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Document and Entity Information - shares	3 Months Ended
Document and Entity Information - shares	Mar. 31, 2017	May 05, 2017
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2017
Document Fiscal Year Focus	2017
Document Fiscal Period Focus	Q1
Trading Symbol	MPW
Entity Registrant Name	MEDICAL PROPERTIES TRUST INC
Entity Central Index Key	0001287865
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		363,994,452
MPT Operating Partnership, L.P. [Member]
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2017
Document Fiscal Year Focus	2017
Document Fiscal Period Focus	Q1
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

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Real estate assets
Land, buildings and improvements, intangible lease assets, and other	$ 4,310,407	$ 4,317,866
Mortgage loans	1,060,397	1,060,400
Net investment in direct financing leases	650,388	648,102
Gross investment in real estate assets	6,021,192	6,026,368
Accumulated depreciation and amortization	(351,462)	(325,125)
Net investment in real estate assets	5,669,730	5,701,243
Cash and cash equivalents	446,948	83,240
Interest and rent receivables	61,912	57,698
Straight-line rent receivables	129,879	116,861
Other loans	154,032	155,721
Other assets	318,229	303,773
Total Assets	6,780,730	6,418,536
Liabilities
Debt, net	3,277,986	2,909,341
Accounts payable and accrued expenses	194,311	207,711
Deferred revenue	19,411	19,933
Lease deposits and other obligations to tenants	32,451	28,323
Total liabilities	3,524,159	3,165,308
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 - 320,801 shares at March 31, 2017 and 320,514 shares at December 31, 2016	321	321
Limited Partners:
Additional paid in capital	3,777,163	3,775,336
Distributions in excess of net income	(443,315)	(434,114)
Accumulated other comprehensive loss	(86,611)	(92,903)
Treasury shares, at cost	(777)	(262)
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital)	3,246,781	3,248,378
Non-controlling interests	9,790	4,850
Total Equity / Capital	3,256,571	3,253,228
Total Liabilities and Equity / Capital	6,780,730	6,418,536
MPT Operating Partnership, L.P. [Member]
Real estate assets
Land, buildings and improvements, intangible lease assets, and other	4,310,407	4,317,866
Mortgage loans	1,060,397	1,060,400
Net investment in direct financing leases	650,388	648,102
Gross investment in real estate assets	6,021,192	6,026,368
Accumulated depreciation and amortization	(351,462)	(325,125)
Net investment in real estate assets	5,669,730	5,701,243
Cash and cash equivalents	446,948	83,240
Interest and rent receivables	61,912	57,698
Straight-line rent receivables	129,879	116,861
Other loans	154,032	155,721
Other assets	318,229	303,773
Total Assets	6,780,730	6,418,536
Liabilities
Debt, net	3,277,986	2,909,341
Accounts payable and accrued expenses	116,819	132,868
Deferred revenue	19,411	19,933
Lease deposits and other obligations to tenants	32,451	28,323
Payable due to Medical Properties Trust, Inc.	77,102	74,453
Total liabilities	3,523,769	3,164,918
Limited Partners:
Accumulated other comprehensive loss	(86,611)	(92,903)
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital)	3,247,171	3,248,768
Non-controlling interests	9,790	4,850
Total Equity / Capital	3,256,961	3,253,618
Total Liabilities and Equity / Capital	6,780,730	6,418,536
MPT Operating Partnership, L.P. [Member] \| General Partner [Member]
Equity / Capital
General Partner - issued and outstanding - 3,207 units at March 31, 2017 and 3,204 units at December 31, 2016	33,357	33,436
MPT Operating Partnership, L.P. [Member] \| Common Units [Member]
Limited Partners:
Limited Partners Capital	$ 3,300,425	$ 3,308,235

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Mar. 31, 2017	Dec. 31, 2016
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	320,801,000	320,514,000
Common stock, shares outstanding	320,801,000	320,514,000
MPT Operating Partnership, L.P. [Member] \| Common Units [Member]
Limited Partners, units issued	317,594,000	317,310,000
Limited Partners, units outstanding	317,594,000	317,310,000
General Partner [Member] \| MPT Operating Partnership, L.P. [Member]
General partner, units issued	3,207,000	3,204,000
General partner, units outstanding	3,207,000	3,204,000
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

Condensed Consolidated Statements of Net Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Revenues
Rent billed	$ 96,763	$ 74,061
Straight-line rent	12,779	8,217
Income from direct financing leases	17,880	18,951
Interest and fee income	28,975	33,770
Total revenues	156,397	134,999
Expenses
Real estate depreciation and amortization	27,586	21,142
Property-related	1,328	901
General and administrative	13,197	11,471
Acquisition expenses	2,756	(1,065)
Total operating expenses	44,867	32,449
Operating income	111,530	102,550
Other income (expense)
Other income (expense)	53	329
Gain on sale of real estate and other asset dispositions, net	7,413	40
Earnings (loss) from equity and other interests	1,714	(5,001)
Unutilized financing fees/debt refinancing costs	(13,629)	(4)
Interest expense	(38,029)	(39,369)
Income tax expense	(867)	(319)
Net other expense	(43,345)	(44,324)
Income from continuing operations	68,185	58,226
Loss from discontinued operations		(1)
Net income	68,185	58,225
Net income attributable to non-controlling interests	(215)	(298)
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 67,970	$ 57,927
Earnings per common share - basic and diluted
Income from continuing operations attributable to MPT common stockholders (Operating Partnership partners)	$ 0.21	$ 0.24
Loss from discontinued operations attributable to MPT common stockholders (Operating Partnership partners)	0	0
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.21	$ 0.24
Weighted average shares outstanding - basic	321,057	237,510
Weighted average shares outstanding - diluted	321,423	237,819
Dividends declared per common share	$ 0.24	$ 0.22
MPT Operating Partnership, L.P. [Member]
Revenues
Rent billed	$ 96,763	$ 74,061
Straight-line rent	12,779	8,217
Income from direct financing leases	17,880	18,951
Interest and fee income	28,975	33,770
Total revenues	156,397	134,999
Expenses
Real estate depreciation and amortization	27,586	21,142
Property-related	1,328	901
General and administrative	13,197	11,471
Acquisition expenses	2,756	(1,065)
Total operating expenses	44,867	32,449
Operating income	111,530	102,550
Other income (expense)
Other income (expense)	53	329
Gain on sale of real estate and other asset dispositions, net	7,413	40
Earnings (loss) from equity and other interests	1,714	(5,001)
Unutilized financing fees/debt refinancing costs	(13,629)	(4)
Interest expense	(38,029)	(39,369)
Income tax expense	(867)	(319)
Net other expense	(43,345)	(44,324)
Income from continuing operations	68,185	58,226
Loss from discontinued operations		(1)
Net income	68,185	58,225
Net income attributable to non-controlling interests	(215)	(298)
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 67,970	$ 57,927
Earnings per common share - basic and diluted
Income from continuing operations attributable to MPT common stockholders (Operating Partnership partners)	$ 0.21	$ 0.24
Loss from discontinued operations attributable to MPT common stockholders (Operating Partnership partners)	0	0
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.21	$ 0.24
Weighted average shares outstanding - basic	321,057	237,510
Weighted average shares outstanding - diluted	321,423	237,819
Dividends declared per common share	$ 0.24	$ 0.22

Condensed Consolidated Statements of Comprehensive Income (Loss) (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Net income	$ 68,185	$ 58,225
Other comprehensive income:
Unrealized gain on interest rate swap		815
Foreign currency translation gain	6,292	20,587
Total comprehensive income	74,477	79,627
Comprehensive income attributable to non-controlling interests	(215)	(298)
Comprehensive income attributable to MPT common stockholders (Operating Partnership partners)	74,262	79,329
MPT Operating Partnership, L.P. [Member]
Net income	68,185	58,225
Other comprehensive income:
Unrealized gain on interest rate swap		815
Foreign currency translation gain	6,292	20,587
Total comprehensive income	74,477	79,627
Comprehensive income attributable to non-controlling interests	(215)	(298)
Comprehensive income attributable to MPT common stockholders (Operating Partnership partners)	$ 74,262	$ 79,329

