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Net investment in real estate assets

(144,235)

(110,888)

^[1]

Accumulated amortization

(15,541)

(11,908)

2,525,353

1,837,043

Cash and cash equivalents

45,979

37,311

Interest and rent receivables

58,499

45,289

Straight-line rent receivables

45,829

35,860

Other loans

160,990

159,243

Other assets

67,920

64,140

Total Assets

2,904,570

2,178,886

Liabilities

Debt, net

1,421,681

1,025,160

Accounts payable and accrued expenses

94,311

65,961

Deferred revenue

23,787

20,609

Lease deposits and other obligations to tenants

20,583

17,342

Total liabilities

1,560,362

1,129,072

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 250,000 shares; issued and outstanding - 161,310 shares at December 31, 2013 and 136,335 shares at December 31, 2012

161

136

Additional paid-in capital

1,618,054

1,295,916

Distributions in excess of net income

(264,804)

(233,494)

Accumulated other comprehensive loss

(8,941)

(12,482)

Treasury shares, at cost

(262)

Total Equity / Capital

1,344,208

1,049,814

Total Liabilities and Equity

2,904,570

2,178,886

MPT Operating Partnership, L.P. [Member]

Real estate assets

Land

154,858

108,456

Buildings and improvements

1,578,336

1,052,479

Construction in progress and other

41,771

38,339

Intangible lease assets

90,490

51,966

Real estate held for sale

25,537

Net investment in direct financing leases

431,024

314,412

Mortgage loans

388,650

368,650

Gross investment in real estate assets

2,685,129

1,959,839

Net investment in real estate assets

(144,235)

(110,888)

Accumulated amortization

(15,541)

(11,908)

2,525,353

1,837,043

Cash and cash equivalents

45,979

37,311

Interest and rent receivables

58,499

45,289

Straight-line rent receivables

45,829

35,860

Other loans

160,990

159,243

Other assets

67,920

64,140

Total Assets

2,904,570

2,178,886

Liabilities

Debt, net

1,421,681

1,025,160

Accounts payable and accrued expenses

58,559

38,177

Deferred revenue

23,787

20,609

Lease deposits and other obligations to tenants

20,583

17,342

Payable due to Medical Properties Trust, Inc.

35,362

27,394

Total liabilities

1,559,972

1,128,682

Commitments and Contingencies

Accumulated other comprehensive loss

(8,941)

(12,482)

Total Equity / Capital

1,344,598

1,050,204

Total Liabilities and Equity

2,904,570

2,178,886

MPT Operating Partnership, L.P. [Member] | Common Units [Member]

MPT Operating Partnership, L.P. [Member] | General Partner [Member]

Limited Partners Capital

1,339,998

1,052,056

Equity / Capital

General partner - issued and outstanding - 1,608 units at December 31, 2013 and 1,357 units at December 31, 2012

13,541

10,630

MPT Operating Partnership, L.P. [Member] | LTIP Units [Member]

Limited Partners Capital

[1]	Includes in accumulated depreciation in real estate held for sale of $3,511 for 2012. Excludes accumulated amortization related to intangible lease assets that are included in real estate held for sale of $426 for 2012.

Consolidated Balance Sheets (Parenthetical) - $ / shares	Dec. 31, 2013	Dec. 31, 2012
Preferred stock, par value	$ 0.001	$ 0.001
Preferred stock, shares authorized	10,000,000	10,000,000
Preferred stock, shares outstanding
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	250,000,000	250,000,000
Common stock, shares issued	136,335,000	136,335,000
Common stock, shares outstanding	136,335,000	136,335,000
MPT Operating Partnership, L.P. [Member] \| General Partner [Member]
General partner, units issued	1,608,000	1,357,000
General partner, units outstanding	1,357,000	1,357,000
MPT Operating Partnership, L.P. [Member] \| LTIP Units [Member]
LTIP Units, shares issued	292,000	221,000
LTIP Units, shares outstanding	292,000	221,000
MPT Operating Partnership, L.P. [Member] \| Common Units [Member]
Limited Partners, units issued	159,702,000	134,978,000
Limited Partners, units outstanding	159,702,000	134,978,000

Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Revenues
Rent billed	$ 132,578	$ 119,883	$ 105,688
Straight-line rent	10,706	7,911	5,277
Income from direct financing leases	40,830	21,728
Interest and fee income	58,409	48,603	21,357
Total revenues	242,523	198,125	132,322
Expenses
Real estate depreciation and amortization	36,978	32,815	30,147
Property-related	2,450	1,477	724
Acquisition expenses	19,494	5,420	4,184
General and administrative	30,063	28,562	27,091
Total operating expense	88,985	68,274	62,146
Operating income	153,538	129,851	70,176
Other income (expense)
Interest and other (expense) income	(319)	(1,662)	18
Earnings from equity and other interests	3,554	2,943	78
Debt refinancing expense			(14,214)
Interest expense	(66,746)	(58,243)	(43,810)
Income tax expense	(726)	(19)	(128)
Net other expenses	(64,237)	(56,981)	(58,056)
Income from continuing operations	89,301	72,870	12,120
Income from discontinued operations	7,914	17,207	14,594
Net income	97,215	90,077	26,714
Net income attributable to non-controlling interests	(224)	(177)	(178)
Net income attributable to MPT common stockholders	$ 96,991	$ 89,900	$ 26,536
Earnings per share (unit) - basic
Income from continuing operations attributable to MPT common stockholders (Operating Partnership partners)	$ 0.59	$ 0.54	$ 0.10
Income from discontinued operations attributable to MPT common stockholders (Operating Partnership partners)	0.05	0.13	0.13
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.64	$ 0.67	$ 0.23
Weighted average shares (units) outstanding - basic	151,439	132,331	110,623
Earnings per share (unit) - diluted
Income from continuing operations attributable to MPT common stockholders (Operating Partnership partners)	$ 0.58	$ 0.54	$ 0.10
Income from discontinued operations attributable to MPT common stockholders / Operating Partnership partners	0.05	0.13	0.13
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.63	$ 0.67	$ 0.23
Weighted average shares (units) outstanding - diluted	152,598	132,333	110,629
MPT Operating Partnership, L.P. [Member]
Revenues
Rent billed	$ 132,578	$ 119,883	$ 105,688
Straight-line rent	10,706	7,911	5,277
Income from direct financing leases	40,830	21,728
Interest and fee income	58,409	48,603	21,357
Total revenues	242,523	198,125	132,322
Expenses
Real estate depreciation and amortization	36,978	32,815	30,147
Property-related	2,450	1,477	724
Acquisition expenses	19,494	5,420	4,184
General and administrative	30,063	28,562	27,074
Total operating expense	88,985	68,274	62,129
Operating income	153,538	129,851	70,193
Other income (expense)
Interest and other (expense) income	(319)	(1,662)	18
Earnings from equity and other interests	3,554	2,943	78
Debt refinancing expense			(14,214)
Interest expense	(66,746)	(58,243)	(43,810)
Income tax expense	(726)	(19)	(128)
Net other expenses	(64,237)	(56,981)	(58,056)
Income from continuing operations	89,301	72,870	12,137
Income from discontinued operations	7,914	17,207	14,594
Net income	97,215	90,077	26,731
Net income attributable to non-controlling interests	(224)	(177)	(178)
Net income attributable to MPT common stockholders	$ 96,991	$ 89,900	$ 26,553
Earnings per share (unit) - basic
Income from continuing operations attributable to MPT common stockholders (Operating Partnership partners)	$ 0.59	$ 0.54	$ 0.10
Income from discontinued operations attributable to MPT common stockholders (Operating Partnership partners)	0.05	0.13	0.13
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.64	$ 0.67	$ 0.23
Weighted average shares (units) outstanding - basic	151,439	132,331	110,623
Earnings per share (unit) - diluted
Income from continuing operations attributable to MPT common stockholders (Operating Partnership partners)	$ 0.58	$ 0.54	$ 0.10
Income from discontinued operations attributable to MPT common stockholders / Operating Partnership partners	0.05	0.13	0.13
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.63	$ 0.67	$ 0.23
Weighted average shares (units) outstanding - diluted	152,598	132,333	110,629

Consolidated Statements of Comprehensive Income (Loss) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Net income	$ 97,215	$ 90,077	$ 26,714
Other comprehensive income (loss):
Unrealized gain (loss) on interest rate swap	3,474	(251)	(8,590)
Foreign currency translation gain	67
Total comprehensive income	100,756	89,826	18,124
Comprehensive income attributable to non-controlling interests	(224)	(177)	(178)
Comprehensive income attributable to MPT common stockholders (Operating Partnership partners)	100,532	89,649	17,946
MPT Operating Partnership, L.P. [Member]
Net income	97,215	90,077	26,731
Other comprehensive income (loss):
Unrealized gain (loss) on interest rate swap	3,474	(251)	(8,590)
Foreign currency translation gain	67
Total comprehensive income	100,756	89,826	18,141
Comprehensive income attributable to non-controlling interests	(224)	(177)	(178)
Comprehensive income attributable to MPT common stockholders (Operating Partnership partners)	$ 100,532	$ 89,649	$ 17,963

