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Document and Entity Information - shares	6 Months Ended
Document and Entity Information - shares	Jun. 30, 2018	Aug. 03, 2018
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Jun. 30, 2018
Document Fiscal Year Focus	2018
Document Fiscal Period Focus	Q2
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		364,858,202
MPT Operating Partnership, L.P. [Member]
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Jun. 30, 2018
Document Fiscal Year Focus	2018
Document Fiscal Period Focus	Q2
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	Jun. 30, 2018	Dec. 31, 2017
Real estate assets
Land, buildings and improvements, intangible lease assets, and other	$ 4,671,829	$ 5,797,605
Real estate held for sale	1,263,257	146,615
Mortgage loans	1,686,866	1,778,316
Net investment in direct financing leases	688,427	698,727
Gross investment in real estate assets	8,310,379	8,421,263
Accumulated depreciation and amortization	(419,061)	(455,712)
Net investment in real estate assets	7,891,318	7,965,551
Cash and cash equivalents	146,569	171,472
Interest and rent receivables	85,181	78,970
Straight-line rent receivables	215,297	185,592
Other loans	147,855	150,209
Other assets	470,604	468,494
Total Assets	8,956,824	9,020,288
Liabilities
Debt, net	4,864,261	4,898,667
Accounts payable and accrued expenses	204,505	211,188
Deferred revenue	14,133	18,178
Lease deposits and other obligations to tenants	28,470	57,050
Total liabilities	5,111,369	5,185,083
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 — 364,731 shares at June 30, 2018 and 364,424 shares at December 31, 2017	365	364
Limited Partners:
Additional paid-in capital	4,338,798	4,333,027
Distributions in excess of net income	(464,784)	(485,932)
Accumulated other comprehensive loss	(42,353)	(26,049)
Treasury shares, at cost	(777)	(777)
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital)	3,831,249	3,820,633
Non-controlling interests	14,206	14,572
Total Equity / Capital	3,845,455	3,835,205
Total Liabilities and Equity / Capital	8,956,824	9,020,288
MPT Operating Partnership, L.P. [Member]
Real estate assets
Land, buildings and improvements, intangible lease assets, and other	4,671,829	5,797,605
Real estate held for sale	1,263,257	146,615
Mortgage loans	1,686,866	1,778,316
Net investment in direct financing leases	688,427	698,727
Gross investment in real estate assets	8,310,379	8,421,263
Accumulated depreciation and amortization	(419,061)	(455,712)
Net investment in real estate assets	7,891,318	7,965,551
Cash and cash equivalents	146,569	171,472
Interest and rent receivables	85,181	78,970
Straight-line rent receivables	215,297	185,592
Other loans	147,855	150,209
Other assets	470,604	468,494
Total Assets	8,956,824	9,020,288
Liabilities
Debt, net	4,864,261	4,898,667
Accounts payable and accrued expenses	112,626	121,465
Deferred revenue	14,133	18,178
Lease deposits and other obligations to tenants	28,470	57,050
Payable due to Medical Properties Trust, Inc.	91,489	89,333
Total liabilities	5,110,979	5,184,693
Limited Partners:
Accumulated other comprehensive loss	(42,353)	(26,049)
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital)	3,831,639	3,821,023
Non-controlling interests	14,206	14,572
Total Equity / Capital	3,845,845	3,835,595
Total Liabilities and Equity / Capital	8,956,824	9,020,288
MPT Operating Partnership, L.P. [Member] \| General Partner [Member]
Equity / Capital
General Partner — issued and outstanding — 3,647 units at June 30, 2018 and 3,644 units at December 31, 2017	38,767	38,489
MPT Operating Partnership, L.P. [Member] \| Common Units [Member]
Limited Partners:
Limited Partners Capital	$ 3,835,225	$ 3,808,583

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Jun. 30, 2018	Dec. 31, 2017
Preferred stock, par value	$ 0.001	$ 0.001
Preferred stock, shares authorized	10,000,000	10,000,000
Preferred stock, shares outstanding	0	0
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	500,000,000	500,000,000
Common stock, shares issued	364,731,000	364,424,000
Common stock, shares outstanding	364,731,000	364,424,000
MPT Operating Partnership, L.P. [Member] \| Common Units [Member]
Limited Partners, units issued	361,084,000	360,780,000
Limited Partners, units outstanding	361,084,000	360,780,000
General Partner [Member] \| MPT Operating Partnership, L.P. [Member]
General partner, units issued	3,647,000	3,644,000
General partner, units outstanding	3,647,000	3,644,000
LTIP Units [Member] \| MPT Operating Partnership, L.P. [Member]
LTIP Units, shares issued	232,000	292,000
LTIP Units, shares outstanding	232,000	292,000

Condensed Consolidated Statements of Net Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Revenues
Rent billed	$ 122,827	$ 103,447	$ 250,838	$ 200,210
Straight-line rent	15,073	16,277	30,864	29,056
Income from direct financing leases	18,934	18,312	36,615	36,192
Interest and fee income	45,068	28,771	88,631	57,746
Total revenues	201,902	166,807	406,948	323,204
Expenses
Interest	58,126	39,710	115,149	77,739
Real estate depreciation and amortization	34,466	29,493	70,268	57,079
Property-related	1,920	1,153	4,104	2,481
General and administrative	19,552	15,079	37,370	28,276
Acquisition costs	411	10,806	411	13,562
Total expenses	114,475	96,241	227,302	179,137
Other income (expense)
Gain on sale of real estate, net	24,151		25,618	7,413
Debt refinancing costs		(751)		(14,380)
Other	2,002	3,367	534	5,134
Total other income (expense)	26,153	2,616	26,152	(1,833)
Income before income tax	113,580	73,182	205,798	142,234
Income tax (expense) benefit	(1,563)	614	(2,738)	(253)
Net income	112,017	73,796	203,060	141,981
Net income attributable to non-controlling interests	(450)	(381)	(892)	(596)
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 111,567	$ 73,415	$ 202,168	$ 141,385
Earnings per common share — basic and diluted
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.30	$ 0.21	$ 0.55	$ 0.42
Weighted average shares outstanding - basic	364,897	349,856	364,889	335,456
Weighted average shares outstanding - diluted	365,541	350,319	365,442	335,871
Dividends declared per common share	$ 0.25	$ 0.24	$ 0.50	$ 0.48
MPT Operating Partnership, L.P. [Member]
Revenues
Rent billed	$ 122,827	$ 103,447	$ 250,838	$ 200,210
Straight-line rent	15,073	16,277	30,864	29,056
Income from direct financing leases	18,934	18,312	36,615	36,192
Interest and fee income	45,068	28,771	88,631	57,746
Total revenues	201,902	166,807	406,948	323,204
Expenses
Interest	58,126	39,710	115,149	77,739
Real estate depreciation and amortization	34,466	29,493	70,268	57,079
Property-related	1,920	1,153	4,104	2,481
General and administrative	19,552	15,079	37,370	28,276
Acquisition costs	411	10,806	411	13,562
Total expenses	114,475	96,241	227,302	179,137
Other income (expense)
Gain on sale of real estate, net	24,151		25,618	7,413
Debt refinancing costs		(751)		(14,380)
Other	2,002	3,367	534	5,134
Total other income (expense)	26,153	2,616	26,152	(1,833)
Income before income tax	113,580	73,182	205,798	142,234
Income tax (expense) benefit	(1,563)	614	(2,738)	(253)
Net income	112,017	73,796	203,060	141,981
Net income attributable to non-controlling interests	(450)	(381)	(892)	(596)
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 111,567	$ 73,415	$ 202,168	$ 141,385
Earnings per common share — basic and diluted
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.30	$ 0.21	$ 0.55	$ 0.42
Weighted average shares outstanding - basic	364,897	349,856	364,889	335,456
Weighted average shares outstanding - diluted	365,541	350,319	365,442	335,871
Dividends declared per common share	$ 0.25	$ 0.24	$ 0.50	$ 0.48

Condensed Consolidated Statements of Comprehensive Income (Unaudited) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Net income	$ 112,017	$ 73,796	$ 203,060	$ 141,981
Other comprehensive income:
Foreign currency translation (loss) gain	(32,392)	34,020	(16,304)	40,312
Total comprehensive income	79,625	107,816	186,756	182,293
Comprehensive income attributable to non-controlling interests	(450)	(381)	(892)	(596)
Comprehensive income attributable to MPT common stockholders (Operating Partnership Partners)	79,175	107,435	185,864	181,697
MPT Operating Partnership, L.P. [Member]
Net income	112,017	73,796	203,060	141,981
Other comprehensive income:
Foreign currency translation (loss) gain	(32,392)	34,020	(16,304)	40,312
Total comprehensive income	79,625	107,816	186,756	182,293
Comprehensive income attributable to non-controlling interests	(450)	(381)	(892)	(596)
Comprehensive income attributable to MPT common stockholders (Operating Partnership Partners)	$ 79,175	$ 107,435	$ 185,864	$ 181,697

- Definition

The consolidated profit or loss for the period, net of income taxes, including the portion attributable to the noncontrolling interest.

