition [Line Items]
Acquisition related costs										26,400
Revenue contributed by the acquired entity										12,400
Income contributed by the acquired entity										8,700
Acquisition-related costs on consummated deals										25,200
Acquisition related costs - transfer taxes on consummated deals										5,800
2014 [Member] \| Germany [Member] \| RHM Rehabilitation Facilities [Member]
Business Acquisition [Line Items]
Purchase price of acquisition							$ 81,000			81,000	63.6
Applicable transfer and other taxes on purchase price							$ 3,600			$ 3,600	€ 3.0
Number of facilities acquired \| Facility							3
2014 [Member] \| Germany [Member] \| Bad Mergentheim [Member] \| RHM Rehabilitation Facilities [Member]
Business Acquisition [Line Items]
Number of beds \| Bed							211			211	211
2014 [Member] \| Germany [Member] \| Bad Tolz [Member] \| RHM Rehabilitation Facilities [Member]
Business Acquisition [Line Items]
Number of beds \| Bed							248			248	248
2014 [Member] \| Germany [Member] \| Bad Liebenstein [Member] \| RHM Rehabilitation Facilities [Member]
Business Acquisition [Line Items]
Number of beds \| Bed							271			271	271
2014 [Member] \| Sherman, TX [Member]
Business Acquisition [Line Items]
Purchase price of acquisition	$ 32,500
2014 [Member] \| Sherman, TX [Member] \| Alecto Healthcare Services [Member]
Business Acquisition [Line Items]
Working capital loan	$ 7,500
Initial leaseback term								15 years
Ownership interest, percentage	20.00%
2014 [Member] \| Sherman, TX [Member] \| Acute Care Hospital [Member]
Business Acquisition [Line Items]
Number of beds \| Bed	237

Real Estate and Loans Receivable - Schedule of Unaudited Supplemental Pro Forma Operating Data (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Business Acquisition, Pro Forma Information [Abstract]
Total revenues	$ 627,583	$ 624,443
Net income	$ 310,019	$ 306,756
Net income per share/unit	$ 0.97	$ 0.96

Real Estate and Loans Receivable - Development Activities - Additional Information (Detail) $ in Thousands		12 Months Ended
	Apr. 30, 2015 USD ($) Leases	Dec. 31, 2016 USD ($) Facility	Dec. 31, 2015 USD ($) RenewalOptions Facility Property	Dec. 31, 2014 USD ($) RenewalOptions	Aug. 23, 2016 USD ($)
Business Acquisition [Line Items]
Current development project		$ 162,770
Ernest [Member]
Business Acquisition [Line Items]
Current development project		28,067
Ernest [Member] \| Inpatient Rehabilitation Hospital [Member] \| Flagstaff Arizona [Member]
Business Acquisition [Line Items]
Current development project					$ 28,100
Ernest [Member] \| Rehabilitation Hospital of Northwestern Ohio [Member] \| Inpatient Rehabilitation Hospital [Member] \| Toledo, OH [Member]
Business Acquisition [Line Items]
Current development project		$ 18,400
Adeptus Health [Member]
Business Acquisition [Line Items]
Term of lease extension, years	5 years
Aggregate commitment amount	$ 250,000
Lease agreement term	15 years
Number of lease extension options \| Leases	3
Percentage of increase in annual rent	2.00%
Development Activities [Member] \| Acute Care Facilities in Altoona [Member]
Business Acquisition [Line Items]
Number of facilities constructed \| Facility		19
Development Activities [Member] \| Oakleaf Surgical Hospital [Member] \| Acute Care Hospital [Member] \| Altoona, WI [Member] \| National Surgical Hospitals [Member]
Business Acquisition [Line Items]
Current development project			$ 30,000
Term of lease, years			15 years
Number of lease extension options in current lease contract \| RenewalOptions			2
Term of lease extension, years			5 years
Development Activities [Member] \| UAB Medical West [Member]
Business Acquisition [Line Items]
Estimated total development cost			$ 8,600
Term of lease, years			15 years
Number of lease extension options in current lease contract \| RenewalOptions			4
Term of lease extension, years			5 years
Lease rent increase percentage			2.00%
Development Activities [Member] \| Adeptus Health [Member]
Business Acquisition [Line Items]
Aggregate commitment amount		$ 500,000
Number of facilities completed \| Facility		54
Number of facilities under construction \| Facility		5
Development Activities [Member] \| Northern Utah Rehabilitation Hospital [Member]
Business Acquisition [Line Items]
Estimated total development cost		$ 19,000
Development Activities [Member] \| First Choice [Member]
Business Acquisition [Line Items]
Number of facilities leased \| RenewalOptions				17
Estimated total development cost				$ 83,000
Development Activities [Member] \| Acute Care Facilities in Altoona [Member]
Business Acquisition [Line Items]
Number of property leased \| Property			3
Development Activities [Member] \| Acute Care Facilities in Altoona [Member] \| 2015 Master Lease [Member]
Business Acquisition [Line Items]
Number of facilities leased \| Facility			17
Estimated total development cost			$ 102,600
Development Activities [Member] \| Acute Care Facilities in Altoona [Member] \| 2014 Master Lease [Member]
Business Acquisition [Line Items]
Number of facilities leased \| Facility			14

Real Estate and Loans Receivable - Summary of Status Update on Current Development Projects (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2016 USD ($)
Business Acquisition [Line Items]
Commitment	$ 162,770
Costs Incurred as of 12/31/2016	53,648
Adeptus Health Two [Member]
Business Acquisition [Line Items]
Commitment	5,848
Costs Incurred as of 12/31/2016	$ 2,710
Estimated Completion Date	1Q 2017
Adeptus Health Three [Member]
Business Acquisition [Line Items]
Commitment	$ 67,185
Costs Incurred as of 12/31/2016	$ 44,948
Estimated Completion Date	2Q 2017
Ernest [Member]
Business Acquisition [Line Items]
Commitment	$ 28,067
Costs Incurred as of 12/31/2016	$ 4,342
Estimated Completion Date	4Q 2017
Adeptus Health Four [Member]
Business Acquisition [Line Items]
Commitment	$ 7,804
Costs Incurred as of 12/31/2016	$ 1,648
Estimated Completion Date	1Q 2018
Adeptus Health Five [Member]
Business Acquisition [Line Items]
Commitment	$ 53,866
Estimated Completion Date	Various

Real Estate and Loans Receivable - Disposals - Additional Information (Detail) $ in Thousands								3 Months Ended	6 Months Ended	12 Months Ended
	Jul. 20, 2016 USD ($) Hospital	Jun. 17, 2016 USD ($)	May 23, 2016 USD ($) Property	Apr. 30, 2016 USD ($)	Aug. 05, 2015 USD ($) Hospital	Jul. 30, 2015 USD ($)	May 20, 2014 USD ($)	Jun. 30, 2016 USD ($)	Jun. 30, 2016 Hospital	Dec. 31, 2016 USD ($)	Dec. 31, 2015 USD ($)	Dec. 31, 2014 USD ($)
Debt Instrument [Line Items]
New loan for hospital property										$ 612,836	$ 380,000	$ 12,500
Proceeds from sale of real estate										198,767	$ 19,175	34,649
Disposals [Member]
Debt Instrument [Line Items]
Acquisition costs							$ 35,000
Real estate impairment charge							$ 3,100
Disposals [Member] \| La Palma Facility [Member]
Debt Instrument [Line Items]
Gain (loss) on sale of real estate												2,900
Proceeds from sale of real estate												12,500
Straight line rent receivables write-off												$ 1,300
Texas [Member]
Debt Instrument [Line Items]
Gain (loss) on sale of real estate						$ 1,500
Proceeds from sale of real estate						9,700
Straight line rent receivables write-off						$ 900
United States [Member]
Debt Instrument [Line Items]
Gain (loss) on sale of real estate					$ 1,700
Number of hospitals sold \| Hospital					6
Proceeds from sale of real estate					$ 9,500
Consideration received as note receivable					1,500
Billed rent receivables write-off					$ 900
Amortization of the related lease intangible asset										$ 700
Capella [Member]
Debt Instrument [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]
Debt Instrument [Line Items]
Term of lease, years									13 years 6 months
Capella [Member] \| Other Stand-Alone Lease [Member]
Debt Instrument [Line Items]
Term of lease, years									11 years 6 months
Post Acute [Member]
Debt Instrument [Line Items]
Number of properties sold \| Property			5
Outstanding loans paid in full			$ 4,000
Proceeds from sale of facilities		$ 28,000	71,000
Gain on real estate dispositions			$ 15,000
Gain (loss) on sale of real estate		8,000
Post Acute [Member] \| Texas [Member]
Debt Instrument [Line Items]
Number of properties sold \| Property			3
Gain offset by non-cash charges		$ 9,000
Post Acute [Member] \| Louisiana [Member]
Debt Instrument [Line Items]
Number of properties sold \| Property			2
HealthSouth [Member]
Debt Instrument [Line Items]
Proceeds from sale of facilities	$ 111,500
Gain on real estate dispositions	$ 45,000
HealthSouth [Member] \| Texas [Member]
Debt Instrument [Line Items]
Number of hospitals sold \| Hospital	3