Consolidated Statements of Equity / Capital - USD ($) shares in Thousands, $ in Thousands	Total	Additional Paid-in Capital [Member]	Distributions in Excess of Net Income [Member]	Treasury Stock [Member]	Common Par Value [Member]	Accumulated Other Comprehensive Loss [Member]	Non- Controlling Interests [Member]	MPT Operating Partnership, L.P. [Member]	MPT Operating Partnership, L.P. [Member] Accumulated Other Comprehensive Loss [Member]	MPT Operating Partnership, L.P. [Member] Non- Controlling Interests [Member]	MPT Operating Partnership, L.P. [Member] General Partner [Member]	MPT Operating Partnership, L.P. [Member] Limited Partner [Member] Common Par Value [Member]	MPT Operating Partnership, L.P. [Member] Limited Partner [Member] Long Term Incentive Plan [Member]
Beginning balance (in shares) at Dec. 31, 2010					110,225						1,102	109,123	94
Beginning balance at Dec. 31, 2010	$ 899,576	$ 1,051,785	$ (148,530)	$ (262)	$ 110	$ (3,641)	$ 114	$ 899,949	$ (3,641)	$ 114	$ 9,035	$ 894,441
Net income	26,714		26,536				178	26,731		178	265	26,020	$ 268
Unrealized gain ( loss) on interest rate swaps	(8,590)					(8,590)		(8,590)	(8,590)
Stock (Unit) vesting and amortization of stock (unit)-based compensation	6,983	6,982			$ 1			6,984			$ 69	$ 6,915
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)					561						5	556	56
Purchase of non-controlling interest	(524)	(441)					(83)	(525)		(83)		$ (442)
Extinguishment of convertible debt	(5,501)	(3,070)	(2,431)					(5,501)			$ (55)	(5,446)
Distributions to non-controlling interests	(209)						(209)	(209)		(209)
Dividends (Distributions) declared ($0.80 in 2011, $0.80 in 2012 and $0.81 in 2013 per common share / unit)	(89,634)		(89,634)					(89,634)			$ (896)	$ (88,470)	$ (268)
Ending balance (in shares) at Dec. 31, 2011					110,786						1,107	109,679	150
Ending balance at Dec. 31, 2011	828,815	1,055,256	(214,059)	(262)	$ 111	(12,231)		829,205	(12,231)		$ 8,418	$ 833,018
Net income	90,077		89,900				177	90,077		177	899	88,733	$ 268
Unrealized gain ( loss) on interest rate swaps	(251)					(251)		(251)	(251)
Stock (Unit) vesting and amortization of stock (unit)-based compensation	7,637	7,636			$ 1			7,637			$ 76	$ 7,561
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)					854						4	850	71
Distributions to non-controlling interests	(177)						(177)	(177)		(177)
Proceeds from offering (net of offering costs)	233,048	233,024			$ 24			233,048			$ 2,331	$ 24,449
Proceeds from offering (net of offering costs) (shares)					24,695						246	24,449
Dividends (Distributions) declared ($0.80 in 2011, $0.80 in 2012 and $0.81 in 2013 per common share / unit)	(109,335)		(109,335)					(109,335)			$ (1,094)	$ (107,973)	$ (268)
Ending balance (in shares) at Dec. 31, 2012					136,335						1,357	134,978	221
Ending balance at Dec. 31, 2012	1,049,814	1,295,916	(233,494)	(262)	$ 136	(12,482)		1,050,204	(12,482)		$ 10,630	$ 1,052,056
Net income	97,215		96,991				224	97,215		224	972	95,748	$ 271
Unrealized gain ( loss) on interest rate swaps	3,474					3,474		3,474	3,474
Foreign currency translation gain	67					67		67	67
Stock (Unit) vesting and amortization of stock (unit)-based compensation	8,833	8,832			$ 1			8,833			$ 88	$ 8,745	71
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)					811						9	802
Distributions to non-controlling interests	(224)						$ (224)	(224)		$ (224)
Proceeds from offering (net of offering costs)	313,330	313,306			$ 24			313,330			$ 3,133	$ 310,197
Proceeds from offering (net of offering costs) (shares)					24,164						242	23,922
Dividends (Distributions) declared ($0.80 in 2011, $0.80 in 2012 and $0.81 in 2013 per common share / unit)	(128,301)		(128,301)					(128,301)			$ (1,282)	$ (126,748)	$ (271)
Ending balance (in shares) at Dec. 31, 2013					161,310						1,608	159,702	292
Ending balance at Dec. 31, 2013	$ 1,344,208	$ 1,618,054	$ (264,804)	$ (262)	$ 161	$ (8,941)		$ 1,344,598	$ (8,941)		$ 13,541	$ 1,339,998

Consolidated Statements of Equity / Capital (Parenthetical) - $ / shares	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Dividends (Distributions) declared per common share / unit	$ 0.81	$ 0.80	$ 0.80
MPT Operating Partnership, L.P. [Member]
Dividends (Distributions) declared per common share / unit	$ 0.81	$ 0.80	$ 0.80

Consolidated Statements of Cash Flow $ in Thousands	12 Months Ended
Consolidated Statements of Cash Flow $ in Thousands	Dec. 31, 2013 USD ($)	Dec. 31, 2012 USD ($)	Dec. 31, 2011 USD ($)
Operating activities
Net income	$ 97,215	$ 90,077	$ 26,714
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	38,818	35,593	35,477
Amortization and write-off of deferred financing costs and debt discount	3,559	3,457	9,289
Premium on extinguishment of debt			13,091
Direct financing lease (interest) accretion	(5,774)	(3,104)
Straight-line rent revenue	(11,265)	7,911	5,277
Share (Unit)-based compensation expense	8,832	7,637	6,983
Impairment charge			564
(Gain) loss from sale of real estate	(7,659)	(16,369)	(5,431)
Provision for uncollectible receivables and loans			1,499
Straight-line rent write-off	1,457	6,456	2,470
Payment of discount on extinguishment of debt			(4,850)
Other adjustments	(70)	538	1,058
Decrease (increase) in:
Interest and rent receivable	(13,211)	(17,261)	(6,118)
Other assets	1,855	91	142
Accounts payable and accrued expenses	23,867	9,201	5,354
Deferred revenue	3,177	(2,698)	170
Net cash provided by operating activities	140,801	105,309	79,270
Investing Activities
Cash paid for acquisitions and other related investments	(654,922)	(621,490)	(278,963)
Net proceeds from sale of real estate	32,409	71,202	41,130
Principal received on loans receivable	7,249	10,931	4,289
Investment in loans receivable	(3,746)	(1,293)	(861)
Construction in progress	(41,452)	(44,570)	(22,999)
Other investments, net	(52,115)	(31,908)	(8,217)
Net cash (used for) provided by investing activities	(712,577)	(617,128)	(265,621)
Financing Activities
Proceeds from term debt, net of discount	424,580	300,000	450,000
Payments of term debt	(11,249)	(232)	(246,262)
Payment of deferred financing costs	(9,760)	(6,247)	(15,454)
Revolving credit facilities, net	(20,000)	35,400	89,600
Distributions paid	(120,309)	(103,952)	(89,601)
Lease deposits and other obligations to tenants	3,231	(11,436)	8,621
Proceeds from sale of common shares/units, net of offering costs	313,331	233,048
Other		(177)	(6,235)
Net cash provided by (used in) financing activities	579,824	446,404	190,669
Increase (decrease) in cash and cash equivalents for the year	8,048	(65,415)	4,318
Effect of exchange rate changes	620
Cash and cash equivalents at beginning of period	37,311	102,726	98,408
Cash and cash equivalents at end of period	45,979	37,311	102,726
Interest paid, including capitalized interest of $1,729 in 2013, $1,596 in 2012, and $896 in 2011	58,110	51,440	38,463
Supplemental schedule of non-cash investing activities:
Real estate acquired via assumption of mortgage loan			(14,592)
Loan conversion to equity interest		1,648
Mortgage loan issued from sale of real estate		3,650
Supplemental schedule of non-cash financing activities:
Assumption of mortgage loan (as part of real estate acquired)			14,592
Dividends declared, not paid	35,778	27,786	22,407
MPT Operating Partnership, L.P. [Member]
Operating activities
Net income	97,215	90,077	26,731
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	38,818	35,593	35,477
Amortization and write-off of deferred financing costs and debt discount	3,559	3,457	9,289
Premium on extinguishment of debt			13,091
Direct financing lease (interest) accretion	(11,265)	(3,104)
Straight-line rent revenue	(5,774)	(8,309)	(7,142)
Share (Unit)-based compensation expense	8,832	7,637	6,983
Impairment charge			564
(Gain) loss from sale of real estate	(7,659)	(16,369)	(5,431)
Provision for uncollectible receivables and loans			1,499
Straight-line rent write-off	1,457	6,456	2,470
Payment of discount on extinguishment of debt			(4,850)
Other adjustments	(70)	538	1,058
Decrease (increase) in:
Interest and rent receivable	(13,211)	(17,261)	(6,118)
Other assets	1,855	91	142
Accounts payable and accrued expenses	23,867	9,201	5,337
Deferred revenue	3,177	(2,698)	170
Net cash provided by operating activities	140,801	105,309	79,270
Investing Activities
Cash paid for acquisitions and other related investments	(654,922)	(621,490)	(278,963)
Net proceeds from sale of real estate	32,409	71,202	41,130
Principal received on loans receivable	7,249	10,931	4,289
Investment in loans receivable	(3,746)	(1,293)	(861)
Construction in progress	(41,452)	(44,570)	(22,999)
Other investments, net	(52,115)	(31,908)	(8,217)
Net cash (used for) provided by investing activities	(712,577)	(617,128)	(265,621)
Financing Activities
Proceeds from term debt, net of discount	424,580	300,000	450,000
Payments of term debt	(11,249)	(232)	(246,262)
Payment of deferred financing costs	(9,760)	(6,247)	(15,454)
Revolving credit facilities, net	(20,000)	35,400	89,600
Distributions paid	(120,309)	(103,952)	(89,601)
Lease deposits and other obligations to tenants	3,231	(11,436)	8,621
Proceeds from sale of common shares/units, net of offering costs	313,331	233,048
Other		(177)	(6,235)
Net cash provided by (used in) financing activities	579,824	446,404	190,669
Increase (decrease) in cash and cash equivalents for the year	8,048	(65,415)	4,318
Effect of exchange rate changes	620
Cash and cash equivalents at beginning of period	37,311	102,726	98,408
Cash and cash equivalents at end of period	45,979	37,311	102,726
Interest paid, including capitalized interest of $1,729 in 2013, $1,596 in 2012, and $896 in 2011	58,110	51,440	38,463
Supplemental schedule of non-cash investing activities:
Real estate acquired via assumption of mortgage loan			(14,592)
Loan conversion to equity interest		1,648
Mortgage loan issued from sale of real estate		3,650
Supplemental schedule of non-cash financing activities:
Assumption of mortgage loan (as part of real estate acquired)			14,592
Dividends declared, not paid	$ 35,778	$ 27,786	$ 22,407