+ References

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-Name Accounting Standards Codification
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-Name Accounting Standards Codification
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-Section 50
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
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-Section 50
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-URI http://asc.fasb.org/extlink&oid=115929826&loc=d3e8736-108599

Reference 6: http://www.xbrl.org/2003/role/exampleRef
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-URI http://asc.fasb.org/extlink&oid=84234705&loc=SL4591551-111686

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
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-URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3000-108585

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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-URI http://asc.fasb.org/extlink&oid=108774443&loc=SL4569616-111683

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=115929826&loc=d3e8933-108599

Reference 10: http://www.xbrl.org/2003/role/exampleRef
-Publisher FASB
-Name Accounting Standards Codification
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-SubTopic 10
-Section 55
-Paragraph 4K
-URI http://asc.fasb.org/extlink&oid=84234705&loc=SL4591552-111686

+ Details

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017
Operating activities
Net income	$ 203,060	$ 141,981
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	74,441	59,825
Amortization of deferred financing costs and debt discount	3,590	3,139
Direct financing lease interest accretion	(4,743)	(4,690)
Straight-line rent revenue	(41,664)	(30,173)
Share / (Unit)-based compensation expense	6,725	4,377
Gain from sale of real estate, net	(25,618)	(7,413)
Straight-line rent and other write-off	13,294	1,117
Debt refinancing costs		14,380
Other adjustments	(14,718)	(5,735)
Changes in:
Interest and rent receivables	(7,285)	(10,786)
Accounts payable and accrued expenses	(10,603)	(11,126)
Net cash provided by operating activities	196,479	154,896
Investing activities
Cash paid for acquisitions and other related investments	(273,728)	(600,781)
Net proceeds from sale of real estate	221,931	64,335
Principal received on loans receivable	262,862	5,188
Investment in loans receivable	(169,435)	(3,574)
Construction in progress and other	(22,875)	(36,002)
Other investments, net	(20,400)	(67,101)
Net cash used for investing activities	(1,645)	(637,935)
Financing activities
Proceeds from term debt		955,280
Payments of term debt		(675,279)
Revolving credit facilities, net	(4,618)	(39,911)
Distributions paid	(180,813)	(151,692)
Lease deposits and other obligations to tenants	(28,001)	5,790
Proceeds from sale of common shares, net of offering costs		548,063
Other financing activities	(2,328)	(16,543)
Net cash (used for) provided by financing activities	(215,760)	625,708
(Decrease) increase in cash, cash equivalents and restricted cash for period	(20,926)	142,669
Effect of exchange rate changes	(3,477)	9,588
Cash, cash equivalents and restricted cash at beginning of period	172,247	84,882
Cash, cash equivalents and restricted cash at end of period	147,844	237,139
Interest paid	115,245	63,371
Supplemental schedule of non-cash financing activities:
Distributions declared, unpaid	91,547	87,519
Cash, cash equivalents and restricted cash are comprised of the following:
Cash and cash equivalents at beginning of period	171,472	83,240
Restricted cash, included in Other assets at beginning of period	$ 775	$ 1,642
Restricted cash and cash equivalents, noncurrent, asset, statement of financial position [Extensible List]	us-gaap:OtherAssets	us-gaap:OtherAssets
Cash, cash equivalents and restricted cash at beginning of period	$ 172,247	$ 84,882
Cash and cash equivalents at end of period	146,569	236,364
Restricted cash, included in Other assets at end of period	$ 1,275	$ 775
Restricted cash and cash equivalents, noncurrent, asset, statement of financial position [Extensible List]	us-gaap:OtherAssets	us-gaap:OtherAssets
Cash, cash equivalents and restricted cash at end of period	$ 147,844	$ 237,139
MPT Operating Partnership, L.P. [Member]
Operating activities
Net income	203,060	141,981
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	74,441	59,825
Amortization of deferred financing costs and debt discount	3,590	3,139
Direct financing lease interest accretion	(4,743)	(4,690)
Straight-line rent revenue	(41,664)	(30,173)
Share / (Unit)-based compensation expense	6,725	4,377
Gain from sale of real estate, net	(25,618)	(7,413)
Straight-line rent and other write-off	13,294	1,117
Debt refinancing costs		14,380
Other adjustments	(14,718)	(5,735)
Changes in:
Interest and rent receivables	(7,285)	(10,786)
Accounts payable and accrued expenses	(10,603)	(11,126)
Net cash provided by operating activities	196,479	154,896
Investing activities
Cash paid for acquisitions and other related investments	(273,728)	(600,781)
Net proceeds from sale of real estate	221,931	64,335
Principal received on loans receivable	262,862	5,188
Investment in loans receivable	(169,435)	(3,574)
Construction in progress and other	(22,875)	(36,002)
Other investments, net	(20,400)	(67,101)
Net cash used for investing activities	(1,645)	(637,935)
Financing activities
Proceeds from term debt		955,280
Payments of term debt		(675,279)
Revolving credit facilities, net	(4,618)	(39,911)
Distributions paid	(180,813)	(151,692)
Lease deposits and other obligations to tenants	(28,001)	5,790
Proceeds from sale of common shares, net of offering costs		548,063
Other financing activities	(2,328)	(16,543)
Net cash (used for) provided by financing activities	(215,760)	625,708
(Decrease) increase in cash, cash equivalents and restricted cash for period	(20,926)	142,669
Effect of exchange rate changes	(3,477)	9,588
Cash, cash equivalents and restricted cash at beginning of period	172,247	84,882
Cash, cash equivalents and restricted cash at end of period	147,844	237,139
Interest paid	115,245	63,371
Supplemental schedule of non-cash financing activities:
Distributions declared, unpaid	91,547	87,519
Cash, cash equivalents and restricted cash are comprised of the following:
Cash and cash equivalents at beginning of period	171,472	83,240
Restricted cash, included in Other assets at beginning of period	$ 775	$ 1,642
Restricted cash and cash equivalents, noncurrent, asset, statement of financial position [Extensible List]	us-gaap:OtherAssets	us-gaap:OtherAssets
Cash, cash equivalents and restricted cash at beginning of period	$ 172,247	$ 84,882
Cash and cash equivalents at end of period	146,569	236,364
Restricted cash, included in Other assets at end of period	$ 1,275	$ 775
Restricted cash and cash equivalents, noncurrent, asset, statement of financial position [Extensible List]	us-gaap:OtherAssets	us-gaap:OtherAssets
Cash, cash equivalents and restricted cash at end of period	$ 147,844	$ 237,139

Organization	6 Months Ended
Organization	Jun. 30, 2018
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 2004. 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 non-real estate activities we undertake are 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 real estate related income flows 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

6 Months Ended

Jun. 30, 2018

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 and six months ended June 30, 2018, are not necessarily indicative of the results that may be expected for the year ending December 31, 2018. The condensed consolidated balance sheet at December 31, 2017 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, 2017, and as updated in our Form 10-Q for the quarter ended March 31, 2018. There have been no material changes to these significant accounting policies other than the following:

On July 1, 2018, we early adopted Accounting Standards Update (“ASU”) No. 2018-07, “Compensation-Stock Compensation.” Under the new standard, non-employee stock awards are to be accounted for similar to employee stock awards. This standard simplifies the accounting for non-employee stock awards, including fixing the value of the stock award at date of grant. The adoption of this standard did not have a material impact on our financial statements.

Recent Accounting Developments:

Leases

In February 2016, the Financial Accounting Board (the “FASB”) issued ASU 2016-02, “Leases”, which sets out the principles for the recognition, measurement, presentation and disclosure of leases for both parties to a contract (i.e. lessees and lessors). The new standard requires lessees to apply a dual approach, classifying leases as either financing or operating leases based on the principle of whether or not the lease is effectively a financed purchase by the lessee. This classification will determine whether lease expense is recognized based on an effective interest method or on a straight-line basis over the term of the lease. A lessee is also required to record a right-of-use asset and a lease liability for all leases with a term greater than 12 months regardless of their classification. Leases with a term of 12 months or less will be accounted for similar to existing guidance for operating leases today. The new standard requires lessors to account for leases using an approach that is substantially equivalent to existing guidance for sales-type leases, direct financing leases and operating leases. In July 2018, the FASB issued ASU 2018-11, “Leases (Topic 842): Targeted Improvements” (“ASU 2018-11”), allowing companies to record a cumulative adjustment to retained earnings in the period of adoption rather than requiring the restatement of prior periods.

We plan to adopt ASU 2016-02 on January 1, 2019, along with ASU 2018-11. We are continuing to evaluate this standard and the impact to us from both a lessor and lessee perspective. We do have leases in which we are the lessee, including ground leases, on which certain of our facilities reside, along with corporate office and equipment leases. Although we do not expect any change in the current classification of these leases, we will record a right-of-use asset and a lease liability on our balance sheet upon adoption of this standard, with any difference recorded as a cumulative adjustment in equity. From a lessor perspective, we do not expect any change in the current classification and accounting of our existing leases. However, we do expect certain non-lease components (including certain operating expenses that the tenants of our facilities are required to pay pursuant to our “triple-net” leases) to be recorded gross versus net of the respective expenses upon adoption of this standard in 2019 in accordance with ASU No. 2014-09.

Reclassifications

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

Variable Interest Entities

At June 30, 2018, 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 June 30, 2018 (in thousands):

VIE Type

Maximum Loss

Exposure(1)

Asset Type

Classification

Carrying

Amount(2)

Loans, net

325,963

Mortgage and other loans

229,367

Equity investments

14,395

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 June 30, 2018, we were not required to provide financial support through a liquidity arrangement or otherwise to our unconsolidated VIEs, including circumstances in which they 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 7 for additional description of the nature, purpose and activities of our more significant VIEs (such as Ernest Health Inc. (“Ernest”)) and interests therein.

Real Estate and Lending Activities

6 Months Ended

Jun. 30, 2018

Text Block [Abstract]

Real Estate and Lending Activities

3. Real Estate and Lending Activities

Acquisitions

We acquired the following assets (in thousands)

	For the Six Months Ended June 30,
	2018			2017
Assets Acquired
Land and land improvements	$	16,121		$	87,620
Building		232,409			399,867
Intangible lease assets — subject to amortization (weighted average useful life 20.0 years for 2018 and 28.5 years for 2017)		25,198			73,722
Net investments in direct financing leases		—			40,450
Liabilities assumed		—			(878	)
Total assets acquired	$	273,728		$	600,781
Loans repaid(1)		(259,378	)		—
Total net assets acquired	$	14,350		$	600,781

(1)

Includes $259.4 million of loans advanced to Steward Health Care System LLC (“Steward”) in 2017 and repaid in 2018 as described more fully below.

2018 Activity

On June 27, 2018, we acquired the fee simple real estate of two general acute care hospitals in Massachusetts from Steward in exchange for the reduction of $259.4 million of mortgage loans made to Steward in October 2016, along with an additional $14.4 million in cash consideration. These properties are being leased to Steward pursuant to the original master lease from October 2016 that has a 15-year term with three five-year extension options, plus consumer-price indexed increases.

2017 Activity

MEDIAN Transactions

On June 22, 2017, we acquired an acute care hospital in Germany for a purchase price of €19.4 million. This property is leased to affiliates of Median Kliniken S.à.r.l. (“MEDIAN”), pursuant to the original master lease agreement effective in 2015 and expiring December 2042 with annual escalators at the greater of one percent or 70% of the change in German CPI.

During the second quarter of 2017, we acquired 11 rehabilitation hospitals in Germany for an aggregate purchase price of €127 million. These 11 properties are leased to affiliates of MEDIAN, pursuant to a third master lease that has terms similar to the original master lease in 2015 with a fixed 27-year lease term ending in August 2043. These acquisitions are part of the portfolio of 20 properties in Germany that we agreed to acquire in July 2016 for €215.7 million, of which seven properties totaling €49.5 million closed in December 2016. The final two properties closed post June 30, 2017 for a purchase price of €39.2 million.

