0000950170-24-023248 | 10-K | XBRL Viewer | Medical Properties Trust INC

Real Estate and Other Activities - Investments in Unconsolidated Real Estate Joint Ventures - Additional Information (Details) - Investments in Unconsolidated Real Estate Joint Ventures [Member] - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Percentage of equity investment	100.00%
Dividend income	$ 69	$ 77
Maximum [Member]
Business Acquisition [Line Items]
Percentage of equity investment	100.00%

Income Taxes - Summary of Reconciliation of Income Tax Benefit (Expense) from the Statutory Income Tax Rate to the Effective Tax Rate Based on Income before Income Taxes (Parenthetical) (Detail)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Income tax at the US statutory federal rate	21.00%	21.00%	21.00%

Real Estate and Other Activities - Summary of Operating Results from Properties Sold (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Business Acquisition [Line Items]
Revenues	$ 871,799	$ 1,542,851	$ 1,544,669
Real estate depreciation and amortization	(603,360)	(332,977)	(321,249)
Real estate and other impairment charges	(376,907)	(268,375)	(39,411)
Other (expense) income	7,586	15,344	45,699
Disposal Group, Not Discontinued Operations [Member]
Business Acquisition [Line Items]
Revenues	37,332	75,084	75,464
Real estate depreciation and amortization	(4,991)	(20,312)	(21,467)
Property-related expenses	(2,467)	(5,492)	(3,479)
Real estate and other impairment charges	(96,405)
Other (expense) income	(1,661)	(1,082)	(1,075)
(Loss) Income from real estate dispositions, net	$ (68,192)	$ 48,198	$ 49,443

- Definition

Amount of revenue recognized from goods sold, services rendered, insurance premiums, or other activities that constitute an earning process. Includes, but is not limited to, investment and interest income before deduction of interest expense when recognized as a component of revenue, and sales and trading gain (loss).

+ References

+ Details

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Dec. 31, 2023
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false
Rule 10b51 Arr Mofified Flag	false
Non Rule 10b51 Arr Modified Flag	false

Real Estate and Other Activities - Development Activities - Summary of Status on Current Development Projects (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($)
Business Acquisition [Line Items]
Commitment	$ 171,562
Costs Incurred as of December 31, 2023	110,073
IMED [Member] \| Spain [Member]
Business Acquisition [Line Items]
Commitment	50,099
Costs Incurred as of December 31, 2023	$ 49,534
Estimated Rent Commencement Date	1Q 2024
IMED [Member] \| Spain [Member]
Business Acquisition [Line Items]
Commitment	$ 37,879
Costs Incurred as of December 31, 2023	$ 17,876
Estimated Rent Commencement Date	3Q 2024
IMED [Member] \| Spain [Member]
Business Acquisition [Line Items]
Commitment	$ 51,984
Costs Incurred as of December 31, 2023	$ 18,640
Estimated Rent Commencement Date	1Q 2025
Lifepoint Behavioral Health [Member] \| Texas [Member]
Business Acquisition [Line Items]
Commitment	$ 31,600
Costs Incurred as of December 31, 2023	$ 24,023
Estimated Rent Commencement Date	1Q 2024

Income Taxes - Schedule of Net NOL and Other Tax Attribute Carryforwards (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($)
U.S. [Member]
Income Taxes [Line Items]
Gross NOL carryforwards	$ 169,970
Tax-effected NOL carryforwards	28,056
Valuation allowance	(27,956)
Net deferred tax asset - NOL carryforwards	$ 100
Expiration periods	2024
Expiration periods	indefinite
Foreign [Member]
Income Taxes [Line Items]
Gross NOL carryforwards	$ 458,913
Tax-effected NOL carryforwards	114,359
Valuation allowance	(4,702)
Net deferred tax asset - NOL carryforwards	$ 109,657
Expiration periods	indefinite

Debt - Senior Unsecured Notes - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2023
Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest	101.00%

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

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+ Details

Real Estate and Other Activities - Disposals - 2023 Activity Additional Information (Detail) $ in Millions, $ in Millions							3 Months Ended			12 Months Ended
	Oct. 10, 2023 AUD ($) Facility	Jul. 11, 2023 USD ($) Facility	May 18, 2023 AUD ($) Facility	Mar. 29, 2023 Facility	Mar. 08, 2023 USD ($)	Sep. 01, 2022 USD ($)	Mar. 31, 2023 AUD ($) Facility	Mar. 31, 2023 USD ($) Facility	Dec. 31, 2021 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($) Facility	Dec. 31, 2021 USD ($) Facility
Debt Instrument [Line Items]
Number of facilities sold \| Facility			7								15	16
Proceeds from sale of facilities									$ 54.5		$ 522.0	$ 246.0
Net impairment charge								$ 86.0
Straight-line rent receivables								37.4
Estimated fees to sell the hospitals								8.0
Deferred gains from our interest rate swap and foreign currency translation in AOCI								$ 8.0
Derivative Instrument, Gain (Loss) Reclassified from AOCI into Income, Effective Portion, Statement of Income or Comprehensive Income [Extensible Enumeration]							Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax	Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax
General Acute Care Facility [Member] \| Australia [Member]
Debt Instrument [Line Items]
Number of facilities sold \| Facility				11
Australia Transaction [Member]
Debt Instrument [Line Items]
Number of facilities sold \| Facility			7
Proceeds from sale of facilities	$ 470		$ 730				$ 1,200
Number of remaining facilities sold \| Facility	4		11
Prime Healthcare Services, Inc. Facilities [Member]
Debt Instrument [Line Items]
Proceeds from sale of facilities						$ 366.0
Prime [Member]
Debt Instrument [Line Items]
Number of facilities sold \| Facility							3	3
Proceeds from sale of facilities					$ 100.0
Non-cash impairment charge								$ 11.0		$ 11.0
Number of facilities acquired \| Facility		3
Facilities acquired by the Prime		$ 100.0

Schedule III - Real Estate Investments and Accumulated Depreciation (Parenthetical) (Detail) $ in Billions	Dec. 31, 2023 USD ($)
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]
Aggregate cost for federal income tax purposes	$ 11.9

Debt - Credit Facility - Additional Information (Detail) - USD ($) $ in Millions			12 Months Ended
	Jun. 29, 2022	May 06, 2022	Dec. 31, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Adjustments to applicable margin			0.375%
Commitment fee			0.30%	0.25%
Minimum [Member]
Debt Instrument [Line Items]
Commitment fee	0.125%
Maximum [Member]
Debt Instrument [Line Items]
Commitment fee	0.30%
Alternate Base Rate [Member] \| Minimum [Member]
Debt Instrument [Line Items]
Applicable margin 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	0.70%
Applicable margin for revolving loans	0.50%
Term Benchmark Loans or RFR Loans [Member] \| Minimum [Member]
Debt Instrument [Line Items]
Applicable margin for revolving loans	0.80%
Term Benchmark Loans or RFR Loans [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Applicable margin for revolving loans	1.50%
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Increase in revolving credit facility		$ 500.0
Debt instrument amendment extended maturity date description			The amendment extended the maturity date of our revolving facility to June 30, 2026 with our option to extend for an additional 12 months.
Unsecured Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Amount of senior unsecured debt		1,800.0
Debt instrument maturity date	Jun. 30, 2026
Credit facilities, amount outstanding			$ 1,500.0	$ 929.6
Line of credit facility, Borrowing capacity			$ 300.0	$ 900.0
Maximum incremental credit facility	$ 1,000.0
Credit facilities, weighted average interest rate			5.90%	3.80%
Term Loan [Member]
Debt Instrument [Line Items]
Amount of senior unsecured debt	$ 200.0	$ 200.0
Debt instrument maturity date	Jun. 30, 2027
Interest rate at end of period			7.20%	5.70%
Term Loan [Member] \| Term Benchmark Loans [Member] \| Minimum [Member]
Debt Instrument [Line Items]
Applicable margin for term loan	0.875%
Term Loan [Member] \| Term Benchmark Loans [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Applicable margin for term loan	1.70%

Income Taxes - Additional Information (Detail) - USD ($)		3 Months Ended			12 Months Ended
	Apr. 01, 2023	Jun. 30, 2023	Sep. 30, 2022	Jun. 30, 2021	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Taxes [Line Items]
Percentage of ordinary taxable income to be distributed for real estate investment trust qualification					90.00%	90.00%	90.00%
Percentage of taxable income to be distributed for federal income tax assumption					100.00%
Amount of foreign income (loss) before income taxes					$ 6,300,000	$ 159,600,000	$ 164,000,000
Amount of domestic income (loss) before income taxes					(144,500,000)	10,800,000	(29,700,000)
Income tax expense (benefit)			$ 5,000,000		$ (130,679,000)	$ 55,900,000	73,948,000
Income tax benefit related to the initial loan impairment							$ 10,000,000
Income tax at the US statutory federal rate					21.00%	21.00%	21.00%
Valuation allowance not expected to be realized					$ 45,700,000
Uncertain tax position liabilities and related interest or penalties					$ 0
United Kingdom [Member]
Income Taxes [Line Items]
Income tax expense (benefit)		$ 161,000
Income tax at the US statutory federal rate	25.00%			19.00%
Deferred tax liabilities, one time adjustment				$ 43,000,000

Real Estate and Other Activities - Alecto Facilities - Additional Information (Detail) - USD ($)
$ in Millions

3 Months Ended

12 Months Ended

Mar. 31, 2023

Dec. 31, 2023

Dec. 31, 2022

Business Acquisition [Line Items]

Real estate impairment charge

$ 86

Total Gross Assets [Member] | Customer Concentration Risk [Member]

Business Acquisition [Line Items]

Percentage of total assets

^[1]

100.00%

[1]	For geographic and facility type concentration metrics in the tables above, we allocate our investments in operating entities pro rata based on the gross book value of the real estate. Such pro rata allocations are subject to change from period to period.

Subsequent Events

12 Months Ended

Dec. 31, 2023

Subsequent Events [Abstract]

Subsequent Events

13. Subsequent Events

Prime

On February 19, 2024, we entered into definitive agreements to sell five properties currently leased to Prime for total proceeds of approximately $250 million along with a $100 million interest-bearing mortgage loan due in approximately nine months. This transaction, closing of which is subject to customary conditions and notice provisions, would result in a gain on real estate of approximately $50 million and a non-cash straight-line rent write-off of approximately $28 million.

As part of this sale transaction, we also agreed to extend the lease maturity of four other facilities with Prime to 2044. This amended lease has inflation-based escalators, collared between 2% and 4% and a purchase option for a value of at least $260 million, which is greater than our net book value for these properties at December 31, 2023.

Other Disposal Transactions

In February 2024, we sold our interest in the Priory syndicated term loan for £90 million (approximately $115 million), resulting in an approximate £6 million economic loss. In addition, we entered into agreements to sell a non-controlling interest in a tenant and two hospitals in South Carolina for total proceeds of approximately $17 million.

Steward

In February 2024, we and certain of Steward's asset backed lenders agreed to a new bridge facility with Steward. As part of this facility, we and the other lenders each funded $37.5 million. If certain milestones are met in regard to Steward's strategic plan to improve its liquidity position and optimize the amount and timing of resources for us and the other lenders, additional fundings may be made. This is in addition to the $60 million funded in January 2024. These advances by us, secured by all of our existing collateral plus new second liens on Steward's managed care business, were made to protect the value of our assets and the related Steward operations while Steward executes its strategic plan as described previously in Note 3.

Schedule IV - Schedule of Mortgage Loans on Real Estate (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Mortgage Loans on Real Estate [Line Items]
Face Amount of Mortgages	$ 310,101
Carrying Amount of Mortgages	$ 310,101	$ 364,420	$ 213,320	$ 248,335
Long-Term First Mortgage Loan [Member]
Mortgage Loans on Real Estate [Line Items]
Periodic Payment Terms	Payable in monthlyinstallments of interest plusprincipal payable in full at maturity
Long-Term First Mortgage Loan [Member] \| Colombia [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	10.50%
Final Maturity Date	2035
Face Amount of Mortgages	$ 146,892
Carrying Amount of Mortgages	$ 146,892
Long-Term First Mortgage Loan [Member] \| Vibra [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	11.50%
Final Maturity Date	2024
Face Amount of Mortgages	$ 7,986
Carrying Amount of Mortgages	$ 7,986
Long-Term First Mortgage Loan [Member] \| Prospect [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	9.00%
Final Maturity Date	2028
Face Amount of Mortgages	$ 155,223
Carrying Amount of Mortgages	$ 155,223

Real Estate and Other Activities - Other Leasing Activities - Additional Information (Details)	Dec. 31, 2023
Business Combinations [Abstract]
Percentage of vacant on leased property	0.30%

Real Estate and Other Activities - Prospect Medical Holdings Additional Information (Detail)
$ in Thousands

1 Months Ended

3 Months Ended

Aug. 31, 2019

USD ($)

Hospital

Mar. 31, 2023

USD ($)

Dec. 31, 2022

USD ($)

Dec. 31, 2023

USD ($)

Jun. 30, 2022

USD ($)

Dec. 31, 2021

USD ($)

Business Acquisition [Line Items]

Additional mortgage loan

$ 1,332,962

$ 235,187

$ 5,350,239

Net impairment charge

$ 86,000

Mortgage Loans [Member]

Business Acquisition [Line Items]

Additional mortgage loan

^[1]

159,735

$ 1,113,300

Prospect [Member]

Business Acquisition [Line Items]

Purchase price of acquisition

$ 1,500,000

Additional mortgage loan

$ 100,000

Term loan

$ 112,900

Net impairment charge

280,000

Prospect [Member] | Pennsylvania [Member]

Business Acquisition [Line Items]

Carrying value of lease requiring residual value guarantee

170,000

Prospect [Member] | Pennsylvania [Member] | Maximum [Member]

Business Acquisition [Line Items]

Carrying value of lease requiring residual value guarantee

$ 250,000

Acute Care Campus [Member] | Prospect [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

[1]

The 2023 column includes a $23 million mortgage loan that was converted to fee simple ownership of one property as described under the Lifepoint Transaction below. The 2021 column includes an £800 million mortgage loan advanced to the Priory Group (“Priory”) in the first quarter of 2021 and converted to fee simple ownership of 35 properties in the second quarter of 2021 as described below.

Debt - Covenants - Additional Information (Detail)	12 Months Ended
Debt - Covenants - Additional Information (Detail)	Dec. 31, 2023
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 - Other Disposal Transactions - Additional Information (Detail) $ in Millions		3 Months Ended	12 Months Ended
	May 18, 2023 Facility	Dec. 31, 2021 USD ($) Operator	Dec. 31, 2022 USD ($) Facility	Dec. 31, 2021 USD ($) Facility Operator
Business Acquisition [Line Items]
Number of operations sold \| Operator		3		3
Proceeds from sale of facilities		$ 54.5	$ 522.0	$ 246.0
Gain (loss) on real estate dispositions		$ 40.0	$ 100.0	$ 52.5
Number of facilities sold \| Facility	7		15	16

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Real estate assets
Land	$ 1,806,765	$ 1,948,216
Buildings and improvements	10,395,612	10,519,728
Intangible lease assets	1,034,810	1,394,471
Investment in financing leases	1,231,630	1,691,323
Mortgage loans	309,315	364,101
Gross investment in real estate assets	14,778,132	15,917,839
Accumulated depreciation	(1,227,619)	(1,008,340)
Accumulated amortization	(180,352)	(184,972)
Net investment in real estate assets	13,370,161	14,724,527
Cash and cash equivalents	250,016	235,668
Interest and rent receivables	45,059	167,035
Straight-line rent receivables	635,987	787,166
Investments in unconsolidated real estate joint ventures	1,474,455	1,497,903
Investments in unconsolidated operating entities	1,778,640	1,444,872
Other loans	292,615	227,839
Other assets	457,911	572,990
Total Assets	18,304,844	19,658,000
Liabilities
Debt, net	10,064,236	10,268,412
Accounts payable and accrued expenses	412,178	621,324
Deferred revenue	37,962	27,727
Obligations to tenants and other lease liabilities	156,603	146,130
Total Liabilities	10,670,979	11,063,593
Commitments and Contingencies
Equity / Capital
Preferred stock, $0.001 par value. Authorized 10,000 shares; no shares outstanding
Common stock, $0.001 par value. Authorized 750,000 shares; issued and outstanding - 598,991 shares at December 31, 2023 and 597,476 shares at December 31, 2022	599	597
Additional paid-in capital	8,560,309	8,535,140
Retained (deficit) earnings	(971,809)	116,285
Accumulated other comprehensive income (loss)	42,501	(59,184)
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital)	7,631,600	8,592,838
Non-controlling interests	2,265	1,569
Total Equity / Capital	7,633,865	8,594,407
Total Liabilities and Equity / Capital	18,304,844	19,658,000
MPT Operating Partnership, L.P. [Member]
Real estate assets
Land	1,806,765	1,948,216
Buildings and improvements	10,395,612	10,519,728
Intangible lease assets	1,034,810	1,394,471
Investment in financing leases	1,231,630	1,691,323
Mortgage loans	309,315	364,101
Accumulated depreciation	(1,227,619)	(1,008,340)
Accumulated amortization	(180,352)	(184,972)
Cash and cash equivalents	250,016	235,668
Interest and rent receivables	45,059	167,035
Straight-line rent receivables	635,987	787,166
Investments in unconsolidated real estate joint ventures	1,474,455	1,497,903
Investments in unconsolidated operating entities	1,778,640	1,444,872
Other loans	292,615	227,839
Other assets	457,911	572,990
Liabilities
Debt, net	10,064,236	10,268,412
Accounts payable and accrued expenses	318,980	444,354
Deferred revenue	37,962	27,727
Obligations to tenants and other lease liabilities	156,603	146,130
Payable due to Medical Properties Trust, Inc.	92,808	176,580
Total Liabilities	10,670,589	11,063,203
Commitments and Contingencies
Equity / Capital
General partner - issued and outstanding - 5,991 units at December 31, 2023 and 5,976 units at December 31, 2022	75,969	86,599
Limited Partners - issued and outstanding - 593,000 units at December 31, 2023 and 591,500 units at December 31, 2022	7,513,520	8,565,813
Accumulated other comprehensive income (loss)	42,501	(59,184)
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital)	7,631,990	8,593,228
Non-controlling interests	2,265	1,569
Total Equity / Capital	7,634,255	8,594,797
Total Liabilities and Equity / Capital	$ 18,304,844	$ 19,658,000

Leases (Lessee) - Summary of Lease Expense (Parenthetical) (Detail) - USD ($)
$ in Thousands

12 Months Ended

Dec. 31, 2023

Dec. 31, 2022

Dec. 31, 2021

Lessee Lease Description [Line Items]

Operating lease cost

^[1],[2]

$ 11,653

$ 12,175

$ 10,694

Property-related [Member]

Lessee Lease Description [Line Items]

Operating lease cost

$ 6,000

$ 5,700

$ 6,300

[1]	$6.0 million, $5.7 million, and $6.3 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2023, 2022, and 2021, respectively.
[2]	Includes short-term leases.

Real Estate and Other Activities - Pipeline Health System - Additional Information (Detail) - Pipeline Health System [Member] $ in Millions	12 Months Ended
	Dec. 31, 2023 USD ($)
Business Acquisition [Line Items]
Cash rent	$ 6
Percentage of defered rent	30.00%
Maximum [Member]
Business Acquisition [Line Items]
Percentage of assets in compliance with terms of lease	1.30%

Summary of Significant Accounting Policies - Summary of Carrying Value and Classification of the Assets and Maximum Exposure (Details) - Variable Interest Entity, Not Primary Beneficiary [Member] $ in Thousands	Dec. 31, 2023 USD ($)
Investments in Unconsolidated Operating Entities [Member]
Variable Interest Entity [Line Items]
Carrying Amount	$ 850,655
Equity Investments Carrying Amount	74,840
Equity Investments	74,840
Mortgage and Other Loans [Member]
Variable Interest Entity [Line Items]
Carrying Amount	149,872
Loans, Net One [Member]
Variable Interest Entity [Line Items]
Maximum Loss Exposure	850,655
Loans, Net Two [Member]
Variable Interest Entity [Line Items]
Maximum Loss Exposure	$ 151,190

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

Dec. 31, 2023

EUR (€)

Dec. 31, 2023

GBP (£)

Dec. 31, 2023

USD ($)

Dec. 05, 2023

Dec. 31, 2022

USD ($)

Dec. 31, 2021

Debt Instrument [Line Items]

Debt

$ 10,109,133

$ 10,325,499

GBP-denominated Borrowings [Member]

Debt Instrument [Line Items]

Debt | £

£ 322

EURO-denominated Borrowings [Member]

Debt Instrument [Line Items]

Debt | €

€ 303

2.550% Senior Unsecured Notes due 2023 [Member]

Debt Instrument [Line Items]

Senior unsecured notes, interest rate

2.55%

Debt

£ 50

$ 483,320

^[1]

3.325% Senior Unsecured Notes due 2025 [Member]

Debt Instrument [Line Items]

Senior unsecured notes, interest rate

3.325%

Debt

^[1]

$ 551,950

$ 535,250

0.993% Senior Unsecured Notes due 2026 [Member]

Debt Instrument [Line Items]

Senior unsecured notes, interest rate

0.993%

Debt

^[1]

$ 551,950

$ 535,250

2.500% Senior Unsecured Notes due 2026 [Member]

Debt Instrument [Line Items]

Senior unsecured notes, interest rate

2.50%

Debt

^[1]

$ 636,550

$ 604,150

5.250% Senior Unsecured Notes due 2026 [Member]

Debt Instrument [Line Items]

Senior unsecured notes, interest rate

5.25%

Debt

$ 500,000

5.000% Senior Unsecured Notes due 2027 [Member]

Debt Instrument [Line Items]

Senior unsecured notes, interest rate

5.00%

Debt

$ 1,400,000

3.692% Senior Unsecured Notes due 2028 [Member]

Debt Instrument [Line Items]

Senior unsecured notes, interest rate

3.692%

Debt

^[1]

$ 763,860

$ 724,980

4.625% Senior Unsecured Notes due 2029 [Member]

Debt Instrument [Line Items]

Senior unsecured notes, interest rate

4.625%

Debt

$ 900,000

3.375% Senior Unsecured Notes due 2030 [Member]

Debt Instrument [Line Items]

Senior unsecured notes, interest rate

3.375%

Debt

^[1]

$ 445,585

$ 422,905

3.500% Senior Unsecured Notes due 2031 [Member]

Debt Instrument [Line Items]

Senior unsecured notes, interest rate

3.50%

Debt

$ 1,300,000

[1]	Non-U.S. dollar denominated debt that reflects the exchange rates at period-end.

Real Estate and Other Activities - Amortization Expense from Existing Lease Intangible Assets (Detail) $ in Thousands	Dec. 31, 2023 USD ($)
Business Combinations [Abstract]
2024	$ 40,934
2025	40,081
2026	39,933
2027	39,664
2028	$ 39,330

Leases (Lessee) (Tables)

12 Months Ended

Dec. 31, 2023

Leases [Abstract]

Summary of Lease Expense

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


	Income Statement	For the Years Ended December 31,
	Classification	2023			2022			2021
Operating lease cost (1)	(2)	$	11,653		$	12,175		$	10,694
Finance lease cost:
Amortization of right-of-use assets	Real estate depreciation and amortization		51			51			51
Interest on lease liabilities	Interest		128			128			128
Sublease income	Other		(4,178	)		(4,485	)		(4,466	)
Total lease cost		$	7,654		$	7,869		$	6,407

(1)

Includes short-term leases.

(2)

$6.0 million, $5.7 million, and $6.3 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2023, 2022, and 2021, respectively.

Schedule Of Future Minimum Rental Payments For Leases Sublease Receivable And Net Payments

Fixed minimum payments due over the remaining lease term under non-cancelable leases of more than one year and amounts to be received in the future from non-cancelable subleases over their remaining lease term at December 31, 2023 are as follows (amounts in thousands):


	Operating Leases			Finance Leases			Amounts To Be Received From Subleases			Net Payments
2024	$	9,292		$	130		$	(4,509	)	$	4,913
2025		9,279			131			(4,389	)		5,021
2026		8,522			133			(4,083	)		4,572
2027		7,985			134			(3,796	)		4,323
2028		8,073			135			(3,804	)		4,404
Thereafter		232,286			4,382			(62,455	)		174,213	(1)
Total undiscounted minimum lease payments	$	275,437		$	5,045		$	(83,036	)	$	197,446
Less: interest		(173,625	)		(3,107	)
Present value of lease liabilities	$	101,812		$	1,938

(1)

Reflects certain ground leases, in which we are the lessee, that have longer initial fixed terms than our existing sublease to our tenants. However, we would expect to either renew the related sublease, enter into a lease with a new tenant, or early terminate the ground lease to reduce or avoid any significant impact from such ground leases.

Summary of Supplemental Balance Sheet Information

Supplemental balance sheet information is as follows (in thousands, except lease terms and discount rate):


	Balance Sheet Classification	December 31, 2023			December 31, 2022
Right of use assets:
Operating leases - real estate	Land	$	63,675		$	63,553
Finance leases - real estate	Land		1,683			1,734
Total real estate right of use assets		$	65,358		$	65,287
Operating leases - corporate	Other assets		24,243			26,225
Total right of use assets		$	89,601		$	91,512

Lease liabilities:
Operating leases	Obligations to tenants and other lease liabilities	$	101,812		$	101,592
Financing leases	Obligations to tenants and other lease liabilities		1,938			1,938
Total lease liabilities		$	103,750		$	103,530

Weighted-average remaining lease term:
Operating leases			32.9			33.2
Finance leases			32.9			33.9
Weighted-average discount rate:
Operating leases			6.2	%		6.1	%
Finance leases			6.6	%		6.6	%

Summary of Supplemental Cash Flow Information

The following is supplemental cash flow information (in thousands):


	For the Years Ended December 31,
	2023		2022		2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows used for operating leases	$	8,210	$	7,169	$	7,330
Operating cash flows used for finance leases		129		128		126
Non-cash activities - Right-of-use assets obtained in exchange for lease obligations:
Operating leases		—		23,066		1,120

Real Estate and Other Activities - Development Activities - Additional Information (Details) $ in Millions	Dec. 31, 2023 USD ($) Projects	Mar. 31, 2023 USD ($)
Massachusetts [Member]
Business Acquisition [Line Items]
Redevelopment of recovery receivables on damage to the original facility		$ 150
Advancement of redevelopment recovery receivables		$ 50
TEXAS And MASSACHUSETTS [Member]
Business Acquisition [Line Items]
Number of other development projects \| Projects	2
Development project amount spent on combined basis	$ 350

Consolidated Statements of Equity / Capital (Parenthetical) - $ / shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Dividends (Distributions) declared per common share / unit	$ 0.88	$ 1.16	$ 1.12
MPT Operating Partnership, L.P. [Member]
Dividends (Distributions) declared per common share / unit	$ 0.88	$ 1.16	$ 1.12

Real Estate and Other Activities - 2022 Activity - Additional Information (Detail) $ in Thousands, € in Millions, £ in Millions												3 Months Ended	12 Months Ended
	Feb. 07, 2023 Facility	Dec. 09, 2022 GBP (£) Facility	Dec. 09, 2022 USD ($) Facility	Jul. 29, 2022 USD ($)	Apr. 29, 2022 EUR (€) Facility	Apr. 25, 2022 USD ($) Facility	Apr. 18, 2022 Facility	Mar. 14, 2022 USD ($) Facility	Mar. 11, 2022 EUR (€) Facility	Mar. 11, 2022 USD ($) Facility	Feb. 16, 2022 GBP (£)	Dec. 31, 2021 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($) Facility	Dec. 31, 2021 USD ($)
Business Acquisition [Line Items]
Gain (loss) on real estate dispositions												$ 40,000		$ 100,000	$ 52,500
Investments in unconsolidated real estate joint ventures													$ 1,474,455	1,497,903
Acquisition loan												$ 5,350,239	235,187	$ 1,332,962	$ 5,350,239
Deferred income tax liabilities and other liabilities, incurred										$ 26,000
Syndicated Term Loan [Member]
Business Acquisition [Line Items]
Purchase price of acquisition \| £											£ 96.5
Acquisition loan \| £											£ 100.0
Loan term											6 years
Corporate Joint Venture [Member]
Business Acquisition [Line Items]
Investments in unconsolidated real estate joint ventures								$ 400,000
United Kingdom [Member] \| Behavioral Health Facilities [Member]
Business Acquisition [Line Items]
Number of facilities acquired \| Facility		6	6
Purchase price of acquisition		£ 233.0	$ 286,000
Real estate financing by third party seller \| £		£ 105.0
Real Estate Partnership [Member]
Business Acquisition [Line Items]
Percentage of equity investment								50.00%
General Acute Care Hospitals [Member]
Business Acquisition [Line Items]
Number of facilities acquired \| Facility	8					2								6
Purchase price of acquisition				$ 26,000		$ 80,000
Lease extension expiration year	2041
General Acute Care Hospitals [Member] \| Finland [Member]
Business Acquisition [Line Items]
Number of facilities acquired \| Facility									4	4
Purchase price of acquisition									€ 178	$ 194,000
General Acute Care Hospitals [Member] \| Arizona [Member]
Business Acquisition [Line Items]
Number of facilities acquired \| Facility							1
General Acute Care Hospitals [Member] \| Spain [Member]
Business Acquisition [Line Items]
Number of facilities acquired \| Facility					3
Purchase price of acquisition \| €					€ 27
Massachusetts-based General Acute Care Hospitals [Member]
Business Acquisition [Line Items]
Number of facilities acquired \| Facility								8
Purchase price of acquisition								$ 1,700,000
Gain (loss) on real estate dispositions								$ 600,000
Nonrecourse secured debt percentage of asset value								55.00%
Proceeds from expected secured debt													$ 1,300,000
Lease extension expiration year								2041
Massachusetts-based General Acute Care Hospitals [Member] \| Macquarie Asset Management [Member]
Business Acquisition [Line Items]
Percentage of equity investment								50.00%

SCHEDULE III - REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION

12 Months Ended

Dec. 31, 2023

SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]

SCHEDULE III - REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION

SCHEDULE III — REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION

December 31, 2023


		Initial Costs				Additions Subsequent to Acquisition				Cost at December 31, 2023(1)						Accumulated						Life on which depreciation in latest income statements is
Location	Type of Property	Land		Buildings		Improve- ments		Carrying Costs		Land		Buildings		Total		Depreciation		Encum- brances		Date of Construction	Date Acquired	computed (Years)
	(Dollar amounts in thousands)
Aberdeen, UK	Acute care general hospital	$	4,252	$	100,721	$	—	$	—	$	4,252	$	100,721	$	104,973	$	10,106	$	—	1985	January 9, 2020		40
Algeciras, Spain	Acute care general hospital		521		8,222		—		—		521		8,222		8,743		377		—	1997	April 29, 2022		40
Altoona, WI	Acute care general hospital		—		29,062		—		—		—		29,062		29,062		6,781		—	2014	August 31, 2014		40
Altrincham, UK	Behavioral health facility		14,644		25,138		—		—		14,644		25,138		39,782		828		—	1890, 2014	December 9, 2022		40
Alvin, TX	Freestanding ER		105		4,087		—		—		105		4,087		4,192		973		—	2014	March 19, 2014		40
Arnold, UK	Behavioral health facility		477		9,916		—		—		477		9,916		10,393		680		—	2008	June 25, 2021		40
Ashtead, UK	Acute care general hospital		37,762		70,798		—		—		37,762		70,798		108,560		8,016		—	1981	August 16, 2019		40
Aurora, CO	Freestanding ER		2,801		4,812		—		—		2,801		4,812		7,613		992		—	2015	September 17, 2015		40
Austin, TX	Freestanding ER		3,610		4,200		—		—		3,610		4,200		7,810		746		—	2017	March 2, 2017		40
Avondale, AZ	Behavioral health facility		5,383		64,650		—		—		5,383		64,650		70,033		3,806		—	2016	October 19, 2021		40
Ayr, UK	Behavioral health facility		16,990		48,655		—		—		16,990		48,655		65,645		3,105		—	2004	June 25, 2021		40
Bad Salzuflen, Germany	Rehabilitation hospital		10,503		26,581		—		—		10,503		26,581		37,084		4,409		—	1974, 2016	November 30, 2017		40
Bad Salzuflen, Germany	Rehabilitation hospital		7,138		23,376		—		—		7,138		23,376		30,514		3,693		—	1989, 2016	November 30, 2017		40
Bad Oeynhausen, Germany	Rehabilitation hospital		1,126		2,752		—		—		1,126		2,752		3,878		468		—	1973, 2010	November 30, 2017		40
Bakersfield, CA	Rehabilitation hospital		2,178		45,253		—		—		2,178		45,253		47,431		2,074		—	2022	May 15, 2020		40
Barby, Germany	Rehabilitation hospital		1,819		20,290		—		—		1,819		20,290		22,109		397		—	1995	April 19, 2023		40
Basingstoke, UK	Acute care general hospital		12,922		50,190		—		—		12,922		50,190		63,112		5,070		—	1984	January 9, 2020		40
Bassenheim, Germany	Rehabilitation hospital		1,122		5,289		—		—		1,122		5,289		6,411		721		—	1887, 1983	February 9, 2019		39
Bath, UK	Acute care general hospital		1,509		31,277		—		—		1,509		31,277		32,786		7,428		—	2008, 2009	July 1, 2014		40
Bath, UK	Acute care general hospital		7,193		13,053		—		—		7,193		13,053		20,246		1,356		—	1992	January 9, 2020		40
Beckenham, UK	Acute care general hospital		5,462		20,948		—		—		5,462		20,948		26,410		2,108		—	1981	January 9, 2020		40
Bedford, UK	Acute care general hospital		1,540		7,504		—		—		1,540		7,504		9,044		764		—	1982	January 9, 2020		40
Bellflower, CA	Behavioral health facility		2,563		—		—		—		2,563		—		2,563		—		—	N/A	August 23, 2019		—
Bennettsville, SC	Acute care general hospital		794		13,245		—		—		794		13,245		14,039		12,308		—	1984	April 1, 2008		42
Big Spring, TX	Acute care general hospital		1,655		21,254		815		—		1,655		22,069		23,724		2,922		—	1973	April 12, 2019		41
Birmingham, UK	Behavioral health facility		927		10,159		—		—		927		10,159		11,086		196		—	1864, 2009	April 14, 2023		40
Birmingham, UK	Acute care general hospital		8,192		42,216		—		—		8,192		42,216		50,408		3,694		—	2017	April 3, 2017		40
Birmingham, UK	Acute care general hospital		9,862		93,867		—		—		9,862		93,867		103,729		9,484		—	1982	January 9, 2020		40
Birmingham, UK	Rehabilitation hospital		—		17,361		—		—		—		17,361		17,361		1,519		—	2018	June 29, 2020		40
Birmingham, UK	Behavioral health facility		412		19,164		—		—		412		19,164		19,576		1,284		—	1900, 1984, 2016	June 25, 2021		40
Blackburn, UK	Acute care general hospital		2,661		51,001		—		—		2,661		51,001		53,662		5,131		—	1957	January 9, 2020		40
Blackburn, UK	Behavioral health facility		20,030		54,338		—		—		20,030		54,338		74,368		3,723		—	1930	June 25, 2021		40
Blue Springs, MO	Acute care general hospital		4,347		23,494		—		—		4,347		23,494		27,841		5,503		—	1980	February 13, 2015		40
Boardman, OH	Long term acute care hospital		79		275		—		—		79		275		354		34		—	2008	August 30, 2019		40
Boise, ID	Long term acute care hospital		1,558		11,027		—		—		1,558		11,027		12,585		1,325		—	2008	February 29, 2012		50
Bolton, UK	Acute care general hospital		1,585		44,534		—		—		1,585		44,534		46,119		4,469		—	1989	January 9, 2020		40
Boonton Township, NJ	Behavioral health facility		6,712		17,031		—		—		6,712		17,031		23,743		1,510		—	1952, 1971-1978	September 30, 2015		40


		Initial Costs				Additions Subsequent to Acquisition				Cost at December 31, 2023(1)						Accumulated						Life on which depreciation in latest income statements is
Location	Type of Property	Land		Buildings		Improve- ments		Carrying Costs		Land		Buildings		Total		Depreciation		Encum- brances		Date of Construction	Date Acquired	computed (Years)
	(Dollar amounts in thousands)
Bossier City, LA	Long term acute care hospital		900		17,818		944		—		900		18,762		19,662		7,170		—	1982	April 1, 2008		40
Bowling Green, KY	Rehabilitation hospital		3,486		56,296		3,550		—		3,486		59,846		63,332		6,920		—	1992	August 30, 2019		40
Brandis, Germany	Rehabilitation hospital		2,214		24,340		—		—		2,214		24,340		26,554		485		—	1995	April 19, 2023		40
Braunfels, Germany	Acute care general hospital		2,175		13,548		—		—		2,175		13,548		15,723		2,910		—	1977	June 30, 2015		40
Bristol, UK	Behavioral health facility		4,705		37,356		—		—		4,705		37,356		42,061		1,085		—	1790, 2014	December 9, 2022		40
Bromley, UK	Behavioral health facility		7,224		15,521		—		—		7,224		15,521		22,745		1,077		—	1714, 1830, 2021	June 25, 2021		40
Broomfield, CO	Freestanding ER		825		3,895		—		—		825		3,895		4,720		925		—	2014	July 3, 2014		40
Bury, UK	Behavioral health facility		8,510		19,391		—		—		8,510		19,391		27,901		1,398		—	2003	June 25, 2021		40
Bussage, UK	Behavioral health facility		8,490		3,753		—		—		8,490		3,753		12,243		262		—	1970	June 25, 2021		40
Cadiz, Spain	Acute care general hospital		299		6,799		—		—		299		6,799		7,098		304		—	2000	April 29, 2022		40
Canterbury, UK	Acute care general hospital		9,185		27,589		—		—		9,185		27,589		36,774		2,781		—	1982	January 9, 2020		40
Carmarthen, UK	Acute care general hospital		910		25,576		—		—		910		25,576		26,486		2,583		—	1990	January 9, 2020		40
Carrollton, TX	Behavioral health facility		4,941		52,227		—		—		4,941		52,227		57,168		3,089		—	2012	October 19, 2021		40
Casper, WY	Rehabilitation hospital		1,683		—		—		—		1,683		—		1,683		—		—	2012	February 29, 2012		—
Caterham, UK	Acute care general hospital		10,552		20,846		—		—		10,552		20,846		31,398		2,394		—	1982	August 16, 2019		40
Cayce, SC	Rehabilitation hospital		1,022		21,159		—		—		1,022		21,159		22,181		255		—	2023	October 21, 2022		40
Chandler, AZ	Freestanding ER		3,517		4,783		—		—		3,517		4,783		8,300		1,036		—	2015	April 24, 2015		40
Chandler, AZ	Freestanding ER		750		3,853		—		—		750		3,853		4,603		795		—	2015	October 7, 2015		40
Cheadle, UK	Acute care general hospital		30,936		162,963		—		—		30,936		162,963		193,899		16,398		—	1981	January 9, 2020		40
Cheadle, UK	Behavioral health facility		29,815		94,808		—		—		29,815		94,808		124,623		6,413		—	1994	July 8, 2020		40
Cheraw, SC	Acute care general hospital		657		18,534		—		—		657		18,534		19,191		15,276		—	1982	April 1, 2008		42
Clarksville, TX	Rehabilitation hospital		2,460		25,540		—		—		2,460		25,540		28,000		2,130		—	2019	December 17, 2020		39
Cologne, Germany	Acute care general hospital		4,426		14,965		—		—		4,426		14,965		19,391		2,475		—	2001	August 7, 2020		40
Colorado Springs, CO	Freestanding ER		600		4,231		—		—		600		4,231		4,831		1,014		—	2014	June 5, 2014		40
Columbus, OH	Behavioral health facility		2,101		44,218		—		—		2,101		44,218		46,319		2,640		—	2017	October 19, 2021		40
Commerce City, TX	Freestanding ER		707		4,248		—		—		707		4,248		4,955		964		—	2014	December 11, 2014		40
Conroe, TX	Behavioral health facility		3,855		38,892		—		—		3,855		38,892		42,747		2,373		—	2018	October 19, 2021		40
Converse, TX	Freestanding ER		750		4,423		—		—		750		4,423		5,173		968		—	2015	April 10, 2015		40
Coral Gables, FL	Acute care general hospital		26,215		84,584		—		—		26,215		84,584		110,799		5,295		—	1959	August 1, 2021		40
Crown Point, IN	Long term acute care hospital		302		528		—		—		302		528		830		73		—	2008	August 30, 2019		40
Croydon, UK	Acute care general hospital		9,943		41,706		—		—		9,943		41,706		51,649		4,225		—	1981	January 9, 2020		40
Dahlen, Germany	Rehabilitation hospital		1,342		11,339		—		—		1,342		11,339		12,681		1,065		—	1993, 2006	August 28, 2018		40
Dallas, TX	Long term acute care hospital		1,421		13,536		—		—		1,421		13,536		14,957		5,865		—	2006	September 5, 2006		40
Darlington, UK	Acute care general hospital		2,088		35,818		—		—		2,088		35,818		37,906		3,138		—	2001	August 7, 2020		40
Darlington, UK	Behavioral health facility		21,246		48,262		—		—		21,246		48,262		69,508		3,533		—	1935, 2018, 2020	June 25, 2021		40
Darlington, UK	Behavioral health facility		5,228		26,348		—		—		5,228		26,348		31,576		1,735		—	1960, 1990	June 25, 2021		40
Denver, CO	Freestanding ER		1,239		4,276		—		—		1,239		4,276		5,515		918		—	2015	June 8, 2015		40
Denville, NJ	Acute care general hospital		15,709		55,772		—		—		15,709		55,772		71,481		4,835		—	1953, 1969-2008	September 30, 2015		40
Detroit, MI	Long term acute care hospital		1,220		8,323		—		—		1,220		8,323		9,543		3,305		—	1956	May 22, 2008		40
Dewsbury, UK	Behavioral health facility		1,120		10,199		—		—		1,120		10,199		11,319		206		—	2012	April 14, 2023		40
Diss, UK	Behavioral health facility		2,910		10,377		—		—		2,910		10,377		13,287		796		—	1840 (2)	June 25, 2021		40
Dorchester, UK	Acute care general hospital		539		31,341		—		—		539		31,341		31,880		3,149		—	1981	January 9, 2020		40
Dormagen, Germany	Rehabilitation hospital		1,909		5,648		—		—		1,909		5,648		7,557		801		—	1993, 2006	August 28, 2018		40
Dover, NJ	Acute care general hospital		3,865		8,693		—		—		3,865		8,693		12,558		802		—	1925, 1927-2008	September 30, 2015		40


		Initial Costs				Additions Subsequent to Acquisition				Cost at December 31, 2023(1)						Accumulated						Life on which depreciation in latest income statements is
Location	Type of Property	Land		Buildings		Improve- ments		Carrying Costs		Land		Buildings		Total		Depreciation		Encum- brances		Date of Construction	Date Acquired	computed (Years)
	(Dollar amounts in thousands)
Droitwich, UK	Acute care general hospital		76		15,298		—		—		76		15,298		15,374		1,550		—	1984	January 9, 2020		40
Dublin, OH	Behavioral health facility		5,118		69,346		—		—		5,118		69,346		74,464		4,058		—	2012	October 19, 2021		40
El Paso, TX	Rehabilitation hospital		4,268		21,345		—		—		4,268		21,345		25,613		1,859		—	2018	December 17, 2020		38
Englewood, CO	Behavioral health facility		3,369		65,480		—		—		3,369		65,480		68,849		3,865		—	2017	October 19, 2021		40
Essex, UK	Behavioral health facility		4,642		43,193		—		—		4,642		43,193		47,835		1,251		—	1790, 1992, 2014	December 9, 2022		40
Euxton, UK	Acute care general hospital		4,617		35,560		—		—		4,617		35,560		40,177		4,145		—	1981	August 16, 2019		40
Firestone, TX	Freestanding ER		495		3,963		—		—		495		3,963		4,458		949		—	2014	June 6, 2014		40
Flagstaff, AZ	Rehabilitation hospital		3,049		22,464		—		—		3,049		22,464		25,513		3,276		—	2016	August 23, 2016		40
Florence, AZ	Acute care general hospital		900		28,462		105		—		900		28,567		29,467		8,388		—	2012	February 7, 2012		40
Floridablanca, Colombia	Acute care general hospital		815		25,478		—		—		815		25,478		26,293		912		—	1997	July 29, 2022		40
Folsom, CA	Long term acute care hospital		3,291		21,293		—		—		3,291		21,293		24,584		2,738		—	2009	August 30, 2019		40
Fort Worth, TX	Behavioral health facility		3,406		34,627		—		—		3,406		34,627		38,033		2,100		—	2014	October 19, 2021		40
Fountain, CO	Freestanding ER		1,508		4,131		—		—		1,508		4,131		5,639		973		—	2014	July 31, 2014		40
Fresno, CA	Rehabilitation hospital		5,507		70,473		—		—		5,507		70,473		75,980		8,228		—	1991	August 30, 2019		40
Frome, UK	Behavioral health facility		2,896		17,545		—		—		2,896		17,545		20,441		1,237		—	1980	June 25, 2021		40
Frome, UK	Behavioral health facility		10,895		10,711		—		—		10,895		10,711		21,606		995		—	1700, 2015, 2017	June 25, 2021		40
Gainesborough, UK	Behavioral health facility		1,528		10,007		—		—		1,528		10,007		11,535		253		—	2008	April 14, 2023		40
Gardena, CA	Acute care general hospital		14,010		65,282		—		—		14,010		65,282		79,292		4,410		—	1966	July 6, 2021		40
Georgetown, TX	Behavioral health facility		4,569		22,858		7,669		—		4,569		30,527		35,096		1,375		—	2014	October 19, 2021		40
Gilbert, AZ	Freestanding ER		1,517		4,661		—		—		1,517		4,661		6,178		981		—	2015	July 22, 2015		40
Gilbert, AZ	Behavioral health facility		4,790		45,076		—		—		4,790		45,076		49,866		2,614		—	2020	October 19, 2021		40
Glasgow, UK	Acute care general hospital		6,442		131,570		—		—		6,442		131,570		138,012		13,194		—	1983	January 9, 2020		40
Glasgow, UK	Behavioral health facility		1,429		15,619		—		—		1,429		15,619		17,048		1,058		—	1900, 1980	June 25, 2021		40
Glendale, AZ	Freestanding ER		1,144		6,087		—		—		1,144		6,087		7,231		1,091		—	2016	October 21, 2016		40
Glendale, AZ	Freestanding ER		1,176		4,046		—		—		1,176		4,046		5,222		868		—	2015	June 5, 2015		40
Gloucester, UK	Acute care general hospital		5,580		61,373		—		—		5,580		61,373		66,953		7,042		—	1990	August 16, 2019		40
Godalming, UK	Behavioral health facility		9,356		18,980		—		—		9,356		18,980		28,336		1,376		—	1796, 2007	June 25, 2021		40
Goodyear, AZ	Freestanding ER		1,800		4,713		—		—		1,800		4,713		6,513		913		—	2016	April 4, 2016		40
Great Missenden, UK	Acute care general hospital		11,770		105,167		—		—		11,770		105,167		116,937		10,600		—	1981	January 9, 2020		40
Grefath, Germany	Rehabilitation hospital		1,200		3,028		—		—		1,200		3,028		4,228		439		—	1886, 1983	August 28, 2018		40
Guildford, UK	Acute care general hospital		6,881		36,427		—		—		6,881		36,427		43,308		3,675		—	1989	January 9, 2020		40
Halsall, UK	Acute care general hospital		2,014		31,159		—		—		2,014		31,159		33,173		3,585		—	1986	August 16, 2019		40
Harrow, UK	Acute care general hospital		38,403		40,415		—		—		38,403		40,415		78,818		4,098		—	1980	January 9, 2020		40
Hartsville, SC	Acute care general hospital		2,050		43,970		—		—		2,050		43,970		46,020		10,625		—	1999	August 31, 2015		34
Hassocks, UK	Behavioral health facility		5,484		28,675		—		—		5,484		28,675		34,159		2,203		—	1998	June 25, 2021		40
Hastings, PA	Acute care general hospital		603		8,834		—		—		603		8,834		9,437		1,453		—	1924	December 17, 2019		30
Hausman, TX	Acute care general hospital		1,500		8,957		—		—		1,500		8,957		10,457		2,407		—	2013	March 1, 2013		40
Heidelberg, Germany	Rehabilitation hospital		6,237		35,625		—		—		6,237		35,625		41,862		6,716		—	1885, 1991	June 22, 2016		40
Helotes, TX	Freestanding ER		1,900		5,115		—		—		1,900		5,115		7,015		1,002		—	2016	March 10, 2016		40
Helsinki, Finland	Acute care general hospital		4,085		67,529		—		—		4,085		67,529		71,614		3,137		—	1992, 2013	March 11, 2022		40
Hemel Hempstead, UK	Behavioral health facility		12,490		6,304		—		—		12,490		6,304		18,794		550		—	1901, 1990	June 25, 2021		40
Hialeah, FL	Acute care general hospital		18,802		107,783		—		—		18,802		107,783		126,585		6,896		—	1950	August 1, 2021		40
Hialeah, FL	Acute care general hospital		75,339		222,271		73,911		—		75,339		296,182		371,521		15,345		—	1969	August 1, 2021		40
Highland Hills, OH	Behavioral health facility		3,148		43,891		—		—		3,148		43,891		47,039		2,622		—	2015	October 19, 2021		40


		Initial Costs				Additions Subsequent to Acquisition					Cost at December 31, 2023(1)						Accumulated						Life on which depreciation in latest income statements is
Location	Type of Property	Land		Buildings		Improve- ments			Carrying Costs		Land		Buildings		Total		Depreciation		Encum- brances		Date of Construction	Date Acquired	computed (Years)
	(Dollar amounts in thousands)
Highland Village, TX	Freestanding ER		3,172		1,551		—			—		3,172		1,551		4,723		479		—	2015	September 22, 2015		40
Highlands Ranch, CO	Freestanding ER		4,200		4,779		—			—		4,200		4,779		8,979		886		—	2016	July 25, 2016		40
Hill County, TX	Acute care general hospital		1,120		17,882		845			—		1,120		18,727		19,847		16,139		—	1980	September 17, 2010		15
Hinckley, UK	Behavioral health facility		2,466		16,804		—			—		2,466		16,804		19,270		1,138		—	1892, 2007	June 25, 2021		40
Hook, UK	Behavioral health facility		5,416		10,315		—			—		5,416		10,315		15,731		759		—	1980	June 25, 2021		40
Hoover, AL	Freestanding ER		—		7,581		—			—		—		7,581		7,581		1,918		—	2015	May 1, 2015		34
Hoover, AL	Freestanding ER		—		1,034		296			—		—		1,330		1,330		308		—	2015	May 1, 2015		34
Hope, AR	Acute care general hospital		1,651		3,359		2,733			—		1,651		6,092		7,743		1,395		—	1984-2001	September 29, 2017		41
Hot Springs, AR	Acute care general hospital		5,622		59,432		21,221			—		5,622		80,653		86,275		17,341		—	1985	August 31, 2015		40
Houston, TX	Acute care general hospital		28,687		104,028		90,934			—		28,687		194,962		223,649		16,337		—	1940-1950	September 29, 2017		41
Houston, TX	Freestanding ER		950		3,996		—			—		950		3,996		4,946		724		—	2016	September 26, 2016		40
Houston, TX	Behavioral health facility		6,063		19,881		2,565			—		6,063		22,446		28,509		1,683		—	2020	October 25, 2019		40
Houston, TX	Acute care general hospital		3,274		27,324		32,499			—		3,274		59,823		63,097		21,142		—	1960	August 10, 2007		40
Huntington Park, CA	Acute care general hospital		3,132		5,002		—			—		3,132		5,002		8,134		386		—	1967	July 6, 2021		40
Huntington Park, CA	Acute care general hospital		3,935		6,103		—			—		3,935		6,103		10,038		461		—	1960-1969	July 6, 2021		40
Idaho Falls, ID	Acute care general hospital		1,822		41,316		30,353			—		1,822		71,669		73,491		17,918		—	2002	April 1, 2008		40
Idaho Falls, ID	Acute care general hospital		1,880		107,608		1,064			—		1,880		108,672		110,552		10,525		—	2020	December 19, 2017		40
Johnstown, PA	Acute care general hospital		8,877		247,158		—			—		8,877		247,158		256,035		33,435		—	1924	December 17, 2019		30
Kansas City, KS	Acute care general hospital		2,351		13,665		—			—		2,351		13,665		16,016		1,355		—	2017	June 10, 2019		50
Kansas City, MO	Acute care general hospital		10,497		64,419		—			—		10,497		64,419		74,916		14,637		—	1978	February 13, 2015		40
Katy, TX	Freestanding ER		1,534		4,174		—			—		1,534		4,174		5,708		756		—	2016	October 10, 2016		40
Katy, TX	Freestanding ER		2,116		3,873		—			—		2,116		3,873		5,989		791		—	2015	October 21, 2015		40
Kuhlungsborn, Germany	Rehabilitation hospital		6,700		17,226		—			—		6,700		17,226		23,926		288		—	1998	June 1, 2023		40
Kuopio, Finland	Acute care general hospital		1,301		43,352		—			—		1,301		43,352		44,653		2,085		—	2017	March 11, 2022		29
Lafayette, IN	Rehabilitation hospital		800		14,968		(25	)		—		800		14,943		15,743		4,068		—	2013	February 1, 2013		40
Lafayette, IN	Behavioral health facility		2,829		10,795		—			—		2,829		10,795		13,624		782		—	2012	October 19, 2021		40
Lander, WY	Acute care general hospital		758		42,849		—			—		758		42,849		43,607		4,579		—	1983	December 17, 2019		40
Lauderdale Lakes, FL	Acute care general hospital		10,657		150,313		—			—		10,657		150,313		160,970		10,300		—	1975	August 1, 2021		40
Lawton, OK	Acute care general hospital		3,944		63,031		—			—		3,944		63,031		66,975		6,770		—	1985	December 17, 2019		40
Layton, UT	Acute care general hospital		14,360		370,154		6,530			—		14,360		376,684		391,044		31,857		—	1976-2010	September 29, 2017		40
League City, TX	Freestanding ER		1,278		3,901		—			—		1,278		3,901		5,179		829		—	2015	June 19, 2015		40
Leawood, KS	Acute care general hospital		2,513		13,938		—			—		2,513		13,938		16,451		1,373		—	2017	June 10, 2019		50
Leeds, UK	Behavioral health facility		2,280		9,521		—			—		2,280		9,521		11,801		665		—	1990	June 25, 2021		40
Lehi, UT	Acute care general hospital		13,368		29,950		1,676			—		13,368		31,626		44,994		5,664		—	2015	September 29, 2017		45
Lewiston, ID	Acute care general hospital		5,389		75,435		—			—		5,389		75,435		80,824		17,006		—	1922	May 1, 2017		40
Little Elm, TX	Freestanding ER		1,241		3,491		—			—		1,241		3,491		4,732		877		—	2013	December 1, 2013		40
London, UK	Acute care general hospital		9,243		61,004		—			—		9,243		61,004		70,247		6,121		—	1984	January 9, 2020		40
London, UK	Behavioral health facility		36,266		51,909		—			—		36,266		51,909		88,175		1,512		—	1811, 2014	December 9, 2022		40
London, UK	Acute care general hospital		3,285		4,148		—			—		3,285		4,148		7,433		422		—	1987	January 9, 2020		40
London, UK	Behavioral health facility		28,936		14,973		—			—		28,936		14,973		43,909		497		—	1790, 1992, 2014	December 9, 2022		40
London, UK	Acute care general hospital		12,451		81,267		—			—		12,451		81,267		93,718		8,133		—	1977	January 9, 2020		40
London, UK	Behavioral health facility		6,161		15,655		—			—		6,161		15,655		21,816		1,076		—	1900, 1960	June 25, 2021		40