Consolidated Statements of Cash Flow (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Interest paid, capitalized	$ 1,729	$ 1,596	$ 896
MPT Operating Partnership, L.P. [Member]
Interest paid, capitalized	$ 1,729	$ 1,596	$ 896

Organization

12 Months Ended

Dec. 31, 2013

Organization

1.	Organization

Medical Properties Trust, Inc., a Maryland corporation, was formed on August 27, 2003, under the General Corporation Law of Maryland for the purpose of engaging in the business of investing in, owning, and leasing commercial real estate. Our operating partnership subsidiary, MPT Operating Partnership, L.P., (the “Operating Partnership”) through which we conduct all of our operations, was formed in September 2003. Through another wholly-owned subsidiary, Medical Properties Trust, LLC, we are the sole general partner of the Operating Partnership. At present, we directly own substantially all of the limited partnership interests in the Operating Partnership and have elected to report our required disclosures and that of the Operating Partnership on a combined basis except where material differences exist.

We have operated as a real estate investment trust (“REIT”) since April 6, 2004, and accordingly, elected REIT status upon the filing in September 2005 of the calendar year 2004 federal income tax return. Accordingly, we will not be subject to U.S. federal income tax, provided that we continue to qualify as a REIT and our distributions to our stockholders equal or exceed our taxable income. Certain activities we undertake must be conducted by entities which we elected to be treated as taxable REIT subsidiaries (“TRSs”). Our TRSs are subject to both U.S. federal and state income taxes.

Our primary business strategy is to acquire and develop real estate and improvements, primarily for long-term lease to providers of healthcare services such as operators of general acute care hospitals, inpatient physical rehabilitation hospitals, long-term acute care hospitals, surgery centers, centers for treatment of specific conditions such as cardiac, pulmonary, cancer, and neurological hospitals, and other healthcare-oriented facilities. We also make mortgage and other loans to operators of similar facilities. In addition, we may obtain profits or equity interests in our tenants, from time to time, in order to enhance our overall return. We manage our business as a single business segment. All of our properties are located in the United States and Europe—we made our first acquisition outside the United States in the fourth quarter of 2013 (as more fully described in Note 3).

The entire disclosure for organization, consolidation and basis of presentation of financial statements disclosure.

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 275
-SubTopic 10
-URI http://asc.fasb.org/subtopic&trid=2134480

Reference 2: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 852
-SubTopic 10
-URI http://asc.fasb.org/subtopic&trid=2209116

Reference 3: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 810
-SubTopic 10
-URI http://asc.fasb.org/subtopic&trid=2197480

Reference 4: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 10
-URI http://asc.fasb.org/subtopic&trid=2122150

Reference 5: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 810
-SubTopic 10
-Section 50
-Paragraph 8
-URI http://asc.fasb.org/extlink&oid=28200181&loc=SL6228881-111685

Reference 6: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 272
-SubTopic 10
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+ Details

Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2013

Summary of Significant Accounting Policies

2.	Summary of Significant Accounting Policies

Use of Estimates: The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.

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

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

At December 31, 2013, we had loans and/or equity investments in certain VIEs, which are also tenants of our facilities (including but not limited to Ernest, Monroe and Vibra). We have determined that we are not the primary beneficiary of these VIEs. The carrying value and classification of the related assets and maximum exposure to loss as a result of our involvement with these VIEs are presented below at December 31, 2013 (in thousands):


VIE Type	Maximum Loss Exposure(1)		Asset Type Classification	Carrying Amount(2)
Loans, net		$283,273	Mortgage and other loans	$	228,996
Equity investments		$ 19,308	Other assets	$	5,198

(1)

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

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

For the VIE types above, we do not consolidate the VIE because we do not have the ability to control the activities (such as the day-to-day healthcare operations of our borrowers or investees) that most significantly impact the VIE’s economic performance. As of December 31, 2013, we were not required to provide financial support through a liquidity arrangement or otherwise to our unconsolidated VIEs, including circumstances in which it could be exposed to further losses (e.g., cash short falls).

Typically, our loans are collateralized by assets of the borrower (some assets of which are on the premises of facilities owned by us) and further supported by limited guarantees made by certain principals of the borrower.

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

Investments in Unconsolidated Entities: Investments in entities in which we have the ability to influence (but not control) are typically accounted for by the equity method. Under the equity method of accounting, our share of the investee’s earnings or losses are included in our consolidated results of operations, and we have elected to record our share of such investee’s earnings or losses on a 90-day lag basis. The initial carrying value of investments in unconsolidated entities is based on the amount paid to purchase the interest in the investee entity. Subsequently, our investments are increased by the equity in our investee earnings and decreased by cash distributions from our investees. To the extent that our cost basis is different from the basis reflected at the investee entity level, the basis difference is generally amortized over the lives of the related assets and liabilities, and such amortization is included in our share of equity in earnings of the investee. 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. If we determine a decline in the fair value of an investment in an unconsolidated investee entity below its carrying value is other - than - temporary, an impairment is recorded.

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

Revenue Recognition: We receive income from operating leases based on the fixed, minimum required rents (base rents) per the lease agreements. Rent revenue from base rents is recorded on the straight-line method over the terms of the related lease agreements for new leases and the remaining terms of existing leases for acquired properties. The straight-line method records the periodic average amount of base rent earned over the term of a lease, taking into account contractual rent increases over the lease term. The straight-line method typically has the effect of recording more rent revenue from a lease than a tenant is required to pay early in the term of the lease. During the later parts of a lease term, this effect reverses with less rent revenue recorded than a tenant is required to pay. Rent revenue as recorded on the straight-line method in the consolidated statements of income is presented as two amounts: billed rent revenue and straight-line revenue. Billed rent revenue is the amount of base rent actually billed to the customer each period as required by the lease. Straight-line rent revenue is the difference between rent revenue earned based on the straight-line method and the amount recorded as billed rent revenue. We record the difference between base rent revenues earned and amounts due per the respective lease agreements, as applicable, as an increase or decrease to straight-line rent receivable.

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

We use direct finance lease accounting (“DFL”) to record rent on certain leases deemed to be financing leases rather than operating leases. For leases accounted for as DFLs, the future minimum lease payments are recorded as a receivable. Unearned income represents the net investment in the DFL, less the sum of minimum lease payments receivable and the estimated residual values of the leased properties. Unearned income is deferred and amortized to income over the lease terms to provide a constant yield when collectability of the lease payments is reasonably assured. Investments in DFLs are presented net of unamortized and unearned income.

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

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

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

Commitment fees received from development and leasing services for lessees 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 and recognized as income over the life of the loan using the interest method.

Tenant payments for certain taxes, insurance, and other operating expenses related to our facilities (most of which are paid directly by our tenants to the government or related vendor) are recorded net of the respective expense as generally our leases are “triple-net” leases, with terms requiring such expenses to be paid by our tenants. Failure on the part of our tenants to pay such expense or to pay late would result in a violation of the lease agreement, which could lead to an event of default, if not cured.

Acquired Real Estate Purchase Price Allocation: We allocate the purchase price of acquired properties to net tangible and identified intangible assets acquired based on their fair values. In making estimates of fair values for purposes of allocating purchase prices of acquired real estate, we utilize a number of sources, from time to time, including independent appraisals that may be obtained in connection with the acquisition or financing of the respective property and other market data. We also consider information obtained about each property as a result of our pre-acquisition due diligence, marketing and leasing activities in estimating the fair value of the tangible and intangible assets acquired.

We 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.

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

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 in-place leases, if any, to expense over the initial term of the respective leases. The value of customer relationship intangibles is amortized to expense over the initial term and any renewal periods in the respective leases, but in no event will the amortization period for intangible assets exceed the remaining depreciable life of the building. If a lease is terminated, the unamortized portion of the in-place lease value and customer relationship intangibles are charged to expense.

Real Estate and Depreciation: Real estate, consisting of land, buildings and improvements, are recorded 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 assets. For assets held for sale, we cease recording depreciation expense and adjust the assets’ value to the lower of its carrying value or fair value, less cost of disposal. Fair value is based on estimated cash flows discounted at a risk-adjusted rate of interest. We classify real estate assets as held for sale when we have commenced an active program to sell the assets, and in the opinion of management, it is probable the asset will be sold within the next 12 months. We record the results of operations from material property sales or planned sales (which include real property, loans and any receivables) as discontinued operations in the consolidated statements of income for all periods presented if we do not have any continuing involvement with the property subsequent to its sale. Results of discontinued operations include interest expense from debt which specifically collateralizes the property sold or held for sale.