On January 30, 2017, we acquired an inpatient rehabilitation hospital in Germany for €8.4 million. This acquisition was the final property to close as part of the six hospital portfolio that we agreed to buy in September 2016 for an aggregate amount of €44.1 million. This property is leased to affiliates of MEDIAN, pursuant to the original long-term master lease agreement reached with MEDIAN in 2015 and as described above.

Other Transactions

On June 1, 2017, we acquired the real estate assets of Ohio Valley Medical Center, a 218-bed acute care hospital located in Wheeling, West Virginia, and the East Ohio Regional Hospital, a 139-bed acute care hospital in Martins Ferry, Ohio, from Ohio Valley Health Services, a not-for-profit entity in West Virginia, for an aggregate purchase price of approximately $40 million. We simultaneously leased the facilities to Alecto Healthcare Services LLC (“Alecto”), pursuant to a lease with a 15-year initial term with 2% annual minimum rent increases and three 5-year extension options. The facilities are cross-defaulted and cross-collateralized with our other hospitals operated by Alecto. We also agreed to provide up to $20.0 million in capital improvement funding on these two facilities - none of which has been funded to date. With these acquisitions, we also obtained a 20% interest in the operator of these facilities.

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 are leased to Steward, pursuant to the existing long-term master lease entered into with Steward in October 2016 and as described above.

On May 1, 2017, we also acquired the real estate of St. Joseph Regional Medical Center, a 145-bed acute care hospital in Lewiston, Idaho for $87.5 million. This facility is leased to RCCH Healthcare Partners (“RCCH”), pursuant to the existing long-term master lease entered into with RCCH in April 2016.

From the respective acquisition dates, the properties acquired in 2017 contributed $8.2 million of revenue and $6.0 million of income (excluding related acquisition expenses and taxes) for the three months ended June 30, 2017, and $8.4 million of revenue and $6.1 million of income (excluding related acquisition expenses and taxes) for the six months ended June 30, 2017. In addition, we expensed $9.1 million and $9.6 million of acquisition-related costs on these 2017 acquisitions for the three and six months ended June 30, 2017, respectively.

Development Activities

During the first six months of 2018, we completed construction on Ernest Flagstaff. This $25.5 million inpatient rehabilitation facility located in Flagstaff, Arizona opened on March 1, 2018 and is being leased to Ernest pursuant to a stand-alone lease, with terms generally similar to the original master lease.

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

Property	Commitment		Costs Incurred as of June 30, 2018		Estimated Completion Date
Circle Health (Birmingham, England)	$	44,825	$	20,942	1Q 2019
Circle Health Rehabilitation (Birmingham, England)		22,269		3,360	3Q 2019
Surgery Partners (Idaho Falls, Idaho)		113,468		23,318	1Q 2020
	$	180,562	$	47,620

Disposals

2018 Activity

Joint Venture Transaction

On June 7, 2018, we entered into a subscription agreement with Primotop Holdings S.à.r.l. (“Primotop”), an entity managed by Primonial Group, pursuant to which Primotop will acquire a 50% interest by way of a joint venture in the real estate of 71 post-acute hospitals in Germany that we currently own, with an aggregate agreed valuation of approximately €1.635 billion. The remaining 50% interest in the joint venture will be retained by us. Immediately following the closing, which is expected to occur during the third quarter of 2018, the joint venture is expected to make cash distributions to us in an aggregate amount of approximately €1.14 billion from the proceeds of the cash contributions from Primotop and certain secured debt financings within the joint venture. In preparation of this joint venture, we issued such secured debt on these properties on August 3, 2018, resulting in gross proceeds of €655 million. At June 30, 2018, the 71 facilities subject to the joint venture were designated as held for sale and included the following net assets (in thousands):

Real estate held for sale	$	1,263,257
Straight-line rent receivables		36,246
	$	1,299,503

Other Transactions

On June 4, 2018, we sold three long-term acute care hospitals located in California, Texas, and Oregon, that were leased and operated by Vibra Healthcare, LLC (“Vibra”), which included our equity investment in operations of the Texas facility. Total proceeds from the transaction were $53.3 million in cash, a mortgage loan in the amount of $18.3 million, and a $1.5 million working capital loan. The transaction resulted in a gain on real estate of $24.2 million, which was partially offset by a $5.1 million non-cash charge to revenue to write-off related straight-line rent receivables.

On March 1, 2018, we sold the real estate of St. Joseph Medical Center in Houston, Texas, for approximately $148 million to Steward. In return, we received a mortgage loan equal to the purchase price, with such loan secured by the underlying real estate. The mortgage loan has terms consistent with the other mortgage loans in the Steward portfolio. This transaction resulted in a gain of $1.5 million, offset by a $1.7 million non-cash charge to revenue to write-off related straight-line rent receivables on this property.

2017 Activity

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

Summary of Operations for Disposed Assets in 2018

The properties sold during 2018 and the assets held for sale (from the Joint Venture Transaction) at June 30, 2018, do not meet the definition of discontinued operations. However, the following represents the operating results (excluding gain on sale and any non-cash charges such as straight-line rent write-offs) from these properties (excluding the St. Joseph sale which was converted to a mortgage loan) for the periods presented (in thousands):

	For the Three Months Ended June 30,						For the Six Months Ended June 30,
	2018			2017			2018			2017
Revenues	$	34,142		$	28,817		$	69,900		$	55,536
Real estate depreciation and amortization		(6,129	)		(7,070	)		(14,902	)		(13,595	)
Property-related expenses		(14	)		(1	)		(255	)		(1	)
Other income (expense)		(410	)		(5,501	)		(969	)		(7,045	)
Income from real estate dispositions, net	$	27,589		$	16,245		$	53,774		$	34,895

As noted previously, we will retain a 50% interest in the Joint Venture Transaction; however, such interest has not been factored into the summary of operations above.

Leasing Operations

At June 30, 2018, leases on 14 Ernest facilities, ten Prime Healthcare Services, Inc. (“Prime”) facilities, and two Alecto facilities are accounted for as direct financing leases (“DFLs”). The components of our net investment in DFLs consisted of the following (in thousands):

	As of June 30, 2018			As of December 31, 2017
Minimum lease payments receivable	$	2,207,355		$	2,294,081
Estimated residual values		434,769			448,339
Less: Unearned income		(1,953,697	)		(2,043,693	)
Net investment in direct financing leases	$	688,427		$	698,727

On March 15, 2018, we entered into a new lease agreement of our long-term acute care facility in Boise, Idaho (the “Boise Lease”) with a joint venture formed by Vibra and Ernest. The new lease has an initial 15-year fixed term (ending March 2033) with three extension options of five years each. With this transaction, we incurred a non-cash charge of $1.5 million to write-off DFL unbilled interest associated with the previous lease to Ernest on this property.

Adeptus Health

As noted in previous filings, we have 16 properties that are transitioning away from Adeptus Health in stages over a two year period as part of Adeptus Health’s confirmed plan of reorganization under Chapter 11 of the Bankruptcy Code. On January 1, 2018 and April 1, 2018, Adeptus Health vacated and stopped making rent payments on five and three properties, respectively. Another seven properties will be transitioned away from Adeptus Health on October 1, 2018, with the remaining property on October 1, 2019. During the transition period, Adeptus Health has and will continue to make lease payments. As a result of the shortening of our lease term on these properties, we recorded a $3.9 million charge to accelerate the amortization of the straight-line rent receivables in the first half of 2018. At June 30, 2018, our investment in these 16 facilities approximates 1% of our total assets. Although no assurances can be made that we will not recognize a loss in the future, we believe at June 30, 2018 that our plans to sell or re-lease these 16 transition facilities will not result in any material loss or impairment.

At June 30, 2018, excluding the 16 transition properties, we have 21 properties leased to Adeptus Health representing $131.3 million or 1.4% of our total assets. During the last fifteen months, we have re-tenanted 22 properties with an investment of $172.1 million to strong credit worthy operators including:

Three Louisiana freestanding emergency facilities to Ochsner Clinic Foundation (“Ochsner”) on April 4, 2017;

11 Colorado freestanding emergency facilities to UCHealth on December 1, 2017; and

Eight Arizona facilities to Dignity Health on June 8, 2018.

Through June 30, 2018, all rent has been paid on these facilities, and we have only incurred a $0.5 million charge to-date related to the write-off of straight-line rent receivables on the facilities re-tenanted to Ochsner in 2017.

Gilbert and Florence Facilities

In the first quarter of 2018, we terminated the lease at our Gilbert and Florence, Arizona facilities due to the tenant not meeting its rent obligations pursuant to the lease. As a result of the lease terminating, we recorded a charge of $1.1 million to reserve against the straight-line rent receivables in February 2018. On April 25, 2018, this former tenant filed for involuntary bankruptcy. At June 30, 2018, all outstanding receivables were completely reserved. Although no assurances can be made that we will not have any impairment charges in the future, we believe our investment in the Gilbert and Florence facilities of $37.8 million at June 30, 2018, is fully recoverable.

Loans

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

	As of June 30, 2018		As of December 31, 2017
Mortgage loans	$	1,686,866	$	1,778,316
Acquisition loans		118,290		118,448
Working capital and other loans		29,565		31,761
	$	1,834,721	$	1,928,525

The decrease in mortgage loans relates to the use of two Steward mortgage loans to fund our acquisition of the related fee simple real estate of two facilities on June 27, 2018 – see “Acquisitions” of this Note 3 for further information. This decrease was partially offset by the new mortgage loans made on the St. Joseph property on March 1, 2018 and as part of the Vibra disposal transaction on June 4, 2018 – see “Disposals” of this Note 3 for further information.

Our non-mortgage loans typically consist of loans to our tenants for acquisitions and working capital purposes. At June 30, 2018, acquisition loans includes $113.6 million in loans to Ernest.

Concentrations of Credit Risk

Our revenue concentration for the six months ended June 30, 2018 as compared to the prior year is as follows (dollars in thousands):

Revenue by Operator

	For the Six Months Ended June 30,
	2018					2017
Operators	Total Revenue		Percentage of Total Revenue			Total Revenue		Percentage of Total Revenue
Steward (1)	$	147,868		36.3	%	$	72,518		22.4	%
Prime		63,590		15.6	%		63,059		19.5	%
MEDIAN		57,289		14.1	%		47,744		14.8	%
Ernest		34,542		8.5	%		35,269		10.9	%
RCCH		20,414		5.0	%		19,632		6.1	%
Other operators		83,245		20.5	%		84,982		26.3	%
Total	$	406,948		100.0	%	$	323,204		100.0	%

(1)

Includes revenue from IASIS prior to being acquired by Steward on September 29, 2017.