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Operating activities
Net income	$ 68,185	$ 58,225
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	28,954	21,694
Direct financing lease interest accretion	(2,286)	(2,612)
Straight-line rent revenue	(13,896)	(8,217)
Share / (Unit)-based compensation expense	1,971	2,020
Amortization of deferred financing costs and debt discount	1,617	1,835
Gain from sale of real estate and other asset dispositions, net	(7,413)	(40)
Straight-line rent and other write-off	1,117
Unutilized financing fees/ debt refinancing costs	13,629	4
Other adjustments	(2,971)	(3,142)
Changes in:
Interest and rent receivables	(4,208)	(3,453)
Accounts payable and accrued liabilities\expenses	(20,428)	3,022
Net cash provided by operating activities	64,271	69,336
Investing activities
Cash paid for acquisitions and other related investments	(9,004)
Net proceeds from sale of real estate	64,335
Principal received on loans receivable	3,233	1,954
Investment in loans receivable	(1,410)
Construction in progress and other	(30,593)	(55,301)
Net cash provided by (used for) investing activities	26,561	(53,347)
Financing activities
Revolving credit facilities, net	90,000	(455,000)
Proceeds from term debt	955,280	500,000
Payments of term debt	(675,201)	(74)
Distributions paid	(74,521)	(52,402)
Lease deposits and other obligations to tenants	3,307	3,371
Debt issuance costs paid and other financing activities	(15,882)	(8,173)
Net cash provided by (used for) financing activities	282,983	(12,278)
Increase in cash and cash equivalents for period	373,815	3,711
Effect of exchange rate changes	(10,107)	7,158
Cash and cash equivalents at beginning of period	83,240	195,541
Cash and cash equivalents at end of period	446,948	206,410
Interest paid	51,601	26,470
Supplemental schedule of non-cash financing activities:
Distributions declared, unpaid	77,172	52,386
MPT Operating Partnership, L.P. [Member]
Operating activities
Net income	68,185	58,225
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	28,954	21,694
Direct financing lease interest accretion	(2,286)	(2,612)
Straight-line rent revenue	(13,896)	(8,217)
Share / (Unit)-based compensation expense	1,971	2,020
Amortization of deferred financing costs and debt discount	1,617	1,835
Gain from sale of real estate and other asset dispositions, net	(7,413)	(40)
Straight-line rent and other write-off	1,117
Unutilized financing fees/ debt refinancing costs	13,629	4
Other adjustments	(2,971)	(3,142)
Changes in:
Interest and rent receivables	(4,208)	(3,453)
Accounts payable and accrued liabilities\expenses	(20,428)	3,022
Net cash provided by operating activities	64,271	69,336
Investing activities
Cash paid for acquisitions and other related investments	(9,004)
Net proceeds from sale of real estate	64,335
Principal received on loans receivable	3,233	1,954
Investment in loans receivable	(1,410)
Construction in progress and other	(30,593)	(55,301)
Net cash provided by (used for) investing activities	26,561	(53,347)
Financing activities
Revolving credit facilities, net	90,000	(455,000)
Proceeds from term debt	955,280	500,000
Payments of term debt	(675,201)	(74)
Distributions paid	(74,521)	(52,402)
Lease deposits and other obligations to tenants	3,307	3,371
Debt issuance costs paid and other financing activities	(15,882)	(8,173)
Net cash provided by (used for) financing activities	282,983	(12,278)
Increase in cash and cash equivalents for period	373,815	3,711
Effect of exchange rate changes	(10,107)	7,158
Cash and cash equivalents at beginning of period	83,240	195,541
Cash and cash equivalents at end of period	446,948	206,410
Interest paid	51,601	26,470
Supplemental schedule of non-cash financing activities:
Distributions declared, unpaid	$ 77,172	$ 52,386

Organization	3 Months Ended
Organization	Mar. 31, 2017
Accounting Policies [Abstract]
Organization	1. Organization Medical Properties Trust, Inc., a Maryland corporation, was formed on August 27, 2003, under the Maryland General Corporation Law for the purpose of engaging in the business of investing in, owning, and leasing commercial real estate. Our operating partnership subsidiary, MPT Operating Partnership, L.P., (the “Operating Partnership”) through which we conduct all of our operations, was formed in September 2003. Through another wholly-owned subsidiary, Medical Properties Trust, LLC, we are the sole general partner of the Operating Partnership. At present, we directly own substantially all of the limited partnership interests in the Operating Partnership and have elected to report our required disclosures and that of the Operating Partnership on a combined basis except where material differences exist. We have operated as a real estate investment trust (“REIT”) since April 6, 2004 and 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 federal income tax in the United States (“U.S.”), provided that we continue to qualify as a REIT and our distributions to our stockholders equal or exceed our taxable income. Certain activities we undertake must be conducted by entities which we elected to be treated as taxable REIT subsidiaries (“TRS”). Our TRS entities are subject to both U.S. federal and state income taxes. For our properties located outside the U.S., we are subject to local taxes; however, we do not expect to incur additional taxes in the U.S. as such income will flow through our REIT. 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. Our properties are located in the U.S. and Europe.

Summary of Significant Accounting Policies

3 Months Ended

Mar. 31, 2017

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

2. Summary of Significant Accounting Policies

Unaudited Interim Condensed Consolidated Financial Statements: The accompanying unaudited interim condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the U.S. for interim financial information, including rules and regulations of the Securities and Exchange Commission (“SEC”). Accordingly, they do not include all of the information and footnotes required by generally accepted accounting principles (“GAAP”) for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair presentation have been included. Operating results for the three month period ended March 31, 2017, are not necessarily indicative of the results that may be expected for the year ending December 31, 2017. The condensed consolidated balance sheet at December 31, 2016 has been derived from the audited financial statements at that date but does not include all of the information and footnotes required by accounting principles generally accepted in the U.S. for complete financial statements.

For information about significant accounting policies, refer to the consolidated financial statements and footnotes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2016. During the three months ended March 31, 2017, there were no material changes to these policies.

Recent Accounting Developments:

Clarifying the Definition of a Business

In January 2017, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“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 rather than as a business combination. 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. A reporting entity must apply the amendments in ASU 2017-01 using a prospective approach. We expect to adopt ASU 2017-01on January 1, 2018 for our 2018 fiscal year. Upon adoption, 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 third party transaction costs that are directly related to an acquisition. Indirect and internal transaction costs will continue to be expensed but we do not expect to include these costs as an adjustment in deriving normalized funds from operations in the future. We expect this change in accounting, once adopted, may decrease our normalized funds from operations by $1.5 million per quarter.

Reclassifications and Revisions

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

Variable Interest Entities

At March 31, 2017, we had loans to and/or equity investments in certain variable interest entities (“VIEs”), which are also tenants of our facilities. We have determined that we are not the primary beneficiary of these VIEs. The carrying value and classification of the related assets and maximum exposure to loss as a result of our involvement with these VIEs are presented below at March 31, 2017 (in thousands):


VIE Type	Maximum Loss Exposure(1)		Asset Type Classification	Carrying Amount(2)
Loans, net	$	320,668	Mortgage and other loans	$	234,821
Equity investments	$	13,114	Other assets	$	—

(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 represents 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 March 31, 2017, 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 Note 5 for additional description of the nature, purpose and activities of our more significant VIEs and interests therein (such as Ernest Health Inc. (“Ernest”)).

Real Estate and Lending Activities

3 Months Ended

Mar. 31, 2017

Text Block [Abstract]

Real Estate and Lending Activities

3. Real Estate and Lending Activities

Acquisitions

We acquired the following assets (in thousands):


	Three Months Ended March 31,
	2017		2016
Assets Acquired
Land	$	1,081	$	—
Building		7,050		—
Intangible		873		—

Total assets acquired	$	9,004	$	—

The purchase price allocations attributable to this first quarter 2017 acquisition are preliminary. When all relevant information is obtained, resulting changes, if any, to our provisional purchase price allocation will be retrospectively 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.

On January 30, 2017, we acquired an inpatient rehabilitation hospital in Germany for €8.4 million. This acquisition was the final property to close as part of the six hospital portfolio that we agreed to buy in September 2016 for an aggregate amount of €44.1 million. This property is leased to affiliates of Median Kliniken S.à r.l. (“MEDIAN”) pursuant to the existing long-term master lease agreement reached with MEDIAN in 2015.

Development Activities

During the 2017 first quarter, we completed construction on the following facilities:

•

Adeptus Health, Inc. (“Adeptus Health”) – We completed two acute care facilities for this tenant and began recording rental income in the quarter. These facilities are leased pursuant to an existing long-term master lease.

•

IMED Group (“IMED”) – Our general acute facility located in Valencia, Spain opened on March 31, 2017, and is being leased to IMED pursuant to a long-term master lease. Our ownership in this facility is effected through a joint venture between us and clients of AXA Real Estate, in which we own a 50% interest. Our share of the aggregate purchase and development cost of this facility is approximately €21 million.

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


Operator	Commitment		Costs Incurred as of March 31, 2017		Estimated Completion Date
Adeptus Health	$	12,220	$	7,939		2Q 2017
Ernest		28,067		5,231		4Q 2017
Adeptus Health		7,804		1,771		1Q 2018

	$	48,091	$	14,941

Disposals

On March 31, 2017, we sold the EASTAR Health System real estate located in Muskogee, Oklahoma, which was leased to RCCH Healthcare Partners (“RCCH”). Total proceeds from this transaction were approximately $64 million resulting in a gain of $7.4 million, partially offset by a $0.6 million non-cash charge to revenue to write-off related straight-line rent receivables on this property.