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 weighted average useful lives of the related real estate and other assets, as follows:


Buildings and improvements			38.2 years
Tenant lease intangibles			18.6 years
Leasehold improvements			22.2 years
Furniture, equipment and other			9.4 years

Losses from Rent Receivables: For all leases, we continuously monitor the performance of our existing tenants including, but not limited to: admission levels and surgery/procedure volumes by type; current operating margins; ratio of our tenant’s operating margins both to facility rent and to facility rent plus other fixed costs; trends in revenue and patient mix; and the effect of evolving healthcare regulations on 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 rent receivables is needed. A provision for losses on rent receivables (including straight-line rent receivables) is ultimately recorded when it becomes probable that the receivable will not be collected in full. The provision is an amount which reduces the receivable to its estimated net realizable value based on a determination of the eventual amounts to be collected either from the debtor or from existing collateral, if any.

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

Loans: Loans consist of mortgage loans, working capital loans and other long-term loans. Mortgage loans are collateralized by interests in real property. Working capital and other long-term loans are generally collateralized by interests in receivables and corporate and individual guarantees. We record loans at cost. We evaluate the collectability of both interest and principal on a loan-by-loan basis (using the same process as we do for assessing the collectability of rents) to determine whether they are impaired. A loan is considered impaired when, based on current information and events, it is probable that we will be unable to collect all amounts due according to the existing contractual terms. When a loan is considered to be impaired, the amount of the allowance is calculated by comparing the recorded investment to either the value determined by discounting the expected future cash flows using the loan’s effective interest rate or to the fair value of the collateral if the loan is collateral dependent. When a loan is deemed to be impaired, we generally place the loan on non-accrual status and record interest income only upon receipt of cash.

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

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

Income Taxes: We conduct our business as a real estate investment trust (“REIT”) under Sections 856 through 860 of the Internal Revenue 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 are not subject to federal income tax on taxable income that we distribute to our stockholders. If we fail to qualify as a REIT in any taxable year, we will then be subject to federal income taxes on our taxable income at regular corporate rates and will not be permitted to qualify for treatment as a REIT for federal income tax purposes for four years following the year during which qualification is lost, unless the 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 federal income tax purposes.

Our financial statements include the operations of taxable REIT subsidiaries (“TRS”), including MPT Development Services, Inc. (“MDS”) and MPT Covington TRS, Inc. (“CVT”), along with 29 others, which are single member LLCs that are disregarded for tax purposes and are reflected in the tax returns of MDS. Our TRS entities are not entitled to a dividends paid deduction and are subject to federal, state, and local income taxes. Our TRS entities are authorized to provide property development, leasing, and management services for third-party owned properties, and they make loans to and/or investments in our lessees.

With the property acquisitions in Germany, we will be subject to income taxes internationally. However, we do not expect to incur any additional income tazes in the United States as such income from our German properties will flow through our REIT income tax returns. For our TRS and international subsidiaries, we determine deferred tax assets and liabilities based on the differences between the financial reporting and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Any increase or decrease in the deferred tax liability 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 the deferred tax asset will not be realized. Any increase or decrease in the valuation allowance that results from a change in circumstances, and that causes us to change our judgment about the realizability of the related deferred tax asset, is reflected in our tax provision when such changes occur.

Stock-Based Compensation: We adopted the 2013 Equity Incentive Plan (the “Equity Incentive Plan”) during the second quarter of 2013, which replaced the 2004 Equity Incentive Plan. Awards of restricted stock, stock options and other equity-based awards with service conditions are amortized to compensation expense over the vesting periods (typically three years), using the straight-line method. Awards of deferred stock units vest when granted and are charged to expense at the date of grant. Awards that contain market conditions are amortized to compensation expense over the derived vesting periods, which correspond to the periods over which we estimate the awards will be earned, which generally range from three to five years, using the straight-line method. Awards with performance conditions are amortized using the straight-line method over the service period in which the performance conditions are measured, adjusted for the probability of achieving the performance conditions.

Deferred Costs: Costs incurred prior to the completion of offerings of stock or other capital instruments that directly relate to the offering are deferred and netted against proceeds received from the offering. External costs incurred in connection with anticipated financings and refinancings of debt are generally capitalized as deferred financing costs in other assets and amortized over the lives of the related loans 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 loan (interest method). For debt without defined principal repayment terms, such as revolving credit agreements, the deferred costs are amortized on the straight-line method over the term of the debt. Leasing commissions and other leasing costs directly attributable to tenant leases are capitalized as deferred leasing costs and amortized on the straight-line method over the terms of the related lease agreements. Costs identifiable with loans made to borrowers are recognized as a reduction in interest income over the life of the loan.

Foreign Currency Translation and Transactions: Certain of our 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, a component of stockholders’ equity on our consolidated balance sheets.

Certain of our U.S. subsidiaries will enter into transactions denominated in foreign currency from time to time. Gains or losses resulting from these foreign currency transactions are translated into U.S. dollars at the rates of exchange prevailing at the dates of the transactions. The effects of transaction gains or losses are included in other income in the consolidated statements of income.

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

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

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

•

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

•

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

•

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

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

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

Fair Value Option Election: For our equity interest in Ernest and related loans (as more fully described in Note 3), we have elected to account for these investments at fair value due to the size of the investments and because we believe this method is more reflective of current values. We have not made a similar election for other equity interest or loans made in or prior to 2012.

Recent Accounting Developments: In July 2013, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update No. 2013-10, Inclusion of the Fed Funds Effective Swap Rate (or Overnight Index Swap Rate) as a Benchmark Interest Rate for Hedge Accounting Purposes (a consensus of the FASB Emerging Issues Task Force) (“ASU 2013-10”). This update permits the Fed Funds Effective Swap Rate to be used as a U.S. benchmark interest rate for hedge accounting purposes under Topic 815, in addition to the interest rates on direct Treasury obligations of the U.S. government and the London Interbank Offered Rate (“LIBOR”). The amendments are effective prospectively for qualifying new or redesignated hedging relationships entered into on or after July 17, 2013. The adoption of ASU 2013-10 on July 17, 2013, did not have a material impact on our 2013 consolidated financial position or results of operations.

In January 2013, the FASB issued Accounting Standards Update (“ASU”) No. 2013-02, Reporting of Amounts Reclassified Out of Accumulated Other Comprehensive Income (“ASU 2013-02”). The amendments in this update require an entity to provide information about the amounts reclassified from accumulated other comprehensive income by component. In addition, an entity is required to present, either on the face of the income statement or in the notes, significant amounts reclassified from accumulated other comprehensive income by the net income line item. The adoption of ASU 2013-02 did not have an impact on our 2013 consolidated financial position or results of operations.

Reclassifications: Certain reclassifications have been made to the consolidated financial statements to conform to the 2013 consolidated financial statement presentation. Assets sold or held for sale have been reclassified to Real Estate Held for Sale on the consolidated balance sheets and related operating results have been reclassified from continuing operations to discontinued operations for all periods presented (see Note 11).

Real Estate and Loans Receivable

12 Months Ended

Dec. 31, 2013

Text Block [Abstract]

Real Estate and Loans Receivable

3.	Real Estate and Loans Receivable

Acquisitions

We acquired the following assets:


	2013		2012		2011
Assets Acquired		(in thousands)
Land	$	41,473	$	518	$	19,705
Building		439,030		8,942		220,769
Intangible lease assets — subject to amortization (weighted average useful life 21.0 years in 2013, 15.0 years in 2012 and 13.9 years in 2011)		38,589		1,040		20,630
Net investments in direct financing leases		110,580		310,000		—
Mortgage loans		20,000		200,000		—
Other loans		5,250		95,690		27,283
Equity investments		—		5,300		5,168

Total assets acquired	$	654,922	$	621,490	$	293,555
Total liabilities assumed		—		—		(14,592	)

Net assets acquired	$	654,922	$	621,490	$	278,963

2013 Activity

RHM Portfolio Acquisition

On November 29, 2013, we acquired 11 rehabilitation facilities in the Federal Republic of Germany from RHM Klinik-und Altenheimbetriebe GmbH & Co. KG (“RHM”) for an aggregate purchase price, excluding €9 million applicable transfer taxes, of €175 million or $237.8 million. Each of the facilities are leased to RHM under a master lease providing for a term of 27 years and for annual rent increases of 2.0% from 2015 through 2017, and of 0.5% thereafter. On December 31, 2020 and every three years thereafter, rent will be increased to reflect 70% of cumulative increases in the German consumer price index.

The RHM Acquisition represents our first acquisition outside of the United States. This acquisition adds a portfolio of assets with a financially stable long-term operating history and helps improve both our tenant and geographic diversification. As of December 31, 2013, we had $240.5 million of gross real estate assets located outside of the United States that generated $1.8 million of revenue in 2013.

On December 12, 2013, we acquired the real estate of Dallas Medical Center in Dallas, Texas from affiliates of Prime for a purchase price of $25 million and leased the facility to Prime with an initial 10-year lease term under the master lease agreement, plus two renewal options of five years each. This lease is accounted for as a direct financing lease.

On September 26, 2013, we acquired three general acute care hospitals from affiliates of IASIS for a combined purchase price of $281.3 million. Each of the facilities were leased back to IASIS under leases with initial 15-year terms plus two renewal options of five years each, and consumer price-indexed rent increases limited to a 2.5% ceiling annually. The lessees have a right of first refusal option with respect to subsequent proposed sales of the facilities. All of our leases with affiliates of IASIS will be cross-defaulted with each other. In addition to the IASIS acquisitions transactions, we have amended our lease with IASIS for the Pioneer Valley Hospital in West Valley City, Utah, which extended the lease to 2028 from 2019 and adjusted the rent.