Revenue by U.S. State and Country

	For the Six Months Ended June 30,
	2018					2017
U.S. States and Other Countries	Total Revenue		Percentage of Total Revenue			Total Revenue		Percentage of Total Revenue
Texas	$	60,361		14.8	%	$	49,851		15.4	%
Massachusetts		54,433		13.4	%		53,159		16.5	%
Utah		41,734		10.3	%		5,057		1.6	%
California		29,422		7.2	%		33,123		10.3	%
Arizona		23,286		5.7	%		15,542		4.8	%
All other states		121,307		29.8	%		109,875		33.9	%
Total U.S.	$	330,543		81.2	%	$	266,607		82.5	%
Germany	$	74,176		18.2	%	$	54,576		16.9	%
United Kingdom, Italy, and Spain		2,229		0.6	%		2,021		0.6	%
Total International	$	76,405		18.8	%	$	56,597		17.5	%
Grand Total	$	406,948		100.0	%	$	323,204		100.0	%

On an individual property basis, we had no investment of any single property greater than 4% of our total assets as of June 30, 2018.

Debt

6 Months Ended

Jun. 30, 2018

Debt Disclosure [Abstract]

Debt

4. Debt

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

	As of June 30, 2018			As of December 31, 2017
Revolving credit facility(A)	$	835,848		$	840,810
Term loan		200,000			200,000
4.000% Senior Unsecured Notes due 2022(B)		584,200			600,250
5.500% Senior Unsecured Notes due 2024		300,000			300,000
6.375% Senior Unsecured Notes due 2024		500,000			500,000
3.325% Senior Unsecured Notes due 2025(B)		584,200			600,250
5.250% Senior Unsecured Notes due 2026		500,000			500,000
5.000% Senior Unsecured Notes due 2027		1,400,000			1,400,000
	$	4,904,248		$	4,941,310
Debt issue costs, net		(39,987	)		(42,643	)
	$	4,864,261		$	4,898,667

(A)	Includes £12 million and £8 million of GBP-denominated borrowings that reflect the exchange rate at June 30, 2018 and December 31, 2017, respectively.

(B)	These notes are Euro-denominated and reflect the exchange rate at June 30, 2018 and December 31, 2017, respectively.

As of June 30, 2018, principal payments due on our debt (which exclude the effects of any discounts, premiums, or debt issue costs recorded) are as follows (in thousands):

2018	$	—
2019		—
2020		—
2021		835,848
2022		784,200
Thereafter		3,284,200
Total	$	4,904,248

2017 Activity

On February 1, 2017, we replaced our previous unsecured credit facility (which we had entered into in 2014 and amended in 2015) with a new revolving credit and term loan agreement (“Credit Facility”). The new agreement included a $1.3 billion unsecured revolving loan facility (same amount as the previous revolving loan facility), a $200 million unsecured term loan facility ($50 million lower than the previous term loan), and a new €200 million unsecured term loan facility.

On March 4, 2017, we redeemed the €200 million aggregate principal amount of our 5.750% Senior Unsecured Notes due 2020.

On March 24, 2017, we completed a €500 million senior unsecured notes offering (“3.325% Senior Unsecured Notes due 2025”). A portion of the proceeds from this offering were used to prepay and extinguish the €200 million term loan facility portion of our Credit Facility on March 30, 2017.

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 first six months of 2017.

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 June 30, 2018, the dividend restriction was 95% of normalized adjusted funds from operations (“NAFFO”). The indentures governing our senior unsecured notes also limit the amount of dividends we can pay based on the sum of 95% of NAFFO, proceeds of equity issuances and certain other net cash proceeds. Finally, our senior unsecured notes require us to maintain total unencumbered assets (as defined in the related indenture) of not less than 150% of our unsecured indebtedness.

In addition to these restrictions, the Credit Facility contains customary financial and operating covenants, including covenants relating to our total leverage ratio, fixed charge coverage ratio, secured leverage ratio, consolidated adjusted net worth, unsecured leverage ratio, and unsecured interest coverage ratio. This Credit Facility also contains customary events of default, including among others, nonpayment of principal or interest, material inaccuracy of representations and failure to comply with our covenants. If an event of default occurs and is continuing under the Credit Facility, the entire outstanding balance may become immediately due and payable. At June 30, 2018, we were in compliance with all such financial and operating covenants.

Common Stock/Partner's Capital	6 Months Ended
Common Stock/Partner's Capital	Jun. 30, 2018
Equity [Abstract]
Common Stock/Partner's Capital	5. Common Stock/Partners’ Capital Medical Properties Trust, Inc. On May 1, 2017, we completed an underwritten public offering of approximately 43.1 million shares (including the exercise of the underwriters’ 30-day option to purchase an additional 5.6 million shares) of our common stock, resulting in net proceeds of approximately $548 million, after deducting offering expenses. MPT Operating Partnership, L.P. At June 30, 2018, the Company has a 99.92% ownership interest in the Operating Partnership with the remainder owned by two other partners, which are employees. During the six months ended June 30, 2017, the Operating Partnership issued approximately 43.1 million units in direct response to the common stock offerings by Medical Properties Trust, Inc. during the same period.

Stock Awards	6 Months Ended
Stock Awards	Jun. 30, 2018
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock Awards	6. Stock Awards We adopted the 2013 Equity Incentive Plan (the “Equity Incentive Plan”) during the second quarter of 2013, which authorizes the issuance of common stock options, restricted stock, restricted stock units, deferred stock units, stock appreciation rights, performance units and awards of interests in our Operating Partnership. The Equity Incentive Plan is administered by the Compensation Committee of the Board of Directors. We have reserved 8,196,770 shares of common stock for awards under the Equity Incentive Plan for which 1,690,590 million shares remain available for future stock awards as of June 30, 2018. Share-based compensation expense totaled $6.7 million and $4.4 million for the six months ended June 30, 2018 and 2017, respectively.

Fair Value of Financial Instruments

6 Months Ended

Jun. 30, 2018

Fair Value Disclosures [Abstract]

Fair Value of Financial Instruments

7. 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 loan 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):

	As of						As of
	June 30, 2018						December 31, 2017
Asset (Liability)	Book Value			Fair Value			Book Value			Fair Value
Interest and rent receivables	$	85,181		$	84,292		$	78,970		$	78,028
Loans (1)		1,605,355			1,627,579			1,698,471			1,722,101
Debt, net		(4,864,261	)		(4,889,856	)		(4,898,667	)		(5,073,707	)

(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 currently existing equity interests or loans.

At June 30, 2018, these amounts were as follows (in thousands):

Asset Type	Fair Value		Original Cost		Asset Type Classification
Mortgage loans	$	115,000	$	115,000	Mortgage loans
Equity investments and other loans		110,672		117,666	Other loans/other assets
	$	225,672	$	232,666

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 June 30, 2018.

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

(60

)

- 100 basis points

Because the fair value of the Ernest investments noted above is below our original cost, we recognized an unrealized loss during the first half of 2018. No unrealized gain/loss on the Ernest investments was recorded in the first half of 2017.

- 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

6 Months Ended

Jun. 30, 2018

Earnings Per Share [Abstract]

Earnings Per Share

8. 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 June 30,
	2018			2017
Numerator:
Net income	$	112,017		$	73,796
Non-controlling interests’ share in net income		(450	)		(381	)
Participating securities’ share in earnings		(323	)		(100	)
Net income, less participating securities’ share in earnings	$	111,244		$	73,315
Denominator:
Basic weighted-average common shares		364,897			349,856
Dilutive potential common shares		644			463
Dilutive weighted-average common shares		365,541			350,319

	For the Six Months Ended June 30,
	2018			2017
Numerator:
Net income	$	203,060		$	141,981
Non-controlling interests’ share in net income		(892	)		(596	)
Participating securities’ share in earnings		(518	)		(225	)
Net income, less participating securities’ share in earnings	$	201,650		$	141,160
Denominator:
Basic weighted-average common shares		364,889			335,456
Dilutive potential common shares		553			415
Dilutive weighted-average common shares		365,442			335,871

MPT Operating Partnership, L.P.

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

	For the Three Months Ended June 30,
	2018			2017
Numerator:
Net income	$	112,017		$	73,796
Non-controlling interests’ share in net income		(450	)		(381	)
Participating securities’ share in earnings		(323	)		(100	)
Net income, less participating securities’ share in earnings	$	111,244		$	73,315
Denominator:
Basic weighted-average units		364,897			349,856
Dilutive potential units		644			463
Diluted weighted-average units		365,541			350,319

	For the Six Months Ended June 30,
	2018			2017
Numerator:
Net income	$	203,060		$	141,981
Non-controlling interests’ share in net income		(892	)		(596	)
Participating securities’ share in earnings		(518	)		(225	)
Net income, less participating securities’ share in earnings	$	201,650		$	141,160
Denominator:
Basic weighted-average units		364,889			335,456
Dilutive potential units		553			415
Diluted weighted-average units		365,442			335,871

Commitments and Contingencies	6 Months Ended
Commitments and Contingencies	Jun. 30, 2018
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	9. Commitments and Contingencies Commitments On September 28, 2016, we entered into definitive agreements to acquire an acute care hospital in Washington for a purchase price of $17.5 million. Upon closing, the facility will be leased to RCCH, pursuant to the current master lease. Closing of this transaction, which is expected to be completed in 2018 is subject to customary real estate, regulatory and other closing conditions. On June 6, 2018, we entered into a definitive agreement to acquire four rehabilitation hospitals in Germany for a purchase price of approximately €23 million (including real estate transfer taxes). Upon closing, these facilities will be leased to affiliates of MEDIAN, pursuant to a new 27-year master lease with annual escalators at the greater of one percent or 70% of the change in German CPI. We expect to complete this transaction during the third quarter of 2018. 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.