Leasing Operations

All of our leases are accounted for as operating leases, except we are accounting for 15 Ernest facilities and 10 Prime Healthcare Services, Inc. (“Prime”) facilities as direct financing leases (“DFLs”). The components of our net investment in DFLs consisted of the following (in thousands):


	As of March 31, 2017			As of December 31, 2016
Minimum lease payments receivable	$	2,192,020		$	2,207,625
Estimated residual values		407,647			407,647
Less: Unearned income		(1,949,279	)		(1,967,170	)

Net investment in direct financing leases	$	650,388		$	648,102

Adeptus Health

On March 2, 2017, Adeptus Health, currently our sixth largest tenant, advised in a filing with the SEC that it would be delayed in the filing of its Annual Report on Form 10-K for the fiscal year ended December 31, 2016. In the filing, Adeptus Health further advised that it had identified material weaknesses with respect to internal control over financial reporting in certain areas and disclosed that there is substantial doubt about its ability to continue as a going concern absent its securing committed long-term financing. On April 4, 2017, we announced an agreement in principle with Deerfield Management Company, L.P. (“Deerfield”) to the restructuring in bankruptcy of Adeptus Health, including the assumption of our master leases of facilities in Texas, Colorado, Arizona and Ohio. Adeptus Health and certain of its subsidiaries filed voluntary petitions for relief under Chapter 11 of the U.S. Bankruptcy Code on April 19, 2017. Deerfield has purchased Adeptus Health’s outstanding bank debt and expects to provide additional financing, along with operational and managerial support, to Adeptus Health during the bankruptcy process. Our agreement with Deerfield provides for the pre-bankruptcy payment of all rent, the assumption of all of our master leases subject to their existing terms, pre-bankruptcy severance from our master leases of three New Orleans area facilities representing about 5% of our Adeptus Health investment and re-leasing them to Ochsner Clinic Foundation (“Ochsner”), and the post-bankruptcy severance from our master leases of 13 facilities in Texas representing about 15% of our Adeptus Health investment. We also agreed to a $3.1 million concession that will reduce our rental revenue by approximately $220 thousand annually over the remaining 14 year initial lease term.

We expect to sell or re-lease to other operators the 13 Texas facilities during transition periods ending in the fourth quarter of 2018. During the transition periods, Adeptus Health is obligated to pay contractual rent until the earlier of (a) transition to a new operator is complete or (b) an agreed future date. The agreed future date for approximately 60 percent of the facilities is one year following bankruptcy exit and the remainder have agreed future dates of 90 days post-bankruptcy exit.

As noted above, our New Orleans free standing emergency facilities (with a total budgeted investment of up to approximately $24.5 million) have been re-leased to Ochsner as of March 31, 2017. The Ochsner leases provide for 15-year initial terms with a 9.2% average minimum lease rate based on our total development and construction cost. Under these leases, Ochsner has the right to purchase the freestanding emergency facilities (i) at our cost within two years of rent commencement or (ii) for the greater of fair market value or our cost after such two-year period. With this transaction, we incurred a non-cash charge of $0.5 million to write-off the straight-line rent receivables associated with the previous Adeptus Health lease on these properties.

Adeptus Health is current on its rent obligations to us through May 2017. In addition, we currently hold letters of credit approximating $12.4 million to cover defaults in rent payments. These letters of credit would cover approximately four months of rent. At March 31, 2017, our investment in Adeptus Health facilities represents less than 6% of our total gross assets. We believe this investment is fully recoverable at March 31, 2017; however, no assurances can be made that we will not have any impairment charges related to this investment in the future.

Loans

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


	As of March 31, 2017		As of December 31, 2016
Mortgage loans	$	1,060,397	$	1,060,400
Acquisition loans		120,766		121,464
Working capital and other loans		33,266		34,257

	$	1,214,429	$	1,216,121

Our non-mortgage loans typically consist of loans to our tenants for acquisitions and working capital purposes. At March 31, 2017, acquisition loans includes $114.8 million in loans to Ernest.

Concentrations of Credit Risk

Our revenue concentration for the three months ended March 31, 2017 as compared to the prior year is as follows (dollars in thousands):

Revenue by Operator


	For the Three Months Ended March 31,
	2017					2016
Operators	Total Revenue		Percentage of Total Revenue			Total Revenue		Percentage of Total Revenue
Prime	$	31,511		20.1	%	$	28,897		21.4	%
Steward		26,584		17.0	%		—		—
MEDIAN		23,450		15.0	%		23,510		17.4	%
Ernest		17,520		11.2	%		16,406		12.2	%
RCCH		9,306		6.0	%		21,477		15.9	%
Other operators		48,026		30.7	%		44,709		33.1	%

Total	$	156,397		100.0	%	$	134,999		100.0	%

Revenue by U.S. State and Country


	For the Three Months Ended March 31,
	2017					2016
U.S. States and Other Countries	Total Revenue		Percentage of Total Revenue			Total Revenue		Percentage of Total Revenue
Massachusetts	$	26,584		17.0	%	$	—		—
Texas		24,737		15.8	%		24,472		18.1	%
California		16,565		10.6	%		16,597		12.3	%
New Jersey		10,943		7.0	%		8,612		6.4	%
Arizona		7,332		4.7	%		5,797		4.3	%
All other states		43,056		27.5	%		54,906		40.7	%

Total U.S.	$	129,217		82.6	%	$	110,384		81.8	%
Germany	$	26,190		16.7	%	$	23,510		17.4	%
United Kingdom, Italy, and Spain		990		0.7	%		1,105		0.8	%

Total International	$	27,180		17.4	%	$	24,615		18.2	%

Grand Total	$	156,397		100.0	%	$	134,999		100.0	%

On a gross asset basis, which is total assets before accumulated depreciation/amortization and assumes all real estate binding commitments on new investments and unfunded amounts on development deals and commenced capital improvement projects are fully funded (see Notes 7 and 8 of Item 1 on this Form 10-Q), our concentration as of March 31, 2017 as compared to December 31, 2016 is as follows (dollars in thousands):

Gross Assets by Operator


	As of March 31, 2017					As of December 31, 2016
Operators	Total Gross Assets		Percentage of Total Gross Assets			Total Gross Assets		Percentage of Total Gross Assets
Steward (1)	$	1,551,292		20.8	%	$	1,250,000		17.5	%
Prime		1,115,356		15.0	%		1,144,055		16.0	%
MEDIAN		1,006,432		13.5	%		993,677		13.9	%
Ernest		627,971		8.4	%		627,906		8.8	%
RCCH		506,265		6.8	%		566,600		7.9	%
Other operators		2,313,871		31.1	%		2,259,980		31.7	%
Other assets		324,635		4.4	%		300,903		4.2	%

Total	$	7,445,822		100.0	%	$	7,143,121		100.0	%

(1)

Includes $600 million of mortgage loans.

Gross Assets by U.S. State and Country


	As of March 31, 2017					As of December 31, 2016
U.S. States and Other Countries	Total Gross Assets		Percentage of Total Gross Assets			Total Gross Assets		Percentage of Total Gross Assets
Massachusetts	$	1,250,000		16.8	%	$	1,250,000		17.5	%
Texas		893,749		12.0	%		947,443		13.3	%
California		542,886		7.3	%		542,889		7.6	%
New Jersey		416,490		5.6	%		447,436		6.3	%
Arizona		331,833		4.5	%		331,834		4.6	%
All other states		2,175,466		29.2	%		1,894,047		26.5	%
Other domestic assets		284,070		3.8	%		264,215		3.7	%

Total U.S.	$	5,894,494		79.2	%	$	5,677,864		79.5	%
Germany	$	1,320,487		17.7	%	$	1,281,649		17.9	%
United Kingdom, Italy, and Spain		190,276		2.5	%		146,920		2.1	%
Other international assets		40,565		0.6	%		36,688		0.5	%

Total International	$	1,551,328		20.8	%	$	1,465,257		20.5	%

Grand Total	$	7,445,822		100.0	%	$	7,143,121		100.0	%

On an individual property basis, we had no investment of any single property greater than 3.2% of our total gross assets as of March 31, 2017.

Debt

3 Months Ended

Mar. 31, 2017

Debt Disclosure [Abstract]

Debt

4. Debt

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


	As of March 31, 2017			As of December 31, 2016
Revolving credit facility	$	380,000		$	290,000
Term loans		213,020			263,101
6.375% Senior Unsecured Notes due 2022:
Principal amount		350,000			350,000
Unamortized premium		1,726			1,814

		351,726			351,814
5.750% Senior Unsecured Notes due 2020(A)		—			210,340
4.000% Senior Unsecured Notes due 2022(A)		532,600			525,850
5.500% Senior Unsecured Notes due 2024		300,000			300,000
6.375% Senior Unsecured Notes due 2024		500,000			500,000
3.325% Senior Unsecured Notes due 2025(A)		532,600			—
5.250% Senior Unsecured Notes due 2026		500,000			500,000

	$	3,309,946		$	2,941,105
Debt issue costs, net		(31,960	)		(31,764	)

	$	3,277,986		$	2,909,341

(A)	These notes are euro-denominated and reflect the exchange rate at March 31, 2017 and December 31, 2016, respectively.