		Initial Costs				Additions Subsequent to Acquisition				Cost at December 31, 2023(1)						Accumulated						Life on which depreciation in latest income statements is
Location	Type of Property	Land		Buildings		Improve- ments		Carrying Costs		Land		Buildings		Total		Depreciation		Encum- brances		Date of Construction	Date Acquired	computed (Years)
	(Dollar amounts in thousands)
London, UK	Behavioral health facility		13,810		6,810		—		—		13,810		6,810		20,620		487		—	1992	June 25, 2021		40
Longmont, CO	Freestanding ER		1,748		4,181		—		—		1,748		4,181		5,929		827		—	2016	February 10, 2016		40
Los Angeles, CA	Acute care general hospital		12,562		40,164		—		—		12,562		40,164		52,726		2,593		—	1972	July 6, 2021		40
Lubbock, TX	Rehabilitation hospital		1,376		28,292		3,648		—		1,376		31,940		33,316		6,718		—	2008	June 16, 2015		40
Lynwood, CA	Acute care general hospital		30,116		148,527		—		—		30,116		148,527		178,643		12,749		—	1940, 1989-2000	August 13, 2020		40
Malaga, SP	Acute care general hospital		748		11,718		—		—		748		11,718		12,466		498		—	2018	April 29, 2022		40
Mandeville, LA	Freestanding ER		2,800		5,370		—		—		2,800		5,370		8,170		962		—	2016	October 28, 2016		40
Marrero, LA	Freestanding ER		1,561		5,801		—		—		1,561		5,801		7,362		1,088		—	2016	July 15, 2016		40
McKinney, TX	Freestanding ER		2,558		4,060		—		—		2,558		4,060		6,618		1,149		—	2015	July 31, 2015		30
McKinney, TX	Behavioral health facility		2,934		—		—		—		2,934		—		2,934		—		—	N/A	October 19, 2021	-
McMinnville, OR	Acute care general hospital		5,000		97,900		—		—		5,000		97,900		102,900		19,124		—	1996	August 31, 2015		41
Melbourne, FL	Acute care general hospital		5,642		17,087		21,830		—		5,642		38,917		44,559		5,172		—	2002	May 1, 2017		42
Melton Mowbray, UK	Behavioral health facility		5,702		15,982		—		—		5,702		15,982		21,684		1,143		—	1990	June 25, 2021		40
Mesa, AZ	Acute care general hospital		6,498		100,032		4,152		—		6,498		104,184		110,682		27,504		—	2007	September 26, 2013		40
Mesa, AZ	Acute care general hospital		2,604		16,400		—		—		2,604		16,400		19,004		707		—	2019	April 18, 2022		40
Meyersdale, PA	Acute care general hospital		390		4,280		—		—		390		4,280		4,670		731		—	1960	December 17, 2019		30
Miami, FL	Acute care general hospital		44,400		107,203		—		—		44,400		107,203		151,603		8,092		—	1955	August 1, 2021		40
Miami, FL	Acute care general hospital		20,430		30,282		10,935		—		20,430		41,217		61,647		1,483		—	1958, 1962, 1988, 2016	April 25, 2022		40
Milton Keynes, UK	Acute care general hospital		5,245		35,861		—		—		5,245		35,861		41,106		3,610		—	1983	January 9, 2020		40
Monmouth, UK	Behavioral health facility		15,506		11,552		—		—		15,506		11,552		27,058		976		—	2017	June 25, 2021		40
Montclair, NJ	Acute care general hospital		7,900		99,640		577		—		8,477		99,640		108,117		24,858		—	1920-2000	April 1, 2014		40
Mount Pleasant, SC	Long term acute care hospital		597		2,198		—		—		597		2,198		2,795		276		—	2012	August 30, 2019		40
New Braunfels, TX	Rehabilitation hospital		1,853		10,622		—		—		1,853		10,622		12,475		850		—	2011	February 29, 2012		40
New Orleans, LA	Freestanding ER		2,850		6,125		—		—		2,850		6,125		8,975		1,110		—	2016	September 23, 2016		40
Newark, NJ	Acute care general hospital		32,957		24,553		—		—		32,957		24,553		57,510		2,019		—	1919, 1920-2003	May 2, 2016		40
Newburgh, IN	Behavioral health facility		1,215		7,212		—		—		1,215		7,212		8,427		472		—	2010	October 19, 2021		40
Northland, MO	Long term acute care hospital		834		17,182		—		—		834		17,182		18,016		5,549		—	2007	February 14, 2011		40
Norwalk, CA	Acute care general hospital		2,811		5,940		—		—		2,811		5,940		8,751		464		—	1959, 1995	July 6, 2021		40
Norwalk, CA	Acute care general hospital		7,946		31,574		5,995		—		7,946		37,569		45,515		2,178		—	1958-1978	July 6, 2021		40
Norwood, MA	Acute care general hospital		6,373		—		—		—		6,373		—		6,373		—		—	N/A	June 27, 2018		46
Nottingham, UK	Acute care general hospital		4,952		45,951		—		—		4,952		45,951		50,903		4,660		—	1983	January 9, 2020		40
Nottingham, UK	Behavioral health facility		10,011		8,960		—		—		10,011		8,960		18,971		735		—	2000	June 25, 2021		40
Nottingham, UK	Behavioral health facility		10,160		3,246		—		—		10,160		3,246		13,406		227		—	1980	June 25, 2021		40
Odessa, TX	Acute care general hospital		6,217		123,518		16,600		—		6,217		140,118		146,335		20,542		—	1973-2004	September 29, 2017		41
Ogden, UT	Rehabilitation hospital		1,759		16,414		—		—		1,759		16,414		18,173		4,025		—	2014	March 1, 2014		40
Oklahoma City, OK	Behavioral health facility		3,641		3,047		—		—		3,641		3,047		6,688		337		—	2017	October 19, 2021		40
Olathe, KS	Behavioral health facility		6,882		55,745		2,052		—		6,882		57,797		64,679		3,376		—	2015	October 19, 2021		40
Olathe, KS	Acute care general hospital		3,485		14,484		—		—		3,485		14,484		17,969		1,442		—	2018	June 10, 2019		50
Orpington, UK	Acute care general hospital		10,338		42,714		—		—		10,338		42,714		53,052		4,312		—	1987	January 9, 2020		40
Ottumwa, IA	Acute care general hospital		2,377		48,697		—		—		2,377		48,697		51,074		7,246		—	1950	December 17, 2019		30
Oulu, Finland	Acute care general hospital		3,173		44,912		—		—		3,173		44,912		48,085		2,187		—	2017	March 11, 2022		40
Overland Park, KS	Acute care general hospital		2,974		14,405		—		—		2,974		14,405		17,379		1,441		—	2017	June 10, 2019		50
Overland Park, KS	Acute care general hospital		3,191		14,263		—		—		3,191		14,263		17,454		1,498		—	2019	June 10, 2019		50
Overlook, TX	Acute care general hospital		2,452		9,666		7		—		2,452		9,673		12,125		2,626		—	2012	February 1, 2013		40
Palestine, TX	Acute care general hospital		1,848		95,257		—		—		1,848		95,257		97,105		9,986		—	1988	December 17, 2019		40
Parker, CO	Freestanding ER		1,300		4,448		—		—		1,300		4,448		5,748		908		—	2015	November 6, 2015		40


		Initial Costs				Additions Subsequent to Acquisition				Cost at December 31, 2023(1)						Accumulated						Life on which depreciation in latest income statements is
Location	Type of Property	Land		Buildings		Improve- ments		Carrying Costs		Land		Buildings		Total		Depreciation		Encum- brances		Date of Construction	Date Acquired	computed (Years)
	(Dollar amounts in thousands)
Pasco, WA	Acute care general hospital		2,594		13,195		—		—		2,594		13,195		15,789		2,404		—	1920	August 31, 2018		30
Pearland, TX	Freestanding ER		1,075		3,577		—		—		1,075		3,577		4,652		835		—	2014	September 8, 2014		40
Petersburg, VA	Rehabilitation hospital		1,302		9,121		—		—		1,302		9,121		10,423		3,534		—	2006	July 1, 2008		40
Phoenix, AZ	Behavioral health facility		2,396		12,643		2,985		—		2,396		15,628		18,024		4,763		—	1979	September 29, 2017		42
Phoenix, AZ	Acute care general hospital		12,695		73,773		4,499		—		12,695		78,272		90,967		13,041		—	1968-1976	September 29, 2017		43
Phoenix, AZ	Acute care general hospital		5,576		45,782		—		—		5,576		45,782		51,358		7,916		—	2017	February 10, 2017		40
Phoenix, AZ	Freestanding ER		1,132		5,052		—		—		1,132		5,052		6,184		853		—	2017	April 13, 2017		40
Plano, TX	Freestanding ER		4,138		1,416		—		—		4,138		1,416		5,554		553		—	2016	September 30, 2016		40
Poole, UK	Acute care general hospital		2,325		38,382		—		—		2,325		38,382		40,707		4,722		—	1996	April 3, 2019		40
Poplar Bluff, MO	Acute care general hospital		2,659		38,694		—		—		2,659		38,694		41,353		15,186		—	1980	April 22, 2008		40
Port Arthur, TX	Acute care general hospital		11,432		76,746		6,877		—		11,432		83,623		95,055		20,870		—	2005	September 26, 2013		40
Port Huron, MI	Acute care general hospital		2,531		14,252		—		—		2,531		14,252		16,783		3,895		—	1953, 1973-1983	December 31, 2015		30
Post Falls, ID	Rehabilitation hospital		417		12,175		1,905		—		767		13,730		14,497		3,442		—	2013	December 31, 2013		40
Preston, UK	Behavioral health facility		8,740		26,001		—		—		8,740		26,001		34,741		1,741		—	1850, 2018, 2021	June 25, 2021		40
Princes Risborough, UK	Acute care general hospital		4,662		—		—		—		4,662		—		4,662		—		—	N/A	January 9, 2020		40
Raleigh, NC	Behavioral health facility		3,469		27,514		—		—		3,469		27,514		30,983		1,769		—	2018	October 19, 2021		40
Reading, UK	Acute care general hospital		34,795		46,173		—		—		34,795		46,173		80,968		5,227		—	1990	August 16, 2019		40
Reading, UK	Acute care general hospital		25,995		83,297		—		—		25,995		83,297		109,292		6,367		—	2012	December 18, 2020		40
Remscheid, Germany	Rehabilitation hospital		1,048		2,528		—		—		1,048		2,528		3,576		357		—	1951, 1983	August 28, 2018		40
Richmond, TX	Behavioral health facility		5,380		6,155		6,017		—		5,380		12,172		17,552		472		—	2014	October 19, 2021		40
Richmond, VA	Long term acute care hospital		1,296		10,071		—		—		1,296		10,071		11,367		1,413		—	1989	August 30, 2019		40
Riverton, WY	Acute care general hospital		1,163		29,647		—		—		1,163		29,647		30,810		3,675		—	1983	December 17, 2019		36
Roaring Springs, PA	Acute care general hospital		1,446		9,549		—		—		1,446		9,549		10,995		1,621		—	1924	December 17, 2019		30
Rochdale, MA	Long term acute care hospital		654		3,368		—		—		654		3,368		4,022		428		—	1989	August 30, 2019		40
Rochdale, MA	Acute care general hospital		67		344		—		—		67		344		411		44		—	1989	August 30, 2019		40
Rochdale, UK	Acute care general hospital		3,577		40,753		—		—		3,577		40,753		44,330		4,113		—	1965	January 9, 2020		40
Rockledge, FL	Acute care general hospital		13,919		23,282		8,428		—		13,919		31,710		45,629		6,584		—	1950, 1970	May 1, 2017		42
Roeland Park, KS	Acute care general hospital		1,569		15,103		—		—		1,569		15,103		16,672		1,473		—	2018	June 10, 2019		50
Romford, UK	Behavioral health facility		5,354		8,766		—		—		5,354		8,766		14,120		692		—	1980	June 25, 2021		40
Rosenberg, TX	Freestanding ER		1,251		4,505		—		—		1,251		4,505		5,756		901		—	2016	January 15, 2016		40
Rowley, UK	Acute care general hospital		2,908		18,302		—		—		2,908		18,302		21,210		2,171		—	1986	August 16, 2019		40
Royston, UK	Behavioral health facility		6,734		20,048		—		—		6,734		20,048		26,782		1,578		—	1906, 1970	June 25, 2021		40
Salt Lake City, UT	Acute care general hospital		13,590		101,915		15,268		—		13,590		117,183		130,773		17,550		—	1906-1987	September 29, 2017		41
San Antonio, TX	Acute care general hospital		8,053		10,851		7,982		—		8,053		18,833		26,886		5,731		—	1978-2002	September 29, 2017		41
San Antonio, TX	Freestanding ER		3,075		4,801		—		—		3,075		4,801		7,876		850		—	2016	December 9, 2016		40
San Antonio, TX	Freestanding ER		351		3,952		—		—		351		3,952		4,303		962		—	2014	January 1, 2014		40
San Antonio, TX	Acute care general hospital		2,248		5,880		—		—		2,248		5,880		8,128		1,641		—	2012	October 2, 2012		40
San Antonio, TX	Freestanding ER		2,377		4,253		—		—		2,377		4,253		6,630		762		—	2016	October 27, 2016		40
San Bernardino, CA	Acute care general hospital		2,209		37,498		—		—		2,209		37,498		39,707		4,439		—	1993	August 30, 2019		40
					—


		Initial Costs				Additions Subsequent to Acquisition				Cost at December 31, 2023(1)						Accumulated						Life on which depreciation in latest income statements is
Location	Type of Property	Land		Buildings		Improve- ments		Carrying Costs		Land		Buildings		Total		Depreciation		Encum- brances		Date of Construction	Date Acquired	computed (Years)
	(Dollar amounts in thousands)

Santa Maria de Feira, PT	Acute care general hospital		1,860		17,839		—		—		1,860		17,839		19,699		1,018		—	2015	October 21, 2021		40
Sebastian, FL	Acute care general hospital		5,733		49,136		58,739		—		5,733		107,875		113,608		14,058		—	1974	May 1, 2017		41
Sharon, PA	Acute care general hospital		6,179		9,066		8,513		—		6,179		17,579		23,758		3,537		—	1950-1980	May 1, 2017		41
Shawnee, KS	Acute care general hospital		3,076		14,945		—		—		3,076		14,945		18,021		1,699		—	2018	June 10, 2019		50
Sheffield, UK	Acute care general hospital		6,614		44,615		—		—		6,614		44,615		51,229		4,528		—	2008	January 9, 2020		40
Sherman, TX	Acute care general hospital		3,363		10,931		—		—		3,363		10,931		14,294		4,326		—	1913, 1960-2010	October 31, 2014		40
Southampton, UK	Behavioral health facility		6,445		18,924		—		—		6,445		18,924		25,369		1,466		—	1820, 1985	June 25, 2021		40
Spartanburg, SC	Rehabilitation hospital		1,135		15,717		—		—		1,135		15,717		16,852		4,079		—	2013	August 1, 2013		40
Stirling, UK	Acute care general hospital		1,054		19,511		—		—		1,054		19,511		20,565		1,274		—	1992	July 6, 2021		40
Stockton, CA	Rehabilitation hospital		2,798		50,610		—		—		2,798		50,610		53,408		835		—	2021	November 23, 2020		40
Surrey, UK	Behavioral health facility		15,047		9,130		—		—		15,047		9,130		24,177		334		—	1950, 2014	December 9, 2022		40
Sussex, NJ	Acute care general hospital		477		2,097		—		—		477		2,097		2,574		191		—	1920	September 30, 2015		40
Swindon, UK	Acute care general hospital		5,328		59,772		—		—		5,328		59,772		65,100		6,013		—	1984	January 9, 2020		40
Tadley, UK	Behavioral health facility		20,918		19,061		—		—		20,918		19,061		39,979		1,565		—	2020	June 25, 2021		40
Tempe, AZ	Acute care general hospital		6,050		10,986		5,239		—		6,050		16,225		22,275		2,856		—	1940	September 29, 2017		41
Texarkana, TX	Acute care general hospital		14,562		—		—		—		14,562		—		14,562		—		—	N/A	September 29, 2017	-
The Woodlands, TX	Freestanding ER		1,976		4,524		—		—		1,976		4,524		6,500		877		—	2016	March 28, 2016		40
Thornton, CO	Freestanding ER		1,350		4,259		—		—		1,350		4,259		5,609		994		—	2014	August 29, 2014		40
Toledo, OH	Rehabilitation hospital		1,134		17,740		—		—		1,134		17,740		18,874		3,437		—	2016	April 1, 2016		40
Tomball, TX	Long term acute care hospital		1,299		20,545		—		—		1,299		20,545		21,844		7,794		—	2005	December 21, 2010		40
Torquay, UK	Acute care general hospital		2,981		35,743		—		—		2,981		35,743		38,724		3,993		—	1981	August 16, 2019		40
Turku, Finland	Acute care general hospital		1,207		58,193		—		—		1,207		58,193		59,400		2,731		—	2018	March 11, 2022		40
Usk, UK	Behavioral health facility		1,730		22,202		—		—		1,730		22,202		23,932		1,472		—	1770, 1850, 1980	June 25, 2021		40
Valencia, SP	Acute care general hospital		11,128		69,552		—		—		11,128		69,552		80,680		4,176		—	2017	December 2, 2021		40
Vancouver, WA	Behavioral health facility		9,313		12,505		—		—		9,313		12,505		21,818		384		—	2018	October 19, 2021		40
Viseu, Portugal	Acute care general hospital		2,535		28,884		—		—		2,535		28,884		31,419		3,307		—	2016	November 28, 2019		37
Warren, OH	Acute care general hospital		5,385		47,588		10,492		—		5,385		58,080		63,465		11,225		—	1982	May 1, 2017		41
Warren, OH	Rehabilitation hospital		2,417		15,857		1,737		—		2,417		17,594		20,011		3,598		—	1922-2000	May 1, 2017		46
Watsonville, CA	Acute care general hospital		16,488		17,800		—		—		16,488		17,800		34,288		2,780		—	1983	September 30, 2019		39
Webster, TX	Long term acute care hospital		663		33,751		—		—		663		33,751		34,414		10,969		—	2004	December 21, 2010		40
West Chester, OH	Behavioral health facility		3,670		61,338		—		—		3,670		61,338		65,008		3,670		—	2013	October 19, 2021		40
West Jordan, UT	Acute care general hospital		16,897		233,256		6,293		—		16,897		239,549		256,446		22,616		—	1983	September 29, 2017		40
West Midlands, UK	Behavioral health facility		1,922		7,162		—		—		1,922		7,162		9,084		149		—	2013	April 14, 2023		40
West Monroe, LA	Acute care general hospital		11,702		69,433		19,116		—		12,254		87,997		100,251		20,928		—	1962	September 26, 2013		40
West Valley City, UT	Acute care general hospital		5,260		58,314		6,644		—		5,260		64,958		70,218		24,100		—	1980	April 22, 2008		40
Wichita, KS	Rehabilitation hospital		1,019		18,374		—		—		1,019		18,374		19,393		7,234		—	1992	April 4, 2008		40
Willenhall, UK	Behavioral health facility		7,289		16,262		—		—		7,289		16,262		23,551		1,100		—	2000	June 25, 2021		40
Winchester, UK	Acute care general hospital		6,487		10,277		—		—		6,487		10,277		16,764		1,060		—	1911	January 9, 2020		40
Windsor, UK	Acute care general hospital		12,184		104,726		—		—		12,184		104,726		116,910		10,500		—	1955	January 9, 2020		40
Woking, UK	Behavioral health facility		7,240		4,680		—		—		7,240		4,680		11,920		358		—	1800, 2020	June 25, 2021		40
Worthing, UK	Acute care general hospital		6,716		30,146		—		—		6,716		30,146		36,862		3,040		—	1994	January 9, 2020		40
York, UK	Behavioral health facility		3,708		6,743		—		—		3,708		6,743		10,451		141		—	2008	April 14, 2023		40
York, UK	Behavioral health facility		21,635		71,771		—		—		21,635		71,771		93,406		4,739		—	1900, 1980	June 25, 2021		40
Youngstown, OH	Acute care general hospital		4,335		3,565		488		—		4,335		4,053		8,388		2,626		—	1929-2003	May 1, 2017		41
		$	1,805,286	$	9,493,186	$	514,703	$	—	$	1,806,765	$	10,006,410	$	11,813,175	$	1,227,619

(1)

The aggregate cost for federal income tax purposes is $11.9 billion.

(2)

Date of construction is based off of best available information, but note that this facility has had multiple updates since initial construction.

The changes in total real estate assets (excluding construction in progress, intangible lease assets, investment in financing leases, and mortgage loans) are as follows for the years ended (in thousands):


	December 31, 2023				December 31, 2022				December 31, 2021
COST
Balance at beginning of period	$	12,300,524			$	13,628,749			$	10,749,707
Acquisitions		143,882				622,999				3,023,966
Transfers from construction in progress		72,791				47,431				—
Additions		87,873				150,290				167,164
Dispositions		(874,519	)			(1,471,529	)			(229,584	)
Other		82,624		(3)		(677,416	)	(3)		(82,504	)	(3)
Balance at end of period	$	11,813,175		(4)	$	12,300,524			$	13,628,749

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


	December 31, 2023			December 31, 2022			December 31, 2021
ACCUMULATED DEPRECIATION
Balance at beginning of period	$	1,008,340		$	950,369		$	728,176
Depreciation		270,816			277,032			262,063
Depreciation on disposed property		(73,765	)		(185,519	)		(35,551	)
Other		22,228			(33,542	)		(4,319	)
Balance at end of period	$	1,227,619		$	1,008,340		$	950,369

(3)

Includes foreign currency fluctuations for all years.

(4)

Excludes approximately $400 million and $170 million of construction and building improvements in progress reflected in buildings and improvements at December 31, 2023 and 2022, respectively.

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Operating activities
Net (loss) income	$ (556,092)	$ 903,819	$ 656,940
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Depreciation and amortization	616,127	345,577	333,781
Amortization of deferred financing costs and debt discount	15,775	17,045	16,856
Straight-line rent revenue and other	(233,703)	(282,504)	(288,717)
Stock / (Unit)-based compensation expense	33,250	49,421	52,110
(Loss) gain on sale of real estate	1,815	(536,755)	(52,471)
Real estate and other impairment charges, net	376,907	268,375	39,411
Straight-line rent and other write-off	649,911	34,605	7,213
Debt refinancing and unutilized financing (benefit) costs	(285)	9,452	27,650
Gain on sale of equity investments			(40,945)
Tax rate changes and other	(167,332)	10,697	34,796
Non-cash revenue from debt and equity securities received	(81,706)
Other adjustments	(23,870)	6,108	11,913
Changes in:
Interest and rent receivables	(141,729)	(116,420)	(23,867)
Other assets	13,750	(4,029)	(4,375)
Accounts payable and accrued expenses	(4,599)	33,576	54,058
Deferred revenue	7,567	43	(12,697)
Net cash provided by operating activities	505,786	739,010	811,656
Investing activities
Cash paid for acquisitions and other related investments	(235,187)	(1,332,962)	(5,350,239)
Net proceeds from sale of real estate	897,500	2,185,574	246,468
Principal received on loans receivable	501,630	53,322	1,595,708
Investment in loans receivable	(250,223)	(207,542)	(58,932)
Construction in progress and other	(114,425)	(109,237)	(67,725)
Proceeds from sale and return of equity investment	12,430	14,295	65,546
Capital additions and other investments, net	(294,167)	(207,394)	(289,239)
Net cash provided by (used for) investing activities	517,558	396,056	(3,858,413)
Financing activities
Proceeds from term debt, net of discount		128,536	3,407,535
Payments of term debt	(988,162)	(869,606)	(1,390,994)
Revolving credit facilities, net	567,910	203,576	559,985
Dividends / Distribution paid	(615,390)	(698,535)	(643,473)
Lease deposits and other obligations to tenants	10,139	(5,020)	17,815
Proceeds from sale of common shares, net of offering costs			1,051,229
Repurchase of common stock / unit		(17,940)
Stock / Unit vesting - satisfaction of tax withholdings	(8,079)	(29,922)
Other financing activities, Payment of debt refinancing and deferred financing costs	13,255	(53,612)	(54,489)
Net cash (used for) provided by financing activities	(1,020,327)	(1,342,523)	2,947,608
Increase (decrease) in cash, cash equivalents, and restricted cash for the year	3,017	(207,457)	(99,149)
Effect of exchange rate changes	11,397	(12,887)	4,662
Cash, cash equivalents, and restricted cash at beginning of year	241,538	461,882	556,369
Cash, cash equivalents, and restricted cash at end of year	255,952	241,538	461,882
Interest paid, including capitalized interest of $14,178 in 2023, $6,454 in 2022,and $3,289 in 2021	406,141	353,838	326,406
Supplemental schedule of non-cash investing activities:
Debt and equity securities received for certain obligations, real estate, and revenue	804,520
Certain obligations and receivable satisfied and real estate sold	722,814
Supplemental schedule of non-cash financing activities:
Dividends declared, unpaid	92,808	176,580	176,494
Cash, cash equivalents, and restricted cash are comprised of the following:
Cash and cash equivalents at beginning of period	235,668	459,227	549,884
Restricted cash, included in Other assets at beginning of period	$ 5,870	$ 2,655	6,485
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	Other Assets	Other Assets
Cash, cash equivalents, and restricted cash at beginning of year	$ 255,952	$ 241,538	461,882
Cash and cash equivalents at end of period	250,016	235,668	459,227
Restricted cash, included in Other assets at end of period	$ 5,936	$ 5,870	$ 2,655
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	Other Assets	Other Assets	Other Assets
Cash, cash equivalents, and restricted cash at end of year	$ 255,952	$ 241,538	$ 461,882
MPT Operating Partnership, L.P. [Member]
Operating activities
Net (loss) income	(556,092)	903,819	656,940
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Depreciation and amortization	616,127	345,577	333,781
Amortization of deferred financing costs and debt discount	15,775	17,045	16,856
Straight-line rent revenue and other	(233,703)	(282,504)	(288,717)
Stock / (Unit)-based compensation expense	33,250	49,421	52,110
(Loss) gain on sale of real estate	1,815	(536,755)	(52,471)
Real estate and other impairment charges, net	376,907	268,375	39,411
Straight-line rent and other write-off	649,911	34,605	7,213
Debt refinancing and unutilized financing (benefit) costs	(285)	9,452	27,650
Gain on sale of equity investments			(40,945)
Tax rate changes and other	(167,332)	10,697	34,796
Non-cash revenue from debt and equity securities received	(81,706)
Other adjustments	(23,870)	6,108	11,913
Changes in:
Interest and rent receivables	(141,729)	(116,420)	(23,867)
Other assets	13,750	(4,029)	(4,375)
Accounts payable and accrued expenses	(4,599)	33,576	54,058
Deferred revenue	7,567	43	(12,697)
Net cash provided by operating activities	505,786	739,010	811,656
Investing activities
Cash paid for acquisitions and other related investments	(235,187)	(1,332,962)	(5,350,239)
Net proceeds from sale of real estate	897,500	2,185,574	246,468
Principal received on loans receivable	501,630	53,322	1,595,708
Investment in loans receivable	(250,223)	(207,542)	(58,932)
Construction in progress and other	(114,425)	(109,237)	(67,725)
Proceeds from sale and return of equity investment	12,430	14,295	65,546
Capital additions and other investments, net	(294,167)	(207,394)	(289,239)
Net cash provided by (used for) investing activities	517,558	396,056	(3,858,413)
Financing activities
Proceeds from term debt, net of discount		128,536	3,407,535
Payments of term debt	(988,162)	(869,606)	(1,390,994)
Revolving credit facilities, net	567,910	203,576	559,985
Dividends / Distribution paid	(615,390)	(698,535)	(643,473)
Lease deposits and other obligations to tenants	10,139	(5,020)	17,815
Proceeds from sale of units, net of offering costs			1,051,229
Repurchase of common stock / unit		(17,940)
Stock / Unit vesting - satisfaction of tax withholdings	(8,079)	(29,922)
Other financing activities, Payment of debt refinancing and deferred financing costs	13,255	(53,612)	(54,489)
Net cash (used for) provided by financing activities	(1,020,327)	(1,342,523)	2,947,608
Increase (decrease) in cash, cash equivalents, and restricted cash for the year	3,017	(207,457)	(99,149)
Effect of exchange rate changes	11,397	(12,887)	4,662
Cash, cash equivalents, and restricted cash at beginning of year	241,538	461,882	556,369
Cash, cash equivalents, and restricted cash at end of year	255,952	241,538	461,882
Interest paid, including capitalized interest of $14,178 in 2023, $6,454 in 2022,and $3,289 in 2021	406,141	353,838	326,406
Supplemental schedule of non-cash investing activities:
Debt and equity securities received for certain obligations, real estate, and revenue	804,520
Certain obligations and receivable satisfied and real estate sold	722,814
Supplemental schedule of non-cash financing activities:
Dividends declared, unpaid	92,808	176,580	176,494
Cash, cash equivalents, and restricted cash are comprised of the following:
Cash and cash equivalents at beginning of period	235,668	459,227	549,884
Restricted cash, included in Other assets at beginning of period	$ 5,870	$ 2,655	$ 6,485
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	Other Assets	Other Assets	Other Assets
Cash, cash equivalents, and restricted cash at beginning of year	$ 255,952	$ 241,538	$ 461,882
Cash and cash equivalents at end of period	250,016	235,668	459,227
Restricted cash, included in Other assets at end of period	$ 5,936	$ 5,870	$ 2,655
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	Other Assets	Other Assets	Other Assets
Cash, cash equivalents, and restricted cash at end of year	$ 255,952	$ 241,538	$ 461,882

Consolidated Statements of Net Income - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Revenues
Rent billed	$ 803,375	$ 968,874	$ 931,942
Straight-line rent	(127,894)	204,159	241,433
Income from financing leases	127,141	203,580	202,599
Interest and other income	69,177	166,238	168,695
Total revenues	871,799	1,542,851	1,544,669
Expenses
Interest	411,171	359,036	367,393
Real estate depreciation and amortization	603,360	332,977	321,249
Property-related	41,567	45,697	39,098
General and administrative	145,588	160,494	145,638
Total expenses	1,201,686	898,204	873,378
Other (expense) income
(loss) gain on sale of real estate	(1,815)	536,755	52,471
Real estate and other impairment charges, net	(376,907)	(268,375)	(39,411)
Earnings from equity interests	13,967	40,800	28,488
Debt refinancing and unutilized financing benefit (costs)	285	(9,452)	(27,650)
Other (including fair value adjustments on securities)	7,586	15,344	45,699
Total other (expense) income	(356,884)	315,072	59,597
(Loss) income before income tax	(686,771)	959,719	730,888
Income tax benefit (expense)	130,679	(55,900)	(73,948)
Net (loss) income	(556,092)	903,819	656,940
Net income attributable to non-controlling interests	(384)	(1,222)	(919)
Net (loss) income attributable to MPT common stockholders (Operating Partnership partners)	$ (556,476)	$ 902,597	$ 656,021
Earnings per common share (units) basic
Net (loss) income attributable to MPT common stockholders (Operating Partnership partners), basic	$ (0.93)	$ 1.5	$ 1.11
Earnings per common share (units) diluted
Net (loss) income attributable to MPT common stockholders (Operating Partnership partners), diluted	$ (0.93)	$ 1.5	$ 1.11
Weighted average shares (units) outstanding basic	598,518	598,634	588,817
Weighted average shares (units) outstanding diluted	598,518	598,837	590,139
MPT Operating Partnership, L.P. [Member]
Revenues
Rent billed	$ 803,375	$ 968,874	$ 931,942
Straight-line rent	(127,894)	204,159	241,433
Income from financing leases	127,141	203,580	202,599
Interest and other income	69,177	166,238	168,695
Total revenues	871,799	1,542,851	1,544,669
Expenses
Interest	411,171	359,036	367,393
Real estate depreciation and amortization	603,360	332,977	321,249
Property-related	41,567	45,697	39,098
General and administrative	145,588	160,494	145,638
Total expenses	1,201,686	898,204	873,378
Other (expense) income
(loss) gain on sale of real estate	(1,815)	536,755	52,471
Real estate and other impairment charges, net	(376,907)	(268,375)	(39,411)
Earnings from equity interests	13,967	40,800	28,488
Debt refinancing and unutilized financing benefit (costs)	285	(9,452)	(27,650)
Other (including fair value adjustments on securities)	7,586	15,344	45,699
Total other (expense) income	(356,884)	315,072	59,597
(Loss) income before income tax	(686,771)	959,719	730,888
Income tax benefit (expense)	130,679	(55,900)	(73,948)
Net (loss) income	(556,092)	903,819	656,940
Net income attributable to non-controlling interests	(384)	(1,222)	(919)
Net (loss) income attributable to MPT common stockholders (Operating Partnership partners)	$ (556,476)	$ 902,597	$ 656,021
Earnings per common share (units) basic
Net (loss) income attributable to MPT common stockholders (Operating Partnership partners), basic	$ (0.93)	$ 1.5	$ 1.11
Earnings per common share (units) diluted
Net (loss) income attributable to MPT common stockholders (Operating Partnership partners), diluted	$ (0.93)	$ 1.5	$ 1.11
Weighted average shares (units) outstanding basic	598,518	598,634	588,817
Weighted average shares (units) outstanding diluted	598,518	598,837	590,139

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

Dec. 31, 2023

GBP (£)

Dec. 31, 2023

USD ($)

Dec. 31, 2022

USD ($)

Debt Instrument [Line Items]

Debt

$ 10,109,133

$ 10,325,499

Debt issue costs and discount, net

(44,897)

(57,087)

Debt, net

10,064,236

10,268,412

Revolving Credit Facility [Member]

Debt Instrument [Line Items]

Debt

^[1]

1,514,420

929,584

Term Loan [Member]

Debt Instrument [Line Items]

Debt

200,000

Term Loan [Member] | Australia [Member]

Debt Instrument [Line Items]

Debt

^[2]

320,164

817,560

Secured term loan due 2024 | British Pound Sterling [Member]

Debt Instrument [Line Items]

Debt

^[2]

133,484

126,690

Term loan due 2025 | British Pound Sterling [Member]

Debt Instrument [Line Items]

Debt

^[2]

891,170

845,810

2.550% Senior Unsecured Notes due 2023 [Member]

Debt Instrument [Line Items]

Debt

£ 50

483,320

^[2]

3.325% Senior Unsecured Notes due 2025 [Member]

Debt Instrument [Line Items]

Debt

^[2]

551,950

535,250

0.993% Senior Unsecured Notes due 2026 [Member]

Debt Instrument [Line Items]

Debt

^[2]

551,950

535,250

2.500% Senior Unsecured Notes due 2026 [Member]

Debt Instrument [Line Items]

Debt

^[2]

636,550

604,150

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

3.692% Senior Unsecured Notes due 2028 [Member]

Debt Instrument [Line Items]

Debt

^[2]

763,860

724,980

4.625% Senior Unsecured Notes due 2029 [Member]

Debt Instrument [Line Items]

Debt

900,000

3.375% Senior Unsecured Notes due 2030 [Member]

Debt Instrument [Line Items]

Debt

^[2]

445,585

422,905

3.500% Senior Unsecured Notes due 2031 [Member]

Debt Instrument [Line Items]

Debt

$ 1,300,000

[1]	Includes £322 million of GBP-denominated borrowings and €303 million of Euro-denominated borrowings that reflect the applicable exchange rates at December 31, 2023.
[2]	Non-U.S. dollar denominated debt that reflects the exchange rates at period-end.

Fair Value of Financial Instruments - Additional Information (Detail) SFr in Millions, $ in Millions	12 Months Ended
	Dec. 31, 2023 CHF (SFr)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Impairment of assets		$ (170.0)	$ (2.9)	$ (22.4)
Maximum [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Market capitalization percentage			9.00%
Minimum [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Market capitalization percentage			7.50%
Steward's Equity [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Equity impairment charges		$ 90.0
Equity investments percentage	9.90%	9.90%
Working capital loans		$ 212.0
Proceeds from Loans		$ 362.0
Steward's Equity [Member] \| Equity Securities [Member] \| International Joint Venture [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Remaining equity investment percentage	90.10%	90.10%
Steward and International Joint Venture [Member] \| Equity Securities [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Addition loan collateralized by equity		$ 219.0
Springstone Inc. and International Joint Venture [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Equity investments unrealized gain/loss			$ 7.0
Favorable fair market value adjustment on investment		$ 34.0
PHP Holdings [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Discount rate on investment	11.00%	11.00%
Discount for lack of marketability percentage on Springstone equity investment	8.00%	8.00%
Swiss Medical Network [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Favorable fair market value adjustment on investment \| SFr	SFr 20
Pennsylvania [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Impairment of assets			$ 170.0

Summary of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2023

Accounting Policies [Abstract]

Use of Estimates

Use of Estimates: The preparation of our consolidated financial statements in conformity with accounting principles generally accepted in the U.S. requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. We believe the estimates and assumptions underlying our consolidated financial statements at December 31, 2023 are reasonable and supportable based on the information available (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). Actual results could differ from those estimates.

Principles of Consolidation

Principles of Consolidation: Property holding entities and other subsidiaries of which we own 100% of the equity or have a controlling financial interest evidenced by ownership of a majority voting interest are consolidated. All inter-company balances and transactions are eliminated. For entities in which we own less than 100% of the equity interest, we consolidate the property if we have the direct or indirect ability to control the entities’ activities based upon the terms of the respective entities’ ownership agreements. For these entities, we record a non-controlling interest representing equity held by non-controlling interests.

We continually evaluate all of our transactions and investments to determine if they represent variable interests in a variable interest entity ("VIE"). If we determine that we have a variable interest in a VIE, we then evaluate if we are the primary beneficiary of the VIE. The evaluation is a qualitative assessment as to whether we have the ability to direct the activities of a VIE that most significantly impact the entity’s economic performance. We consolidate each VIE in which we, by virtue of or transactions with our investments in the entity, are considered to be the primary beneficiary.

At December 31, 2023, we had loans and/or equity investments in certain VIEs, which are also tenants of our facilities. We have determined that we were 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 at December 31, 2023 are presented below (in thousands):


VIE Type	Carrying Amount(1)		Asset Type Classification	Maximum Loss Exposure(2)
Loans, net	$	850,655	Investments in Unconsolidated Operating Entities	$	850,655
Loans, net		149,872	Mortgage and other loans		151,190
Equity investments		74,840	Investments in Unconsolidated Operating Entities		74,840

(1)

Carrying amount only reflects the net book value of our loan or equity investment in the VIE.

(2)

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 investments in VIEs represents the current carrying values of such investments plus any other related assets (such as rent receivables), less any liabilities.

For the VIE types above, we do not consolidate the VIE because we do not have the ability to control the activities (such as the day-to-day healthcare operations of our borrowers or investees) that most significantly impact the VIE's economic performance. As of December 31, 2023, 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).

Investments in Unconsolidated Entities

Investments in Unconsolidated Entities: Investments in entities in which we have the ability to significantly influence (but not control) are accounted for by the equity method. This includes the five investments in unconsolidated real estate joint ventures at December 31, 2023. Under the equity method of accounting, our share of the investee’s earnings or losses are included in the “Earnings from equity interests” line of our consolidated statements of net income. Except for our joint ventures with Primotop Holdings S.à.r.l. ("Primotop") and Macquarie Asset Management ("MAM") (for which we handle the accounting of), we have elected to record our share of such investee’s earnings or losses on a lag basis (not to exceed three months). The initial carrying value of investments in unconsolidated entities is based on the amount paid to purchase the interest in the investee entity. Subsequently, our investments are increased/decreased by our share in the investees’ earnings/losses and decreased by cash distributions from our investees. To the extent that our cost basis is different from the basis reflected at the investee entity level, the basis difference is generally amortized over the lives of the related assets and liabilities, and such amortization is included in our share of equity in earnings of the investee.

We evaluate our equity method investments for impairment based upon a comparison of the fair value of the equity method investment to its carrying value, when impairment indicators exist. If we determine a decline in the fair value of an investment in an unconsolidated investee entity below its carrying value is other-than-temporary, an impairment is recorded.

Investments in entities in which we do not control nor do we have the ability to significantly influence and for which there is no readily determinable fair value (such as our investment in affiliates of Steward Health Care System LLC (“Steward”)) are accounted for at cost, less any impairment, plus or minus changes resulting from observable price changes in orderly transactions involving the investee. Cash distributions on these types of investments are recorded to either income upon receipt (if a return on investment) or as a reduction of our investment (if the distributions received are in excess of our share of the investee’s earnings). For similar investments but for which there are readily determinable fair values, such investments are measured at fair value, with unrealized gains and losses recorded in income.

Cash and Cash Equivalents

Cash and Cash Equivalents: Certificates of deposit, short-term investments with original maturities of three months or less, and money-market mutual funds are considered cash equivalents. The majority of our cash and cash equivalents are held at major commercial banks, which at times may exceed the Federal Deposit Insurance Corporation limit. We have not experienced any losses to-date on our invested cash. Cash and cash equivalents which have been restricted as to its use are recorded in other assets.

Revenue Recognition

Revenue Recognition: Our revenues are primarily from leases and loans. For leases, we follow Accounting Standards Codification (“ASC”) 842, “Leases”, (“ASC 842”). ASC 842 sets out the principles for the recognition, measurement, presentation, and disclosure of leases for both parties to a contract (i.e. lessees and lessors). For lessors, we apply this standard as follows:

Operating Lease Revenue

We receive income from operating leases based on the fixed required rents (base rents) per the lease agreements. Rent revenue from base rents is recorded on the cash basis method, when collectability of the lease payments is not deemed probable. Rent revenue from base rents is recorded on the straight-line method, when collectability of the lease payments is deemed probable, over the terms of the related lease agreements for new leases and the remaining terms of existing leases for those acquired as part of a property acquisition. The straight-line method records the periodic average amount of base rents earned over the term of a lease, taking into account contractual rent increases over the lease term. The straight-line method typically has the effect of recording more rent revenue from a lease than a tenant is required to pay early in the term of the lease. During the later parts of a lease term, this effect reverses with less rent revenue recorded than a tenant is required to pay. Rent revenue, as recorded on the straight-line method, in our consolidated statements of net income is presented as two amounts: rent billed and straight-line rent. Rent billed revenue is the amount of base rent actually billed to our tenants each period as required by the lease. Straight-line rent revenue is the difference between rent revenue earned based on the straight-line method and the amount recorded as rent billed revenue. We record the difference between rent revenues earned and amounts due per the respective lease agreements, as applicable, as an increase or decrease to straight-line rent receivables.

Rental payments received prior to their recognition as income are classified as deferred revenue.

Financing Lease Revenue

Under ASC 842, if an acquisition and subsequent lease of a property back to the seller does not meet the definition of a sale, we must account for the transaction as a financing lease with income recognized using the imputed interest method.

Another type of financing lease is a direct financing lease (“DFL”). For leases accounted for as DFLs, the future minimum lease payments are recorded as a receivable at lease inception, while, the difference between the future minimum lease payments and the estimated residual values less the cost of the properties is recorded as unearned income. Unearned income is deferred and amortized to income over the lease term to provide a constant yield when collectability of the lease payments is reasonably assured. Investments in DFLs are presented net of unearned income.

Other Leasing Revenue

We begin recording base rent income from our development projects when the lessee takes physical possession of the facility, which may be different from the stated start date of the lease. Also, during construction of our development projects, we may be entitled to accrue rent based on the cost paid during the construction period (construction period rent). We accrue construction period rent as a receivable with a corresponding offset to deferred revenue during the construction period. When the lessee takes physical possession of the facility, we begin recognizing the deferred construction period revenue on the straight-line method over the term of the lease.

We also receive additional rent (contingent rent) under some leases based on increases in the consumer price index (“CPI”) (or similar index outside the U.S.) or when CPI exceeds the annual minimum percentage increase as stipulated in the lease. Contingent rents are recorded as rent billed revenue in the period earned.

Tenant payments for ground leases along with other operating expenses, such as property taxes and insurance, that are paid directly by us and reimbursed by our tenants are presented on a gross basis with the related revenues recorded in “Interest and other income” and the related expenses in “Property-related” in our consolidated statements of net income. All payments of other operating expenses made directly by the tenant to the applicable government or appropriate third-party vendor are recorded on a net basis.

Interest Revenue

We receive interest income from our tenants/borrowers on mortgage loans, working capital loans, and other long-term loans. Interest income from these loans is recognized as earned based upon the principal outstanding and terms of the loans.

Other Revenue

Commitment fees received from lessees for development and leasing services are initially recorded as deferred revenue and recognized as income over the initial term of a lease to produce a constant effective yield on the lease (interest method). Commitment and origination fees from lending services are also recorded as deferred revenue initially and recognized as income over the life of the loan using the interest method.

Acquired Real Estate Purchase Price Allocation

Acquired Real Estate Purchase Price Allocation: We account for acquisitions of real estate under asset acquisition accounting rules. Under this accounting standard, we allocate the purchase price (including any third-party transaction costs directly related to the acquisition) of acquired properties to tangible and identified intangible assets acquired and liabilities assumed (if any) based on their relative fair values. In making estimates of fair values for purposes of allocating purchase prices of acquired real estate, we may utilize a number of sources, from time-to-time, including available real estate broker data, independent appraisals that may be obtained in connection with the acquisition, internal data from previous acquisitions or developments, and other market data, including market comparables for significant assumptions such as market rental, capitalization, and discount rates. We also consider information obtained about each property as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the tangible and intangible assets acquired.

We measure the aggregate value of lease intangible assets acquired based on the difference between (i) the property valued with new or in-place leases adjusted to market rental rates and (ii) the property valued as if vacant. Management’s estimates of value are made using methods similar to those used by independent appraisers (e.g., discounted cash flow analysis). Factors considered by management in our analysis include an estimate of carrying costs during hypothetical expected lease-up periods, considering current market conditions, and costs to execute similar leases. We also consider information obtained about each targeted facility as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the intangible assets acquired. In estimating carrying costs, management includes real estate taxes, insurance, and other operating expenses and estimates of lost rentals at market rates during the expected lease-up periods, which we expect to be about six months, but can be longer depending on specific local market conditions. Management also estimates costs to execute similar leases including leasing commissions, legal costs, and other related expenses to the extent that such costs are not already incurred in connection with a new lease origination as part of the transaction.

Other intangible assets acquired may include customer relationship intangible values which are based on management’s evaluation of the specific characteristics of each prospective tenant’s lease and our overall relationship with that tenant. Characteristics to be considered by management in allocating these values include the nature and extent of our existing business relationships with the tenant, growth prospects for developing new business with the tenant, the tenant’s credit quality, and expectations of lease renewals, including those existing under the terms of the lease agreement, among other factors.

We amortize the value of our lease intangible assets to expense over the term of the respective leases. If a lease is terminated early, the unamortized portion of the lease intangibles are charged to expense.

We record above-market and below-market in-place lease values, if any, for our facilities, which are based on the present value of the difference between (i) the contractual amounts to be paid pursuant to the in-place leases and (ii) management’s estimate of fair market lease rates for the corresponding in-place leases, measured over a period equal to the remaining non-cancelable term of the lease. We amortize any resulting capitalized above-market lease values as a reduction of rental income over the lease term. We amortize any resulting capitalized below-market lease values as an increase to rental income over the lease term. If a lease is terminated early, the unamortized portion of the capitalized above/below market lease value is recognized in rental income at that time.

Real Estate and Depreciation

Real Estate and Depreciation: Real estate, consisting of land, buildings and improvements, is maintained at cost. Although typically paid by our tenants, any expenditure for ordinary maintenance and repairs that we pay are expensed to operations as incurred. Significant renovations and improvements, which improve and/or extend the useful life of the asset, are capitalized and depreciated over their estimated useful lives. We record impairment losses on long-lived assets used in operations when events and circumstances indicate that the assets might be impaired and the undiscounted cash flows estimated to be generated by those assets, including an estimated liquidation amount, during the expected holding periods are less than the carrying amounts of those assets. Impairment losses are measured as the difference between carrying value and fair value of the assets. For assets held for sale, we cease recording depreciation expense and adjust the assets’ value to the lower of its carrying value or fair value, less cost of disposal. Fair value is typically based on estimated cash flows discounted at a risk-adjusted rate of interest. We classify real estate assets as held for sale when we have commenced an active program to sell the assets, and in the opinion of management, it is probable the asset will be sold within the next 12 months.

Construction in progress includes the cost of land, the cost of construction of buildings, improvements, and fixed equipment, and costs for design and engineering. Other costs, such as interest, legal, property taxes, and corporate project supervision, which can be directly associated with the project during construction, are also included in construction in progress. We commence capitalization of costs associated with a development project when the development of the future asset is probable and activities necessary to get the underlying property ready for its intended use have been initiated. We stop the capitalization of costs when the property is substantially complete and ready for its intended use.

Depreciation is calculated on the straight-line method over the estimated useful lives of the related real estate and other assets. Our weighted-average useful lives at December 31, 2023 are as follows:


Buildings and improvements		39.1 years
Lease intangibles		28.0 years
Leasehold improvements		13.9 years
Furniture, equipment, and other		5.3 years

Losses from Rent Receivables

Credit Losses:

Losses from Rent Receivables: For our leases, we review tenant provided financial data and monitor the performance of our tenants in areas generally consisting of: admission levels and surgery/procedure volumes by type; current operating margins; ratio of our tenant's operating margins both to facility rent and to facility rent plus other fixed costs; trends in revenue, cash collections, patient mix; and the effect of evolving healthcare regulations, adverse economic and political conditions, such as rising inflation and interest rates, and other events ongoing on a tenant's profitability and liquidity.