Summary of Significant Accounting Policies (Policies)

6 Months Ended

Jun. 30, 2018

Accounting Policies [Abstract]

Unaudited Interim Condensed Consolidated Financial Statements

Recent Accounting Developments

Recent Accounting Developments:

Leases

Reclassifications

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

Variable Interest Entities

VIE Type

Maximum Loss

Exposure(1)

Asset Type

Classification

Carrying

Amount(2)

Loans, net

325,963

Mortgage and other loans

229,367

Equity investments

14,395

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

Summary of Significant Accounting Policies (Tables)

6 Months Ended

Jun. 30, 2018

Accounting Policies [Abstract]

Carrying Value and Classification of Related Assets and Maximum Exposure to Loss

The carrying value and classification of the related assets and maximum exposure to loss as a result of our involvement with these VIEs are presented below at June 30, 2018 (in thousands):

VIE Type

Maximum Loss

Exposure(1)

Asset Type

Classification

Carrying

Amount(2)

Loans, net

325,963

Mortgage and other loans

229,367

Equity investments

14,395

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)

6 Months Ended

Jun. 30, 2018

Text Block [Abstract]

Assets Acquired

We acquired the following assets (in thousands)

	For the Six Months Ended June 30,
	2018			2017
Assets Acquired
Land and land improvements	$	16,121		$	87,620
Building		232,409			399,867
Intangible lease assets — subject to amortization (weighted average useful life 20.0 years for 2018 and 28.5 years for 2017)		25,198			73,722
Net investments in direct financing leases		—			40,450
Liabilities assumed		—			(878	)
Total assets acquired	$	273,728		$	600,781
Loans repaid(1)		(259,378	)		—
Total net assets acquired	$	14,350		$	600,781

(1)

Includes $259.4 million of loans advanced to Steward Health Care System LLC (“Steward”) in 2017 and repaid in 2018 as described more fully below.

Summary of Status Update on Current Development Projects

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

Property	Commitment		Costs Incurred as of June 30, 2018		Estimated Completion Date
Circle Health (Birmingham, England)	$	44,825	$	20,942	1Q 2019
Circle Health Rehabilitation (Birmingham, England)		22,269		3,360	3Q 2019
Surgery Partners (Idaho Falls, Idaho)		113,468		23,318	1Q 2020
	$	180,562	$	47,620

Summary of Facilities Subject to Joint Venture Designated as Held for Sale

At June 30, 2018, the 71 facilities subject to the joint venture were designated as held for sale and included the following net assets (in thousands):

Real estate held for sale	$	1,263,257
Straight-line rent receivables		36,246
	$	1,299,503

Summary of Operations for Disposed Assets in 2018

	For the Three Months Ended June 30,						For the Six Months Ended June 30,
	2018			2017			2018			2017
Revenues	$	34,142		$	28,817		$	69,900		$	55,536
Real estate depreciation and amortization		(6,129	)		(7,070	)		(14,902	)		(13,595	)
Property-related expenses		(14	)		(1	)		(255	)		(1	)
Other income (expense)		(410	)		(5,501	)		(969	)		(7,045	)
Income from real estate dispositions, net	$	27,589		$	16,245		$	53,774		$	34,895

Components of Net Investment in Direct Financing Leases

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

	As of June 30, 2018			As of December 31, 2017
Minimum lease payments receivable	$	2,207,355		$	2,294,081
Estimated residual values		434,769			448,339
Less: Unearned income		(1,953,697	)		(2,043,693	)
Net investment in direct financing leases	$	688,427		$	698,727

Summary of Loans

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

	As of June 30, 2018		As of December 31, 2017
Mortgage loans	$	1,686,866	$	1,778,316
Acquisition loans		118,290		118,448
Working capital and other loans		29,565		31,761
	$	1,834,721	$	1,928,525

Schedule of Revenue by Operator

Revenue by Operator

	For the Six Months Ended June 30,
	2018					2017
Operators	Total Revenue		Percentage of Total Revenue			Total Revenue		Percentage of Total Revenue
Steward (1)	$	147,868		36.3	%	$	72,518		22.4	%
Prime		63,590		15.6	%		63,059		19.5	%
MEDIAN		57,289		14.1	%		47,744		14.8	%
Ernest		34,542		8.5	%		35,269		10.9	%
RCCH		20,414		5.0	%		19,632		6.1	%
Other operators		83,245		20.5	%		84,982		26.3	%
Total	$	406,948		100.0	%	$	323,204		100.0	%

(1)

Includes revenue from IASIS prior to being acquired by Steward on September 29, 2017.

Schedule of Revenue from External Customers by Geographic Areas

Revenue by U.S. State and Country

	For the Six Months Ended June 30,
	2018					2017
U.S. States and Other Countries	Total Revenue		Percentage of Total Revenue			Total Revenue		Percentage of Total Revenue
Texas	$	60,361		14.8	%	$	49,851		15.4	%
Massachusetts		54,433		13.4	%		53,159		16.5	%
Utah		41,734		10.3	%		5,057		1.6	%
California		29,422		7.2	%		33,123		10.3	%
Arizona		23,286		5.7	%		15,542		4.8	%
All other states		121,307		29.8	%		109,875		33.9	%
Total U.S.	$	330,543		81.2	%	$	266,607		82.5	%
Germany	$	74,176		18.2	%	$	54,576		16.9	%
United Kingdom, Italy, and Spain		2,229		0.6	%		2,021		0.6	%
Total International	$	76,405		18.8	%	$	56,597		17.5	%
Grand Total	$	406,948		100.0	%	$	323,204		100.0	%

- Definition

Tabular disclosure of information related to a disposal group. Includes, but is not limited to, a discontinued operation, disposal classified as held-for-sale or disposed of by means other than sale or disposal of an individually significant component.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 7: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 11: http://fasb.org/us-gaap/role/ref/legacyRef
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+ Details

Debt (Tables)

6 Months Ended

Jun. 30, 2018

Debt Disclosure [Abstract]

Summary of Debt

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

	As of June 30, 2018			As of December 31, 2017
Revolving credit facility(A)	$	835,848		$	840,810
Term loan		200,000			200,000
4.000% Senior Unsecured Notes due 2022(B)		584,200			600,250
5.500% Senior Unsecured Notes due 2024		300,000			300,000
6.375% Senior Unsecured Notes due 2024		500,000			500,000
3.325% Senior Unsecured Notes due 2025(B)		584,200			600,250
5.250% Senior Unsecured Notes due 2026		500,000			500,000
5.000% Senior Unsecured Notes due 2027		1,400,000			1,400,000
	$	4,904,248		$	4,941,310
Debt issue costs, net		(39,987	)		(42,643	)
	$	4,864,261		$	4,898,667

(A)	Includes £12 million and £8 million of GBP-denominated borrowings that reflect the exchange rate at June 30, 2018 and December 31, 2017, respectively.

(B)	These notes are Euro-denominated and reflect the exchange rate at June 30, 2018 and December 31, 2017, respectively.

Principal Payments Due on Debt

As of June 30, 2018, principal payments due on our debt (which exclude the effects of any discounts, premiums, or debt issue costs recorded) are as follows (in thousands):

2018	$	—
2019		—
2020		—
2021		835,848
2022		784,200
Thereafter		3,284,200
Total	$	4,904,248

Fair Value of Financial Instruments (Tables)

6 Months Ended

Jun. 30, 2018

Fair Value Disclosures [Abstract]

Summary of Fair Value Information of Financial Instruments

The following table summarizes fair value estimates for our financial instruments (in thousands):

	As of						As of
	June 30, 2018						December 31, 2017
Asset (Liability)	Book Value			Fair Value			Book Value			Fair Value
Interest and rent receivables	$	85,181		$	84,292		$	78,970		$	78,028
Loans (1)		1,605,355			1,627,579			1,698,471			1,722,101
Debt, net		(4,864,261	)		(4,889,856	)		(4,898,667	)		(5,073,707	)

(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 June 30, 2018, these amounts were as follows (in thousands):

Asset Type	Fair Value		Original Cost		Asset Type Classification
Mortgage loans	$	115,000	$	115,000	Mortgage loans
Equity investments and other loans		110,672		117,666	Other loans/other assets
	$	225,672	$	232,666

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

(60

)

- 100 basis points

Earnings Per Share (Tables)

6 Months Ended

Jun. 30, 2018

Earnings Per Share [Abstract]

Calculation of Earnings Per Share

Medical Properties Trust, Inc.

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

	For the Three Months Ended June 30,
	2018			2017
Numerator:
Net income	$	112,017		$	73,796
Non-controlling interests’ share in net income		(450	)		(381	)
Participating securities’ share in earnings		(323	)		(100	)
Net income, less participating securities’ share in earnings	$	111,244		$	73,315
Denominator:
Basic weighted-average common shares		364,897			349,856
Dilutive potential common shares		644			463
Dilutive weighted-average common shares		365,541			350,319

	For the Six Months Ended June 30,
	2018			2017
Numerator:
Net income	$	203,060		$	141,981
Non-controlling interests’ share in net income		(892	)		(596	)
Participating securities’ share in earnings		(518	)		(225	)
Net income, less participating securities’ share in earnings	$	201,650		$	141,160
Denominator:
Basic weighted-average common shares		364,889			335,456
Dilutive potential common shares		553			415
Dilutive weighted-average common shares		365,442			335,871

MPT Operating Partnership, L.P.

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

	For the Three Months Ended June 30,
	2018			2017
Numerator:
Net income	$	112,017		$	73,796
Non-controlling interests’ share in net income		(450	)		(381	)
Participating securities’ share in earnings		(323	)		(100	)
Net income, less participating securities’ share in earnings	$	111,244		$	73,315
Denominator:
Basic weighted-average units		364,897			349,856
Dilutive potential units		644			463
Diluted weighted-average units		365,541			350,319

	For the Six Months Ended June 30,
	2018			2017
Numerator:
Net income	$	203,060		$	141,981
Non-controlling interests’ share in net income		(892	)		(596	)
Participating securities’ share in earnings		(518	)		(225	)
Net income, less participating securities’ share in earnings	$	201,650		$	141,160
Denominator:
Basic weighted-average units		364,889			335,456
Dilutive potential units		553			415
Diluted weighted-average units		365,442			335,871

Summary of Significant Accounting Policies - Carrying Value and Classification of Related Assets and Maximum Exposure to Loss (Detail)	Jun. 30, 2018 USD ($)
Mortgage and other loans [Member]
Variable Interest Entity [Line Items]
Carrying Amount	$ 229,367,000
Loans, net [Member]
Variable Interest Entity [Line Items]
Maximum Loss Exposure	325,963,000
Equity investments [Member]
Variable Interest Entity [Line Items]
Maximum Loss Exposure	$ 14,395,000

Real Estate and Lending Activities - Assets Acquired (Detail) - USD ($)
$ in Thousands

Jun. 30, 2018

Jun. 30, 2017

Business Acquisition [Line Items]

Total assets acquired

$ 273,728

$ 600,781

Liabilities assumed

(878)

Loans repaid

^[1]

(259,378)

Total net assets acquired

14,350

600,781

Land and Land Improvements [Member]

Business Acquisition [Line Items]

Total assets acquired

16,121

87,620

Building [Member]

Business Acquisition [Line Items]

Total assets acquired

232,409

399,867

Intangible Lease Assets - Subject to Amortization [Member]

Business Acquisition [Line Items]

Total assets acquired

$ 25,198

73,722

Net Investments in Direct Financing Leases [Member]

Business Acquisition [Line Items]

Total assets acquired

$ 40,450

[1]	Includes $259.4 million of loans advanced to Steward Health Care System LLC (“Steward”) in 2017 and repaid in 2018 as described more fully below.