As of March 31, 2017, principal payments due on our debt (which exclude the effects of any discounts, premiums, or debt issue costs recorded) are as follows (in thousands):


2017	$	239
2018		12,781
2019		—
2020		—
2021		380,000
Thereafter		2,915,200

Total	$	3,308,220

2017 Activity

On February 1, 2017, we replaced our unsecured credit facility with a new revolving credit and term loan agreement (“Credit Facility”). 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 had a maturity date of January 31, 2020; however, it was paid off on March 30, 2017 – see below. The commitment fee on the revolving loan 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 Credit Facility may be made as either ABR Loans or Eurodollar Loans. The applicable margin for term loans that are ABR Loans is adjustable on a sliding scale from 0.00% to 0.95% based on our current credit rating. The applicable margin for term loans that are Eurodollar Loans is adjustable on a sliding scale from 0.90% to 1.95% based on our current credit rating. The applicable margin for revolving loans that are ABR Loans is adjustable on a sliding scale from 0.00% to 0.65% based on our current credit rating. The applicable margin for revolving loans that are Eurodollar Loans is adjustable on a sliding scale from 0.875% to 1.65% based on our current credit rating. The commitment fee is adjustable on a sliding scale from 0.125% to 0.30% based on our current credit rating and is payable on the revolving loan facility. At March 31, 2017, the interest rate in effect on our term loan and revolver was 2.49% and 2.24%, respectively.

On March 4, 2017, we redeemed the €200 million aggregate principal amount of our 5.750% Senior Unsecured Notes due 2020 and incurred a redemption premium of approximately $9 million. We funded this redemption, including the premium and accrued interest, with the proceeds of the new euro term loan together with cash on hand.

On March 24, 2017, we completed a €500 million senior unsecured notes offering (“3.325% Senior Unsecured Notes due 2025”). Interest on the notes is payable annually on March 24 of each year. The notes pay interest in cash at a rate of 3.325% per year. The notes mature on March 24, 2025. We may redeem some or all of the 3.325% Senior Unsecured Notes due 2025 at any time. If the notes are redeemed prior to 90 days before maturity, the redemption price will be equal to 100% of their principal amount, plus a make-whole premium, plus accrued and unpaid interest up to, but excluding, the applicable redemption date. Within the period beginning on or after 90 days before maturity, the notes may be redeemed, in whole or in part, at a redemption price equal to 100% of their principal amount, plus accrued and unpaid interest to, but excluding, the applicable redemption date. The 3.325% Senior Unsecured Notes due 2025 are fully and unconditionally guaranteed on a senior unsecured basis by us. In the event of a change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest up to, but excluding, the date of the purchase.

On March 30, 2017, we prepaid and extinguished the €200 million of outstanding term loans under the euro term loan facility portion of our Credit Facility. To fund such prepayment, including accrued and unpaid interest thereon, we used part of the proceeds of the 3.325% Senior Unsecured Notes due 2025.

With the replacement of our old credit facility, the redemption of the 5.750% Senior Unsecured Notes due 2020, and the payoff of our €200 million euro term loan, we incurred a debt refinancing charge of approximately $14 million in the 2017 first quarter.

2016 Activity

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.

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. At March 31, 2017, the dividend restriction was 95% of normalized adjusted funds from operations (“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 March 31, 2017, we were in compliance with all such financial and operating covenants.

Fair Value of Financial Instruments

3 Months Ended

Mar. 31, 2017

Fair Value Disclosures [Abstract]

Fair Value of Financial Instruments

5. Fair Value of Financial Instruments

We have various assets and liabilities that are considered financial instruments. We estimate that the carrying value of cash and cash equivalents and accounts payable and accrued expenses approximate their fair values. We estimate the fair value of our interest and rent receivables using Level 2 inputs such as discounting the estimated future cash flows using the current rates at which similar receivables would be made to others with similar credit ratings and for the same remaining maturities. The fair value of our mortgage loans 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):


	March 31, 2017						December 31, 2016
Asset (Liability)	Book Value			Fair Value			Book Value			Fair Value
Interest and rent receivables	$	61,912		$	61,941		$	57,698		$	57,707
Loans (1)		985,570			1,018,548			986,987			1,017,428
Debt, net		(3,277,986	)		(3,372,482	)		(2,909,341	)		(2,966,759	)

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

Items Measured at Fair Value on a Recurring Basis

Our equity interest in Ernest along with their related loans are 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 existing equity interests or loans.

At March 31, 2017, these amounts were as follows (in thousands):


Asset Type	Fair Value		Cost		Asset Type Classification
Mortgage loans	$	112,836	$	112,836		Mortgage loans
Acquisition and other loans		116,023		116,023		Other loans
Equity investments		3,300		3,300		Other assets

	$	232,159	$	232,159

Our mortgage and other loans with Ernest are recorded at fair value based on Level 2 inputs by discounting the estimated cash flows using the market rates which similar loans would be made to borrowers with similar credit ratings and the same remaining maturities. Our equity investment in Ernest is 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 forecast assumptions associated with the investee. We classify the equity investment 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 the cash flow model, 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 marketability discount (“DLOM”) on our equity investment of 40% at March 31, 2017.

In regards to the underlying projection of revenues and expenses used in the discounted cash flow model, such projections are provided by Ernest. However, we will modify such projections (including underlying assumptions used) as needed based on our review and analysis of Ernest’s 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	$	(53	)
- 100 basis points		53

Because the fair value of the Ernest investments noted above approximate their original cost, we did not recognize any unrealized gains/losses during the first quarter of 2017 or 2016. To date, we have not received any distribution payments from our equity investment in Ernest.

- 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

Earnings Per Share

3 Months Ended

Mar. 31, 2017

Earnings Per Share [Abstract]

Earnings Per Share

6. Earnings Per Share

Medical Properties Trust, Inc.

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


	For the Three Months Ended March 31,
	2017			2016
Numerator:
Income from continuing operations	$	68,185		$	58,226
Non-controlling interests’ share in net income		(215	)		(298	)
Participating securities’ share in earnings		(125	)		(144	)

Income from continuing operations, less participating securities’ share in earnings		67,845			57,784
Loss from discontinued operations		—			(1	)

Net income, less participating securities’ share in earnings	$	67,845		$	57,783

Denominator:
Basic weighted-average common shares		321,057			237,510
Dilutive potential common shares		366			309

Dilutive weighted-average common shares		321,423			237,819

MPT Operating Partnership, L.P.

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


	For the Three Months Ended March 31,
	2017			2016
Numerator:
Income from continuing operations	$	68,185		$	58,226
Non-controlling interests’ share in net income		(215	)		(298	)
Participating securities’ share in earnings		(125	)		(144	)

Income from continuing operations, less participating securities’ share in earnings		67,845			57,784
Loss from discontinued operations		—			(1	)

Net income, less participating securities’ share in earnings	$	67,845		$	57,783

Denominator:
Basic weighted-average units		321,057			237,510
Dilutive potential units		366			309

Diluted weighted-average units		321,423			237,819

Commitments and Contingencies	3 Months Ended
Commitments and Contingencies	Mar. 31, 2017
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	7. 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 with annual escalators of the greater of one percent or 70% of the annual percentage change in the German consumer price index. Closing of the transaction, which began during the fourth quarter of 2016, is subject to customary real estate, regulatory and other closing conditions. As of March 31, 2017, we have closed seven of the 20 facilities in the amount of €49.5 million, and we expect the remaining 13 facilities to close in the second quarter of 2017. On September 28, 2016, we entered into a definitive agreement to acquire one acute care hospital in Washington for a purchase price to us of approximately $17.5 million. Upon closing, this facility will be leased to RCCH, pursuant to the current long-term master lease. Closing of the transaction, which is expected to be completed no later than the fourth quarter of 2017, is subject to customary real estate, regulatory and other closing conditions. On March 8, 2017, we entered a non-binding agreement to purchase the real estate of two acute care hospitals in West Virginia and Ohio for an aggregate purchase price of $40.0 million and lease them to Alecto, which is the current operator of three facilities in our portfolio. The lease on these facilities is expected to have a 15-year initial term with 2% annual minimum increases and three 5-year extension options. The facilities will be cross-defaulted and cross collateralized with our other hospitals currently operated by Alecto. With these acquisitions, we will also obtain a 20% interest in the operator of these facilities. We expect to complete this transaction in the second quarter of 2017. On March 31, 2017, we entered into a definitive agreement to acquire one acute care hospital in Germany for a purchase price to us of approximately €20 million. Upon closing, this facility will be leased to affiliates of MEDIAN, pursuant to an existing 27-year master lease with terms similar to the master lease agreement reached with MEDIAN in 2015. We expect to complete this transaction during the second quarter of 2017. 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 those proceedings is not presently expected to materially affect our financial position, results of operations or cash flows.