On July 18, 2013, we acquired the real estate of Esplanade Rehab Hospital in Corpus Christi, Texas (now operating as Corpus Christi Rehabilitation Hospital). The total purchase price was $10.5 million including $0.5 million for adjacent land. The facility is leased to an affiliate of Ernest under the master lease agreement entered into with Ernest in 2012 that initially provided for a 20-year term with three five-year extension options, plus consumer price-indexed rent increases, limited to a 2% floor and 5% ceiling annually. This lease is accounted for as a DFL. In addition, we made a $5.3 million loan on this property with terms similar to the lease terms.

On June 11, 2013, we acquired the real estate of two acute care hospitals in Kansas from affiliates of Prime for a combined purchase price of $75 million and leased the facilities to the operator under a master lease agreement. The master lease is for 10 years and contains two renewal options of five years each, and the rent increases annually based on the greater of the consumer price-index or 2%. This lease is accounted for as a DFL.

On December 31, 2013, we provided a $20 million mortgage financing to Alecto Healthcare Services for the 204-bed Olympia Medical Center.

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

From the respective acquisition dates, these 2013 acquisitions contributed $13.6 million and $10.6 million of revenue and income (excluding related acquisition expenses) for the period ended December 31, 2013. In addition, we incurred $19.5 million of acquisition related expenses in 2013, of which $18.0 million (including $12 million in transfer taxes as a part of the RHM acquisition) related to acquisitions consummated as of December 31, 2013.

2012 Activity

On February 29, 2012, we made loans to and acquired assets from Ernest for a combined purchase price and investment of $396.5 million (“Ernest Transaction”).

Real Estate Acquisition and Mortgage Loan Financing

Pursuant to a definitive real property asset purchase agreement, we acquired from Ernest and certain of its subsidiaries (i) a portfolio of five rehabilitation facilities (including a ground lease interest relating to a community-based acute rehabilitation facility in Wyoming), (ii) seven long-term acute care facilities located in seven states and (iii) undeveloped land in Provo, Utah (collectively, the “Acquired Facilities”) for an aggregate purchase price of $200 million, subject to certain adjustments. The Acquired Facilities are leased to subsidiaries of Ernest pursuant to a master lease agreement. The master lease agreement has a 20-year term with three five-year extension options and provided for an initial rental rate of 9%, with consumer price-indexed increases, limited to a 2% floor and 5% ceiling annually thereafter. In addition, we made Ernest a $100 million loan secured by a first mortgage interest in four subsidiaries of Ernest, which has terms similar to the leasing terms described above.

Acquisition Loan and Equity Contribution

Through an affiliate of one of our TRSs, we made investments of approximately $96.5 million in Ernest Health Holdings, LLC, which is the owner of Ernest. These investments are structured as a $93.2 million acquisition loan and a $3.3 million equity contribution.

The interest rate on the acquisition loan is 15%. Ernest is required to pay us a minimum of 6% and 7% of the loan amount in years one and two, respectively, and 10% thereafter, although there are provisions in the loan agreement that are expected to result in full payment of the 15% preference when funds are sufficient. Any of the 15% in excess of the minimum that is not paid may be accrued and paid upon the occurrence of a capital or liquidity event and is payable at maturity. The loan may be prepaid without penalty at any time.

On July 3, 2012, we funded a $100 million mortgage loan secured by the real property of Centinela Hospital Medical Center. Centinela is a 369 bed acute care facility that is operated by Prime. This mortgage loan is cross-defaulted with other mortgage loans to Prime and certain master lease agreements. The initial term of this mortgage loan runs through 2022.

On September 19, 2012, we acquired the real estate of the 380 bed St. Mary’s Regional Medical Center, an acute care hospital in Reno, Nevada for $80 million and the real estate of the 140 bed Roxborough Memorial Hospital in Pennsylvania for $30 million. The acquired facilities are leased to Prime pursuant to a master lease agreement, which is more fully described below in the Leasing Operations section.

On December 14, 2012, we acquired the real estate of a 40 bed long-term acute care hospital in Hammond, Louisiana for $10.5 million and leased the facility to the operator under a 15-year lease, with three five-year extension options. The rent escalates annually based on consumer price indexed increases. As part of this transaction, we made a secured working capital loan of $2.5 million as well as a revolving loan of up to $2.0 million. In addition, we made a $2.0 million equity investment for a 25% equity ownership in the operator of this facility.

From the respective acquisition dates in 2012 through that year end, these 2012 acquisitions contributed $46.3 million and $46.1 million of revenue and income (excluding related acquisition expenses) for the period ended December 31, 2012. In addition, we incurred $5.4 million of acquisition related expenses in 2012, of which $5.1 million related to acquisitions consummated as of December 31, 2012.

2011 Activity

On January 4, 2011, we acquired the real estate of the 19-bed, 4-year old Gilbert Hospital in a suburb of Phoenix, Arizona area for $17.1 million. Gilbert Hospital is operated by affiliates of Visionary Health, LLC, the same group that operates our Florence, Arizona facility. We acquired this asset subject to an existing lease that expires in May 2022. The lease contains three five-year extension options, and the rent escalates annually at 2.5%.

On January 31, 2011, we acquired for $23.5 million the real estate of the 60-bed Atrium Medical Center at Corinth in the Dallas area, a long-term acute care hospital that was completed in 2009 and is subject to a lease that expires in June 2024. The lease contains two ten-year extension options, and the rent escalates annually based on consumer price indexed increases and to be not less than 1% or greater than 5%. In addition, through one of our affiliates, we invested $1.3 million to acquire approximately 19% of a joint venture arrangement with an affiliate of Vibra Healthcare, LLC (“Vibra”) that will manage and has acquired a 51% interest in the operations of the facility. We also made a $5.2 million working capital loan to the joint venture. The former operators of the hospital, comprised primarily of local physicians, retained ownership of 49% of the operating entity.

On February 4, 2011, we purchased for $58 million the real estate of Bayonne Medical Center, a 6-story, 278-bed acute care hospital in the New Jersey area of metropolitan New York, and leased the facility to the operator under a 15-year lease, with six five-year extension options. The rent escalates annually based on consumer price indexed increases. The operator is an affiliate of a private hospital operating company that acquired the hospital in 2008.

On February 9, 2011, we acquired the real estate of the 306-bed Alvarado Hospital in San Diego, California for $70 million from Prime. Prime is the operator of the facility.

On February 14, 2011, we completed the acquisition of the Northland LTACH Hospital located in Kansas City, a 35-bed hospital that opened in April 2008 and has a lease that expires in 2028. The lease contains three five-year extension options, and the rent increases annually at 2.75%. This hospital is currently being operated by Kindred Healthcare Inc. The purchase price of this hospital was $19.5 million, which included the assumption of a $15 million existing mortgage loan that matures in January 2018.

On July 18, 2011, we acquired the real estate of the 40-bed Vibra Specialty Hospital of DeSoto in Desoto, Texas for $13.0 million. This long-term acute care facility is leased to a subsidiary of Vibra for a fixed term of 15 years with three five-year extension options. Rent escalates annually based on consumer priced indexed increases. In addition, we made a $2.5 million equity investment in the operator of this facility for a 25% equity ownership.

On September 30, 2011, we purchased the real estate of a 40-bed long-term acute care facility in New Braunfels, Texas for $10.0 million. This facility is leased to an affiliate of Post Acute Medical, LLC for a fixed term of 15 years with three five-year extension options. Rent escalates annually based on consumer priced indexed increases. In addition, we made a $1.4 million equity investment for a 25% equity ownership in the operator of this facility and funded a $2.0 million working capital loan.

On November 4, 2011, we made investments in Hoboken University Medical Center in Hoboken, New Jersey, a 350-bed acute care facility. The total investment for this transaction was $75.0 million, comprising $50.0 million for the acquisition of an 100% ownership of the real estate, a secured working capital loan of up to $20.0 million (of which $15.1 million has been funded to-date), and the funding of a $5.0 million convertible note, which provides us with the option to acquire up to 25% of the hospital operator—See Loans section of this Note 3 for an update. The lease with the tenant has an initial term of 15 years, contains six five-year extension options, and the rent escalates annually based on consumer price indexed increases.

From the respective acquisition dates in 2011 through that year-end, these 2011 acquisitions contributed $21.2 million of revenue and $14.1 million of income (excluding related acquisition expenses). In addition, we incurred $4.2 million in acquisition related expenses in 2011, of which $1.9 million related to acquisitions consummated as of December 31, 2011.

The results of operations for each of the properties acquired in 2013 and 2012 are included in our consolidated results from the effective date of each acquisition. The following table sets forth certain unaudited pro forma consolidated financial data for 2013 and 2012, as if each acquisition was consummated on the same terms at the beginning of 2012 and 2011, respectively. Supplemental pro forma earnings were adjusted to exclude $18.0 million and $5.1 million of acquisition-related costs on these consummated deals incurred during 2013 and 2012, respectively (dollar amounts in thousands except per share/unit data).


	2013		2012
	(Amounts in thousands except per share/unit amounts)
Total revenues	$	288,159	$	280,539
Net income		133,258		135,402
Net income per share/unit	$	0.82	$	0.85

Development Activities

On June 11, 2013, we entered into a master funding and development agreement with First Choice Emergency Room, LLC (“First Choice”) to develop up to 25 freestanding emergency room facilities for a maximum aggregate funding of $100 million. During 2013, we began construction on eight of these emergency room facilities for a total development price of $37.8 million. One of the facilities was completed in the fourth quarter of 2013, while the others are expected to be completed in 2014. We have funded $9.1 million through the end of 2013 for these facilities still under construction.