Real Estate and Loans Receivable - Assets Acquired (Parenthetical) (Detail) - USD ($)
$ in Thousands

6 Months Ended

Jun. 30, 2018

Jun. 30, 2017

Business Acquisition [Line Items]

Loans repaid

^[1]

$ 259,378

Steward Health Care System LLC [Member]

Business Acquisition [Line Items]

Loans repaid

$ 259,400

Intangible Lease Assets - Subject to Amortization [Member]

Business Acquisition [Line Items]

Weighted average useful life of acquired intangible lease assets (in years)

20 years

28 years 6 months

[1]	Includes $259.4 million of loans advanced to Steward Health Care System LLC (“Steward”) in 2017 and repaid in 2018 as described more fully below.

Real Estate and Lending Activities - 2018 Activity - Additional Information (Detail) $ in Thousands		1 Months Ended	6 Months Ended
	Jun. 27, 2018 USD ($) RenewalOption Hospital	Oct. 31, 2016 USD ($)	Jun. 30, 2018 USD ($)	Jun. 30, 2017 USD ($)
Business Acquisition [Line Items]
Payment of cash consideration for acquisition			$ 273,728	$ 600,781
2018 [Member] \| General Acute Care Hospital and Healthcare System [Member]
Business Acquisition [Line Items]
Term of lease	15 years
Number of lease extension options \| RenewalOption	3
Term of lease extension, years	5 years
Number of facilities acquired \| Hospital	2
Mortgage financing		$ 259,400
Payment of cash consideration for acquisition	$ 14,400

Real Estate and Lending Activities - 2017 Activity - Additional Information (Detail) € in Millions						1 Months Ended		3 Months Ended		5 Months Ended	6 Months Ended
	Jun. 06, 2018 EUR (€) Hospital	Jun. 22, 2017 EUR (€)	Jun. 01, 2017 USD ($) RenewalOption Bed	May 01, 2017 USD ($) Hospital Bed	Jan. 30, 2017 EUR (€)	Dec. 31, 2016 EUR (€) Property	Jul. 31, 2016 EUR (€) Property	Jun. 30, 2017 USD ($) Hospital Property	Jun. 30, 2017 EUR (€) Hospital Property	Jan. 30, 2017 EUR (€) Hospital	Jun. 30, 2017 USD ($)
Germany [Member] \| Rehabilitation Hospital with Covenant Health System [Member]
Business Acquisition [Line Items]
Number of facilities acquired \| Hospital	4									6
Purchase price of acquisition \| €					€ 8.4					€ 44.1
Germany [Member] \| Rehabilitation Hospital with Covenant Health System [Member] \| MEDIAN [Member]
Business Acquisition [Line Items]
Term of lease	27 years
Lease rent increase percentage	70.00%
Lease rate	1.00%
Germany [Member] \| Acute Care Hospital [Member]
Business Acquisition [Line Items]
Purchase price of acquisition \| €	€ 23.0
2017 [Member] \| Business Acquisitions [Member]
Business Acquisition [Line Items]
Revenue contributed by the acquired entity								$ 8,200,000			$ 8,400,000
Income contributed by the acquired entity								6,000,000			6,100,000
Acquisition related costs								$ 9,100,000			$ 9,600,000
2017 [Member] \| Acute Care Hospital [Member] \| Alecto Healthcare Services [Member] \| Ohio Valley Medical Center [Member]
Business Acquisition [Line Items]
Number of beds acquired \| Bed			218
2017 [Member] \| Acute Care Hospital [Member] \| Alecto Healthcare Services [Member] \| East Ohio Regional Hospital [Member]
Business Acquisition [Line Items]
Number of beds acquired \| Bed			139
2017 [Member] \| Germany [Member] \| Rehabilitation Hospital with Covenant Health System [Member] \| Third Master Lease [Member]
Business Acquisition [Line Items]
Number of facilities acquired							20	11	11
Acquisition costs \| €							€ 215.7		€ 127.0
Term of lease									27 years
Lease agreement, end date								2043-08	2043-08
Number of properties closed \| Property						7		2	2
Amount of properties closed \| €						€ 49.5			€ 39.2
2017 [Member] \| Germany [Member] \| Acute Care Hospital [Member] \| MEDIAN [Member]
Business Acquisition [Line Items]
Lease agreement, end date		2042-12
Purchase price of acquisition \| €		€ 19.4
Lease rent increase percentage		70.00%
Lease rate		1.00%
2017 [Member] \| West Virginia and Ohio [Member] \| Acute Care Hospital [Member] \| Alecto Healthcare Services [Member]
Business Acquisition [Line Items]
Term of lease			15 years
Purchase price of acquisition			$ 40,000,000
Percentage of increase in annual rent			2.00%
Number of lease extension options \| RenewalOption			3
Term of lease extension, years			5 years
Additional fund committed to the tenant for capital improvements			$ 20,000,000
Purchase price of acquisition funded			$ 0
Ownership interest percentage in operator facility			20.00%
2017 [Member] \| Florida, Ohio, and Pennsylvania [Member] \| Community Health Systems, Inc. [Member]
Business Acquisition [Line Items]
Number of facilities acquired \| Hospital				8
Purchase price of acquisition				$ 301,300,000
2017 [Member] \| IDAHO, Lewiston \| Acute Care Hospital [Member] \| St. Joseph Regional Medical Center [Member]
Business Acquisition [Line Items]
Purchase price of acquisition				$ 87,500,000
Number of beds acquired \| Bed				145

Real Estate and Lending Activities - Acquisitions - Additional Information (Detail) - Germany [Member] - Rehabilitation Hospital with Covenant Health System [Member] € in Millions			5 Months Ended
	Jun. 06, 2018 Hospital	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	4		6

Real Estate and Lending Activities - Development Activities - Additional Information (Detail) $ in Millions	6 Months Ended
	Jun. 30, 2018 USD ($)
Ernest [Member] \| Development Activities [Member]
Business Acquisition [Line Items]
Estimated total development cost	$ 25.5

Real Estate and Lending Activities - Summary of Status Update on Current Development Projects (Detail) $ in Thousands	6 Months Ended
	Jun. 30, 2018 USD ($)
Business Acquisition [Line Items]
Commitment	$ 180,562
Costs Incurred as of June 30, 2018	47,620
Circle Health [Member] \| Birmingham, England [Member]
Business Acquisition [Line Items]
Commitment	44,825
Costs Incurred as of June 30, 2018	$ 20,942
Estimated Completion Date	1Q 2019
Circle Health Rehabilitation [Member] \| Birmingham, England [Member]
Business Acquisition [Line Items]
Commitment	$ 22,269
Costs Incurred as of June 30, 2018	$ 3,360
Estimated Completion Date	3Q 2019
Surgery Partners [Member] \| Idaho Falls, ID [Member]
Business Acquisition [Line Items]
Commitment	$ 113,468
Costs Incurred as of June 30, 2018	$ 23,318
Estimated Completion Date	1Q 2020

Real Estate and Lending Activities - Disposals - Additional Information (Detail) $ in Thousands, € in Millions						3 Months Ended	6 Months Ended
	Aug. 03, 2018 EUR (€)	Jun. 07, 2018 EUR (€) Hospital	Jun. 04, 2018 USD ($) Hospital	Mar. 01, 2018 USD ($)	Mar. 31, 2017 USD ($)	Sep. 30, 2018 EUR (€)	Jun. 30, 2018 USD ($) Facility	Jun. 30, 2017 USD ($)	Dec. 31, 2017 USD ($)
Debt Instrument [Line Items]
Proceeds from sale of facilities					$ 64,000
Loans, Balance							$ 1,834,721		$ 1,928,525
Gain on real estate dispositions					7,400
Gain offset by non-cash charges					$ 600
Net proceeds from sale of real estate							221,931	$ 64,335
Steward Health Care System LLC [Member] \| Houston, Texas [Member] \| St. Joseph Medical Center [Member]
Debt Instrument [Line Items]
Gain on real estate dispositions				$ 1,500
Gain offset by non-cash charges				1,700
Net proceeds from sale of real estate				$ 148,000
Working Capital Loans [Member]
Debt Instrument [Line Items]
Loans, Balance							29,565		31,761
Mortgage Loans [Member]
Debt Instrument [Line Items]
Loans, Balance							1,686,866		$ 1,778,316
Germany [Member] \| Acute Care Hospital [Member]
Debt Instrument [Line Items]
Ownership interest in joint venture under the equity method		50.00%
Aggregate value of ownership interest		€ 1,635					$ 1,299,503
Number of facilities designated as held for sale \| Facility							71
Germany [Member] \| Acute Care Hospital [Member] \| Subsequent Event [Member]
Debt Instrument [Line Items]
Proceeds from issuance of new secured debt \| €	€ 655
California, Texas, and Oregon [Member] \| Vibra Healthcare, LLC [Member]
Debt Instrument [Line Items]
Proceeds from sale of facilities			$ 53,300
Gain on real estate dispositions			24,200
Gain offset by non-cash charges			5,100
California, Texas, and Oregon [Member] \| Working Capital Loans [Member] \| Vibra Healthcare, LLC [Member]
Debt Instrument [Line Items]
Loans, Balance			1,500
California, Texas, and Oregon [Member] \| Mortgage Loans [Member] \| Vibra Healthcare, LLC [Member]
Debt Instrument [Line Items]
Loans, Balance			$ 18,300
California, Texas, and Oregon [Member] \| Long-term Acute Care Hospital [Member] \| Vibra Healthcare, LLC [Member]
Debt Instrument [Line Items]
Number of properties sold \| Hospital			3
Primotop Holdings S.a.r.l. [Member] \| Germany [Member] \| Acute Care Hospital [Member]
Debt Instrument [Line Items]
Ownership interest in joint venture under the equity method		50.00%
Number of facilities acquired \| Hospital		71
Primotop Holdings S.a.r.l. [Member] \| Germany [Member] \| Scenario, Forecast [Member] \| Acute Care Hospital [Member]
Debt Instrument [Line Items]
Proceeds from joint venture \| €						€ 1,140