Subsequent Events	3 Months Ended
Subsequent Events	Mar. 31, 2017
Subsequent Events [Abstract]
Subsequent Events	8. Subsequent Events On May 1, 2017, we completed an underwritten public offering of 43.1 million shares (including the exercise of the underwriters’ 30-day option to purchase an additional 5.6 million shares) of our common stock, resulting in net proceeds of $547.6 million, after deducting estimated offering expenses. On May 1, 2017, we acquired the real estate of St. Joseph Regional Medical Center, a 145-bed acute care hospital in Lewiston, Idaho for $87.5 million. This facility will be leased to RCCH, pursuant to the existing long-term master lease entered into with RCCH in April 2016. On May 1, 2017, we acquired eight hospitals previously affiliated with Community Health Systems, Inc. in Florida, Ohio, and Pennsylvania for an aggregate purchase price of $301.3 million. These facilities will be leased to Steward Health Care System LLC (“Steward”), pursuant to the existing long-term master lease entered into with Steward in October 2016. In April 2017, we completed the acquisition of the long leasehold interest of a development site in Birmingham, England from the Circle Health Group (the tenant of our existing site in Bath, England) for a purchase price of approximately £2.72 million. Simultaneously with the acquisition, we entered into contracts with the property freeholder and the Circle Health Group committing us to construct an acute care hospital on the site. Our total development costs are anticipated to be approximately £30 million. Circle Health Group is contracted to enter into a lease of the hospital following completion of construction for an initial 15-year term with rent to be calculated based on our total development costs.

Summary of Significant Accounting Policies (Policies)

3 Months Ended

Mar. 31, 2017

Accounting Policies [Abstract]

Unaudited Interim Condensed Consolidated Financial Statements

Recent Accounting Developments

Recent Accounting Developments:

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.

Variable Interest Entities

Variable Interest Entities


VIE Type	Maximum Loss Exposure(1)		Asset Type Classification	Carrying Amount(2)
Loans, net	$	320,668	Mortgage and other loans	$	234,821
Equity investments	$	13,114	Other assets	$	—

(1)

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

See Note 3 and Note 5 for additional description of the nature, purpose and activities of our more significant VIEs and interests therein (such as Ernest Health Inc. (“Ernest”)).

Summary of Significant Accounting Policies (Tables)

3 Months Ended

Mar. 31, 2017

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 March 31, 2017 (in thousands):


VIE Type	Maximum Loss Exposure(1)		Asset Type Classification	Carrying Amount(2)
Loans, net	$	320,668	Mortgage and other loans	$	234,821
Equity investments	$	13,114	Other assets	$	—

(1)

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

- 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 Lending Activities (Tables)

3 Months Ended

Mar. 31, 2017

Text Block [Abstract]

Assets Acquired

We acquired the following assets (in thousands):


	Three Months Ended March 31,
	2017		2016
Assets Acquired
Land	$	1,081	$	—
Building		7,050		—
Intangible		873		—

Total assets acquired	$	9,004	$	—

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 March 31, 2017		Estimated Completion Date
Adeptus Health	$	12,220	$	7,939		2Q 2017
Ernest		28,067		5,231		4Q 2017
Adeptus Health		7,804		1,771		1Q 2018

	$	48,091	$	14,941

Components of Net Investment in Direct Financing Leases

The components of our net investment in DFLs consisted of the following (in thousands):


	As of March 31, 2017			As of December 31, 2016
Minimum lease payments receivable	$	2,192,020		$	2,207,625
Estimated residual values		407,647			407,647
Less: Unearned income		(1,949,279	)		(1,967,170	)

Net investment in direct financing leases	$	650,388		$	648,102

Summary of Loans

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


	As of March 31, 2017		As of December 31, 2016
Mortgage loans	$	1,060,397	$	1,060,400
Acquisition loans		120,766		121,464
Working capital and other loans		33,266		34,257

	$	1,214,429	$	1,216,121

Schedule of Revenue by Operator

Revenue by Operator


	For the Three Months Ended March 31,
	2017					2016
Operators	Total Revenue		Percentage of Total Revenue			Total Revenue		Percentage of Total Revenue
Prime	$	31,511		20.1	%	$	28,897		21.4	%
Steward		26,584		17.0	%		—		—
MEDIAN		23,450		15.0	%		23,510		17.4	%
Ernest		17,520		11.2	%		16,406		12.2	%
RCCH		9,306		6.0	%		21,477		15.9	%
Other operators		48,026		30.7	%		44,709		33.1	%

Total	$	156,397		100.0	%	$	134,999		100.0	%

Schedule of Revenue from External Customers by Geographic Areas

Revenue by U.S. State and Country


	For the Three Months Ended March 31,
	2017					2016
U.S. States and Other Countries	Total Revenue		Percentage of Total Revenue			Total Revenue		Percentage of Total Revenue
Massachusetts	$	26,584		17.0	%	$	—		—
Texas		24,737		15.8	%		24,472		18.1	%
California		16,565		10.6	%		16,597		12.3	%
New Jersey		10,943		7.0	%		8,612		6.4	%
Arizona		7,332		4.7	%		5,797		4.3	%
All other states		43,056		27.5	%		54,906		40.7	%

Total U.S.	$	129,217		82.6	%	$	110,384		81.8	%
Germany	$	26,190		16.7	%	$	23,510		17.4	%
United Kingdom, Italy, and Spain		990		0.7	%		1,105		0.8	%

Total International	$	27,180		17.4	%	$	24,615		18.2	%

Grand Total	$	156,397		100.0	%	$	134,999		100.0	%

Schedule of Gross Assets by Operator

Gross Assets by Operator


	As of March 31, 2017					As of December 31, 2016
Operators	Total Gross Assets		Percentage of Total Gross Assets			Total Gross Assets		Percentage of Total Gross Assets
Steward (1)	$	1,551,292		20.8	%	$	1,250,000		17.5	%
Prime		1,115,356		15.0	%		1,144,055		16.0	%
MEDIAN		1,006,432		13.5	%		993,677		13.9	%
Ernest		627,971		8.4	%		627,906		8.8	%
RCCH		506,265		6.8	%		566,600		7.9	%
Other operators		2,313,871		31.1	%		2,259,980		31.7	%
Other assets		324,635		4.4	%		300,903		4.2	%

Total	$	7,445,822		100.0	%	$	7,143,121		100.0	%

(1)

Includes $600 million of mortgage loans.

Schedule of Gross Assets by Geographic Areas

Gross Assets by U.S. State and Country


	As of March 31, 2017					As of December 31, 2016
U.S. States and Other Countries	Total Gross Assets		Percentage of Total Gross Assets			Total Gross Assets		Percentage of Total Gross Assets
Massachusetts	$	1,250,000		16.8	%	$	1,250,000		17.5	%
Texas		893,749		12.0	%		947,443		13.3	%
California		542,886		7.3	%		542,889		7.6	%
New Jersey		416,490		5.6	%		447,436		6.3	%
Arizona		331,833		4.5	%		331,834		4.6	%
All other states		2,175,466		29.2	%		1,894,047		26.5	%
Other domestic assets		284,070		3.8	%		264,215		3.7	%

Total U.S.	$	5,894,494		79.2	%	$	5,677,864		79.5	%
Germany	$	1,320,487		17.7	%	$	1,281,649		17.9	%
United Kingdom, Italy, and Spain		190,276		2.5	%		146,920		2.1	%
Other international assets		40,565		0.6	%		36,688		0.5	%

Total International	$	1,551,328		20.8	%	$	1,465,257		20.5	%

Grand Total	$	7,445,822		100.0	%	$	7,143,121		100.0	%

Debt (Tables)

3 Months Ended

Mar. 31, 2017

Debt Disclosure [Abstract]

Summary of Debt

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


	As of March 31, 2017			As of December 31, 2016
Revolving credit facility	$	380,000		$	290,000
Term loans		213,020			263,101
6.375% Senior Unsecured Notes due 2022:
Principal amount		350,000			350,000
Unamortized premium		1,726			1,814

		351,726			351,814
5.750% Senior Unsecured Notes due 2020(A)		—			210,340
4.000% Senior Unsecured Notes due 2022(A)		532,600			525,850
5.500% Senior Unsecured Notes due 2024		300,000			300,000
6.375% Senior Unsecured Notes due 2024		500,000			500,000
3.325% Senior Unsecured Notes due 2025(A)		532,600			—
5.250% Senior Unsecured Notes due 2026		500,000			500,000

	$	3,309,946		$	2,941,105
Debt issue costs, net		(31,960	)		(31,764	)

	$	3,277,986		$	2,909,341

(A)	These notes are euro-denominated and reflect the exchange rate at March 31, 2017 and December 31, 2016, respectively.