On May 20, 2013, we entered into an agreement to finance the development of and lease an inpatient rehabilitation facility in South Ogden, Utah for $19.2 million, which will be leased to Ernest under the 2012 master lease. The facility is expected to be completed in the 2014 second quarter. We have funded $16.4 million through the end of 2013.

On March 4, 2013, we entered into an agreement to finance the development of and lease an inpatient rehabilitation facility in Post Falls, Idaho for $14.4 million, which will be leased to Ernest under the 2012 master lease.

On December 20, 2012, we entered into an agreement to finance the development of and lease an acute care facility in Altoona, Wisconsin for $33.5 million, which will be leased to an affiliate of National Surgical Hospitals.

On October 1, 2012, we agreed to fund the construction of an inpatient rehabilitation hospital in Spartanburg, South Carolina that will be operated by Ernest. The facility was completed in 2013 for a total development cost of $16.9 million, and we began recognizing rent in August 2013.

On June 13, 2012, we entered into an agreement with Ernest to fund the development of and lease a 40-bed rehabilitation hospital in Lafayette, Indiana. The facility was completed in 2013 for a total development costs of $15.7 million, and we began recognizing rent in February 2013.

On May 4, 2012, we amended the current lease on our Victoria, Texas facility with Post Acute Medical to extend the current lease term to 2028, and we agreed to develop and lease a 26-bed facility next to the existing facility. The facilities will be operated as separate LTACH and rehabilitation hospitals. We completed development of the rehabilitation facility in 2013 for a total development costs of $9.4 million, and began recognizing rent in December 2013.

On March 1, 2012, we received a certificate of occupancy for our constructed Florence acute care facility near Phoenix, Arizona. With this, we started recognizing rent on this facility in March 2012. Land and building costs associated with this property approximates $30 million, and the lease term is 25 years.

On October 14, 2011, we entered into agreements with a joint venture of Emerus Holding, Inc. and Baptist Health System, to acquire, provide for development funding and lease three acute care hospitals for $30.0 million in the suburban markets of San Antonio, Texas. The three facilities are subject to a master lease structure with an initial term of 15 years and three five-year extension options. Rent escalates annually based on consumer priced indexed increases and to be not less than one percent or greater than three percent. We completed development and started recognizing rent on one of the facilities in October 2012 and in 2013 for the remaining two facilities.

In regards to our Twelve Oaks facility, approximately 55% of this facility became occupied as of January 23, 2013, pursuant to a 15 year lease.

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

Property

Location

Property Type

Operator

Commitment

Costs Incurred
as of
12/31/13

Estimated
Completion
Date

First Choice ER- Nacogdoches

San Antonio, TX

Acute Care Hospital

First Choice ER, LLC

5,100

2,681

1Q 2014

First Choice ER- Brodie

Austin, TX

Acute Care Hospital

First Choice ER, LLC

5,470

1,950

2Q 2014

First Choice ER- Alvin

Houston, TX

Acute Care Hospital

First Choice ER, LLC

5,240

1,328

2Q 2014

Northern Utah Rehabilitation Hospital

South Ogden, UT

Inpatient Rehabilitation Hospital

Ernest Health, Inc.

19,153

16,391

2Q 2014

First Choice ER- Briar Forest

Houston, TX

Acute Care Hospital

First Choice ER, LLC

5,833

1,386

3Q 2014

First Choice ER- Cedar Hill

Cedar Hill, TX

Acute Care Hospital

First Choice ER, LLC

5,768

1,167

3Q 2014

First Choice ER- Firestone

Firestone, CO

Acute Care Hospital

First Choice ER, LLC

5,172

544

3Q 2014

Oakleaf Surgical Hospital

Altoona, WI

Acute Care Hospital

National Surgical
Hospitals

33,500

16,324

3Q 2014

First Choice Emergency Rooms

Various

Acute Care Hospital

First Choice

62,217

—

Various

147,453

41,771

Disposals

On November 27, 2013, we sold the real estate of an inpatient rehabilitation facility, Warm Springs Rehabilitation Hospital of San Antonio, for $14 million, resulting in a gain on sale of $5.6 million.

On April 17, 2013, we sold two long-term acute care hospitals, Summit Hospital of Southeast Arizona and Summit Hospital of Southeast Texas, for total proceeds of $18.5 million, resulting in a gain of $2.1 million.

On December 27, 2012, we sold our Huntington Beach facility for $12.5 million, resulting in a gain of $1.9 million. Due to this sale, we wrote-off $0.7 million of straight-line rent receivable.

During the third quarter of 2012, we entered into a definitive agreement to sell the real estate of two LTACH facilities, Thornton and New Bedford, to Vibra for total cash proceeds of $42 million. The sale of Thornton was completed on September 28, 2012, resulting in a gain of $8.4 million. Due to this sale, we wrote-off $1.6 million in straight-line rent receivables. The sale of New Bedford was completed on October 22, 2012, resulting in a gain of $7.2 million. Associated with this sale, we wrote-off $4.1 million in straight-line rent receivables in the fourth quarter 2012.

On August 21, 2012, we sold our Denham Springs facility for $5.2 million, resulting in a gain of $0.3 million.

On June 15, 2012, we sold the HealthSouth Rehabilitation Hospital of Fayetteville in Fayetteville, Arkansas for $16 million, resulting in a loss of $1.4 million. In connection with this sale, HealthSouth Corporation agreed to extend the lease on our Wichita, Kansas property, which is now set to end in March 2022.

On December 30, 2011, we sold Sherman Oaks Hospital in Sherman Oaks, California to Prime for $20.0 million, resulting in a gain of $3.1 million. Due to this sale, we wrote-off $1.2 million in straight-line rent receivables.

On December 30, 2011, we sold MountainView Regional Rehabilitation Hospital in Morgantown, West Virginia to HealthSouth Corporation for $21.1 million, resulting in a gain of $2.3 million.

For each of these disposals, the operating results of these facilities for the current and all prior periods have been included in discontinued operations, and we have reclassified the related real estate to Real Estate Held for Sale.

Intangible Assets

At December 31, 2013 and 2012, our intangible lease assets were $90.5 million ($75.0 million, net of accumulated amortization) and $52.0 million ($40.1 million, net of accumulated amortization), respectively.

We recorded amortization expense related to intangible lease assets of $4.0 million, $3.9 million, and $5.2 million in 2013, 2012, and 2011, respectively, and expect to recognize amortization expense from existing lease intangible assets as follows: (amounts in thousands)


For the Year Ended December 31:
2014	$	5,086
2015		4,896
2016		4,855
2017		4,845
2018		4,784

As of December 31, 2013, capitalized lease intangibles have a weighted average remaining life of 18.6 years.

Leasing Operations

All of our leases are accounted for as operating leases except we are accounting for 13 Ernest facilities and five Prime facilities as DFLs. The components of our net investment in DFLs consisted of the following (dollars in thousands):


	As of December 31, 2013
Minimum lease payments receivable	$	1,647,567
Estimated residual values		211,863
Less unearned income		(1,428,406	)

Net investment in direct financing leases	$	431,024

Minimum rental payments due to us in future periods under operating leases and DFL, which have non-cancelable terms extending beyond one year at December 31, 2013, are as follows: (amounts in thousands)


	Total Under Operating Leases		Total Under DFLs		Total
2014	$	166,602	$	42,535	$	209,137
2015		164,754		43,386		208,140
2016		165,517		44,254		209,771
2017		165,418		45,139		210,557
2018		165,679		46,041		211,720
Thereafter		1,536,759		601,981		2,138,740

	$	2,364,729	$	823,336	$	3,188,065

On July 3, 2012, we entered into master lease agreements with certain subsidiaries of Prime, which replaced the then current leases with the same tenants covering the same properties. The master leases are for 10 years and contain two renewal options of five years each. The initial lease rate is generally consistent with the blended average rate of the prior lease agreements. However, the annual escalators, which in the prior leases were limited, have been increased to 100% of consumer price index increases, along with a minimum floor. The master leases include repurchase options substantially similar to those in the prior leases, including provisions establishing minimum repurchase prices equal to our total investment.

In the 2011 fourth quarter, we consented to the sale by Vibra of its Dallas LTACH, for which we own the real estate to an affiliate of LifeCare Reit 2, Inc. (“LifeCare”) and LifeCare executed a restated lease agreement. As a result of this transaction, we wrote off the related straight line rent receivables of $1.3 million and accelerated the amortization of the related lease intangibles resulting in $0.6 million of expense in the 2011 fourth quarter.

Monroe Facility

As of December 31, 2013, we have advanced $31.1 million to the operator/lessee of Monroe Hospital in Bloomington, Indiana pursuant to a working capital loan agreement, including $1.2 million in advances during 2013. In addition, as of December 31, 2013, we have $21.0 million of rent, interest and other charges owed to us by the operator, of which $6.0 million of interest receivables are significantly more than 90 days past due. Because the operator has not made all payments required by the working capital loan agreement and the related real estate lease agreement, we consider the loan to be impaired. During 2010, we recorded a $12 million impairment charge on the working capital loan and recorded a valuation allowance for unbilled straight-line rent in the amount of $2.5 million. We have not recognized any interest income on the Monroe loan since it was considered impaired and have not recorded any unbilled rent since 2010. In addition, we stopped recording rental revenue on April 1, 2013, until we begin receiving cash payments.