Real Estate and Lending Activities - Summary of Facilities Subject to Joint Venture Designated as Held for Sale (Detail) $ in Thousands, € in Millions	Jun. 30, 2018 USD ($)	Jun. 07, 2018 EUR (€)	Dec. 31, 2017 USD ($)
Business Acquisition [Line Items]
Real estate held for sale	$ 1,263,257		$ 146,615
Straight-line rent receivables	215,297		$ 185,592
Germany [Member] \| Acute Care Hospital [Member]
Business Acquisition [Line Items]
Real estate held for sale	1,263,257
Straight-line rent receivables	36,246
Total	$ 1,299,503	€ 1,635

Real Estate and Lending Activities - Summary of Operations for Disposed Assets in 2018 (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Disposal Group Not Discontinued Operation Income Statement Disclosures [Abstract]
Revenues	$ 34,142	$ 28,817	$ 69,900	$ 55,536
Real estate depreciation and amortization	(6,129)	(7,070)	(14,902)	(13,595)
Property-related expenses	(14)	(1)	(255)	(1)
Other income (expense)	(410)	(5,501)	(969)	(7,045)
Income from real estate dispositions, net	$ 27,589	$ 16,245	$ 53,774	$ 34,895

Real Estate and Lending Activities - Leasing Operations - Additional Information (Detail) $ in Millions		6 Months Ended
	Mar. 15, 2018 USD ($) RenewalOption	Jun. 30, 2018 Lease
Ernest [Member]
Business Acquisition [Line Items]
Number of direct financing leases		14
Prime Facilities [Member]
Business Acquisition [Line Items]
Number of direct financing leases		10
Alecto Healthcare Services [Member]
Business Acquisition [Line Items]
Number of direct financing leases		2
Vibra Healthcare, LLC [Member] \| Acute Care Hospital [Member]
Business Acquisition [Line Items]
Term of lease, years	15 years
Number of lease extension options \| RenewalOption	3
Term of lease extension, years	5 years
Write off of unbilled direct finance lease rent \| $	$ 1.5

Real Estate and Lending Activities - Components of Net Investment in Direct Financing Leases (Detail) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Business Combinations [Abstract]
Minimum lease payments receivable	$ 2,207,355	$ 2,294,081
Estimated residual values	434,769	448,339
Less: Unearned income	(1,953,697)	(2,043,693)
Net investment in direct financing leases	$ 688,427	$ 698,727

Real Estate and Lending Activities - Adeptus Health - Additional Information (Detail) $ in Millions								6 Months Ended	15 Months Ended
	Oct. 01, 2018 Facility	Jun. 08, 2018 Facility	Apr. 01, 2018 Property	Jan. 01, 2018 Property	Dec. 01, 2017 Facility	Apr. 04, 2017 Facility	Mar. 31, 2017 USD ($)	Jun. 30, 2018 USD ($) Property Facility	Jun. 30, 2018 USD ($) Property
Business Acquisition [Line Items]
Gain offset by non-cash charges \| $							$ 0.6
Adeptus Health [Member]
Business Acquisition [Line Items]
Number of properties closed \| Property			3	5
Amortization of straight line rent receivables \| $								$ 3.9
Number of facilities transitioned \| Facility								16
Percentage of investment in facilities on total assets								1.00%
Number of leased properties \| Property								21
Leased properties \| $								$ 131.3	$ 131.3
Number of properties re-tenanted \| Property									22
Transitioned properties investment \| $								172.1	$ 172.1
Adeptus Health [Member] \| Ochsner [Member]
Business Acquisition [Line Items]
Gain offset by non-cash charges \| $								$ 0.5
Adeptus Health [Member] \| Total Gross Assets [Member] \| Credit Concentration Risk [Member]
Business Acquisition [Line Items]
Percentage of Total Gross Assets								1.40%
Adeptus Health [Member] \| Louisiana Freestanding Emergency Facilities [Member]
Business Acquisition [Line Items]
Number of facilities transferred \| Facility						3
Adeptus Health [Member] \| Colorado Freestanding Emergency Facilities [Member]
Business Acquisition [Line Items]
Number of facilities transferred \| Facility					11
Adeptus Health [Member] \| Arizona Freestanding Emergency Facilities [Member]
Business Acquisition [Line Items]
Number of facilities transferred \| Facility		8
Adeptus Health [Member] \| Scenario, Forecast [Member]
Business Acquisition [Line Items]
Number of facilities transitioned \| Facility	7

Real Estate and Lending Activities - Gilbert and Florence Facilities - Additional Information (Detail) - USD ($) $ in Millions		6 Months Ended
	Mar. 31, 2017	Jun. 30, 2018
Business Acquisition [Line Items]
Gain offset by non-cash charges	$ 0.6
Gilbert and Florence Facilities [Member]
Business Acquisition [Line Items]
Gain offset by non-cash charges		$ 1.1
Total budgeted investment		$ 37.8

Real Estate and Lending Activities - Summary of Loans (Detail) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Loans [Line Items]
Loans, Balance	$ 1,834,721	$ 1,928,525
Mortgage Loans [Member]
Loans [Line Items]
Loans, Balance	1,686,866	1,778,316
Acquisition Loans [Member]
Loans [Line Items]
Loans, Balance	118,290	118,448
Working Capital and Other Loans [Member]
Loans [Line Items]
Loans, Balance	$ 29,565	$ 31,761

Real Estate and Lending Activities - Loans - Additional Information (Detail) $ in Millions	Jun. 30, 2018 USD ($)
Ernest Transaction and Other Acquisitions [Member]
Business Acquisition [Line Items]
Existing mortgage loans	$ 113.6

Real Estate and Lending Activities - Schedule of Revenue by Operator (Detail) - USD ($)
$ in Thousands

3 Months Ended

6 Months Ended

Jun. 30, 2018

Jun. 30, 2017

Jun. 30, 2018

Jun. 30, 2017

Investment And Revenue From External Customers [Line Items]

Total Revenue

$ 201,902

$ 166,807

$ 406,948

$ 323,204

Revenue [Member] | Credit Concentration Risk [Member]

Investment And Revenue From External Customers [Line Items]

Total Revenue

$ 406,948

$ 323,204

Percentage of Total Revenue

100.00%

Revenue [Member] | Prime [Member] | Credit Concentration Risk [Member]

Investment And Revenue From External Customers [Line Items]

Total Revenue

$ 63,590

$ 63,059

Percentage of Total Revenue

15.60%

19.50%

Revenue [Member] | Steward [Member] | Credit Concentration Risk [Member]

Investment And Revenue From External Customers [Line Items]

Total Revenue

^[1]

$ 147,868

$ 72,518

Percentage of Total Revenue

^[1]

36.30%

22.40%

Revenue [Member] | MEDIAN [Member] | Credit Concentration Risk [Member]

Investment And Revenue From External Customers [Line Items]

Total Revenue

$ 57,289

$ 47,744

Percentage of Total Revenue

14.10%

14.80%

Revenue [Member] | Ernest [Member] | Credit Concentration Risk [Member]

Investment And Revenue From External Customers [Line Items]

Total Revenue

$ 34,542

$ 35,269

Percentage of Total Revenue

8.50%

10.90%

Revenue [Member] | RCCH [Member] | Credit Concentration Risk [Member]

Investment And Revenue From External Customers [Line Items]

Total Revenue

$ 20,414

$ 19,632

Percentage of Total Revenue

5.00%

6.10%

Revenue [Member] | Other Operators [Member] | Credit Concentration Risk [Member]

Investment And Revenue From External Customers [Line Items]

Total Revenue

$ 83,245

$ 84,982

Percentage of Total Revenue

20.50%

26.30%

[1]	Includes revenue from IASIS prior to being acquired by Steward on September 29, 2017.

Real Estate and Lending Activities - Schedule of Revenue from External Customers by Geographic Areas (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 201,902	$ 166,807	$ 406,948	$ 323,204
Revenue [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue			$ 406,948	$ 323,204
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			$ 54,433	$ 53,159
Percentage of Total Revenue			13.40%	16.50%
Revenue [Member] \| Texas [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue			$ 60,361	$ 49,851
Percentage of Total Revenue			14.80%	15.40%
Revenue [Member] \| Utah [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue			$ 41,734	$ 5,057
Percentage of Total Revenue			10.30%	1.60%
Revenue [Member] \| California [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue			$ 29,422	$ 33,123
Percentage of Total Revenue			7.20%	10.30%
Revenue [Member] \| Arizona [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue			$ 23,286	$ 15,542
Percentage of Total Revenue			5.70%	4.80%
Revenue [Member] \| All Other States [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue			$ 121,307	$ 109,875
Percentage of Total Revenue			29.80%	33.90%
Revenue [Member] \| United States [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue			$ 330,543	$ 266,607
Percentage of Total Revenue			81.20%	82.50%
Revenue [Member] \| Germany [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue			$ 74,176	$ 54,576
Percentage of Total Revenue			18.20%	16.90%
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			$ 2,229	$ 2,021
Percentage of Total Revenue			0.60%	0.60%
Revenue [Member] \| International [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue			$ 76,405	$ 56,597
Percentage of Total Revenue			18.80%	17.50%

Real Estate and Lending Activities - Concentrations of Credit Risk - Additional Information (Detail) - Pro Forma [Member] - Total Gross Assets [Member] - Customer Concentration Risk [Member]	Jun. 30, 2018 Investment
Business Acquisition [Line Items]
Number of investment in property	0
Maximum percentage of entity's assets invested on single property	4.00%

Debt - Summary of Debt (Detail) - USD ($)
$ in Thousands

Jun. 30, 2018

Dec. 31, 2017

Debt Instrument [Line Items]

Debt

$ 4,904,248

$ 4,941,310

Debt issue costs, net

(39,987)

(42,643)

Debt, net

4,864,261

4,898,667

Revolving Credit Facility [Member]

Debt Instrument [Line Items]

Debt

^[1]

835,848

840,810

Term Loan [Member]

Debt Instrument [Line Items]

Debt

200,000

4.000% Senior Unsecured Notes due 2022 [Member]

Debt Instrument [Line Items]

Debt

^[2]

584,200

600,250

5.500% Senior Unsecured Notes Due 2024 [Member]

Debt Instrument [Line Items]

Debt

300,000

3.325% Senior Unsecured Notes Due 2025 [Member]

Debt Instrument [Line Items]

Debt

^[2]

584,200

600,250

6.375% Senior Unsecured Notes due 2024 [Member]

Debt Instrument [Line Items]

Debt

500,000

5.250% Senior Unsecured Notes Due 2026 [Member]

Debt Instrument [Line Items]

Debt

500,000

5.000% Senior Unsecured Notes Due 2027 [Member]

Debt Instrument [Line Items]

Debt

$ 1,400,000

[1]	Includes £12 million and £8 million of GBP-denominated borrowings that reflect the exchange rate at June 30, 2018 and December 31, 2017, respectively.
[2]	These notes are Euro-denominated and reflect the exchange rate at June 30, 2018 and December 31, 2017, respectively.