Real Estate and Loans Receivable - Summary of Operations for Disposed Assets in 2016 (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Disposal Group, Including Discontinued Operation, Income Statement Disclosures [Abstract]
Revenues	$ 7,851	$ 18,112	$ 18,225
Real estate depreciation and amortization	(1,754)	(3,795)	(3,789)
Property-related expenses	(114)	(121)	(60)
Other income (expense)	(23)	1,079	462
Income from real estate dispositions, net	$ 5,960	$ 15,275	$ 14,838

Real Estate and Loans Receivable - Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Debt Instrument [Line Items]
Intangible lease assets	$ 296,176	$ 256,950
Intangible Assets [Member]
Debt Instrument [Line Items]
Intangible lease assets	296,200	257,000
Accumulated amortization, net	263,800	231,700
Amortization expense related to intangible lease assets	$ 13,400	$ 9,100	$ 7,000
Capitalized lease intangibles, weighted average life (in years)	22 years 1 month 6 days

Real Estate and Loans Receivable - Amortization Expense from Existing Lease Intangible Assets (Detail) $ in Thousands	Dec. 31, 2016 USD ($)
Business Combinations [Abstract]
2017	$ 22,130
2018	22,069
2019	22,021
2020	21,818
2021	$ 21,751

Real Estate and Loans Receivable - Leasing Operations - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2016 Leases
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 and Loans Receivable - Components of Net Investment in Direct Financing Leases (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Business Combinations [Abstract]
Minimum lease payments receivable	$ 2,207,625	$ 2,587,912
Estimated residual values	407,647	393,097
Less unearned income	(1,967,170)	(2,354,013)
Net investment in direct financing leases	$ 648,102	$ 626,996

Real Estate and Loans Receivable - Minimum Rental Payments Due under Operating Leases with Non-Cancelable Terms (Detail) $ in Thousands	Dec. 31, 2016 USD ($)
Leases User Charges And Commitments [Line Items]
2017	$ 7,328
2018	7,249
2019	6,925
2020	6,944
2021	6,024
Thereafter	251,981
Minimum rental payments, total	286,451
Minimum Rental Payments [Member]
Leases User Charges And Commitments [Line Items]
2017	448,477
2018	452,476
2019	457,518
2020	461,579
2021	468,172
Thereafter	8,751,394
Minimum rental payments, total	11,039,616
Minimum Rental Payments [Member] \| Operating Leases [Member]
Leases User Charges And Commitments [Line Items]
2017	386,058
2018	388,808
2019	392,577
2020	395,339
2021	400,607
Thereafter	7,077,794
Minimum rental payments, total	9,041,183
Minimum Rental Payments [Member] \| Direct Financing Leases [Member]
Leases User Charges And Commitments [Line Items]
2017	62,419
2018	63,668
2019	64,941
2020	66,240
2021	67,565
Thereafter	1,673,600
Minimum rental payments, total	$ 1,998,433

Real Estate and Loans Receivable - Adeptus Health - Additional Information (Detail) - Adeptus Health [Member]	1 Months Ended
	Dec. 31, 2016 USD ($) Property
Business Acquisition [Line Items]
Outstanding rent receivables	$ 0
Letter of credit outstanding	12,400,000
Net investment	$ 400,000,000
Number of leased properties \| Property	59
Investment percentage of total assets	7.00%

- Definition

The carrying value as of the balance sheet date of the current and noncurrent portions of long-term obligations drawn from a line of credit, which is a bank's commitment to make loans up to a specific amount. Examples of items that might be included in the application of this element may consist of letters of credit, standby letters of credit, and revolving credit arrangements, under which borrowings can be made up to a maximum amount as of any point in time conditional on satisfaction of specified terms before, as of and after the date of drawdowns on the line. Includes short-term obligations that would normally be classified as current liabilities but for which (a) postbalance sheet date issuance of a long term obligation to refinance the short term obligation on a long term basis, or (b) the enterprise has entered into a financing agreement that clearly permits the enterprise to refinance the short-term obligation on a long term basis and the following conditions are met (1) the agreement does not expire within 1 year and is not cancelable by the lender except for violation of an objectively determinable provision, (2) no violation exists at the BS date, and (3) the lender has entered into the financing agreement is expected to be financially capable of honoring the agreement.

+ References + Details

Real Estate and Loans Receivable - Hoboken Facility - Additional Information (Detail) - Hoboken Facility [Member] $ in Millions	Sep. 30, 2015 USD ($)
Business Acquisition [Line Items]
Percentage of ownership in subsidiary	10.00%
Real estate investment	$ 5

Real Estate and Loans Receivable - Twelve Oaks Facility - Additional Information (Detail) - Twelve Oaks Facility [Member] - USD ($) $ in Millions	3 Months Ended	12 Months Ended
	Sep. 30, 2015	Dec. 31, 2015	Sep. 30, 2016
Business Acquisition [Line Items]
Outstanding amount receivable from tenant past due including interest			$ 2.5
Gain offset by non-cash charges	$ 1.9
Amortization of leased intangible assets		$ 0.5

Real Estate and Loans Receivable - Monroe Facility - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2014
Business Acquisition [Line Items]
Impairment charges	$ 7,229	$ 50,128
Monroe Properties [Member]
Business Acquisition [Line Items]
Impairment charges		$ 47,000
Net investment	$ 36,000

Real Estate and Loans Receivable - Summary of Loans (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Loans [Line Items]
Loans, Balance	$ 1,216,121	$ 1,422,403
Mortgage Loans [Member]
Loans [Line Items]
Loans, Balance	$ 1,060,400	$ 757,581
Loans, Weighted Average Interest Rate	8.80%	9.50%
Acquisition Loans [Member]
Loans [Line Items]
Loans, Balance	$ 121,464	$ 610,469
Loans, Weighted Average Interest Rate	13.70%	9.10%
Working Capital and Other Loans [Member]
Loans [Line Items]
Loans, Balance	$ 34,257	$ 54,353
Loans, Weighted Average Interest Rate	9.00%	10.20%

Real Estate and Loans Receivable - Loans - Additional Information (Detail) - USD ($) $ in Thousands					1 Months Ended	12 Months Ended
	Oct. 03, 2016	Oct. 01, 2016	Apr. 30, 2016	Mar. 01, 2012	Sep. 30, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Business Acquisition [Line Items]
Mortgage financing						$ 612,836	$ 380,000	$ 12,500
Existing mortgage loans						$ 1,060,336	$ 757,500	$ 397,500	$ 388,650
Amount of convertible note converted into equity interest				$ 1,700
Convertible note				$ 5,000
Percentage of equity shares from convertible debt		15.10%		9.90%		25.00%
Remaining convertible debt after conversion of part of debt						$ 3,300
Capella [Member]
Business Acquisition [Line Items]
Outstanding loans paid						489,000
Steward [Member] \| 2016 [Member]
Business Acquisition [Line Items]
Increase in mortgage loans	$ 600,000
Capella [Member]
Business Acquisition [Line Items]
Proceeds from prepayment of mortgage loans			$ 210,000
Mortgage financing			$ 93,300
General Acute Care Hospital and Healthcare System [Member] \| 2016 [Member]
Business Acquisition [Line Items]
Mortgage financing					$ 100,000
Ernest Transaction and Other Acquisitions [Member]
Business Acquisition [Line Items]
Existing mortgage loans						$ 115,000