Losses from Operating Lease Receivables: We utilize the information above along with the tenant’s payment and default history in evaluating (on a property-by-property basis) whether or not a provision for losses on outstanding billed rent and/or straight-line rent receivables is needed. A provision for losses on rent receivables (including straight-line rent receivables) is ultimately recorded when it becomes probable that the receivable will not be collected in full. The provision is an amount which reduces lease income to the lesser of a) lease payments that have been collected (cash basis) or b) income under the straight-line method.

Losses on Financing Lease Receivables: We apply a forward-looking “expected credit loss” model to all of our financing receivables, including financing leases and loans. To do this, we have grouped our financial instruments into two primary pools of similar credit risk: secured and unsecured. The secured instruments include our investments in financing receivables as all are secured by the underlying real estate, among other collateral. Within the two primary pools, we further grouped our instruments into sub-pools based on several tenant/borrower characteristics, including years of experience in the healthcare industry and in a particular market or region and overall capitalization. We then determined a credit loss percentage per pool based on our history over a period of time that closely matches the remaining terms of the financial instruments being analyzed and adjusted as needed for current trends or unusual circumstances. We have applied these credit loss percentages to the book value of the related instruments to establish a credit loss reserve on our financing lease receivables and such credit loss reserve (including the underlying assumptions) is reviewed and adjusted quarterly. If a financing receivable is under performing and is deemed uncollectible based on the lessee’s overall financial condition, we will adjust the credit loss reserve based on the fair value of the underlying collateral.

We made the accounting policy election to exclude interest receivables from the credit loss reserve model. Instead, such receivables are impaired and an allowance recorded when it is deemed probable that we will be unable to collect all amounts due. Like operating lease receivables, the need for an allowance is based upon our assessment of the lessee’s overall financial condition, economic resources and payment record, the prospects for support from any financially responsible guarantors, and, if appropriate, the realizable value of any collateral. Financing leases are placed on non-accrual status when we determine that the collectability of contractual amounts is not reasonably assured. If on non-accrual status, we generally account for the financing lease on a cash basis, in which income is recognized only upon receipt of cash.

Loans

Loans: Loans consist of mortgage loans, working capital loans, and other loans. Mortgage loans are collateralized by interests in real property. Working capital and other loans are typically collateralized by interests in receivables and corporate and individual guarantees. We record loans at cost. Like our financing lease receivables, we establish credit loss reserves on all outstanding loans based on historical credit losses of similar instruments. Such credit loss reserves, including the underlying assumptions, are reviewed and adjusted quarterly. If a loan’s performance worsens and foreclosure is deemed probable for our collateral-based loans (after considering the borrower’s overall financial condition as described above for leases), we will adjust the allowance for expected credit losses based on the current fair value of such collateral at the time the loan is deemed uncollectible. If the loan is not collateralized, the loan will be reserved for/written-off once it is determined that such loan is no longer collectible. Interest receivables on loans are excluded from the forward looking credit loss reserve model; however, we assess their collectability similar to how we assess collectability for interest receivables on financing leases described above.

The following table summarizes our credit loss reserves (in thousands):


	December 31, 2023			December 31, 2022
Balance at beginning of the year	$	121,146		$	48,527
Provision for credit loss, net		10,194			99,009
Expected credit loss reserve related to financial instruments sold, repaid, or satisfied		(35,339	)		(26,390	)
Balance at end of year	$	96,001		$	121,146

Earnings Per Share/Units

Earnings Per Share/Units: Basic earnings per common share/unit is computed by dividing net income by the weighted-average number of shares/units outstanding during the period. Diluted earnings per common share/unit is calculated by including the effect of dilutive securities.

Our unvested restricted stock awards contain non-forfeitable rights to dividends, and accordingly, these awards are deemed to be participating securities. These participating securities are included in the earnings allocation in computing both basic and diluted earnings per common share/unit.

Income Taxes

Income Taxes: We conduct our business as a REIT under Sections 856 through 860 of the Internal Revenue Code of 1986, as amended (“the Code”). To qualify as a REIT, we must meet certain organizational and operational requirements, including a requirement to distribute to stockholders at least 90% of our REIT’s ordinary taxable income. As a REIT, we generally pay little U.S. federal and state income tax because of the dividends paid deduction that we are allowed to take. If we fail to qualify as a REIT in any taxable year, we will then be subject to U.S. federal income taxes on our taxable income at regular corporate rates and will not be permitted to qualify for treatment as a REIT for U.S. federal income tax purposes for four years following the year during which qualification is lost, unless the Internal Revenue Service grants us relief under certain statutory provisions. Such an event could materially adversely affect our net income and net cash available for distribution to stockholders. However, we intend to operate in such a manner so that we will remain qualified as a REIT for U.S. federal income tax purposes.

Our financial statements include the operations of TRS entities. None of our TRS entities are entitled to a dividends paid deduction and are subject to U.S. federal, state, and local income taxes. Our TRS entities are authorized to provide property development, leasing, and management services for third-party owned properties, and we will make non-mortgage loans to and/or investments in our lessees through these entities.

With the property acquisitions and investments in Europe and South America, we are subject to income taxes internationally. However, we do not expect to incur any additional income taxes, of a significant nature, in the U.S. as the majority such income from our international properties flows through our REIT income tax returns. For our TRS entities and international subsidiaries, we determine deferred tax assets and liabilities based on the differences between the financial reporting and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Any increase or decrease in our deferred tax assets/liabilities that results from a change in circumstances and that causes us to change our judgment about expected future tax consequences of events, is reflected in our tax provision when such changes occur. Deferred income taxes also reflect the impact of operating loss carryforwards. A valuation allowance is provided if we believe it is more likely than not that all or some portion of our deferred tax assets will not be realized. Any increase or decrease in the valuation allowance that results from a change in circumstances, and that causes us to change our judgment about our ability to realize the related deferred tax asset, is reflected in our tax provision when such changes occur.

The calculation of our income taxes involves dealing with uncertainties in the application of complex tax laws and regulations in a multitude of jurisdictions across our global operations. An income tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, on the basis of technical merits. However, if a more likely than not position cannot be reached, we record a liability as an offset to the tax benefit and adjust the liabilities when our judgment changes as a result of the evaluation of new information not previously available. Because of the complexity of some of these uncertainties, the ultimate resolution may result in a payment that is materially different from our current estimate of the uncertain tax position liabilities. These differences will be reflected as increases or decreases to income tax expense in the period in which new information is available.

Stock-Based Compensation

Stock-Based Compensation: We adopted the 2019 Equity Incentive Plan (the “Equity Incentive Plan”) during the second quarter of 2019, which was amended during the second quarter of 2022. Awards of restricted stock and other equity-based awards with service conditions are valued at the average stock price per share on the date of grant and are amortized to compensation expense over the service periods (typically three years), using the straight-line method. Awards that contain market conditions are valued on the grant date using a Monte Carlo valuation model and are amortized to compensation expense over the derived service periods, which correspond to the periods over which we estimate the awards will be earned, which generally range from three to five years, using the straight-line method. Awards with performance conditions are valued at the average stock price per share on the date of grant and are amortized using the straight-line method over the service period, adjusted for the probability of achieving the performance conditions. Forfeitures of stock-based awards are recognized as they occur.

Deferred Costs

Deferred Costs: Costs incurred that directly relate to the offerings of stock are deferred and netted against proceeds received from the offering. Leasing commissions and other third-party leasing costs that would not have been incurred if the lease was not obtained are capitalized as deferred leasing costs and amortized on the straight-line method over the terms of the related lease agreements. Costs identifiable with loans made to borrowers are capitalized and recognized as a reduction in interest income over the life of the loan.

Deferred Financing Costs

Deferred Financing Costs: We generally capitalize financing costs incurred in connection with new financings and refinancings of debt. These costs are amortized over the lives of the related debt as an addition to interest expense. For debt with defined principal re-payment terms, the deferred costs are amortized to produce a constant effective yield on the debt (interest method) and are included within “Debt, net” on our consolidated balance sheets. For debt without defined principal repayment terms, such as our revolving credit facility, the deferred costs are amortized on the straight-line method over the term of the debt and are included as a component of “Other assets” on our consolidated balance sheets.

Foreign Currency Translation and Transactions

Foreign Currency Translation and Transactions: Certain of our international subsidiaries’ functional currencies are the local currencies of their respective countries. We translate the results of operations of our foreign subsidiaries into U.S. dollars using average rates of exchange in effect during the period, and we translate balance sheet accounts using exchange rates in effect at the end of the period. We record resulting currency translation adjustments in accumulated other comprehensive income (loss), a component of stockholders’ equity/partnership capital on our consolidated balance sheets.

Certain of our U.S. subsidiaries will enter into short-term and long-term transactions denominated in a foreign currency from time-to-time. Gains or losses resulting from these foreign currency transactions are revalued into U.S. dollars at the rates of exchange prevailing at the dates of the transactions. The effects of revaluation gains or losses on our short-term transactions are included in other income (expense) in the consolidated statements of income, while the revaluation effects on our long-term investments are recorded in accumulated other comprehensive income (loss) on our consolidated balance sheets.

Derivative Financial Investments and Hedging Activities

Derivative Financial Investments and Hedging Activities: During our normal course of business, we may use certain types of derivative instruments for the purpose of managing interest rate and/or foreign currency risk. We record our derivative and hedging instruments at fair value on the balance sheet. Changes in the estimated fair value of derivative instruments that are not designated as hedges or that do not meet the criteria for hedge accounting are recognized in earnings. For derivatives designated as cash flow hedges, the change in the estimated fair value of the effective portion of the derivative is recognized in accumulated other comprehensive income (loss) on our consolidated balance sheets, whereas the change in the estimated fair value of the ineffective portion is recognized in earnings. For derivatives designated as fair value hedges, the change in the estimated fair value of the effective portion of the derivatives offsets the change in the estimated fair value of the hedged item, whereas the change in the estimated fair value of the ineffective portion is recognized in earnings.

To qualify for hedge accounting, we formally document all relationships between hedging instruments and hedged items, as well as our risk management objective and strategy for undertaking the hedge prior to entering into a derivative transaction. This process includes specific identification of the hedging instrument and the hedge transaction, the nature of the risk being hedged and how the hedging instrument’s effectiveness in hedging the exposure to the hedged transaction’s variability in cash flows attributable to the hedged risk will be assessed. Both at the inception of the hedge and on an ongoing basis, we assess whether the derivatives that are used in hedging transactions are highly effective in offsetting changes in cash flows or fair values of hedged items. In addition, for cash flow hedges, we assess whether the underlying forecasted transaction will occur. We discontinue hedge accounting if a derivative is not determined to be highly effective as a hedge or that it is probable that the underlying forecasted transaction will not occur.

Fair Value Measurement

Fair Value Measurement: We measure and disclose the estimated fair value of financial assets and liabilities utilizing a hierarchy of valuation techniques based on whether the inputs to a fair value measurement are considered to be observable or unobservable in a marketplace. Observable inputs reflect market data obtained from independent sources, while unobservable inputs

reflect our market assumptions. This hierarchy requires the use of observable market data when available. These inputs have created the following fair value hierarchy:

•

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

•

Level 2 — quoted prices for similar instruments in active markets; quoted prices for identical or similar instruments in markets that are not active; and model-derived valuations in which significant inputs and significant value drivers are observable in active markets; and

•

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

We measure fair value using a set of standardized procedures that are outlined herein for all assets and liabilities which are required to be measured at their estimated fair value on either a recurring or non-recurring basis. When available, we utilize quoted market prices from an independent third party source to determine fair value and classify such items in Level 1. In some instances where a market price is available, but the instrument is in an inactive or over-the-counter market, we apply the dealer (market maker) pricing estimate and classify the asset or liability in Level 2.

If quoted market prices or inputs are not available, fair value measurements are based upon valuation models that utilize current market or independently sourced market inputs, such as interest rates, option volatilities, credit spreads, market capitalization rates, etc. Items valued using such internally-generated valuation techniques are classified according to the lowest level input that is significant to the fair value measurement. As a result, the asset or liability could be classified in either Level 2 or 3 even though there may be some significant inputs that are readily observable. Internal fair value models and techniques that have been used by us include discounted cash flow, market approach valuations, and Monte Carlo valuation models. We also consider counterparty’s and our own credit risk on derivatives and other liabilities measured at their estimated fair value.

Fair Value Option Election: For our equity investment in the international joint venture and Lifepoint Behavioral Health, ("Lifepoint Behavioral"), as well as our investment in PHP Holdings, along with any related investments such as loans (see Note 3 for more details), we have elected to account for these investments at fair value due to the size of the investments and because we believe this method is more reflective of current values. We have not made a similar election for other investments that exist at December 31, 2023.

Leases (Lessee)

Pursuant to ASC 842, we are required to apply a dual approach, classifying leases (in which we are the lessee) as either financing or operating leases based on the principle of whether or not the lease is effectively a financed purchase. This classification determines whether lease expense is recognized based on an effective interest method (for finance leases) or on a straight-line basis (for operating leases) over the term of the lease. We record a right-of-use asset and a lease liability for all material leases with a term greater than 12 months regardless of their classification. Leases with a term of 12 months or less are off balance sheet with lease expense recognized on a straight-line basis over the lease term.

Reclassification

Reclassifications: Certain amounts in the consolidated financial statements for prior periods have been reclassified to conform to the current period presentation. For the year ended December 31, 2021, $39.4 million has been reclassified from "Other (including fair value adjustments on securities)" to "Real estate and other impairment charges, net" in our consolidated statements of net income. There is no impact to net income.

Recent Accounting Developments

Segment Reporting

In November 2023, the Financial Accounting Standards Board ("FASB") issued ASU 2023-07, "Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures" ("ASU 2023-07") to improve reportable segment disclosure requirements, primarily through enhanced disclosures about significant segment expenses. ASU 2023-07 is effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024. We do not expect to have a significant impact from the adoption of this standard on our consolidated financial statements and disclosures, as we consider our investments in healthcare real estate, other loans, and any investments in our tenants a single reportable segment.

Income Taxes

In December 2023, the FASB issued ASU 2023-09, "Income Taxes (Topic 740): Improvements to Income Tax Disclosures" ("ASU 2023-09") which focuses on income tax disclosures regarding effective tax rates and cash income taxes paid. This standard requires public entities to disclose (1) specific categories in the rate reconciliation, (2) the income or loss from continuing operations before income tax expense or benefit, and (3) provide additional information for certain reconciling items at or above a quantitative threshold of 5% of the statutory tax. Additionally, this standard requires disclosure of income taxes paid (net of refunds), separated by international, federal, state, and local jurisdictions. ASU 2023-09 is effective for annual periods beginning after December 15, 2024. We are currently evaluating the potential impact of the adoption of this standard on our consolidated financial statements.

Consolidated Statements of Cash Flows (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Interest paid, capitalized	$ 14,178	$ 6,454	$ 3,289
MPT Operating Partnership, L.P. [Member]
Interest paid, capitalized	$ 14,178	$ 6,454	$ 3,289

Real Estate and Other Activities - Other Tenant Matters - Additional Information (Details) - Other Tenant Updates [Member] $ in Millions	6 Months Ended	12 Months Ended
	Dec. 31, 2023 USD ($) Operator	Dec. 31, 2023 Operator
Business Acquisition [Line Items]
Number of other domestic property \| Operator	2	2
Percentage of assets representing properties leased and loan to internation joint ventures		2.50%
Unpaid rent or interest receivables and straight-line rent receivables reserved \| $	$ 95

Debt

12 Months Ended

Dec. 31, 2023

Debt Disclosure [Abstract]

Debt

4. Debt

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


	As of December 31, 2023			As of December 31, 2022
Revolving credit facility(A)	$	1,514,420		$	929,584
Term loan		200,000			200,000
British pound sterling secured term loan due 2024(B)		133,484			126,690
British pound sterling term loan due 2025(B)		891,170			845,810
Australian term loan facility(B)		320,164			817,560
2.550% Senior Unsecured Notes due 2023(B)		—			483,320
3.325% Senior Unsecured Notes due 2025(B)		551,950			535,250
0.993% Senior Unsecured Notes due 2026(B)		551,950			535,250
2.500% Senior Unsecured Notes due 2026(B)		636,550			604,150
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)		763,860			724,980
4.625% Senior Unsecured Notes due 2029		900,000			900,000
3.375% Senior Unsecured Notes due 2030(B)		445,585			422,905
3.500% Senior Unsecured Notes due 2031		1,300,000			1,300,000
	$	10,109,133		$	10,325,499
Debt issue costs and discount, net		(44,897	)		(57,087	)
	$	10,064,236		$	10,268,412

(A)

Includes £322 million of GBP-denominated borrowings and €303 million of Euro-denominated borrowings that reflect the applicable exchange rates at December 31, 2023.

(B)

Non-U.S. dollar denominated debt that reflects the exchange rates at period-end.

As of December 31, 2023, 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):


2024	$	453,648
2025		1,443,120
2026		3,202,920
2027		1,600,000
2028		763,860
Thereafter		2,645,585
Total	$	10,109,133

2023 Activity

In 2023, we purchased approximately £50 million of our 2.550% Senior Unsecured Notes due 2023 at a discounted price and yield averaging approximately 13%. As a result of this prepayment, we realized an approximate $1.1 million gain. On December 5, 2023, we fully paid off the remaining £350 million balance of our 2.550% Senior Unsecured Notes due 2023 with cash on-hand and proceeds from our unsecured credit facility ("Credit Facility").

On May 18, 2023, we completed the first phase of the Australia Transaction in which we sold seven of the 11 Australia facilities for A$730 million. We used the proceeds from the first phase of this sale to prepay A$730 million of the A$1.2 billion Australian term loan. As a result of this prepayment, we incurred approximately $0.8 million to accelerate the amortization of related debt issue costs. The final phase closed on October 10, 2023, in which we sold the remaining four facilities for approximately A$470 million and used the proceeds to pay down our revolving credit facility.

Credit Facility

On May 6, 2022, we increased the amount of our Credit Facility by $500 million by exercising the accordion feature. In addition, our revolver and U.S. dollar term loan were modified with Secured Overnight Financing Rate as a replacement reference rate to U.S. dollar LIBOR. Currently, our Credit Facility includes a $1.8 billion unsecured revolving loan facility and a $200 million unsecured term loan facility.

On June 29, 2022, we amended our Credit Facility. The amendment extended the maturity date of our revolving facility to June 30, 2026 with our option to extend for an additional 12 months. The maturity date of our $200 million unsecured term loan facility was extended to June 30, 2027. Additionally, we may request incremental term loan and/or revolving loan commitments in an aggregate amount not to exceed $1 billion.

Under the amended Credit Facility and at our election, loans may be made as either ABR Loans or Term Benchmark Loans. The applicable margin for term loans that are ABR Loans is adjustable on a sliding scale from 0.00% to 0.70% based on current credit rating. The applicable margin for term loans that are Term Benchmark Loans is adjustable on a sliding scale from 0.875% to 1.70% based on current credit rating. The applicable margin for revolving loans that are ABR Loans is adjustable on a sliding scale from 0.00% to 0.50% based on current credit rating. The applicable margin for revolving loans that are Term Benchmark Loans or RFR Loans, as defined in the Credit Facility agreement, is adjustable on a sliding scale from 0.80% to 1.50% based on current credit rating. The facility fee is adjustable on a sliding scale from 0.125% to 0.30% based on current credit rating and is payable on the revolving loan facility. During 2023, our credit rating negatively changed, resulting in adjustments to the applicable margin by 0.375% and an increase to the facility fee from 0.25% to 0.30%.

At December 31, 2023, we had $1.5 billion outstanding on the revolving credit facility, whereas, we had $929.6 million outstanding on our revolving credit facility at December 31, 2022. At December 31, 2023 and 2022, our availability under our revolving credit facility was $0.3 billion and $0.9 billion, respectively. The weighted-average interest rate on the revolving facility was 5.9% and 3.8% during 2023 and 2022, respectively.

At December 31, 2023 and 2022, the interest rate in effect on our term loan was 7.2% and 5.7%, respectively.

Non-U.S. Term Loans

British Pound Sterling Term Loan due 2024

On December 9, 2022, we entered into a £105 million secured sterling-denominated term loan, of which we used to partially fund the Priory acquisition on the same date. This term loan matures on December 9, 2024, and has a fixed interest rate of 5.250%.

British Pound Sterling Term Loan due 2025

On January 6, 2020, we entered into a £700 million unsecured sterling-denominated term loan with Bank of America, N.A., as administrative agent, and several lenders from time-to-time are parties thereto. The term loan matures on January 15, 2025. The applicable margin under the term loan is adjustable based on a pricing grid from 0.85% to 1.65% dependent on our current credit rating. On March 4, 2020, we entered into an interest rate swap transaction (effective March 6, 2020) to fix the interest rate to approximately 0.70% for the duration of the loan. The applicable margin for the pricing grid (which can vary based on our credit rating) increased from 1.25% to 1.65% on March 10, 2023 with the change in credit rating, for an all-in fixed rate at December 31, 2023 of 2.349%.

Australian Term Loan

On May 23, 2019, we entered into an A$1.2 billion term loan with Bank of America, N.A., as administrative agent, and several lenders from time-to-time are parties thereto. The term loan matures on May 23, 2024. The interest rate under the term loan is adjustable based on a pricing grid from 0.85% to 1.65%, dependent on our current senior unsecured credit rating. On June 27, 2019, we entered into an interest rate swap transaction (effective July 3, 2019) to fix the interest rate to approximately 1.20% for the duration of the loan as long as the reference rate stays above 0.00%. The current applicable margin for the pricing grid (which can vary based on our credit rating) increased from 1.25% to 1.65% on March 10, 2023 with the change in credit rating, for an all-in fixed rate at December 31, 2023 of 2.85%. As noted earlier, on May 18, 2023, we prepaid A$730 million of this term loan.

Interest Rate Swaps

At December 31, 2023, we had a derivative asset of approximately $43 million related to the combination of the sterling-denominated term loan interest rate swap and the Australian dollar term loan interest rate swap. At December 31, 2022, we had a derivative asset of approximately $93.2 million related to the combination of the sterling-denominated term loan interest rate swap and the Australian dollar term loan interest rate swap. Derivative assets are included in “Other assets” on our consolidated balance sheets.

Senior Unsecured Notes

The following are the basic terms of our senior unsecured notes at December 31, 2023 (par value amounts in thousands):


	Offering Completion Date	Maturity Date	Par Value		% of Par Value			Interest Payment Frequency
3.325% Senior Unsecured Notes due 2025	March 24, 2017	March 24, 2025	€	500,000		100.000	%	Annually
0.993% Senior Unsecured Notes due 2026	October 6, 2021	October 15, 2026	€	500,000		100.000	%	Annually
2.500% Senior Unsecured Notes due 2026	March 24, 2021	March 24, 2026	£	500,000		99.937	%	Annually
5.250% Senior Unsecured Notes due 2026	July 22, 2016	August 1, 2026	$	500,000		100.000	%	Semi-annually
5.000% Senior Unsecured Notes due 2027	September 7, 2017	October 15, 2027	$	1,400,000		100.000	%	Semi-annually
3.692% Senior Unsecured Notes due 2028	December 5, 2019	June 5, 2028	£	600,000		99.998	%	Annually
4.625% Senior Unsecured Notes due 2029	July 26, 2019	August 1, 2029	$	900,000		99.500	%	Semi-annually
3.375% Senior Unsecured Notes due 2030	March 24, 2021	April 24, 2030	£	350,000		99.448	%	Annually
3.500% Senior Unsecured Notes due 2031	December 4, 2020	March 15, 2031	$	1,300,000		100.000	%	Semi-annually

We may repurchase, redeem, or refinance senior unsecured notes from time-to-time. We may purchase senior notes for cash through open market purchases, privately negotiated transactions, or a tender offer. In some cases, we may redeem some or all of the notes at any time, but may require a redemption premium that will decrease over time. In the event of a change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase. Redemptions and repurchases of debt, if any, will depend on prevailing market conditions, our liquidity requirements, contractual restrictions, and other factors.

Debt Refinancing and Unutilized Financing Costs

2023

In 2023, we recognized a $1.1 million benefit related to the purchase of £50 million of our 2.550% Senior Unsecured Notes due 2023 at a discounted price, partially offset by $0.8 million of costs associated with the partial prepayment of our A$1.2 billion Australian term loan in the second quarter of 2023.

2022

In 2022, we incurred approximately $9.5 million of debt refinancing costs. These costs were incurred as a result of the payoff of our July 2021 Interim Credit Facility with proceeds from the Macquarie Transaction on March 14, 2022, along with the amendment of our Credit Facility on June 29, 2022.

2021

With the termination of our January 2021 Interim Credit Facility and other debt activity, we incurred approximately $7.3 million of debt refinancing costs in 2021.

With proceeds from our 0.993% Senior Unsecured Notes due 2026 offering, on October 22, 2021, we redeemed all of our outstanding €500 million aggregate principal amount of 4.000% senior unsecured notes that were due in 2022, including accrued and unpaid interest. As a result of this redemption, we incurred a charge of approximately $20 million (including redemption premiums and accelerated amortization of deferred debt issuance costs).

Covenants

Our debt facilities impose certain restrictions on us, including restrictions on our ability to: incur debts; create or incur liens; provide guarantees in respect of obligations of any other entity; make redemptions and repurchases of our capital stock; prepay, redeem, or repurchase debt; engage in mergers or consolidations; enter into affiliated transactions; dispose of real estate or other assets; and change our business. In addition, the credit agreements governing our Credit Facility limit the amount of dividends we can pay as a percentage of normalized adjusted funds from operations (“NAFFO”), as defined in the agreements, on a rolling four quarter basis. At December 31, 2023, the dividend restriction was 95% of NAFFO. The indentures governing our senior unsecured notes also limit the amount of dividends we can pay based on the sum of 95% of NAFFO, proceeds of equity issuances, and certain other net cash proceeds. Finally, our senior unsecured notes require us to maintain total unencumbered assets (as defined in the related indenture) of not less than 150% of our unsecured indebtedness.

In addition to these restrictions, the Credit Facility contains customary financial and operating covenants, including covenants relating to our total leverage ratio, fixed charge coverage ratio, secured leverage ratio, consolidated adjusted net worth, unsecured leverage ratio, and unsecured interest coverage ratio. The Credit Facility also contains customary events of default, including among others, nonpayment of principal or interest, material inaccuracy of representations, and failure to comply with our covenants. If an event of default occurs and is continuing under the Credit Facility, the entire outstanding balance may become immediately due and payable. At December 31, 2023, we were in compliance with all such financial and operating covenants.

Income Taxes - Summary of Reconciliation of Income Tax Benefit (Expense) Benefit from the Statutory Income Tax Rate to the Effective Tax Rate Based on Income before Income Taxes (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Sep. 30, 2022	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
(Loss) income before income tax		$ (686,771)	$ 959,719	$ 730,888
Income tax benefit (expense) at the U.S. statutory federal rate (21% in 2023, 2022, and 2021)		144,222	(201,541)	(153,486)
Decrease (increase) in income tax resulting from:
Foreign rate differential		(4,122)	1,826	2,742
State income taxes, net of federal benefit		1,275	(1,886)
U.S. earnings not subject to federal income tax		(115,189)	165,705	132,266
Change in valuation allowance		(45,692)	(11,281)	(10,040)
Statutory tax rate change			(941)	(43,924)
Interest disallowance		(3,421)	(1,737)	(646)
Tax Impact of UK REIT conversion		160,641
Other items, net		(7,035)	(6,045)	(860)
Income tax benefit (expense)	$ (5,000)	$ 130,679	$ (55,900)	$ (73,948)

Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2023

Accounting Policies [Abstract]

Summary of Carrying Value and Classification of the Assets and Maximum Exposure

The carrying value and classification of the related assets and maximum exposure to loss as a result of our involvement with these VIEs at December 31, 2023 are presented below (in thousands):


VIE Type	Carrying Amount(1)		Asset Type Classification	Maximum Loss Exposure(2)
Loans, net	$	850,655	Investments in Unconsolidated Operating Entities	$	850,655
Loans, net		149,872	Mortgage and other loans		151,190
Equity investments		74,840	Investments in Unconsolidated Operating Entities		74,840

(1)

Carrying amount only reflects the net book value of our loan or equity investment in the VIE.

(2)

Estimated Useful Lives of Related Real Estate and Other Assets


Buildings and improvements		39.1 years
Lease intangibles		28.0 years
Leasehold improvements		13.9 years
Furniture, equipment, and other		5.3 years

Summary of Credit Loss Reserves

The following table summarizes our credit loss reserves (in thousands):


	December 31, 2023			December 31, 2022
Balance at beginning of the year	$	121,146		$	48,527
Provision for credit loss, net		10,194			99,009
Expected credit loss reserve related to financial instruments sold, repaid, or satisfied		(35,339	)		(26,390	)
Balance at end of year	$	96,001		$	121,146

- 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 Other Activities - Investments in Unconsolidated Operating Entities - Additional Information (Details) SFr in Millions, $ in Millions	12 Months Ended
	Dec. 31, 2023 CHF (SFr)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Swiss Medical Network [Member]
Business Acquisition [Line Items]
Favorable fair market value adjustment on investment \| SFr	SFr 20
PHP Holdings Equity Investment [Member]
Business Acquisition [Line Items]
Favorable fair market value adjustment on investment		$ 45.0
COVID-19 Pandemic [Member] \| Other [Member]
Business Acquisition [Line Items]
Favorable non-cash fair value adjustment on investment		$ 45.0	$ 2.3

Fair Value of Financial Instruments (Tables)

12 Months Ended

Dec. 31, 2023

Fair Value Disclosures [Abstract]

Summary of Fair Value Information of Financial Instruments

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


	December 31, 2023							December 31, 2022
Asset (Liability)	Book Value				Fair Value			Book Value				Fair Value
Interest and rent receivables	$	45,059			$	45,476		$	167,035			$	163,101
Loans(1)		1,302,727		(2)		1,202,383			1,405,615		(2)		1,360,113
Debt, net		(10,064,236	)			(8,256,465	)		(10,268,412	)			(8,697,042	)

(1)

Excludes the convertible loan made in May 2023 to PHP Holdings and the acquisition loan made in May 2020 related to our investment in the international joint venture, along with the related subsequent investment in the real estate of three hospitals in Colombia, as these assets are accounted for under the fair value option method, as noted below. In addition for December 31, 2022 only, this excludes the acquisition and mortgage loans made to Lifepoint Behavioral, which were satisfied in full in February 2023 as further described in Note 3.

(2)

Includes $162.4 million and $223.8 million of mortgage loans, a $323.8 million and $315.9 million shareholder loan included in investments in unconsolidated real estate joint ventures, $526.9 million and $640.4 million of loans that are part of our investments in unconsolidated operating entities, and $289.6 million and $225.5 million of other loans at December 31, 2023 and December 31, 2022, respectively.

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

At December 31, 2023 and 2022, the amounts recorded under the fair value option method were as follows (in thousands):


	As of December 31, 2023				As of December 31, 2022
Asset (Liability)	Fair Value		Original Cost		Fair Value		Original Cost		Asset Type Classification
Mortgage loans	$	146,892	$	146,892	$	140,260	$	140,260	Mortgage loans
Equity investment and other loans		939,903		912,999		434,609		441,943	Investments in unconsolidated operating entities/Other loans

Schedule of Effects of Movement in DLOM by Sensitivity Analysis by Using Basis Point Variations


Basis Point Change in Marketability Discount	Estimated Increase (Decrease) in Fair Value
+ 100 basis points	$	(7,571	)
- 100 basis points		7,571

Real Estate and Other Activities - Schedule of Concentrations of Credit Risk (Parenthetical) (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Investments in unconsolidated operating entities	$ 1,778,640	$ 1,444,872
PHP Holdings [Member]
Business Acquisition [Line Items]
Investments in unconsolidated operating entities	$ 699,535

Schedule III - Changes in Total Real Estate Assets (Detail) - USD ($)
$ in Thousands

12 Months Ended

Dec. 31, 2023

Dec. 31, 2022

Dec. 31, 2021

SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]

Balance at beginning of period

$ 12,300,524

$ 13,628,749

$ 10,749,707

Acquisitions

143,882

622,999

3,023,966

Transfers from construction in progress

72,791

47,431

Additions

87,873

150,290

167,164

Dispositions

(874,519)

(1,471,529)

(229,584)

Other

^[1]

82,624

(677,416)

(82,504)

Balance at end of period

$ 11,813,175

^[2]

$ 12,300,524

$ 13,628,749

[1]	Includes foreign currency fluctuations for all years.
[2]	Excludes approximately $400 million and $170 million of construction and building improvements in progress reflected in buildings and improvements at December 31, 2023 and 2022, respectively.

Stock Awards - Additional Information (Detail) - USD ($) $ in Thousands		12 Months Ended
	Dec. 08, 2023	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock / (Unit)-based compensation expense		$ 33,250	$ 49,421	$ 52,110
Stock-based compensation expense, unrecognized cost		$ 52,000
Stock-based compensation expense, unrecognized cost, reorganization period (in years)		1 year 10 months 24 days
Stock-based awards, fair value		$ 22,500	$ 82,600	$ 49,900
Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock awards vesting period in years		10 years
Equity Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Reserved shares of new common stock for awards under the Equity Incentive Plan		28,900,000
Common stock remaining for future stock awards transferred to the equity incentive plan		8,800,000
Maximum number of shares of common stock that may be awarded		5,000,000
Cumulative benefit catchup from adjusting payout probability		$ 13,200
Incremental expense of stock awards		$ 3,500
Service-Based Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement by share based payment award, expected service period (in years)		3 years
Performance-Based Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement by share based payment award, expected service period (in years)		3 years
Market-Based Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of increase in share price	7.00%
Common stock remaining for future stock awards transferred to the equity incentive plan	2,500,000
Stock awards vesting period in years	4 years

Common Stock/Partners' Capital - Additional Information (Detail) - USD ($)			12 Months Ended
	Oct. 09, 2022	Jan. 11, 2021	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Class Of Stock [Line Items]
Common stock, shares issued			598,991,000	597,476,000
Proceeds from sale of common shares / units, net of offering costs					$ 1,051,229,000
Shares issued price per share	$ 0.001
Stock repurchase, Value				$ 17,940,000
Stock repurchase program expiration date	Oct. 10, 2023
Maximum [Member]
Class Of Stock [Line Items]
Stock repurchase program, authorized amount	$ 500,000,000
MPT Operating Partnership, L.P. [Member]
Class Of Stock [Line Items]
Stock repurchase, Value				$ 17,940,000
Redemption of common units			$ 0
MPT Operating Partnership, L.P. [Member] \| Limited Partner [Member]
Class Of Stock [Line Items]
Number of share sold					52,532,000
Stock repurchase, Shares				1,629,000
Stock repurchase, Value				$ 17,761,000
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] \| MPT TRS, Inc [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%
Common Units [Member]
Class Of Stock [Line Items]
Number of share sold					53,063,000
Stock repurchase, Shares				1,645,000
Stock repurchase, Value				$ 2,000
Public Offering [Member]
Class Of Stock [Line Items]
Common stock, shares issued		36,800,000
Proceeds from sale of common shares / units, net of offering costs		$ 711,000,000
At-the-Market Equity Offering Program [Member]
Class Of Stock [Line Items]
Proceeds from sale of common shares / units, net of offering costs					$ 340,000,000
At-the-Market Equity Offering Program [Member] \| Common Units [Member]
Class Of Stock [Line Items]
Number of share sold					16,300,000

Stock Awards

12 Months Ended

Dec. 31, 2023

Share-Based Payment Arrangement [Abstract]

Stock Awards

7. Stock Awards

Stock Awards

During the second quarter of 2022, we amended the 2019 Equity Incentive Plan (the "Equity Incentive Plan"), 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. Our Equity Incentive Plan is administered by the Compensation Committee of the Board of Directors ("Board"), and we have reserved 28.9 million shares of common stock for awards, of which 8.8 million shares remain available for future stock awards as of December 31, 2023. The Equity Incentive Plan contains a limit of 5 million shares as the maximum number of shares of common stock that may be awarded to an individual in any fiscal year. Awards under the Equity Incentive Plan are subject to forfeiture due to termination of employment prior to vesting and/or from not achieving the respective performance/market conditions. In the event of a change in control, outstanding and unvested options will immediately vest, unless otherwise provided in the participant’s award or employment agreement, and restricted stock, restricted stock units, deferred stock units, and other stock-based awards will vest if so provided in the participant’s award agreement. The term of the awards is set by the Compensation Committee, though Incentive Stock Options may not have terms of more than ten years. Forfeited awards (along with shares withheld for payroll tax withholding purposes) are returned to the Equity Incentive Plan and are then available to be re-issued as future awards. For each share of common stock issued by Medical Properties Trust, Inc. pursuant to its Equity Incentive Plan, the Operating Partnership issues a corresponding number of Operating Partnership units.

For the past three years, we have only granted restricted stock and restricted stock units pursuant to our Equity Incentive Plan. These stock-based awards have been granted in the form of service-based awards, performance awards based on company-specific performance hurdles, and market-based awards. See below for further details on each of these stock-based awards:

Service-Based Awards

In 2023, 2022, and 2021, the Compensation Committee granted service-based awards to employees and non-employee directors. Service-based awards vest as the employee/director provides the required service (typically over three years). Dividends are generally paid on these awards prior to vesting.

Performance-Based Awards

In 2023, 2022, and 2021, the Compensation Committee granted performance-based awards to employees. Generally, dividends are not paid on performance awards until the award is earned. See below for details of such performance-based award grants.

In 2023, 2022, and 2021, a target number of stock awards were granted to employees that could be earned based on the achievement of specific performance thresholds as set by our Compensation Committee. The performance thresholds were based on a three-year period with the opportunity to earn a portion of the award earlier. More or less shares than the target number of shares are available to be earned based on our performance compared to the set thresholds. At the end of each of the performance periods, any earned shares during such period will vest on January 1 of the following calendar year. The performance thresholds for 2023 are based

on strategic transactions (including individual property disposals and larger asset disposals through joint venture transactions) and EBITDA, while 2022 and 2021 awards were based on funds from operations growth, EBITDA, and acquisitions.

Certain performance awards granted were subject to a modifier which increases or decreases the actual shares earned in each performance period. The modifier for the 2023, 2022, and 2021 awards was based on two components: 1) how our total shareholder return (“TSR”) compared to the Dow Jones U.S. Real Estate Health Care Index for 2023 and 2022 and the SNL U.S. REIT Healthcare Index for 2021 and 2) how our TSR compared to a threshold set by the Compensation Committee.

Market-Based Awards

In 2023, the Compensation Committee granted market-based awards to employees, other than the Chief Executive Officer and Chief Financial Officer. Generally, dividends are not paid on market-based awards until the award is earned. See details below of such market-based award grant.

On December 8, 2023, the Compensation Committee approved market-based restricted stock awards of 2,500,000 shares of common stock at the target level of achievement. These shares will be earned at the target level only if the Company's share price increases to $7.00 per share, with the opportunity to earn more shares (up to three times target), based on higher stock price hurdles. The actual number of shares to be earned pursuant to these awards will be determined based on a trailing 20-trading day average closing price of the Company's common stock during the four-year period following the grant date of December 8, 2023. Earned shares will vest in equal quarterly installments over two years following the date that the Compensation Committee makes a determination of achievement of the performance metrics, subject to the grantee’s continued employment through such date, provided that all unvested earned shares will vest in full following the end of the four-year performance period.

The following summarizes stock-based award activity in 2023 and 2022 (which includes awards granted in 2023, 2022, and any applicable prior years), respectively:

For the Year Ended December 31, 2023:


	Vesting Based on Service					Vesting Based on Market/Performance Conditions
	Shares			Weighted-Average Value at Award Date		Shares			Weighted-Average Value at Award Date
Nonvested awards at beginning of the year		810,483		$	21.02		4,349,081		$	18.26
Awarded		1,210,448		$	10.36		10,270,260		$	8.47
Vested		(864,482	)	$	16.60		(1,591,846	)	$	19.65
Forfeited		(11,653	)	$	12.27		(450,703	)	$	12.44
Nonvested awards at end of year		1,144,796		$	13.01		12,576,792		$	10.20

For the Year Ended December 31, 2022:


	Vesting Based on Service					Vesting Based on Market/Performance Conditions
	Shares			Weighted-Average Value at Award Date		Shares			Weighted-Average Value at Award Date
Nonvested awards at beginning of the year		922,954		$	20.26		5,477,536		$	15.86
Awarded		659,393		$	21.18		1,828,971		$	18.45
Vested		(750,854	)	$	20.25		(2,924,722	)	$	13.87
Forfeited		(21,010	)	$	20.06		(32,704	)	$	19.17
Nonvested awards at end of year		810,483		$	21.02		4,349,081		$	18.26

The value of stock-based awards is charged to compensation expense over the service periods. For the years ended December 31, 2023, 2022, and 2021, we recorded $33.3 million, $49.4 million, and $52.1 million, respectively, of non-cash compensation expense. The decrease in share-based compensation in 2023 is a result of a $13.2 million cumulative catch-up in 2023 from lowering the payout probability of certain performance awards, partially offset by an incremental $3.5 million of expense from the acceleration of stock awards for a retiring executive officer.

The remaining unrecognized cost from stock-based awards at December 31, 2023, is $52.0 million, which will be recognized over a weighted-average period of 1.9 years. Stock-based awards that vested in 2023, 2022, and 2021, had a value of $22.5 million, $82.6 million, and $49.9 million, respectively.

SCHEDULE IV - MORTGAGE LOANS ON REAL ESTATE

12 Months Ended

Dec. 31, 2023

SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Abstract]

SCHEDULE IV - MORTGAGE LOANS ON REAL ESTATE

SCHEDULE IV — MORTGAGE LOANS ON REAL ESTATE

MEDICAL PROPERTIES TRUST, INC. AND MPT OPERATING PARTNERSHIP, L.P.

December 31, 2023


Column A	Column B			Column C	Column D	Column E			Column F		Column G(1)		Column H
Description	Interest Rate			Final Maturity Date	Periodic Payment Terms	Prior Liens			Face Amount of Mortgages		Carrying Amount of Mortgages		Principal Amount of Loans Subject to Delinquent Principal or Interest
	(Dollar amounts in thousands)
Long-term first mortgage loan:					Payable in monthly installments of interest plus principal payable in full at maturity
Colombia(4)		10.50	%	2035			(2	)	$	146,892	$	146,892		(3	)
Vibra		11.50	%	2024			(2	)		7,986		7,986		(3	)
Prospect(5)		9.00	%	2028			(2	)		155,223		155,223	(3) (6)
									$	310,101	$	310,101		(7	)

(1)

The aggregate cost for federal income tax purposes is $310.1 million.

(2)

There were no prior liens on loans as of December 31, 2023.

(3)

Mortgage loans were not delinquent with respect to principal or interest.

(4)

Mortgage loans covering three properties.

(5)

Mortgage loans covering four properties.

(6)

Interest on the Prospect loans becomes due and payable beginning March 1, 2024.

(7)

Excludes allowance for credit loss of $0.8 million at December 31, 2023.

Changes in mortgage loans (excluding allowance for credit loss) for the years ended December 31, 2023, 2022, and 2021 are summarized as follows:


	Year Ended December 31,
	2023				2022			2021
	(Dollar amounts in thousands)
Balance at beginning of year	$	364,420			$	213,320		$	248,335
Additions during year:
New mortgage loans and additional advances on existing loans		155,223				177,924			1,128,695		(9)
Exchange rate fluctuations		31,530				(15,824	)		(3,640	)
		551,173				375,420			1,373,390
Deductions during year:
Collection of principal		(241,072	)	(8)		(11,000	)		(1,160,070	)	(9)
		(241,072	)			(11,000	)		(1,160,070	)
Balance at end of year	$	310,101			$	364,420		$	213,320

(8)

Includes a $151 million mortgage loan satisfied in exchange for non-controlling ownership interest in PHP Holdings as part of the Prospect Transaction in the second quarter of 2023 as more fully described in Note 3 to Item 8 of this Annual Report on Form 10-K.

(9)

Includes an £800 million mortgage loan advanced to Priory in the first quarter of 2021 that was redeemed as part of the acquisition of the underlying fee simple real estate in the second quarter of 2021 as more fully described in Note 3 to Item 8 of this Annual Report on Form 10-K.

Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Parenthetical) (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Mortgage loans	$ 309,315	$ 364,101
Investments in unconsolidated real estate joint ventures	1,474,455	1,497,903
Investments in unconsolidated operating entities	1,778,640	1,444,872
Shareholder Loan [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Mortgage loans	162,400	223,800
Investments in unconsolidated real estate joint ventures	323,800	315,900
Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Investments in unconsolidated operating entities	526,900	640,400
Other loans	$ 289,600	$ 225,500

Debt - British Pound Sterling Term Loan - Additional Information (Detail) - British Pound Sterling [Member] - GBP (£)	Dec. 09, 2022	Mar. 04, 2020	Jan. 06, 2020	Dec. 31, 2023	Mar. 10, 2023	Mar. 09, 2023
Term loan due 2024
Debt Instrument [Line Items]
Line of Credit Facility, Maximum Borrowing Capacity	£ 105,000,000
Debt instrument maturity date	Dec. 09, 2024
Senior unsecured notes, interest rate	5.25%
Term loan due 2025 \| Bank of America, N.A
Debt Instrument [Line Items]
Line of Credit Facility, 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				2.349%
Term loan due 2025 \| Bank of America, N.A \| Minimum [Member]
Debt Instrument [Line Items]
Applicable margin adjustable based on pricing grid, percentage			0.85%
Term loan due 2025 \| Bank of America, N.A \| Maximum [Member]
Debt Instrument [Line Items]
Applicable margin adjustable based on pricing grid, percentage			1.65%
Term loan due 2025 \| Bank of America, N.A \| Credit Rating
Debt Instrument [Line Items]
Variable interest rate					1.65%	1.25%

Leases (Lessee) - Summary of Supplemental Cash Flow Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows used for operating leases	$ 8,210	$ 7,169	$ 7,330
Operating cash flows used for finance leases	$ 129	128	126
Non-cash activities - Right-of-use assets obtained in exchange for lease obligations:
Operating leases		$ 23,066	$ 1,120

Real Estate and Other Activities - Summary of Details Related to Investments (Parenthetical) (Details) - Steward [Member] $ in Millions	3 Months Ended
	Dec. 31, 2023 USD ($)
Business Acquisition [Line Items]
Impairment of equity investment	$ 90
Income Valuation Approach [Member] \| Level 3 Inputs [Member] \| Minimum [Member]
Business Acquisition [Line Items]
Market capitalization rate	6.50%
Income Valuation Approach [Member] \| Level 3 Inputs [Member] \| Maximum [Member]
Business Acquisition [Line Items]
Market capitalization rate	9.50%

Other Assets

12 Months Ended

Dec. 31, 2023

Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]

Other Assets

12. Other Assets

The following is a summary of our other assets on our consolidated balance sheets (in thousands):


	As of December 31,
	2023		2022
Debt issue costs, net(1)	$	8,513	$	12,036
Other corporate assets		275,688		256,438
Prepaids and other assets		173,710		304,516
Total other assets	$	457,911	$	572,990

(1)

Relates to our revolving credit facility

Other corporate assets include building, land and land improvements associated with our corporate offices, furniture and fixtures, equipment, corporate vehicles, aircraft, enterprise and other software, deposits, and right-of-use assets associated with corporate leases. Included in prepaids and other assets is prepaid insurance, prepaid taxes, deferred income tax assets (net of valuation allowances, if any), non-tenant receivables, derivative assets, and lease incentives provided to tenants, among other items.

Other corporate assets are higher in 2023 due to funding our new corporate headquarters, with an initial budget estimate of approximately $150 million. Prepaids and other assets decreased in 2023 primarily due to a reduction in the value of our interest rate swaps as further discussed in Note 4 and reserving for lease incentives made to tenants and other receivables as further discussed in Note 3.

Real Estate and Other Activities - Summary of Investments in Unconsolidated Operating Entities (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	$ 1,778,640	$ 1,444,872
PHP Holdings [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	699,535
Steward Loan Investment [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	361,591	362,831
International Joint Venture [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	225,960	231,402
Swiss Medical Network [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	186,113	157,145
Priory [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	163,837	156,575
Steward Equity Investment [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	35,696	125,862
Aevis Victoria SA [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	77,345	72,904
Aspris Children's Services [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	15,986	16,023
Lifepoint Behavioral [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	11,429	200,827
Caremax [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	$ 1,148	8,526
Prospect [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities		$ 112,777

Schedule II - Schedule of Valuation and Qualifying Accounts (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]
Balance at Beginning of Year	$ 393,057	$ 154,161	$ 146,637
Additions, Charged Against Operations	755,627	294,861	69,131
Addition, Charged to Other Accounts			7,340
Deductions, Net Recoveries/Write-offs	(270,366)	(55,965)	(68,947)
Balance at End of Year	$ 878,318	$ 393,057	$ 154,161

Income Taxes

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Income Taxes

5. Income Taxes

Medical Properties Trust, Inc.

We have maintained and intend to maintain our election as a REIT under the Code. To qualify as a REIT, we must meet a number of organizational and operational requirements, including a requirement to distribute at least 90% of our REIT taxable income to our stockholders. As a REIT, we generally will not be subject to U.S. federal income tax if we distribute 100% of our REIT taxable income to our stockholders and satisfy certain other requirements; instead, income tax is paid directly by our stockholders on the dividends distributed to them. If our REIT taxable income exceeds our dividends in a tax year, REIT tax rules allow us to designate dividends from the subsequent tax year in order to avoid current taxation on undistributed income. If we fail to qualify as a REIT in any taxable year, we will be subject to federal income taxes at regular corporate rates. Taxable income from non-REIT activities managed through our TRS entities is subject to applicable U.S. federal, state, and local income taxes. Our international subsidiaries are also subject to income or other taxes in the jurisdictions in which they operate.

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


	For the Years Ended December 31,
	2023			2022			2021
Current income tax (expense) benefit:
Domestic	$	(7,756	)	$	1,111		$	(1,559	)
Foreign		(24,257	)		(27,751	)		(18,964	)
		(32,013	)		(26,640	)		(20,523	)
Deferred income tax (expense) benefit:
Domestic		8,926			(15,628	)		6,915
Foreign		153,766			(13,632	)		(60,340	)
		162,692			(29,260	)		(53,425	)
Income tax benefit (expense)	$	130,679		$	(55,900	)	$	(73,948	)

A reconciliation of income tax benefit (expense) from the statutory income tax rate to the effective tax rate based on (loss) income before income taxes for the years ended December 31, 2023, 2022, and 2021 is as follows (in thousands):


	For the Years Ended December 31,
	2023			2022			2021
(Loss) income before income tax	$	(686,771	)	$	959,719		$	730,888
Income tax benefit (expense) at the U.S. statutory federal rate (21% in 2023, 2022, and 2021)		144,222			(201,541	)		(153,486	)
Decrease (increase) in income tax resulting from:
Foreign rate differential		(4,122	)		1,826			2,742
State income taxes, net of federal benefit		1,275			(1,886	)		—
U.S. earnings not subject to federal income tax		(115,189	)		165,705			132,266
Change in valuation allowance		(45,692	)		(11,281	)		(10,040	)
Statutory tax rate change		—			(941	)		(43,924	)
Interest disallowance		(3,421	)		(1,737	)		(646	)
Tax Impact of UK REIT conversion		160,641			—			—
Other items, net		(7,035	)		(6,045	)		(860	)
Total income tax benefit (expense)	$	130,679		$	(55,900	)	$	(73,948	)

In 2023, we elected to move a majority of our U.K. assets into a U.K. REIT regime with an effective date of July 1, 2023. With this election, we adjusted the deferred tax liabilities associated with these properties, resulting in a $161 million income tax benefit. Going forward, these U.K. assets will be subject only to a withholding tax on earnings upon distribution out of the U.K. REIT.

In 2022, we incurred approximately $5 million of income tax expense from the credit loss recovery on loans made to the Watsonville Community Hospital; whereas, in 2021, we recorded an approximate $10 million income tax benefit related to the initial loan impairment.

During the 2021 second quarter, the U.K. enacted an increase in its corporate income tax rates from 19% to 25% effective April 1, 2023, which resulted in a one-time adjustment to our net deferred tax liabilities of approximately $43 million.

The foreign provision for income taxes is based on foreign profit before income taxes of $6.3 million, $159.6 million, and $164.0 million in 2023, 2022, and 2021, respectively.

The domestic provision for income taxes is based on income (loss) before income taxes of $(144.5) million in 2023, $10.8 million in 2022, and $(29.7) million in 2021 from our TRS entities.

