0001564590-21-026134 | 10-Q | XBRL Viewer | Medical Properties Trust INC

Earnings Per Share/Unit (Tables)

3 Months Ended

Mar. 31, 2021

Medical Properties Trust, Inc.

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

	For the Three Months Ended March 31,
	2021			2020
Numerator:
Net income	$	163,880		$	81,157
Non-controlling interests’ share in net income		(97	)		(165	)
Participating securities’ share in earnings		(370	)		(464	)
Net income, less participating securities’ share in earnings	$	163,413		$	80,528
Denominator:
Basic weighted-average common shares		576,240			521,076
Dilutive potential common shares		1,301			1,103
Diluted weighted-average common shares		577,541			522,179

MPT Operating Partnership, L.P.

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

	For the Three Months Ended March 31,
	2021			2020
Numerator:
Net income	$	163,880		$	81,157
Non-controlling interests’ share in net income		(97	)		(165	)
Participating securities’ share in earnings		(370	)		(464	)
Net income, less participating securities’ share in earnings	$	163,413		$	80,528
Denominator:
Basic weighted-average units		576,240			521,076
Dilutive potential units		1,301			1,103
Diluted weighted-average units		577,541			522,179

Debt - 2.500% Senior Unsecured Notes Due 2028 - Additional Information (Detail) - 2.500% Senior Unsecured Notes due 2026 [Member] - USD ($)

3 Months Ended

Mar. 24, 2021

Mar. 31, 2021

Dec. 31, 2020

^[1]

Debt Instrument [Line Items]

Senior unsecured notes face amount

$ 500,000,000

Percentage of par value on senior notes

99.937%

Senior unsecured notes, payable term

interest on the notes is payable annually on March 24 of each year, commencing on March 24, 2022.

Debt instrument maturity date

Mar. 24, 2026

Senior unsecured notes, interest rate

2.50%

^[1]

2.50%

[1]	Non-U.S. dollar denominated debt that reflects the exchange rate at March 31, 2021 and December 31, 2020, respectively.

Debt - Principal Payments Due for Debt (Detail) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Debt Disclosure [Abstract]
2022	$ 586,500
2023	551,320
2024	1,090,939
2025	1,551,310
Thereafter	6,298,535
Total	$ 10,078,604	$ 8,934,187

Debt (Tables)

3 Months Ended

Mar. 31, 2021

Debt Disclosure [Abstract]

Summary of Debt

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

	As of March 31, 2021			As of December 31, 2020
Revolving credit facility(A)	$	179,179		$	165,407
Term loan		200,000			200,000
British pound sterling term loan(B)		964,810			956,900
Australian term loan facility(B)		911,760			923,280
4.000% Senior Unsecured Notes due 2022(B)		586,500			610,800
2.550% Senior Unsecured Notes due 2023(B)		551,320			546,800
3.325% Senior Unsecured Notes due 2025(B)		586,500			610,800
2.500% Senior Unsecured Notes due 2026(B)		689,150			—
5.250% Senior Unsecured Notes due 2026		500,000			500,000
5.000% Senior Unsecured Notes due 2027		1,400,000			1,400,000
3.692% Senior Unsecured Notes due 2028(B)		826,980			820,200
4.625% Senior Unsecured Notes due 2029		900,000			900,000
3.375% Senior Unsecured Notes due 2030(B)		482,405			—
3.500% Senior Unsecured Notes due 2031		1,300,000			1,300,000
	$	10,078,604		$	8,934,187
Debt issue costs and discount, net		(79,066	)		(68,729	)
	$	9,999,538		$	8,865,458

(A)

Includes £130 million and £121 million of GBP-denominated borrowings that reflect the exchange rate at March 31, 2021 and December 31, 2020, respectively.

(B)

Non-U.S. dollar denominated debt that reflects the exchange rate at March 31, 2021 and December 31, 2020, respectively.

Principal Payments Due on Debt

As of March 31, 2021, principal payments due on our debt (which exclude the effects of any discounts, premiums, or debt issue costs recorded) are as follows (amounts in thousands):

2021	$	—
2022		586,500
2023		551,320
2024		1,090,939
2025		1,551,310
Thereafter		6,298,535
Total	$	10,078,604

Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Detail) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Fair Value Disclosures [Abstract]
Interest and rent receivables, Book value	$ 44,558	$ 46,208
Loans, Book value	2,501,480	751,341
Debt, net Book value	(9,999,538)	(8,865,458)
Interest and rent receivables, Fair value	43,729	45,381
Loans, Fair value	2,501,963	756,608
Debt, net Fair value	$ (10,219,474)	$ (9,226,564)

Real Estate and Other Activities - Summary of Loans (Net of Allowance for Credit Loss) (Detail) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Business Combinations [Abstract]
Mortgage loans	$ 1,324,865	$ 248,080
Acquisition loans	682,665	338,273
Other loans	840,001	520,095
Total	$ 2,847,531	$ 1,106,448

Contingencies

3 Months Ended

Mar. 31, 2021

Commitments And Contingencies Disclosure [Abstract]

Contingencies

9. 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.

Real Estate and Other Activities - Adeptus Health - Additional Information (Detail) - Adeptus Health [Member] $ in Millions	3 Months Ended
	Mar. 31, 2021 USD ($) Facility Lease	Mar. 31, 2020 USD ($)
Business Acquisition [Line Items]
Number of leased properties \| Lease	60
Real estate impairment charge		$ 9.9
Number Of Facilities Transitioned \| Facility	17
Draw on letter of credit	$ 9.1
Maximum [Member]
Business Acquisition [Line Items]
Percentage of vacant on leased property	1.00%

Stock Awards

3 Months Ended

Mar. 31, 2021

Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]

Stock Awards

6. Stock Awards

We adopted the 2019 Equity Incentive Plan (the “Equity Incentive Plan”) during the second quarter of 2019, which authorizes the issuance of common stock options, restricted stock, restricted stock units, deferred stock units, stock appreciation rights, performance units, and other stock-based awards. The Equity Incentive Plan is administered by the Compensation Committee of the Board of Directors, and we have reserved 12.9 million shares of common stock for awards, out of which 6.2 million shares remain available for future stock awards as of March 31, 2021. Share-based compensation expense totaled $12.3 million and $10.0 million for the three months ended March 31, 2021 and 2020, respectively.

Real Estate and Other Activities - 2020 Activity - Additional Information (Detail) £ in Millions			3 Months Ended
	Jun. 16, 2020 RenewalOption	Jan. 08, 2020 GBP (£) Hospital	Mar. 31, 2021
Business Acquisition [Line Items]
Term of lease extension, years			5 years
Acute Care Hospital [Member] \| United Kingdom [Member] \| BMI [Member]
Business Acquisition [Line Items]
Number of facilities acquired \| Hospital		30
Purchase price of acquisition \| £		£ 1,500.0
Unearned rent revenue \| £		£ 27.6
Number of leased properties \| Hospital		52
Initial fixed term of lease		2050
Existence of option to extend	true	false
Lease extension options, description			two five-year renewal options
Number of lease extension options \| RenewalOption	2
Term of lease extension, years	5 years

Debt - Senior Unsecured Notes - Additional Information (Detail) - Unsecured Debt - GBP (£)	Mar. 26, 2021	Mar. 24, 2021
Debt Instrument [Line Items]
Senior unsecured notes face amount		£ 850,000,000
Interim Credit Facility [Member]
Debt Instrument [Line Items]
Payoff of credit facility	£ 850,000,000
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Line of credit	£ 341,000,000