Real Estate and Loans Receivable - Schedule of Revenue by Operator (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Investment And Revenue From External Customers [Line Items]
Total Revenue	$ 153,283	$ 126,555	$ 126,300	$ 134,999	$ 131,546	$ 114,570	$ 99,801	$ 95,961	$ 541,137	$ 441,878	$ 312,532
Revenue [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue									$ 541,137	$ 441,878
Percentage of Total Revenue									100.00%	100.00%
Revenue [Member] \| Credit Concentration Risk [Member] \| Prime [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue									$ 120,558	$ 104,325
Percentage of Total Revenue									22.30%	23.60%
Revenue [Member] \| Credit Concentration Risk [Member] \| Median [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue									$ 93,425	$ 78,540
Percentage of Total Revenue									17.30%	17.80%
Revenue [Member] \| Credit Concentration Risk [Member] \| Ernest [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue									$ 67,742	$ 61,988
Percentage of Total Revenue									12.50%	14.00%
Revenue [Member] \| Credit Concentration Risk [Member] \| RCCH [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue									$ 52,720	$ 28,567
Percentage of Total Revenue									9.70%	6.40%
Revenue [Member] \| Credit Concentration Risk [Member] \| Other Operators [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue									$ 206,692	$ 168,458
Percentage of Total Revenue									38.20%	38.20%

Real Estate and Loans Receivable - Schedule of Revenue from External Customers by Geographic Areas (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 153,283	$ 126,555	$ 126,300	$ 134,999	$ 131,546	$ 114,570	$ 99,801	$ 95,961	$ 541,137	$ 441,878	$ 312,532
Revenue [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue									$ 541,137	$ 441,878
Percentage of Total Revenue									100.00%	100.00%
Revenue [Member] \| Texas [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue									$ 96,992	$ 87,541
Percentage of Total Revenue									17.90%	19.80%
Revenue [Member] \| California [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue									$ 66,197	$ 66,120
Percentage of Total Revenue									12.20%	15.00%
Revenue [Member] \| New Jersey [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue									$ 39,084	$ 27,688
Percentage of Total Revenue									7.20%	6.30%
Revenue [Member] \| Massachusetts [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue									$ 26,098	$ 69
Percentage of Total Revenue									4.80%	0.00%
Revenue [Member] \| Arizona [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue									$ 23,798	$ 21,188
Percentage of Total Revenue									4.40%	4.80%
Revenue [Member] \| Other States [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue									$ 187,363	$ 156,256
Percentage of Total Revenue									34.70%	35.30%
Revenue [Member] \| United States [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue									$ 439,532	$ 358,862
Percentage of Total Revenue									81.20%	81.20%
Revenue [Member] \| Germany [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue									$ 97,382	$ 78,540
Percentage of Total Revenue									18.00%	17.80%
Revenue [Member] \| United Kingdom, Italy, and Spain [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue									$ 4,223	$ 4,476
Percentage of Total Revenue									0.80%	1.00%
Revenue [Member] \| International [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue									$ 101,605	$ 83,016
Percentage of Total Revenue									18.80%	18.80%

Real Estate and Loans Receivable - Concentration of Credit Risks and Related Party Transactions - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Related Party Transactions [Member]
Business Acquisition [Line Items]
Lease and interest revenue earned from tenants	$ 282.9	$ 215.4	$ 101.8
Assets, Total [Member] \| Geographic Concentration Risk [Member] \| United States [Member]
Business Acquisition [Line Items]
Percentage of total assets accounted	80.00%
Assets, Total [Member] \| Geographic Concentration Risk [Member] \| Europe (primarily Germany) [Member]
Business Acquisition [Line Items]
Percentage of total assets accounted	20.00%

Debt - Summary of Debt (Detail) - USD ($) $ in Thousands	12 Months Ended
Debt - Summary of Debt (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Debt Instrument [Line Items]
Principal amount	$ 2,939,291
Debt issue costs, net	(31,764)	$ (28,367)
Debt	2,909,341	3,322,541
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Debt	290,000	1,100,000
Term Loans [Member]
Debt Instrument [Line Items]
Debt	263,101	263,400
Senior Unsecured Notes Due 2016 [Member]
Debt Instrument [Line Items]
Debt		125,000
6.875% Senior Unsecured Notes Due 2021 [Member]
Debt Instrument [Line Items]
Debt		450,000
6.375% Senior Unsecured Notes Due 2022 [Member]
Debt Instrument [Line Items]
Principal amount	350,000	350,000
Unamortized premium	1,814	2,168
Debt	351,814	352,168
5.750% Senior Unsecured Notes Due 2020 [Member]
Debt Instrument [Line Items]
Debt	210,340	217,240
4.000% Senior Unsecured Notes due 2022 [Member]
Debt Instrument [Line Items]
Debt	525,850	543,100
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
5.250% Senior Unsecured Notes Due 2026 [Member]
Debt Instrument [Line Items]
Debt	500,000
Senior Unsecured Debt [Member]
Debt Instrument [Line Items]
Debt	$ 2,941,105	$ 3,350,908

Debt - Summary of Debt (Parenthetical) (Detail)	Dec. 31, 2016	Jul. 22, 2016	Dec. 31, 2015	Apr. 17, 2014	Oct. 10, 2013	Feb. 17, 2012	Apr. 26, 2011
6.875% Senior Unsecured Notes Due 2021 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	6.875%		6.875%				6.875%
6.375% Senior Unsecured Notes Due 2022 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	6.375%		6.375%			6.375%
5.750% Senior Unsecured Notes Due 2020 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	5.75%		5.75%		5.75%
4.000% Senior Unsecured Notes due 2022 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	4.00%		4.00%
5.500% Senior Unsecured Notes Due 2024 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	5.50%			5.50%
6.375% Senior Unsecured Notes due 2024 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	6.375%
5.250% Senior Unsecured Notes Due 2026 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	5.25%	5.25%

Debt - Principal Payments Due for Debt (Detail) $ in Thousands	Dec. 31, 2016 USD ($)
Debt Disclosure [Abstract]
2017	$ 320
2018	302,781
2019	250,000
2020	210,340
2021	0
Thereafter	2,175,850
Total	$ 2,939,291

Debt - Revolving Credit Facility - Additional Information (Detail) - USD ($)		1 Months Ended		12 Months Ended
	Jun. 19, 2014	Sep. 30, 2015	Nov. 30, 2014	Dec. 31, 2016	Dec. 31, 2015	Aug. 04, 2015	Oct. 17, 2014
Debt Instrument [Line Items]
Aggregate committed amount of credit facility		$ 1,950,000,000
Credit facility, amendment fees incurred		100,000
Term Loans [Member]
Debt Instrument [Line Items]
Aggregate committed amount of credit facility		250,000,000
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Amount of senior unsecured credit facility paid off	$ 900,000,000
Accordion to credit facility		400,000,000					$ 250,000,000
Aggregate committed amount of credit facility		$ 1,300,000,000				$ 1,250,000,000	1,150,000,000
Revolving Credit Facility [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Accordion to credit facility							$ 400,000,000
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Amount of senior unsecured debt	775,000,000
Credit facilities, amount outstanding				$ 290,000,000	$ 1,100,000,000
Refinancing charge	300,000
Aggregate committed amount of credit facility				$ 1,000,000,000
Debt instrument, basis spread of interest rate			0.40%
Credit facilities, percentage of commitment fee on unused capacity			0.30%
Credit facilities, weighted average interest rate				2.00%	1.70%
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member] \| Federal Funds Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			0.50%
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member] \| Euro Dollar Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			1.00%
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member] \| London Interbank Offered Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			1.40%
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member] \| Minimum [Member]
Debt Instrument [Line Items]
Credit facilities, amount outstanding	400,000,000
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Credit facilities, amount outstanding	100,000,000
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member] \| Revolving Credit Facility Matures in June 2018 [Member] \| Federal Funds Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate				0.50%
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member] \| Revolving Credit Facility Matures in June 2018 [Member] \| Euro Dollar Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate				1.00%
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member] \| Revolving Credit Facility Matures in June 2018 [Member] \| Minimum [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate				0.70%
Credit facilities, percentage of commitment fee on unused capacity				0.25%
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member] \| Revolving Credit Facility Matures in June 2018 [Member] \| Minimum [Member] \| London Interbank Offered Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate				1.70%
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member] \| Revolving Credit Facility Matures in June 2018 [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate				1.25%
Credit facilities, percentage of commitment fee on unused capacity				0.35%
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member] \| Revolving Credit Facility Matures in June 2018 [Member] \| Maximum [Member] \| London Interbank Offered Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate				2.25%
Revolving Credit Facility [Member] \| Term Loans [Member]
Debt Instrument [Line Items]
Amount of senior unsecured credit facility paid off	250,000,000
Amount of senior unsecured debt	$ 125,000,000