Debt - Summary of Debt (Parenthetical) (Detail)
$ in Thousands, £ in Millions

Jun. 30, 2018

USD ($)

Jun. 30, 2018

GBP (£)

Dec. 31, 2017

USD ($)

Dec. 31, 2017

GBP (£)

Mar. 24, 2017

Debt Instrument [Line Items]

Debt

$ 4,904,248

$ 4,941,310

GBP-denominated Borrowings [Member]

Debt Instrument [Line Items]

Debt | £

£ 12

£ 8

4.000% Senior Unsecured Notes due 2022 [Member]

Debt Instrument [Line Items]

Senior unsecured notes, interest rate

^[1]

4.00%

Debt

^[1]

$ 584,200

600,250

5.500% Senior Unsecured Notes Due 2024 [Member]

Debt Instrument [Line Items]

Senior unsecured notes, interest rate

5.50%

Debt

$ 300,000

300,000

6.375% Senior Unsecured Notes due 2024 [Member]

Debt Instrument [Line Items]

Senior unsecured notes, interest rate

6.375%

Debt

$ 500,000

500,000

3.325% Senior Unsecured Notes Due 2025 [Member]

Debt Instrument [Line Items]

Senior unsecured notes, interest rate

3.325%

^[1]

3.325%

^[1]

3.325%

Debt

^[1]

$ 584,200

600,250

5.000% Senior Unsecured Notes Due 2027 [Member]

Debt Instrument [Line Items]

Senior unsecured notes, interest rate

5.00%

Debt

$ 1,400,000

1,400,000

5.250% Senior Unsecured Notes Due 2026 [Member]

Debt Instrument [Line Items]

Senior unsecured notes, interest rate

5.25%

Debt

$ 500,000

[1]	These notes are Euro-denominated and reflect the exchange rate at June 30, 2018 and December 31, 2017, respectively.

Debt - Principal Payments Due for Debt (Detail) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Debt Disclosure [Abstract]
2021	$ 835,848
2022	784,200
Thereafter	3,284,200
Total	$ 4,904,248	$ 4,941,310

Debt - Additional Information (Detail)
$ in Thousands

3 Months Ended

6 Months Ended

Mar. 30, 2017

EUR (€)

Mar. 04, 2017

EUR (€)

Feb. 01, 2017

USD ($)

Jun. 30, 2017

USD ($)

Jun. 30, 2018

Jun. 30, 2017

USD ($)

Mar. 24, 2017

EUR (€)

Feb. 01, 2017

EUR (€)

Debt Instrument [Line Items]

Debt refinancing charge

$ 751

$ 14,380

5.750% Senior Unsecured Notes Due 2020 [Member]

Debt Instrument [Line Items]

Senior notes, redemption date

Mar. 04, 2017

Amount of senior unsecured debt redeemed | €

€ 200,000,000

Senior unsecured notes, interest rate

5.75%

Senior unsecured notes, redemption description

On March 4, 2017, we redeemed the €200 million aggregate principal amount of our 5.750% Senior Unsecured Notes due 2020.

Debt refinancing charge

$ 14,000

3.325% Senior Unsecured Notes Due 2025 [Member]

Debt Instrument [Line Items]

Senior unsecured notes, interest rate

3.325%

^[1]

3.325%

Senior unsecured notes face amount | €

€ 500,000,000

Unsecured Revolving Credit Facility [Member]

Debt Instrument [Line Items]

Amount of senior unsecured debt

$ 1,300,000

Term Loan [Member]

Debt Instrument [Line Items]

Amount of senior unsecured debt

200,000

€ 200,000,000

Decrease in unsecured debt from previous facility

$ 50,000

Prepaid and extinguished term loans | €

€ 200,000,000

[1]	These notes are Euro-denominated and reflect the exchange rate at June 30, 2018 and December 31, 2017, respectively.

Debt - Covenants - Additional Information (Detail)	6 Months Ended
Debt - Covenants - Additional Information (Detail)	Jun. 30, 2018
Debt Disclosure [Abstract]
Percentage of dividends which could be paid from adjusted operating funds	95.00%
Percentage of dividends which could be paid from operation funds	95.00%
Maximum percentage of total unencumbered assets	150.00%

Common Stock/Partners' Capital - Additional Information (Detail) shares in Thousands, $ in Thousands		6 Months Ended
	May 01, 2017 USD ($) shares	Jun. 30, 2018 Partner shares	Jun. 30, 2017 USD ($) shares	Dec. 31, 2017 shares
Class of Stock [Line Items]
Common stock, shares issued		364,731		364,424
Proceeds from sale of common shares / units, net of offering costs \| $			$ 548,063
MPT Operating Partnership, L.P. [Member]
Class of Stock [Line Items]
Proceeds from sale of common shares / units, net of offering costs \| $			$ 548,063
Ownership interest in equity		99.92%
Number of other partners \| Partner		2
Number of units sold			43,100
Public Offering [Member]
Class of Stock [Line Items]
Common stock, shares issued	43,100
Additional shares purchased by underwriters	5,600
Proceeds from sale of common shares / units, net of offering costs \| $	$ 548,000

Stock Awards - Additional Information (Detail) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share / (Unit)-based compensation expense	$ 6,725	$ 4,377
Equity Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Reserved shares of common stock for awards under the Equity Incentive Plan	8,196,770
Common stock remaining for future stock awards transferred to the equity incentive plan	1,690,590,000,000

Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Detail) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Fair Value Disclosures [Abstract]
Interest and rent receivables, Book value	$ 85,181	$ 78,970
Loans, Book value	1,605,355	1,698,471
Debt, net Book value	(4,864,261)	(4,898,667)
Interest and rent receivables, Fair value	84,292	78,028
Loans, Fair value	1,627,579	1,722,101
Debt, net Fair value	$ (4,889,856)	$ (5,073,707)

Fair Value of Financial Instruments - Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis (Detail) $ in Thousands	Jun. 30, 2018 USD ($)
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	$ 225,672
Original Cost	232,666
Fair Value Measurements, Recurring [Member] \| Equity Method Investments and Other Loans [Member] \| Other Loans and Other Assets [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	110,672
Original Cost	117,666
Fair Value Measurements, Recurring [Member] \| Mortgage Loans [Member] \| Mortgage Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	115,000
Original Cost	$ 115,000

Fair Value of Financial Instruments - Additional information (Detail)	6 Months Ended
	Jun. 30, 2017 USD ($)	Jun. 30, 2018
Ernest [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Unrealized gain/loss on investments	$ 0
Valuation Technique, Discounted Cash Flow [Member] \| Measurement Input, Discount Rate [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Adjustment for DLOM on our equity investment		40

Fair Value of Financial Instruments - Summary Showing Sensitivity Analysis by Using Basis Point Variations (Detail) $ in Thousands	6 Months Ended
	Jun. 30, 2018 USD ($)
Fair Value Disclosures [Abstract]
Estimated Increase (Decrease) In Fair Value of Financial Instruments plus 100 basis points	$ (60)
Estimated Increase (Decrease) In Fair Value of Financial Instruments minus 100 basis points	$ 60

Earnings Per Share - Calculation of Earnings Per Share (Detail) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Net income	$ 112,017	$ 73,796	$ 203,060	$ 141,981
Net income attributable to non-controlling interests	(450)	(381)	(892)	(596)
Participating securities’ share in earnings	(323)	(100)	(518)	(225)
Net income, less participating securities’ share in earnings	$ 111,244	$ 73,315	$ 201,650	$ 141,160
Basic weighted-average common shares	364,897	349,856	364,889	335,456
Dilutive potential common shares	644	463	553	415
Dilutive weighted-average common shares	365,541	350,319	365,442	335,871
MPT Operating Partnership, L.P. [Member]
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Net income	$ 112,017	$ 73,796	$ 203,060	$ 141,981
Net income attributable to non-controlling interests	(450)	(381)	(892)	(596)
Participating securities’ share in earnings	(323)	(100)	(518)	(225)
Net income, less participating securities’ share in earnings	$ 111,244	$ 73,315	$ 201,650	$ 141,160
Basic weighted-average common shares	364,897	349,856	364,889	335,456
Dilutive potential common shares	644	463	553	415
Dilutive weighted-average common shares	365,541	350,319	365,442	335,871

- Definition

The consolidated profit or loss for the period, net of income taxes, including the portion attributable to the noncontrolling interest.

+ References

+ Details

Commitments and Contingencies - Additional Information (Detail) € in Millions, $ in Millions				5 Months Ended
	Jun. 06, 2018 EUR (€) Hospital	Jan. 30, 2017 EUR (€)	Sep. 28, 2016 USD ($)	Jan. 30, 2017 EUR (€) Hospital
Washington and Idaho [Member] \| Acute Care Hospital [Member]
Commitment And Contingencies [Line Items]
Purchase price of acquisition \| $			$ 17.5
Germany [Member] \| Acute Care Hospital [Member]
Commitment And Contingencies [Line Items]
Purchase price of acquisition	€ 23.0
Germany [Member] \| Rehabilitation Hospitals [Member]
Commitment And Contingencies [Line Items]
Purchase price of acquisition		€ 8.4		€ 44.1
Number of facilities acquired \| Hospital	4			6
Germany [Member] \| Rehabilitation Hospitals [Member] \| MEDIAN [Member]
Commitment And Contingencies [Line Items]
Term of lease, years	27 years
Lease rent increase percentage	70.00%
Lease rate	1.00%