At December 31, 2023 and 2022, components of our deferred tax assets and liabilities were as follows (in thousands):


	2023			2022
Deferred tax assets:
Operating loss and interest deduction carry forwards	$	143,683		$	175,922
Depreciation		45,146			—
Partnership investments		15,768			—
Other		18,899			15,218
Total deferred tax assets		223,496			191,140
Valuation allowance		(117,191	)		(71,499	)
Total net deferred tax assets	$	106,305		$	119,641
Deferred tax liabilities:
Property and equipment	$	(158,330	)	$	(294,181	)
Net unbilled revenue		(65,727	)		(63,324	)
Partnership investments		—			(26,268	)
Other		(10,687	)		(27,153	)
Total deferred tax liabilities		(234,744	)		(410,926	)
Net deferred tax asset (liability)	$	(128,439	)	$	(291,285	)

At December 31, 2023, we had net NOL and other tax attribute carryforwards as follows (in thousands):


	U.S.			Foreign
Gross NOL carryforwards	$	169,970		$	458,913

Tax-effected NOL carryforwards	$	28,056		$	114,359
Valuation allowance		(27,956	)		(4,702	)
Net deferred tax asset - NOL carryforwards	$	100		$	109,657
Expiration periods	2024-indefinite			indefinite

Valuation Allowance

A valuation allowance has been recorded on certain foreign and domestic net operating loss carryforwards and other net deferred tax assets that may not be realized. As of each reporting date, we consider all new evidence that could impact the future realization of our deferred tax assets. In the evaluation of the need for a valuation allowance on our deferred income tax assets, we consider all available positive and negative evidence, including scheduled reversals of deferred income tax liabilities, carryback of future period losses to prior periods, projected future taxable income, tax planning strategies, and recent financial performance.

During 2023, a valuation allowance of $45.7 million has been recorded against a portion of our deferred tax assets to recognize only the components of the deferred tax assets that is more likely than not to be realized. The valuation allowance was primarily recorded against deferred tax assets for NOLs, non-depreciable basis of real property, and other tax attributes that we believe will not be realized. Valuation allowance activity recorded generally follows the activity of the associated deferred tax asset that is not expected to be recognized. From time-to-time, we may acquire deferred tax assets as part of real estate transactions and will assess the need for a valuation allowance as part of the opening balance sheet. Additionally, valuation allowances will be remeasured for foreign currency translation fluctuations through other comprehensive income.

We have no material uncertain tax position liabilities and related interest or penalties.

REIT Status

We have met the annual REIT distribution requirements by payment of at least 90% of our REIT taxable income in 2023, 2022, and 2021. Earnings and profits, which determine the taxability of such distributions, will differ from net income reported for financial reporting purposes due primarily to differences in cost basis, differences in the estimated useful lives used to compute depreciation, and differences between the allocation of our net income and loss for financial reporting purposes and for tax reporting purposes.

A schedule of per share distributions we paid and reported to our stockholders is set forth in the following:


	For the Years Ended December 31,
Per share:	2023			2022		2021
Ordinary dividend (1)	$	1.0639		$	0.4703	$	0.7646
Long-term capital gain (2)		0.1061			0.6797		0.1654
Return of capital		—			—		0.1800
Total	$	1.1700	(3)	$	1.1500	$	1.1100

(1)

For the years ended December 31, 2023, 2022, and 2021, includes Section 199A dividends of 1.0639, 0.4703, and 0.7646, respectively.

(2)

For the years ended December 31, 2023, 2022, and 2021, includes Unrecaptured Section 1250 gains of 0.1061, 0.2574, and 0.0583, respectively.

(3)

Includes the fourth quarter dividend declared on November 9, 2023, and paid on January 11, 2024, as it will be taxable to stockholders as part of their 2023 dividend income.

Similar to our U.S. REIT, we have met all requirements of our U.K. REIT as of December 31, 2023.

MPT Operating Partnership, L.P.

As a partnership, the allocated share of income of the Operating Partnership is included in the income tax returns of the general and limited partners. Accordingly, no accounting for income taxes is generally required for such income of the Operating Partnership. However, the Operating Partnership has formed TRS entities on behalf of Medical Properties Trust, Inc., which are subject to U.S. federal, state, and local income taxes at regular corporate rates, and its international subsidiaries are subject to income and other taxes in the jurisdictions in which they operate. See discussion above under Medical Properties Trust, Inc. for more details of income and other taxes associated with our TRS entities and international operations.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-13

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(h)(2))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//740/tableOfContent

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-14

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-21

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 270
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482526/740-270-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 17
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-17

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB TOPIC 6.I.5.Q1)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479360/740-10-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Subparagraph (SAB Topic 11.C)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479360/740-10-S99-2

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 30
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482603/740-30-50-2

+ Details

Debt - Additional Information (Detail)
$ in Thousands, € in Millions, £ in Millions

12 Months Ended

May 18, 2023

USD ($)

Dec. 31, 2023

USD ($)

Dec. 31, 2022

USD ($)

Dec. 31, 2021

EUR (€)

Dec. 31, 2021

USD ($)

Dec. 31, 2023

GBP (£)

Dec. 31, 2023

USD ($)

Dec. 05, 2023

Debt Instrument [Line Items]

Principal amount

$ 10,325,499

$ 10,109,133

Debt issuance offset cost

$ 800

0.993% Senior Unsecured Notes due 2026 [Member]

Debt Instrument [Line Items]

Principal amount

^[1]

$ 535,250

$ 551,950

Senior unsecured notes, interest rate

0.993%

Senior unsecured notes, maturity year

2026

Debt instrument maturity date

Oct. 15, 2026

4.000% Senior Unsecured Notes Due 2022 [Member]

Debt Instrument [Line Items]

Senior unsecured notes, interest rate

4.00%

Senior unsecured notes, maturity year

2022

Senior unsecured notes redemption amount including accrued and unpaid interest | €

€ 500

Term Loans [Member]

Debt Instrument [Line Items]

Principal amount

$ 200,000

Debt refinancing costs | €

€ 20

Term Loans [Member] | Australia [Member]

Debt Instrument [Line Items]

Principal amount

^[1]

817,560

320,164

Term loan

$ 1,200,000

3.500% Senior Unsecured Notes due 2031 [Member]

Debt Instrument [Line Items]

Principal amount

$ 1,300,000

Senior unsecured notes, interest rate

3.50%

Debt instrument maturity date

Mar. 15, 2031

2.550% Senior Unsecured Notes due 2023 [Member]

Debt Instrument [Line Items]

Gain on prepayment of Debt

$ 1,100

Principal amount

$ 483,320

^[1]

£ 50

Senior unsecured notes, interest rate

2.55%

Senior unsecured notes, maturity year

2023

Waterland Private Equity Fund VII C.V. [Member] | Interim Credit Facility [Member]

Debt Instrument [Line Items]

Debt refinancing costs

$ 9,500

$ 7,300

Debt instrument maturity date

Jun. 29, 2022

[1]	Non-U.S. dollar denominated debt that reflects the exchange rates at period-end.

Summary of Significant Accounting Policies - Estimated Useful Lives of Related Real Estate and Other Assets (Detail)	Dec. 31, 2023
Buildings and improvements [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	39 years 1 month 6 days
Lease Intangibles [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	28 years
Leasehold improvements [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	13 years 10 months 24 days
Furniture, equipment and other [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	5 years 3 months 18 days

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]	MPT Operating Partnership, L.P. [Member] Limited Partner [Member]	Common Par Value [Member]	Additional Paid-in Capital [Member]	Retained (Deficit) Earnings [Member]	Accumulated Other Comprehensive Income (Loss) [Member]	Accumulated Other Comprehensive Income (Loss) [Member] MPT Operating Partnership, L.P. [Member]	Non-Controlling Interests [Member]	Non-Controlling Interests [Member] MPT Operating Partnership, L.P. [Member]
Beginning balance at Dec. 31, 2020	$ 7,343,857	$ 7,344,247	$ 73,977	$ 7,316,269	$ 541	$ 7,460,726	$ (71,411)	$ (51,324)	$ (51,324)	$ 5,325	$ 5,325
Beginning balance (in shares) at Dec. 31, 2020			5,414	535,939	541,353
Net (loss) income	656,940	656,940	$ 6,560	$ 649,461			656,021			919	919
Unrealized gain (loss) on interest rate swaps, net of tax	52,288	52,288						52,288	52,288
Foreign currency translation gain (loss)	(37,691)	(37,691)						(37,691)	(37,691)
Stock (Unit) vesting and amortization of stock-based compensation	52,110	52,110	$ 521	$ 51,589	$ 3	52,107
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)			23	2,309	2,332
Distributions to non-controlling interests, net	(761)	(761)								(761)	(761)
Proceeds from offering (net of offering costs)	1,051,229	1,051,229	$ 10,512	$ 1,040,717	$ 53	1,051,176
Proceeds from offering (net of offering costs) (shares)			531	52,532	53,063
Dividends (Distributions) declared	(672,301)	(672,301)	$ (6,723)	$ (665,578)			(672,301)
Ending balance at Dec. 31, 2021	8,445,671	8,446,061	$ 84,847	$ 8,392,458	$ 597	8,564,009	(87,691)	(36,727)	(36,727)	5,483	5,483
Ending balance (in shares) at Dec. 31, 2021			5,968	590,780	596,748
Net (loss) income	903,819	903,819	$ 9,026	$ 893,571			902,597			1,222	1,222
Unrealized gain (loss) on interest rate swaps, net of tax	100,550	100,550						100,550	100,550
Foreign currency translation gain (loss)	(123,007)	(123,007)						(123,007)	(123,007)
Stock (Unit) vesting and amortization of stock-based compensation	49,421	49,421	$ 494	$ 48,927	$ 3	49,418
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)			37	3,638	3,675
Stock (Unit) vesting - satisfaction of tax withholding	(29,922)	(29,922)	$ (299)	$ (29,623)	$ (1)	(29,921)
Stock (Unit) vesting - satisfaction of tax withholding (shares)			(13)	(1,289)	(1,302)
Repurchase of units	(17,940)	(17,940)	$ (179)	$ (17,761)	$ (2)	(17,938)
Repurchase of units (shares)			(16)	(1,629)	(1,645)
Acquisition of non-controlling interest	(35,022)	(35,022)	$ (304)	$ (30,124)		(30,428)				(4,594)	(4,594)
Issuance of non-controlling interest	1,054	1,054								1,054	1,054
Distributions to non-controlling interests, net	(1,596)	(1,596)								(1,596)	(1,596)
Dividends (Distributions) declared	(698,621)	(698,621)	(6,986)	(691,635)			(698,621)
Ending balance at Dec. 31, 2022	8,594,407	8,594,797	$ 86,599	$ 8,565,813	$ 597	8,535,140	116,285	(59,184)	(59,184)	1,569	1,569
Ending balance (in shares) at Dec. 31, 2022			5,976	591,500	597,476
Net (loss) income	(556,092)	(556,092)	$ (5,564)	$ (550,912)			(556,476)			384	384
Unrealized gain (loss) on interest rate swaps, net of tax	(34,932)	(34,932)						(34,932)	(34,932)
Reclassification of interest rate swap gain to earnings, net of tax	(28,553)	(28,553)						(28,553)	(28,553)
Foreign currency translation gain (loss)	162,680	162,680						162,680	162,680
Reclassification of foreign currency translation loss from AOCI	2,490	2,490						2,490	2,490
Stock (Unit) vesting and amortization of stock-based compensation	33,250	33,250	$ 332	$ 32,918	$ 2	33,248
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)			25	2,432	2,457
Stock (Unit) vesting - satisfaction of tax withholding	(8,079)	(8,079)	$ (81)	$ (7,998)		(8,079)
Stock (Unit) vesting - satisfaction of tax withholding (shares)			(10)	(932)	(942)
Issuance of non-controlling interest	1,375	1,375								1,375	1,375
Distributions to non-controlling interests, net	(1,063)	(1,063)								(1,063)	(1,063)
Dividends (Distributions) declared	(531,618)	(531,618)	$ (5,317)	$ (526,301)			(531,618)
Ending balance at Dec. 31, 2023	$ 7,633,865	$ 7,634,255	$ 75,969	$ 7,513,520	$ 599	$ 8,560,309	$ (971,809)	$ 42,501	$ 42,501	$ 2,265	$ 2,265
Ending balance (in shares) at Dec. 31, 2023			5,991	593,000	598,991

Consolidated Statements of Comprehensive (Loss) Income - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Net (loss) income	$ (556,092)	$ 903,819	$ 656,940
Other comprehensive (loss) income:
Unrealized (loss) gain on interest rate swaps, net of tax	(34,932)	100,550	52,288
Reclassification of interest rate swap gain from AOCI, net of tax	(28,553)
Foreign currency translation gain (loss)	162,680	(123,007)	(37,691)
Reclassification of foreign currency translation loss from AOCI	2,490
Total comprehensive (loss) income	(454,407)	881,362	671,537
Comprehensive income attributable to non-controlling interests	(384)	(1,222)	(919)
Comprehensive (loss) income attributable to MPT common stockholders (Operating Partnership Partners)	(454,791)	880,140	670,618
MPT Operating Partnership, L.P. [Member]
Net (loss) income	(556,092)	903,819	656,940
Other comprehensive (loss) income:
Unrealized (loss) gain on interest rate swaps, net of tax	(34,932)	100,550	52,288
Reclassification of interest rate swap gain from AOCI, net of tax	(28,553)
Foreign currency translation gain (loss)	162,680	(123,007)	(37,691)
Reclassification of foreign currency translation loss from AOCI	2,490
Total comprehensive (loss) income	(454,407)	881,362	671,537
Comprehensive income attributable to non-controlling interests	(384)	(1,222)	(919)
Comprehensive (loss) income attributable to MPT common stockholders (Operating Partnership Partners)	$ (454,791)	$ 880,140	$ 670,618

Schedule IV - Changes in Mortgage Loans Excluding Allowance for Credit Loss (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Abstract]
Balance at beginning of year	$ 364,420	$ 213,320	$ 248,335
New mortgage loans and additional advances on existing loans	155,223	177,924	1,128,695
Exchange rate fluctuations	31,530	(15,824)	(3,640)
Mortgage loans on real estate including additions during year	551,173	375,420	1,373,390
Collection of principal	(241,072)	(11,000)	(1,160,070)
Deductions during year	(241,072)	(11,000)	(1,160,070)
Balance at end of year	$ 310,101	$ 364,420	$ 213,320

Real Estate and Other Activities - Summary of Operating Results from Properties Sold (Parenthetical) (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2023	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Business Acquisition [Line Items]
Gains				$ 40,945
Net impairment charge	$ 86,000
Prime [Member]
Business Acquisition [Line Items]
Non-cash impairment charge	$ 11,000	$ 11,000
Australia Transaction [Member]
Business Acquisition [Line Items]
Straight-line rent write-offs		37,400
Net impairment charge		$ 86,000
Disposal Group, Not Discontinued Operations [Member]
Business Acquisition [Line Items]
Straight-line rent write-offs			$ 42,000

Consolidated Balance Sheets (Parenthetical) - $ / shares	Dec. 31, 2023	Dec. 31, 2022
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	598,991,000	597,476,000
Common stock, shares outstanding	598,991,000	597,476,000
General Partner [Member] \| MPT Operating Partnership, L.P. [Member]
General partner, units issued	5,991,000	5,976,000
General partner, units outstanding	5,991,000	5,976,000
Common Units \| MPT Operating Partnership, L.P. [Member]
Limited Partners, units issued	593,000,000	591,500,000
Limited Partners, units outstanding	593,000,000	591,500,000

Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2023

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

2. Summary of Significant Accounting Policies


VIE Type	Carrying Amount(1)		Asset Type Classification	Maximum Loss Exposure(2)
Loans, net	$	850,655	Investments in Unconsolidated Operating Entities	$	850,655
Loans, net		149,872	Mortgage and other loans		151,190
Equity investments		74,840	Investments in Unconsolidated Operating Entities		74,840

(1)

Carrying amount only reflects the net book value of our loan or equity investment in the VIE.

(2)

Operating Lease Revenue

Rental payments received prior to their recognition as income are classified as deferred revenue.

Financing Lease Revenue

Other Leasing Revenue

Interest Revenue

Other Revenue


Buildings and improvements		39.1 years
Lease intangibles		28.0 years
Leasehold improvements		13.9 years
Furniture, equipment, and other		5.3 years

Credit Losses:

The following table summarizes our credit loss reserves (in thousands):


	December 31, 2023			December 31, 2022
Balance at beginning of the year	$	121,146		$	48,527
Provision for credit loss, net		10,194			99,009
Expected credit loss reserve related to financial instruments sold, repaid, or satisfied		(35,339	)		(26,390	)
Balance at end of year	$	96,001		$	121,146

reflect our market assumptions. This hierarchy requires the use of observable market data when available. These inputs have created the following fair value hierarchy:

•

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

•

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

Leases (Lessee)

Recent Accounting Developments

Segment Reporting

Income Taxes

Fair Value of Financial Instruments

12 Months Ended

Dec. 31, 2023

Fair Value Disclosures [Abstract]

Fair Value of Financial Instruments

10. Fair Value of Financial Instruments

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

the fair value of our revolving credit facility and term loans using Level 2 inputs based on the present value of future payments, discounted at a rate which we consider appropriate for such debt.

Fair value estimates are made at a specific point in time, are subjective in nature, and involve uncertainties and matters of significant judgment. Settlement of such fair value amounts may not be a prudent management decision.

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


	December 31, 2023							December 31, 2022
Asset (Liability)	Book Value				Fair Value			Book Value				Fair Value
Interest and rent receivables	$	45,059			$	45,476		$	167,035			$	163,101
Loans(1)		1,302,727		(2)		1,202,383			1,405,615		(2)		1,360,113
Debt, net		(10,064,236	)			(8,256,465	)		(10,268,412	)			(8,697,042	)

(1)

(2)

Items Measured at Fair Value on a Recurring Basis

Our equity investment and related loan to the international joint venture, our loan investment in the real estate of three hospitals operated by subsidiaries of the international joint venture in Colombia, our equity investment in Lifepoint Behavioral, and our investment in PHP Holdings are measured at fair value on a recurring basis as we elected to account for these investments using the fair value option at the point of initial investment. Our acquisition and mortgage loans to Lifepoint Behavioral (which were satisfied in full in February 2023 as described in Note 3) were also accounted for under the fair value option method at December 31, 2022. We elected to account for these investments at fair value due to the size of the investments and because we believe this method was more reflective of current values.

At December 31, 2023 and 2022, the amounts recorded under the fair value option method were as follows (in thousands):


	As of December 31, 2023				As of December 31, 2022
Asset (Liability)	Fair Value		Original Cost		Fair Value		Original Cost		Asset Type Classification
Mortgage loans	$	146,892	$	146,892	$	140,260	$	140,260	Mortgage loans
Equity investment and other loans		939,903		912,999		434,609		441,943	Investments in unconsolidated operating entities/Other loans

Our loans to the international joint venture and its subsidiaries (as well as the Lifepoint Behavioral loans at December 31, 2022) are recorded at fair value based on Level 2 and Level 3 inputs by discounting the estimated cash flows using the market rates at which similar loans would be made to borrowers with similar credit ratings and the same remaining maturities, while also considering the value of the underlying collateral of the loans. Our equity investment in Lifepoint Behavioral is recorded at fair value based on Level 2 inputs by discounting the estimated cash flows expected to be realized as part of the Lifepoint Transaction described in Note 3 to the consolidated financial statements. Our equity investment in the international joint venture and our investment in PHP Holdings are recorded at fair value based on Level 3 inputs, by using a discounted cash flow model, which requires significant estimates of our investee such as projected revenue and expenses and appropriate consideration of the underlying risk profile of the forecasted assumptions associated with the investee. We classify our valuations of these investments as Level 3, as we use certain unobservable inputs to the valuation methodology that are significant to the fair value measurement, and the valuations require management judgment due to the absence of quoted market prices. For the cash flow models, our unobservable inputs include use of a discount rate (which is based on a weighted-average cost of capital) and an adjustment for a marketability discount ("DLOM"). In regard to the underlying projections used in the discounted cash flow model, such projections are provided by the investees. However, we may modify such projections as needed based on our review and analysis of historical results, meetings with key members of management, and our understanding of trends and developments within the healthcare industry.

In 2023, we recorded a favorable fair value adjustment of approximately $34 million on our investments accounted for under the fair value option method (primarily from our investment in PHP Holdings as described in Note 3), compared to an unfavorable adjustment of approximately $7 million in 2022.

The discount rate and DLOM on our investment in PHP Holdings was approximately 11% and 8%, respectively, at December 31, 2023. In arriving at the DLOM, we 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 full basis point variations (in thousands):


Basis Point Change in Marketability Discount	Estimated Increase (Decrease) in Fair Value
+ 100 basis points	$	(7,571	)
- 100 basis points		7,571

Items Measured at Fair Value on a Nonrecurring Basis

In addition to items that are measured at fair value on a recurring basis, we have assets and liabilities that are measured, from time-to-time, at fair value on a nonrecurring basis, such as for impairment purposes of our financial instruments and for certain equity investments without a readily determinable fair value.

Impairment of Non-Real Estate Investments

Our non-real estate investments in Steward and related affiliates include our 9.9% equity investment, approximately $212 million in working capital loans, and an approximate $362 million loan made in 2021, proceeds of which were used to redeem a similarly sized convertible loan held by Steward’s former private equity sponsor. In addition, the $219 million loan to the international joint venture is collateralized by the equity of Steward held by an investor in both Steward and the international joint venture. To assess recovery of these investments, we performed a valuation of Steward’s business at December 31, 2023, with assistance from a third-party, independent valuation firm, using a market valuation approach, with Level 3 inputs including the selected revenue multiple range of 0.50x to 0.60x in reference to comparable transactions. After reducing the derived fair value for the loans to Steward discussed above, we arrived at a fair value for Steward’s equity. We then compared our equity investment’s carrying value to our 9.9% share of the fair value of Steward’s equity, which resulted in the need for an impairment charge of approximately $90 million. The value of the investor's share of the remaining 90.1% of Steward's equity that collateralizes the loan to the international joint venture was sufficient to support recovery of this investment.

In 2022, we performed an impairment analysis on our investments in financing leases with Prospect using an income approach with Level 3 inputs including the selected market capitalization rate range of 7.5% to 9.0%. For these assets, we divided the expected operating income (i.e. rent revenue less expenses, if any) from the underlying properties by a market capitalization rate. We then compared the carrying value of our investment to the derived fair value, which resulted a $170 million impairment to the Pennsylvania assets.

Equity Investments Without a Readily Determinable Fair Value

For our equity investment in Swiss Medical Network (which does not have a readily determinable fair value), we marked our investment to fair value in the 2023 third quarter based on the price paid by a new investor in the same security, resulting in a CHF 20 million favorable adjustment.

- 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

Real Estate and Other Activities - Summary of Details Related to Investments (Details) - USD ($)
$ in Thousands

3 Months Ended

12 Months Ended

Dec. 31, 2023

Dec. 31, 2022

Dec. 31, 2021

Business Acquisition [Line Items]

Rent Billed

$ 803,375

$ 968,874

$ 931,942

Straight-line rent

(127,894)

204,159

241,433

Interest and other income

69,177

166,238

168,695

Real estate and other impairment charges, net

376,907

268,375

39,411

Earnings from equity interests

$ 13,967

$ 40,800

$ 28,488

Steward [Member]

Business Acquisition [Line Items]

Total

$ 714

Steward [Member] | Reserve of Unpaid Rent and Lease Incentives [Member]

Business Acquisition [Line Items]

Rent Billed

154

Steward [Member] | Reserve of Straight-line Rent Receivables [Member]

Business Acquisition [Line Items]

Straight-line rent

224

Steward [Member] | Reserve of Unpaid Interest Receivables [Member]

Business Acquisition [Line Items]

Interest and other income

Steward [Member] | Impairment Charge on Equity Investment and Other Assets [Member]

Business Acquisition [Line Items]

Real estate and other impairment charges, net

^[1]

171

Steward [Member] | Impairment Charge on Real Estate Assets [Member]

Business Acquisition [Line Items]

Real estate and other impairment charges, net

^[2]

100

Macquarie Asset Management [Member] | Steward [Member] | Reserve of Unpaid Rent and Straight-line Rent Receivables [Member]

Business Acquisition [Line Items]

Earnings from equity interests

$ 30

[1]

For our non-real estate investments in Steward, we compared our carrying value of all such investments to the fair value of the underlying collateral, which resulted in a $90 million impairment to our equity investment. The remaining charge relates to reserving for other outstanding receivables, including receivables for reimbursement of property taxes and insurance.

[2]

For the real estate leased to Steward, we made a comparison of the projected undiscounted future cash flows with the net book value of each asset. For less than 10 of these properties, the carrying value was deemed not recoverable, and we recorded an impairment charge to reduce the carrying value to its estimated fair value. In estimating fair value for these properties, we, along with assistance from a third-party, independent valuation firm, used a combination of cost, market and income approaches using Level 3 inputs. The cost approach used comparable sales to value the land and cost manuals to value the improvements. The value derived from the market approach was based on sale prices of similar properties. For the income approach, we divided the expected operating income (i.e. rent revenue less expenses, if any) from the property by a market capitalization rate (range from 6.5% to 9.5%).

Leases (Lessee) - Summary of Supplemental Balance Sheet Information (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Right of use assets:
Finance leases	$ 1,683	$ 1,734
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List]	Land	Land
Total real estate right of use assets	$ 65,358	$ 65,287
Total right of use assets	89,601	91,512
Lease liabilities:
Operating leases	$ 101,812	$ 101,592
Operating Lease, Liability, Statement of Financial Position [Extensible Enumeration]	us-gaap:OtherLiabilities	us-gaap:OtherLiabilities
Financing leases	$ 1,938	$ 1,938
Finance Lease, Liability, Statement of Financial Position [Extensible Enumeration]	us-gaap:OtherLiabilities	us-gaap:OtherLiabilities
Total lease liabilities	$ 103,750	$ 103,530
Weighted-average remaining lease term:
Operating leases	32 years 10 months 24 days	33 years 2 months 12 days
Finance leases	32 years 10 months 24 days	33 years 10 months 24 days
Weighted-average discount rate:
Operating leases	6.20%	6.10%
Finance leases	6.60%	6.60%
Corporate [Member]
Right of use assets:
Operating leases	$ 24,243	$ 26,225
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	Other Assets	Other Assets
Real Estate [Member]
Right of use assets:
Operating leases	$ 63,675	$ 63,553
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	Land	Land

Commitments and Contingencies - Additional Information (Detail) $ in Millions			3 Months Ended	12 Months Ended
	May 18, 2023 Facility	Oct. 05, 2022 USD ($) Facility	Dec. 31, 2021 USD ($)	Dec. 31, 2022 USD ($) Facility	Dec. 31, 2021 USD ($) Facility
Commitment And Contingencies [Line Items]
Number of facilities sold \| Facility	7			15	16
Expected cash proceeds on transaction close			$ 54.5	$ 522.0	$ 246.0
Prospect [Member] \| Connecticut [Member]
Commitment And Contingencies [Line Items]
Number of facilities sold \| Facility		3
Expected cash proceeds on transaction close		$ 457.0
Excepted proceeds in cash		$ 355.0

Document and Entity Information - USD ($) shares in Millions, $ in Billions	12 Months Ended
	Dec. 31, 2023	Feb. 16, 2024	Jun. 30, 2023
Document Information [Line Items]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2023
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	FY
Trading Symbol	MPW
Entity Registrant Name	Medical Properties Trust, Inc
Entity Central Index Key	0001287865
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	Yes
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Filer Category	Large Accelerated Filer
Document Financial Statement Error Correction [Flag]	false
Entity Shell Company	false
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
Entity Common Stock, Shares Outstanding		599.1
Entity Public Float			$ 5.5
Title of 12(b) Security	Common stock, par value $0.001 per share, of Medical Properties Trust, Inc.
Security Exchange Name	NYSE
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 Annual Report	true
Document Transition Report	false
Entity Interactive Data Current	Yes
Auditor Name	PricewaterhouseCoopers LLP
Auditor Location	Birmingham, Alabama
Auditor Firm ID	238
Document Type	10-K
Documents Incorporated by Reference	Portions of the definitive Proxy Statement of Medical Properties Trust, Inc. for the Annual Meeting of Stockholders to be held on May 30, 2024 are incorporated by reference into Items 10 through 14 of Part III, of this Annual Report on Form 10-K.
MPT Operating Partnership, L.P. [Member]
Document Information [Line Items]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2023
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	FY
Entity Registrant Name	MPT Operating Partnership, L.P.
Entity Central Index Key	0001524607
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	Yes
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Filer Category	Non-accelerated Filer
Document Financial Statement Error Correction [Flag]	false
Entity Shell Company	false
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
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
Entity Interactive Data Current	Yes
Auditor Name	PricewaterhouseCoopers LLP
Auditor Location	Birmingham, Alabama
Auditor Firm ID	238
Document Type	10-K

Income Taxes - Schedule of Per Share Distributions to Stockholders (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Common share distribution	$ 1.17	$ 1.15	$ 1.11
Ordinary dividend	1.0639	0.4703	0.7646
Long-term capital gain	0.1061	0.6797	0.1654
Return of capital			0.18
Total	$ 1.17	$ 1.15	$ 1.11

Real Estate and Other Activities - Prospect - Additional Information (Details) - USD ($) $ in Thousands		7 Months Ended	12 Months Ended
	May 23, 2023	Dec. 31, 2023	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Business Acquisition [Line Items]
Revenues			$ 871,799	$ 1,542,851	$ 1,544,669
Maximum [Member] \| PHP Holdings [Member]
Business Acquisition [Line Items]
First lien secured loan	$ 75,000
Prospect [Member]
Business Acquisition [Line Items]
Rental Revenue		$ 14,000
Revenues			96,000
Prospect [Member] \| PHP Holdings [Member]
Business Acquisition [Line Items]
Investment received in lieu of cash		82,000	82,000
Change in fair value adjustments		45,000
Investments		$ 700,000	$ 700,000

Real Estate and Other Activities - Alecto Healthcare Services LLC - Additional Information (Details) - Alecto Healthcare Services LLC [Member] - Texas [Member] $ in Millions	Jun. 16, 2023 USD ($) Property
Business Acquisition [Line Items]
Number of properties leased \| Property	1
Net book value of leased property \| $	$ 11

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

Dec. 31, 2023

Dec. 31, 2022

Dec. 31, 2021

Business Acquisition [Line Items]

Total assets acquired

$ 235,187

$ 1,332,962

$ 5,350,239

Liabilities assumed

(25,727)

(82,508)

Loans repaid

^[1]

(22,900)

(1,103,410)

Total net assets acquired

212,287

1,332,962

4,246,829

Land and Land Improvements [Member]

Business Acquisition [Line Items]

Total assets acquired

28,916

135,301

642,312

Building [Member]

Business Acquisition [Line Items]

Total assets acquired

114,966

487,698

2,381,654

Intangible Lease Assets [Member]

Business Acquisition [Line Items]

Total assets acquired

16,305

45,394

262,385

Mortgage Loans [Member]

Business Acquisition [Line Items]

Total assets acquired

^[1]

159,735

1,113,300

Other Loans [Member]

Business Acquisition [Line Items]

Total assets acquired

25,000

Investments in Unconsolidated Real Estate Joint Ventures [Member]

Business Acquisition [Line Items]

Total assets acquired

399,456

Investments In Unconsolidated Operating Entities [Member]

Business Acquisition [Line Items]

Total assets acquired

$ 50,000

$ 131,105

$ 1,033,096

[1]

Real Estate and Other Activities - Schedule of Concentrations of Credit Risk - (Details) - USD ($)
$ in Thousands

12 Months Ended

Dec. 31, 2023

Dec. 31, 2022

Dec. 31, 2021

Business Acquisition [Line Items]

Total Assets

$ 18,304,844

$ 19,658,000

Operator Concentration Risk [Member] | Total Gross Assets [Member]

Business Acquisition [Line Items]

Total Assets

^[1]

$ 18,304,844

$ 19,658,000

Percentage of concentration risk

100.00%

Operator Concentration Risk [Member] | Total Gross Assets [Member] | Other Assets [Member]

Business Acquisition [Line Items]

Percentage of concentration risk

11.00%

^[2]

8.20%

Operator Concentration Risk [Member] | Total Gross Assets [Member] | Steward [Member]

Business Acquisition [Line Items]

Total Assets

^[1]

$ 3,518,537

$ 4,762,673

Percentage of concentration risk

19.20%

24.20%

Operator Concentration Risk [Member] | Total Gross Assets [Member] | Circle [Member]

Business Acquisition [Line Items]

Total Assets

^[1]

$ 2,119,392

$ 2,062,474

Percentage of concentration risk

11.60%

10.50%

Operator Concentration Risk [Member] | Total Gross Assets [Member] | Prospect [Member]

Business Acquisition [Line Items]

Total Assets

^[1]

$ 1,092,974

$ 1,483,599

Percentage of concentration risk

6.00%

7.50%

Operator Concentration Risk [Member] | Total Gross Assets [Member] | Priory [Member]

Business Acquisition [Line Items]

Total Assets

^[1]

$ 1,391,005

$ 1,290,213

Percentage of concentration risk

7.60%

6.60%

Operator Concentration Risk [Member] | Total Gross Assets [Member] | Lifepoint Behavioral [Member]

Business Acquisition [Line Items]

Total Assets

^[1]

$ 813,527

$ 985,959

Percentage of concentration risk

4.40%

5.00%

Operator Concentration Risk [Member] | Total Gross Assets [Member] | Other Operators [Member]

Business Acquisition [Line Items]

Total Assets

^[1]

$ 7,352,012

$ 7,461,923

Percentage of concentration risk

40.20%

38.00%

Operator Concentration Risk [Member] | Total Gross Assets [Member] | Other Assets by Operator [Member]

Business Acquisition [Line Items]

Total Assets

^[1]

$ 2,017,397

$ 1,611,159

Geographic Concentration Risk [Member] | Total Gross Assets [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 18,304,844

$ 19,658,000

Percentage of concentration risk

^[3]

100.00%

Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Texas [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 1,891,482

$ 1,967,948

Percentage of concentration risk

^[3]

10.30%

10.00%

Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Florida [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 1,348,210

$ 1,324,555

Percentage of concentration risk

^[3]

7.40%

6.80%

Geographic Concentration Risk [Member] | Total Gross Assets [Member] | California [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 1,252,674

$ 1,450,112

Percentage of concentration risk

^[3]

6.80%

7.40%

Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Massachusetts [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 732,550

$ 761,694

Percentage of concentration risk

^[3]

4.00%

3.90%

Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Utah [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 824,048

$ 1,224,484

Percentage of concentration risk

^[3]

4.50%

6.20%

Geographic Concentration Risk [Member] | Total Gross Assets [Member] | All Other States [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 3,726,145

$ 4,245,306

Percentage of concentration risk

^[3]

20.40%

21.60%

Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Other Domestic Assets [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 1,397,170

$ 1,028,946

Percentage of concentration risk

^[3]

7.60%

5.20%

Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Total U.S. [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 11,172,279

$ 12,003,045

Percentage of concentration risk

^[3]

61.00%

61.10%

Geographic Concentration Risk [Member] | Total Gross Assets [Member] | United Kingdom [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 4,261,944

$ 4,083,244

Percentage of concentration risk

^[3]

23.30%

20.80%

Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Germany [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 734,630

$ 664,900

Percentage of concentration risk

^[3]

4.00%

3.40%

Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Switzerland [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 735,891

$ 748,947

Percentage of concentration risk

^[3]

4.00%

3.80%

Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Spain [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 252,529

$ 222,316

Percentage of concentration risk

^[3]

1.40%

1.10%

Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Finland [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 218,322

$ 224,152

Percentage of concentration risk

^[3]

1.20%

1.10%

Geographic Concentration Risk [Member] | Total Gross Assets [Member] | All Other Countries [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 309,022

$ 1,129,183

Percentage of concentration risk

^[3]

1.70%

5.70%

Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Other International Assets [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 620,227

$ 582,213

Percentage of concentration risk

^[3]

3.40%

3.00%

Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Total International [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 7,132,565

$ 7,654,955

Percentage of concentration risk

^[3]

39.00%

38.90%

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

Business Acquisition [Line Items]

Percentage of concentration risk

10.00%

Geographic Concentration Risk [Member] | Revenue [Member] | Circle [Member]

Business Acquisition [Line Items]

Percentage of concentration risk

10.00%

Geographic Concentration Risk [Member] | Revenue [Member] | Prospect [Member]

Business Acquisition [Line Items]

Percentage of concentration risk

10.00%

Customer Concentration Risk [Member] | Total Gross Assets [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 18,304,844

$ 19,658,000

Percentage of concentration risk

^[3]

100.00%

Customer Concentration Risk [Member] | Total Gross Assets [Member] | Other Assets [Member]

Business Acquisition [Line Items]

Percentage of concentration risk

^[3]

11.00%

8.20%

Customer Concentration Risk [Member] | Total Gross Assets [Member] | General Acute Care Hospitals [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 11,764,151

$ 13,386,376

Percentage of concentration risk

^[3]

64.30%

68.10%

Customer Concentration Risk [Member] | Total Gross Assets [Member] | Behavioral Health Facilities [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 2,576,983

$ 2,727,326

Percentage of concentration risk

^[3]

14.10%

13.90%

Customer Concentration Risk [Member] | Total Gross Assets [Member] | Inpatient Rehabilitation Hospital [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 1,445,399

$ 1,418,603

Percentage of concentration risk

^[3]

7.90%

7.20%

Customer Concentration Risk [Member] | Total Gross Assets [Member] | Long-term Acute Care Hospital [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 270,849

$ 277,772

Percentage of concentration risk

^[3]

1.50%

1.40%

Customer Concentration Risk [Member] | Total Gross Assets [Member] | Freestanding E R Urgent Care Facilities [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 230,065

$ 236,764

Percentage of concentration risk

^[3]

1.20%

Customer Concentration Risk [Member] | Total Gross Assets [Member] | Other Assets By Facility [Member]

Business Acquisition [Line Items]

Total Assets

^[3]

$ 2,017,397

$ 1,611,159

[1]	Total assets by operator are generally comprised of real estate assets, mortgage loans, investments in unconsolidated real estate joint ventures, investments in unconsolidated operating entities, and other loans.
[2]	Includes our investment in PHP Holdings of $700 million as part of the Prospect Transaction as further described in this same Note 3.
[3]	For geographic and facility type concentration metrics in the tables above, we allocate our investments in operating entities pro rata based on the gross book value of the real estate. Such pro rata allocations are subject to change from period to period.

Debt - Interest Rate Swaps - Additional Information (Detail) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Derivative asset	$ 43.0	$ 93.2
Derivative Asset, Statement of Financial Position [Extensible Enumeration]	Other Assets	Other Assets

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

- Definition

Fair value, after the effects of master netting arrangements, of a financial asset or other contract with one or more underlyings, notional amount or payment provision or both, and the contract can be net settled by means outside the contract or delivery of an asset. Includes assets not subject to a master netting arrangement and not elected to be offset.

+ References

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+ Details

Real Estate and Other Activities (Tables)

12 Months Ended

Dec. 31, 2023

Real Estate [Abstract]

Net Assets Acquired

For the years ended December 31, 2023, 2022, and 2021, we acquired or invested in the following net assets (in thousands):


	2023			2022			2021
Land and land improvements	$	28,916		$	135,301		$	642,312
Buildings		114,966			487,698			2,381,654
Intangible lease assets — subject to amortization (weighted-average useful life of 24.8 years in 2023, 21.3 years in 2022, and 34.5 years in 2021)		16,305			45,394			262,385
Mortgage loans(1)		—			159,735			1,113,300
Investments in unconsolidated real estate joint ventures		—			399,456			—
Investments in unconsolidated operating entities		50,000			131,105			1,033,096
Other loans		25,000			—			—
Liabilities assumed		—			(25,727	)		(82,508	)
	$	235,187		$	1,332,962		$	5,350,239
Loans repaid(1)		(22,900	)		—			(1,103,410	)
Total net assets acquired	$	212,287		$	1,332,962		$	4,246,829

(1)

Summary of Status on Current Development Projects

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


Property	Commitment		Costs Incurred as of December 31, 2023		Estimated Rent Commencement Date
IMED (Spain)	$	50,099	$	49,534	1Q 2024
Lifepoint Behavioral Health (Texas)		31,600		24,023	1Q 2024
IMED (Spain)		37,879		17,876	3Q 2024
IMED (Spain)		51,984		18,640	1Q 2025
	$	171,562	$	110,073

Summary of Operating Results from Properties

The following represents the operating results from properties sold for the periods presented (in thousands):


	For the Year Ended December 31,
	2023			2022			2021
Revenues	$	37,332		$	75,084		$	75,464
Real estate depreciation and amortization		(4,991	)		(20,312	)		(21,467	)
Property-related expenses		(2,467	)		(5,492	)		(3,479	)
Real estate and other impairment charges(1)		(96,405	)		—			—
Other (expense) income		(1,661	)		(1,082	)		(1,075	)
(Loss) income from real estate dispositions, net	$	(68,192	)	$	48,198		$	49,443

(1)

Includes an approximate $86 million net impairment charge (including $37.4 million of straight-line rent write-offs) associated with the Australia Transaction and an approximate $11 million impairment charge associated with the repurchase of three Prime facilities.

Amortization Expense from Existing Lease Intangible Assets

We recorded amortization expense related to intangible lease assets of $332.5 million (including $286 million for accelerating the amortization of the in-place lease intangibles related to the Utah properties associated with the Steward Utah Transaction as described in this same Note 3), $55.9 million, and $56.0 million in 2023, 2022, and 2021, respectively, and expect to recognize amortization expense from existing lease intangible assets as follows (amounts in thousands):


For the Year Ended December 31:
2024	$	40,934
2025		40,081
2026		39,933
2027		39,664
2028		39,330

Summary of Total Future Minimum Lease Payments to be Received

The following table summarizes total future minimum lease payments to be received, excluding operating expense reimbursements, tenant recoveries, and other lease/loan-related adjustments to revenue (i.e., straight-line rents, deferred revenues, or reserves/write-offs), from tenants under noncancelable leases as of December 31, 2023 (amounts in thousands):


	Total Under Operating Leases		Total Under Financing Leases		Total
2024	$	979,053	$	111,929	$	1,090,982
2025		994,198		114,224		1,108,422
2026		1,010,217		116,566		1,126,783
2027		1,064,958		118,954		1,183,912
2028		1,077,981		121,390		1,199,371
Thereafter		25,489,598		3,079,714		28,569,312
	$	30,616,005	$	3,662,777	$	34,278,782

Components of Total Investment in Financing Leases

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


	As of December 31, 2023			As of December 31, 2022
Minimum lease payments receivable	$	611,669		$	880,253
Estimated unguaranteed residual values		203,818			203,818
Less: Unearned income and allowance for credit loss		(571,059	)		(731,915	)
Net investment in direct financing leases		244,428			352,156
Other financing leases (net of allowance for credit loss)		987,202			1,339,167
Total investment in financing leases	$	1,231,630		$	1,691,323

Summary of Details Related to Investments [Table Text Block]

Due to the operational and liquidity challenges that Steward is facing, we moved to the cash basis of accounting for our leases and loans with Steward effective December 31, 2023. This resulted in the reserving of all unpaid rent and interest receivables at December 31, 2023 and the reversal of previously recognized straight-line rent receivables. See table below for a detail of these and other charges recorded related to our investments in Steward in the 2023 fourth quarter (in millions):


Description	Amount		Income Statement Classification
Reserve of unpaid rent and lease incentives	$	154	Rent billed
Reserve of straight-line rent receivables		224	Straight-line rent
Reserve of unpaid interest receivables		35	Interest and other income
Impairment charge on equity investment and other assets (1)		171	Real estate and other impairment charges, net
Impairment charge on real estate assets (2)		100	Real estate and other impairment charges, net
Reserve of unpaid rent and straight-line rent receivables in the MAM partnership		30	Earnings from equity interests
Total	$	714

(1)

(2)

Summary of Investments in Unconsolidated Operating Entities

The following is a summary of our investments in unconsolidated real estate joint ventures by operator (amounts in thousands):


Operator	Ownership Percentage	As of December 31, 2023		As of December 31, 2022
Swiss Medical Network	70%	$	472,434	$	454,083
MEDIAN	50%		471,336		482,735
Steward (Macquarie Transaction)	50%		394,052		417,701
Policlinico di Monza	50%		80,562		86,245
HM Hospitales	45%		56,071		57,139
Total		$	1,474,455	$	1,497,903

The following is a summary of our investments in unconsolidated operating entities (amounts in thousands):


Operator	As of December 31, 2023		As of December 31, 2022
PHP Holdings	$	699,535	$	—
Steward (loan investment)		361,591		362,831
International joint venture		225,960		231,402
Swiss Medical Network		186,113		157,145
Priory		163,837		156,575
Aevis Victoria SA ("Aevis")		77,345		72,904
Steward (equity investment)		35,696		125,862
Aspris Children's Services ("Aspris")		15,986		16,023
Lifepoint Behavioral		11,429		200,827
Caremax		1,148		8,526
Prospect		—		112,777
Total	$	1,778,640	$	1,444,872

Schedule of Concentrations of Credit Risk

See below for our concentration details (dollars in thousands):

Total Assets by Operator


	As of December 31, 2023						As of December 31, 2022
Operators	Total Assets (1)			Percentage of Total Assets			Total Assets (1)		Percentage of Total Assets
Steward	$	3,518,537			19.2	%	$	4,762,673		24.2	%
Circle		2,119,392			11.6	%		2,062,474		10.5	%
Priory		1,391,005			7.6	%		1,290,213		6.6	%
Prospect		1,092,974			6.0	%		1,483,599		7.5	%
Lifepoint Behavioral Health		813,527			4.4	%		985,959		5.0	%
Other operators		7,352,012			40.2	%		7,461,923		38.0	%
Other assets		2,017,397	(2)		11.0	%		1,611,159		8.2	%
Total	$	18,304,844			100.0	%	$	19,658,000		100.0	%

(1)

Total assets by operator are generally comprised of real estate assets, mortgage loans, investments in unconsolidated real estate joint ventures, investments in unconsolidated operating entities, and other loans.

(2)

Includes our investment in PHP Holdings of $700 million as part of the Prospect Transaction as further described in this same Note 3.

Total Assets by U.S. State and Country (a)


	As of December 31, 2023					As of December 31, 2022
U.S. States and Other Countries	Total Assets		Percentage of Total Assets			Total Assets		Percentage of Total Assets
Texas	$	1,891,482		10.3	%	$	1,967,948		10.0	%
Florida		1,348,210		7.4	%		1,324,555		6.8	%
California		1,252,674		6.8	%		1,450,112		7.4	%
Utah		824,048		4.5	%		1,224,484		6.2	%
Massachusetts		732,550		4.0	%		761,694		3.9	%
All other states		3,726,145		20.4	%		4,245,306		21.6	%
Other domestic assets		1,397,170		7.6	%		1,028,946		5.2	%
Total U.S.	$	11,172,279		61.0	%	$	12,003,045		61.1	%
United Kingdom	$	4,261,944		23.3	%	$	4,083,244		20.8	%
Switzerland		735,891		4.0	%		748,947		3.8	%
Germany		734,630		4.0	%		664,900		3.4	%
Spain		252,529		1.4	%		222,316		1.1	%
Finland		218,322		1.2	%		224,152		1.1	%
All other countries		309,022		1.7	%		1,129,183		5.7	%
Other international assets		620,227		3.4	%		582,213		3.0	%
Total international	$	7,132,565		39.0	%	$	7,654,955		38.9	%
Grand total	$	18,304,844		100.0	%	$	19,658,000		100.0	%

Total Assets by Facility Type (a)


	As of December 31, 2023					As of December 31, 2022
Facility Types	Total Assets		Percentage of Total Assets			Total Assets		Percentage of Total Assets
General acute care hospitals	$	11,764,151		64.3	%	$	13,386,376		68.1	%
Behavioral health facilities		2,576,983		14.1	%		2,727,326		13.9	%
Inpatient rehabilitation hospitals		1,445,399		7.9	%		1,418,603		7.2	%
Long-term acute care hospitals		270,849		1.5	%		277,772		1.4	%
Freestanding ER/urgent care facilities		230,065		1.2	%		236,764		1.2	%
Other assets		2,017,397		11.0	%		1,611,159		8.2	%
Total	$	18,304,844		100.0	%	$	19,658,000		100.0	%

(a)

For geographic and facility type concentration metrics in the tables above, we allocate our investments in operating entities pro rata based on the gross book value of the real estate. Such pro rata allocations are subject to change from period to period.

Other Assets - Additional Information (Detail) $ in Millions	12 Months Ended
	Dec. 31, 2023 USD ($)
Other Assets [Abstract]
Corporate funding	$ 150

Stock Awards - Stock-based Award Activity (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Vesting Based on Service [Member]
Employee Restricted Equity Awards Vesting Activity [Line Items]
Nonvested awards at beginning of the year, Shares	810,483	922,954
Awarded, Shares	1,210,448	659,393
Vested, Shares	(864,482)	(750,854)
Forfeited, Shares	(11,653)	(21,010)
Nonvested awards at end of year, Shares	1,144,796	810,483
Nonvested awards at beginning of the year, Weighted Average Value at Award Date	$ 21.02	$ 20.26
Awarded, Weighted Average Value at Award Date	10.36	21.18
Vested, Weighted Average Value at Award Date	16.60	20.25
Forfeited, Weighted Average Value at Award Date	12.27	20.06
Nonvested awards at end of year, Weighted Average Value at Award Date	$ 13.01	$ 21.02
Vesting Based on Market/Performance Conditions [Member]
Employee Restricted Equity Awards Vesting Activity [Line Items]
Nonvested awards at beginning of the year, Shares	4,349,081	5,477,536
Awarded, Shares	10,270,260	1,828,971
Vested, Shares	(1,591,846)	(2,924,722)
Forfeited, Shares	(450,703)	(32,704)
Nonvested awards at end of year, Shares	12,576,792	4,349,081
Nonvested awards at beginning of the year, Weighted Average Value at Award Date	$ 18.26	$ 15.86
Awarded, Weighted Average Value at Award Date	8.47	18.45
Vested, Weighted Average Value at Award Date	19.65	13.87
Forfeited, Weighted Average Value at Award Date	12.44	19.17
Nonvested awards at end of year, Weighted Average Value at Award Date	$ 10.20	$ 18.26

Summary of Significant Accounting Policies - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Significant Accounting Policies [Line Items]
Threshold ownership percentage for inter company balances and transactions elimination	100.00%
Expected lease-up periods for estimating lost rentals, in months	6 months
Percentage of ordinary taxable income to be distributed for real estate investment trust qualification	90.00%	90.00%	90.00%
Number of years of federal income tax at corporate rates on failure to qualify as REIT	4 years
Real estate and other impairment charges, net	$ 376,907	$ 268,375	$ 39,411
Minimum percentage of reconciling items quantitative threshold of the statutory tax	5.00%
Time-Based Awards [Member]
Significant Accounting Policies [Line Items]
Stock award service period in years	3 years
Market Conditions Based Awards [Member] \| Minimum [Member]
Significant Accounting Policies [Line Items]
Stock award service period in years	3 years
Market Conditions Based Awards [Member] \| Maximum [Member]
Significant Accounting Policies [Line Items]
Stock award service period in years	5 years

Schedule III - Changes in Accumulated Depreciation (Parenthetical) (Detail) $ in Millions	Dec. 31, 2023 USD ($)
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]
Construction and building improvements in progress	$ 400

Real Estate and Other Activities - 2023 Activity - Additional Information (Detail) $ in Thousands, £ in Millions						1 Months Ended	3 Months Ended			12 Months Ended
	May 23, 2023 USD ($)	Apr. 14, 2023 GBP (£) Facility	Feb. 07, 2023 USD ($) Facility	Jul. 29, 2022 USD ($)	Apr. 25, 2022 USD ($) Facility	Aug. 31, 2019 USD ($) Hospital	Jun. 30, 2023 GBP (£) Facility	Mar. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($) Facility	Jun. 30, 2022 USD ($)	Dec. 31, 2021 USD ($)
Business Acquisition [Line Items]
Net impairment charge								$ 86,000
Additional mortgage loan									$ 1,332,962	$ 235,187	$ 1,332,962		$ 5,350,239
PHP Holdings [Member]
Business Acquisition [Line Items]
Capital restructuring costs										654,000
Equity investment										68,000
Convertible loan										$ 586,000
PHP Holdings [Member] \| Maximum [Member]
Business Acquisition [Line Items]
First lien secured loan	$ 75,000
Prospect [Member]
Business Acquisition [Line Items]
Purchase price of acquisition						$ 1,500,000
Term loan						$ 112,900
Net impairment charge									280,000
Additional mortgage loan												$ 100,000
Investment, Type [Extensible Enumeration]										Mortgage Loans [Member]
Pay down of debt instruments	375,000
Reconstitution of asset	1,700,000
Prospect [Member] \| Maximum [Member]
Business Acquisition [Line Items]
First lien secured loan	75,000
Prospect [Member] \| Acute Care Campus [Member]
Business Acquisition [Line Items]
Number of facilities acquired \| Hospital						14
Prospect [Member] \| Mortgage Loans [Member]
Business Acquisition [Line Items]
First lien secured loan	150,000
Prospect [Member] \| PHP Holdings [Member]
Business Acquisition [Line Items]
Revenue for rent and interest										$ 82,000
Unpaid rent and interest	112,900
Convertible loan								$ 50,000
Prospect [Member] \| PHP Holdings [Member] \| Mortgage Loans [Member]
Business Acquisition [Line Items]
Unpaid rent and interest	$ 151,000									151,000
Prospect [Member] \| Pennsylvania [Member]
Business Acquisition [Line Items]
Carrying value of lease requiring residual value guarantee									170,000		170,000
Unbilled rent accruals										$ 112,000
Prospect [Member] \| Pennsylvania [Member] \| Maximum [Member]
Business Acquisition [Line Items]
Carrying value of lease requiring residual value guarantee									$ 250,000		$ 250,000
General Acute Care Hospitals [Member]
Business Acquisition [Line Items]
Purchase price of acquisition				$ 26,000	$ 80,000
Number of facilities acquired \| Facility			8		2						6
Lease extension expiration term			5 years
Lease extension expiration year			2041
Behavioral Health Hospitals [Member]
Business Acquisition [Line Items]
Number of facilities acquired \| Facility		5					3
Payment for acquisition \| £		£ 44					£ 70
Number of leased facilities \| Facility		5
Springstone Health Opco, LLC [Member]
Business Acquisition [Line Items]
Purchase price of acquisition			$ 250,000
Additional mortgage loan			$ 205,000
Springstone Health Opco, LLC [Member] \| Behavioral Health Hospitals [Member]
Business Acquisition [Line Items]
Number of facilities acquired \| Facility			18

Earnings Per Share/Unit - Calculation of Earnings Per Share (Detail) - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Net (loss) income	$ (556,092)	$ 903,819	$ 656,940
Non-controlling interests’ share in earnings	(384)	(1,222)	(919)
Participating securities’ share in earnings	(1,644)	(1,602)	(2,161)
Net (loss) income, less participating securities' share in earnings	$ (558,120)	$ 900,995	$ 653,860
Basic weighted-average common shares	598,518	598,634	588,817
Dilutive potential common shares		203	1,322
Diluted weighted-average common shares	598,518	598,837	590,139
MPT Operating Partnership, L.P. [Member]
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Net (loss) income	$ (556,092)	$ 903,819	$ 656,940
Non-controlling interests’ share in earnings	(384)	(1,222)	(919)
Participating securities’ share in earnings	(1,644)	(1,602)	(2,161)
Net (loss) income, less participating securities' share in earnings	$ (558,120)	$ 900,995	$ 653,860
Basic weighted-average common shares	598,518	598,634	588,817
Dilutive potential common shares		203	1,322
Diluted weighted-average common shares	598,518	598,837	590,139

- Definition

Amount of Net Income (Loss) attributable to noncontrolling interest.