- Definition

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

+ References + Details

Real Estate and Other Activities

3 Months Ended

Mar. 31, 2021

Real Estate [Abstract]

Real Estate and Other Activities

3. Real Estate and Other Activities

New Investments

We acquired or invested in the following net assets (in thousands):

	For the Three Months Ended March 31,
	2021		2020

Land and land improvements	$	—	$	265,991
Buildings		—		1,608,771
Intangible lease assets — subject to amortization (weighted- average useful life 30.8 years for 2020)		—		231,774
Mortgage loans		1,090,400		—
Other loans and assets		688,017		1,328
Liabilities assumed		—		(134,203	)
Total net assets acquired	$	1,778,417	$	1,973,661

2021 Activity

Priory Group Transaction

On January 19, 2021, we completed the first of two phases in the Priory Group (“Priory”) transaction in which we funded an £800 million interim mortgage loan on an identified portfolio of Priory real estate assets. In phase two, in a series of transactions we expect will be completed during the 2021 second quarter, we will acquire a portfolio of select real estate assets from Priory (now owned by Waterland Private Equity Fund VII C.V. (“Waterland VII”)) in individual sale-and-leaseback transactions, subject to customary real estate and other closing conditions. As all conditions to closing for a particular asset are satisfied, the applicable purchase price for the asset will be paid by us by proportionally converting and reducing the principal balance of the interim mortgage loan we made to Waterland VII in phase one. The aggregate purchase price for the real estate assets we acquire from Priory is thus expected to be approximately £800 million, plus customary stamp duty, tax, and other transaction costs.

In addition, we agreed to provide Waterland VII with a 364-day £250 million acquisition loan, which we funded on January 19, 2021, in connection with the closing of Waterland VII’s acquisition of Priory. The loan is secured by the same security assets securing the £800 million interim mortgage loan.

In connection with these transactions, we also acquired a 9.9% passive equity interest in the Waterland VII affiliate that indirectly owns Priory for a nominal amount.

We funded this investment using £500 million from a new $900 million interim credit facility as described in Note 4, £350 million from our revolving facility, and the remainder from cash on-hand.

Other

On January 8, 2021, we made a $335 million loan to Steward Health Care System LLC (“Steward”), which was used to redeem a similarly sized convertible loan from Steward’s former private equity sponsor.

2020 Activity

Circle Transaction

On January 8, 2020, we acquired a portfolio of 30 acute care hospitals located throughout the United Kingdom for a net purchase price of approximately £1.5 billion from affiliates of BMI Healthcare, Inc. (“BMI”), as part of a share purchase in which we also inherited certain deferred income tax liabilities and £27.6 million of unearned rent revenue. In a related transaction, affiliates of Circle Health Ltd. (“Circle”) entered into definitive agreements to acquire BMI and assume operations of its 52 facilities in the United Kingdom. As part of our acquisition, we inherited 30 existing leases with the operator that had initial fixed terms ending in 2050, with no renewal options but with annual inflation-based escalators. Once final regulatory approval was received in the 2020 second quarter, these 30 leases with Circle were amended (effective June 16, 2020) to include two five-year renewal options and improve the annual inflation-based escalators. These 30 leases are cross-defaulted and guaranteed by Circle.

Development Activities

During the 2020 first quarter, we completed construction and began recording rental income on a general acute care facility located in Idaho Falls, Idaho. This facility commenced rent on January 21, 2020 and is being leased to Surgery Partners, Inc. pursuant to an existing long-term lease.

See table below for a status summary of our current development projects (in thousands):

Property	Commitment		Costs Incurred as of March 31, 2021		Estimated Rent Commencement Date
Ernest Health, Inc. ("Ernest") (Bakersfield, California)	$	47,929	$	28,502	4Q 2021
Ernest (Stockton, California)		47,700		13,539	1Q 2022
	$	95,629	$	42,041

Disposals

2021 Activity

During the first three months of 2021, we completed the sale of one facility and an ancillary property for approximately $11 million, resulting in a net gain of approximately $1.0 million.

2020 Activity

During the first three months of 2020, we sold four ancillary properties resulting in a net gain of $1.3 million.

Leasing Operations (Lessor)

We acquire and develop healthcare facilities and lease the facilities to healthcare operating companies under long-term net leases (typical initial fixed terms of 15 years) and most include renewal options at the election of our tenants, generally in five year increments. Approximately 99% of our leases provide annual rent escalations based on increases in the Consumer Price Index (or similar index outside the U.S.) and/or fixed minimum annual rent escalations ranging from 0.5% to 3.0%. Many of our domestic leases contain purchase options with pricing set at various terms but in no case less than our total investment. For five properties with a carrying value of $230 million, our leases require a residual value guarantee from the tenant. Our leases typically require the tenant to handle and bear most of the costs associated with our properties including repair/maintenance, property taxes, and insurance. We routinely inspect our properties to ensure the residual value of each of our assets is being maintained. Except for leases classified as financing leases as noted below, all of our leases are classified as operating leases.

At March 31, 2021, leases on 13 Ernest facilities and five Prime Healthcare Services, Inc. (“Prime”) facilities are accounted for as direct financing leases and leases on 13 of our Prospect Medical Holdings, Inc. (“Prospect”) facilities and five of our Ernest facilities are accounted for as a financing. The components of our total investment in financing leases consisted of the following (in thousands):

	As of March 31, 2021			As of December 31, 2020
Minimum lease payments receivable	$	1,217,689		$	1,228,966
Estimated residual values		203,818			203,818
Less: Unearned income and allowance for credit loss		(956,490	)		(969,061	)
Net investment in direct financing leases		465,017			463,723
Other financing leases (net of allowance for credit loss)		1,556,463			1,547,199
Total investment in financing leases	$	2,021,480		$	2,010,922

COVID-19 Rent Deferrals

In the first quarter of 2021, we collected $0.8 million of rent previously deferred due to the COVID-19 pandemic. Pursuant to our agreements with certain tenants, we expect the remaining outstanding deferred rent balance of approximately $10.6 million as of March 31, 2021, to be paid over specified periods in the future, with interest.

Adeptus Health

As discussed in previous filings, our original real estate portfolio of approximately 60 properties leased to Adeptus Health, Inc. (“Adeptus”) has gone through significant changes starting with Adeptus filing for Chapter 11 bankruptcy in 2017. During 2020, we transitioned the remaining facilities away from Adeptus, which resulted in impairment charges including approximately $9.9 million in the first quarter of 2020, along with a charge to write-off straight-line rent and other receivables, partially offset by a draw on a $9.1 million letter of credit. However, these transition measures have also provided for new tenant relationships being formed with strong credit worthy operators like Ochsner Health System, Dignity Health, UC Health, and HCA Healthcare, that are now leasing approximately 40 of these transitional facilities under long-term leases. At March 31, 2021, 17 of these transitional properties, representing less than 1% of our total assets, remain vacant, and each of these properties are in various stages of being re-leased or sold. At March 31, 2021, we believe our investment in these real estate assets are fully recoverable, but no assurances can be given that we will not have any further impairments in future periods.

Alecto Facilities

As noted in previous filings, we originally leased four acute care facilities to and had a mortgage loan on a fifth property (Olympia Medical Center) with Alecto Healthcare Services LLC (“Alecto”). During the first quarter of 2020, we donated the Wheeling facility to a local municipality, resulting in a $9.1 million real estate impairment charge. In addition, we re-leased one acute care facility to West Virginia University and sold another facility in 2020. In the first quarter of 2021, Alecto completed the sale of Olympia Medical Center to the UCLA Health System. Our proceeds of approximately $51 million from this sale were used to payoff the mortgage and working capital loans in full, with the remaining proceeds used to recover certain past due amounts. At March 31, 2021, we continue to lease one acute care facility to Alecto approximating 0.1% of our total assets.