Principal Payments Due on Debt

As of March 31, 2017, principal payments due on our debt (which exclude the effects of any discounts, premiums, or debt issue costs recorded) are as follows (in thousands):


2017	$	239
2018		12,781
2019		—
2020		—
2021		380,000
Thereafter		2,915,200

Total	$	3,308,220

Fair Value of Financial Instruments (Tables)

3 Months Ended

Mar. 31, 2017

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):


	March 31, 2017						December 31, 2016
Asset (Liability)	Book Value			Fair Value			Book Value			Fair Value
Interest and rent receivables	$	61,912		$	61,941		$	57,698		$	57,707
Loans (1)		985,570			1,018,548			986,987			1,017,428
Debt, net		(3,277,986	)		(3,372,482	)		(2,909,341	)		(2,966,759	)

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

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

At March 31, 2017, these amounts were as follows (in thousands):


Asset Type	Fair Value		Cost		Asset Type Classification
Mortgage loans	$	112,836	$	112,836		Mortgage loans
Acquisition and other loans		116,023		116,023		Other loans
Equity investments		3,300		3,300		Other assets

	$	232,159	$	232,159

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	$	(53	)
- 100 basis points		53

Earnings Per Share (Tables)

3 Months Ended

Mar. 31, 2017

Earnings Per Share [Abstract]

Calculation of Earnings Per Share

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


	For the Three Months Ended March 31,
	2017			2016
Numerator:
Income from continuing operations	$	68,185		$	58,226
Non-controlling interests’ share in net income		(215	)		(298	)
Participating securities’ share in earnings		(125	)		(144	)

Income from continuing operations, less participating securities’ share in earnings		67,845			57,784
Loss from discontinued operations		—			(1	)

Net income, less participating securities’ share in earnings	$	67,845		$	57,783

Denominator:
Basic weighted-average common shares		321,057			237,510
Dilutive potential common shares		366			309

Dilutive weighted-average common shares		321,423			237,819

MPT Operating Partnership, L.P.

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


	For the Three Months Ended March 31,
	2017			2016
Numerator:
Income from continuing operations	$	68,185		$	58,226
Non-controlling interests’ share in net income		(215	)		(298	)
Participating securities’ share in earnings		(125	)		(144	)

Income from continuing operations, less participating securities’ share in earnings		67,845			57,784
Loss from discontinued operations		—			(1	)

Net income, less participating securities’ share in earnings	$	67,845		$	57,783

Denominator:
Basic weighted-average units		321,057			237,510
Dilutive potential units		366			309

Diluted weighted-average units		321,423			237,819

Summary of Significant Accounting Policies - Additional Information (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2017 USD ($)
Accounting Standards Update No. 2017-01 [Member]
Summary Of Significant Accounting Policies [Line Items]
Decrease normalized funds from operations	$ (1.5)

Summary of Significant Accounting Policies - Carrying Value and Classification of Related Assets and Maximum Exposure to Loss (Detail)	Mar. 31, 2017 USD ($)
Mortgage and other loans [Member]
Variable Interest Entity [Line Items]
Carrying Amount	$ 234,821,000
Loans, net [Member]
Variable Interest Entity [Line Items]
Maximum Loss Exposure	320,668,000
Equity investments [Member]
Variable Interest Entity [Line Items]
Maximum Loss Exposure	$ 13,114,000

Real Estate and Lending Activities - Assets Acquired (Detail) $ in Thousands	Mar. 31, 2017 USD ($)
Business Acquisition [Line Items]
Total assets acquired	$ 9,004
Land [Member]
Business Acquisition [Line Items]
Total assets acquired	1,081
Building [Member]
Business Acquisition [Line Items]
Total assets acquired	7,050
Intangible [Member]
Business Acquisition [Line Items]
Total assets acquired	$ 873

Real Estate and Lending Activities - Acquisitions - Additional Information (Detail) - Germany [Member] - Rehabilitation Hospital with Covenant Health System [Member] € in Millions		5 Months Ended
	Jan. 30, 2017 EUR (€)	Jan. 30, 2017 EUR (€) Hospital
Business Acquisition [Line Items]
Purchase price of acquisition \| €	€ 8.4	€ 44.1
Number of facilities acquired \| Hospital		6

Real Estate and Lending Activities - Development Activities - Additional Information (Detail) - Development Activities [Member] - Acute Care Facilities [Member] € in Millions	3 Months Ended
	Mar. 31, 2017 EUR (€) Facility
Adeptus Health [Member]
Business Acquisition [Line Items]
Number of facilities constructed \| Facility	2
IMED [Member] \| Spain [Member]
Business Acquisition [Line Items]
Ownership interests acquired	50.00%
Acquisition costs \| €	€ 21

Real Estate and Lending Activities - Summary of Status Update on Current Development Projects (Detail) $ in Thousands	3 Months Ended
	Mar. 31, 2017 USD ($)
Business Acquisition [Line Items]
Commitment	$ 48,091
Costs Incurred as of 03/31/2017	14,941
Adeptus Health Three [Member]
Business Acquisition [Line Items]
Commitment	12,220
Costs Incurred as of 03/31/2017	$ 7,939
Estimated Completion Date	2Q 2017
Ernest [Member]
Business Acquisition [Line Items]
Commitment	$ 28,067
Costs Incurred as of 03/31/2017	$ 5,231
Estimated Completion Date	4Q 2017
Adeptus Health Four [Member]
Business Acquisition [Line Items]
Commitment	$ 7,804
Costs Incurred as of 03/31/2017	$ 1,771
Estimated Completion Date	1Q 2018

Real Estate and Lending Activities - Disposals - Additional Information (Detail) $ in Millions	Mar. 31, 2017 USD ($)
Business Combinations [Abstract]
Proceeds from sale of facilities	$ 64.0
Gain on real estate dispositions	7.4
Gain offset by non-cash charges	$ 0.6

Real Estate and Lending Activities - Leasing Operations - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2017 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 Lending Activities - Components of Net Investment in Direct Financing Leases (Detail) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Business Combinations [Abstract]
Minimum lease payments receivable	$ 2,192,020	$ 2,207,625
Estimated residual values	407,647	407,647
Less: Unearned income	(1,949,279)	(1,967,170)
Net investment in direct financing leases	$ 650,388	$ 648,102

Real Estate and Lending Activities - Adeptus Health - Additional Information (Detail) $ in Thousands			3 Months Ended	12 Months Ended
	Apr. 04, 2017 USD ($) Facility	Mar. 31, 2017 USD ($)	Mar. 31, 2017 USD ($)	Dec. 31, 2016
Business Acquisition [Line Items]
Gain offset by non-cash charges		$ 600
Total Gross Assets [Member] \| Credit Concentration Risk [Member]
Business Acquisition [Line Items]
Percentage of Total Gross Assets			100.00%	100.00%
Louisiana [Member] \| Ochsner [Member]
Business Acquisition [Line Items]
Total budgeted investment		24,500	$ 24,500
Term of lease, years			15 years
Average minimum lease rate on development and construction cost			9.20%
Gain offset by non-cash charges			$ 500
Free standing emergency facilities, lease purchase description			Under these leases, Ochsner has the right to purchase the freestanding emergency facilities (i) at our cost within two years of rent commencement or (ii) for the greater of fair market value or our cost after such two-year period.
Adeptus Health [Member]
Business Acquisition [Line Items]
Percentage of contractual rent committed on transitional facilities			60.00%
Letter of credit hold to cover defaults		$ 12,400	$ 12,400
Number of months covers by letter of credit defaults			4 months
Adeptus Health [Member] \| Maximum [Member] \| Total Gross Assets [Member] \| Credit Concentration Risk [Member]
Business Acquisition [Line Items]
Percentage of Total Gross Assets			6.00%
Adeptus Health [Member] \| Subsequent Event [Member] \| Deerfield [Member]
Business Acquisition [Line Items]
One-time rental credit	$ 3,100
Adeptus Health [Member] \| Subsequent Event [Member] \| Ochsner [Member]
Business Acquisition [Line Items]
Percentage of re-leasing facility	5.00%
Decrease in rent revenue	$ (220)
Number of facilities expected to sell or re-lease \| Facility	13
Remaining year from initial lease term	14 years
Adeptus Health [Member] \| Subsequent Event [Member] \| New Operators [Member]
Business Acquisition [Line Items]
Percentage of transitional facilities to be re-leased or sold	15.00%

Real Estate and Lending Activities - Summary of Loans (Detail) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Loans [Line Items]
Loans, Balance	$ 1,214,429	$ 1,216,121
Mortgage Loans [Member]
Loans [Line Items]
Loans, Balance	1,060,397	1,060,400
Acquisition Loans [Member]
Loans [Line Items]
Loans, Balance	120,766	121,464
Working Capital and Other Loans [Member]
Loans [Line Items]
Loans, Balance	$ 33,266	$ 34,257

Real Estate and Lending Activities - Loans - Additional Information (Detail) $ in Millions	Mar. 31, 2017 USD ($)
Ernest Transaction and Other Acquisitions [Member]
Business Acquisition [Line Items]
Existing mortgage loans	$ 114.8

Real Estate and Lending Activities - Schedule of Revenue by Operator (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Investment And Revenue From External Customers [Line Items]
Total Revenue	$ 156,397	$ 134,999
Revenue [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue	$ 156,397	$ 134,999
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	$ 31,511	$ 28,897
Percentage of Total Revenue	20.10%	21.40%
Revenue [Member] \| Credit Concentration Risk [Member] \| Steward [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue	$ 26,584
Percentage of Total Revenue	17.00%
Revenue [Member] \| Credit Concentration Risk [Member] \| MEDIAN [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue	$ 23,450	$ 23,510
Percentage of Total Revenue	15.00%	17.40%
Revenue [Member] \| Credit Concentration Risk [Member] \| Ernest [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue	$ 17,520	$ 16,406
Percentage of Total Revenue	11.20%	12.20%
Revenue [Member] \| Credit Concentration Risk [Member] \| RCCH [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue	$ 9,306	$ 21,477
Percentage of Total Revenue	6.00%	15.90%
Revenue [Member] \| Credit Concentration Risk [Member] \| Other Operators [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue	$ 48,026	$ 44,709
Percentage of Total Revenue	30.70%	33.10%