+ References + Details

- 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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+ Details

Stock Awards (Tables)

12 Months Ended

Dec. 31, 2023

Share-Based Payment Arrangement [Abstract]

Stock-based Award Activity

The following summarizes stock-based award activity in 2023 and 2022 (which includes awards granted in 2023, 2022, and any applicable prior years), respectively:

For the Year Ended December 31, 2023:


	Vesting Based on Service					Vesting Based on Market/Performance Conditions
	Shares			Weighted-Average Value at Award Date		Shares			Weighted-Average Value at Award Date
Nonvested awards at beginning of the year		810,483		$	21.02		4,349,081		$	18.26
Awarded		1,210,448		$	10.36		10,270,260		$	8.47
Vested		(864,482	)	$	16.60		(1,591,846	)	$	19.65
Forfeited		(11,653	)	$	12.27		(450,703	)	$	12.44
Nonvested awards at end of year		1,144,796		$	13.01		12,576,792		$	10.20

For the Year Ended December 31, 2022:


	Vesting Based on Service					Vesting Based on Market/Performance Conditions
	Shares			Weighted-Average Value at Award Date		Shares			Weighted-Average Value at Award Date
Nonvested awards at beginning of the year		922,954		$	20.26		5,477,536		$	15.86
Awarded		659,393		$	21.18		1,828,971		$	18.45
Vested		(750,854	)	$	20.25		(2,924,722	)	$	13.87
Forfeited		(21,010	)	$	20.06		(32,704	)	$	19.17
Nonvested awards at end of year		810,483		$	21.02		4,349,081		$	18.26

Real Estate and Other Activities - 2021 Activity - Additional Information (Detail) € in Millions, £ in Millions, SFr in Millions, $ in Millions														12 Months Ended
	May 01, 2023 Facility	Feb. 07, 2023 Facility	Jul. 29, 2022 USD ($)	Apr. 25, 2022 USD ($) Facility	Mar. 14, 2022 USD ($) Facility	Dec. 02, 2021 EUR (€)	Oct. 21, 2021 EUR (€)	Oct. 19, 2021 USD ($)	Aug. 01, 2021 USD ($) Hospital	Jul. 06, 2021 GBP (£) Hospital	Jul. 06, 2021 USD ($) Hospital	Jun. 25, 2021 GBP (£) Property	Jan. 19, 2021 GBP (£)	Dec. 31, 2022 Facility	Mar. 11, 2022 USD ($)	Jun. 30, 2021 Property	Apr. 16, 2021 CHF (SFr)	Jan. 08, 2021 USD ($)
Business Acquisition [Line Items]
Deferred income tax liabilities and other liabilities, incurred															$ 26.0
General Acute Care Hospitals [Member]
Business Acquisition [Line Items]
Purchase price of acquisition			$ 26.0	$ 80.0
Number of facilities acquired \| Facility		8		2										6
Lease extension expiration term		5 years
Lease extension expiration year		2041
Swiss Medical Network [Member]
Business Acquisition [Line Items]
Equity investment \| SFr																	SFr 145
Massachusetts Based General Acute Care Hospitals [Member]
Business Acquisition [Line Items]
Purchase price of acquisition					$ 1,700.0
Nonrecourse Secured Debt Percentage Of Asset Value					55.00%
Number of facilities acquired \| Facility					8
Lease extension expiration year					2041
Portugal [Member] \| Acute Care Hospital [Member]
Business Acquisition [Line Items]
Purchase price of acquisition \| €							€ 17.8
Florida [Member] \| General Acute Care Hospitals [Member]
Business Acquisition [Line Items]
Purchase price of acquisition									$ 900.0
Number of facilities acquired \| Hospital									5
Los Angeles, California [Member] \| Acute Care Hospital [Member]
Business Acquisition [Line Items]
Number of facilities acquired \| Hospital										4	4
Los Angeles, California [Member] \| On Campus Medical Office Buildings [Member]
Business Acquisition [Line Items]
Number of facilities acquired \| Hospital										2	2
Los Angeles, California [Member] \| Acute Care Hospital and On Campus Medical Office Buildings [Member]
Business Acquisition [Line Items]
Purchase price of acquisition											$ 215.0
Stirling, Scotland [Member] \| Acute Care Hospital [Member]
Business Acquisition [Line Items]
Purchase price of acquisition \| £										£ 15.6
General Acute Hospital [Member] \| Valencia, Spain [Member]
Business Acquisition [Line Items]
Purchase price of acquisition \| €						€ 46.0
Ownership interest						50.00%
Priory Group [Member]
Business Acquisition [Line Items]
Number of real estate assets acquired \| Property																35
Deferred income tax liabilities and other liabilities, incurred \| £												£ 47.1
Waterland Fund [Member]
Business Acquisition [Line Items]
Number of real estate assets acquired \| Property												35
Payment for acquisition \| £												£ 800.0
Purchase price of acquisition loan \| £													£ 250.0
Waterland Fund [Member] \| United Kingdom [Member]
Business Acquisition [Line Items]
Purchase price of acquisition \| £													£ 800.0
Waterland Fund [Member] \| Waterland Private Equity Fund Affiliate [Member]
Business Acquisition [Line Items]
Ownership interest													9.90%
Springstone Inc. [Member]
Business Acquisition [Line Items]
Purchase price of acquisition								$ 185.0
Consideration of other transaction costs								950.0
Incurred deferred income tax liabilities								$ 8.0
Steward Health Care System LLC [Member]
Business Acquisition [Line Items]
Number of facilities acquired \| Facility	5
Other loan to affiliates																		$ 335.0

Real Estate and Other Activities - Summary of Total Future Minimum Lease Payments to be Received (Detail) $ in Thousands	Dec. 31, 2023 USD ($)
Lessor Lease Description [Line Items]
2024	$ 1,090,982
2025	1,108,422
2026	1,126,783
2027	1,183,912
2028	1,199,371
Thereafter	28,569,312
Future minimum lease payments to be received	34,278,782
Operating Leases [Member]
Lessor Lease Description [Line Items]
2024	979,053
2025	994,198
2026	1,010,217
2027	1,064,958
2028	1,077,981
Thereafter	25,489,598
Future minimum lease payments to be received	30,616,005
Financing Leases [Member]
Lessor Lease Description [Line Items]
2024	111,929
2025	114,224
2026	116,566
2027	118,954
2028	121,390
Thereafter	3,079,714
Future minimum lease payments to be received	$ 3,662,777

Earnings Per Share/Unit

12 Months Ended

Dec. 31, 2023

Earnings Per Share [Abstract]

Earnings Per Share/Unit

6. Earnings Per Share/Unit

Medical Properties Trust, Inc.

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


	For the Years Ended December 31,
	2023			2022			2021
Numerator:
Net (loss) income	$	(556,092	)	$	903,819		$	656,940
Non-controlling interests’ share in earnings		(384	)		(1,222	)		(919	)
Participating securities’ share in earnings		(1,644	)		(1,602	)		(2,161	)
Net (loss) income, less participating securities’ share in earnings	$	(558,120	)	$	900,995		$	653,860
Denominator:
Basic weighted-average common shares		598,518			598,634			588,817
Dilutive potential common shares(1)		—			203			1,322
Diluted weighted-average common shares		598,518			598,837			590,139

MPT Operating Partnership, L.P.

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


	For the Years Ended December 31,
	2023			2022			2021
Numerator:
Net (loss) income	$	(556,092	)	$	903,819		$	656,940
Non-controlling interests’ share in earnings		(384	)		(1,222	)		(919	)
Participating securities’ share in earnings		(1,644	)		(1,602	)		(2,161	)
Net (loss) income, less participating securities’ share in earnings	$	(558,120	)	$	900,995		$	653,860
Denominator:
Basic weighted-average units		598,518			598,634			588,817
Dilutive potential units(1)		—			203			1,322
Diluted weighted-average units		598,518			598,837			590,139

(1)

The above computation of diluted earnings per share does not include 32,382 potential common shares/units as inclusion of these shares when a loss exists would be antidilutive.

Debt (Tables)

12 Months Ended

Dec. 31, 2023

Debt Disclosure [Abstract]

Summary of Debt

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


	As of December 31, 2023			As of December 31, 2022
Revolving credit facility(A)	$	1,514,420		$	929,584
Term loan		200,000			200,000
British pound sterling secured term loan due 2024(B)		133,484			126,690
British pound sterling term loan due 2025(B)		891,170			845,810
Australian term loan facility(B)		320,164			817,560
2.550% Senior Unsecured Notes due 2023(B)		—			483,320
3.325% Senior Unsecured Notes due 2025(B)		551,950			535,250
0.993% Senior Unsecured Notes due 2026(B)		551,950			535,250
2.500% Senior Unsecured Notes due 2026(B)		636,550			604,150
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)		763,860			724,980
4.625% Senior Unsecured Notes due 2029		900,000			900,000
3.375% Senior Unsecured Notes due 2030(B)		445,585			422,905
3.500% Senior Unsecured Notes due 2031		1,300,000			1,300,000
	$	10,109,133		$	10,325,499
Debt issue costs and discount, net		(44,897	)		(57,087	)
	$	10,064,236		$	10,268,412

(A)

Includes £322 million of GBP-denominated borrowings and €303 million of Euro-denominated borrowings that reflect the applicable exchange rates at December 31, 2023.

(B)

Non-U.S. dollar denominated debt that reflects the exchange rates at period-end.

Principal Payments Due on Debt

As of December 31, 2023, 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):


2024	$	453,648
2025		1,443,120
2026		3,202,920
2027		1,600,000
2028		763,860
Thereafter		2,645,585
Total	$	10,109,133

Basic Terms of Senior Unsecured Notes

The following are the basic terms of our senior unsecured notes at December 31, 2023 (par value amounts in thousands):


	Offering Completion Date	Maturity Date	Par Value		% of Par Value			Interest Payment Frequency
3.325% Senior Unsecured Notes due 2025	March 24, 2017	March 24, 2025	€	500,000		100.000	%	Annually
0.993% Senior Unsecured Notes due 2026	October 6, 2021	October 15, 2026	€	500,000		100.000	%	Annually
2.500% Senior Unsecured Notes due 2026	March 24, 2021	March 24, 2026	£	500,000		99.937	%	Annually
5.250% Senior Unsecured Notes due 2026	July 22, 2016	August 1, 2026	$	500,000		100.000	%	Semi-annually
5.000% Senior Unsecured Notes due 2027	September 7, 2017	October 15, 2027	$	1,400,000		100.000	%	Semi-annually
3.692% Senior Unsecured Notes due 2028	December 5, 2019	June 5, 2028	£	600,000		99.998	%	Annually
4.625% Senior Unsecured Notes due 2029	July 26, 2019	August 1, 2029	$	900,000		99.500	%	Semi-annually
3.375% Senior Unsecured Notes due 2030	March 24, 2021	April 24, 2030	£	350,000		99.448	%	Annually
3.500% Senior Unsecured Notes due 2031	December 4, 2020	March 15, 2031	$	1,300,000		100.000	%	Semi-annually

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
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Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 235
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-Name Accounting Standards Codification
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-Paragraph 3
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+ Details

Real Estate and Other Activities - Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Jun. 30, 2023	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Business Acquisition [Line Items]
Intangible lease assets		$ 1,034,810	$ 1,394,471
Accumulated amortization, net		900,000	1,200,000
Amortization expense related to intangible lease assets		$ 332,500	$ 55,900	$ 56,000
Capitalized lease intangibles, weighted average life (in years)		24 years
In-place lease intangibles [Member]
Business Acquisition [Line Items]
Amortization of Intangible Assets	$ 286,000	$ 286,000

Real Estate and Other Activities - Concentration of Credit Risks and Related Party Transactions - Additional Information (Detail) - USD ($)
$ in Millions

12 Months Ended

Dec. 31, 2023

Dec. 31, 2022

Dec. 31, 2021

Related Party Transactions [Member]

Business Acquisition [Line Items]

Revenues earned from tenants

$ 83.0

$ 135.5

$ 63.9

Total Gross Assets [Member] | Customer Concentration Risk [Member]

Business Acquisition [Line Items]

Maximum percentage of entity's assets invested on single property

2.00%

Percentage of concentration risk

^[1]

100.00%

Total Gross Assets [Member] | Customer Concentration Risk [Member] | Behavioral health facilities

Business Acquisition [Line Items]

Percentage of concentration risk

^[1]

14.10%

13.90%

Total Gross Assets [Member] | Customer Concentration Risk [Member] | Long Term Acute Care Hospital

Business Acquisition [Line Items]

Percentage of concentration risk

^[1]

1.50%

1.40%

Total Gross Assets [Member] | Operator Concentration Risk [Member]

Business Acquisition [Line Items]

Percentage of concentration risk

100.00%

Total Gross Assets [Member] | Operator Concentration Risk [Member] | Steward Health Care System LLC [Member]

Business Acquisition [Line Items]

Percentage of concentration risk

19.20%

24.20%

Total Gross Assets [Member] | Operator Concentration Risk [Member] | Circle [Member]

Business Acquisition [Line Items]

Percentage of concentration risk

11.60%

10.50%

Total Gross Assets [Member] | Operator Concentration Risk [Member] | Prospect [Member]

Business Acquisition [Line Items]

Percentage of concentration risk

6.00%

7.50%

Total Gross Assets [Member] | Geographic Concentration [Member]

Business Acquisition [Line Items]

Percentage of concentration risk

^[1]

100.00%

Total Gross Assets [Member] | Geographic Concentration [Member] | U.S. [Member]

Business Acquisition [Line Items]

Percentage of concentration risk

^[1]

61.00%

61.10%

Revenue [Member] | Geographic Concentration [Member] | Steward Health Care System LLC [Member]

Business Acquisition [Line Items]

Percentage of concentration risk

10.00%

Revenue [Member] | Geographic Concentration [Member] | Circle [Member]

Business Acquisition [Line Items]

Percentage of concentration risk

10.00%

Revenue [Member] | Geographic Concentration [Member] | Prospect [Member]

Business Acquisition [Line Items]

Percentage of concentration risk

10.00%

[1]	For geographic and facility type concentration metrics in the tables above, we allocate our investments in operating entities pro rata based on the gross book value of the real estate. Such pro rata allocations are subject to change from period to period.

Subsequent Events - Additional Information (Detail) £ in Millions, $ in Millions					3 Months Ended	12 Months Ended
	Feb. 29, 2024 GBP (£)	Feb. 29, 2024 USD ($)	Feb. 19, 2024 USD ($) Property	Sep. 01, 2022 USD ($) Property	Dec. 31, 2021 USD ($)	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)	Jan. 31, 2024 USD ($)
Subsequent Event [Line Items]
Proceeds from sale of facilities					$ 54.5	$ 522.0	$ 246.0
Gain (loss) on real estate dispositions					$ 40.0	$ 100.0	$ 52.5
Prime Healthcare Services, Inc. Facilities [Member]
Subsequent Event [Line Items]
Number of properties sold \| Property				11
Proceeds from sale of facilities				$ 366.0
Subsequent Event [Member] \| Priory [Member]
Subsequent Event [Line Items]
Proceeds from sale of noncontrolling interests in tenant and hospitals		$ 17.0
Economic loss on sale of term loan		6.0
Proceed from sale of interest in syndicated term loan	£ 90	115.0
Subsequent Event [Member] \| Prime Healthcare Services, Inc. Facilities [Member]
Subsequent Event [Line Items]
Number of properties sold \| Property			5
Proceeds from sale of facilities			$ 250.0
Gain (loss) on real estate dispositions			50.0
Proceeds from interest-bearing mortgage loan			100.0
Non-cash straight-line rent write-offs			28.0
Lease purchase option value			$ 260.0
Subsequent Event [Member] \| Prime Healthcare Services, Inc. Facilities [Member] \| Minimum [Member]
Subsequent Event [Line Items]
Inflation-based percentage for amended lease			2.00%
Subsequent Event [Member] \| Prime Healthcare Services, Inc. Facilities [Member] \| Maximum [Member]
Subsequent Event [Line Items]
Inflation-based percentage for amended lease			4.00%
Subsequent Event [Member] \| Steward [Member]
Subsequent Event [Line Items]
Bridge Loan								$ 60.0
Loan facility funded shares		$ 37.5

Schedule III - Real Estate Investments and Accumulated Depreciation (Detail) - USD ($)
$ in Thousands

12 Months Ended

Dec. 31, 2023

Dec. 31, 2022

Dec. 31, 2021

Dec. 31, 2020

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Initial costs, land

$ 1,805,286

Initial costs, buildings

9,493,186

Additions subsequent to acquisition, Improvements

514,703

Land at cost

1,806,765

Buildings at cost

10,006,410

Total at cost

11,813,175

^[1]

$ 12,300,524

$ 13,628,749

$ 10,749,707

Accumulated Depreciation

$ 1,227,619

1,008,340

Princes Risborough, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

$ 4,662

4,662

4,662

$ 0

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1981 [Member] | Ashtead, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 37,762

Initial costs, buildings

70,798

Land at cost

37,762

Buildings at cost

70,798

Total at cost

108,560

Accumulated Depreciation

8,016

Encumbrances

$ 0

Date of Construction

1981

Date Acquired

Aug. 16, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

1981 [Member] | Beckenham, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 5,462

Initial costs, buildings

20,948

Land at cost

5,462

Buildings at cost

20,948

Total at cost

26,410

Accumulated Depreciation

2,108

Encumbrances

$ 0

Date of Construction

1981

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1981 [Member] | Cheadle, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 30,936

Initial costs, buildings

162,963

Land at cost

30,936

Buildings at cost

162,963

Total at cost

193,899

Accumulated Depreciation

16,398

Encumbrances

$ 0

Date of Construction

1981

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1981 [Member] | Croydon, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 9,943

Initial costs, buildings

41,706

Land at cost

9,943

Buildings at cost

41,706

Total at cost

51,649

Accumulated Depreciation

4,225

Encumbrances

$ 0

Date of Construction

1981

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1981 [Member] | Dorchester, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 539

Initial costs, buildings

31,341

Land at cost

539

Buildings at cost

31,341

Total at cost

31,880

Accumulated Depreciation

3,149

Encumbrances

$ 0

Date of Construction

1981

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1981 [Member] | Euxton, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 4,617

Initial costs, buildings

35,560

Land at cost

4,617

Buildings at cost

35,560

Total at cost

40,177

Accumulated Depreciation

4,145

Encumbrances

$ 0

Date of Construction

1981

Date Acquired

Aug. 16, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

1981 [Member] | Great Missenden, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 11,770

Initial costs, buildings

105,167

Land at cost

11,770

Buildings at cost

105,167

Total at cost

116,937

Accumulated Depreciation

10,600

Encumbrances

$ 0

Date of Construction

1981

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1981 [Member] | Torquay, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 2,981

Initial costs, buildings

35,743

Land at cost

38,724

Buildings at cost

35,743

Total at cost

2,981

Accumulated Depreciation

3,993

Encumbrances

$ 0

Date of Construction

1981

Date Acquired

Aug. 16, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

2008 [Member] | Arnold, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 477

Initial costs, buildings

9,916

Land at cost

477

Buildings at cost

9,916

Total at cost

10,393

Accumulated Depreciation

680

Encumbrances

$ 0

Date of Construction

2008

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2008 [Member] | Bath, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 1,509

Initial costs, buildings

31,277

Land at cost

1,509

Buildings at cost

31,277

Total at cost

32,786

Accumulated Depreciation

7,428

Encumbrances

$ 0

Date of Construction

2008

Date Acquired

Jul. 01, 2014

Life on which depreciation in latest income statements is computed (Years)

40 years

2008 [Member] | Boardman, OH [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Long term acute care hospital

Initial costs, land

$ 79

Initial costs, buildings

275

Land at cost

Buildings at cost

275

Total at cost

354

Accumulated Depreciation

Encumbrances

$ 0

Date of Construction

2008

Date Acquired

Aug. 30, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

2008 [Member] | Boise, ID [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Long term acute care hospital

Initial costs, land

$ 1,558

Initial costs, buildings

11,027

Land at cost

1,558

Buildings at cost

11,027

Total at cost

12,585

Accumulated Depreciation

1,325

Encumbrances

$ 0

Date of Construction

2008

Date Acquired

Feb. 29, 2012

Life on which depreciation in latest income statements is computed (Years)

50 years

2008 [Member] | Crown Point, IN [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Long term acute care hospital

Initial costs, land

$ 302

Initial costs, buildings

528

Land at cost

302

Buildings at cost

528

Total at cost

830

Accumulated Depreciation

Encumbrances

$ 0

Date of Construction

2008

Date Acquired

Aug. 30, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

2008 [Member] | Denville, NJ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 15,709

Initial costs, buildings

55,772

Land at cost

15,709

Buildings at cost

55,772

Total at cost

71,481

Accumulated Depreciation

4,835

Encumbrances

$ 0

Date of Construction

2008

Date Acquired

Sep. 30, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

2008 [Member] | Dover NJ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 3,865

Initial costs, buildings

8,693

Land at cost

3,865

Buildings at cost

8,693

Total at cost

12,558

Accumulated Depreciation

802

Encumbrances

$ 0

Date of Construction

2008

Date Acquired

Sep. 30, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

2008 [Member] | Gainesborough UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, buildings

$ 10,007

Land at cost

1,528

Buildings at cost

10,007

Total at cost

11,535

Accumulated Depreciation

$ 253

Date of Construction

2008

Date Acquired

Apr. 14, 2023

Life on which depreciation in latest income statements is computed (Years)

40 years

2008 [Member] | Lubbock, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 1,376

Initial costs, buildings

28,292

Additions subsequent to acquisition, Improvements

3,648

Land at cost

1,376

Buildings at cost

31,940

Total at cost

33,316

Accumulated Depreciation

6,718

Encumbrances

$ 0

Date of Construction

2008

Date Acquired

Jun. 16, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

2008 [Member] | Sheffield, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 6,614

Initial costs, buildings

44,615

Land at cost

51,229

Buildings at cost

44,615

Total at cost

6,614

Accumulated Depreciation

4,528

Encumbrances

$ 0

Date of Construction

2008

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

2008 [Member] | York, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 3,708

Initial costs, buildings

6,743

Land at cost

10,451

Buildings at cost

6,743

Total at cost

3,708

Accumulated Depreciation

$ 141

Date of Construction

2008

Life on which depreciation in latest income statements is computed (Years)

40 hours

1811 [Member] | London, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 36,266

Initial costs, buildings

51,909

Land at cost

36,266

Buildings at cost

51,909

Total at cost

88,175

Accumulated Depreciation

1,512

Encumbrances

$ 0

Date of Construction

1811

Date Acquired

Dec. 09, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

1890 [Member] | Altrincham, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 14,644

Initial costs, buildings

25,138

Land at cost

14,644

Buildings at cost

25,138

Total at cost

39,782

Accumulated Depreciation

828

Encumbrances

$ 0

Date of Construction

1890

Date Acquired

Dec. 09, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

1790 [Member] | Bristol, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 4,705

Initial costs, buildings

37,356

Land at cost

4,705

Buildings at cost

37,356

Total at cost

42,061

Accumulated Depreciation

1,085

Encumbrances

$ 0

Date of Construction

1790

Date Acquired

Dec. 09, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

1790 [Member] | Essex, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 4,642

Initial costs, buildings

43,193

Land at cost

4,642

Buildings at cost

43,193

Total at cost

47,835

Accumulated Depreciation

1,251

Encumbrances

$ 0

Date of Construction

1790

Date Acquired

Dec. 09, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

1790 [Member] | London, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 28,936

Initial costs, buildings

14,973

Land at cost

28,936

Buildings at cost

14,973

Total at cost

43,909

Accumulated Depreciation

497

Encumbrances

$ 0

Date of Construction

1790

Date Acquired

Dec. 09, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

2014 [Member] | Altoona, WI [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, buildings

$ 29,062

Buildings at cost

29,062

Total at cost

29,062

Accumulated Depreciation

6,781

Encumbrances

$ 0

Date of Construction

2014

Date Acquired

Aug. 31, 2014

Life on which depreciation in latest income statements is computed (Years)

40 years

2014 [Member] | Altrincham, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 14,644

Initial costs, buildings

25,138

Land at cost

14,644

Buildings at cost

25,138

Total at cost

39,782

Accumulated Depreciation

828

Encumbrances

$ 0

Date of Construction

2014

Date Acquired

Dec. 09, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

2014 [Member] | Alvin, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 105

Initial costs, buildings

4,087

Land at cost

105

Buildings at cost

4,087

Total at cost

4,192

Accumulated Depreciation

973

Encumbrances

$ 0

Date of Construction

2014

Date Acquired

Mar. 19, 2014

Life on which depreciation in latest income statements is computed (Years)

40 years

2014 [Member] | Bristol, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 4,705

Initial costs, buildings

37,356

Land at cost

4,705

Buildings at cost

37,356

Total at cost

42,061

Accumulated Depreciation

1,085

Encumbrances

$ 0

Date of Construction

2014

Date Acquired

Dec. 09, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

2014 [Member] | Broomfield, CO [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 825

Initial costs, buildings

3,895

Land at cost

825

Buildings at cost

3,895

Total at cost

4,720

Accumulated Depreciation

925

Encumbrances

$ 0

Date of Construction

2014

Date Acquired

Jul. 03, 2014

Life on which depreciation in latest income statements is computed (Years)

40 years

2014 [Member] | Commerce City, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 707

Initial costs, buildings

4,248

Land at cost

707

Buildings at cost

4,248

Total at cost

4,955

Accumulated Depreciation

964

Encumbrances

$ 0

Date of Construction

2014

Date Acquired

Dec. 11, 2014

Life on which depreciation in latest income statements is computed (Years)

40 years

2014 [Member] | Colorado Springs CO [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 600

Initial costs, buildings

4,231

Land at cost

600

Buildings at cost

4,231

Total at cost

4,831

Accumulated Depreciation

1,014

Encumbrances

$ 0

Date of Construction

2014

Date Acquired

Jun. 05, 2014

Life on which depreciation in latest income statements is computed (Years)

40 years

2014 [Member] | Essex, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 4,642

Initial costs, buildings

43,193

Land at cost

4,642

Buildings at cost

43,193

Total at cost

47,835

Accumulated Depreciation

1,251

Encumbrances

$ 0

Date of Construction

2014

Date Acquired

Dec. 09, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

2014 [Member] | Firestone, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 495

Initial costs, buildings

3,963

Land at cost

495

Buildings at cost

3,963

Total at cost

4,458

Accumulated Depreciation

949

Encumbrances

$ 0

Date of Construction

2014

Date Acquired

Jun. 06, 2014

Life on which depreciation in latest income statements is computed (Years)

40 years

2014 [Member] | Fort Worth, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 3,406

Initial costs, buildings

34,627

Land at cost

3,406

Buildings at cost

34,627

Total at cost

38,033

Accumulated Depreciation

2,100

Encumbrances

$ 0

Date of Construction

2014

Date Acquired

Oct. 19, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2014 [Member] | Fountain, CO [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 1,508

Initial costs, buildings

4,131

Land at cost

1,508

Buildings at cost

4,131

Total at cost

5,639

Accumulated Depreciation

973

Encumbrances

$ 0

Date of Construction

2014

Date Acquired

Jul. 31, 2014

Life on which depreciation in latest income statements is computed (Years)

40 years

2014 [Member] | Georgetown, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 4,569

Initial costs, buildings

22,858

Additions subsequent to acquisition, Improvements

7,669

Land at cost

4,569

Buildings at cost

30,527

Total at cost

35,096

Accumulated Depreciation

1,375

Encumbrances

$ 0

Date of Construction

2014

Date Acquired

Oct. 19, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2014 [Member] | London, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 36,266

Initial costs, buildings

51,909

Land at cost

36,266

Buildings at cost

51,909

Total at cost

88,175

Accumulated Depreciation

1,512

Encumbrances

$ 0

Date of Construction

2014

Date Acquired

Dec. 09, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

2014 [Member] | Ogden, UT [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 1,759

Initial costs, buildings

16,414

Land at cost

1,759

Buildings at cost

16,414

Total at cost

18,173

Accumulated Depreciation

4,025

Encumbrances

$ 0

Date of Construction

2014

Date Acquired

Mar. 01, 2014

Life on which depreciation in latest income statements is computed (Years)

40 years

2014 [Member] | Pearland, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 1,075

Initial costs, buildings

3,577

Land at cost

4,652

Buildings at cost

3,577

Total at cost

1,075

Accumulated Depreciation

835

Encumbrances

$ 0

Date of Construction

2014

Date Acquired

Sep. 08, 2014

Life on which depreciation in latest income statements is computed (Years)

40 years

2014 [Member] | San Antonio, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 351

Initial costs, buildings

3,952

Buildings at cost

3,952

Total at cost

351

Accumulated Depreciation

962

Encumbrances

$ 0

Date of Construction

2014

Date Acquired

Jan. 01, 2014

Life on which depreciation in latest income statements is computed (Years)

40 years

2014 [Member] | Richmond, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 5,380

Initial costs, buildings

6,155

Additions subsequent to acquisition, Improvements

6,017

Land at cost

17,552

Buildings at cost

12,172

Total at cost

5,380

Accumulated Depreciation

472

Encumbrances

$ 0

Date of Construction

2014

Date Acquired

Oct. 19, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2014 [Member] | San Antonio, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Land at cost

$ 4,303

2014 [Member] | Surrey, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 15,047

Initial costs, buildings

9,130

Land at cost

24,177

Buildings at cost

9,130

Total at cost

15,047

Accumulated Depreciation

334

Encumbrances

$ 0

Date of Construction

2014

Date Acquired

Dec. 09, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

2014 [Member] | Thornton, CO [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 1,350

Initial costs, buildings

4,259

Land at cost

5,609

Buildings at cost

4,259

Total at cost

1,350

Accumulated Depreciation

994

Encumbrances

$ 0

Date of Construction

2014

Date Acquired

Aug. 29, 2014

Life on which depreciation in latest income statements is computed (Years)

40 years

2014-2 [Member] | London, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

$ 28,936

28,936

14,973

43,909

Accumulated Depreciation

497

2014-2 [Member] | London, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Initial costs, buildings

$ 14,973

1887 [Member] | Bassenheim, Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 1,122

Initial costs, buildings

5,289

Land at cost

1,122

Buildings at cost

5,289

Total at cost

6,411

Accumulated Depreciation

721

Encumbrances

$ 0

Date of Construction

1887

Date Acquired

Feb. 09, 2019

Life on which depreciation in latest income statements is computed (Years)

39 years

1974 [Member] | Bad Salzuflen, Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 10,503

Initial costs, buildings

26,581

Land at cost

10,503

Buildings at cost

26,581

Total at cost

37,084

Accumulated Depreciation

4,409

Encumbrances

$ 0

Date of Construction

1974

Date Acquired

Nov. 30, 2017

Life on which depreciation in latest income statements is computed (Years)

40 years

1974 [Member] | Sebastian Fl

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 5,733

Initial costs, buildings

49,136

Additions subsequent to acquisition, Improvements

58,739

Land at cost

113,608

Buildings at cost

107,875

Total at cost

5,733

Accumulated Depreciation

14,058

Encumbrances

$ 0

Date of Construction

1974

Date Acquired

May 01, 2017

Life on which depreciation in latest income statements is computed (Years)

41 years

2017 [Member] | Austin, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 3,610

Initial costs, buildings

4,200

Land at cost

3,610

Buildings at cost

4,200

Total at cost

7,810

Accumulated Depreciation

746

Encumbrances

$ 0

Date of Construction

2017

Date Acquired

Mar. 02, 2017

Life on which depreciation in latest income statements is computed (Years)

40 years

2017 [Member] | Birmingham, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 8,192

Initial costs, buildings

42,216

Land at cost

8,192

Buildings at cost

42,216

Total at cost

50,408

Accumulated Depreciation

3,694

Encumbrances

$ 0

Date of Construction

2017

Date Acquired

Apr. 03, 2017

Life on which depreciation in latest income statements is computed (Years)

40 years

2017 [Member] | Columbus OH [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 2,101

Initial costs, buildings

44,218

Land at cost

2,101

Buildings at cost

44,218

Total at cost

46,319

Accumulated Depreciation

2,640

Encumbrances

$ 0

Date of Construction

2017

Date Acquired

Oct. 19, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2017 [Member] | Englewood, CO [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 3,369

Initial costs, buildings

65,480

Land at cost

3,369

Buildings at cost

65,480

Total at cost

68,849

Accumulated Depreciation

3,865

Encumbrances

$ 0

Date of Construction

2017

Date Acquired

Oct. 19, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2017 [Member] | Frome, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 2,896

Initial costs, buildings

10,711

Land at cost

2,896

Buildings at cost

17,545

Total at cost

20,441

Accumulated Depreciation

1,237

Encumbrances

$ 0

Date of Construction

2017

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2017 [Member] | Kansas City, KS [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 2,351

Initial costs, buildings

13,665

Land at cost

2,351

Buildings at cost

13,665

Total at cost

16,016

Accumulated Depreciation

1,355

Encumbrances

$ 0

Date of Construction

2017

Date Acquired

Jun. 10, 2019

Life on which depreciation in latest income statements is computed (Years)

50 years

2017 [Member] | Kuopio, Finland [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 1,301

Initial costs, buildings

43,352

Land at cost

1,301

Buildings at cost

43,352

Total at cost

44,653

Accumulated Depreciation

2,085

Encumbrances

$ 0

Date of Construction

2017

Date Acquired

Mar. 11, 2022

Life on which depreciation in latest income statements is computed (Years)

29 years

2017 [Member] | Leawood, KS [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 2,513

Initial costs, buildings

13,938

Land at cost

2,513

Buildings at cost

13,938

Total at cost

16,451

Accumulated Depreciation

1,373

Encumbrances

$ 0

Date of Construction

2017

Date Acquired

Jun. 10, 2019

Life on which depreciation in latest income statements is computed (Years)

50 years

2017 [Member] | Oulu, Finland [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 3,173

Initial costs, buildings

44,912

Land at cost

3,173

Buildings at cost

44,912

Total at cost

48,085

Accumulated Depreciation

2,187

Encumbrances

$ 0

Date of Construction

2017

Date Acquired

Mar. 11, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

2017 [Member] | Overland Park, KS [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 2,974

Initial costs, buildings

14,405

Land at cost

2,974

Buildings at cost

14,405

Total at cost

17,379

Accumulated Depreciation

1,441

Encumbrances

$ 0

Date of Construction

2017

Date Acquired

Jun. 10, 2019

Life on which depreciation in latest income statements is computed (Years)

50 years

2017 [Member] | Monmouth, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 15,506

Initial costs, buildings

11,552

Land at cost

15,506

Buildings at cost

11,552

Total at cost

27,058

Accumulated Depreciation

976

Encumbrances

$ 0

Date of Construction

2017

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2017 [Member] | Oklahoma City, OK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 3,641

Initial costs, buildings

3,047

Land at cost

3,641

Buildings at cost

3,047

Total at cost

6,688

Accumulated Depreciation

337

Encumbrances

$ 0

Date of Construction

2017

Date Acquired

Oct. 19, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2017 [Member] | Phoenix, AZ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 5,576

Initial costs, buildings

45,782

Land at cost

51,358

Buildings at cost

45,782

Total at cost

5,576

Accumulated Depreciation

7,916

Encumbrances

$ 0

Date of Construction

2017

Date Acquired

Feb. 10, 2017

Life on which depreciation in latest income statements is computed (Years)

40 years

2017 [Member] | Phoenix, AZ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 1,132

Initial costs, buildings

5,052

Land at cost

6,184

Buildings at cost

5,052

Total at cost

1,132

Accumulated Depreciation

853

Encumbrances

$ 0

Date of Construction

2017

Date Acquired

Apr. 13, 2017

Life on which depreciation in latest income statements is computed (Years)

40 years

2017 [Member] | Texarkana, Texas [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 14,562

Land at cost

14,562

Total at cost

14,562

Accumulated Depreciation

Encumbrances

$ 0

Date Acquired

Sep. 29, 2017

2017 [Member] | The Woodlands, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Initial costs, buildings

$ 4,524

2017 [Member] | Valencia, Spain [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 11,128

Initial costs, buildings

69,552

Land at cost

80,680

Buildings at cost

69,552

Total at cost

11,128

Accumulated Depreciation

4,176

Encumbrances

$ 0

Date of Construction

2017

Date Acquired

Dec. 02, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1864 [Member] | Birmingham, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Initial costs, land

$ 927

Initial costs, buildings

10,159

Land at cost

927

Buildings at cost

10,159

Total at cost

11,086

Accumulated Depreciation

196

Encumbrances

Date of Construction

1864

Date Acquired

Apr. 14, 2023

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | Avondale, AZ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 5,383

Initial costs, buildings

64,650

Land at cost

5,383

Buildings at cost

64,650

Total at cost

70,033

Accumulated Depreciation

3,806

Encumbrances

$ 0

Date of Construction

2016

Date Acquired

Oct. 19, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | Bad Salzuflen, Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 10,503

Initial costs, buildings

26,581

Land at cost

10,503

Buildings at cost

26,581

Total at cost

37,084

Accumulated Depreciation

4,409

Encumbrances

$ 0

Date of Construction

2016

Date Acquired

Nov. 30, 2017

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | Birmingham, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 412

Initial costs, buildings

19,164

Land at cost

412

Buildings at cost

19,164

Total at cost

19,576

Accumulated Depreciation

1,284

Encumbrances

$ 0

Date of Construction

2016

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | Goodyear, AZ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 1,800

Initial costs, buildings

4,713

Land at cost

1,800

Buildings at cost

4,713

Total at cost

6,513

Accumulated Depreciation

913

Encumbrances

$ 0

Date of Construction

2016

Date Acquired

Apr. 04, 2016

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | Flagstaff, AZ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 3,049

Initial costs, buildings

22,464

Land at cost

3,049

Buildings at cost

22,464

Total at cost

25,513

Accumulated Depreciation

3,276

Encumbrances

$ 0

Date of Construction

2016

Date Acquired

Aug. 23, 2016

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | Helotes, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 1,900

Initial costs, buildings

5,115

Land at cost

1,900

Buildings at cost

5,115

Total at cost

7,015

Accumulated Depreciation

1,002

Encumbrances

$ 0

Date of Construction

2016

Date Acquired

Mar. 10, 2016

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | Glendale,AZ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 1,144

Initial costs, buildings

6,087

Land at cost

1,144

Buildings at cost

6,087

Total at cost

7,231

Accumulated Depreciation

1,091

Encumbrances

$ 0

Date of Construction

2016

Date Acquired

Oct. 21, 2016

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | Houston, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 950

Initial costs, buildings

3,996

Land at cost

950

Buildings at cost

3,996

Total at cost

4,946

Accumulated Depreciation

724

Encumbrances

$ 0

Date of Construction

2016

Date Acquired

Sep. 26, 2016

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | Highlands Ranch, CO [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 4,200

Initial costs, buildings

4,779

Land at cost

4,200

Buildings at cost

4,779

Total at cost

8,979

Accumulated Depreciation

886

Encumbrances

$ 0

Date of Construction

2016

Date Acquired

Jul. 25, 2016

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | Katy, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 1,534

Initial costs, buildings

4,174

Land at cost

1,534

Buildings at cost

4,174

Total at cost

5,708

Accumulated Depreciation

756

Encumbrances

$ 0

Date of Construction

2016

Date Acquired

Oct. 10, 2016

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | Longmont, CO [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 1,748

Initial costs, buildings

4,181

Land at cost

1,748

Total at cost

5,929

Accumulated Depreciation

827

Encumbrances

$ 0

Date of Construction

2016

Date Acquired

Feb. 10, 2016

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | Mandeville, LA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 2,800

Initial costs, buildings

5,370

Land at cost

2,800

Buildings at cost

5,370

Total at cost

8,170

Accumulated Depreciation

962

Encumbrances

$ 0

Date of Construction

2016

Date Acquired

Oct. 28, 2016

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | Marrero, LA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 1,561

Initial costs, buildings

5,801

Land at cost

1,561

Buildings at cost

5,801

Total at cost

7,362

Accumulated Depreciation

1,088

Encumbrances

$ 0

Date of Construction

2016

Date Acquired

Jul. 15, 2016

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | Miami, FL [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 20,430

Initial costs, buildings

30,282

Additions subsequent to acquisition, Improvements

10,935

Land at cost

20,430

Buildings at cost

41,217

Total at cost

61,647

Accumulated Depreciation

1,483

Encumbrances

$ 0

Date of Construction

2016

Date Acquired

Apr. 25, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | New Orleans, LA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 2,850

Initial costs, buildings

6,125

Land at cost

2,850

Buildings at cost

6,125

Total at cost

8,975

Accumulated Depreciation

1,110

Encumbrances

$ 0

Date of Construction

2016

Date Acquired

Sep. 23, 2016

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | San Antonio, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 3,075

Initial costs, buildings

4,801

Land at cost

7,876

Buildings at cost

4,801

Total at cost

3,075

Accumulated Depreciation

850

Encumbrances

$ 0

Date of Construction

2016

Date Acquired

Dec. 09, 2016

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | Plano, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 4,138

Initial costs, buildings

1,416

Land at cost

5,554

Buildings at cost

1,416

Total at cost

4,138

Accumulated Depreciation

553

Encumbrances

$ 0

Date of Construction

2016

Date Acquired

Sep. 30, 2016

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | Rosenberg, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 1,251

Initial costs, buildings

4,505

Land at cost

5,756

Buildings at cost

4,505

Total at cost

1,251

Accumulated Depreciation

901

Encumbrances

$ 0

Date of Construction

2016

Date Acquired

Jan. 15, 2016

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | San Antonio, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 2,377

Initial costs, buildings

4,253

Land at cost

6,630

Buildings at cost

4,253

Total at cost

2,377

Accumulated Depreciation

762

Encumbrances

$ 0

Date of Construction

2016

Date Acquired

Oct. 27, 2016

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | The Woodlands, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Freestanding ER

$ 1,976

6,500

4,524

1,976

Accumulated Depreciation

877

Encumbrances

$ 0

Date of Construction

2016

Date Acquired

Mar. 28, 2016

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | Toledo, OH [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 1,134

Initial costs, buildings

17,740

Land at cost

18,874

Buildings at cost

17,740

Total at cost

1,134

Accumulated Depreciation

3,437

Encumbrances

$ 0

Date of Construction

2016

Date Acquired

Apr. 01, 2016

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | Viseu, Portugal [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 2,535

Initial costs, buildings

28,884

Land at cost

31,419

Buildings at cost

28,884

Total at cost

2,535

Accumulated Depreciation

3,307

Encumbrances

$ 0

Date of Construction

2016

Date Acquired

Nov. 28, 2019

Life on which depreciation in latest income statements is computed (Years)

37 years

1989 [Member] | Bad Salzuflen, Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 7,138

Initial costs, buildings

23,376

Land at cost

7,138

Buildings at cost

23,376

Total at cost

30,514

Accumulated Depreciation

3,693

Encumbrances

$ 0

Date of Construction

1989

Date Acquired

Nov. 30, 2017

Life on which depreciation in latest income statements is computed (Years)

40 years

1989 [Member] | Bolton, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 1,585

Initial costs, buildings

44,534

Land at cost

1,585

Buildings at cost

44,534

Total at cost

46,119

Accumulated Depreciation

4,469

Encumbrances

$ 0

Date of Construction

1989

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1989 [Member] | Guildford, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 6,881

Initial costs, buildings

36,427

Land at cost

6,881

Buildings at cost

36,427

Total at cost

43,308

Accumulated Depreciation

3,675

Encumbrances

$ 0

Date of Construction

1989

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1989 [Member] | Lynwood, CA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 30,116

Initial costs, buildings

148,527

Land at cost

30,116

Buildings at cost

148,527

Total at cost

178,643

Accumulated Depreciation

12,749

Encumbrances

$ 0

Date of Construction

1989

Date Acquired

Aug. 13, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1989 [Member] | Richmond, VA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Long term acute care hospital

Initial costs, land

$ 1,296

Initial costs, buildings

10,071

Land at cost

11,367

Buildings at cost

10,071

Total at cost

1,296

Accumulated Depreciation

1,413

Encumbrances

$ 0

Date of Construction

1989

Date Acquired

Aug. 30, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

1989 [Member] | Rochdale, MA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Long term acute care hospital

Initial costs, land

$ 654

Initial costs, buildings

3,368

Land at cost

4,022

Buildings at cost

3,368

Total at cost

654

Accumulated Depreciation

428

Encumbrances

$ 0

Date of Construction

1989

Date Acquired

Aug. 30, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

1989 [Member] | Rochdale, MA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 67

Initial costs, buildings

344

Land at cost

411

Buildings at cost

344

Total at cost

Accumulated Depreciation

Encumbrances

$ 0

Date of Construction

1989

Date Acquired

Aug. 30, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

2004 [Member] | Ayr, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 16,990

Initial costs, buildings

48,655

Land at cost

16,990

Buildings at cost

48,655

Total at cost

65,645

Accumulated Depreciation

3,105

Encumbrances

$ 0

Date of Construction

2004

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2004 [Member] | Odessa, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 6,217

Initial costs, buildings

123,518

Additions subsequent to acquisition, Improvements

16,600

Land at cost

6,217

Buildings at cost

140,118

Total at cost

146,335

Accumulated Depreciation

20,542

Encumbrances

$ 0

Date of Construction

2004

Date Acquired

Sep. 29, 2017

Life on which depreciation in latest income statements is computed (Years)

41 years

2004 [Member] | Webster, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Long term acute care hospital

Initial costs, land

$ 663

Initial costs, buildings

33,751

Land at cost

34,414

Buildings at cost

33,751

Total at cost

663

Accumulated Depreciation

10,969

Encumbrances

$ 0

Date of Construction

2004

Date Acquired

Dec. 21, 2010

Life on which depreciation in latest income statements is computed (Years)

40 years

1973 [Member] | Bad Oeynhausen, Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 1,126

Initial costs, buildings

2,752

Land at cost

1,126

Buildings at cost

2,752

Total at cost

3,878

Accumulated Depreciation

468

Encumbrances

$ 0

Date of Construction

1973

Date Acquired

Nov. 30, 2017

Life on which depreciation in latest income statements is computed (Years)

40 years

1973 [Member] | Big Spring, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 1,655

Initial costs, buildings

21,254

Additions subsequent to acquisition, Improvements

815

Land at cost

1,655

Buildings at cost

22,069

Total at cost

23,724

Accumulated Depreciation

2,922

Encumbrances

$ 0

Date of Construction

1973

Date Acquired

Apr. 12, 2019

Life on which depreciation in latest income statements is computed (Years)

41 years

1973 [Member] | Odessa, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 6,217

Initial costs, buildings

123,518

Additions subsequent to acquisition, Improvements

16,600

Land at cost

6,217

Buildings at cost

140,118

Total at cost

146,335

Accumulated Depreciation

20,542

Encumbrances

$ 0

Date of Construction

1973

Date Acquired

Sep. 29, 2017

Life on which depreciation in latest income statements is computed (Years)

41 years

1973 [Member] | Port Huron, MI

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 2,531

Initial costs, buildings

14,252

Land at cost

16,783

Buildings at cost

14,252

Total at cost

2,531

Accumulated Depreciation

3,895

Encumbrances

$ 0

Date of Construction

1973

Date Acquired

Dec. 31, 2015

Life on which depreciation in latest income statements is computed (Years)

30 years

2015 [Member] | Aurora, CO [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 2,801

Initial costs, buildings

4,812

Land at cost

2,801

Buildings at cost

4,812

Total at cost

7,613

Accumulated Depreciation

992

Encumbrances

$ 0

Date of Construction

2015

Date Acquired

Sep. 17, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

2015 [Member] | Chandler, AZ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 3,517

Initial costs, buildings

4,783

Land at cost

3,517

Buildings at cost

4,783

Total at cost

8,300

Accumulated Depreciation

1,036

Encumbrances

$ 0

Date of Construction

2015

Date Acquired

Apr. 24, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

2015 [Member] | Converse, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 750

Initial costs, buildings

4,423

Land at cost

750

Buildings at cost

4,423

Total at cost

5,173

Accumulated Depreciation

968

Encumbrances

$ 0

Date of Construction

2015

Date Acquired

Apr. 10, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

2015 [Member] | Denver, CO [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 1,239

Initial costs, buildings

4,276

Land at cost

1,239

Buildings at cost

4,276

Total at cost

5,515

Accumulated Depreciation

918

Encumbrances

$ 0

Date of Construction

2015

Date Acquired

Jun. 08, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

2015 [Member] | Frome, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Date of Construction

2015

2015 [Member] | Frome, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 2,896

Initial costs, buildings

10,711

Land at cost

2,896

Buildings at cost

17,545

Total at cost

20,441

Accumulated Depreciation

1,237

Encumbrances

$ 0

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2015 [Member] | Gilbert, AZ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 1,517

Initial costs, buildings

4,661

Land at cost

1,517

Buildings at cost

4,661

Total at cost

6,178

Accumulated Depreciation

981

Encumbrances

$ 0

Date of Construction

2015

Date Acquired

Jul. 22, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

2015 [Member] | Glendale,AZ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 1,176

Initial costs, buildings

4,046

Land at cost

1,176

Buildings at cost

4,046

Total at cost

5,222

Accumulated Depreciation

868

Encumbrances

$ 0

Date of Construction

2015

Date Acquired

Jun. 05, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

2015 [Member] | Highland Hills, OH [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 3,148

Initial costs, buildings

43,891

Land at cost

3,148

Buildings at cost

43,891

Total at cost

47,039

Accumulated Depreciation

2,622

Encumbrances

$ 0

Date of Construction

2015

Date Acquired

Oct. 19, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2015 [Member] | Highland Village TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 3,172

Initial costs, buildings

1,551

Land at cost

3,172

Buildings at cost

1,551

Total at cost

4,723

Accumulated Depreciation

479

Encumbrances

$ 0

Date of Construction

2015

Date Acquired

Sep. 22, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

2015 [Member] | Hoover, AL [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 0