Loans

The following is a summary of our loans (net of allowance for credit loss) (in thousands):

	As of March 31, 2021		As of December 31, 2020
Mortgage loans	$	1,324,865	$	248,080
Acquisition loans		682,665		338,273
Other loans		840,001		520,095
Total	$	2,847,531	$	1,106,448

The increase in mortgage and acquisition loans relates to the £800 million and £250 million loans funded in connection with the Priory Group Transaction (as more fully described above in this Note 3).

Other loans consist of loans to our tenants for working capital and other purposes and include our shareholder loan made to the joint venture with Primotop Holdings S.à.r.l. (“Primotop”) in the amount of €297 million. The increase in other loans is primarily related to the $335 million loan to Steward (as more fully described above in this Note 3).

Other Investment Activities

Pursuant to our existing 9.9% equity interest in Steward, we received an $11 million cash distribution during the first quarter of 2021, which was accounted for as a return of capital.

Pursuant to our 4.9% stake in Aevis Victoria SA (“Aevis”), we recorded a $4.1 million favorable non-cash fair value adjustment to mark our investment in Aevis stock to market during the first quarter of 2021; whereas, this was a $10.4 million unfavorable non-cash fair value adjustment in the 2020 first quarter.

Concentrations of Credit Risk

We monitor concentration risk in several ways due to the nature of our real estate assets that are vital to the communities in which they are located and given our history of being able to replace inefficient operators of our facilities, if needed, with more effective operators:

Facility concentration – At March 31, 2021, our largest single property represented approximately 3% of our total assets, similar to December 31, 2020.

Operator concentration – For the three months ended March 31, 2021, revenue from Steward, Circle, and Prospect, individually, represented more than 10% of our total revenues. In comparison, Steward, Circle, Prospect, and Prime, individually, represented more than 10% of our total revenues for the 2020 first quarter.

Geographic concentration – At March 31, 2021, investments in the U.S., Europe, Australia, and South America represented approximately 63%, 31%, 5%, and 1%, respectively, of our total assets, compared to 65%, 28%, 6%, and 1%, respectively, at December 31, 2020.

Facility type concentration – For the three months ended March 31, 2021, approximately 83% of our revenues are from our general acute care facilities, while rehabilitation and long-term acute care facilities make up 8% and 2%, respectively. Freestanding ER/urgent care facilities and behavioral health facilities combined to make up the remaining 7%. In comparison, general acute care, rehabilitation, and long-term acute care facilities made up 86%, 9%, and 3%, respectively, of our total revenues for the three months ended March 31, 2020, while freestanding ER/urgent care facilities and behavioral health facilities combined to make up the remaining 2%.

Real Estate and Other Activities - Disposals - Additional Information (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2021 USD ($) Facility	Mar. 31, 2020 USD ($) Property
Business Combinations [Abstract]
Number of facilities sold \| Facility	1
Number of properties sold \| Property		4
Proceeds from sale of facilities	$ 11.0
Gain (loss) on real estate dispositions	$ 1.0	$ 1.3

Real Estate and Other Activities - COVID-19 Rent Deferrals - Additional Information (Detail) - COVID-19 Pandemic [Member] $ in Millions	Mar. 31, 2021 USD ($)
Business Acquisition [Line Items]
Deferred lease income	$ 0.8
Remaining outstanding deferred rent to be received	$ 10.6

Real Estate and Other Activities - Net Assets Acquired (Parenthetical) (Detail)	3 Months Ended
	Mar. 31, 2020
Intangible Lease Assets - Subject to Amortization [Member]
Business Acquisition [Line Items]
Weighted-average useful life of acquired intangible lease assets (in years)	30 years 9 months 18 days

Summary of Significant Accounting Policies

3 Months Ended

Mar. 31, 2021

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 statement have been included. Operating results for the three months ended March 31, 2021, are not necessarily indicative of the results that may be expected for the year ending December 31, 2021. The condensed consolidated balance sheet at December 31, 2020 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.

The preparation of our condensed consolidated financial statements in conformity with GAAP requires us to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities as of the date of the condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. We believe the estimates and assumptions underlying our condensed consolidated financial statements are reasonable and supportable based on the information available as of March 31, 2021 (particularly as it relates to our assessments of the recoverability of our real estate and the adequacy of our credit loss reserves on loans and financing receivables). Although COVID-19 vaccines continue to roll out worldwide and hospitals around the world have generally returned to their normal operations, the ultimate impact to our tenants’ results of operations and liquidity and their ability to pay our rent and interest due to the impact of COVID-19 cannot be predicted with 100% confidence. This makes any estimates and assumptions as of March 31, 2021 inherently less certain than they would be absent the potential impact of COVID-19. Actual results may ultimately differ from our estimates.

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, 2020. There have been no material changes to these significant accounting policies other than the following:

Recent Accounting Developments

Reference Rate Reform

In March 2020, the Financial Accounting Standards Board (“FASB”) issued ASU No. 2020-04, “Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting” (“ASU 2020-04”) to simplify the accounting for contract modifications made to replace LIBOR or other reference rates that are expected to be discontinued because of reference rate reform. The guidance provides optional expedients and exceptions for applying GAAP to contracts, hedging relationships, and other transactions affected by reference rate reform if certain criterion are met. The optional expedients and exceptions can be applied to contract modifications made until December 31, 2022. On January 7, 2021, the FASB issued ASU No. 2021-01, “Reference Rate Reform (Topic 848)” (“ASU 2021-01”), which clarifies that certain optional expedients and exceptions in Topic 848 for contract modifications and hedge accounting apply to derivatives that are affected by the transition. We have evaluated our contracts that are referenced to LIBOR or other reference rates expected to be discontinued. We expect our British pound sterling term loan and corresponding interest rate swap to be modified with a replacement reference rate during 2021, and we expect to account for such modifications using the expedients and exceptions provided for in ASU 2020-04 and ASU 2021-01. We are continuing to evaluate the need to modify our U.S. dollar LIBOR contracts, such as our unsecured credit facility, as the requirement to replace the U.S. dollar LIBOR has been extended to June 30, 2023. Moreover, we do not expect any impact to our Australian dollar term loan and corresponding interest rate swap, as these contracts are not referenced to rates that are expected to be discontinued.

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 March 31, 2021, we had loans and/or equity investments in certain variable interest entities approximating $350 million, which represents our maximum exposure to loss as a result of our involvement in such entities. We have determined that we were not the primary beneficiary of any variable interest entity in which we hold a variable interest because we do not control the activities (such as the day-to-day operations) that most significantly impact the economic performance of these entities.

Fair Value of Financial Instruments (Tables)

3 Months Ended

Mar. 31, 2021

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 March 31, 2021						As of December 31, 2020
Asset (Liability)	Book Value			Fair Value			Book Value			Fair Value
Interest and rent receivables	$	44,558		$	43,729		$	46,208		$	45,381
Loans(1)		2,501,480			2,501,963			751,341			756,608
Debt, net		(9,999,538	)		(10,219,474	)		(8,865,458	)		(9,226,564	)

(1)

Excludes the $205 million acquisition loan made in May 2020 to our international joint venture and related investment in the real estate of three hospitals in Colombia.