Debt - Term Loans - Additional Information (Detail) - USD ($)		3 Months Ended	12 Months Ended
	Feb. 14, 2011	Jun. 30, 2014	Dec. 31, 2016	Dec. 31, 2015	Sep. 30, 2015
Debt Instrument [Line Items]
Aggregate committed amount of credit facility					$ 1,950,000,000
2014 Term Loan [Member]
Debt Instrument [Line Items]
Paid off term loan		$ 125,000,000
Aggregate committed amount of credit facility					$ 250,000,000
Debt instrument, maturity date			Jun. 30, 2019
Interest rate at end of period			2.36%	2.05%
2014 Term Loan [Member] \| Minimum [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			0.60%
2014 Term Loan [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			1.20%
2014 Term Loan [Member] \| Federal Funds Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate		0.50%	0.50%
2014 Term Loan [Member] \| Eurodollar Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate		1.00%	1.00%
2014 Term Loan [Member] \| Initial Spread [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			0.65%
2014 Term Loan [Member] \| London Interbank Offered Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			1.65%
2014 Term Loan [Member] \| London Interbank Offered Rate [Member] \| Minimum [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			1.60%
2014 Term Loan [Member] \| London Interbank Offered Rate [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			2.20%
Mortgage Loans [Member] \| Northland LTACH Hospital [Member]
Debt Instrument [Line Items]
Debt instrument, maturity date			Jan. 01, 2018
Liabilities acquired	$ 14,600,000
Amortization period			30 years
Interest rate			6.20%
Collateralized real estate property			$ 16,400,000	$ 16,900,000
Term Loans [Member]
Debt Instrument [Line Items]
Debt instrument face amount			$ 13,100,000

Debt - Senior Unsecured Notes Due 2016 - Additional Information (Detail) - Senior Unsecured Notes Due 2016 [Member] - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2006
Debt Instrument [Line Items]
Senior unsecured notes, value of offering		$ 125.0
Credit facilities, periodic payments of interest		$ 65.0
Senior notes frequency of periodic payment	Quarterly
Unsecured senior notes, year of maturity		2016-07
London Interbank Offered Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate		2.30%

Debt - Interest Rate Swap - Additional Information (Detail) - USD ($)	1 Months Ended	3 Months Ended	12 Months Ended
	Oct. 31, 2011	Jun. 30, 2010	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Interest Rate Swap [Member]
Debt Instrument [Line Items]
Hedge ineffectiveness and income statement effect in period			$ 0	$ 0	$ 0
Senior Unsecured Notes Due 2016 [Member]
Debt Instrument [Line Items]
Portion of debt instrument face amount		$ 65,000,000
Senior Unsecured Notes Due 2016 [Member] \| Interest Rate Contract [Member]
Debt Instrument [Line Items]
Fair value of the interest rate swaps				$ 2,900,000
Senior Unsecured Notes Due 2016 [Member] \| Interest Rate Contract One [Member]
Debt Instrument [Line Items]
Interest rate of interest rate derivative instrument		5.507%
Maturity date of interest rate swap				2016-07
Senior Unsecured Notes Due 2016 [Member] \| Interest Rate Contract Two [Member]
Debt Instrument [Line Items]
Maturity date of interest rate swap				2016-07
Interest rate swap, amount fixed	$ 60,000,000
Interest rate of derivative instrument	5.675%

Debt - 6.875% Senior Unsecured Notes Due 2021 - Additional Information (Detail) - 6.875% Senior Unsecured Notes Due 2021 [Member] - USD ($) $ in Millions		3 Months Ended	12 Months Ended
	Jul. 22, 2016	Sep. 30, 2016	Dec. 31, 2016	Dec. 31, 2015	Apr. 26, 2011
Debt Instrument [Line Items]
Debt instrument face amount					$ 450.0
Senior unsecured notes, interest rate			6.875%	6.875%	6.875%
Senior notes frequency of periodic payment			Interest on the notes was payable semi-annually on May 1 and November 1 of each year.
Notes redeemed	$ 450.0
Debt refinancing charge		$ 22.5
Redemption premium		$ 15.5

Debt - 6.375% Senior Unsecured Notes Due 2022 - Additional Information (Detail) - 6.375% Senior Unsecured Notes Due 2022 [Member] - USD ($)			12 Months Ended
	Aug. 20, 2013	Feb. 17, 2012	Dec. 31, 2016	Dec. 31, 2015
Debt Instrument [Line Items]
Senior unsecured notes face amount	$ 150,000,000	$ 200,000,000
Senior unsecured notes, maturity date		Feb. 15, 2022
Senior unsecured notes, interest rate		6.375%	6.375%	6.375%
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest		101.00%
Debt instrument redemption price	102.00%
Debt instrument effective rate	5.998%
Senior notes frequency of periodic payment			Interest on these notes is payable semi-annually on February 15 and August 15 of each year.
Senior unsecured notes, redemption description			We may redeem some or all of the notes at a premium that will decrease over time, plus accrued and unpaid interest to, but not including, the redemption date. In the event of a change of control, each holder of the 6.375% Senior Unsecured Notes due 2022 may require us to repurchase some or all of its notes at a repurchase price equal to 101% of the aggregate principal amount plus accrued and unpaid interest to the date of purchase.

Debt - 5.750% Senior Unsecured Notes Due 2020 - Additional Information (Detail) - 5.750% Senior Unsecured Notes Due 2020 [Member] - EUR (€) € in Millions		12 Months Ended
	Oct. 10, 2013	Dec. 31, 2016	Dec. 31, 2015
Debt Instrument [Line Items]
Senior unsecured notes, value of offering	€ 200
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest	101.00%
Senior unsecured notes, interest rate	5.75%	5.75%	5.75%
Debt instrument, maturity date	Oct. 01, 2020
Senior unsecured notes, payable term		Interest on the notes is payable semi-annually on April 1 and October 1 of each year.
Senior unsecured notes, redemption description		We may redeem some or all of the notes at any time at a "make-whole" redemption price 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 - 4.000% Senior Unsecured Notes Due 2022 - Additional Information (Detail) - 4.000% Senior Unsecured Notes Due 2022 [Member] - EUR (€)		12 Months Ended
	Aug. 19, 2015	Dec. 31, 2016
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, redemption price percentage	101.00%
Senior unsecured notes, maturity date	Aug. 19, 2022
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 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 the Company. 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 Notes Due 2024 - Additional Information (Detail) - 5.500% Senior Unsecured Notes Due 2024 [Member] - USD ($)		12 Months Ended
	Apr. 17, 2014	Dec. 31, 2016
Debt Instrument [Line Items]
Senior unsecured notes face amount	$ 300,000,000
Senior unsecured notes, maturity date	May 01, 2024
Senior unsecured notes, interest rate	5.50%	5.50%
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 semi-annually on May 1 and November 1 of each year
Senior notes, earliest redemption date	May 01, 2019
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 addition, at any time prior to May 1, 2017, we may redeem up to 35% of the aggregate principal amount of the notes using the proceeds of one or more equity offerings. 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.
Maximum [Member]
Debt Instrument [Line Items]
Senior unsecured notes, redemption percentage on principal amount	35.00%