Initial costs, buildings

7,581

Land at cost

Buildings at cost

1,330

Total at cost

1,330

Accumulated Depreciation

308

Encumbrances

$ 0

Date of Construction

2015

Date Acquired

May 01, 2015

Life on which depreciation in latest income statements is computed (Years)

34 years

2015 [Member] | Katy, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 2,116

Initial costs, buildings

3,873

Land at cost

2,116

Buildings at cost

3,873

Total at cost

5,989

Accumulated Depreciation

791

Encumbrances

$ 0

Date of Construction

2015

Date Acquired

Oct. 21, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

2015 [Member] | Lehi, UT [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 13,368

Initial costs, buildings

29,950

Additions subsequent to acquisition, Improvements

1,676

Land at cost

13,368

Buildings at cost

31,626

Total at cost

44,994

Accumulated Depreciation

5,664

Encumbrances

$ 0

Date of Construction

2015

Date Acquired

Sep. 29, 2017

Life on which depreciation in latest income statements is computed (Years)

45 years

2015 [Member] | League City, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 1,278

Initial costs, buildings

3,901

Land at cost

1,278

Buildings at cost

3,901

Total at cost

5,179

Accumulated Depreciation

829

Encumbrances

$ 0

Date of Construction

2015

Date Acquired

Jun. 19, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

2015 [Member] | McKinney, Texas [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 2,558

Initial costs, buildings

4,060

Land at cost

2,558

Buildings at cost

4,060

Total at cost

6,618

Accumulated Depreciation

1,149

Encumbrances

$ 0

Date of Construction

2015

Date Acquired

Jul. 31, 2015

Life on which depreciation in latest income statements is computed (Years)

30 years

2015 [Member] | Olathe, KS [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 6,882

Initial costs, buildings

55,745

Additions subsequent to acquisition, Improvements

2,052

Land at cost

6,882

Buildings at cost

57,797

Total at cost

64,679

Accumulated Depreciation

3,376

Encumbrances

$ 0

Date of Construction

2015

Date Acquired

Oct. 19, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2015 [Member] | Parker, CO [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 1,300

Initial costs, buildings

4,448

Land at cost

1,300

Buildings at cost

4,448

Total at cost

$ 5,748

Accumulated Depreciation

908

Encumbrances

$ 0

Date of Construction

2015

Date Acquired

Nov. 06, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

2015 [Member] | Santa Maria de Feira, PT [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 1,860

Initial costs, buildings

17,839

Land at cost

19,699

Buildings at cost

17,839

Total at cost

1,860

Accumulated Depreciation

1,018

Encumbrances

$ 0

Date of Construction

2015

Date Acquired

Oct. 21, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1970 [Member] | Bussage, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 8,490

Initial costs, buildings

3,753

Land at cost

8,490

Buildings at cost

3,753

Total at cost

12,243

Accumulated Depreciation

262

Encumbrances

$ 0

Date of Construction

1970

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1970 [Member] | Rockledge, FL [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 13,919

Initial costs, buildings

23,282

Additions subsequent to acquisition, Improvements

8,428

Land at cost

45,629

Buildings at cost

31,710

Total at cost

13,919

Accumulated Depreciation

6,584

Encumbrances

$ 0

Date of Construction

1970

Date Acquired

May 01, 2017

Life on which depreciation in latest income statements is computed (Years)

42 years

1970 [Member] | Royston, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 6,734

Initial costs, buildings

20,048

Land at cost

26,782

Buildings at cost

20,048

Total at cost

6,734

Accumulated Depreciation

1,578

Encumbrances

$ 0

Date of Construction

1970

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1992 [Member] | Bath, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 7,193

Initial costs, buildings

13,053

Land at cost

7,193

Buildings at cost

13,053

Total at cost

20,246

Accumulated Depreciation

1,356

Encumbrances

$ 0

Date of Construction

1992

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1992 [Member] | Bowling Green, KY [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 3,486

Initial costs, buildings

56,296

Additions subsequent to acquisition, Improvements

3,550

Land at cost

3,486

Buildings at cost

59,846

Total at cost

63,332

Accumulated Depreciation

6,920

Encumbrances

$ 0

Date of Construction

1992

Date Acquired

Aug. 30, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

1992 [Member] | Essex, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 4,642

Initial costs, buildings

43,193

Land at cost

4,642

Buildings at cost

43,193

Total at cost

47,835

Accumulated Depreciation

1,251

Encumbrances

$ 0

Date of Construction

1992

Date Acquired

Dec. 09, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

1992 [Member] | Helsinki, Finland [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 4,085

Initial costs, buildings

67,529

Land at cost

4,085

Buildings at cost

67,529

Total at cost

71,614

Accumulated Depreciation

3,137

Encumbrances

$ 0

Date of Construction

1992

Date Acquired

Mar. 11, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

1992 [Member] | London, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 28,936

Initial costs, buildings

14,973

Land at cost

28,936

Buildings at cost

14,973

Total at cost

43,909

Accumulated Depreciation

497

Encumbrances

$ 0

Date of Construction

1992

Date Acquired

Dec. 09, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

1992 [Member] | Stirling, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 1,054

Initial costs, buildings

19,511

Land at cost

20,565

Buildings at cost

19,511

Total at cost

1,054

Accumulated Depreciation

1,274

Encumbrances

$ 0

Date of Construction

1992

Date Acquired

Jul. 06, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1992 [Member] | Wichita, KS [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 1,019

Initial costs, buildings

18,374

Land at cost

19,393

Buildings at cost

18,374

Total at cost

1,019

Accumulated Depreciation

7,234

Encumbrances

$ 0

Date of Construction

1992

Date Acquired

Apr. 04, 2008

Life on which depreciation in latest income statements is computed (Years)

40 years

1992 - 2 [Member] | London, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Initial costs, land

$ 13,810

Initial costs, buildings

6,810

Land at cost

13,810

Buildings at cost

6,810

Total at cost

20,620

Accumulated Depreciation

487

Encumbrances

$ 0

Date of Construction

1992

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1984 [Member] | Basingstoke, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 12,922

Initial costs, buildings

50,190

Land at cost

12,922

Buildings at cost

50,190

Total at cost

63,112

Accumulated Depreciation

5,070

Encumbrances

$ 0

Date of Construction

1984

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1984 [Member] | Bennettsville, SC [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 794

Initial costs, buildings

13,245

Land at cost

794

Buildings at cost

13,245

Total at cost

14,039

Accumulated Depreciation

12,308

Encumbrances

$ 0

Date of Construction

1984

Date Acquired

Apr. 01, 2008

Life on which depreciation in latest income statements is computed (Years)

42 years

1984 [Member] | Birmingham, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 412

Initial costs, buildings

19,164

Land at cost

412

Buildings at cost

19,164

Total at cost

19,576

Accumulated Depreciation

1,284

Encumbrances

$ 0

Date of Construction

1984

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1984 [Member] | Droitwich, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 76

Initial costs, buildings

15,298

Land at cost

Buildings at cost

15,298

Total at cost

15,374

Accumulated Depreciation

1,550

Encumbrances

$ 0

Date of Construction

1984

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1984 [Member] | Hope, AR [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 1,651

Initial costs, buildings

3,359

Additions subsequent to acquisition, Improvements

2,733

Land at cost

1,651

Buildings at cost

6,092

Total at cost

7,743

Accumulated Depreciation

1,395

Encumbrances

$ 0

Date of Construction

1984

Date Acquired

Sep. 29, 2017

Life on which depreciation in latest income statements is computed (Years)

41 years

1984 [Member] | London, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 3,285

Initial costs, buildings

61,004

Land at cost

3,285

Buildings at cost

4,148

Total at cost

7,433

Accumulated Depreciation

422

Encumbrances

$ 0

Date of Construction

1987

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1984 [Member] | Swindon, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 5,328

Initial costs, buildings

59,772

Land at cost

65,100

Buildings at cost

59,772

Total at cost

5,328

Accumulated Depreciation

6,013

Encumbrances

$ 0

Date of Construction

1984

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1980 [Member] | Blue Springs, MO [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 4,347

Initial costs, buildings

23,494

Land at cost

4,347

Buildings at cost

23,494

Total at cost

27,841

Accumulated Depreciation

5,503

Encumbrances

$ 0

Date of Construction

1980

Date Acquired

Feb. 13, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

1980 [Member] | Frome, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 10,895

Initial costs, buildings

17,545

Land at cost

10,895

Buildings at cost

10,711

Total at cost

$ 21,606

Life on which depreciation in latest income statements is computed (Years)

40 years

1980 [Member] | Frome, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Accumulated Depreciation

$ 995

Encumbrances

$ 0

Date of Construction

1980

Date Acquired

Jun. 25, 2021

1980 [Member] | Glasgow, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 1,429

Initial costs, buildings

15,619

Land at cost

1,429

Buildings at cost

15,619

Total at cost

17,048

Accumulated Depreciation

1,058

Encumbrances

$ 0

Date of Construction

1980

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1980 [Member] | Harrow, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 38,403

Initial costs, buildings

40,415

Land at cost

38,403

Buildings at cost

40,415

Total at cost

78,818

Accumulated Depreciation

4,098

Encumbrances

$ 0

Date of Construction

1980

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1980 [Member] | Hill County, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 1,120

Initial costs, buildings

17,882

Additions subsequent to acquisition, Improvements

845

Land at cost

1,120

Buildings at cost

18,727

Total at cost

19,847

Accumulated Depreciation

16,139

Encumbrances

$ 0

Date of Construction

1980

Date Acquired

Sep. 17, 2010

Life on which depreciation in latest income statements is computed (Years)

15 years

1980 [Member] | Hinckley, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

$ 5,416

5,416

10,315

15,731

Accumulated Depreciation

759

Encumbrances

$ 0

Date of Construction

1980

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1980 [Member] | Hook, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Initial costs, buildings

$ 10,315

1980 [Member] | Nottingham, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 10,011

Initial costs, buildings

8,960

Land at cost

10,011

Buildings at cost

8,960

Total at cost

18,971

Accumulated Depreciation

735

Encumbrances

$ 0

Date of Construction

2000

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1980 [Member] | Poplar Bluff, MO [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 2,659

Initial costs, buildings

38,694

Land at cost

41,353

Buildings at cost

38,694

Total at cost

2,659

Accumulated Depreciation

15,186

Encumbrances

$ 0

Date of Construction

1980

Date Acquired

Apr. 22, 2008

Life on which depreciation in latest income statements is computed (Years)

40 years

1980 [Member] | Romford, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 5,354

Initial costs, buildings

8,766

Land at cost

14,120

Buildings at cost

8,766

Total at cost

5,354

Accumulated Depreciation

692

Encumbrances

$ 0

Date of Construction

1980

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1980 [Member] | Sharon, PA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 6,179

Initial costs, buildings

9,066

Additions subsequent to acquisition, Improvements

8,513

Land at cost

23,758

Buildings at cost

17,579

Total at cost

6,179

Accumulated Depreciation

3,537

Encumbrances

$ 0

Date of Construction

1980

Date Acquired

May 01, 2017

Life on which depreciation in latest income statements is computed (Years)

41 years

1980 [Member] | Usk, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 1,730

Initial costs, buildings

22,202

Land at cost

23,932

Buildings at cost

22,202

Total at cost

1,730

Accumulated Depreciation

1,472

Encumbrances

$ 0

Date of Construction

1980

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1980 [Member] | West Valley City, UT [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 5,260

Initial costs, buildings

58,314

Additions subsequent to acquisition, Improvements

6,644

Land at cost

70,218

Buildings at cost

64,958

Total at cost

5,260

Accumulated Depreciation

24,100

Encumbrances

$ 0

Date of Construction

1980

Date Acquired

Apr. 22, 2008

Life on which depreciation in latest income statements is computed (Years)

40 years

1980 [Member] | York, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 21,635

Initial costs, buildings

71,771

Land at cost

93,406

Buildings at cost

71,771

Total at cost

21,635

Accumulated Depreciation

4,739

Encumbrances

$ 0

Date of Construction

1980

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 hours

1985 [Member] | Aberdeen, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 4,252

Initial costs, buildings

100,721

Land at cost

4,252

Buildings at cost

100,721

Total at cost

104,973

Accumulated Depreciation

10,106

Encumbrances

$ 0

Date of Construction

1985

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1985 [Member] | Hot Springs, AR [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 5,622

Initial costs, buildings

59,432

Additions subsequent to acquisition, Improvements

21,221

Land at cost

5,622

Buildings at cost

80,653

Total at cost

86,275

Accumulated Depreciation

17,341

Encumbrances

$ 0

Date of Construction

1985

Date Acquired

Aug. 31, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

1985 [Member] | Lawton, OK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 3,944

Initial costs, buildings

63,031

Land at cost

3,944

Buildings at cost

63,031

Total at cost

66,975

Accumulated Depreciation

6,770

Encumbrances

$ 0

Date of Construction

1985

Date Acquired

Dec. 17, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

1985 [Member] | Southampton, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 6,445

Initial costs, buildings

18,924

Land at cost

25,369

Buildings at cost

18,924

Total at cost

6,445

Accumulated Depreciation

1,466

Encumbrances

$ 0

Date of Construction

1985

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1997 [Member] | Algeciras, Spain [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 521

Initial costs, buildings

8,222

Land at cost

521

Buildings at cost

8,222

Total at cost

8,743

Accumulated Depreciation

377

Encumbrances

$ 0

Date of Construction

1997

Date Acquired

Apr. 29, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

1997 [Member] | Floridablanca, Colombia [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 815

Initial costs, buildings

25,478

Land at cost

815

Buildings at cost

25,478

Total at cost

26,293

Accumulated Depreciation

912

Encumbrances

$ 0

Date of Construction

1997

Date Acquired

Jul. 29, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

1982 [Member] | Bedford, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 1,540

Initial costs, buildings

7,504

Land at cost

1,540

Buildings at cost

7,504

Total at cost

9,044

Accumulated Depreciation

764

Encumbrances

$ 0

Date of Construction

1982

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1982 [Member] | Birmingham, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 9,862

Initial costs, buildings

93,867

Land at cost

9,862

Buildings at cost

93,867

Total at cost

103,729

Accumulated Depreciation

9,484

Encumbrances

$ 0

Date of Construction

1982

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1982 [Member] | Bossier City, LA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Long term acute care hospital

Initial costs, land

$ 900

Initial costs, buildings

17,818

Additions subsequent to acquisition, Improvements

944

Land at cost

900

Buildings at cost

18,762

Total at cost

19,662

Accumulated Depreciation

7,170

Encumbrances

$ 0

Date of Construction

1982

Date Acquired

Apr. 01, 2008

Life on which depreciation in latest income statements is computed (Years)

40 years

1982 [Member] | Brandis, Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Initial costs, buildings

$ 13,548

1982 [Member] | Cheraw, SC [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 657

Initial costs, buildings

18,534

Land at cost

657

Buildings at cost

18,534

Total at cost

19,191

Accumulated Depreciation

15,276

Encumbrances

$ 0

Date of Construction

1982

Date Acquired

Apr. 01, 2008

Life on which depreciation in latest income statements is computed (Years)

42 years

1982 [Member] | Caterham, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 10,552

Initial costs, buildings

20,846

Land at cost

10,552

Buildings at cost

20,846

Total at cost

31,398

Accumulated Depreciation

2,394

Encumbrances

$ 0

Date of Construction

1982

Date Acquired

Aug. 16, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

1982 [Member] | Canterbury, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 9,185

Initial costs, buildings

27,589

Land at cost

9,185

Buildings at cost

27,589

Total at cost

36,774

Accumulated Depreciation

2,781

Encumbrances

$ 0

Date of Construction

1982

Date Acquired

Jan. 09, 2020

1982 [Member] | Warren, OH [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 5,385

Initial costs, buildings

47,588

Additions subsequent to acquisition, Improvements

10,492

Land at cost

63,465

Buildings at cost

58,080

Total at cost

5,385

Accumulated Depreciation

11,225

Encumbrances

$ 0

Date of Construction

1982

Date Acquired

May 01, 2017

Life on which depreciation in latest income statements is computed (Years)

41 years

2023 [Member] | Cayce, SC [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 1,022

Initial costs, buildings

21,159

Land at cost

1,022

Buildings at cost

21,159

Total at cost

22,181

Accumulated Depreciation

255

Encumbrances

$ 0

Date of Construction

2023

Date Acquired

Oct. 21, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

2018 [Member] | Birmingham, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, buildings

$ 17,361

Buildings at cost

17,361

Total at cost

17,361

Accumulated Depreciation

1,519

Encumbrances

$ 0

Date of Construction

2018

Date Acquired

Jun. 29, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

2018 [Member] | Conroe, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 3,855

Initial costs, buildings

38,892

Land at cost

3,855

Buildings at cost

38,892

Total at cost

42,747

Accumulated Depreciation

2,373

Encumbrances

$ 0

Date of Construction

2018

Date Acquired

Oct. 19, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2018 [Member] | Darlington, United Kingdom [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

$ 21,246

21,246

48,262

69,508

Accumulated Depreciation

3,533

Encumbrances

$ 0

Date of Construction

2018

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2018 [Member] | Darlington UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Initial costs, buildings

$ 48,262

2018 [Member] | El Paso, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 4,268

Initial costs, buildings

21,345

Land at cost

4,268

Buildings at cost

21,345

Total at cost

25,613

Accumulated Depreciation

1,859

Encumbrances

$ 0

Date of Construction

2018

Date Acquired

Dec. 17, 2020

Life on which depreciation in latest income statements is computed (Years)

38 years

2018 [Member] | Malaga, SP [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 748

Initial costs, buildings

11,718

Land at cost

748

Buildings at cost

11,718

Total at cost

12,466

Accumulated Depreciation

498

Encumbrances

$ 0

Date of Construction

2018

Date Acquired

Apr. 29, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

2018 [Member] | Olathe, KS [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 3,485

Initial costs, buildings

14,484

Land at cost

3,485

Buildings at cost

14,484

Total at cost

17,969

Accumulated Depreciation

1,442

Encumbrances

$ 0

Date of Construction

2018

Date Acquired

Jun. 10, 2019

Life on which depreciation in latest income statements is computed (Years)

50 years

2018 [Member] | Preston, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 8,740

Initial costs, buildings

26,001

Land at cost

34,741

Buildings at cost

26,001

Total at cost

8,740

Accumulated Depreciation

1,741

Encumbrances

$ 0

Date of Construction

2018

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2018 [Member] | Raleigh, NC [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 3,469

Initial costs, buildings

27,514

Land at cost

30,983

Buildings at cost

27,514

Total at cost

3,469

Accumulated Depreciation

1,769

Encumbrances

$ 0

Date of Construction

2018

Date Acquired

Oct. 19, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2018 [Member] | Roeland Park, KS [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 1,569

Initial costs, buildings

15,103

Land at cost

16,672

Buildings at cost

15,103

Total at cost

1,569

Accumulated Depreciation

1,473

Encumbrances

$ 0

Date of Construction

2018

Date Acquired

Jun. 10, 2019

Life on which depreciation in latest income statements is computed (Years)

50 years

2018 [Member] | Shawnee, KS [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 3,076

Initial costs, buildings

14,945

Land at cost

18,021

Buildings at cost

14,945

Total at cost

3,076

Accumulated Depreciation

1,699

Encumbrances

$ 0

Date of Construction

2018

Date Acquired

Jun. 10, 2019

Life on which depreciation in latest income statements is computed (Years)

50 years

2018 [Member] | Turku, Finland [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 1,207

Initial costs, buildings

58,193

Land at cost

59,400

Buildings at cost

58,193

Total at cost

1,207

Accumulated Depreciation

2,731

Encumbrances

$ 0

Date of Construction

2018

Date Acquired

Mar. 11, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

2018 [Member] | Vancouver, WA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 9,313

Initial costs, buildings

12,505

Land at cost

21,818

Buildings at cost

12,505

Total at cost

9,313

Accumulated Depreciation

$ 384

Date of Construction

2018

Date Acquired

Oct. 19, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1900 [Member] | Birmingham, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 412

Initial costs, buildings

19,164

Land at cost

412

Buildings at cost

19,164

Total at cost

19,576

Accumulated Depreciation

1,284

Encumbrances

$ 0

Date of Construction

1900

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1900 [Member] | York, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Buildings at cost

$ 71,771

1972 [Member] | Bellflower, CA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

$ 2,563

2,563

2,563

$ 0

Aug. 23, 2019

1972 [Member] | Los Angeles, CA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 12,562

Initial costs, buildings

40,164

Land at cost

12,562

Total at cost

52,726

Accumulated Depreciation

2,593

Encumbrances

$ 0

Date of Construction

1972

Date Acquired

Jul. 06, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1957 [Member] | Blackburn, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 2,661

Initial costs, buildings

51,001

Land at cost

2,661

Buildings at cost

51,001

Total at cost

53,662

Accumulated Depreciation

5,131

Encumbrances

$ 0

Date of Construction

1957

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

2006 [Member] | Dallas, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Long term acute care hospital

Initial costs, land

$ 1,421

Initial costs, buildings

13,536

Land at cost

1,421

Buildings at cost

13,536

Total at cost

14,957

Accumulated Depreciation

5,865

Encumbrances

$ 0

Date of Construction

2006

Date Acquired

Sep. 05, 2006

Life on which depreciation in latest income statements is computed (Years)

40 years

2006 [Member] | Dahlen, Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 1,342

Initial costs, buildings

11,339

Land at cost

1,342

Buildings at cost

11,339

Total at cost

12,681

Accumulated Depreciation

1,065

Encumbrances

$ 0

Date of Construction

2006

Date Acquired

Aug. 28, 2018

Life on which depreciation in latest income statements is computed (Years)

40 years

2006 [Member] | Dormagen Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 1,909

Initial costs, buildings

5,648

Land at cost

1,909

Buildings at cost

5,648

Total at cost

7,557

Accumulated Depreciation

801

Encumbrances

$ 0

Date of Construction

2006

Date Acquired

Aug. 28, 2018

Life on which depreciation in latest income statements is computed (Years)

40 years

2006 [Member] | Petersburg, VA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 1,302

Initial costs, buildings

9,121

Land at cost

10,423

Buildings at cost

9,121

Total at cost

1,302

Accumulated Depreciation

3,534

Encumbrances

$ 0

Date of Construction

2006

Date Acquired

Jul. 01, 2008

Life on which depreciation in latest income statements is computed (Years)

40 years

1930 [Member] | Blackburn, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 20,030

Initial costs, buildings

54,338

Land at cost

20,030

Buildings at cost

54,338

Total at cost

74,368

Accumulated Depreciation

3,723

Encumbrances

$ 0

Date of Construction

1930

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1952 [Member] | Boonton Township, NJ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 6,712

Initial costs, buildings

17,031

Land at cost

6,712

Buildings at cost

17,031

Total at cost

23,743

Accumulated Depreciation

1,510

Encumbrances

$ 0

Date of Construction

1952

Date Acquired

Sep. 30, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

2009 [Member] | Bath, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 1,509

Initial costs, buildings

31,277

Land at cost

1,509

Buildings at cost

31,277

Total at cost

32,786

Accumulated Depreciation

7,428

Encumbrances

$ 0

Date of Construction

2009

Date Acquired

Jul. 01, 2014

Life on which depreciation in latest income statements is computed (Years)

40 years

2009 [Member] | Birmingham, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Initial costs, land

$ 927

Initial costs, buildings

10,159

Land at cost

927

Buildings at cost

10,159

Total at cost

11,086

Accumulated Depreciation

196

Encumbrances

Date of Construction

2009

Date Acquired

Apr. 14, 2023

Life on which depreciation in latest income statements is computed (Years)

40 years

2009 [Member] | Folsom, CA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Long term acute care hospital

Initial costs, land

$ 3,291

Initial costs, buildings

21,293

Land at cost

3,291

Buildings at cost

21,293

Total at cost

24,584

Accumulated Depreciation

2,738

Encumbrances

$ 0

Date of Construction

2009

Date Acquired

Aug. 30, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

1983 [Member] | Bassenheim, Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 1,122

Initial costs, buildings

5,289

Land at cost

1,122

Buildings at cost

5,289

Total at cost

6,411

Accumulated Depreciation

721

Encumbrances

$ 0

Date of Construction

1983

Date Acquired

Feb. 09, 2019

Life on which depreciation in latest income statements is computed (Years)

39 years

1983 [Member] | Glasgow, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 6,442

Initial costs, buildings

131,570

Land at cost

6,442

Buildings at cost

131,570

Total at cost

138,012

Accumulated Depreciation

13,194

Encumbrances

$ 0

Date of Construction

1983

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1983 [Member] | Grefath, Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 1,200

Initial costs, buildings

3,028

Land at cost

1,200

Buildings at cost

3,028

Total at cost

4,228

Accumulated Depreciation

439

Encumbrances

$ 0

Date of Construction

1983

Date Acquired

Aug. 28, 2018

Life on which depreciation in latest income statements is computed (Years)

40 years

1983 [Member] | Lander, WY [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 758

Initial costs, buildings

42,849

Land at cost

758

Buildings at cost

42,849

Total at cost

43,607

Accumulated Depreciation

4,579

Encumbrances

$ 0

Date of Construction

1983

Date Acquired

Dec. 17, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

1983 [Member] | Nottingham, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 4,952

Initial costs, buildings

45,951

Land at cost

4,952

Buildings at cost

45,951

Total at cost

50,903

Accumulated Depreciation

4,660

Encumbrances

$ 0

Date of Construction

1983

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1983 [Member] | Milton Keynes, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 5,245

Initial costs, buildings

35,861

Land at cost

5,245

Buildings at cost

35,861

Total at cost

41,106

Accumulated Depreciation

3,610

Encumbrances

$ 0

Date of Construction

1983

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1983 [Member] | Port Huron, MI

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 2,531

Initial costs, buildings

14,252

Land at cost

16,783

Buildings at cost

14,252

Total at cost

2,531

Accumulated Depreciation

3,895

Encumbrances

$ 0

Date of Construction

1983

Date Acquired

Dec. 31, 2015

Life on which depreciation in latest income statements is computed (Years)

30 years

1983 [Member] | Remscheid, Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 1,048

Initial costs, buildings

2,528

Land at cost

3,576

Buildings at cost

2,528

Total at cost

1,048

Accumulated Depreciation

357

Encumbrances

$ 0

Date of Construction

1983

Date Acquired

Aug. 28, 2018

Life on which depreciation in latest income statements is computed (Years)

40 years

1983 [Member] | Riverton, WY [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 1,163

Initial costs, buildings

29,647

Land at cost

30,810

Buildings at cost

29,647

Total at cost

1,163

Accumulated Depreciation

3,675

Encumbrances

$ 0

Date of Construction

1983

Date Acquired

Dec. 17, 2019

Life on which depreciation in latest income statements is computed (Years)

36 years

1983 [Member] | Watsonville, CA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 16,488

Initial costs, buildings

17,800

Land at cost

34,288

Buildings at cost

17,800

Total at cost

16,488

Accumulated Depreciation

2,780

Encumbrances

$ 0

Date of Construction

1983

Date Acquired

Sep. 30, 2019

Life on which depreciation in latest income statements is computed (Years)

39 years

1983 [Member] | West Jordan, UT [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 16,897

Initial costs, buildings

233,256

Additions subsequent to acquisition, Improvements

6,293

Land at cost

256,446

Buildings at cost

239,549

Total at cost

16,897

Accumulated Depreciation

22,616

Encumbrances

$ 0

Date of Construction

1983

Date Acquired

Sep. 29, 2017

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | Bad Salzuflen, Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 7,138

Initial costs, buildings

23,376

Land at cost

7,138

Buildings at cost

23,376

Total at cost

30,514

Accumulated Depreciation

3,693

Encumbrances

$ 0

Date Acquired

Nov. 30, 2017

Life on which depreciation in latest income statements is computed (Years)

40 years

2016 [Member] | Longmont, CO [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Buildings at cost

$ 4,181

2010 [Member] | Bad Oeynhausen, Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 1,126

Initial costs, buildings

2,752

Land at cost

1,126

Buildings at cost

2,752

Total at cost

3,878

Accumulated Depreciation

468

Encumbrances

$ 0

Date of Construction

2010

Date Acquired

Nov. 30, 2017

Life on which depreciation in latest income statements is computed (Years)

40 years

2010 [Member] | Layton, UT [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 14,360

Initial costs, buildings

370,154

Additions subsequent to acquisition, Improvements

6,530

Land at cost

14,360

Buildings at cost

376,684

Total at cost

391,044

Accumulated Depreciation

31,857

Encumbrances

$ 0

Date of Construction

2010

Date Acquired

Sep. 29, 2017

Life on which depreciation in latest income statements is computed (Years)

40 years

2010 [Member] | Newburgh, IN [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 1,215

Initial costs, buildings

7,212

Land at cost

1,215

Buildings at cost

7,212

Total at cost

8,427

Accumulated Depreciation

472

Encumbrances

$ 0

Date of Construction

2010

Date Acquired

Oct. 19, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2010 [Member] | Sherman, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 3,363

Initial costs, buildings

10,931

Land at cost

14,294

Buildings at cost

10,931

Total at cost

3,363

Accumulated Depreciation

4,326

Encumbrances

$ 0

Date of Construction

2010

Date Acquired

Oct. 31, 2014

Life on which depreciation in latest income statements is computed (Years)

40 years

2022 [Member] | Bakersfield, CA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 2,178

Initial costs, buildings

45,253

Land at cost

2,178

Buildings at cost

45,253

Total at cost

47,431

Accumulated Depreciation

2,074

Encumbrances

$ 0

Date of Construction

2022

Date Acquired

May 15, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1922 [Member] | Lewiston, ID [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 5,389

Initial costs, buildings

75,435

Land at cost

5,389

Buildings at cost

75,435

Total at cost

80,824

Accumulated Depreciation

17,006

Encumbrances

$ 0

Date of Construction

1922

Date Acquired

May 01, 2017

Life on which depreciation in latest income statements is computed (Years)

40 years

1922 [Member] | London, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Buildings at cost

$ 40,164

1922 [Member] | Warren, OH [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 2,417

Initial costs, buildings

15,857

Additions subsequent to acquisition, Improvements

1,737

Land at cost

20,011

Buildings at cost

17,594

Total at cost

2,417

Accumulated Depreciation

3,598

Encumbrances

$ 0

Date of Construction

1922

Date Acquired

May 01, 2017

Life on which depreciation in latest income statements is computed (Years)

46 years

2013 [Member] | Hausman, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 1,500

Initial costs, buildings

8,957

Land at cost

1,500

Buildings at cost

8,957

Total at cost

10,457

Accumulated Depreciation

2,407

Encumbrances

$ 0

Date of Construction

2013

Date Acquired

Mar. 01, 2013

Life on which depreciation in latest income statements is computed (Years)

40 years

2013 [Member] | Helsinki, Finland [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 4,085

Initial costs, buildings

67,529

Land at cost

4,085

Buildings at cost

67,529

Total at cost

71,614

Accumulated Depreciation

3,137

Encumbrances

$ 0

Date of Construction

2013

Date Acquired

Mar. 11, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

2013 [Member] | Lafayette, IN [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 800

Initial costs, buildings

14,968

Additions subsequent to acquisition, Improvements

(25)

Land at cost

800

Buildings at cost

14,943

Total at cost

15,743

Accumulated Depreciation

4,068

Encumbrances

$ 0

Date of Construction

2013

Date Acquired

Feb. 01, 2013

Life on which depreciation in latest income statements is computed (Years)

40 years

2013 [Member] | Little Elm, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 1,241

Initial costs, buildings

3,491

Land at cost

1,241

Buildings at cost

3,491

Total at cost

4,732

Accumulated Depreciation

877

Encumbrances

$ 0

Date of Construction

2013

Date Acquired

Dec. 01, 2013

Life on which depreciation in latest income statements is computed (Years)

40 years

2013 [Member] | Post Falls Idaho

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 417

Initial costs, buildings

12,175

Additions subsequent to acquisition, Improvements

1,905

Land at cost

14,497

Buildings at cost

13,730

Total at cost

767

Accumulated Depreciation

3,442

Encumbrances

$ 0

Date of Construction

2013

Date Acquired

Dec. 31, 2013

Life on which depreciation in latest income statements is computed (Years)

40 years

2013 [Member] | Spartanburg, SC [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 1,135

Initial costs, buildings

15,717

Land at cost

16,852

Buildings at cost

15,717

Total at cost

1,135

Accumulated Depreciation

4,079

Encumbrances

$ 0

Date of Construction

2013

Date Acquired

Aug. 01, 2013

Life on which depreciation in latest income statements is computed (Years)

40 years

2013 [Member] | West Chester, OH [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 3,670

Initial costs, buildings

61,338

Land at cost

65,008

Buildings at cost

61,338

Total at cost

3,670

Accumulated Depreciation

3,670

Encumbrances

$ 0

Date of Construction

2013

Date Acquired

Oct. 19, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2013 [Member] | West Midlands, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 1,922

Initial costs, buildings

7,162

Land at cost

9,084

Buildings at cost

7,162

Total at cost

1,922

Accumulated Depreciation

$ 149

Date of Construction

2013

Date Acquired

Apr. 14, 2023

Life on which depreciation in latest income statements is computed (Years)

40 years

1971 [Member] | Boonton Township, NJ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 6,712

Initial costs, buildings

17,031

Land at cost

6,712

Buildings at cost

17,031

Total at cost

23,743

Accumulated Depreciation

1,510

Encumbrances

$ 0

Date of Construction

1971

Date Acquired

Sep. 30, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

1978 [Member] | Boonton Township, NJ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 6,712

Initial costs, buildings

17,031

Land at cost

6,712

Buildings at cost

17,031

Total at cost

23,743

Accumulated Depreciation

1,510

Encumbrances

$ 0

Date of Construction

1978

Date Acquired

Sep. 30, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

1978 [Member] | Phoenix, AZ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 12,695

Initial costs, buildings

73,773

Additions subsequent to acquisition, Improvements

4,499

Land at cost

90,967

Buildings at cost

78,272

Total at cost

12,695

Accumulated Depreciation

13,041

Encumbrances

$ 0

Date of Construction

1968

Date Acquired

Sep. 29, 2017

Life on which depreciation in latest income statements is computed (Years)

43 years

2007 [Member] | Godalming, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 9,356

Initial costs, buildings

18,980

Land at cost

9,356

Buildings at cost

18,980

Total at cost

28,336

Accumulated Depreciation

1,376

Encumbrances

$ 0

Date of Construction

2007

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2007 [Member] | Hinckley, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 2,466

Initial costs, buildings

16,804

Land at cost

2,466

Buildings at cost

16,804

Total at cost

19,270

Accumulated Depreciation

1,138

Encumbrances

$ 0

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2007 [Member] | Northland, MO [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Long term acute care hospital

Initial costs, land

$ 834

Initial costs, buildings

17,182

Land at cost

834

Buildings at cost

17,182

Total at cost

18,016

Accumulated Depreciation

5,549

Encumbrances

$ 0

Date of Construction

2007

Date Acquired

Feb. 14, 2011

Life on which depreciation in latest income statements is computed (Years)

40 years

2007 [Member] | Mesa, AZ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 6,498

Initial costs, buildings

100,032

Additions subsequent to acquisition, Improvements

4,152

Land at cost

6,498

Buildings at cost

104,184

Total at cost

110,682

Accumulated Depreciation

27,504

Encumbrances

$ 0

Date of Construction

2007

Date Acquired

Sep. 26, 2013

Life on which depreciation in latest income statements is computed (Years)

40 years

2015 [Member] | Chandler, AZ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 750

Initial costs, buildings

3,853

Land at cost

750

Buildings at cost

3,853

Total at cost

4,603

Accumulated Depreciation

795

Encumbrances

$ 0

Date of Construction

2015

Date Acquired

Oct. 07, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

2015 [Member] | Hoover, AL [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Freestanding ER

Initial costs, land

$ 0

Initial costs, buildings

1,034

Additions subsequent to acquisition, Improvements

296

Land at cost

Buildings at cost

7,581

Total at cost

7,581

Accumulated Depreciation

1,918

Encumbrances

$ 0

Date of Construction

2015

Date Acquired

May 01, 2015

Life on which depreciation in latest income statements is computed (Years)

34 years

1978 [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Date of Construction

1978

Date Acquired

Jul. 06, 2021

1978 [Member] | Kansas City, MO [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 10,497

Initial costs, buildings

64,419

Land at cost

10,497

Buildings at cost

64,419

Total at cost

74,916

Accumulated Depreciation

14,637

Encumbrances

$ 0

Date of Construction

1978

Date Acquired

Feb. 13, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

1978 [Member] | Norwalk, CA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 7,946

Initial costs, buildings

31,574

Additions subsequent to acquisition, Improvements

5,995

Land at cost

7,946

Buildings at cost

37,569

Total at cost

45,515

Accumulated Depreciation

2,178

Encumbrances

$ 0

Life on which depreciation in latest income statements is computed (Years)

40 years

1978 [Member] | San Antonio, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 8,053

Initial costs, buildings

10,851

Additions subsequent to acquisition, Improvements

7,982

Land at cost

26,886

Buildings at cost

18,833

Total at cost

8,053

Accumulated Depreciation

5,731

Encumbrances

$ 0

Date of Construction

1978

Date Acquired

Sep. 29, 2017

Life on which depreciation in latest income statements is computed (Years)

41 years

1977 [Member] | Braunfels, Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

$ 2,175

2,175

13,548

15,723

Accumulated Depreciation

2,910

Encumbrances

$ 0

Date of Construction

1977

Date Acquired

Jun. 30, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

1977 [Member] | London, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 12,451

Initial costs, buildings

81,267

Land at cost

12,451

Buildings at cost

81,267

Total at cost

93,718

Accumulated Depreciation

8,133

Encumbrances

$ 0

Date of Construction

1977

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1965 [Member] | Rochdale, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 3,577

Initial costs, buildings

40,753

Land at cost

44,330

Buildings at cost

40,753

Total at cost

3,577

Accumulated Depreciation

4,113

Encumbrances

$ 0

Date of Construction

1965

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1714 [Member] | Bromley, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 7,224

Initial costs, buildings

15,521

Land at cost

7,224

Buildings at cost

15,521

Total at cost

22,745

Accumulated Depreciation

1,077

Encumbrances

$ 0

Date of Construction

1714

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1979 [Member] | Phoenix, AZ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 2,396

Initial costs, buildings

12,643

Additions subsequent to acquisition, Improvements

2,985

Land at cost

18,024

Buildings at cost

15,628

Total at cost

2,396

Accumulated Depreciation

4,763

Encumbrances

$ 0

Date of Construction

1979

Date Acquired

Sep. 29, 2017

Life on which depreciation in latest income statements is computed (Years)

42 years

2012 [Member] | Carrollton, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 4,941

Initial costs, buildings

52,227

Land at cost

4,941

Buildings at cost

52,227

Total at cost

57,168

Accumulated Depreciation

3,089

Encumbrances

$ 0

Date of Construction

2012

Date Acquired

Oct. 19, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2012 [Member] | Casper, WY [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

$ 1,683

1,683

1,683

$ 0

2012

Feb. 29, 2012

2012 [Member] | Dewsburry, UK

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

ehavioral health facility

Initial costs, land

$ 1,120

Initial costs, buildings

10,199

Land at cost

1,120

Buildings at cost

10,199

Total at cost

11,319

Accumulated Depreciation

206

Encumbrances

$ 0

Date of Construction

2012

Date Acquired

Apr. 14, 2023

Life on which depreciation in latest income statements is computed (Years)

40 years

2012 [Member] | Dublin, OH [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 5,118

Initial costs, buildings

69,346

Land at cost

5,118

Buildings at cost

69,346

Total at cost

74,464

Accumulated Depreciation

4,058

Encumbrances

$ 0

Date of Construction

2012

Date Acquired

Oct. 19, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2012 [Member] | Florence, AZ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 900

Initial costs, buildings

28,462

Additions subsequent to acquisition, Improvements

105

Land at cost

900

Buildings at cost

28,567

Total at cost

29,467

Accumulated Depreciation

8,388

Encumbrances

$ 0

Date of Construction

2012

Date Acquired

Feb. 07, 2012

Life on which depreciation in latest income statements is computed (Years)

40 years

2012 [Member] | Lafayette, IN [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 2,829

Initial costs, buildings

10,795

Land at cost

2,829

Buildings at cost

10,795

Total at cost

13,624

Accumulated Depreciation

782

Encumbrances

$ 0

Date of Construction

2012

Date Acquired

Oct. 19, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2012 [Member] | Overlook, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 2,452

Initial costs, buildings

9,666

Additions subsequent to acquisition, Improvements

Land at cost

2,452

Buildings at cost

9,673

Total at cost

12,125

Accumulated Depreciation

2,626

Encumbrances

$ 0

Date of Construction

2012

Date Acquired

Feb. 01, 2013

Life on which depreciation in latest income statements is computed (Years)

40 years

2012 [Member] | Mount Pleasant, SC [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Long term acute care hospital

Initial costs, land

$ 597

Initial costs, buildings

2,198

Land at cost

597

Buildings at cost

2,198

Total at cost

2,795

Accumulated Depreciation

276

Encumbrances

$ 0

Date of Construction

2012

Date Acquired

Aug. 30, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

2012 [Member] | San Antonio, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 2,248

Initial costs, buildings

5,880

Land at cost

8,128

Buildings at cost

5,880

Total at cost

2,248

Accumulated Depreciation

1,641

Encumbrances

$ 0

Date of Construction

2012

Date Acquired

Oct. 02, 2012

Life on which depreciation in latest income statements is computed (Years)

40 years

2012 [Member] | Reading, United Kingdom [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 25,995

Initial costs, buildings

83,297

Land at cost

109,292

Buildings at cost

83,297

Total at cost

25,995

Accumulated Depreciation

6,367

Encumbrances

$ 0

Date of Construction

2012

Date Acquired

Dec. 18, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

2003 [Member] | Bury, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 8,510

Initial costs, buildings

19,391

Land at cost

8,510

Buildings at cost

19,391

Total at cost

27,901

Accumulated Depreciation

1,398

Encumbrances

$ 0

Date of Construction

2003

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2003 [Member] | Newark, NJ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 32,957

Initial costs, buildings

24,553

Land at cost

32,957

Buildings at cost

24,553

Total at cost

57,510

Accumulated Depreciation

2,019

Encumbrances

$ 0

Date of Construction

2003

Date Acquired

May 02, 2016

Life on which depreciation in latest income statements is computed (Years)

40 years

2003 [Member] | Youngstown, OH [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 4,335

Initial costs, buildings

3,565

Land at cost

8,388

Buildings at cost

4,053

Total at cost

4,335

Accumulated Depreciation

2,626

Encumbrances

$ 0

Date of Construction

2003

Date Acquired

May 01, 2017

Life on which depreciation in latest income statements is computed (Years)

41 years

1990 [Member] | Bossier City, LA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Initial costs, buildings

$ 26,348

1990 [Member] | Carmarthen, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 910

Initial costs, buildings

25,576

Land at cost

910

Buildings at cost

25,576

Total at cost

26,486

Accumulated Depreciation

2,583

Encumbrances

$ 0

Date of Construction

1990

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1990 [Member] | Darlington, United Kingdom [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

$ 5,228

5,228

26,348

31,576

Accumulated Depreciation

1,735

Encumbrances

$ 0

Date of Construction

1990

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1990 [Member] | Gloucester, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 5,580

Initial costs, buildings

61,373

Land at cost

5,580

Buildings at cost

61,373

Total at cost

66,953

Accumulated Depreciation

7,042

Encumbrances

$ 0

Date of Construction

1990

Date Acquired

Aug. 16, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

1990 [Member] | Hemel Hempstead, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 12,490

Initial costs, buildings

6,304

Land at cost

12,490

Buildings at cost

6,304

Total at cost

18,794

Accumulated Depreciation

550

Encumbrances

$ 0

Date of Construction

1990

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1990 [Member] | Leeds, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 2,280

Initial costs, buildings

9,521

Land at cost

2,280

Buildings at cost

9,521

Total at cost

11,801

Accumulated Depreciation

665

Encumbrances

$ 0

Date of Construction

1990

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1990 [Member] | Melton Mowbray, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 5,702

Initial costs, buildings

15,982

Land at cost

5,702

Buildings at cost

15,982

Total at cost

21,684

Accumulated Depreciation

1,143

Encumbrances

$ 0

Date of Construction

1990

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1990 [Member] | Reading, United Kingdom [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 34,795

Initial costs, buildings

46,173

Land at cost

80,968

Buildings at cost

46,173

Total at cost

34,795

Accumulated Depreciation

5,227

Encumbrances

$ 0

Date of Construction

1990

Date Acquired

Aug. 16, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

1956 [Member] | Detroit, MI [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Long term acute care hospital

Initial costs, land

$ 1,220

Initial costs, buildings

8,323

Land at cost

1,220

Buildings at cost

8,323

Total at cost

9,543

Accumulated Depreciation

3,305

Encumbrances

$ 0

Date of Construction

1956

Date Acquired

May 22, 2008

Life on which depreciation in latest income statements is computed (Years)

40 years

1953 [Member] | Denville, NJ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 15,709

Initial costs, buildings

55,772

Land at cost

15,709

Buildings at cost

55,772

Total at cost

71,481

Accumulated Depreciation

4,835

Encumbrances

$ 0

Date of Construction

1953

Date Acquired

Sep. 30, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

1953 [Member] | Port Huron, MI

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 2,531

Initial costs, buildings

14,252

Land at cost

16,783

Buildings at cost

14,252

Total at cost

2,531

Accumulated Depreciation

3,895

Encumbrances

$ 0

Date of Construction

1953

Date Acquired

Dec. 31, 2015

Life on which depreciation in latest income statements is computed (Years)

30 years

1976 [Member] | Layton, UT [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 14,360

Initial costs, buildings

370,154

Additions subsequent to acquisition, Improvements

6,530

Land at cost

14,360

Buildings at cost

376,684

Total at cost

391,044

Accumulated Depreciation

31,857

Encumbrances

$ 0

Date of Construction

1976

Date Acquired

Sep. 29, 2017

Life on which depreciation in latest income statements is computed (Years)

40 years

1976 [Member] | Phoenix, AZ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 12,695

Initial costs, buildings

73,773

Additions subsequent to acquisition, Improvements

4,499

Land at cost

90,967

Buildings at cost

78,272

Total at cost

12,695

Accumulated Depreciation

13,041

Encumbrances

$ 0

Date of Construction

1976

Date Acquired

Sep. 29, 2017

Life on which depreciation in latest income statements is computed (Years)

43 years

2019 [Member] | Clarksville, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 2,460

Initial costs, buildings

25,540

Land at cost

2,460

Buildings at cost

25,540

Total at cost

28,000

Accumulated Depreciation

2,130

Encumbrances

$ 0

Date of Construction

2019

Date Acquired

Dec. 17, 2020

Life on which depreciation in latest income statements is computed (Years)

39 years

2019 [Member] | Mesa, AZ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 2,604

Initial costs, buildings

16,400

Land at cost

2,604

Buildings at cost

16,400

Total at cost

19,004

Accumulated Depreciation

707

Encumbrances

$ 0

Date of Construction

2019

Date Acquired

Apr. 18, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

2019 [Member] | Overland Park, KS [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 3,191

Initial costs, buildings

14,263

Land at cost

3,191

Buildings at cost

14,263

Total at cost

17,454

Accumulated Depreciation

1,498

Encumbrances

$ 0

Date of Construction

2019

Date Acquired

Jun. 10, 2019

Life on which depreciation in latest income statements is computed (Years)

50 years

2011 [Member] | London, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Initial costs, land

$ 1,853

Initial costs, buildings

$ 10,622

2011 [Member] | New Braunfels, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Land at cost

$ 1,853

Buildings at cost

10,622

Total at cost

12,475

Accumulated Depreciation

850

Encumbrances

$ 0

Date of Construction

2011

Date Acquired

Feb. 29, 2012

Life on which depreciation in latest income statements is computed (Years)

40 years

1959 [Member] | Canterbury, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Life on which depreciation in latest income statements is computed (Years)

40 years

1959 [Member] | Coral Gables, FL [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 26,215

Initial costs, buildings

84,584

Land at cost

26,215

Buildings at cost

84,584

Total at cost

110,799

Accumulated Depreciation

5,295

Encumbrances

$ 0

Date of Construction

1959

Date Acquired

Aug. 01, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1959 [Member] | Norwalk, CA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 2,811

Initial costs, buildings

5,940

Land at cost

2,811

Buildings at cost

5,940

Total at cost

8,751

Accumulated Depreciation

464

Encumbrances

$ 0

Date of Construction

1959

Date Acquired

Jul. 06, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1994 [Member] | Cheadle, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 29,815

Initial costs, buildings

94,808

Land at cost

29,815

Buildings at cost

94,808

Total at cost

124,623

Accumulated Depreciation

6,413

Encumbrances

$ 0

Date of Construction

1994

Date Acquired

Jul. 08, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1994 [Member] | Worthing, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 6,716

Initial costs, buildings

30,146

Land at cost

36,862

Buildings at cost

30,146

Total at cost

6,716

Accumulated Depreciation

3,040

Encumbrances

$ 0

Date of Construction

1994

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

2001 [Member] | Cologne Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 4,426

Initial costs, buildings

14,965

Land at cost

4,426

Buildings at cost

14,965

Total at cost

19,391

Accumulated Depreciation

2,475

Encumbrances

$ 0

Date of Construction

2001

Date Acquired

Aug. 07, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

2001 [Member] | Darlington, United Kingdom [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 2,088

Initial costs, buildings

35,818

Land at cost

2,088

Buildings at cost

35,818

Total at cost

37,906

Accumulated Depreciation

3,138

Encumbrances

$ 0

Date of Construction

2001

Date Acquired

Aug. 07, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

2001 [Member] | Hope, AR [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 1,651

Initial costs, buildings

3,359

Additions subsequent to acquisition, Improvements

2,733

Land at cost

1,651

Buildings at cost

6,092

Total at cost

7,743

Accumulated Depreciation

1,395

Encumbrances

$ 0

Date of Construction

2001

Date Acquired

Sep. 29, 2017

Life on which depreciation in latest income statements is computed (Years)

41 years

2001 [Member] | Norwood, MA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

$ 6,373

6,373

$ 6,373

Jun. 27, 2018

Life on which depreciation in latest income statements is computed (Years)

46 years

1925 [Member] | Dover NJ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 3,865

Initial costs, buildings

8,693

Land at cost

3,865

Buildings at cost

8,693

Total at cost

12,558

Accumulated Depreciation

802

Encumbrances

$ 0

Date of Construction

1925

Date Acquired

Sep. 30, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

1935 [Member] | Darlington, United Kingdom [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

$ 21,246

21,246

48,262

69,508

Accumulated Depreciation

3,533

Encumbrances

$ 0

Date of Construction

1935

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1935 [Member] | Darlington UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Initial costs, buildings

$ 48,262

1960 [Member] | Bossier City, LA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Initial costs, buildings

$ 26,348

1960 [Member] | Darlington, United Kingdom [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

$ 5,228

5,228

26,348

31,576

Accumulated Depreciation

1,735

Encumbrances

$ 0

Date of Construction

1960

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1960 [Member] | Houston, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 3,274

Initial costs, buildings

27,324

Additions subsequent to acquisition, Improvements

32,499

Land at cost

3,274

Buildings at cost

59,823

Total at cost

63,097

Accumulated Depreciation

21,142

Encumbrances

$ 0

Date of Construction

1960

Date Acquired

Aug. 10, 2007

Life on which depreciation in latest income statements is computed (Years)

40 years

1960 [Member] | Huntington Park, CA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 3,132

Initial costs, buildings

6,103

Land at cost

3,132

Buildings at cost

5,002

Total at cost

8,134

Accumulated Depreciation

386

Encumbrances

$ 0

Date of Construction

1960

Date Acquired

Jul. 06, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1960 [Member] | London, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 6,161

Initial costs, buildings

15,655

Land at cost

6,161

Buildings at cost

15,655

Total at cost

21,816

Accumulated Depreciation

1,076

Encumbrances

$ 0

Date of Construction

1960

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1960 [Member] | Meyersdale, PA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 390

Initial costs, buildings

4,280

Land at cost

390

Buildings at cost

4,280

Total at cost

4,670

Accumulated Depreciation

731

Encumbrances

$ 0

Date of Construction

1960

Date Acquired

Dec. 17, 2019

Life on which depreciation in latest income statements is computed (Years)

30 years

1960 [Member] | Sherman, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 3,363

Initial costs, buildings

10,931

Land at cost

14,294

Buildings at cost

10,931

Total at cost

3,363

Accumulated Depreciation

4,326

Encumbrances

$ 0

Date of Construction

1960

Date Acquired

Oct. 31, 2014

Life on which depreciation in latest income statements is computed (Years)

40 years

1840 [Member] | Diss, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 2,910

Initial costs, buildings

10,377

Land at cost

2,910

Buildings at cost

10,377

Total at cost

13,287

Accumulated Depreciation

796

Encumbrances

$ 0

Date of Construction

1840

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1993 [Member] | Dahlen, Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 1,342