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

At March 31, 2021 and December 31, 2020, the amounts recorded under the fair value option method were as follows (in thousands):

	As of March 31, 2021				As of December 31, 2020
Asset (Liability)	Fair Value		Original Cost		Fair Value		Original Cost		Asset Type Classification
Mortgage loans	$	127,564	$	127,564	$	136,332	$	136,332	Mortgage loans
Equity investment and other loans		218,487		218,487		218,775		218,775	Equity investments/Other loans

Fair Value of Financial Instruments - Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis (Detail) - Fair Value, Recurring [Member] - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Mortgage Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair value	$ 127,564	$ 136,332
Original Cost	127,564	136,332
Equity Method Investment and Other Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair value	218,487	218,775
Original Cost	$ 218,487	$ 218,775

Real Estate and Other Activities - Loans - Additional Information (Detail) € in Millions, £ in Millions, $ in Millions	Jan. 19, 2021 GBP (£)	Mar. 31, 2021 EUR (€)	Jan. 08, 2021 USD ($)
Primotop Holdings S.a.r.l. [Member]
Loans [Line Items]
Shareholder loan to joint venture \| €		€ 297
Waterland Private Equity Fund VII C.V. [Member]
Loans [Line Items]
Funded for interim mortgage loan	£ 800
Purchase price of acquisition with 364-day acquisition loan	£ 250
Steward Health Care System LLC [Member]
Loans [Line Items]
Other loan \| $			$ 335

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Real estate assets
Land, buildings and improvements, intangible lease assets, and other	$ 12,107,170	$ 12,078,927
Investment in financing leases	2,021,480	2,010,922
Mortgage loans	1,324,865	248,080
Gross investment in real estate assets	15,453,515	14,337,929
Accumulated depreciation and amortization	(903,798)	(833,529)
Net investment in real estate assets	14,549,717	13,504,400
Cash and cash equivalents	746,753	549,884
Interest and rent receivables	44,558	46,208
Straight-line rent receivables	545,385	490,462
Equity investments	1,080,214	1,123,623
Other loans	1,522,666	858,368
Other assets	256,382	256,069
Total Assets	18,745,675	16,829,014
Liabilities
Debt, net	9,999,538	8,865,458
Accounts payable and accrued expenses	445,595	438,750
Deferred revenue	21,533	36,177
Obligations to tenants and other lease liabilities	158,799	144,772
Total Liabilities	10,625,465	9,485,157
Equity / Capital
Preferred stock, $0.001 par value. Authorized 10,000 shares; no shares outstanding
Common stock, $0.001 par value. Authorized 750,000 shares; issued and outstanding — 583,109 shares at March 31, 2021 and 541,419 shares at December 31, 2020	583	541
Additional paid-in capital	8,252,966	7,461,503
Distributions in excess of net income	(71,071)	(71,411)
Accumulated other comprehensive loss	(66,720)	(51,324)
Treasury shares, at cost	(777)	(777)
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital)	8,114,981	7,338,532
Non-controlling interests	5,229	5,325
Total Equity / Capital	8,120,210	7,343,857
Total Liabilities and Equity / Capital	18,745,675	16,829,014
MPT Operating Partnership, L.P. [Member]
Real estate assets
Land, buildings and improvements, intangible lease assets, and other	12,107,170	12,078,927
Investment in financing leases	2,021,480	2,010,922
Mortgage loans	1,324,865	248,080
Gross investment in real estate assets	15,453,515	14,337,929
Accumulated depreciation and amortization	(903,798)	(833,529)
Net investment in real estate assets	14,549,717	13,504,400
Cash and cash equivalents	746,753	549,884
Interest and rent receivables	44,558	46,208
Straight-line rent receivables	545,385	490,462
Equity investments	1,080,214	1,123,623
Other loans	1,522,666	858,368
Other assets	256,382	256,069
Total Assets	18,745,675	16,829,014
Liabilities
Debt, net	9,999,538	8,865,458
Accounts payable and accrued expenses	281,762	290,757
Deferred revenue	21,533	36,177
Obligations to tenants and other lease liabilities	158,799	144,772
Payable due to Medical Properties Trust, Inc.	163,443	147,603
Total Liabilities	10,625,075	9,484,767
Equity / Capital
Accumulated other comprehensive loss	(66,720)	(51,324)
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital)	8,115,371	7,338,922
Non-controlling interests	5,229	5,325
Total Equity / Capital	8,120,600	7,344,247
Total Liabilities and Equity / Capital	18,745,675	16,829,014
General Partner [Member] \| MPT Operating Partnership, L.P. [Member]
Equity / Capital
General Partner — issued and outstanding — 5,830 units at March 31,2021 and 5,414 units at December 31, 2020	81,896	73,977
Total Equity / Capital	81,896	73,977
Common Units \| MPT Operating Partnership, L.P. [Member]
Equity / Capital
Limited Partners — issued and outstanding — 577,279 units at March 31, 2021 and 536,005 units at December 31, 2020	$ 8,100,195	$ 7,316,269

Real Estate and Other Activities - Other Investment Activities - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020	Jan. 08, 2021
COVID-19 Pandemic [Member]
Business Acquisition [Line Items]
Unfavorable non-cash fair value adjustment on investment		$ 10.4
Aevis Victoria SA [Member]
Business Acquisition [Line Items]
Favorable non-cash fair value adjustment on investment	$ 4.1
Ownership interest in joint venture under the cost method	4.90%
Steward Health Care System LLC [Member]
Business Acquisition [Line Items]
Distribution on Steward equity investment	$ 11.0
Passive equity interest			9.90%

Real Estate and Other Activities - Components of Total Investment in Financing Leases (Detail) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Direct Financing Lease Net Investment In Leases [Abstract]
Minimum lease payments receivable	$ 1,217,689	$ 1,228,966
Estimated residual values	203,818	203,818
Less: Unearned income and allowance for credit loss	(956,490)	(969,061)
Net investment in direct financing leases	465,017	463,723
Other financing leases (net of allowance for credit loss)	1,556,463	1,547,199
Total investment in financing leases	$ 2,021,480	$ 2,010,922

Common Stock/Partners' Capital - Additional Information (Detail) - USD ($) shares in Thousands, $ in Thousands		3 Months Ended
	Jan. 11, 2021	Mar. 31, 2021	Mar. 31, 2020	Dec. 31, 2020
Class Of Stock [Line Items]
Common stock, shares issued		583,109		541,419
Proceeds from sale of common shares / units, net of offering costs		$ 779,241	$ 61,682
MPT Operating Partnership, L.P. [Member]
Class Of Stock [Line Items]
Number of units sold		39,900	2,600
MPT Operating Partnership, L.P. [Member] \| Medical Properties Trust, LLC. [Member]
Class Of Stock [Line Items]
Percentage of ownership of general partner		100.00%
MPT Operating Partnership, L.P. [Member] \| Operating Partnership [Member]
Class Of Stock [Line Items]
Percentage of ownership limited partner		100.00%
MPT Operating Partnership, L.P. [Member] \| MPT TRS, Inc [Member]
Class Of Stock [Line Items]
Percentage of ownership of general partner		100.00%
At-the-Market Equity Offering Program [Member]
Class Of Stock [Line Items]
Proceeds from sale of common shares / units, net of offering costs		$ 105,500
Public Offering [Member]
Class Of Stock [Line Items]
Common stock, shares issued	36,800
Proceeds from sale of common shares / units, net of offering costs	$ 711,000
At-the-Market Equity Offering Program [Member]
Class Of Stock [Line Items]
Proceeds from sale of common shares / units, net of offering costs		$ 67,600	$ 62,000
Common Units [Member]
Class Of Stock [Line Items]
Number of share sold		39,949	2,601
Common Units [Member] \| At-the-Market Equity Offering Program [Member]
Class Of Stock [Line Items]
Number of share sold		4,900
Common Units [Member] \| At-the-Market Equity Offering Program [Member]
Class Of Stock [Line Items]
Number of share sold		3,100	2,600

Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Parenthetical) (Detail) - Fair Value, Recurring [Member] $ in Millions	1 Months Ended	12 Months Ended
	May 31, 2020 USD ($) Health_Center	Dec. 31, 2020 Health_Center
Colombia [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Number of facilities acquired \| Health_Center		3
Acquisition Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair value \| $	$ 205
Book value \| $	$ 205
Acquisition Loans [Member] \| Colombia [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Number of facilities acquired \| Health_Center	3

Real Estate and Other Activities (Tables)

3 Months Ended

Mar. 31, 2021

Real Estate [Abstract]

Net Assets Acquired

We acquired or invested in the following net assets (in thousands):

	For the Three Months Ended March 31,
	2021		2020

Land and land improvements	$	—	$	265,991
Buildings		—		1,608,771
Intangible lease assets — subject to amortization (weighted- average useful life 30.8 years for 2020)		—		231,774
Mortgage loans		1,090,400		—
Other loans and assets		688,017		1,328
Liabilities assumed		—		(134,203	)
Total net assets acquired	$	1,778,417	$	1,973,661

Summary of Status on Current Development Projects

See table below for a status summary of our current development projects (in thousands):

Property	Commitment		Costs Incurred as of March 31, 2021		Estimated Rent Commencement Date
Ernest Health, Inc. ("Ernest") (Bakersfield, California)	$	47,929	$	28,502	4Q 2021
Ernest (Stockton, California)		47,700		13,539	1Q 2022
	$	95,629	$	42,041

Components of Total Investment in Financing Leases

The components of our total investment in financing leases consisted of the following (in thousands):

	As of March 31, 2021			As of December 31, 2020
Minimum lease payments receivable	$	1,217,689		$	1,228,966
Estimated residual values		203,818			203,818
Less: Unearned income and allowance for credit loss		(956,490	)		(969,061	)
Net investment in direct financing leases		465,017			463,723
Other financing leases (net of allowance for credit loss)		1,556,463			1,547,199
Total investment in financing leases	$	2,021,480		$	2,010,922

Summary of Loans (Net of Allowance for Credit Loss)

The following is a summary of our loans (net of allowance for credit loss) (in thousands):

	As of March 31, 2021		As of December 31, 2020
Mortgage loans	$	1,324,865	$	248,080
Acquisition loans		682,665		338,273
Other loans		840,001		520,095
Total	$	2,847,531	$	1,106,448

Condensed Consolidated Statements of Comprehensive Income (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Net income	$ 163,880	$ 81,157
Other comprehensive income:
Unrealized gain (loss) on interest rate swap, net of tax	15,504	(25,103)
Foreign currency translation loss	(30,900)	(23,272)
Total comprehensive income	148,484	32,782
Comprehensive income attributable to non-controlling interests	(97)	(165)
Comprehensive income attributable to MPT common stockholders (Operating Partnership Partners)	148,387	32,617
MPT Operating Partnership, L.P. [Member]
Net income	163,880	81,157
Other comprehensive income:
Unrealized gain (loss) on interest rate swap, net of tax	15,504	(25,103)
Foreign currency translation loss	(30,900)	(23,272)
Total comprehensive income	148,484	32,782
Comprehensive income attributable to non-controlling interests	(97)	(165)
Comprehensive income attributable to MPT common stockholders (Operating Partnership Partners)	$ 148,387	$ 32,617

- Definition

Amount after tax of increase (decrease) in equity from transactions and other events and circumstances from net income (loss) and other comprehensive income (loss), attributable to noncontrolling interests. Excludes changes in equity resulting from investments by owners and distributions to owners.

+ References + Details

- Definition

Amount after tax of increase (decrease) in equity from transactions and other events and circumstances from net income and other comprehensive income. Excludes changes in equity resulting from investments by owners and distributions to owners.

+ References + Details

- Definition

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

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(g)(1)(ii))
-URI http://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 220
-SubTopic 10
-Section 45
-Paragraph 1A
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=121641772&loc=SL7669619-108580

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 7
-URI http://asc.fasb.org/extlink&oid=109222650&loc=SL51721683-107760

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 50
-Paragraph 1
-Subparagraph (b)(2)
-URI http://asc.fasb.org/extlink&oid=109234566&loc=d3e22499-107794

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 825
-SubTopic 10
-Section 50
-Paragraph 28
-Subparagraph (f)
-URI http://asc.fasb.org/extlink&oid=75031198&loc=d3e14064-108612

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 810
-SubTopic 10
-Section 50
-Paragraph 1A
-Subparagraph (a)(1)
-URI http://asc.fasb.org/extlink&oid=109239629&loc=SL4573702-111684

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 942
-SubTopic 235
-Section S99
-Paragraph 1
-Subparagraph (SX 210.9-05(b)(2))
-URI http://asc.fasb.org/extlink&oid=120399901&loc=d3e537907-122884

Reference 8: http://www.xbrl.org/2003/role/exampleRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 31
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8924-108599

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 220
-SubTopic 10
-Section 45
-Paragraph 1B
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=121641772&loc=SL7669625-108580

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 50
-Paragraph 9
-URI http://asc.fasb.org/extlink&oid=109234566&loc=d3e22663-107794

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8736-108599

Reference 12: 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=120311839&loc=d3e8933-108599

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 810
-SubTopic 10
-Section 50
-Paragraph 1A
-Subparagraph (c)(1)
-URI http://asc.fasb.org/extlink&oid=109239629&loc=SL4573702-111684

Reference 14: http://www.xbrl.org/2003/role/exampleRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 810
-SubTopic 10
-Section 55
-Paragraph 4J
-URI http://asc.fasb.org/extlink&oid=120409616&loc=SL4591551-111686

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 30
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8906-108599

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 230
-SubTopic 10
-Section 45
-Paragraph 2
-URI http://asc.fasb.org/extlink&oid=121586364&loc=d3e3000-108585

Reference 17: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 810
-SubTopic 10
-Section 45
-Paragraph 19
-URI http://asc.fasb.org/extlink&oid=108774443&loc=SL4569616-111683

Reference 18: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 323
-SubTopic 10
-Section 50
-Paragraph 3
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=114001798&loc=d3e33918-111571

Reference 19: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (f)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8933-108599

Reference 20: http://www.xbrl.org/2003/role/exampleRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 810
-SubTopic 10
-Section 55
-Paragraph 4K
-URI http://asc.fasb.org/extlink&oid=120409616&loc=SL4591552-111686

Reference 21: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 50
-Paragraph 8
-URI http://asc.fasb.org/extlink&oid=109234566&loc=d3e22658-107794

+ Details

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

Mar. 31, 2021

USD ($)

Mar. 31, 2021

GBP (£)

Mar. 24, 2021

Dec. 31, 2020

USD ($)

Dec. 31, 2020

GBP (£)

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Mar. 31, 2021	Dec. 31, 2020
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	750,000,000	750,000,000
Common stock, shares issued	583,109,000	541,419,000
Common stock, shares outstanding	583,109,000	541,419,000
General Partner [Member] \| MPT Operating Partnership, L.P. [Member]
General partner, units issued	5,830,000	5,414,000
General partner, units outstanding	5,830,000	5,414,000
Common Units \| MPT Operating Partnership, L.P. [Member]
Limited Partners, units issued	577,279,000	536,005,000
Limited Partners, units outstanding	577,279,000	536,005,000