At December 31, 2013, our net investment (exclusive of the related real estate) of approximately $40.3 million is our maximum exposure to Monroe and the amount is deemed collectible/recoverable. In making this determination, we considered our first priority secured interest in approximately (i) $4 million in hospital patient receivables, (ii) cash balances of approximately $0.1 million, (iii) our assessment of the realizable value of our other collateral and (iv) projected EBITDA of the hospital operations that we have modeled under various scenarios for sensitivity purposes. In order to recover our aggregate net investment in Monroe, we believe a restructuring of our lease and loan with a new operator may be needed. Among other provisions, we expect this would include our participation in future operating income and sale proceeds, if any, over a multi-year period. We are presently negotiating the potential terms of such a restructuring with several separate parties, although there is no assurance that we will complete a transaction with any of these parties. Moreover, we may conclude that the potential lease income and our share of operating income and sale proceeds would be insufficient for us to recover all of our net investment , in which case further impairment charges would be necessary. The amount, if any, of such further impairment is uncertain, and no assurances can be made that we will not have additional impairment charges on our working capital loan or other receivables in the future. Additional uncertainty may result if our current lessee/borrower enters bankruptcy proceedings, which is possible.

Florence facility

On March 6, 2013, the tenant of our $29.4 million facility in Phoenix, Arizona filed for Chapter 11 bankruptcy. Florence is current on its rent, and at December 31, 2013, we had less than $0.8 million of receivables outstanding. In addition, we have a letter of credit for approximately $1.2 million to cover any rent and other monetary payments not paid in the future. Although no assurances can be made that we will not have any impairment charges in the future, we believe our investment in Florence at December 31, 2013, is fully recoverable.

Gilbert facility

In 2014, the tenant of our $17.1 million facility in Gilbert, Arizona filed for Chapter 11 bankruptcy, and we sent notice of termination of the lease prior to the bankruptcy filing. Gilbert was current on its rent through December 31, 2013. However, we did have approximately $0.9 million of straight-line rent receivables associated with this lease at December 31, 2013. Although no assurances can be made that we will not have any impairment charges or write-offs of receivables in the future, we believe our investment in Gilbert at December 31, 2013, is fully recoverable.

Loans

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


	As of December 31, 2013					As of December 31, 2012
	Balance		Weighted Average Interest Rate			Balance		Weighted Average Interest Rate
Mortgage loans	$	388,650		10.2	%	$	368,650		10.0	%
Acquisition loans		103,266		14.5	%		98,433		14.7	%
Working capital and other loans		57,724		10.9	%		60,810		10.8	%

	$	549,640				$	527,893

Our mortgage loans cover 9 of our properties with four operators. The increase from 2012 is primarily related to the $20 million loan for the Olympia property as previously discussed under the heading of Acquisitions in this Note 3.

Other loans typically consist of loans to our tenants for acquisitions and working capital purposes. Our $98.0 million acquisition loans with Ernest, our Hoboken convertible loan and our $19.1 million working capital loan to Monroe (net of $12 million loan loss reserve) are included in other loans.

On March 1, 2012, pursuant to our convertible note agreement, we converted $1.6 million of our $5.0 million convertible note into a 9.9% equity interest in the operator of our Hoboken University Medical Center facility. At December 31, 2013, $3.4 million remains outstanding on the convertible note, and we retain the option, to convert this remainder into an additional 15.1% equity interest in the operator.

Concentration of Credit Risks

For the year ended December 31, 2013 and 2012, revenue from affiliates of Ernest (including rent and interest from mortgage and acquisition loans) accounted for 20.2% and 18.6% of total revenue, respectively. From an investment concentration perspective, Ernest represented 15.9% and 18.2% of our total assets at December 31, 2013 and December 31, 2012, respectively.

For the years ended December 31, 2013 and 2012, revenue from affiliates of Prime (including rent and interest from mortgage loans) accounted for 32.0% and 27.3%, respectively, of total revenue. From an investment concentration perspective, Prime represented 24.5% and 27.9% of our total assets at December 31, 2013 and December 31, 2012, respectively.

On an individual property basis, we had no investment of any single property greater than 4% of our total assets as of December 31, 2013.

From a geographic perspective, Investments located in California represented 18.7% of our total assets at December 31, 2013, down from 24.0% in the prior year. Investments located in Texas represented 22.7% of our total assets at December 31, 2013, down from 23.6% in the prior year. In addition, we further expanded our portfolio into Europe with the RHM portfolio acquisition, which represents less than 9% of total assets at December 31, 2013.

Related Party Transactions

Lease and interest revenue earned from tenants in which we have an equity interest in were $70.0 million, $54.3 million and $5.5 million in 2013, 2012 and 2011, respectively.

Debt

12 Months Ended

Dec. 31, 2013

Debt Disclosure [Abstract]

Debt

Debt

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


	As of December 31, 2013					As of December 31, 2012
	Balance		Interest Rate			Balance			Interest Rate
Revolving credit facility	$	105,000		Variable		$	125,000			Variable
2006 Senior Unsecured Notes		125,000		Various			125,000			Various
2011 Senior Unsecured Notes		450,000		6.875	%		450,000			6.875	%
2012 Senior Unsecured Notes:
Principal amount		350,000		6.375	%		200,000			6.375	%
Unamortized premium		2,873					—

		352,873					200,000
Exchangeable senior notes:
Principal amount		—					11,000			9.250	%
Unamortized discount		—					(37	)

		—					10,963
2013 Senior Unsecured Notes		274,860		5.75	%		—

Term loans		113,948		Various			114,197			Various

	$	1,421,681				$	1,025,160

As of December 31, 2013, principal payments due on our debt (which exclude the effects of any discounts or premiums recorded) are as follows: (A)


2014	$	265
2015		105,283
2016		225,299
2017		320
2018		12,781
Thereafter		1,074,860

Total	$	1,418,808

(A)	Our 2013 Senior Unsecured Notes are Euro-denominated. We have used the exchange rate at December 31, 2013 in this debt maturity schedule.

In order to fund our 2013 acquisitions disclosed in Note 3, we completed a public offering of €200 million aggregate principal amount of our 5.750% Senior Notes due 2020 (the “2013 Senior Unsecured Notes”) and did a $150 million tack on to our 2012 Senior Unsecured Notes.

To help fund the 2012 acquisitions disclosed in Note 3, on February 17, 2012, we completed the “2012 Senior Unsecured Notes” for $200 million, resulting in net proceeds, after underwriting discount, of $196.5 million. These 2012 Senior Unsecured Notes accrue interest at a fixed rate of 6.375% per year and mature on February 15, 2022. The 2012 Senior Unsecured Notes include covenants substantially consistent with our 2011 Senior Unsecured Notes. In addition, on March 9, 2012, we closed on a $100 million senior unsecured term loan facility (“2012 Term Loan”).

Revolving Credit Facility

In March 2012, we exercised the $70 million accordion feature on our unsecured revolving credit facility, increasing the capacity from $330 million to $400 million. The unsecured revolving credit facility matures in October 2015. The interest rate is (1) the higher of the “prime rate” or federal funds rate plus 0.5%, plus a spread initially set at 1.60%, but that is adjustable from 1.60% to 2.40% based on current total leverage, or (2) LIBOR plus a spread initially set at 2.60%, but that is adjustable from 2.60% to 3.40% based on current total leverage. Interest rate spread was 2.85% at December 31, 2013 and 2012. In addition to interest expense, we are required to pay a quarterly commitment fee on the undrawn portion of the revolving credit facility, ranging from 0.375% to 0.500% per year. At December 31, 2013 and 2012, our outstanding balance on the revolving credit facility was $105 million and $125 million, respectively. At December 31, 2013, our availability under our revolving credit facility was $295 million. The weighted average interest rate on this facility was 3.2% and 3.2% for 2013 and 2012, respectively.

2013 Senior Unsecured Notes

On October 10, 2013, we completed the 2013 Senior Unsecured Notes offering for €200 million (or $274.9 million.) Interest on the Notes will be payable semi-annually on April 1 and October 1 of each year, commencing on April 1, 2014. The 2013 Senior Unsecured Notes will pay interest in cash at a rate of 5.750% per year. The Notes mature on October 1, 2020. We may redeem some or all of the 2013 Senior Unsecured Notes at any time prior to October 1, 2016 at a “make-whole” redemption price. On or after October 1, 2016, we may redeem some or all of the Notes at a premium that will decrease over time. In addition, at any time and from time to time prior to October 1, 2016, we may redeem up to 35% of the aggregate principal amount of the 2013 Senior Unsecured Notes using the proceeds of one or more equity offerings. The 2013 Senior Unsecured Notes are fully and unconditionally guaranteed, jointly and severally, on an unsecured basis, by certain subsidiary guarantors. In the event of a change of control, each holder of the 2013 Senior Unsecured Notes may require us to repurchase some or all of our 2013 Senior Unsecured Notes at a repurchase price equal to 101% of the aggregate principal amount of the 2013 Senior Unsecured Notes plus accrued and unpaid interest to the date of purchase.

2012 Senior Unsecured Notes

On February 17, 2012, we completed a $200 million offering of senior unsecured notes (“2012 Senior Unsecured Notes”) (resulting in net proceeds of $196.5 million, after underwriting discount). On August 20, 2013, we completed a $150 million tack on to the notes (resulting in net proceeds of $150.4 million, after underwriting discount). These 2012 Senior Unsecured Notes accrue interest at a fixed rate of 6.375% per year and mature on February 15, 2022. The 2013 tack on offering, was issued at a premium (price of 102%), resulting in an effective rate of 5.998%. Interest on these notes is payable semi-annually on February 15 and August 15 of each year. We may redeem some or all of the 2012 Senior Unsecured Notes at any time prior to February 15, 2017 at a “make-whole” redemption price. On or after February 15, 2017, we may redeem some or all of the 2012 Senior Unsecured Notes at a premium that will decrease over time, plus accrued and unpaid interest to, but not including, the redemption date. The 2012 Senior Unsecured Notes are guaranteed, jointly and severally, on an unsecured basis, by certain subsidiary guarantors. In the event of a change of control, each holder of the 2012 Senior Unsecured Notes may require us to repurchase some or all of its 2012 Senior Unsecured Notes at a repurchase price equal to 101% of the aggregate principal amount plus accrued and unpaid interest to the date of purchase.