Debt - 6.375% Senior Unsecured Notes Due 2024 - Additional Information (Detail) - 6.375% Senior Unsecured Notes Due 2024 [Member] - Revolving Credit Facility [Member] - USD ($)		12 Months Ended
	Feb. 22, 2016	Dec. 31, 2016
Debt Instrument [Line Items]
Senior unsecured notes face amount	$ 500,000,000
Senior unsecured notes, maturity date	Mar. 01, 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. 01, 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]
Debt Instrument [Line Items]
Senior unsecured notes, redemption percentage on principal amount	35.00%

Debt - 5.250% Senior Unsecured Notes Due 2026 - Additional Information (Detail) - 5.250% Senior Unsecured Notes Due 2026 [Member] - USD ($)		12 Months Ended
	Jul. 22, 2016	Dec. 31, 2016
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 commencing date of payment	Feb. 01, 2017
Senior unsecured notes, interest rate	5.25%	5.25%
Senior unsecured notes, maturity date	Aug. 01, 2026
Senior notes, earliest redemption date	Aug. 01, 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 105.25% 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%
Maximum [Member]
Debt Instrument [Line Items]
Senior unsecured notes, redemption percentage on principal amount	35.00%

Debt - Other Financing - Additional Information (Detail) - USD ($)	3 Months Ended
	Sep. 30, 2015	Jul. 27, 2015
Debt Instrument [Line Items]
Aggregate committed amount of credit facility	$ 1,950,000,000
Capella [Member]
Debt Instrument [Line Items]
Underwriting fees	$ 3,900,000
Bridge Loan [Member] \| Capella [Member]
Debt Instrument [Line Items]
Aggregate committed amount of credit facility		$ 1,000,000,000

Debt - Covenants - Additional Information (Detail)	12 Months Ended
Debt - Covenants - Additional Information (Detail)	Dec. 31, 2016
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 Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
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 loss before income taxes	$ 23,500,000	$ 29,400,000	$ 7,500,000
Amount of domestic income (loss) before income taxes	(1,400,000)	7,100,000	$ (20,900,000)
U.S federal NOLs	60,000,000
U.S. state NOLs	113,500,000
U.S. federal and state capital loss carryforwards	$ 8,100,000
U.S. federal and state NOLs, expiration period	Between 2021 and 2035
U.S. federal and state capital loss, expiration year	2022
U.S federal alternative minimum tax credits carry forward	$ 300,000
Foreign NOLs	$ 13,300,000
Cumulative pre-tax loss position period	3 years
Valuation allowance	$ 15,975,000	$ 23,005,000
Uncertain tax position liabilities and related interest or penalties	0
Valuation Allowance of Deferred Tax Assets [Member]
Income Taxes [Line Items]
Valuation allowance	4,000,000
Valuation Allowance of Deferred Tax Assets Foreign [Member]
Income Taxes [Line Items]
Valuation allowance	2,200,000
Valuation Allowance of Deferred Tax Assets Foreign [Member] \| Current Year Earnings [Member]
Income Taxes [Line Items]
Valuation allowance	$ 2,000,000

Income Taxes - Schedule of Income Tax (Benefit) Expense (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Current income tax expense:
Domestic	$ 42	$ 147	$ 114
Foreign	1,856	1,614	225
Total income tax expense	1,898	1,761	339
Deferred income tax (benefit) expense:
Domestic	147	(360)	(23)
Foreign	(8,875)	102	24
Total income tax expense	(8,728)	(258)	1
Income tax (benefit) expense	$ (6,830)	$ 1,503	$ 340

Income Taxes - Schedule of Deferred Tax Assets and liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Deferred tax liabilities:
Property and equipment	$ (3,781)	$ (1,636)
Unbilled rent	(7,045)	(4,495)
Partnership investments	(5,103)	(3,362)
Other	(6,757)	(6,141)
Total deferred tax liabilities	(22,686)	(15,634)
Deferred tax assets:
Operating loss and interest deduction carry forwards	28,289	19,016
Other	10,085	10,314
Total deferred tax assets	38,374	29,330
Valuation allowance	(15,975)	(23,005)
Total net deferred tax assets	22,399	6,325
Net deferred tax (liability)	$ (287)	$ (9,309)

Income Taxes - Summary of Reconciliation of the Income Tax (Benefit) Expense at the Statutory Income Tax Rate and the Effective Tax Rate for Income from Continuing Operations before Income Taxes (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Income Tax Disclosure [Abstract]
Income from continuing operations (before-tax)	$ 219,108	$ 141,430	$ 51,138
Income tax at the US statutory federal rate (35%)	76,688	49,501	17,898
Increase (decrease) resulting from:
Rate differential	1,434	5,047	1,145
State income taxes, net of federal benefit	66	(601)	(337)
Dividends paid deduction	(84,927)	(57,109)	(27,873)
Equity Investments	4,297
Change in valuation allowance	(6,104)	6,174	8,988
Other items, net	1,716	(1,509)	519
Income tax (benefit) expense	$ (6,830)	$ 1,503	$ 340

Income Taxes - Summary of Reconciliation of the Income Tax (Benefit) Expense at the Statutory Income Tax Rate and the Effective Tax Rate for Income from Continuing Operations before Income Taxes (Parenthetical) (Detail)	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Income Tax Disclosure [Abstract]
Income tax at the US statutory federal rate	35.00%	35.00%	35.00%

Income Taxes - Schedule of Per Share Distributions to Stockholders (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Income Tax Disclosure [Abstract]
Common share distribution	$ 0.900000	$ 0.870000	$ 0.840000
Ordinary income	0.619368	0.769535	0.520692
Capital gains	0.102552		0.000276
Unrecaptured Sec. 1250 gain	0.045432		0.000276
Return of capital	$ 0.178080	$ 0.100465	$ 0.319032

Earnings Per Share/Unit - Calculation of Earnings Per Share (Detail) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Income from continuing operations	$ 43,245	$ 70,543	$ 53,924	$ 58,226	$ 58,339	$ 23,123	$ 22,489	$ 35,976	$ 225,938	$ 139,927	$ 50,798
Non-controlling interests' share in continuing operations									(889)	(329)	(274)
Participating securities' share in earnings									(559)	(1,029)	(894)
Income from continuing operations, less participating securities' share in earnings									224,490	138,569	49,630
Income (loss) from discontinued operations attributable to MPT									(1)		(2)
Net income, less participating securities' share in earnings									$ 224,489	$ 138,569	$ 49,628
Basic weighted-average common shares	319,833	246,230	238,082	237,510	237,011	223,948	208,071	202,958	260,414	217,997	169,999
Dilutive potential common shares									658	307	541
Diluted weighted-average common shares	319,994	247,468	239,008	237,819	237,011	223,948	208,640	203,615	261,072	218,304	170,540
MPT Operating Partnership, L.P. [Member]
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Income from continuing operations	$ 43,245	$ 70,543	$ 53,924	$ 58,226	$ 58,339	$ 23,123	$ 22,489	$ 35,976	$ 225,938	$ 139,927	$ 50,798
Non-controlling interests' share in continuing operations									(889)	(329)	(274)
Participating securities' share in earnings									(559)	(1,029)	(894)
Income from continuing operations, less participating securities' share in earnings									224,490	138,569	49,630
Income (loss) from discontinued operations attributable to MPT									(1)		(2)
Net income, less participating securities' share in earnings									$ 224,489	$ 138,569	$ 49,628
Basic weighted-average common shares	319,833	246,230	238,082	237,510	237,011	223,948	208,071	202,958	260,414	217,997	169,999
Dilutive potential common shares									658	307	541
Diluted weighted-average common shares	319,994	247,468	239,008	237,819	237,011	223,948	208,640	203,615	261,072	218,304	170,540