Document and Entity Information - shares shares in Millions	3 Months Ended
Document and Entity Information - shares shares in Millions	Mar. 31, 2021	May 03, 2021
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2021
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q1
Trading Symbol	MPW
Entity Registrant Name	MEDICAL PROPERTIES TRUST, INC.
Entity Central Index Key	0001287865
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		588.2
Title of 12(b) Security	Common stock, par value $0.001 per share, of Medical Properties Trust, Inc.
Security Exchange Name	NYSE
Entity Shell Company	false
Entity File Number	001-32559
Entity Tax Identification Number	20-0191742
Entity Address, Address Line One	1000 Urban Center Drive
Entity Address, Address Line Two	Suite 501
Entity Address, City or Town	Birmingham
Entity Address, State or Province	AL
Entity Address, Postal Zip Code	35242
City Area Code	(205)
Local Phone Number	969-3755
Entity Incorporation, State or Country Code	MD
Document Quarterly Report	true
Document Transition Report	false
MPT Operating Partnership, L.P. [Member]
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2021
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q1
Entity Registrant Name	MPT OPERATING PARTNERSHIP, L.P.
Entity Central Index Key	0001524607
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity File Number	333-177186
Entity Tax Identification Number	20-0242069
Entity Address, Address Line One	1000 Urban Center Drive
Entity Address, Address Line Two	Suite 501
Entity Address, City or Town	Birmingham
Entity Address, State or Province	AL
Entity Address, Postal Zip Code	35242
City Area Code	(205)
Local Phone Number	969-3755
Entity Incorporation, State or Country Code	DE

Debt - Covenants - Additional Information (Detail)	3 Months Ended
Debt - Covenants - Additional Information (Detail)	Mar. 31, 2021
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%

Real Estate and Other Activities - Net Assets Acquired (Detail) - USD ($) $ in Thousands	Mar. 31, 2021	Mar. 31, 2020
Business Acquisition [Line Items]
Liabilities assumed		$ (134,203)
Total net assets acquired	$ 1,778,417	1,973,661
Land and Land Improvements [Member]
Business Acquisition [Line Items]
Total assets acquired		265,991
Building [Member]
Business Acquisition [Line Items]
Total assets acquired		1,608,771
Intangible Lease Assets - Subject to Amortization [Member]
Business Acquisition [Line Items]
Total assets acquired		231,774
Mortgage Loans [Member]
Business Acquisition [Line Items]
Total assets acquired	1,090,400
Other Loans and Assets [Member]
Business Acquisition [Line Items]
Total assets acquired	$ 688,017	$ 1,328

Summary of Significant Accounting Policies - Additional Information (Detail) $ in Millions	Mar. 31, 2021 USD ($)
Accounting Policies [Abstract]
Loans and/or equity investments in variable interest entities	$ 350

Condensed Consolidated Statements of Net Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Revenues
Rent billed	$ 213,344	$ 171,767
Straight-line rent	54,873	31,421
Income from financing leases	50,894	52,436
Interest and other income	43,654	38,508
Total revenues	362,765	294,132
Expenses
Interest	86,972	80,899
Real estate depreciation and amortization	75,642	60,921
Property-related	5,453	5,412
General and administrative	36,073	33,385
Total expenses	204,140	180,617
Other income (expense)
Gain on sale of real estate	989	1,325
Real estate impairment charges		(19,006)
Earnings from equity interests	7,101	4,079
Debt refinancing and unutilized financing costs	(2,269)	(611)
Other (including mark-to-market adjustments on equity securities)	7,794	(14,135)
Total other income (expense)	13,615	(28,348)
Income before income tax	172,240	85,167
Income tax expense	(8,360)	(4,010)
Net income	163,880	81,157
Net income attributable to non-controlling interests	(97)	(165)
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 163,783	$ 80,992
Earnings per common share (units) basic and diluted
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.28	$ 0.15
Weighted average shares (units) outstanding basic	576,240	521,076
Weighted average shares (units) outstanding diluted	577,541	522,179
Dividends declared per common share (unit)	$ 0.28	$ 0.27
MPT Operating Partnership, L.P. [Member]
Revenues
Rent billed	$ 213,344	$ 171,767
Straight-line rent	54,873	31,421
Income from financing leases	50,894	52,436
Interest and other income	43,654	38,508
Total revenues	362,765	294,132
Expenses
Interest	86,972	80,899
Real estate depreciation and amortization	75,642	60,921
Property-related	5,453	5,412
General and administrative	36,073	33,385
Total expenses	204,140	180,617
Other income (expense)
Gain on sale of real estate	989	1,325
Real estate impairment charges		(19,006)
Earnings from equity interests	7,101	4,079
Debt refinancing and unutilized financing costs	(2,269)	(611)
Other (including mark-to-market adjustments on equity securities)	7,794	(14,135)
Total other income (expense)	13,615	(28,348)
Income before income tax	172,240	85,167
Income tax expense	(8,360)	(4,010)
Net income	163,880	81,157
Net income attributable to non-controlling interests	(97)	(165)
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 163,783	$ 80,992
Earnings per common share (units) basic and diluted
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.28	$ 0.15
Weighted average shares (units) outstanding basic	576,240	521,076
Weighted average shares (units) outstanding diluted	577,541	522,179
Dividends declared per common share (unit)	$ 0.28	$ 0.27

Fair Value of Financial Instruments - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2020 Health_Center
Fair Value, Recurring [Member] \| Colombia [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Number of facilities acquired	3

Condensed Consolidated Statements of Equity / Capital (Parenthetical) - $ / shares	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Dividends (Distributions) declared per common share / unit	$ 0.28	$ 0.27
MPT Operating Partnership, L.P. [Member]
Dividends (Distributions) declared per common share / unit	0.28	0.27
MPT Operating Partnership, L.P. [Member] \| General Partner [Member]
Dividends (Distributions) declared per common share / unit	0.28	0.27
Retained Earnings / Distributions in Excess of Net Income [Member]
Dividends (Distributions) declared per common share / unit	0.28	0.27
Common Par Value [Member] \| MPT Operating Partnership, L.P. [Member] \| Limited Partner [Member]
Dividends (Distributions) declared per common share / unit	$ 0.28	$ 0.27

Stock Awards - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share / (Unit)-based compensation expense	$ 12,264	$ 10,036
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	12,900,000
Common stock remaining for future stock awards transferred to the equity incentive plan	6,200,000