Initial costs, buildings

11,339

Land at cost

1,342

Buildings at cost

11,339

Total at cost

12,681

Accumulated Depreciation

1,065

Encumbrances

$ 0

Date of Construction

1993

Date Acquired

Aug. 28, 2018

Life on which depreciation in latest income statements is computed (Years)

40 years

1993 [Member] | Dormagen Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 1,909

Initial costs, buildings

5,648

Land at cost

1,909

Buildings at cost

5,648

Total at cost

7,557

Accumulated Depreciation

801

Encumbrances

$ 0

Date of Construction

1993

Date Acquired

Aug. 28, 2018

Life on which depreciation in latest income statements is computed (Years)

40 years

1993 [Member] | San Bernardino, CA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 2,209

Initial costs, buildings

37,498

Land at cost

39,707

Buildings at cost

37,498

Total at cost

2,209

Accumulated Depreciation

4,439

Encumbrances

$ 0

Date of Construction

1993

Date Acquired

Aug. 30, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

1830 [Member] | Bromley, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 7,224

Initial costs, buildings

15,521

Land at cost

7,224

Buildings at cost

15,521

Total at cost

22,745

Accumulated Depreciation

1,077

Encumbrances

$ 0

Date of Construction

1830

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1969 [Member] | Denville, NJ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 15,709

Initial costs, buildings

55,772

Land at cost

15,709

Buildings at cost

55,772

Total at cost

71,481

Accumulated Depreciation

4,835

Encumbrances

$ 0

Date of Construction

1969

Date Acquired

Sep. 30, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

1969 [Member] | Hialeah, FL [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 18,802

Initial costs, buildings

222,271

Additions subsequent to acquisition, Improvements

73,911

Land at cost

18,802

Buildings at cost

107,783

Total at cost

126,585

Accumulated Depreciation

6,896

Encumbrances

$ 0

Date of Construction

1950

Date Acquired

Aug. 01, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1969 [Member] | Huntington Park, CA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 3,132

Initial costs, buildings

6,103

Land at cost

3,132

Buildings at cost

5,002

Total at cost

8,134

Accumulated Depreciation

386

Encumbrances

$ 0

Date of Construction

1969

Date Acquired

Jul. 06, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1927 [Member] | Dover NJ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 3,865

Initial costs, buildings

8,693

Land at cost

3,865

Buildings at cost

8,693

Total at cost

12,558

Accumulated Depreciation

802

Encumbrances

$ 0

Date of Construction

1927

Date Acquired

Sep. 30, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

2021 [Member] | Bromley, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 7,224

Initial costs, buildings

15,521

Land at cost

7,224

Buildings at cost

15,521

Total at cost

22,745

Accumulated Depreciation

1,077

Encumbrances

$ 0

Date of Construction

2021

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2021 [Member] | McKinney, Texas [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 2,934

Initial costs, buildings

2,934

2,934

$ 0

Oct. 19, 2021

2021 [Member] | Preston, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 8,740

Initial costs, buildings

26,001

Land at cost

34,741

Buildings at cost

26,001

Total at cost

8,740

Accumulated Depreciation

1,741

Encumbrances

$ 0

Date of Construction

2021

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2021 [Member] | Stockton, California [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 2,798

Initial costs, buildings

50,610

Land at cost

53,408

Buildings at cost

50,610

Total at cost

2,798

Accumulated Depreciation

835

Encumbrances

$ 0

Date of Construction

2021

Date Acquired

Nov. 23, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

2020 [Member] | Darlington, United Kingdom [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

$ 21,246

21,246

48,262

69,508

Accumulated Depreciation

3,533

Encumbrances

$ 0

Date of Construction

2020

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2020 [Member] | Darlington UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Initial costs, buildings

$ 48,262

2020 [Member] | Gilbert, AZ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 4,790

Initial costs, buildings

45,076

Land at cost

4,790

Buildings at cost

45,076

Total at cost

49,866

Accumulated Depreciation

2,614

Encumbrances

$ 0

Date of Construction

2020

Date Acquired

Oct. 19, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2020 [Member] | Houston, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 6,063

Initial costs, buildings

19,881

Additions subsequent to acquisition, Improvements

2,565

Land at cost

6,063

Buildings at cost

22,446

Total at cost

28,509

Accumulated Depreciation

1,683

Encumbrances

$ 0

Date of Construction

2020

Date Acquired

Oct. 25, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

2020 [Member] | Idaho Falls, ID [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 1,880

Initial costs, buildings

107,608

Additions subsequent to acquisition, Improvements

1,064

Land at cost

1,880

Buildings at cost

108,672

Total at cost

110,552

Accumulated Depreciation

10,525

Encumbrances

$ 0

Date of Construction

2020

Date Acquired

Dec. 19, 2017

Life on which depreciation in latest income statements is computed (Years)

40 years

2020 [Member] | Tadley, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 20,918

Initial costs, buildings

19,061

Land at cost

39,979

Buildings at cost

19,061

Total at cost

20,918

Accumulated Depreciation

1,565

Encumbrances

$ 0

Date of Construction

2020

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2020 [Member] | Woking, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 7,240

Initial costs, buildings

4,680

Land at cost

11,920

Buildings at cost

4,680

Total at cost

7,240

Accumulated Depreciation

358

Encumbrances

$ 0

Date of Construction

2020

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1986 [Member] | Halsall, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 2,014

Initial costs, buildings

31,159

Land at cost

2,014

Buildings at cost

31,159

Total at cost

33,173

Accumulated Depreciation

3,585

Encumbrances

$ 0

Date of Construction

1986

Date Acquired

Aug. 16, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

1986 [Member] | Rowley, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 2,908

Initial costs, buildings

18,302

Land at cost

21,210

Buildings at cost

18,302

Total at cost

2,908

Accumulated Depreciation

2,171

Encumbrances

$ 0

Date of Construction

1986

Date Acquired

Aug. 16, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

1999 [Member] | Hartsville, SC [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 2,050

Initial costs, buildings

43,970

Land at cost

2,050

Buildings at cost

43,970

Total at cost

46,020

Accumulated Depreciation

10,625

Encumbrances

$ 0

Date of Construction

1999

Date Acquired

Aug. 31, 2015

Life on which depreciation in latest income statements is computed (Years)

34 years

1924 [Member] | Hastings, PA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 603

Initial costs, buildings

8,834

Land at cost

603

Buildings at cost

8,834

Total at cost

9,437

Accumulated Depreciation

1,453

Encumbrances

$ 0

Date of Construction

1924

Date Acquired

Dec. 17, 2019

Life on which depreciation in latest income statements is computed (Years)

30 years

1924 [Member] | Johnstown, PA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 8,877

Initial costs, buildings

247,158

Land at cost

8,877

Buildings at cost

247,158

Total at cost

256,035

Accumulated Depreciation

33,435

Encumbrances

$ 0

Date of Construction

1924

Date Acquired

Dec. 17, 2019

Life on which depreciation in latest income statements is computed (Years)

30 years

1924 [Member] | Roaring Springs, PA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 1,446

Initial costs, buildings

9,549

Land at cost

10,995

Buildings at cost

9,549

Total at cost

1,446

Accumulated Depreciation

1,621

Encumbrances

$ 0

Date of Construction

1924

Date Acquired

Dec. 17, 2019

Life on which depreciation in latest income statements is computed (Years)

30 years

1950 [Member] | Hialeah, FL [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 75,339

Initial costs, buildings

107,783

Land at cost

75,339

Buildings at cost

296,182

Total at cost

371,521

Accumulated Depreciation

15,345

Encumbrances

$ 0

Date of Construction

1969

Date Acquired

Aug. 01, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1950 [Member] | Houston, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 28,687

Initial costs, buildings

104,028

Additions subsequent to acquisition, Improvements

90,934

Land at cost

28,687

Buildings at cost

194,962

Total at cost

223,649

Accumulated Depreciation

16,337

Encumbrances

$ 0

Date of Construction

1950

Date Acquired

Sep. 29, 2017

Life on which depreciation in latest income statements is computed (Years)

41 years

1950 [Member] | Lynwood, CA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Land at cost

$ 30,116

1950 [Member] | Ottumwa, IA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 2,377

Initial costs, buildings

48,697

Land at cost

2,377

Buildings at cost

48,697

Total at cost

51,074

Accumulated Depreciation

7,246

Encumbrances

$ 0

Date of Construction

1950

Date Acquired

Dec. 17, 2019

Life on which depreciation in latest income statements is computed (Years)

30 years

1950 [Member] | Rockledge, FL [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 13,919

Initial costs, buildings

23,282

Additions subsequent to acquisition, Improvements

8,428

Land at cost

45,629

Buildings at cost

31,710

Total at cost

13,919

Accumulated Depreciation

6,584

Encumbrances

$ 0

Date of Construction

1950

Date Acquired

May 01, 2017

Life on which depreciation in latest income statements is computed (Years)

42 years

1950 [Member] | Sharon, PA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 6,179

Initial costs, buildings

9,066

Additions subsequent to acquisition, Improvements

8,513

Land at cost

23,758

Buildings at cost

17,579

Total at cost

6,179

Accumulated Depreciation

3,537

Encumbrances

$ 0

Date of Construction

1950

Date Acquired

May 01, 2017

Life on which depreciation in latest income statements is computed (Years)

41 years

1950 [Member] | Surrey, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 15,047

Initial costs, buildings

9,130

Land at cost

24,177

Buildings at cost

9,130

Total at cost

15,047

Accumulated Depreciation

334

Encumbrances

$ 0

Date of Construction

1950

Date Acquired

Dec. 09, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

1991 [Member] | Fresno, CA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 5,507

Initial costs, buildings

70,473

Land at cost

5,507

Buildings at cost

70,473

Total at cost

75,980

Accumulated Depreciation

8,228

Encumbrances

$ 0

Date of Construction

1991

Date Acquired

Aug. 30, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

1991 [Member] | Heidelberg, Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 6,237

Initial costs, buildings

35,625

Land at cost

6,237

Buildings at cost

35,625

Total at cost

41,862

Accumulated Depreciation

6,716

Encumbrances

$ 0

Date of Construction

1991

Date Acquired

Jun. 22, 2016

Life on which depreciation in latest income statements is computed (Years)

40 years

1700 [Member] | Frome, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 2,896

Initial costs, buildings

10,711

Land at cost

2,896

Buildings at cost

17,545

Total at cost

20,441

Accumulated Depreciation

1,237

Encumbrances

$ 0

Date of Construction

1700

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1966 [Member] | Gardena, CA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 14,010

Initial costs, buildings

65,282

Land at cost

14,010

Buildings at cost

65,282

Total at cost

79,292

Accumulated Depreciation

4,410

Encumbrances

$ 0

Date of Construction

1966

Date Acquired

Jul. 06, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1900 [Member] | Glasgow, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 1,429

Initial costs, buildings

15,619

Land at cost

1,429

Buildings at cost

15,619

Total at cost

17,048

Accumulated Depreciation

1,058

Encumbrances

$ 0

Date of Construction

1900

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1900 [Member] | London, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 6,161

Initial costs, buildings

15,655

Land at cost

6,161

Buildings at cost

15,655

Total at cost

21,816

Accumulated Depreciation

1,076

Encumbrances

$ 0

Date of Construction

1900

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1900 [Member] | York, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 21,635

Initial costs, buildings

71,771

Land at cost

93,406

Total at cost

21,635

Accumulated Depreciation

4,739

Encumbrances

$ 0

Date of Construction

1900

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 hours

1796 [Member] | Godalming, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 9,356

Initial costs, buildings

18,980

Land at cost

9,356

Buildings at cost

18,980

Total at cost

28,336

Accumulated Depreciation

1,376

Encumbrances

$ 0

Date of Construction

1796

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1886 [Member] | Grefath, Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 1,200

Initial costs, buildings

3,028

Land at cost

1,200

Buildings at cost

3,028

Total at cost

4,228

Accumulated Depreciation

439

Encumbrances

$ 0

Date of Construction

1886

Date Acquired

Aug. 28, 2018

Life on which depreciation in latest income statements is computed (Years)

40 years

1998 [Member] | Kuhlungsborn Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 6,700

Initial costs, buildings

17,226

Land at cost

6,700

Total at cost

23,926

Accumulated Depreciation

$ 288

Date of Construction

1998

Date Acquired

Jun. 01, 2023

Life on which depreciation in latest income statements is computed (Years)

40 years

1998 [Member] | Hassocks, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

$ 5,484

5,484

28,675

34,159

Accumulated Depreciation

2,203

Encumbrances

$ 0

Date of Construction

1998

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1885 [Member] | Heidelberg, Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 6,237

Initial costs, buildings

35,625

Land at cost

6,237

Buildings at cost

35,625

Total at cost

41,862

Accumulated Depreciation

6,716

Encumbrances

$ 0

Date of Construction

1885

Date Acquired

Jun. 22, 2016

Life on which depreciation in latest income statements is computed (Years)

40 years

1901 [Member] | Hemel Hempstead, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 12,490

Initial costs, buildings

6,304

Land at cost

12,490

Buildings at cost

6,304

Total at cost

18,794

Accumulated Depreciation

550

Encumbrances

$ 0

Date of Construction

1901

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2005 [Member] | Port Arthur, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 11,432

Initial costs, buildings

76,746

Additions subsequent to acquisition, Improvements

6,877

Land at cost

95,055

Buildings at cost

83,623

Total at cost

11,432

Accumulated Depreciation

20,870

Encumbrances

$ 0

Date of Construction

2005

Date Acquired

Sep. 26, 2013

Life on which depreciation in latest income statements is computed (Years)

40 years

2005 [Member] | Tomball, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Long term acute care hospital

Initial costs, land

$ 1,299

Initial costs, buildings

20,545

Land at cost

21,844

Buildings at cost

20,545

Total at cost

1,299

Accumulated Depreciation

7,794

Encumbrances

$ 0

Date of Construction

2005

Date Acquired

Dec. 21, 2010

Life on which depreciation in latest income statements is computed (Years)

40 years

2002 [Member] | Idaho Falls, ID [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 1,822

Initial costs, buildings

41,316

Additions subsequent to acquisition, Improvements

30,353

Land at cost

1,822

Buildings at cost

71,669

Total at cost

73,491

Accumulated Depreciation

17,918

Encumbrances

$ 0

Date of Construction

2002

Date Acquired

Apr. 01, 2008

Life on which depreciation in latest income statements is computed (Years)

40 years

2002 [Member] | Melbourne, FL [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 5,642

Initial costs, buildings

17,087

Additions subsequent to acquisition, Improvements

21,830

Land at cost

5,642

Buildings at cost

38,917

Total at cost

44,559

Accumulated Depreciation

5,172

Encumbrances

$ 0

Date of Construction

2002

Date Acquired

May 01, 2017

Life on which depreciation in latest income statements is computed (Years)

42 years

2002 [Member] | San Antonio, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 8,053

Initial costs, buildings

10,851

Additions subsequent to acquisition, Improvements

7,982

Land at cost

26,886

Buildings at cost

18,833

Total at cost

8,053

Accumulated Depreciation

5,731

Encumbrances

$ 0

Date of Construction

2002

Date Acquired

Sep. 29, 2017

Life on which depreciation in latest income statements is computed (Years)

41 years

1892 [Member] | Hinckley, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 2,466

Initial costs, buildings

16,804

Land at cost

2,466

Buildings at cost

16,804

Total at cost

19,270

Accumulated Depreciation

1,138

Encumbrances

$ 0

Date of Construction

1892

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2000 [Member] | Cadiz Spain [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 299

Initial costs, buildings

6,799

Land at cost

299

Buildings at cost

6,799

Total at cost

7,098

Accumulated Depreciation

304

Encumbrances

$ 0

Date of Construction

2000

Date Acquired

Apr. 29, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

2000 [Member] | Hinckley, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Date of Construction

2007

2000 [Member] | Lynwood, CA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 30,116

Initial costs, buildings

148,527

Land at cost

30,116

Buildings at cost

148,527

Total at cost

178,643

Accumulated Depreciation

12,749

Encumbrances

$ 0

Date of Construction

2000

Date Acquired

Aug. 13, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

2000 [Member] | Montclair, NJ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Initial costs, land

$ 7,900

Initial costs, buildings

99,640

Additions subsequent to acquisition, Improvements

577

Buildings at cost

$ 99,640

Life on which depreciation in latest income statements is computed (Years)

40 years

2000 [Member] | Nottingham, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 10,160

Initial costs, buildings

3,246

Land at cost

10,160

Buildings at cost

3,246

Total at cost

13,406

Accumulated Depreciation

227

Encumbrances

$ 0

Date of Construction

1980

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

2000 [Member] | Montclair New Jersey [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Land at cost

$ 8,477

Total at cost

108,117

Accumulated Depreciation

24,858

Encumbrances

$ 0

Date of Construction

2000

Date Acquired

Apr. 01, 2014

2000 [Member] | Warren, OH [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 2,417

Initial costs, buildings

15,857

Additions subsequent to acquisition, Improvements

1,737

Land at cost

20,011

Buildings at cost

17,594

Total at cost

2,417

Accumulated Depreciation

3,598

Encumbrances

$ 0

Date of Construction

2000

Date Acquired

May 01, 2017

Life on which depreciation in latest income statements is computed (Years)

46 years

2000 [Member] | Willenhall, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 7,289

Initial costs, buildings

16,262

Land at cost

23,551

Buildings at cost

16,262

Total at cost

7,289

Accumulated Depreciation

1,100

Encumbrances

$ 0

Date of Construction

2000

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1967 [Member] | Huntington Park, CA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 3,935

Initial costs, buildings

5,002

Land at cost

3,935

Buildings at cost

6,103

Total at cost

10,038

Accumulated Depreciation

461

Encumbrances

$ 0

Date of Construction

1967

Date Acquired

Jul. 06, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1975 [Member] | Lauderdale Lakes, FL [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 10,657

Initial costs, buildings

150,313

Land at cost

10,657

Buildings at cost

150,313

Total at cost

160,970

Accumulated Depreciation

10,300

Encumbrances

$ 0

Date of Construction

1975

Date Acquired

Aug. 01, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1987 [Member] | London, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 9,243

Initial costs, buildings

4,148

Land at cost

9,243

Buildings at cost

61,004

Total at cost

70,247

Accumulated Depreciation

6,121

Encumbrances

$ 0

Date of Construction

1984

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1987 [Member] | Orpington, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 10,338

Initial costs, buildings

42,714

Land at cost

10,338

Buildings at cost

42,714

Total at cost

53,052

Accumulated Depreciation

4,312

Encumbrances

$ 0

Date of Construction

1987

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1987 [Member] | Salt Lake City, UT [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 13,590

Initial costs, buildings

101,915

Additions subsequent to acquisition, Improvements

15,268

Land at cost

130,773

Buildings at cost

117,183

Total at cost

13,590

Accumulated Depreciation

17,550

Encumbrances

$ 0

Date of Construction

1987

Date Acquired

Sep. 29, 2017

Life on which depreciation in latest income statements is computed (Years)

41 years

1926 [Member] | Norwood, MA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

$ 6,373

6,373

$ 6,373

Jun. 27, 2018

Life on which depreciation in latest income statements is computed (Years)

46 years

1996 [Member] | Mcminnville, OR [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 5,000

Initial costs, buildings

97,900

Land at cost

5,000

Buildings at cost

97,900

Total at cost

102,900

Accumulated Depreciation

19,124

Encumbrances

$ 0

Date of Construction

1996

Date Acquired

Aug. 31, 2015

Life on which depreciation in latest income statements is computed (Years)

41 years

1996 [Member] | Poole, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 2,325

Initial costs, buildings

38,382

Land at cost

40,707

Buildings at cost

38,382

Total at cost

2,325

Accumulated Depreciation

4,722

Encumbrances

$ 0

Date of Construction

1996

Date Acquired

Apr. 03, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

1955 [Member] | Miami, FL [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 44,400

Initial costs, buildings

107,203

Land at cost

44,400

Buildings at cost

107,203

Total at cost

151,603

Accumulated Depreciation

8,092

Encumbrances

$ 0

Date of Construction

1955

Date Acquired

Aug. 01, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1955 [Member] | Windsor, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 12,184

Initial costs, buildings

104,726

Land at cost

116,910

Buildings at cost

104,726

Total at cost

12,184

Accumulated Depreciation

10,500

Encumbrances

$ 0

Date of Construction

1955

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1988 [Member] | Hassocks, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Initial costs, buildings

$ 28,675

1988 [Member] | Miami, FL [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 20,430

Initial costs, buildings

30,282

Additions subsequent to acquisition, Improvements

10,935

Land at cost

20,430

Buildings at cost

41,217

Total at cost

61,647

Accumulated Depreciation

1,483

Encumbrances

$ 0

Date of Construction

1988

Date Acquired

Apr. 25, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

1988 [Member] | Palestine, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 1,848

Initial costs, buildings

95,257

Land at cost

1,848

Buildings at cost

95,257

Total at cost

97,105

Accumulated Depreciation

9,986

Encumbrances

$ 0

Date of Construction

1988

Date Acquired

Dec. 17, 2019

Life on which depreciation in latest income statements is computed (Years)

40 years

1920 [Member] | Montclair, NJ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 7,900

Initial costs, buildings

99,640

Additions subsequent to acquisition, Improvements

577

Land at cost

8,477

Buildings at cost

99,640

Total at cost

108,117

Accumulated Depreciation

24,858

Encumbrances

$ 0

Date of Construction

1920

Date Acquired

Apr. 01, 2014

Life on which depreciation in latest income statements is computed (Years)

40 years

1920 [Member] | Pasco, WA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 2,594

Initial costs, buildings

13,195

Land at cost

15,789

Buildings at cost

13,195

Total at cost

2,594

Accumulated Depreciation

2,404

Encumbrances

$ 0

Date of Construction

1920

Date Acquired

Aug. 31, 2018

Life on which depreciation in latest income statements is computed (Years)

30 years

1920 [Member] | Newark, NJ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 32,957

Initial costs, buildings

24,553

Land at cost

32,957

Buildings at cost

24,553

Total at cost

57,510

Accumulated Depreciation

2,019

Encumbrances

$ 0

Date of Construction

1920

Date Acquired

May 02, 2016

Life on which depreciation in latest income statements is computed (Years)

40 years

1920 [Member] | Sussex, NJ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 477

Initial costs, buildings

2,097

Land at cost

2,574

Buildings at cost

2,097

Total at cost

477

Accumulated Depreciation

191

Encumbrances

$ 0

Date of Construction

1920

Date Acquired

Sep. 30, 2015

Life on which depreciation in latest income statements is computed (Years)

40 years

1919 [Member] | Newark, NJ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 32,957

Initial costs, buildings

24,553

Land at cost

32,957

Buildings at cost

24,553

Total at cost

57,510

Accumulated Depreciation

2,019

Encumbrances

$ 0

Date of Construction

1919

Date Acquired

May 02, 2016

Life on which depreciation in latest income statements is computed (Years)

40 years

1958 [Member] | Miami, FL [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 20,430

Initial costs, buildings

30,282

Additions subsequent to acquisition, Improvements

10,935

Land at cost

20,430

Buildings at cost

41,217

Total at cost

61,647

Accumulated Depreciation

1,483

Encumbrances

$ 0

Date of Construction

1958

Date Acquired

Apr. 25, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

1958 [Member] | Norwalk, CA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 7,946

Initial costs, buildings

31,574

Additions subsequent to acquisition, Improvements

5,995

Land at cost

7,946

Buildings at cost

37,569

Total at cost

45,515

Accumulated Depreciation

2,178

Encumbrances

$ 0

Date of Construction

1958

Date Acquired

Jul. 06, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1995 [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Land at cost

$ 2,811

Total at cost

8,751

Accumulated Depreciation

464

Encumbrances

$ 0

1995 [Member] | Barby, Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 1,819

Initial costs, buildings

20,290

Land at cost

1,819

Buildings at cost

20,290

Total at cost

22,109

Accumulated Depreciation

397

Encumbrances

$ 0

Date of Construction

1995

Date Acquired

Apr. 19, 2023

Life on which depreciation in latest income statements is computed (Years)

40 years

1995 [Member] | Brandis, Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Initial costs, land

$ 2,214

Initial costs, buildings

24,340

Land at cost

2,214

Buildings at cost

24,340

Total at cost

26,554

Accumulated Depreciation

485

Encumbrances

Date of Construction

1995

Date Acquired

Apr. 19, 2023

Life on which depreciation in latest income statements is computed (Years)

40 years

1995 [Member] | Norwalk, CA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Initial costs, land

$ 2,811

Initial costs, buildings

5,940

Buildings at cost

$ 5,940

Date of Construction

1995

Date Acquired

Jul. 06, 2021

1906 [Member] | Salt Lake City, UT [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 13,590

Initial costs, buildings

101,915

Additions subsequent to acquisition, Improvements

15,268

Land at cost

130,773

Buildings at cost

117,183

Total at cost

13,590

Accumulated Depreciation

17,550

Encumbrances

$ 0

Date of Construction

1906

Date Acquired

Sep. 29, 2017

Life on which depreciation in latest income statements is computed (Years)

41 years

1906 [Member] | Royston, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 6,734

Initial costs, buildings

20,048

Land at cost

26,782

Buildings at cost

20,048

Total at cost

6,734

Accumulated Depreciation

1,578

Encumbrances

$ 0

Date of Construction

1906

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1850 [Member] | Preston, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 8,740

Initial costs, buildings

26,001

Land at cost

34,741

Buildings at cost

26,001

Total at cost

8,740

Accumulated Depreciation

1,741

Encumbrances

$ 0

Date of Construction

1850

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1850 [Member] | Usk, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 1,730

Initial costs, buildings

22,202

Land at cost

23,932

Buildings at cost

22,202

Total at cost

1,730

Accumulated Depreciation

1,472

Encumbrances

$ 0

Date of Construction

1850

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1951 [Member] | Remscheid, Germany [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Rehabilitation hospital

Initial costs, land

$ 1,048

Initial costs, buildings

2,528

Land at cost

3,576

Buildings at cost

2,528

Total at cost

1,048

Accumulated Depreciation

357

Encumbrances

$ 0

Date of Construction

1951

Date Acquired

Aug. 28, 2018

Life on which depreciation in latest income statements is computed (Years)

40 years

1913 [Member] | Sherman, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 3,363

Initial costs, buildings

10,931

Land at cost

14,294

Buildings at cost

10,931

Total at cost

3,363

Accumulated Depreciation

4,326

Encumbrances

$ 0

Date of Construction

1913

Date Acquired

Oct. 31, 2014

Life on which depreciation in latest income statements is computed (Years)

40 years

1820 [Member] | Southampton, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 6,445

Initial costs, buildings

18,924

Land at cost

25,369

Buildings at cost

18,924

Total at cost

6,445

Accumulated Depreciation

1,466

Encumbrances

$ 0

Date of Construction

1820

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1940 [Member] | Houston, TX [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 28,687

Initial costs, buildings

104,028

Additions subsequent to acquisition, Improvements

90,934

Land at cost

28,687

Buildings at cost

194,962

Total at cost

223,649

Accumulated Depreciation

16,337

Encumbrances

$ 0

Date of Construction

1940

Date Acquired

Sep. 29, 2017

Life on which depreciation in latest income statements is computed (Years)

41 years

1940 [Member] | Lynwood, CA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Initial costs, land

$ 30,116

Initial costs, buildings

148,527

Buildings at cost

148,527

Total at cost

178,643

Accumulated Depreciation

12,749

Encumbrances

$ 0

Date of Construction

1940

Date Acquired

Aug. 13, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1940 [Member] | Tempe, AZ [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 6,050

Initial costs, buildings

10,986

Additions subsequent to acquisition, Improvements

5,239

Land at cost

22,275

Buildings at cost

16,225

Total at cost

6,050

Accumulated Depreciation

2,856

Encumbrances

$ 0

Date of Construction

1940

Date Acquired

Sep. 29, 2017

Life on which depreciation in latest income statements is computed (Years)

41 years

1770 [Member] | Usk, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 1,730

Initial costs, buildings

22,202

Land at cost

23,932

Buildings at cost

22,202

Total at cost

1,730

Accumulated Depreciation

1,472

Encumbrances

$ 0

Date of Construction

1770

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1962 [Member] | Miami, FL [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 20,430

Initial costs, buildings

30,282

Additions subsequent to acquisition, Improvements

10,935

Land at cost

20,430

Buildings at cost

41,217

Total at cost

61,647

Accumulated Depreciation

1,483

Encumbrances

$ 0

Date of Construction

1962

Date Acquired

Apr. 25, 2022

Life on which depreciation in latest income statements is computed (Years)

40 years

1962 [Member] | West Monroe, LA [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 11,702

Initial costs, buildings

69,433

Additions subsequent to acquisition, Improvements

19,116

Land at cost

100,251

Buildings at cost

87,997

Total at cost

12,254

Accumulated Depreciation

20,928

Encumbrances

$ 0

Date of Construction

1962

Date Acquired

Sep. 26, 2013

Life on which depreciation in latest income statements is computed (Years)

40 years

1911 [Member] | Winchester, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 6,487

Initial costs, buildings

10,277

Land at cost

16,764

Buildings at cost

10,277

Total at cost

6,487

Accumulated Depreciation

1,060

Encumbrances

$ 0

Date of Construction

1911

Date Acquired

Jan. 09, 2020

Life on which depreciation in latest income statements is computed (Years)

40 years

1800 [Member] | Woking, UK [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Behavioral health facility

Initial costs, land

$ 7,240

Initial costs, buildings

4,680

Land at cost

11,920

Buildings at cost

4,680

Total at cost

7,240

Accumulated Depreciation

358

Encumbrances

$ 0

Date of Construction

1800

Date Acquired

Jun. 25, 2021

Life on which depreciation in latest income statements is computed (Years)

40 years

1929 [Member] | Youngstown, OH [Member]

SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]

Type of property

Acute care general hospital

Initial costs, land

$ 4,335

Initial costs, buildings

3,565

Land at cost

8,388

Buildings at cost

4,053

Total at cost

4,335

Accumulated Depreciation

2,626

Encumbrances

$ 0

Date of Construction

1929

Date Acquired

May 01, 2017

Life on which depreciation in latest income statements is computed (Years)

41 years

[1]	Excludes approximately $400 million and $170 million of construction and building improvements in progress reflected in buildings and improvements at December 31, 2023 and 2022, respectively.

Real Estate and Other Activities

12 Months Ended

Dec. 31, 2023

Real Estate [Abstract]

Real Estate and Other Activities

3. Real Estate and Other Activities

New Investments

For the years ended December 31, 2023, 2022, and 2021, we acquired or invested in the following net assets (in thousands):


	2023			2022			2021
Land and land improvements	$	28,916		$	135,301		$	642,312
Buildings		114,966			487,698			2,381,654
Intangible lease assets — subject to amortization (weighted-average useful life of 24.8 years in 2023, 21.3 years in 2022, and 34.5 years in 2021)		16,305			45,394			262,385
Mortgage loans(1)		—			159,735			1,113,300
Investments in unconsolidated real estate joint ventures		—			399,456			—
Investments in unconsolidated operating entities		50,000			131,105			1,033,096
Other loans		25,000			—			—
Liabilities assumed		—			(25,727	)		(82,508	)
	$	235,187		$	1,332,962		$	5,350,239
Loans repaid(1)		(22,900	)		—			(1,103,410	)
Total net assets acquired	$	212,287		$	1,332,962		$	4,246,829

(1)

2023 Activity

Prospect Transaction

In August 2019, we invested in a portfolio of 14 acute care hospitals in three states (California, Pennsylvania, and Connecticut) operated by and master leased to or mortgaged by Prospect Medical Holdings, Inc. ("Prospect") for a combined investment of approximately $1.5 billion. In addition, we originated a $112.9 million term loan cross-defaulted to the master lease and mortgage loan agreements and further secured by a parent guaranty. In the 2022 second quarter, we funded an additional $100 million towards the existing mortgage loan that was secured by a first lien on a California hospital. Prospect's operations were negatively impacted by the coronavirus global pandemic commencing in early 2020, but Prospect remained current with respect to contractual rent and interest payments until the fourth quarter of 2022. Accordingly, and due further to the termination of certain refinancing negotiations between Prospect and certain third parties in early 2023 that would have recapitalized Prospect and provided for payment of unpaid rent and interest, we recorded an approximate $280 million impairment charge in the 2022 fourth quarter. As part of this charge, we reduced the carrying value of the underperforming Pennsylvania properties by approximately $170 million (to approximately $250 million) and reserved all unbilled rent accruals for a total of $112 million.

However, Prospect continued to pursue a recapitalization plan, and, in late March 2023, Prospect received a binding commitment from several lenders to provide liquidity to pay down certain debt instruments. Along with these commitments from third-party lenders, we agreed to pursue certain transactions with Prospect as part of their recapitalization plan, including originating a $50 million convertible loan to PHP Holdings, the managed care business of Prospect, in the first quarter of 2023.

On May 23, 2023, Prospect completed its recapitalization plan, which included receiving $375 million in new financing from several lenders. Along with this new debt capital from third-party lenders, we agreed to the following restructuring of our then $1.7 billion investment in Prospect including: a) maintaining the master lease covering six California hospitals without any changes in rental rates or escalator provisions, but with cash payments starting in September 2023 for a substantial portion of the contractual

monthly rent due on these California properties, b) transitioning the Pennsylvania properties back to Prospect in return for a $150 million first lien mortgage on the facilities, c) providing up to $75 million in a loan secured by a first lien on Prospect's accounts receivable and certain other assets, of which we have funded in full as of December 31, 2023, d) continuing to pursue the previously disclosed sale of the Connecticut properties to Yale New Haven ("Yale"), as more fully described in Note 8 to the consolidated financial statements, and e) obtaining a non-controlling ownership interest in PHP Holdings of approximately $654 million, after applying a discount for lack of marketability, consisting of an approximate $68 million equity investment and $586 million loan convertible into equity of PHP Holdings (collectively, the "Prospect Transaction"). This non-controlling ownership interest was received in exchange for unpaid rent and interest through December 2022, previously unrecorded rent and interest revenue in 2023 totaling approximately $82 million, our $151 million mortgage loan on a California property, our $112.9 million term loan, and other obligations at the time of such investment.

Lifepoint Transaction

On February 7, 2023, a subsidiary of Lifepoint Health, Inc. ("Lifepoint") acquired a majority interest in Springstone (now Lifepoint Behavioral) (the "Lifepoint Transaction") based on an enterprise value of $250 million. As part of the transaction, we received approximately $205 million in full satisfaction of our initial acquisition loan, including accrued interest, and we retained our minority equity investment in the operations of Lifepoint Behavioral. Separately, we converted a mortgage loan (as part of our initial acquisition in 2021) into the fee simple ownership of a property in Washington, which is leased, along with the other 18 behavioral health hospitals already leased to Lifepoint Behavioral, under the master lease agreement. In connection with the Lifepoint Transaction, Lifepoint extended its current lease with us on eight existing general acute care hospitals by five years to 2041.

Other Transactions

In the second quarter of 2023, we acquired three inpatient rehabilitation facilities for a total of approximately €70 million. These hospitals are leased to Median Kliniken S.á.r.l ("MEDIAN") pursuant to a long-term master lease with annual inflation-based escalators.

On April 14, 2023, we acquired five behavioral health hospitals located in the U.K. for approximately £44 million. These hospitals are leased to Priory pursuant to five separate lease agreements with annual inflation-based escalators.

2022 Activity

Macquarie Transaction

On March 14, 2022, we completed a transaction with MAM, an unrelated party, to form a partnership (the “Macquarie Transaction”), pursuant to which we contributed eight Massachusetts-based general acute care hospitals that are leased to Steward, and a fund managed by MAM acquired, for cash consideration, a 50% interest in the partnership. The transaction valued the portfolio at approximately $1.7 billion, and we recognized a gain on sale of real estate of approximately $600 million from this transaction, partially offset by the write-off of unbilled straight-line rent receivables. The partnership raised nonrecourse secured debt of 55% of asset value, and we received proceeds, including from the secured debt, of approximately $1.3 billion. We obtained a 50% interest in the real estate partnership valued at approximately $400 million (included in the "Investments in unconsolidated real estate joint ventures" line of our consolidated balance sheets), which is being accounted for under the equity method of accounting.

In connection with this transaction, we separated the eight Massachusetts-based facilities into a new master lease with terms generally identical to the other master lease, and the initial fixed lease term of both master leases was extended to 2041.

Other Transactions

On December 9, 2022, we acquired six behavioral health facilities in the U.K. for £233 million ($286 million), plus customary tax and other transaction costs. These hospitals are leased to Priory pursuant to separate long-term leases with inflation-based escalators. As part of this transaction, the third-party seller of the real estate provided £105 million of seller financing - see Note 4 for further details on this debt.

On March 11, 2022, we acquired four general acute care hospitals in Finland for €178 million ($194 million). These hospitals are leased to Pihlajalinna pursuant to a long-term lease with annual inflation-based escalators. We acquired these facilities by purchasing the shares of the real estate holding entities, which included deferred income tax and other liabilities of approximately $26 million.

On February 16, 2022, we agreed to participate in an existing syndicated term loan with a term of six years originated on behalf of Priory, of which we funded £96.5 million towards a £100 million participation level in the variable rate loan.

Other investments in 2022 included six general acute care facilities. Three general acute care facilities, located throughout Spain, were acquired on April 29, 2022 for €27 million and are leased to GenesisCare pursuant to a long-term lease with annual inflation-based escalators. Two general acute care facilities, one in Arizona and the other in Florida, were acquired on April 18 and 25, 2022, respectively, for approximately $80 million and are leased to Steward pursuant to a master lease agreement with annual inflation-based escalators. The other general acute care facility, located in Colombia, was acquired on July 29, 2022 for $26 million and is leased to Fundación Cardiovascular de Colombia pursuant to a long-term lease with inflation-based escalators.

2021 Activity

Priory Group Transaction

On January 19, 2021, we completed the first of two phases in the Priory transaction in which we funded an £800 million interim mortgage loan on an identified portfolio of Priory real estate assets in the U.K. On June 25, 2021, we completed the second phase of the transaction in which we converted this mortgage loan to fee simple ownership in a portfolio of 35 select real estate assets from Priory (which is ultimately owned by two Waterland Private Equity funds (“Waterland Fund”) through its ownership of MEDIAN) in individual sale-and-leaseback transactions. Therefore, the net aggregate purchase price for the real estate assets we acquired from Priory was approximately £800 million, plus customary stamp duty, tax, and other transaction costs. As part of the real estate acquisition (for which some of the assets were acquired by the share purchase of real estate holding entities), we incurred deferred income tax liabilities and other liabilities of approximately £47.1 million.

In addition to the real estate investment, on January 19, 2021, we made a £250 million acquisition loan to Waterland Fund, in connection with the closing of Waterland Fund’s acquisition of Priory, which was repaid in full plus interest on October 22, 2021.

Finally, we acquired a 9.9% passive equity interest in the Waterland Fund affiliate that indirectly owns Priory.

Other Transactions

On December 2, 2021, we acquired the remaining 50% interest in a general acute hospital operated by IMED Hospitales ("IMED") in Valencia, Spain, which was formerly owned by our joint venture partner. We followed the asset acquisition cost accumulation model to account for this acquisition and included the carrying amount of our previously held equity interest, along with the approximately €46 million consideration paid and direct transaction costs incurred, in determining the total cost allocated to the net assets acquired.

On October 21, 2021, we acquired an acute care facility in Portugal for €17.8 million. This facility is leased to Atrys Health pursuant to a long-term master lease with annual escalations.

On October 19, 2021, we invested in 18 inpatient behavioral health facilities throughout the U.S. and an interest in the operations of Springstone (now Lifepoint Behavioral) for total consideration of $950 million (including an acquisition loan of approximately $185 million), plus closing and other transaction costs. We also incurred deferred income tax liabilities of approximately $8.0 million. After the Lifepoint Transaction in 2023, these facilities are now leased to Lifepoint Behavioral pursuant to a long-term master lease with annual escalations and multiple extension options.

On August 1, 2021, we completed the acquisition of five general acute care hospitals located in South Florida for approximately $900 million, plus closing and other transaction costs. These hospitals are leased to Steward pursuant to a master lease, with annual inflation-based escalators.

On July 6, 2021, we acquired four acute care hospitals and two on-campus medical office buildings in Los Angeles, California for $215 million. These hospitals are leased to Pipeline Health System, LLC ("Pipeline") pursuant to a long-term lease with annual inflation-based escalators.

On July 6, 2021, we also acquired an acute care hospital in Stirling, Scotland for £15.6 million. This hospital is leased to Circle Health Ltd. (“Circle”) pursuant to a long-term lease with annual inflation-based escalators.

On April 16, 2021, we made a CHF 145 million investment in Swiss Medical Network, our tenant via our Infracore SA ("Infracore") equity investment.

On January 8, 2021, we made a $335 million loan to affiliates of Steward, all of the proceeds of which were used to redeem a similarly sized convertible loan held by Steward’s former private equity sponsor.

Development Activities

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


Property	Commitment		Costs Incurred as of December 31, 2023		Estimated Rent Commencement Date
IMED (Spain)	$	50,099	$	49,534	1Q 2024
Lifepoint Behavioral Health (Texas)		31,600		24,023	1Q 2024
IMED (Spain)		37,879		17,876	3Q 2024
IMED (Spain)		51,984		18,640	1Q 2025
	$	171,562	$	110,073

We have two other development projects ongoing in Texas (Wadley development) and Massachusetts (Norwood redevelopment). These are not highlighted above given the ongoing restructuring of Steward. However, on a combined basis, we have spent approximately $350 million through December 31, 2023.

Separately, on the Norwood redevelopment, we have approximately $150 million, net of payments received to date, due to us from a combination of recovery receivables (included in "Other assets" in the consolidated balance sheets) associated with the damage to the original facility in 2020 and a $50 million advance (reflected in "Other loans" in the consolidated balance sheets) made to Steward in the first half of 2023 that is secured by, among other things, proceeds from Steward's business interruption insurance claims.

2023 Activity

During 2023, we completed construction and began recording rental income on one inpatient rehabilitation facility located in Lexington, South Carolina, which commenced rent on July 1, 2023 and another inpatient rehabilitation facility located in Stockton, California, which commenced rent on May 1, 2023. Both of these facilities are leased to Ernest Health, Inc. ("Ernest") pursuant to an existing long-term master lease.

2022 Activity

During 2022, we completed construction and began recording rental income on an inpatient rehabilitation facility located in Bakersfield, California. This facility commenced rent on March 1, 2022 and is leased to Ernest pursuant to an existing long-term master lease.

Disposals

2023 Activity

On March 30, 2023, we entered into a definitive agreement to sell our 11 general acute care facilities located in Australia and operated by Healthscope Ltd. ("Healthscope") (the "Australia Transaction") to affiliates of HMC Capital for cash proceeds of approximately A$1.2 billion. As a result, we designated the Australian portfolio as held for sale in the first quarter of 2023 and have recorded approximately $86 million of net impairment charges, which included $37.4 million of straight-line rent receivables and approximately $8 million in fees to sell the hospitals. This impairment charge was partially offset by approximately $8 million of deferred gains from our interest rate swap and foreign currency translation in accumulated other comprehensive income that was reclassified to earnings as part of the transaction. This transaction was set to close in two phases. The first phase closed on May 18, 2023, in which we sold seven of the 11 facilities for A$730 million, and the final phase closed on October 10, 2023, in which we sold the remaining four facilities for approximately A$470 million.

On March 8, 2023, we received notice that Prime Healthcare Services, Inc. ("Prime") planned to exercise its right to repurchase from us the real estate associated with one master lease for approximately $100 million. As such, we recorded an approximate $11 million non-cash impairment charge in the first quarter of 2023 related to unbilled rent on the three facilities that were sold. On July 11, 2023, Prime acquired the three facilities for $100 million.

Summary of Operations for Assets Disposed in 2023

The following represents the operating results from properties sold for the periods presented (in thousands):


	For the Year Ended December 31,
	2023			2022			2021
Revenues	$	37,332		$	75,084		$	75,464
Real estate depreciation and amortization		(4,991	)		(20,312	)		(21,467	)
Property-related expenses		(2,467	)		(5,492	)		(3,479	)
Real estate and other impairment charges(1)		(96,405	)		—			—
Other (expense) income		(1,661	)		(1,082	)		(1,075	)
(Loss) income from real estate dispositions, net	$	(68,192	)	$	48,198		$	49,443

(1)

2022 Activity

On March 14, 2022, we completed the previously described partnership with MAM, in which we sold the real estate of eight Massachusetts-based general acute care hospitals, with a fair value of approximately $1.7 billion. See "New Investments" in this same Note 3 for further details on this transaction.

During 2022, we also completed the sale of 15 other facilities (including 11 properties sold on September 1, 2022 to Prime for proceeds of $366 million) and five ancillary properties for total proceeds of approximately $522 million and recognized a gain on the sale of real estate of approximately $100 million, along with a $42 million write-off of straight-line rent receivables due to the early termination of certain properties' expected lease terms.

2021 Activity

During the 2021 fourth quarter, we sold our interest in the operations of three operators (two of which were in Germany) for proceeds of approximately $54.5 million, resulting in a net gain of approximately $40 million.

During 2021, we also completed the sale of 16 facilities and an ancillary property for approximately $246 million, resulting in a net gain on real estate of approximately $52.5 million.

The properties sold during 2023, 2022, and 2021 do not meet the definition of discontinued operations.

Intangible Assets

At December 31, 2023 and 2022, our intangible lease assets were $1.0 billion ($0.9 billion, net of accumulated amortization) and $1.4 billion ($1.2 billion, net of accumulated amortization), respectively.


For the Year Ended December 31:
2024	$	40,934
2025		40,081
2026		39,933
2027		39,664
2028		39,330

As of December 31, 2023, capitalized lease intangibles have a weighted-average remaining life of 24.0 years.

Leasing Operations (Lessor)

We acquire and develop healthcare facilities and lease the facilities to healthcare operating companies. The initial fixed lease terms of these infrastructure-type assets are typically at least 15 years, and most include renewal options at the election of our tenants, generally in five year increments. Over 99% of our leases provide annual rent escalations based on increases in the CPI (or similar indices outside the U.S.) and/or fixed minimum annual rent escalations. Many of our domestic leases contain purchase options with

pricing set at various terms but in no case less than our total initial investment. 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.


	Total Under Operating Leases		Total Under Financing Leases		Total
2024	$	979,053	$	111,929	$	1,090,982
2025		994,198		114,224		1,108,422
2026		1,010,217		116,566		1,126,783
2027		1,064,958		118,954		1,183,912
2028		1,077,981		121,390		1,199,371
Thereafter		25,489,598		3,079,714		28,569,312
	$	30,616,005	$	3,662,777	$	34,278,782

For all of our properties subject to lease, we are the legal owner of the property and the tenant's right to use and possess such property is guided by the terms of a lease. At December 31, 2023, we account for all of these leases as operating leases, except where GAAP requires alternative classification, including leases on 13 Ernest facilities that are accounted for as DFLs and leases on nine of our Prospect facilities and five of our Ernest facilities that are accounted for as a financing. The components of our total investment in financing leases consisted of the following (in thousands):


	As of December 31, 2023			As of December 31, 2022
Minimum lease payments receivable	$	611,669		$	880,253
Estimated unguaranteed residual values		203,818			203,818
Less: Unearned income and allowance for credit loss		(571,059	)		(731,915	)
Net investment in direct financing leases		244,428			352,156
Other financing leases (net of allowance for credit loss)		987,202			1,339,167
Total investment in financing leases	$	1,231,630		$	1,691,323

The decrease in our investment in financing leases during 2023 is the result of selling three Prime facilities in the third quarter of 2023 and the sale of four Pennsylvania properties as part of the Prospect Transaction.

Other Leasing Activities

At December 31, 2023, our vacant properties represent less than 0.3% of total assets. We are in various stages of either releasing or selling these vacant properties.

See below for an update on some of our tenants:

Steward Health Care System

Utah Transaction

On May 1, 2023, Catholic Health Initiatives Colorado ("CHIC"), a wholly owned subsidiary of CommonSpirit Health ("CommonSpirit"), acquired the Utah hospital operations of five general acute care facilities previously operated by Steward (the "Steward Utah Transaction"). As a result of this transaction, we received $100 million on May 1, 2023, of the $150 million loan made in the 2022 second quarter (see "Other Investment Activities" in this same Note 3 for details). The new lease with CHIC for these Utah assets had an initial fixed term of 15 years with annual escalation provisions, along with early lessee purchase options at the greater of fair market value or our gross investment. As part of this transaction, we severed these facilities from the master lease with Steward, and accordingly accelerated the amortization of the associated in-place lease intangibles (approximately $286 million) and wrote-off approximately $95 million of straight-line rent receivables in 2023.

Operational and Liquidity Challenges

Steward delayed paying a portion of its September 2023 rent and paid only $16 million of its required $70 million of rent and interest obligations (including our share of rent due to the Massachusetts partnership with MAM) for the 2023 fourth quarter. Due to these payment shortfalls, we have engaged financial and legal advisors to advise us on our best options to protect our investments,

including the recovery of unpaid rent and interest. To this point, we funded a $60 million bridge loan in January 2024 secured by our existing collateral as well as new second liens on the managed care business of Steward. As discussed in Note 13 to the consolidated financial statements, we and certain of Steward’s asset backed lenders agreed to a new bridge facility in February 2024 and have funded an additional $37.5 million each to Steward. In addition to these fundings, we agreed to a forbearance agreement in which we consented to the deferral of unpaid rent and interest through December 2023, as well as a limited and tapering deferral of rent in 2024. Partial rent payments began in 2024, and we have received approximately $20 million through February 22, 2024. Per the forbearance agreement, full rent and interest payments are required to resume in June 2024.


Description	Amount		Income Statement Classification
Reserve of unpaid rent and lease incentives	$	154	Rent billed
Reserve of straight-line rent receivables		224	Straight-line rent
Reserve of unpaid interest receivables		35	Interest and other income
Impairment charge on equity investment and other assets (1)		171	Real estate and other impairment charges, net
Impairment charge on real estate assets (2)		100	Real estate and other impairment charges, net
Reserve of unpaid rent and straight-line rent receivables in the MAM partnership		30	Earnings from equity interests
Total	$	714

(1)

(2)

At December 31, 2023 and after the impairment charges discussed above, we believe our remaining investment in real estate leased to Steward, our equity and loan investments in Steward, and other assets are fully recoverable. However, no assurances can be given that Steward will be able to comply with the terms of the forbearance agreement, that we will be able to re-tenant or sell properties at favorable terms, or we will not have any additional impairments in future periods.

Alecto Healthcare Services LLC

On June 16, 2023, Alecto Healthcare Services LLC ("Alecto") filed for Chapter 11 bankruptcy in Delaware. At the time, we leased one property to Alecto in Sherman, Texas that has a net book value of approximately $11 million at December 31, 2023. We accounted for this lease with Alecto under the cash basis and did not recognize any revenue related to this property in the 2023 third or fourth quarters. As a result of this bankruptcy, we entered into a restructuring agreement involving the Sherman facility and American Healthcare Systems. Effective January 1, 2024, American Healthcare Systems is our new tenant, working under the terms of the existing lease that was in place with a term ending in January 2039.

Prospect

Starting January 1, 2023, we began accounting for our leases and loans to Prospect on a cash basis versus our normal accrual method. During 2023, we recognized approximately $96 million of revenue. Of this, approximately $82 million was recorded as part of the Prospect Transaction, in which we received additional investments in PHP Holdings, in lieu of cash, for the rent and interest that was owed. Subsequent to the Prospect Transaction, we recognized approximately $14 million of revenue representing cash received for rents on our California properties (in line with the amended terms of the master lease), rent on our Connecticut properties, and interest on the $75 million loan discussed earlier in this Note 3.

In regard to PHP Holdings, we account for our investment (both the equity investment and convertible loan) using the fair value option method. Each quarter, we mark such investment to fair value as more fully described in Note 10 to the consolidated financial statements. Subsequent to the Prospect Transaction in May 2023, we have recorded approximately $45 million of positive fair value adjustments, resulting in a total investment in PHP Holdings of approximately $700 million at December 31, 2023.

At December 31, 2023, we believe our remaining investment in the Prospect real estate, our investment in PHP Holdings, and other assets are fully recoverable, but no assurances can be given that we will not have any impairments in future periods.

Pipeline Health System

On October 2, 2022, Pipeline filed for reorganization relief under Chapter 11 protection of the United States Bankruptcy Code in the Southern District of Texas, while keeping its hospitals open to continue providing care to the communities served. On February 6, 2023, Pipeline emerged from bankruptcy. Per the bankruptcy settlement, Pipeline's current lease of our California assets remains in place, and we were repaid on February 7, 2023 for all rent that was outstanding at December 31, 2022, along with what was due for the first quarter of 2023. As part of the settlement, we deferred approximately $6 million, or approximately 30%, of rent in 2023 to be paid in 2024 with interest. As of December 31, 2023, Pipeline, representing less than 1.3% of total assets, was in compliance with the terms of our lease.