Stock Awards - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 7.9	$ 11.1	$ 9.2
Stock-based compensation expense, unrecognized cost	$ 12.4
Stock-based compensation expense, unrecognized cost, reorganization period (in years)	2 years 9 months 11 days
Restricted equity awards, fair value	$ 12.7	$ 10.2	$ 10.2
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
Common stock remaining for future stock awards transferred to the equity incentive plan	5,265,916
Maximum number of shares of common stock that may be awarded	5,000,000
Service-Based Awards [Member] \| Minimum [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
Service-Based Awards [Member] \| Maximum [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
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
Percentage of performance award grant in period	50.00%
Stock-based awards expiration date	Dec. 31, 2018
Percentage of performance award to be earned of shareholder return reaches shareholder limit	100.00%
Common stock options awarded, dividend yield	7.00%
Share based payment award, weighted average risk-free rate of return	1.00%
Share based payment award, expected volatility rate	24.40%
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] \| Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned	27.00%
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%
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
Percentage of shareholder return to be earned	3.00%
Percentage of performance award to be earned of shareholder return reaches shareholder limit	100.00%
Common stock options awarded, dividend yield	7.00%
Share based payment award, weighted average risk-free rate of return	1.00%
Share based payment award, expected volatility rate	24.40%
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.
2016 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of performance awards forfeited	2,400
Number of performance awards earned and vested	0
Number of performance awards to be earned	797,404
40% Of 2015 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
Percentage of performance award grant in period		40.00%
Stock-based awards expiration date	Dec. 31, 2017
Common stock options awarded, dividend yield		7.20%
Share based payment award, weighted average risk-free rate of return		1.10%
Share based payment award, expected volatility rate		20.00%
Percentage of shareholder return annually		9.00%
Annual total shareholder return (in years)		3 years
30% of 2015 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
Percentage of performance award grant in period		30.00%
Stock-based awards expiration date	Dec. 31, 2017
Percentage of performance award to be earned of shareholder return reaches shareholder limit		100.00%
Common stock options awarded, dividend yield		7.20%
Share based payment award, weighted average risk-free rate of return		1.10%
Share based payment award, expected volatility rate		20.00%
30% of 2015 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 December 31, 2017, 2018, and 2019.
30% of 2015 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%
30% of 2015 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%
Remaining % of 2015 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, 2017
Percentage of shareholder return to be earned		6.00%
Percentage of performance award to be earned of shareholder return reaches shareholder limit		100.00%
Common stock options awarded, dividend yield		7.20%
Share based payment award, weighted average risk-free rate of return		1.10%
Share based payment award, expected volatility rate		20.00%
Remaining % of 2015 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 December 31, 2017, 2018, and 2019.
2015 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of performance awards forfeited	66,792	4,500
Number of performance awards earned and vested	98,526	0
Number of performance awards to be earned	702,070
40% of 2014 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
Percentage of performance award grant in period			40.00%
Stock-based awards expiration date	Dec. 31, 2018
Common stock options awarded, dividend yield			8.00%
Share based payment award, weighted average risk-free rate of return			1.70%
Share based payment award, expected volatility rate			27.00%
Percentage of shareholder return annually			9.00%
Annual total shareholder return (in years)			5 years
30% of 2014 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
Percentage of performance award grant in period			30.00%
Stock-based awards expiration date	Dec. 31, 2016
Percentage of performance award to be earned of shareholder return reaches shareholder limit			100.00%
Common stock options awarded, dividend yield			8.00%
Share based payment award, weighted average risk-free rate of return			0.80%
Share based payment award, expected volatility rate			27.00%
30% of 2014 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 December 31, 2016, 2017, and 2018.
30% of 2014 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%
30% of 2014 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%
Remaining % of 2014 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, 2016
Percentage of shareholder return to be earned			6.00%
Percentage of performance award to be earned of shareholder return reaches shareholder limit			100.00%
Common stock options awarded, dividend yield			8.00%
Share based payment award, weighted average risk-free rate of return			0.80%
Share based payment award, expected volatility rate			27.00%
Remaining % of 2014 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 December 31, 2016, 2017, and 2018.
2014 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of performance awards forfeited	500,000
Number of performance awards earned and vested	99,959	0	108,261
Number of performance awards to be earned	99,935
Number of additional performance awards forfeited	72,003

Stock Awards - Restricted Equity Awards Activity (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Vesting Based on Service [Member]
Employee Restricted Equity Awards Vesting Activity [Line Items]
Nonvested awards at beginning of the year, Shares	509,634	452,263
Awarded, Shares	254,574	407,969
Vested, Shares	(349,356)	(343,904)
Forfeited, Shares	(67,724)	(6,694)
Nonvested awards at end of year, Shares	347,128	509,634
Nonvested awards at beginning of the year, Weighted Average Value at Award Date	$ 13.25	$ 12.11
Awarded, Weighted Average Value at Award Date	13.07	13.94
Vested, Weighted Average Value at Award Date	13.07	12.56
Forfeited, Weighted Average Value at Award Date	13.06	13.08
Nonvested awards at end of year, Weighted Average Value at Award Date	$ 13.35	$ 13.25
Vesting Based on Market/Performance Conditions [Member]
Employee Restricted Equity Awards Vesting Activity [Line Items]
Nonvested awards at beginning of the year, Shares	2,331,152	2,428,518
Awarded, Shares	799,804	871,888
Vested, Shares	(671,983)	(406,970)
Forfeited, Shares	(647,298)	(562,284)
Nonvested awards at end of year, Shares	1,811,675	2,331,152
Nonvested awards at beginning of the year, Weighted Average Value at Award Date	$ 6.38	$ 5.81
Awarded, Weighted Average Value at Award Date	7.30	6.62
Vested, Weighted Average Value at Award Date	6.50	4.94
Forfeited, Weighted Average Value at Award Date	6.28	5.33
Nonvested awards at end of year, Weighted Average Value at Award Date	$ 6.78	$ 6.38

Commitments and Contingencies - Additional Information (Detail) € in Millions, $ in Millions						12 Months Ended
	Jan. 27, 2017 EUR (€) Facility	Dec. 31, 2016 EUR (€) Facility	Sep. 28, 2016 USD ($) Hospital	Sep. 09, 2016 EUR (€) Hospital	Jul. 20, 2016 EUR (€) Hospital	Dec. 31, 2016 USD ($)	Dec. 31, 2015 USD ($)	Dec. 31, 2014 USD ($)
Commitment And Contingencies [Line Items]
Term of lease period						30 years or more
Lease and Rental Expenses \| $						$ 6.8	$ 4.6	$ 2.3
Sublease rental income \| $						$ 4.2	$ 2.3	$ 0.3
Washington and Idaho [Member]
Commitment And Contingencies [Line Items]
Number of rehabilitation hospitals \| Hospital			2
Purchase price of acquisition \| $			$ 105.0
Germany [Member] \| Facility Closing One [Member]
Commitment And Contingencies [Line Items]
Number of rehabilitation hospitals \| Hospital					20
Purchase price of acquisition					€ 215.7
Number of facilities closed \| Facility		7
Consideration received on closing of facilities		€ 49.5
Term of lease, years					27 years
Germany [Member] \| Facility Closing Two [Member]
Commitment And Contingencies [Line Items]
Number of rehabilitation hospitals \| Hospital				6
Purchase price of acquisition				€ 44.1
Number of facilities closed \| Facility		5
Consideration received on closing of facilities		€ 35.7
Germany [Member] \| Facility Closing Two [Member] \| Subsequent Event [Member]
Commitment And Contingencies [Line Items]
Number of facilities closed \| Facility	1
Consideration received on closing of facilities	€ 8.4

Commitments and Contingencies - Fixed Minimum Rental Payments Due under Operating Leases with Non-Cancelable Terms (Detail) $ in Thousands	Dec. 31, 2016 USD ($)
Commitments and Contingencies Disclosure [Abstract]
2017	$ 7,328
2018	7,249
2019	6,925
2020	6,944
2021	6,024
Thereafter	251,981
Minimum rental payments, total	286,451
2017	(4,725)
2018	(4,731)
2019	(4,755)
2020	(4,860)
2021	(4,966)
Thereafter	(249,662)
Sub lease minimum rental payments receivable, total	(273,699)
2017	2,603
2018	2,518
2019	2,170
2020	2,084
2021	1,058
Thereafter	2,319
Minimum rental payments, total	$ 12,752