Real Estate and Lending Activities - Schedule of Revenue from External Customers by Geographic Areas (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 156,397	$ 134,999
Revenue [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 156,397	$ 134,999
Percentage of Total Revenue	100.00%	100.00%
Revenue [Member] \| Massachusetts [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 26,584
Percentage of Total Revenue	17.00%
Revenue [Member] \| Texas [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 24,737	$ 24,472
Percentage of Total Revenue	15.80%	18.10%
Revenue [Member] \| California [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 16,565	$ 16,597
Percentage of Total Revenue	10.60%	12.30%
Revenue [Member] \| New Jersey [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 10,943	$ 8,612
Percentage of Total Revenue	7.00%	6.40%
Revenue [Member] \| Arizona [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 7,332	$ 5,797
Percentage of Total Revenue	4.70%	4.30%
Revenue [Member] \| All Other States [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 43,056	$ 54,906
Percentage of Total Revenue	27.50%	40.70%
Revenue [Member] \| United States [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 129,217	$ 110,384
Percentage of Total Revenue	82.60%	81.80%
Revenue [Member] \| Germany [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 26,190	$ 23,510
Percentage of Total Revenue	16.70%	17.40%
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	$ 990	$ 1,105
Percentage of Total Revenue	0.70%	0.80%
Revenue [Member] \| International [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 27,180	$ 24,615
Percentage of Total Revenue	17.40%	18.20%

Real Estate and Lending Activities - Schedule of Gross Assets by Operator (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2017	Dec. 31, 2016
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 6,780,730	$ 6,418,536
Total Gross Assets [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 7,445,822	$ 7,143,121
Percentage of Total Gross Assets	100.00%	100.00%
Total Gross Assets [Member] \| Credit Concentration Risk [Member] \| Steward [Member]
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 1,551,292	$ 1,250,000
Percentage of Total Gross Assets	20.80%	17.50%
Total Gross Assets [Member] \| Credit Concentration Risk [Member] \| Prime [Member]
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 1,115,356	$ 1,144,055
Percentage of Total Gross Assets	15.00%	16.00%
Total Gross Assets [Member] \| Credit Concentration Risk [Member] \| MEDIAN [Member]
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 1,006,432	$ 993,677
Percentage of Total Gross Assets	13.50%	13.90%
Total Gross Assets [Member] \| Credit Concentration Risk [Member] \| Ernest [Member]
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 627,971	$ 627,906
Percentage of Total Gross Assets	8.40%	8.80%
Total Gross Assets [Member] \| Credit Concentration Risk [Member] \| RCCH [Member]
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 506,265	$ 566,600
Percentage of Total Gross Assets	6.80%	7.90%
Total Gross Assets [Member] \| Credit Concentration Risk [Member] \| Other Operators [Member]
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 2,313,871	$ 2,259,980
Percentage of Total Gross Assets	31.10%	31.70%
Total Gross Assets [Member] \| Credit Concentration Risk [Member] \| Other Assets [Member]
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 324,635	$ 300,903
Percentage of Total Gross Assets	4.40%	4.20%

Real Estate and Lending Activities - Schedule of Gross Assets by Operator (Parenthetical) (Detail) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 6,780,730	$ 6,418,536
Mortgage Loans [Member] \| Credit Concentration Risk [Member] \| Steward [Member]
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 600,000

Real Estate and Lending Activities - Schedule of Gross Assets by Geographic Areas (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2017	Dec. 31, 2016
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 6,780,730	$ 6,418,536
Total Gross Assets [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 7,445,822	$ 7,143,121
Percentage of Total Gross Assets	100.00%	100.00%
Total Gross Assets [Member] \| Massachusetts [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 1,250,000	$ 1,250,000
Percentage of Total Gross Assets	16.80%	17.50%
Total Gross Assets [Member] \| Texas [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 893,749	$ 947,443
Percentage of Total Gross Assets	12.00%	13.30%
Total Gross Assets [Member] \| California [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 542,886	$ 542,889
Percentage of Total Gross Assets	7.30%	7.60%
Total Gross Assets [Member] \| New Jersey [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 416,490	$ 447,436
Percentage of Total Gross Assets	5.60%	6.30%
Total Gross Assets [Member] \| Arizona [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 331,833	$ 331,834
Percentage of Total Gross Assets	4.50%	4.60%
Total Gross Assets [Member] \| All Other States [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 2,175,466	$ 1,894,047
Percentage of Total Gross Assets	29.20%	26.50%
Total Gross Assets [Member] \| Other Domestic Assets [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 284,070	$ 264,215
Percentage of Total Gross Assets	3.80%	3.70%
Total Gross Assets [Member] \| United States [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 5,894,494	$ 5,677,864
Percentage of Total Gross Assets	79.20%	79.50%
Total Gross Assets [Member] \| Germany [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 1,320,487	$ 1,281,649
Percentage of Total Gross Assets	17.70%	17.90%
Total Gross Assets [Member] \| United Kingdom, Italy, and Spain [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 190,276	$ 146,920
Percentage of Total Gross Assets	2.50%	2.10%
Total Gross Assets [Member] \| Other International Assets [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 40,565	$ 36,688
Percentage of Total Gross Assets	0.60%	0.50%
Total Gross Assets [Member] \| International [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 1,551,328	$ 1,465,257
Percentage of Total Gross Assets	20.80%	20.50%

Real Estate and Lending Activities - Concentrations of Credit Risk - Additional Information (Detail) - Total Gross Assets [Member] - Customer Concentration Risk [Member]	Mar. 31, 2017 Investment
Business Acquisition [Line Items]
Number of investment in property	0
Maximum percentage of entity's gross assets invested on single property	3.20%

Debt - Summary of Debt (Detail) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Debt Instrument [Line Items]
Debt	$ 3,308,220
Debt issue costs, net	(31,960)	$ (31,764)
Debt, net	3,277,986	2,909,341
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Debt	380,000	290,000
Term Loans [Member]
Debt Instrument [Line Items]
Debt	213,020	263,101
6.375% Senior Unsecured Notes Due 2022 [Member]
Debt Instrument [Line Items]
Debt	350,000	350,000
Unamortized premium	1,726	1,814
Debt, net	351,726	351,814
5.750% Senior Unsecured Notes Due 2020 [Member]
Debt Instrument [Line Items]
Debt		210,340
4.000% Senior Unsecured Notes due 2022 [Member]
Debt Instrument [Line Items]
Debt	532,600	525,850
5.500% Senior Unsecured Notes Due 2024 [Member]
Debt Instrument [Line Items]
Debt	300,000	300,000
6.375% Senior Unsecured Notes due 2024 [Member]
Debt Instrument [Line Items]
Debt	500,000	500,000
3.325% Senior Unsecured Notes Due 2025 [Member]
Debt Instrument [Line Items]
Debt	532,600
5.250% Senior Unsecured Notes Due 2026 [Member]
Debt Instrument [Line Items]
Debt	500,000	500,000
Senior Unsecured Debt [Member]
Debt Instrument [Line Items]
Debt	$ 3,309,946	$ 2,941,105

Debt - Summary of Debt (Parenthetical) (Detail)	Mar. 31, 2017	Mar. 24, 2017	Mar. 04, 2017	Dec. 31, 2016
6.375% Senior Unsecured Notes Due 2022 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	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%			6.375%
3.325% Senior Unsecured Notes Due 2025 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	3.325%	3.325%		3.325%
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	Mar. 31, 2017 USD ($)
Debt Disclosure [Abstract]
2017	$ 239
2018	12,781
2019	0
2020	0
2021	380,000
Thereafter	2,915,200
Total	$ 3,308,220