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Operating activities
Net income	$ 163,880	$ 81,157
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	78,606	63,833
Amortization of deferred financing costs and debt discount	3,817	3,210
Straight-line rent revenue and other	(65,333)	(47,846)
Share / (Unit)-based compensation expense	12,264	10,036
Gain from sale of real estate	(989)	(1,325)
Impairment charges		19,006
Straight-line rent and other (recovery) write-off	(5,238)	7,717
Debt refinancing and unutilized financing costs	2,269	611
Pre-acquisition rent collected - Circle Transaction		(35,020)
Other adjustments	(3,575)	(421)
Changes in:
Interest and rent receivables	13,396	2,137
Accounts payable and accrued expenses	5,062	(4,221)
Deferred revenue	(15,429)	8,040
Net cash provided by operating activities	188,730	106,914
Investing activities
Cash paid for acquisitions and other related investments	(1,778,417)	(1,973,661)
Net proceeds from sale of real estate	10,905	9,597
Principal received on loans receivable	40,937
Investment in loans receivable	(23,935)	(2,307)
Return of equity investment	11,000	63,122
Capital additions and other investments, net	(42,050)	8,460
Net cash used for investing activities	(1,781,560)	(1,894,789)
Financing activities
Proceeds from term debt, net of discount	1,839,735	915,950
Payments of term debt	(689,450)
Revolving credit facilities, net	8,910
Dividends / Distribution paid	(147,666)	(138,074)
Lease deposits and other obligations to tenants	12,900	2,348
Proceeds from sale of common shares, net of offering costs	779,241	61,682
Payment of debt refinancing, deferred financing costs, and other financing activities	(18,479)	(6,687)
Net cash provided by financing activities	1,785,191	835,219
Increase (decrease) in cash, cash equivalents, and restricted cash for period	192,361	(952,656)
Effect of exchange rate changes	4,356	(9,157)
Cash, cash equivalents, and restricted cash at beginning of period	556,369	1,467,991
Cash, cash equivalents, and restricted cash at end of period	753,086	506,178
Interest paid	82,471	80,721
Supplemental schedule of non-cash financing activities:
Dividend / Distributions declared, unpaid	163,443	141,667
Cash, cash equivalents, and restricted cash are comprised of the following:
Cash and cash equivalents at beginning of period	549,884	1,462,286
Restricted cash, included in Other assets at beginning of period	$ 6,485	$ 5,705
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	us-gaap:OtherAssets	us-gaap:OtherAssets
Cash, cash equivalents, and restricted cash at beginning of period	$ 556,369	$ 1,467,991
Cash and cash equivalents at end of period	746,753	500,213
Restricted cash, included in Other assets at end of period	$ 6,333	$ 5,965
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	us-gaap:OtherAssets	us-gaap:OtherAssets
Cash, cash equivalents, and restricted cash at end of period	$ 753,086	$ 506,178
MPT Operating Partnership, L.P. [Member]
Operating activities
Net income	163,880	81,157
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	78,606	63,833
Amortization of deferred financing costs and debt discount	3,817	3,210
Straight-line rent revenue and other	(65,333)	(47,846)
Share / (Unit)-based compensation expense	12,264	10,036
Gain from sale of real estate	(989)	(1,325)
Impairment charges		19,006
Straight-line rent and other (recovery) write-off	(5,238)	7,717
Debt refinancing and unutilized financing costs	2,269	611
Pre-acquisition rent collected - Circle Transaction		(35,020)
Other adjustments	(3,575)	(421)
Changes in:
Interest and rent receivables	13,396	2,137
Accounts payable and accrued expenses	5,062	(4,221)
Deferred revenue	(15,429)	8,040
Net cash provided by operating activities	188,730	106,914
Investing activities
Cash paid for acquisitions and other related investments	(1,778,417)	(1,973,661)
Net proceeds from sale of real estate	10,905	9,597
Principal received on loans receivable	40,937
Investment in loans receivable	(23,935)	(2,307)
Return of equity investment	11,000	63,122
Capital additions and other investments, net	(42,050)	8,460
Net cash used for investing activities	(1,781,560)	(1,894,789)
Financing activities
Proceeds from term debt, net of discount	1,839,735	915,950
Payments of term debt	(689,450)
Revolving credit facilities, net	8,910
Dividends / Distribution paid	(147,666)	(138,074)
Lease deposits and other obligations to tenants	12,900	2,348
Proceeds from sale of units, net of offering costs	779,241	61,682
Payment of debt refinancing, deferred financing costs, and other financing activities	(18,479)	(6,687)
Net cash provided by financing activities	1,785,191	835,219
Increase (decrease) in cash, cash equivalents, and restricted cash for period	192,361	(952,656)
Effect of exchange rate changes	4,356	(9,157)
Cash, cash equivalents, and restricted cash at beginning of period	556,369	1,467,991
Cash, cash equivalents, and restricted cash at end of period	753,086	506,178
Interest paid	82,471	80,721
Supplemental schedule of non-cash financing activities:
Dividend / Distributions declared, unpaid	163,443	141,667
Cash, cash equivalents, and restricted cash are comprised of the following:
Cash and cash equivalents at beginning of period	549,884	1,462,286
Restricted cash, included in Other assets at beginning of period	$ 6,485	$ 5,705
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	us-gaap:OtherAssets	us-gaap:OtherAssets
Cash, cash equivalents, and restricted cash at beginning of period	$ 556,369	$ 1,467,991
Cash and cash equivalents at end of period	746,753	500,213
Restricted cash, included in Other assets at end of period	$ 6,333	$ 5,965
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	us-gaap:OtherAssets	us-gaap:OtherAssets
Cash, cash equivalents, and restricted cash at end of period	$ 753,086	$ 506,178

Earnings Per Share/Unit - Calculation of Earnings Per Share (Detail) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Net income	$ 163,880	$ 81,157
Non-controlling interests’ share in net income	(97)	(165)
Participating securities’ share in earnings	(370)	(464)
Net income, less participating securities’ share in earnings	$ 163,413	$ 80,528
Basic weighted-average common shares	576,240	521,076
Dilutive potential common shares	1,301	1,103
Diluted weighted-average common shares	577,541	522,179
MPT Operating Partnership, L.P. [Member]
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Net income	$ 163,880	$ 81,157
Non-controlling interests’ share in net income	(97)	(165)
Participating securities’ share in earnings	(370)	(464)
Net income, less participating securities’ share in earnings	$ 163,413	$ 80,528
Basic weighted-average common shares	576,240	521,076
Dilutive potential common shares	1,301	1,103
Diluted weighted-average common shares	577,541	522,179

Debt - British Pound Sterling Term Loan - Additional Information (Detail) - Term Loan [Member] - Bank of America, N.A [Member] - British Pound Sterling [Member] - EUR (€)	Mar. 04, 2020	Jan. 06, 2020	Mar. 31, 2020
Debt Instrument [Line Items]
Maximum borrowing capacity		€ 700,000,000
Debt instrument maturity date		Jan. 15, 2025
Debt instrument effective date	Mar. 06, 2020
Effective interest rate	0.70%
Senior unsecured notes, interest rate			1.95%
Minimum [Member]
Debt Instrument [Line Items]
Applicable margin adjustable based on pricing grid, percentage		0.85%
Maximum [Member]
Debt Instrument [Line Items]
Applicable margin adjustable based on pricing grid, percentage		1.65%
Credit Rating [Member]
Debt Instrument [Line Items]
Variable interest rate			1.25%