Common Stock/Partner's Capital - Additional Information (Detail) $ / shares in Units, $ in Thousands						12 Months Ended
	Oct. 07, 2016 USD ($) $ / shares shares	Sep. 30, 2016 USD ($) shares	Mar. 01, 2016 USD ($)	Aug. 11, 2015 USD ($) shares	Jan. 14, 2015 USD ($) shares	Dec. 31, 2016 USD ($) Partner Director Employee $ / shares shares	Dec. 31, 2015 USD ($) $ / shares shares	Dec. 31, 2014 USD ($) shares	Aug. 04, 2015 $ / shares shares	Jun. 30, 2015 $ / shares shares
Class of Stock [Line Items]
Proceeds from sale of common shares / units, net of offering costs \| $						$ 1,173,651	$ 817,389	$ 138,173
Common stock, shares issued \| shares						320,514,000	236,744,000
Common stock, shares authorized \| shares						500,000,000	500,000,000		500,000,000	250,000,000
Common stock, par value \| $ / shares						$ 0.001	$ 0.001		$ 0.001	$ 0.001
Common Units [Member]
Class of Stock [Line Items]
Number of share sold \| shares						82,749,000	63,250,000	10,656,000
Common Units [Member] \| Private Placement [Member] \| Cerberus Capital Management [Member]
Class of Stock [Line Items]
Number of share sold \| shares	10,300,000
Sale of Stock, price per share \| $ / shares	$ 14.50
Proceeds from sale of common shares / units, net of offering costs \| $	$ 150,000
MPT Operating Partnership, L.P. [Member]
Class of Stock [Line Items]
Proceeds from sale of common shares / units, net of offering costs \| $						$ 1,173,651	$ 817,389	$ 138,173
Ownership interest in equity						99.90%
Percentage of ownership of general partner						100.00%
Number of other partners \| Partner						3
Employee [Member]
Class of Stock [Line Items]
Number of partners shared remaining ownership percentage \| Employee						2
Director [Member]
Class of Stock [Line Items]
Number of partners shared remaining ownership percentage \| Director						1
Market Equity Offering Program [Member]
Class of Stock [Line Items]
Proceeds from sale of common shares / units, net of offering costs \| $						$ 224,000
Common stock, shares issued \| shares						15,000,000
Sales commission percentage			1.25%
Sales commissions, amount \| $						$ 2,800
Market Equity Offering Program [Member] \| Maximum [Member]
Class of Stock [Line Items]
Value of stock \| $			$ 227,000
Public Offering [Member]
Class of Stock [Line Items]
Proceeds from sale of common shares / units, net of offering costs \| $		$ 799,500		$ 337,000	$ 480,000
Common stock, shares issued \| shares		57,500,000		28,750,000	34,500,000
Additional shares purchased by underwriters \| shares		7,500,000		3,800,000	4,500,000

Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Fair Value Disclosures [Abstract]
Interest and rent receivables, Book value	$ 57,698	$ 46,939
Loans, Book value	986,987	508,851
Debt, net Book value	(2,909,341)	(3,322,541)
Interest and rent receivables, Fair value	57,707	46,858
Loans, Fair value	1,017,428	543,859
Debt, net Fair value	$ (2,966,759)	$ (3,372,773)

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, 2016	Dec. 31, 2015
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	$ 232,434	$ 920,901
Cost	232,434	920,901
Fair Value Measurements, Recurring [Member] \| Equity investments [Member] \| Other Assets [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	3,300	7,349
Cost	3,300	7,349
Fair Value Measurements, Recurring [Member] \| Acquisition and Other Loans [Member] \| Other Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	116,298	603,552
Cost	116,298	603,552
Fair Value Measurements, Recurring [Member] \| Mortgage Loans [Member] \| Mortgage Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	112,836	310,000
Cost	$ 112,836	$ 310,000

Fair Value of Financial Instruments - Additional information (Detail)	12 Months Ended
	Dec. 31, 2016
Fair Value Disclosures [Abstract]
Adjustment for DLOM on our equity investment	40.00%

Fair Value of Financial Instruments - Summary Showing Sensitivity Analysis by Using Basis Point Variations (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2016 USD ($)
+100 basis points [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated Increase (Decrease) In Fair Value of Financial Instruments	$ (49)
- 100 basis points [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated Increase (Decrease) In Fair Value of Financial Instruments	$ 49

Other Assets - Summary of Other Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Other Assets [Abstract]
Debt issue costs, net	$ 4,478	$ 7,628
Equity investments	177,430	129,337
Other corporate assets	77,580	31,547
Prepaids and other assets	44,285	27,028
Total other assets	$ 303,773	$ 195,540

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, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Quarterly Financial Information [Line Items]
Revenues	$ 153,283	$ 126,555	$ 126,300	$ 134,999	$ 131,546	$ 114,570	$ 99,801	$ 95,961	$ 541,137	$ 441,878	$ 312,532
Income from continuing operations	43,245	70,543	53,924	58,226	58,339	23,123	22,489	35,976	225,938	139,927	50,798
Net income	43,245	70,543	53,924	58,225	58,339	23,123	22,489	35,976	225,937	139,927	50,796
Net income attributable to MPT common stockholders	$ 43,039	$ 70,358	$ 53,724	$ 57,927	$ 58,237	$ 23,057	$ 22,407	$ 35,897	$ 225,048	$ 139,598	$ 50,522
Net income attributable to MPT common stockholders per share - basic	$ 0.13	$ 0.29	$ 0.23	$ 0.24	$ 0.24	$ 0.10	$ 0.11	$ 0.18	$ 0.86	$ 0.64	$ 0.29
Weighted average shares outstanding - basic	319,833	246,230	238,082	237,510	237,011	223,948	208,071	202,958	260,414	217,997	169,999
Net income attributable to MPT common stockholders per share - diluted	$ 0.13	$ 0.28	$ 0.22	$ 0.24	$ 0.24	$ 0.10	$ 0.11	$ 0.17	$ 0.86	$ 0.63	$ 0.29
Weighted average shares outstanding - diluted	319,994	247,468	239,008	237,819	237,011	223,948	208,640	203,615	261,072	218,304	170,540
MPT Operating Partnership, L.P. [Member]
Quarterly Financial Information [Line Items]
Revenues	$ 153,283	$ 126,555	$ 126,300	$ 134,999	$ 131,546	$ 114,570	$ 99,801	$ 95,961	$ 541,137	$ 441,878	$ 312,532
Income from continuing operations	43,245	70,543	53,924	58,226	58,339	23,123	22,489	35,976	225,938	139,927	50,798
Net income	43,245	70,543	53,924	58,225	58,339	23,123	22,489	35,976	225,937	139,927	50,796
Net income attributable to MPT common stockholders	$ 43,039	$ 70,358	$ 53,724	$ 57,927	$ 58,237	$ 23,057	$ 22,407	$ 35,897	$ 225,048	$ 139,598	$ 50,522
Net income attributable to MPT common stockholders per share - basic	$ 0.13	$ 0.29	$ 0.23	$ 0.24	$ 0.24	$ 0.10	$ 0.11	$ 0.18	$ 0.86	$ 0.64	$ 0.29
Weighted average shares outstanding - basic	319,833	246,230	238,082	237,510	237,011	223,948	208,071	202,958	260,414	217,997	169,999
Net income attributable to MPT common stockholders per share - diluted	$ 0.13	$ 0.28	$ 0.22	$ 0.24	$ 0.24	$ 0.10	$ 0.11	$ 0.17	$ 0.86	$ 0.63	$ 0.29
Weighted average shares outstanding - diluted	319,994	247,468	239,008	237,819	237,011	223,948	208,640	203,615	261,072	218,304	170,540