Debt - Additional Information (Detail) € in Millions						3 Months Ended
Debt - Additional Information (Detail) € in Millions	Mar. 30, 2017 EUR (€)	Mar. 24, 2017 EUR (€)	Mar. 04, 2017 EUR (€)	Feb. 01, 2017 USD ($)	Feb. 22, 2016 USD ($)	Mar. 31, 2017 USD ($)	Feb. 01, 2017 EUR (€)	Dec. 31, 2016
Debt Instrument [Line Items]
Total Facility amount at a rate				0.25%
Aggregate committed amount of credit facility \| $				$ 500,000,000
Debt refinancing charge \| $						$ 14,000,000
Minimum [Member]
Debt Instrument [Line Items]
Commitment fee				0.125%
Maximum [Member]
Debt Instrument [Line Items]
Commitment fee				0.30%
Alternate Base Rate [Member] \| Minimum [Member]
Debt Instrument [Line Items]
Applicable margin				0.00%
Applicable margin for revolving loans				0.00%
Alternate Base Rate [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Applicable margin				0.95%
Applicable margin for revolving loans				0.65%
Eurodollar Loans [Member] \| Minimum [Member]
Debt Instrument [Line Items]
Applicable margin				0.90%
Applicable margin for revolving loans				0.875%
Eurodollar Loans [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Applicable margin				1.95%
Applicable margin for revolving loans				1.65%
Term Loans [Member]
Debt Instrument [Line Items]
Amount of senior unsecured debt				$ 200,000,000			€ 200
Debt instrument, maturity date				Feb. 01, 2022
Interest rate at end of period						2.49%
Prepaid and extinguished of outstanding term loans \| €	€ 200
Term Loans [Member] \| Euro [Member]
Debt Instrument [Line Items]
Debt instrument, maturity date				Jan. 31, 2020
Revolver [Member]
Debt Instrument [Line Items]
Interest rate at end of period						2.24%
Unsecured Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Amount of senior unsecured debt \| $				$ 1,300,000,000
Debt instrument, maturity date				Feb. 28, 2021
3.325% Senior Unsecured Notes Due 2025 [Member]
Debt Instrument [Line Items]
Debt instrument, maturity date		Mar. 24, 2025
Senior unsecured notes, interest rate		3.325%				3.325%		3.325%
Senior unsecured notes, redemption description						Notes are redeemed prior to 90 days before maturity, the redemption price will be equal to 100% of their principal amount, plus a make-whole premium, plus accrued and unpaid interest up to, but excluding, the applicable redemption date. Within the period beginning on or after 90 days before maturity, the notes may be redeemed, in whole or in part, at a redemption price equal to 100% of their principal amount, plus accrued and unpaid interest to, but excluding, the applicable redemption date. The 3.325% Senior Unsecured Notes due 2025 are fully and unconditionally guaranteed on a senior unsecured basis by us. In the event of a change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest up to, but excluding, the date of the purchase.
Senior unsecured notes face amount \| €		€ 500
Senior notes frequency of periodic payment						Interest on the notes is payable annually on March 24 of each year.
Senior unsecured notes, redemption period		90 days
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest		101.00%
3.325% Senior Unsecured Notes Due 2025 [Member] \| Redeemed Prior to 90 Days [Member]
Debt Instrument [Line Items]
Senior unsecured notes, redemption percentage on principal amount		100.00%
3.325% Senior Unsecured Notes Due 2025 [Member] \| Redeemed Beginning on or After 90 Days [Member]
Debt Instrument [Line Items]
Senior unsecured notes, redemption percentage on principal amount		100.00%
5.750% Senior Unsecured Notes Due 2020 [Member]
Debt Instrument [Line Items]
Amount of senior unsecured debt redeemed \| €			€ 200
Senior unsecured notes, interest rate			5.75%			5.75%		5.75%
Senior notes, redemption date			Mar. 04, 2017
Senior unsecured notes, redemption description						We redeemed the €200 million aggregate principal amount of our 5.750% Senior Unsecured Notes due 2020 and incurred a redemption premium of approximately $9 million. We funded this redemption, including the premium and accrued interest, with the proceeds of the new euro term loan together with cash on hand.
Redemption Premium \| €			€ 9
6.375% Senior Unsecured Notes Due 2024 [Member] \| Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Debt instrument, maturity date					Mar. 01, 2024
Senior unsecured notes, interest rate					6.375%
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.
Senior unsecured notes face amount \| $					$ 500,000,000
Senior notes frequency of periodic payment						Interest on the notes is paid in cash at a rate of 6.375% per year.
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest					101.00%
Debt instrument, redemption price percentage					106.375%
Senior notes, earliest redemption date					Mar. 01, 2019
6.375% Senior Unsecured Notes Due 2024 [Member] \| Revolving Credit Facility [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Senior unsecured notes, redemption percentage on principal amount					35.00%

Debt - Covenants - Additional Information (Detail)	3 Months Ended
Debt - Covenants - Additional Information (Detail)	Mar. 31, 2017
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%

Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Detail) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Fair Value Disclosures [Abstract]
Interest and rent receivables, Book value	$ 61,912	$ 57,698
Loans, Book value	985,570	986,987
Debt, net Book value	(3,277,986)	(2,909,341)
Interest and rent receivables, Fair value	61,941	57,707
Loans, Fair value	1,018,548	1,017,428
Debt, net Fair value	$ (3,372,482)	$ (2,966,759)

Fair Value of Financial Instruments - Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis (Detail) $ in Thousands	Mar. 31, 2017 USD ($)
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	$ 232,159
Cost	232,159
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
Cost	3,300
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	116,023
Cost	116,023
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
Cost	$ 112,836

Fair Value of Financial Instruments - Additional information (Detail)	3 Months Ended
	Mar. 31, 2017
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	3 Months Ended
	Mar. 31, 2017 USD ($)
Fair Value Disclosures [Abstract]
Estimated Increase (Decrease) In Fair Value of Financial Instruments plus 100 basis points	$ (53)
Estimated Increase (Decrease) In Fair Value of Financial Instruments minus 100 basis points	$ 53

Earnings Per Share - Calculation of Earnings Per Share (Detail) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Income from continuing operations	$ 68,185	$ 58,226
Non-controlling interests' share in net income	(215)	(298)
Participating securities' share in earnings	(125)	(144)
Income from continuing operations, less participating securities' share in earnings	67,845	57,784
Loss from discontinued operations		(1)
Net income, less participating securities' share in earnings	$ 67,845	$ 57,783
Basic weighted-average common shares	321,057	237,510
Dilutive potential common shares	366	309
Diluted weighted-average units	321,423	237,819
MPT Operating Partnership, L.P. [Member]
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Income from continuing operations	$ 68,185	$ 58,226
Non-controlling interests' share in net income	(215)	(298)
Participating securities' share in earnings	(125)	(144)
Income from continuing operations, less participating securities' share in earnings	67,845	57,784
Loss from discontinued operations		(1)
Net income, less participating securities' share in earnings	$ 67,845	$ 57,783
Basic weighted-average common shares	321,057	237,510
Dilutive potential common shares	366	309
Diluted weighted-average units	321,423	237,819

Commitments and Contingencies - Additional Information (Detail) € in Millions, $ in Millions					3 Months Ended		8 Months Ended
	Mar. 31, 2017 EUR (€)	Mar. 08, 2017 USD ($) Facility Hospital	Sep. 28, 2016 USD ($) Hospital	Jul. 20, 2016 EUR (€) Hospital	Jun. 30, 2017 Hospital	Mar. 31, 2017 EUR (€) Hospital	Mar. 31, 2017 USD ($) Hospital
Germany [Member] \| Acute Care Hospital [Member] \| MEDIAN [Member]
Commitment And Contingencies [Line Items]
Number of facilities acquired						1
Purchase price of acquisition \| €						€ 20.0
Term of lease, years						27 years
Germany [Member] \| Facility Closing One [Member]
Commitment And Contingencies [Line Items]
Number of facilities acquired				20			7
Purchase price of acquisition	€ 49.5			€ 215.7			$ 49.5
Germany [Member] \| Facility Closing One [Member] \| MEDIAN [Member]
Commitment And Contingencies [Line Items]
Term of lease, years				27 years
Lease rent increase percentage				70.00%
Germany [Member] \| Scenario, Forecast [Member] \| Facility Closing One [Member]
Commitment And Contingencies [Line Items]
Number of facilities acquired					13
Washington and Idaho [Member] \| Acute Care Hospital [Member]
Commitment And Contingencies [Line Items]
Number of facilities acquired			1
Purchase price of acquisition \| $			$ 17.5
West Virginia and Ohio [Member] \| Acute Care Hospital [Member] \| Alecto Healthcare Services [Member]
Commitment And Contingencies [Line Items]
Number of facilities acquired		2
Purchase price of acquisition \| $		$ 40.0
Lease rent increase percentage		2.00%
Term of lease, years		15 years
Term of lease extension, years		5 years
Number of lease extension options in current lease contract \| Facility		3
Ownership interest percentage in operator facility		20.00%

Subsequent Events - Additional Information (Detail) - Subsequent Event [Member] £ in Thousands, shares in Millions, $ in Millions		1 Months Ended
	May 01, 2017 USD ($) Hospital Bed shares	Apr. 30, 2017 GBP (£)
Birmingham, England
Subsequent Event [Line Items]
Purchase price of acquisition \| £		£ 2,720
Term of lease, years		15 years
Total development costs anticipated \| £		£ 30,000
Community Health Systems, Inc. [Member] \| Florida, Ohio, and Pennsylvania [Member]
Subsequent Event [Line Items]
Purchase price of acquisition	$ 301.3
Number of facilities acquired \| Hospital	8
Acute Care Hospital [Member] \| IDAHO, Lewiston \| St. Joseph Regional Medical Center [Member]
Subsequent Event [Line Items]
Number of beds acquired \| Bed	145
Purchase price of acquisition	$ 87.5
Public Offering [Member]
Subsequent Event [Line Items]
Common stock, shares issued \| shares	43.1
Proceeds from sale of common shares / units, net of offering costs	$ 547.6
Public Offering [Member] \| Over-Allotment Option [Member]
Subsequent Event [Line Items]
Common stock, shares issued \| shares	5.6