Condensed Consolidated Statements of Equity / Capital - USD ($) shares in Thousands, $ in Thousands	Total	MPT Operating Partnership, L.P. [Member]	MPT Operating Partnership, L.P. [Member] General Partner [Member]	Cumulative Effect, Period of Adoption, Adjustment [Member]	Cumulative Effect, Period of Adoption, Adjustment [Member] MPT Operating Partnership, L.P. [Member]	Cumulative Effect, Period of Adoption, Adjustment [Member] MPT Operating Partnership, L.P. [Member] General Partner [Member]	Common Par Value [Member]	Common Par Value [Member] MPT Operating Partnership, L.P. [Member] Limited Partner [Member]	Common Par Value [Member] Cumulative Effect, Period of Adoption, Adjustment [Member] MPT Operating Partnership, L.P. [Member] Limited Partner [Member]	Additional Paid-in Capital [Member]	Retained Earnings / Distributions in Excess of Net Income [Member]	Retained Earnings / Distributions in Excess of Net Income [Member] Cumulative Effect, Period of Adoption, Adjustment [Member]	Accumulated Other Comprehensive Loss [Member]	Accumulated Other Comprehensive Loss [Member] MPT Operating Partnership, L.P. [Member]	Treasury Shares [Member]	Non-Controlling Interests [Member]	Non-Controlling Interests [Member] MPT Operating Partnership, L.P. [Member]	Long Term Incentive Plan [Member] MPT Operating Partnership, L.P. [Member] Limited Partner [Member]
Beginning balance at Dec. 31, 2019	$ 7,028,154	$ 7,028,544	$ 70,939				$ 518	$ 7,020,403		$ 7,008,199	$ 83,012		$ (62,905)	$ (62,905)	$ (777)	$ 107	$ 107
Beginning balance (Accounting Standards Update 2016-13) at Dec. 31, 2019				$ (8,399)	$ (8,399)	$ (84)			$ (8,315)			$ (8,399)
Beginning balance (in shares) at Dec. 31, 2019			5,176				517,522	512,346										232
Net income	81,157	81,157	$ 810					$ 80,182			80,992					165	165
Unrealized gain (loss) on interest rate swap, net of tax	(25,103)	(25,103)											(25,103)	(25,103)
Foreign currency translation loss	(23,272)	(23,272)											(23,272)	(23,272)
Stock (Unit) vesting and amortization of stock (unit)-based compensation	10,036	10,036	$ 100				$ 2	$ 9,936		10,034
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)			23				2,312	2,289
Distributions to non-controlling interests	(165)	(165)														(165)	(165)
Proceeds from offering (net of offering costs)	61,682	61,682	$ 617				$ 2	$ 61,065		61,680
Proceeds from offering (net of offering costs) (shares)			26				2,601	2,575
Dividends (Distributions) declared	(141,580)	(141,580)	$ (1,416)					$ (140,164)			(141,580)
Ending balance at Mar. 31, 2020	6,982,510	6,982,900	$ 70,966				$ 522	$ 7,023,107		7,079,913	14,025		(111,280)	(111,280)	(777)	107	107
Ending balance (in shares) at Mar. 31, 2020			5,225				522,435	517,210										232
Beginning balance at Dec. 31, 2020	7,343,857	7,344,247	$ 73,977				$ 541	$ 7,316,269		7,461,503	(71,411)		(51,324)	(51,324)	(777)	5,325	5,325
Beginning balance (in shares) at Dec. 31, 2020			5,414				541,419	536,005
Net income	163,880	163,880	$ 1,638					$ 162,145			163,783					97	97
Unrealized gain (loss) on interest rate swap, net of tax	15,504	15,504											15,504	15,504
Foreign currency translation loss	(30,900)	(30,900)											(30,900)	(30,900)
Stock (Unit) vesting and amortization of stock (unit)-based compensation	12,264	12,264	$ 123				$ 2	$ 12,141		12,262
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)			17				1,741	1,724
Distributions to non-controlling interests	(193)	(193)														(193)	(193)
Proceeds from offering (net of offering costs)	779,241	779,241	$ 7,792				$ 40	$ 771,449		779,201
Proceeds from offering (net of offering costs) (shares)			399				39,949	39,550
Dividends (Distributions) declared	(163,443)	(163,443)	$ (1,634)					$ (161,809)			(163,443)
Ending balance at Mar. 31, 2021	$ 8,120,210	$ 8,120,600	$ 81,896				$ 583	$ 8,100,195		$ 8,252,966	$ (71,071)		$ (66,720)	$ (66,720)	$ (777)	$ 5,229	$ 5,229
Ending balance (in shares) at Mar. 31, 2021			5,830				583,109	577,279

Organization - Additional Information (Detail)	Mar. 31, 2021 Facility State Country
Business Acquisition [Line Items]
Number of facilities \| Facility	425
Number of states \| State	33
Europe [Member]
Business Acquisition [Line Items]
Number of countries	6
South America [Member]
Business Acquisition [Line Items]
Number of countries	1

Subsequent Events - Additional Information (Detail) - Subsequent Event [Member] SFr in Millions, $ in Millions	May 07, 2021 USD ($)	Apr. 16, 2021 CHF (SFr)
Subsequent Event [Line Items]
Loan principal prepayments received \| $	$ 75
Swiss Medical Network [Member]
Subsequent Event [Line Items]
Equity investment and shareholder loan \| SFr		SFr 145

Debt - Interim Credit Facility - Additional Information (Detail) - Jan. 15, 2021 - Waterland Private Equity Fund VII C.V. [Member] - Interim Credit Facility [Member] £ in Millions	USD ($)	GBP (£)
Debt Instrument [Line Items]
Line of credit facility, Borrowing capacity \| $	$ 900,000,000
Line of credit \| £		£ 500
Line of credit, terminated date	Mar. 26, 2021

Debt - Credit Facility Amendment - Additional Information (Detail) $ in Millions	Jan. 15, 2021 USD ($)
Minimum [Member]
Debt Instrument [Line Items]
Commitment fee	0.125%
Maximum [Member]
Debt Instrument [Line Items]
Commitment fee	0.30%
Unsecured Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Amount of senior unsecured debt	$ 1,300
Debt instrument maturity date	Feb. 01, 2024
Term Loan [Member]
Debt Instrument [Line Items]
Amount of senior unsecured debt	$ 200
Debt instrument maturity date	Feb. 01, 2026
Alternate Base Rate [Member] \| Minimum [Member]
Debt Instrument [Line Items]
Applicable margin for term loan	0.00%
Applicable margin for revolving loans	0.00%
Alternate Base Rate [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Applicable margin for term loan	0.85%
Applicable margin for revolving loans	0.55%
Eurodollar Loans [Member] \| Minimum [Member]
Debt Instrument [Line Items]
Applicable margin for term loan	0.85%
Applicable margin for revolving loans	0.825%
Eurodollar Loans [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Applicable margin for term loan	1.85%
Applicable margin for revolving loans	1.55%

Real Estate and Other Activities - Leasing Operations (Lessor) - Additional Information (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2021 USD ($) Property Lease
Lessor Lease Description [Line Items]
Term of lease	15 years
Lease renewal term	5 years
Annual rent escalations	99.00%
Number of properties \| Property	5
Carrying value of lease requiring residual value guarantee \| $	$ 230
Ernest Health Inc [Member]
Lessor Lease Description [Line Items]
Number of direct financing leases	13
Number of financing leases	5
Prime Facilities [Member]
Lessor Lease Description [Line Items]
Number of direct financing leases	5
Prospect [Member]
Lessor Lease Description [Line Items]
Number of financing leases	13
Minimum [Member]
Lessor Lease Description [Line Items]
Fixed minimum annual escalations	0.50%
Maximum [Member]
Lessor Lease Description [Line Items]
Fixed minimum annual escalations	3.00%

Real Estate and Other Activities - Alecto Facilities - Additional Information (Detail) - Alecto Healthcare Services [Member] $ in Millions	3 Months Ended		12 Months Ended
	Mar. 31, 2021 USD ($) Property	Mar. 31, 2020 USD ($)	Dec. 31, 2020 Property
Business Acquisition [Line Items]
Number of leased properties	4
Number of properties owned	1
Real estate impairment charge \| $		$ 9.1
Number of re-leased properties			1
Proceeds from sale of mortgage loans \| $	$ 51.0
Total Gross Assets [Member] \| Customer Concentration Risk [Member]
Business Acquisition [Line Items]
Percentage of total assets	0.10%