Subsequent Events - Additional Information (Detail) € in Millions				3 Months Ended	12 Months Ended
	Feb. 02, 2017 EUR (€)	Feb. 01, 2017 USD ($)	Oct. 10, 2013 EUR (€)	Mar. 31, 2017 USD ($)	Dec. 31, 2016	Feb. 01, 2017 EUR (€)	Dec. 31, 2015	Sep. 30, 2015 USD ($)
Subsequent Event [Line Items]
Aggregate committed amount of credit facility								$ 1,950,000,000
Subsequent Event [Member]
Subsequent Event [Line Items]
Total Facility amount at a rate		0.25%
Aggregate committed amount of credit facility		$ 500,000,000
Minimum [Member] \| Subsequent Event [Member]
Subsequent Event [Line Items]
Facility fee		0.125%
Maximum [Member] \| Subsequent Event [Member]
Subsequent Event [Line Items]
Facility fee		0.30%
Unsecured Revolving Credit Facility [Member] \| Subsequent Event [Member]
Subsequent Event [Line Items]
Amount of senior unsecured debt		$ 1,300,000,000
Debt instrument, maturity date		Feb. 28, 2021
Term Loans [Member] \| Subsequent Event [Member]
Subsequent Event [Line Items]
Amount of senior unsecured debt		$ 200,000,000				€ 200
Debt instrument, maturity date		Feb. 01, 2022
Alternate Base Rate [Member] \| Minimum [Member] \| Subsequent Event [Member]
Subsequent Event [Line Items]
Applicable margin		0.00%
Applicable margin for revolving loans		0.00%
Alternate Base Rate [Member] \| Maximum [Member] \| Subsequent Event [Member]
Subsequent Event [Line Items]
Applicable margin		0.95%
Applicable margin for revolving loans		0.65%
Eurodollar Loans [Member] \| Minimum [Member] \| Subsequent Event [Member]
Subsequent Event [Line Items]
Applicable margin		0.90%
Applicable margin for revolving loans		0.875%
Eurodollar Loans [Member] \| Maximum [Member] \| Subsequent Event [Member]
Subsequent Event [Line Items]
Applicable margin		1.95%
Applicable margin for revolving loans		1.65%
Euro [Member] \| Term Loans [Member] \| Subsequent Event [Member]
Subsequent Event [Line Items]
Debt instrument, maturity date		Jan. 31, 2020
5.750% Senior Unsecured Notes Due 2020 [Member]
Subsequent Event [Line Items]
Amount of senior unsecured debt \| €			€ 200
Debt instrument, maturity date			Oct. 01, 2020
Senior unsecured notes, interest rate			5.75%		5.75%		5.75%
Senior unsecured notes, redemption description					We may redeem some or all of the notes at any time at a "make-whole" redemption price 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.
5.750% Senior Unsecured Notes Due 2020 [Member] \| Subsequent Event [Member]
Subsequent Event [Line Items]
Amount of senior unsecured debt \| €	€ 200
Senior unsecured notes, interest rate	5.75%
Senior notes, redemption date	Mar. 04, 2017
Senior unsecured notes, redemption description	We delivered an irrevocable notice of full redemption to the holders of the â,¬200 million aggregate principal amount of our 5.750% Senior Notes due 2020 and set a redemption date of March 4, 2017. To fund such redemption, including any premium and accrued interest, we plan to use the proceeds of the new euro term loan together with cash on hand.
5.750% Senior Unsecured Notes Due 2020 [Member] \| Scenario, Forecast [Member]
Subsequent Event [Line Items]
Debt refinancing charge				$ 13,000,000
Redemption premium				$ 9,000,000

Schedule II - Schedule of Valuation and Qualifying Accounts (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Valuation and Qualifying Accounts [Abstract]
Balance at Beginning of Year	$ 27,384	$ 20,129	$ 41,573
Additions charged against operations	2,722	8,205	65,512
Deductions,Net recoveries/write offs	(11,254)	(950)	(86,956)
Balance at end of year	$ 18,852	$ 27,384	$ 20,129

Schedule II - Schedule of Valuation and Qualifying Accounts (Parenthetical) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2014	Dec. 31, 2015
Impairment charges	$ 7,229	$ 50,128
Increase (decrease) in valuation allowance	(6,900)
Net deferred tax assets reserve			$ 6,200
Twelve Oaks Facility [Member]
Rent reserves	1,900
Write offs related to payment of rent, late fees, and loans	3,300
Rent and late fee reserves			1,500
Corinth Facility [Member]
Rent reserves	800
Write offs for rent and interest reserves	800
M/C Healthcare Loan [Member]
Write offs related to loan	$ 100
Healthtrax Properties [Member]
Rent reserves			$ 500
Monroe Properties [Member]
Impairment charges		47,000
Write offs for rent and interest reserves		9,500
Increase (decrease) in valuation allowance		$ 9,000

Schedule III - Real Estate Investments and Accumulated Depreciation (Parenthetical) (Detail) $ in Thousands	Dec. 31, 2016 USD ($)
SEC Schedule III, Real Estate and Accumulated Depreciation Disclosure [Abstract]
Aggregate cost for federal income tax purposes	$ 4,471,179

Schedule III - Changes in Total Real Estate Assets (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
SEC Schedule III, Real Estate and Accumulated Depreciation Disclosure [Abstract]
Balance at beginning of period	$ 2,991,590	$ 2,040,727	$ 1,733,194
Acquisitions	745,948	975,239	263,811
Transfers from construction in progress	163,080	23,163	41,772
Additions	33,279	7,376	84,831
Dispositions	(138,886)	(24,701)	(56,590)
Other	173,031	(30,214)	(26,291)
Balance at end of period	$ 3,968,042	$ 2,991,590	$ 2,040,727

Schedule III - Changes in Accumulated Depreciation (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
SEC Schedule III, Real Estate and Accumulated Depreciation Disclosure [Abstract]
Balance at beginning of period	$ 232,675	$ 181,441	$ 144,235
Depreciation	81,010	60,796	46,935
Depreciation on disposed property	(19,086)	(8,887)	(9,213)
Other	(1,813)	(675)	(516)
Balance at end of period	$ 292,786	$ 232,675	$ 181,441

Schedule IV - Schedule of Mortgage Loans on Real Estate (Detail)	12 Months Ended
	Dec. 31, 2016 USD ($)
Mortgage Loans on Real Estate [Line Items]
Prior Liens	$ 0
Face Amount of Mortgages	1,060,336,000
Carrying Amount of Mortgages	1,060,336,000
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	2022
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	11.60%
Final Maturity Date	2022
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	2022
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	2022
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	10.60%
Final Maturity Date	2022
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	9.60%
Final Maturity Date	2032
Face Amount of Mortgages	$ 112,836,000
Carrying Amount of Mortgages	112,836,000
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	11.00%
Final Maturity Date	2022
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	11.20%
Final Maturity Date	2024
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] \| St. Joseph Medical Center [Member]
Mortgage Loans on Real Estate [Line Items]
Interest rate	8.50%
Final Maturity Date	2025
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	8.50%
Final Maturity Date	2025
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	8.50%
Final Maturity Date	2020
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	2031
Face Amount of Mortgages	$ 600,000,000
Carrying Amount of Mortgages	600,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0

Schedule IV - Schedule of Mortgage Loans on Real Estate (Parenthetical) (Detail)	Dec. 31, 2016 USD ($) Property
Mortgage Loans on Real Estate [Line Items]
Prior Liens	$ 0
Carrying amount of mortgages, federal income tax purposes	1,060,000
Unamortized loan issue costs	$ 100,000
Ernest Mortgage Loan [Member] \| Long-Term First Mortgage Loan [Member]
Mortgage Loans on Real Estate [Line Items]
Number of properties \| Property	4
Capella Mortgage Loan [Member] \| Long-Term First Mortgage Loan [Member]
Mortgage Loans on Real Estate [Line Items]
Number of properties \| Property	4

Schedule IV - Changes in Mortgage Loans Excluding Unamortized Loan Issue Costs (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Mortgage Loans on Real Estate [Abstract]
Balance at beginning of year	$ 757,500	$ 397,500	$ 388,650
New mortgage loans and additional advances on existing loans	612,836	380,000	12,500
Mortgage loans on real estate including additions during year	1,370,336	777,500	401,150
Collection of principal	(310,000)	(20,000)	(3,650)
Deductions during year	(310,000)	(20,000)	(3,650)
Balance at end of year	$ 1,060,336	$ 757,500	$ 397,500