Other Tenant Matters

We have two other domestic operators that have seen a decline in operating results. For the properties leased to these operators and our loan to the international joint venture (combined representing approximately 2.5% of our total assets at December 31, 2023), we have determined that it is no longer probable that these tenants/borrower will be able to pay their future rent/interest in full. As a result, we reserved approximately $95 million of unpaid rent/interest receivables and straight-line rent receivables between the third and fourth quarters of 2023 and will account for future rent/interest for these operators under the cash method. We are currently in various stages of either selling or re-tenanting the related facilities. At December 31, 2023, we believe these real estate and loan investments are fully recoverable. However, no assurances can be given that we will not have any additional impairments in future periods.

Investments in Unconsolidated Entities

Investments in Unconsolidated Real Estate Joint Ventures

Our primary business strategy is to acquire real estate and lease to providers of healthcare services. Typically, we directly own 100% of such investments. However, from time-to-time, we will co-invest with other investors that share a similar view that hospital real estate is a necessary infrastructure-type asset in communities. In these types of investments, we will own undivided interests of less than 100% of the real estate and share control over the assets through unconsolidated real estate joint ventures. The underlying real estate and leases in these unconsolidated real estate joint ventures are generally structured similarly and carry a similar risk profile to the rest of our real estate portfolio.

The following is a summary of our investments in unconsolidated real estate joint ventures by operator (amounts in thousands):


Operator	Ownership Percentage	As of December 31, 2023		As of December 31, 2022
Swiss Medical Network	70%	$	472,434	$	454,083
MEDIAN	50%		471,336		482,735
Steward (Macquarie Transaction)	50%		394,052		417,701
Policlinico di Monza	50%		80,562		86,245
HM Hospitales	45%		56,071		57,139
Total		$	1,474,455	$	1,497,903

For 2023 and 2022, we received $69 million and $77 million, respectively, in dividends from these real estate joint ventures.

Investments in Unconsolidated Operating Entities

Our investments in unconsolidated operating entities are noncontrolling investments that are typically made in conjunction with larger real estate transactions in which the operators are vetted as part of our overall underwriting process. In many cases, we would

not be able to acquire the larger real estate portfolio without such investments in operators. These investments also offer the opportunity to enhance our overall return and provide for certain minority rights and protections.

The following is a summary of our investments in unconsolidated operating entities (amounts in thousands):


Operator	As of December 31, 2023		As of December 31, 2022
PHP Holdings	$	699,535	$	—
Steward (loan investment)		361,591		362,831
International joint venture		225,960		231,402
Swiss Medical Network		186,113		157,145
Priory		163,837		156,575
Aevis Victoria SA ("Aevis")		77,345		72,904
Steward (equity investment)		35,696		125,862
Aspris Children's Services ("Aspris")		15,986		16,023
Lifepoint Behavioral		11,429		200,827
Caremax		1,148		8,526
Prospect		—		112,777
Total	$	1,778,640	$	1,444,872

The change year over year primarily relates to the payoff of the Lifepoint Behavioral loan in February 2023, as part of the Lifepoint Transaction, and the new investment in PHP Holdings, as more fully described previously in the Prospect Transaction.

For our investments marked to fair value, we recorded approximately $45 million in favorable non-cash fair value adjustments during 2023 as shown in the "Other (including fair value adjustments on securities)" line of the consolidated statements of net income; whereas, this was a $2.3 million favorable non-cash fair value adjustment for 2022. The amount recorded in 2023 includes an approximate $45 million favorable fair market value adjustment to our investment in PHP Holdings and an approximate CHF 20 million favorable adjustment to our investment in Swiss Medical Network, partially offset by decreases in value from marking other securities to market, including our equity investment in the international joint venture.

Other Investment Activities

In 2023, we invested approximately $105 million for a participation in Steward's syndicated asset-backed credit facility, and we loaned an additional $40 million. On August 17, 2023, we sold the $105 million interest to a global asset manager for approximately $100 million, and Steward agreed to repay the remaining balance with interest at the credit facility rate. Steward repaid approximately $2 million of this $5 million loan on November 3, 2023.

Also in 2023, we received repayment of the CHF 60 million mortgage loan from Infracore that was originally made in the fourth quarter of 2022.

In 2022, we funded $150 million to Steward pursuant to a secured loan. The loan bears interest at a current market rate plus a component of additional interest upon repayment. The loan is prepayable without penalty ($100 million of which was repaid as part of the Steward Utah Transaction) and due January 1, 2028.

Concentrations of Credit Risks

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

Total Assets by Operator


	As of December 31, 2023						As of December 31, 2022
Operators	Total Assets (1)			Percentage of Total Assets			Total Assets (1)		Percentage of Total Assets
Steward	$	3,518,537			19.2	%	$	4,762,673		24.2	%
Circle		2,119,392			11.6	%		2,062,474		10.5	%
Priory		1,391,005			7.6	%		1,290,213		6.6	%
Prospect		1,092,974			6.0	%		1,483,599		7.5	%
Lifepoint Behavioral Health		813,527			4.4	%		985,959		5.0	%
Other operators		7,352,012			40.2	%		7,461,923		38.0	%
Other assets		2,017,397	(2)		11.0	%		1,611,159		8.2	%
Total	$	18,304,844			100.0	%	$	19,658,000		100.0	%

(1)

(2)

Includes our investment in PHP Holdings of $700 million as part of the Prospect Transaction as further described in this same Note 3.

Total Assets by U.S. State and Country (a)


	As of December 31, 2023					As of December 31, 2022
U.S. States and Other Countries	Total Assets		Percentage of Total Assets			Total Assets		Percentage of Total Assets
Texas	$	1,891,482		10.3	%	$	1,967,948		10.0	%
Florida		1,348,210		7.4	%		1,324,555		6.8	%
California		1,252,674		6.8	%		1,450,112		7.4	%
Utah		824,048		4.5	%		1,224,484		6.2	%
Massachusetts		732,550		4.0	%		761,694		3.9	%
All other states		3,726,145		20.4	%		4,245,306		21.6	%
Other domestic assets		1,397,170		7.6	%		1,028,946		5.2	%
Total U.S.	$	11,172,279		61.0	%	$	12,003,045		61.1	%
United Kingdom	$	4,261,944		23.3	%	$	4,083,244		20.8	%
Switzerland		735,891		4.0	%		748,947		3.8	%
Germany		734,630		4.0	%		664,900		3.4	%
Spain		252,529		1.4	%		222,316		1.1	%
Finland		218,322		1.2	%		224,152		1.1	%
All other countries		309,022		1.7	%		1,129,183		5.7	%
Other international assets		620,227		3.4	%		582,213		3.0	%
Total international	$	7,132,565		39.0	%	$	7,654,955		38.9	%
Grand total	$	18,304,844		100.0	%	$	19,658,000		100.0	%

Total Assets by Facility Type (a)


	As of December 31, 2023					As of December 31, 2022
Facility Types	Total Assets		Percentage of Total Assets			Total Assets		Percentage of Total Assets
General acute care hospitals	$	11,764,151		64.3	%	$	13,386,376		68.1	%
Behavioral health facilities		2,576,983		14.1	%		2,727,326		13.9	%
Inpatient rehabilitation hospitals		1,445,399		7.9	%		1,418,603		7.2	%
Long-term acute care hospitals		270,849		1.5	%		277,772		1.4	%
Freestanding ER/urgent care facilities		230,065		1.2	%		236,764		1.2	%
Other assets		2,017,397		11.0	%		1,611,159		8.2	%
Total	$	18,304,844		100.0	%	$	19,658,000		100.0	%

(a)

From a revenue concentration perspective and excluding reserves recorded during the year, Steward, Circle, and Prospect individually represented more than 10% of our total revenues for the years ended December 31, 2023, 2022, and 2021.

On an individual property basis, our largest investment in any single property was approximately 2% of our total assets as of December 31, 2023.

Related Party Transactions

Revenues earned from tenants and real estate joint ventures in which we had an equity interest (accounted for under either the equity or fair value option methods) during the year were $83.0 million, $135.5 million, and $63.9 million for 2023, 2022, and 2021, respectively.

Real Estate and Other Activities - Other Leasing Activities - Additional Information (Detail)	Dec. 31, 2023
Business Acquisition [Line Items]
Percentage of vacant on leased property	0.30%

Schedule II: Valuation and Qualifying Accounts

12 Months Ended

Dec. 31, 2023

SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]

Schedule II: Valuation and Qualifying Accounts

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

December 31, 2023


			Additions						Deductions
Year Ended December 31,	Balance at Beginning of Year(1)		Charged Against Operations(1)			Charged to Other Accounts			Net Recoveries/ Write-offs(1)				Balance at End of Year(1)
	(In thousands)
2023	$	393,057	$	755,627	(2)	$	—		$	(270,366	)	(3)	$	878,318
2022	$	154,161	$	294,861	(4)	$	—		$	(55,965	)	(5)	$	393,057
2021	$	146,637	$	69,131	(6)	$	7,340	(7)	$	(68,947	)	(8)	$	154,161

(1)

Includes real estate impairment reserves, allowances for doubtful accounts, straight-line rent reserves, credit loss reserves, tax valuation allowances, and other reserves.

(2)

Represents $261 million increase in accounts receivable reserves, $259 million increase in straight-line rent receivable reserves, $90 million increase to equity investment impairment reserves, and $89 million increase to real estate impairment reserves, as further described in Note 3 to Item 8 of this Annual Report on Form 10-K. Also includes an increase of $10 million in credit loss reserves and an approximately $47 million increase in valuation allowances to reserve against our net deferred tax assets in 2023.

(3)

Includes a $170 million decrease in real estate impairment reserves, an approximately $35 million decrease in credit loss reserves related to transitioning properties back to a tenant in exchange for a first-lien mortgage, and a $50 million recovery of previously reserved interest satisfied as part of the “Prospect Transaction” as disclosed in Note 3 to Item 8 of this Annual Report on Form 10-K. Also includes an approximately $11 million write-off of previously reserved accounts receivable.

(4)

Represents a $170.6 million increase to real estate impairment reserves, $0.5 million increase in accounts receivable and other reserves, $114.0 million increase in credit loss reserves on financing-type receivables, and a $9.8 million increase in valuation allowance to reserve against our net deferred tax assets in 2022.

(5)

Includes a $2.9 million decrease in real estate impairment reserves related to disposals in 2022, a $11.7 million decrease in accounts receivable and other reserves, a net credit loss recovery of approximately $15 million on the Watsonville loans, and a $26.4 million decrease of credit loss reserves related to financial instruments sold, repaid, or satisfied in 2022.

(6)

Represents a $41.7 million increase in credit loss reserves on financing-type receivables, $8 million increase in accounts receivable and other reserves, and an approximately $20 million increase in valuation allowances to reserve against our net deferred tax assets in 2021.

(7)

Represents $7.3 million of tax valuation allowances recorded as part of the purchase price allocation of the Priory Transaction as disclosed in Note 3 to Item 8 of this Annual Report on Form 10-K.

(8)

Includes a $22.4 million decrease in real estate impairment reserves related to disposals in 2021, a $38.7 million decrease in accounts receivable and other reserves, $6.0 million decrease of equity investment impairment reserves related to disposals in 2021, and $1.9 million of credit loss recovery related to loan paydowns in 2021.

Real Estate and Other Activities - Leasing Operations (Lessor) - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2023 Lease
Lessor Lease Description [Line Items]
Lease renewal term	5 years
Annual rent escalations	99.00%
Minimum [Member]
Lessor Lease Description [Line Items]
Term of lease	15 years
Ernest [Member]
Lessor Lease Description [Line Items]
Number of direct financing leases	13
Number of financing leases	5

Earnings Per Share/Unit - Calculation of Earnings Per Share (Parenthetical) (Detail)	12 Months Ended
	Dec. 31, 2023 shares
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Potential common shares/units inclusion of shares	32,382
MPT Operating Partnership, L.P. [Member]
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Potential common shares/units inclusion of shares	32,382

Other Assets (Tables)

12 Months Ended

Dec. 31, 2023

Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]

Summary of Other Assets

The following is a summary of our other assets on our consolidated balance sheets (in thousands):


	As of December 31,
	2023		2022
Debt issue costs, net(1)	$	8,513	$	12,036
Other corporate assets		275,688		256,438
Prepaids and other assets		173,710		304,516
Total other assets	$	457,911	$	572,990

(1)

Relates to our revolving credit facility

Schedule IV - Changes in Mortgage Loans Excluding Allowance for Credit Loss (Parenthetical) (Detail)
$ in Thousands, £ in Millions

12 Months Ended

May 23, 2023

USD ($)

Dec. 31, 2023

USD ($)

Dec. 31, 2023

GBP (£)

Dec. 31, 2023

USD ($)

Dec. 31, 2021

USD ($)

Mar. 31, 2021

GBP (£)

Mortgage Loans on Real Estate [Line Items]

Advanced to the mortgage loan

^[1]

$ 22,900

$ 1,103,410

PHP Holdings [Member] | Prospect Medical Holdings Inc [Member]

Mortgage Loans on Real Estate [Line Items]

Unpaid rent and interest

$ 112,900

Mortgage Loans [Member] | PHP Holdings [Member] | Prospect Medical Holdings Inc [Member]

Mortgage Loans on Real Estate [Line Items]

Unpaid rent and interest

$ 151,000

Mortgage Loans [Member] | Priory Group [Member]

Mortgage Loans on Real Estate [Line Items]

Advanced to the mortgage loan | £

£ 23

£ 800

[1]

Income Taxes - Schedule of Income Tax Benefit (Expense) (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Sep. 30, 2022	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Current income tax (expense) benefit:
Domestic		$ (7,756)	$ 1,111	$ (1,559)
Foreign		(24,257)	(27,751)	(18,964)
Total income tax expense		(32,013)	(26,640)	(20,523)
Deferred income tax (expense) benefit:
Domestic		8,926	(15,628)	6,915
Foreign		153,766	(13,632)	(60,340)
Total income tax expense		162,692	(29,260)	(53,425)
Income tax benefit (expense)	$ (5,000)	$ 130,679	$ (55,900)	$ (73,948)

- Definition

Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

+ References + Details

Fair Value of Financial Instruments - Schedule of Effects of Movement in DLOM by Sensitivity Analysis by Using Basis Point Variations (Detail) - PHP Holdings [Member] $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($)
+ 100 Basis Points [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Estimated Increase (Decrease) in Fair Value	$ (7,571)
- 100 Basis Points [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Estimated Increase (Decrease) in Fair Value	$ 7,571

Real Estate and Other Activities - Net Assets Acquired (Parenthetical) (Detail)
$ in Thousands, £ in Millions

12 Months Ended

Dec. 31, 2023

GBP (£)

Dec. 31, 2022

Dec. 31, 2021

USD ($)

Dec. 31, 2023

USD ($)

Jun. 30, 2021

Property

Mar. 31, 2021

GBP (£)

Business Acquisition [Line Items]

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

24 years

Advanced to the mortgage loan | $

^[1]

$ 1,103,410

$ 22,900

Priory Group [Member]

Business Acquisition [Line Items]

Number of real estate assets acquired | Property

Mortgage Loans [Member] | Priory Group [Member]

Business Acquisition [Line Items]

Advanced to the mortgage loan | £

£ 23

£ 800

Intangible Lease Assets [Member]

Business Acquisition [Line Items]

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

24 years 9 months 18 days

21 years 3 months 18 days

34 years 6 months

[1]

Organization - Additional Information (Detail)	12 Months Ended
Organization - Additional Information (Detail)	Dec. 31, 2023 Facility Country State
Business Acquisition [Line Items]
Percentage of leased assets owned	100.00%
Number of facilities \| Facility	439
Number of states \| State	31
Europe [Member]
Business Acquisition [Line Items]
Number of countries	7
South America [Member]
Business Acquisition [Line Items]
Number of countries	1

Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Fair Value Disclosures [Abstract]
Interest and rent receivables, Book value	$ 45,059	$ 167,035
Loans, Book value	1,302,727	1,405,615
Debt, net Book value	(10,064,236)	(10,268,412)
Interest and rent receivables, Fair value	45,476	163,101
Loans, Fair value	1,202,383	1,360,113
Debt, net Fair value	$ (8,256,465)	$ (8,697,042)

- Definition

Amount, after deduction of unamortized premium (discount) and debt issuance cost, of long-term debt. Excludes lease obligation.

+ References + Details

Real Estate and Other Activities - Summary of Investments in Unconsolidated Real Estate Joint Ventures by Operator (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated real estate joint ventures	$ 1,474,455	$ 1,497,903
MEDIAN [Member]
Schedule of Equity Method Investments [Line Items]
Ownership interest	50.00%
Investments in unconsolidated real estate joint ventures	$ 471,336	482,735
Swiss Medical Network [Member]
Schedule of Equity Method Investments [Line Items]
Ownership interest	70.00%
Investments in unconsolidated real estate joint ventures	$ 472,434	454,083
Steward (Macquarie Transaction) [Member]
Schedule of Equity Method Investments [Line Items]
Ownership interest	50.00%
Investments in unconsolidated real estate joint ventures	$ 394,052	417,701
Policlinico di Monza [Member]
Schedule of Equity Method Investments [Line Items]
Ownership interest	50.00%
Investments in unconsolidated real estate joint ventures	$ 80,562	86,245
HM Hospital [Member]
Schedule of Equity Method Investments [Line Items]
Ownership interest	45.00%
Investments in unconsolidated real estate joint ventures	$ 56,071	$ 57,139

Debt - Principal Payments Due for Debt (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Debt Disclosure [Abstract]
2024	$ 453,648
2025	1,443,120
2026	3,202,920
2027	1,600,000
2028	763,860
Thereafter	2,645,585
Total	$ 10,109,133	$ 10,325,499

Schedule III - Changes in Accumulated Depreciation (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]
Balance at beginning of period	$ 1,008,340	$ 950,369	$ 728,176
Depreciation	270,816	277,032	262,063
Depreciation on disposed property	(73,765)	(185,519)	(35,551)
Other	22,228	(33,542)	(4,319)
Balance at end of period	$ 1,227,619	$ 1,008,340	$ 950,369

Fair Value of Financial Instruments - Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis (Detail) - Fair Value, Recurring - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Mortgage Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	$ 146,892	$ 140,260
Original Cost	146,892	140,260
Equity Method Investment and Other Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	939,903	434,609
Original Cost	$ 912,999	$ 441,943

- Definition

Cost of the investment.

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- Definition

Fair value of investment in security owned.

+ References

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-URI https://asc.fasb.org//1943274/2147479617/946-210-S99-1

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
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Reference 19: http://www.xbrl.org/2003/role/disclosureRef
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Reference 20: http://www.xbrl.org/2003/role/disclosureRef
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Reference 22: http://www.xbrl.org/2003/role/disclosureRef
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Reference 23: http://www.xbrl.org/2003/role/disclosureRef
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Reference 24: http://www.xbrl.org/2003/role/disclosureRef
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Reference 25: http://www.xbrl.org/2003/role/disclosureRef
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Reference 26: http://www.xbrl.org/2003/role/disclosureRef
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Reference 27: http://www.xbrl.org/2003/role/disclosureRef
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Reference 28: http://www.xbrl.org/2003/role/disclosureRef
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Reference 29: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Real Estate and Other Activities - Steward Health Care System - Additional Information (Details) $ in Millions			2 Months Ended	3 Months Ended			12 Months Ended
	Feb. 29, 2024 USD ($)	May 01, 2023 USD ($) Facility	Feb. 22, 2024 USD ($)	Dec. 31, 2023 USD ($)	Jun. 30, 2023 USD ($)	Jun. 30, 2022 USD ($)	Dec. 31, 2023 USD ($)	Jan. 31, 2024 USD ($)
Business Acquisition [Line Items]
Partial cash rent Payments				$ 16.0
Rent and interest obligations due				$ 70.0
Catholic Health Initiatives Colorado [Member]
Business Acquisition [Line Items]
Initial lease term		15 years
In-place lease intangibles [Member]
Business Acquisition [Line Items]
Amortization of Intangible Assets					$ 286.0		$ 286.0
Steward Health Care System LLC [Member]
Business Acquisition [Line Items]
Number of facilities acquired \| Facility		5
Proceeds received to paydown outstanding loan		$ 100.0
Proceeds to paydown of actual outstanding loan						$ 150.0
Straight-line rent write-offs					$ 95.0
Steward Health Care System LLC [Member] \| Subsequent Event [Member]
Business Acquisition [Line Items]
Bridge Loan								$ 60.0
Loan facility funded shares	$ 37.5
Revenue for rent and interest			$ 20.0

Organization

12 Months Ended

Dec. 31, 2023

Organization, Consolidation and Presentation of Financial Statements [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 healthcare real estate. Our operating partnership subsidiary, MPT Operating Partnership, L.P. (the “Operating Partnership”), through which we conduct substantially all of our operations, was formed in September 2003. At present, we own all of the 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 operate as a real estate investment trust (“REIT”). Accordingly, we are generally not subject to United States (“U.S.”) federal income tax on our REIT taxable income, provided that we continue to qualify as a REIT and our distributions to our stockholders equal or exceed such taxable income. Similarly, as of July 1, 2023, the majority of our real estate operations in the United Kingdom ("U.K.") operate as a REIT and generally are subject only to a withholding tax on earnings upon distribution out of the U.K. REIT. Certain non-real estate activities we undertake in the U.S. 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. (excluding those assets that are in the U.K. REIT), we are subject to the local income taxes of the jurisdictions where our properties reside and/or legal entities are domiciled; however, we do not expect to incur additional taxes, of a significant nature, in the U.S. from foreign-based income as the majority of such income flows through our REIT.

Our primary business strategy is to acquire and develop healthcare facilities and lease the facilities to healthcare operating companies under long-term net leases, which require the tenant to bear most of the costs associated with the property. The majority of our leased assets are owned 100%; however, we do own some leased assets through joint ventures with other partners that share our view that healthcare facilities are part of the infrastructure of any community, which we refer to as investments in unconsolidated real estate joint ventures. We also may make mortgage loans to healthcare operators collateralized by their real estate. In addition, we may make noncontrolling investments in our tenants (which we refer to as investments in unconsolidated operating entities), from time-to-time, typically in conjunction with larger real estate transactions with the tenant, which may enhance our overall return and provide for certain minority rights and protections.

Our business model facilitates acquisitions and recapitalizations, and allows operators of healthcare facilities to unlock the value of their real estate to fund facility improvements, technology upgrades, and other investments in operations. At December 31, 2023, we have investments in 439 facilities in 31 states in the U.S., in seven countries in Europe, and one country in South America. Our properties consist of general acute care hospitals, behavioral health facilities, inpatient physical rehabilitation facilities, long-term acute care hospitals, and freestanding ER/urgent care facilities. We manage our business as a single business segment.

Income Taxes - Schedule of Deferred Tax Assets and liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Operating loss and interest deduction carry forwards	$ 143,683	$ 175,922
Depreciation	45,146
Partnership investments	15,768
Other	18,899	15,218
Total deferred tax assets	223,496	191,140
Valuation allowance	(117,191)	(71,499)
Total net deferred tax assets	106,305	119,641
Property and equipment	(158,330)	(294,181)
Net unbilled revenue	(65,727)	(63,324)
Partnership investments		(26,268)
Other	(10,687)	(27,153)
Total deferred tax liabilities	(234,744)	(410,926)
Net deferred tax asset (liability)	$ (128,439)	$ (291,285)

Debt - Basic Terms of Senior Unsecured Notes (Details) - 12 months ended Dec. 31, 2023	EUR (€)	GBP (£)	USD ($)
3.325% Senior Unsecured Notes due 2025 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Mar. 24, 2017
Debt instrument maturity date	Mar. 24, 2025
Par Value \| €	€ 500,000,000
% of Par Value	100.00%
Interest Payment Frequency	Annually
0.993% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Oct. 06, 2021
Debt instrument maturity date	Oct. 15, 2026
Par Value \| €	€ 500,000,000
% of Par Value	100.00%
Interest Payment Frequency	Annually
2.500% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Mar. 24, 2021
Debt instrument maturity date	Mar. 24, 2026
Par Value \| £		£ 500,000,000
% of Par Value	99.937%
Interest Payment Frequency	Annually
5.250% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Jul. 22, 2016
Debt instrument maturity date	Aug. 01, 2026
Par Value			$ 500,000,000
% of Par Value	100.00%
Interest Payment Frequency	Semi-annually
5.000% Senior Unsecured Notes due 2027 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Sep. 07, 2017
Debt instrument maturity date	Oct. 15, 2027
Par Value			1,400,000,000
% of Par Value	100.00%
Interest Payment Frequency	Semi-annually
3.692% Senior Unsecured Notes due 2028 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Dec. 05, 2019
Debt instrument maturity date	Jun. 05, 2028
Par Value \| £		600,000,000
% of Par Value	99.998%
Interest Payment Frequency	Annually
4.625% Senior Unsecured Notes due 2029 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Jul. 26, 2019
Debt instrument maturity date	Aug. 01, 2029
Par Value			900,000,000
% of Par Value	99.50%
Interest Payment Frequency	Semi-annually
3.375% Senior Unsecured Notes due 2030 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Mar. 24, 2021
Debt instrument maturity date	Apr. 24, 2030
Par Value \| £		£ 350,000,000
% of Par Value	99.448%
Interest Payment Frequency	Annually
3.500% Senior Unsecured Notes due 2031 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Dec. 04, 2020
Debt instrument maturity date	Mar. 15, 2031
Par Value			$ 1,300,000,000
% of Par Value	100.00%
Interest Payment Frequency	Semi-annually

Common Stock/Partner's Capital

12 Months Ended

Dec. 31, 2023

Equity [Abstract]

Common Stock/Partner's Capital

9. Common Stock/Partner’s Capital

Medical Properties Trust, Inc.

2022 Activity

On October 9, 2022, the Board of the Company authorized a stock repurchase program (the "Stock Repurchase Program") for up to $500 million of common stock, par value $0.001 per share. In 2022, we repurchased 1.6 million shares for a total of $17.9 million. The Stock Repurchase Program expired on October 10, 2023.

2021 Activity

On January 11, 2021, we completed an underwritten public offering of 36.8 million shares of our common stock, resulting in net proceeds of approximately $711 million, after deducting underwriting discounts and commissions and offering expenses.

In addition, we sold 16.3 million shares of common stock under our at-the-market equity offering program during 2021, resulting in net proceeds of approximately $340 million.

MPT Operating Partnership, L.P.

At December 31, 2023, the Operating Partnership is made up of a general partner, Medical Properties Trust, LLC (“General Partner”) and limited partners, including the Company (which owns 100% of the General Partner) and MPT TRS, Inc. (which is 100% owned by the General Partner). By virtue of its ownership of the General Partner, the Company has a 100% ownership interest in the Operating Partnership.

In regards to distributions, the Operating Partnership shall distribute cash at such times and in such amounts as are determined by the General Partner in its sole and absolute discretion, to common unit holders who are common unit holders on the record date. However, per the Second Amended and Restated Agreement of Limited Partnership of MPT Operating Partnership, L.P. (“Operating Partnership Agreement”), the General Partner shall use its reasonable efforts to cause the Operating Partnership to distribute amounts sufficient to enable the Company to pay stockholder dividends that will allow the Company to (i) meet its distribution requirement for qualification as a REIT and (ii) avoid any U.S. federal income or excise tax liability imposed by the Code, other than to the extent the Company elects to retain and pay income tax on its net capital gain. In accordance with the Operating Partnership Agreement, LTIP units are treated as common units for distribution purposes.

The Operating Partnership’s net income will generally be allocated first to the General Partner to the extent of any cumulative losses and then to the partners in accordance with their respective percentage interests in the common units issued by the Operating Partnership. Any losses of the Operating Partnership will be allocated pro-rata to the partners in accordance with their respective percentage interests in the common units issued by the Operating Partnership until their adjusted capital balances are reduced to zero, then to the General Partner. In accordance with the Operating Partnership Agreement, LTIP units are treated as common units for purposes of income and loss allocations. Limited partners have the right to require the Operating Partnership to redeem part or all of their common units. It is at the Operating Partnership’s discretion to redeem such common units for cash based on the fair market value of an equivalent number of shares of the Company’s common stock at the time of redemption or, alternatively, redeem the common units for shares of the Company’s common stock on a one-for-one basis, subject to adjustment in the event of stock splits, stock dividends, or similar events. LTIP units must wait two years from the issuance of the LTIP units to be redeemed, and then converted to common units. No LTIP units exist at December 31, 2023.

For each share of common stock issued/repurchased by Medical Properties Trust, Inc., the Operating Partnership issues/repurchases a corresponding number of operating partnership units.

Other Assets - Summary of Other Assets on our Condensed Consolidated Balance Sheets (Detail) - USD ($)
$ in Thousands

Dec. 31, 2023

Dec. 31, 2022

Other Assets [Abstract]

Debt issue costs, net

^[1]

$ 8,513

$ 12,036

Other corporate assets

275,688

256,438

Prepaids and other assets

173,710

304,516

Total other assets

$ 457,911

$ 572,990

[1]	Relates to our revolving credit facility

Schedule IV - Schedule of Mortgage Loans on Real Estate (Parenthetical) (Detail)	Dec. 31, 2023 USD ($) Property
Mortgage Loans on Real Estate [Line Items]
Prior Liens	$ 0
Carrying amount of mortgages, federal income tax purposes	310,100,000
Unamortized loan issue costs	$ 800,000
Colombia [Member] \| Long-Term First Mortgage Loan [Member]
Mortgage Loans on Real Estate [Line Items]
Number of properties \| Property	3
Prospect [Member] \| Long-Term First Mortgage Loan [Member]
Mortgage Loans on Real Estate [Line Items]
Number of properties \| Property	4

Income Taxes - Schedule of Per Share Distributions to Stockholders (Parenthetical) (Details) - $ / shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Section 199A Dividends	$ 1.0639	$ 0.4703	$ 0.7646
Unrecaptured Sec. 1250 gain	$ 0.1061	$ 0.2574	$ 0.0583
Dividend declared date	Nov. 09, 2023
Dividend paid date	Jan. 11, 2024

Leases (Lessee)

12 Months Ended

Dec. 31, 2023

Leases [Abstract]

Leases (Lessee)

11. Leases (Lessee)

We lease the land underlying certain of our facilities (for which we sublease to our tenants), along with corporate offices and equipment. Our leases have remaining lease terms that vary in years, and some of the leases have initial fixed terms (or renewal options available) that extend the leases up to, or just beyond, the depreciable life of the properties that occupy the leased land. Renewal options that we are reasonably certain to exercise are recognized in our right-of-use assets and lease liabilities. As most of our leases do not provide an implicit rate, we use our incremental borrowing rate based on the information available at lease commencement date in determining the present value of future payments.

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


	Income Statement	For the Years Ended December 31,
	Classification	2023			2022			2021
Operating lease cost (1)	(2)	$	11,653		$	12,175		$	10,694
Finance lease cost:
Amortization of right-of-use assets	Real estate depreciation and amortization		51			51			51
Interest on lease liabilities	Interest		128			128			128
Sublease income	Other		(4,178	)		(4,485	)		(4,466	)
Total lease cost		$	7,654		$	7,869		$	6,407

(1)

Includes short-term leases.

(2)


	Operating Leases			Finance Leases			Amounts To Be Received From Subleases			Net Payments
2024	$	9,292		$	130		$	(4,509	)	$	4,913
2025		9,279			131			(4,389	)		5,021
2026		8,522			133			(4,083	)		4,572
2027		7,985			134			(3,796	)		4,323
2028		8,073			135			(3,804	)		4,404
Thereafter		232,286			4,382			(62,455	)		174,213	(1)
Total undiscounted minimum lease payments	$	275,437		$	5,045		$	(83,036	)	$	197,446
Less: interest		(173,625	)		(3,107	)
Present value of lease liabilities	$	101,812		$	1,938

(1)

Supplemental balance sheet information is as follows (in thousands, except lease terms and discount rate):


	Balance Sheet Classification	December 31, 2023			December 31, 2022
Right of use assets:
Operating leases - real estate	Land	$	63,675		$	63,553
Finance leases - real estate	Land		1,683			1,734
Total real estate right of use assets		$	65,358		$	65,287
Operating leases - corporate	Other assets		24,243			26,225
Total right of use assets		$	89,601		$	91,512

Lease liabilities:
Operating leases	Obligations to tenants and other lease liabilities	$	101,812		$	101,592
Financing leases	Obligations to tenants and other lease liabilities		1,938			1,938
Total lease liabilities		$	103,750		$	103,530

Weighted-average remaining lease term:
Operating leases			32.9			33.2
Finance leases			32.9			33.9
Weighted-average discount rate:
Operating leases			6.2	%		6.1	%
Finance leases			6.6	%		6.6	%

The following is supplemental cash flow information (in thousands):


	For the Years Ended December 31,
	2023		2022		2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows used for operating leases	$	8,210	$	7,169	$	7,330
Operating cash flows used for finance leases		129		128		126
Non-cash activities - Right-of-use assets obtained in exchange for lease obligations:
Operating leases		—		23,066		1,120

Debt - 2023 Activity - Additional Information (Details)
$ in Thousands, £ in Millions, $ in Millions

3 Months Ended

12 Months Ended

Dec. 05, 2023

GBP (£)

Oct. 10, 2023

AUD ($)

Facility

May 18, 2023

AUD ($)

Facility

Mar. 31, 2023

AUD ($)

Dec. 31, 2021

USD ($)

Dec. 31, 2023

USD ($)

Dec. 31, 2022

USD ($)

Facility

Dec. 31, 2021

USD ($)

Facility

Dec. 31, 2023

GBP (£)

Dec. 31, 2023

USD ($)

May 18, 2023

USD ($)

Debt Instrument [Line Items]

Principal amount

$ 10,325,499

$ 10,109,133

Number of facilities sold | Facility

Accelerated amortization debt issue costs

$ 800

Proceeds from sale of facilities

$ 54,500

$ 522,000

$ 246,000

Australia Transaction [Member]

Debt Instrument [Line Items]

Number of facilities sold | Facility

Number of remaining facilities sold | Facility

Proceeds from the sale of first tranche prepay

$ 730

Proceeds from sale of facilities

$ 470

730

$ 1,200

2.550% Senior Unsecured Notes due 2023 [Member]

Debt Instrument [Line Items]

Principal amount

$ 483,320

^[1]

£ 50

Senior unsecured notes, interest rate

2.55%

Purchase yield average percentage

13.00%

Gain on prepayment of Debt

$ 1,100

Debt instrument paid off | £

£ 350

Term Loan [Member]

Debt Instrument [Line Items]

Principal amount

$ 200,000

Term Loan [Member] | Australia Transaction [Member]

Debt Instrument [Line Items]

Term loan

$ 1,200

[1]	Non-U.S. dollar denominated debt that reflects the exchange rates at period-end.

Real Estate and Other Activities - Watsonville Community Hospital - Additional Information (Detail) - USD ($)
$ in Thousands

12 Months Ended

Dec. 31, 2022

Dec. 31, 2023

Dec. 31, 2021

Business Acquisition [Line Items]

Loans repaid

^[1]

$ 22,900

$ 1,103,410

Watsonville, California [Member]

Business Acquisition [Line Items]

Provision (recovery) for credit loss

$ 15,000

[1]

Real Estate and Other Activities - Other Investment Activities - Additional Information (Detail) SFr in Millions, $ in Millions			12 Months Ended
	Nov. 03, 2023 USD ($)	Aug. 17, 2023 USD ($)	Dec. 31, 2023 CHF (SFr)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Steward Health Care System L L C [Member]
Business Acquisition [Line Items]
Other investment on secured loan with credit facility collateral		$ 40
Secured loan amount					$ 150
Repayment received on credit facility availed	$ 2
Repayment received on credit facility availed, total amount	$ 5
Repayments of mortgage loan			SFr 60	$ 100
Steward Health Care System L L C [Member] \| Asset-Backed Securities [Member]
Business Acquisition [Line Items]
Investments				$ 105
Sale of investment		105
Global Asset Manager [Member]
Business Acquisition [Line Items]
Sale of investment		$ 100

Summary of Significant Accounting Policies - Summary of Credit Loss Reserves (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Accounting Policies [Abstract]
Balance at beginning of the year	$ 121,146	$ 48,527
Provision for credit loss, net	10,194	99,009
Expected credit loss reserve related to financial instruments sold, repaid, or satisfied	(35,339)	(26,390)
Balance at end of year	$ 96,001	$ 121,146

- Definition

Amount of allowance for credit loss on financing receivable. Excludes allowance for financing receivable covered under loss sharing agreement.

+ References + Details

Pay vs Performance Disclosure - USD ($) $ in Thousands	12 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Pay vs Performance Disclosure
Net Income (Loss)	$ (556,476)	$ 902,597	$ 656,021

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(g)(1)(ii))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 323
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481687/323-10-50-3

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 825
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 28
-Subparagraph (f)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482907/825-10-50-28

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 220
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482765/220-10-50-6

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483443/250-10-50-3

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (b)(2)
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+ Details

Real Estate and Other Activities - Disposals - 2022 Activity Additional Information (Detail) $ in Millions				3 Months Ended	12 Months Ended
	May 18, 2023 Facility	Sep. 01, 2022 USD ($) Property	Mar. 14, 2022 USD ($) Facility	Dec. 31, 2021 USD ($)	Dec. 31, 2022 USD ($) Facility Property	Dec. 31, 2021 USD ($) Facility
Debt Instrument [Line Items]
Number of facilities sold \| Facility	7				15	16
Proceeds from sale of facilities				$ 54.5	$ 522.0	$ 246.0
Number of ancillary properties sold \| Property					5
Gain (loss) on real estate dispositions				$ 40.0	$ 100.0	$ 52.5
Disposal Group, Not Discontinued Operations [Member]
Debt Instrument [Line Items]
Straight-line rent write-offs					$ 42.0
Massachusetts-based General Acute Care Hospitals [Member]
Debt Instrument [Line Items]
Number of facilities acquired \| Facility			8
Purchase price of acquisition			$ 1,700.0
Gain (loss) on real estate dispositions			$ 600.0
Prime Healthcare Services, Inc. Facilities [Member]
Debt Instrument [Line Items]
Number of properties sold \| Property		11
Proceeds from sale of facilities		$ 366.0

Earnings Per Share/Unit (Tables)

12 Months Ended

Dec. 31, 2023

Earnings Per Share [Abstract]

Calculation of Earnings Per Share

Medical Properties Trust, Inc.

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


	For the Years Ended December 31,
	2023			2022			2021
Numerator:
Net (loss) income	$	(556,092	)	$	903,819		$	656,940
Non-controlling interests’ share in earnings		(384	)		(1,222	)		(919	)
Participating securities’ share in earnings		(1,644	)		(1,602	)		(2,161	)
Net (loss) income, less participating securities’ share in earnings	$	(558,120	)	$	900,995		$	653,860
Denominator:
Basic weighted-average common shares		598,518			598,634			588,817
Dilutive potential common shares(1)		—			203			1,322
Diluted weighted-average common shares		598,518			598,837			590,139

MPT Operating Partnership, L.P.

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


	For the Years Ended December 31,
	2023			2022			2021
Numerator:
Net (loss) income	$	(556,092	)	$	903,819		$	656,940
Non-controlling interests’ share in earnings		(384	)		(1,222	)		(919	)
Participating securities’ share in earnings		(1,644	)		(1,602	)		(2,161	)
Net (loss) income, less participating securities’ share in earnings	$	(558,120	)	$	900,995		$	653,860
Denominator:
Basic weighted-average units		598,518			598,634			588,817
Dilutive potential units(1)		—			203			1,322
Diluted weighted-average units		598,518			598,837			590,139

(1)

The above computation of diluted earnings per share does not include 32,382 potential common shares/units as inclusion of these shares when a loss exists would be antidilutive.

Real Estate and Other Activities - Components of Total Investment in Financing Leases (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Direct Financing Lease Net Investment In Leases [Abstract]
Minimum lease payments receivable	$ 611,669	$ 880,253
Estimated unguaranteed residual values	203,818	203,818
Less: Unearned income and allowance for credit loss	(571,059)	(731,915)
Net investment in direct financing leases	244,428	352,156
Other financing leases (net of allowance for credit loss)	987,202	1,339,167
Total investment in financing leases	$ 1,231,630	$ 1,691,323

Leases (Lessee) - Schedule of Fixed Minimum Rental Payments Due under Leases with Non-Cancelable Terms (Detail) - USD ($)
$ in Thousands

Dec. 31, 2023

Dec. 31, 2022

Leases [Abstract]

Operating Leases, 2024

$ 9,292

Operating Leases, 2025

9,279

Operating Leases, 2026

8,522

Operating Leases, 2027

7,985

Operating Leases, 2028

8,073

Operating Leases, Thereafter

232,286

Operating Leases, Total undiscounted minimum lease payments

275,437

Operating Leases, Less: interest

(173,625)

Operating Leases, Present value of lease liabilities

101,812

$ 101,592

130

131

133

134

135

Finance Leases, Thereafter

4,382

Finance Leases, Total undiscounted minimum lease payments

5,045

Finance Leases, Less: interest

(3,107)

Finance Leases, Present value of lease liabilities

1,938

$ 1,938

Amounts To Be Received From Subleases, 2024

(4,509)

Amounts To Be Received From Subleases, 2025

(4,389)

Amounts To Be Received From Subleases, 2026

(4,083)

Amounts To Be Received From Subleases, 2027

(3,796)

Amounts To Be Received From Subleases, 2028

(3,804)

Amounts To Be Received From Subleases, Thereafter

(62,455)

Amounts To Be Received From Subleases, Total undiscounted minimum lease payments

(83,036)

4,913

5,021

4,572

4,323

4,404

Net Payments, Thereafter

^[1]

174,213

Net Payments, Total undiscounted minimum lease payments

$ 197,446

[1]

Debt - Australian Term Loan - Additional Information (Detail) - Term Loan [Member] - Bank of America, N.A - Australia [Member] - AUD ($)	May 18, 2023	Jun. 27, 2019	May 23, 2019	Dec. 31, 2023	Mar. 10, 2023	Mar. 09, 2023
Debt Instrument [Line Items]
Line of credit facility, Borrowing capacity			$ 1,200,000,000
Debt instrument maturity date			May 23, 2024
Debt instrument effective date		Jul. 03, 2019
Effective interest rate		1.20%
Reference rate		0.00%
Senior unsecured notes, interest rate				2.85%
Prepaid term loan	$ 730,000,000
Credit Rating
Debt Instrument [Line Items]
Variable interest rate					1.65%	1.25%
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%

Commitments and Contingencies

12 Months Ended

Dec. 31, 2023

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

8. Commitments and Contingencies

Commitments

On October 5, 2022, we entered into definitive agreements to sell three Prospect facilities located in Connecticut to Yale for approximately $457 million, of which we expect to receive $355 million in cash and have received the remainder in additional investments in PHP Holdings - part of the Prospect Transaction discussed in Note 3. Closing of this transaction is subject to certain regulatory approvals and the completion of Yale's acquisition of the hospital operations from Prospect. No assurances can be given that this transaction will be consummated as described or at all.

Contingencies

In 2023 and early 2024, we became party to various lawsuits as described below:

Securities and Derivative Litigation

On April 13, 2023, we and certain of our executives were named as defendants in a putative federal securities class action lawsuit alleging false and/or misleading statements and/or omissions resulted in artificially inflated prices for our common stock, filed by a purported stockholder in the United States District Court for the Northern District of Alabama, Case No. 2:23-cv-00486. The complaint seeks class certification on behalf of purchasers of our common stock between July 15, 2019 and February 22, 2023 and unspecified damages including interest and an award of reasonable costs and expenses. This class action complaint was amended on September 22, 2023 and alleges that we made material misstatements or omissions relating to the financial health of certain of our tenants.

Members of our Board of Directors were also named as defendants in two related shareholder derivative lawsuits filed by purported stockholders in the United States District Court for the Northern District of Alabama on October 19, 2023 (Case No. 2:23-cv-01415) and December 7, 2023 (Case No. 2:23-cv-01667). The Company was named as a nominal defendant in both complaints. These shareholder derivative complaints both make allegations similar to those made in the Alabama securities lawsuit described above relating to purported material misstatements or omissions relating to the financial health of certain of our tenants. On February 16, 2024, members of our Board of Directors were named as defendants in a shareholder derivative lawsuit filed by a purported stockholder in the United States District Court for the District of Maryland (Case No. 1:24-cv-00471). The Company was named as a nominal defendant. This shareholder derivative complaint makes allegations similar to those made in the Alabama securities and derivative lawsuits described above relating to purported material misstatements or omissions relating to the financial health of certain of our tenants.

On September 29, 2023, we and certain of our executives were named as defendants in a putative federal securities class action lawsuit filed by a purported stockholder in the United States District Court for the Southern District of New York, Case No. 1:23-cv-08597. The complaint seeks class certification on behalf of purchasers of our common stock between May 23, 2023 and August 17, 2023 and alleges false and/or misleading statements and/or omissions in connection with certain transactions involving Prospect. On December 18, 2023, members of our Board of Directors were named as defendants in a related shareholder derivative action filed by a purported stockholder in the United States District Court for the Southern District of New York, Case No. 1:23-cv-10934. The Company was named as a nominal defendant. The complaint makes allegations similar to those made in the New York securities lawsuit relating to purported false and/or misleading statements and/or omissions in connection with certain transactions involving Prospect. On February 21, 2024, members of our Board of Directors were named as defendants in a shareholder derivative lawsuit filed by a purported stockholder in the United States District Court for the District of Maryland (Case No. 1:24-cv-00527). The Company was named as a nominal defendant. This shareholder derivative complaint makes allegations similar to those made in the New York securities and derivative lawsuits described above relating to purported false and/or misleading statements and/or omissions in connection with certain transactions involving Prospect.

We believe these claims are without merit and intend to defend the remaining open cases vigorously. We have not recorded a liability related to the lawsuits above because, at this time, we are unable to determine whether an unfavorable outcome is probable or to estimate reasonably possible losses.

Defamation Litigation

On March 30, 2023, we commenced an action in the United States District Court for the Northern District of Alabama, Case No. 2:23-cv-00408, against short-seller Viceroy Research LLC ("Viceroy") and its members. We are seeking injunctive relief and damages for defamation, civil conspiracy, tortious interference, private nuisance, and unjust enrichment based on defamatory statements expressed against us. On June 29, 2023, we won a preliminary ruling in this lawsuit after Viceroy's motion to dismiss the case was denied by a judge in the United States District Court for the Northern District of Alabama.

From time-to-time, we are a party to other legal proceedings, claims, or regulatory inquiries and investigations arising out of, or incidental to, our business. While we are unable to predict with certainty the outcome of any particular matter, 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.

Schedule II - Schedule of Valuation and Qualifying Accounts (Parenthetical) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Increase in accounts receivable reserves	$ 261,000
Increase in straight-line rent receivable reserves	259,000
Increase (decrease) in real estate impairment reserves	89,000	$ 170,600
Write-off of previously reserved accounts receivable	11,000
Equity investment impairments reserves related to disposals			$ 6,000
Increase in accounts receivable and other reserves		500	8,000
Decrease in accounts receivable and other reserves		11,700	38,700
Tax valuation allowances recorded as part of purchase price allocation			7,340
Increase (decrease) in real estate impairment reserves related to disposals	(170,000)	(2,900)	(22,400)
Credit loss recovery related to loan paydowns			1,900
Increase in credit loss reserves on financing-type receivables	10,000	114,000	41,700
Decrease in credit loss reserves on financing-type receivables	35,000	26,400
Increase in equity investment impairments	90,000
Recovery of previously reserved interest	50,000
Watsonville, California [Member]
Provision (recovery) for credit loss		15,000
Priory Group [Member]
Tax valuation allowances recorded as part of purchase price allocation			7,300
Valuation Allowance, Deferred Tax Asset [Member]
Increase (decrease) in valuation allowances	$ 47,000	$ 9,800	$ 20,000

Leases (Lessee) - Summary of Lease Expense (Detail) - USD ($)
$ in Thousands

12 Months Ended

Dec. 31, 2023

Dec. 31, 2022

Dec. 31, 2021

Lessee Lease Description [Line Items]

Operating lease cost

^[1],[2]

$ 11,653

$ 12,175

$ 10,694

Finance lease cost:

Total lease cost

7,654

7,869

6,407

Real Estate Depreciation and Amortization [Member]

Finance lease cost:

Amortization of right-of-use assets

Interest [Member]

Finance lease cost:

Interest on lease liabilities

128

Other [Member]

Finance lease cost:

Sublease income

$ (4,178)

$ (4,485)

$ (4,466)

[1]	$6.0 million, $5.7 million, and $6.3 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2023, 2022, and 2021, respectively.
[2]	Includes short-term leases.

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Schedule of Income Tax Benefit (Expense)

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


	For the Years Ended December 31,
	2023			2022			2021
Current income tax (expense) benefit:
Domestic	$	(7,756	)	$	1,111		$	(1,559	)
Foreign		(24,257	)		(27,751	)		(18,964	)
		(32,013	)		(26,640	)		(20,523	)
Deferred income tax (expense) benefit:
Domestic		8,926			(15,628	)		6,915
Foreign		153,766			(13,632	)		(60,340	)
		162,692			(29,260	)		(53,425	)
Income tax benefit (expense)	$	130,679		$	(55,900	)	$	(73,948	)

Summary of Reconciliation of Income Tax Benefit (Expense) from the Statutory Income Tax Rate to the Effective Tax Rate Based on Income before Income Taxes


	For the Years Ended December 31,
	2023			2022			2021
(Loss) income before income tax	$	(686,771	)	$	959,719		$	730,888
Income tax benefit (expense) at the U.S. statutory federal rate (21% in 2023, 2022, and 2021)		144,222			(201,541	)		(153,486	)
Decrease (increase) in income tax resulting from:
Foreign rate differential		(4,122	)		1,826			2,742
State income taxes, net of federal benefit		1,275			(1,886	)		—
U.S. earnings not subject to federal income tax		(115,189	)		165,705			132,266
Change in valuation allowance		(45,692	)		(11,281	)		(10,040	)
Statutory tax rate change		—			(941	)		(43,924	)
Interest disallowance		(3,421	)		(1,737	)		(646	)
Tax Impact of UK REIT conversion		160,641			—			—
Other items, net		(7,035	)		(6,045	)		(860	)
Total income tax benefit (expense)	$	130,679		$	(55,900	)	$	(73,948	)

Schedule of Deferred Tax Assets and Liabilities

At December 31, 2023 and 2022, components of our deferred tax assets and liabilities were as follows (in thousands):


	2023			2022
Deferred tax assets:
Operating loss and interest deduction carry forwards	$	143,683		$	175,922
Depreciation		45,146			—
Partnership investments		15,768			—
Other		18,899			15,218
Total deferred tax assets		223,496			191,140
Valuation allowance		(117,191	)		(71,499	)
Total net deferred tax assets	$	106,305		$	119,641
Deferred tax liabilities:
Property and equipment	$	(158,330	)	$	(294,181	)
Net unbilled revenue		(65,727	)		(63,324	)
Partnership investments		—			(26,268	)
Other		(10,687	)		(27,153	)
Total deferred tax liabilities		(234,744	)		(410,926	)
Net deferred tax asset (liability)	$	(128,439	)	$	(291,285	)

Schedule of Net NOL and Other Tax Attribute Carryforwards

At December 31, 2023, we had net NOL and other tax attribute carryforwards as follows (in thousands):


	U.S.			Foreign
Gross NOL carryforwards	$	169,970		$	458,913

Tax-effected NOL carryforwards	$	28,056		$	114,359
Valuation allowance		(27,956	)		(4,702	)
Net deferred tax asset - NOL carryforwards	$	100		$	109,657
Expiration periods	2024-indefinite			indefinite

Schedule of Per Share Distributions to Stockholders

A schedule of per share distributions we paid and reported to our stockholders is set forth in the following:


	For the Years Ended December 31,
Per share:	2023			2022		2021
Ordinary dividend (1)	$	1.0639		$	0.4703	$	0.7646
Long-term capital gain (2)		0.1061			0.6797		0.1654
Return of capital		—			—		0.1800
Total	$	1.1700	(3)	$	1.1500	$	1.1100

(1)

For the years ended December 31, 2023, 2022, and 2021, includes Section 199A dividends of 1.0639, 0.4703, and 0.7646, respectively.

(2)

For the years ended December 31, 2023, 2022, and 2021, includes Unrecaptured Section 1250 gains of 0.1061, 0.2574, and 0.0583, respectively.

(3)

Includes the fourth quarter dividend declared on November 9, 2023, and paid on January 11, 2024, as it will be taxable to stockholders as part of their 2023 dividend income.