2011 Senior Unsecured Notes

On April 26, 2011, we closed on a private placement of $450 million aggregate principal amount of 6.875% Senior Notes due 2021 (the “2011 Senior Unsecured Notes”) to qualified institutional buyers in reliance on Rule 144A under the Securities Act. The 2011 Senior Unsecured Notes were subsequently registered under the Securities Act pursuant to an exchange offer. Interest on the 2011 Senior Unsecured Notes is payable semi-annually on May 1 and November 1 of each year. The 2011 Senior Unsecured Notes pay interest in cash at a rate of 6.875% per year and mature on May 1, 2021. We may redeem some or all of the 2011 Senior Unsecured Notes at any time prior to May 1, 2016 at a “make-whole” redemption price. On or after May 1, 2016, we may redeem some or all of the 2011 Senior Unsecured Notes at a premium that will decrease over time, plus accrued and unpaid interest to, but not including, the redemption date. The 2011 Senior Unsecured Notes are guaranteed, jointly and severally, on an unsecured basis, by the certain subsidiary guarantors. In the event of a change of control, each holder of the 2011 Senior Unsecured Notes may require us to repurchase some or all of its 2011 Senior Unsecured Notes at a repurchase price equal to 101% of the aggregate principal amount plus accrued and unpaid interest to the date of purchase.

2006 Senior Unsecured Notes

During 2006, we issued $125.0 million of Senior Unsecured Notes (the “2006 Senior Unsecured Notes”). The 2006 Senior Unsecured Notes were placed in private transactions exempt from registration under the Securities Act of 1933, as amended, (the “Securities Act”). One of the issuances of the 2006 Senior Unsecured Notes totaling $65.0 million paid interest quarterly at a fixed annual rate of 7.871% through July 30, 2011, thereafter, at a floating annual rate of three-month LIBOR plus 2.30% and can be called at par value by us at any time. This portion of the 2006 Senior Unsecured Notes matures in July 2016. The remaining issuances of 2006 Senior Unsecured Notes paid interest quarterly at fixed annual rates ranging from 7.333% to 7.715% through October 30, 2011, thereafter, at a floating annual rate of three-month LIBOR plus 2.30% and can also called at par value by us at any time. These remaining notes mature in October 2016.

During the second quarter 2010, we entered into an interest rate swap to manage our exposure to variable interest rates by fixing $65 million of our $125 million 2006 Senior Unsecured Notes, which started July 31, 2011 (date on which the interest rate turned variable) through maturity date (or July 2016), at a rate of 5.507%. We also entered into an interest rate swap to fix $60 million of 2006 Senior Unsecured Notes which started October 31, 2011 (date on which the related interest rate turned variable) through the maturity date (or October 2016) at a rate of 5.675%. At December 31, 2013 and 2012, the fair value of the interest rate swaps was $9.0 million and $12.5 million, respectively, which is reflected in accounts payable and accrued expenses on the consolidated balance sheets.

We account for our interest rate swaps as cash flow hedges. Accordingly, the effective portion of changes in the fair value of our swaps is recorded as a component of accumulated other comprehensive income/loss on the balance sheet and reclassified into earnings in the same period, or periods, during which the hedged transactions effects earnings, while any ineffective portion is recorded through earnings immediately. We did not have any hedge ineffectiveness from inception of our interest rate swaps through December 31, 2013 and therefore, there was no income statement effect recorded during the years ended December 31, 2013, 2012, and 2011. We do not expect any of the current losses included in accumulated other comprehensive loss to be reclassified into earnings in the next 12 months. At December 31, 2013 and 2012, we have posted $5.0 million and $6.6 million of collateral related to our interest rate swaps, respectively, which is reflected in other assets on our consolidated balance sheets.

Term Loans

As noted previously, we closed on the 2012 Term Loan for $100 million on March 9, 2012. The 2012 Term Loan facility has an interest rate option of (1) LIBOR plus an initial spread of 2.25% or (2) the higher of the “prime rate”, federal funds rate plus 0.5%, or Eurodollar rate plus 1.0%, plus an initial spread of 1.25%. The interest rate in effect at December 31, 2013 and December 31, 2012 were 2.43% and 2.47%, respectively. The 2012 Term Loan facility is scheduled to mature on March 9, 2016, but we have the option to extend the facility one year to March 9, 2017.

In connection with our acquisition of the Northland LTACH Hospital on February 14, 2011, we assumed a $14.6 million mortgage. The Northland mortgage loan requires monthly principal and interest payments based on a 30-year amortization period. The Northland mortgage loan has a fixed interest rate of 6.2%, matures on January 1, 2018 and can be prepaid after January 1, 2013, subject to a certain prepayment premium. At December 31, 2013, the remaining balance on this term loan was $13.9 million. The loan was collateralized the real estate of the Northland LTACH Hospital, which had a net book value of $18.0 million and $18.5 million at December 31, 2013 and 2012, respectively.

Exchangeable Senior Notes

In March 2008, our Operating Partnership issued and sold, in a private offering, $75.0 million of Exchangeable Senior Notes (the “2008 Exchangeable Notes”) and received proceeds of $72.8 million. In April 2008, the Operating Partnership sold an additional $7.0 million of the 2008 Exchangeable Notes (under the initial purchasers’ overallotment option) and received proceeds of $6.8 million. The interest rate on our 2008 Exchangeable Notes was 9.25% per annum. In July 2011, we used a portion of the proceeds from the 2011 Senior Unsecured Notes to repurchase 85% of the outstanding 2008 Exchangeable Notes at a price of 118.5% of the principal amount plus accrued and unpaid interest (or $84.2 million) pursuant to a cash tender offer. Additionally, in August 2011, we repurchased $1.5 million of the outstanding 2008 Exchangeable Notes in the open market. The remainder of our 2008 Exchangeable Notes were paid in full in April 2013.

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 revolving credit facility and 2012 Term Loan limit the amount of dividends we can pay as a percentage of normalized adjusted funds from operations, as defined in the agreements, on a rolling four quarter basis. At December 31, 2013, the dividend restriction was 95% of normalized adjusted FFO. The indentures governing our 2011 and 2012 Senior Unsecured Notes also limit the amount of dividends we can pay based on the sum of 95% of funds from operations, proceeds of equity issuances and certain other net cash proceeds. Finally, our 2011 and 2012 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 revolving credit facility and 2012 Term Loan contain customary financial and operating covenants, including covenants relating to our total leverage ratio, fixed charge coverage ratio, mortgage secured leverage ratio, recourse mortgage secured leverage ratio, consolidated adjusted net worth, facility leverage ratio, and unsecured interest coverage ratio. This 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 facility, the entire outstanding balance may become immediately due and payable. At December 31, 2013, we were in compliance with all such financial and operating covenants.

Income Taxes

12 Months Ended

Dec. 31, 2013

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 Internal Revenue Code of 1986, as amended. To qualify as a REIT, we must meet a number of organizational and operational requirements, including a requirement to distribute at least 90% of our taxable income to our stockholders. As a REIT, we generally will not be subject to federal income tax if we distribute 100% of our taxable income to our stockholders and satisfy certain other requirements. Income tax is paid directly by our stockholders on the dividends distributed to them. If our taxable income exceeds our dividends in a tax year, REIT tax rules allow us to designate dividends from the subsequent tax year in order to avoid current taxation on undistributed income. If we fail to qualify as a REIT in any taxable year, we will be subject to federal income taxes at regular corporate rates, including any applicable alternative minimum tax. Taxable income from non-REIT activities managed through our taxable REIT subsidiaries is subject to applicable United States federal, state and local income taxes. Our international subsidiaries are also subject to income taxes in the jurisdictions in which they operate.

From our taxable REIT subsidiaries and our foreign operations (which realized a $12.9 million loss before income taxes in 2013 primarily due to the real estate transfer taxes), we incurred income tax expenses as follows (in thousands):


	For the Years Ended December 31,
	2013		2012		2011
Domestic	$	568	$	19	$	128
Foreign		158		—		—

	$	726	$	19	$	128

At December 31, 2013 and 2012, components of our deferred tax assets and liabilities were as follows (in thousands):


	2013			2012
Deferred tax liabilities:
Property and equipment	$	(2,870	)	$	(2,370	)
Other		(2,923	)		(1,673	)

Total deferred tax liabilities		(5,793	)		(4,043	)

Deferred tax assets:
Loan loss and other reserves		7,751			7,218
Operating loss and interest deduction carry forwards		2,283			3,938
Other		3,371			1,261

Total deferred tax assets		13,405			12,417
Valuation allowance		(7,843	)		(8,540	)

Net deferred tax (liability)	$	(231	)	$	(166	)

At December 31, 2013, we had U.S. federal and state NOLs of $0.2 million and $7.6 million, respectively, that expire in 2026 through 2032.

In 2013, our valuation allowance increased by $1.9 million as a result of book losses sustained by our German subsidiaries as the result of significant acquisition expenses incurred. This was offset by a $2.6 million decrease in the valuation allowance at one of the U.S. TRS entities (MDS), which generated income in 2013 (after having historical losses). We believe (based on cumulative losses) that we should reserve for our net deferred tax assets. We will continue to monitor this valuation allowance and, if circumstances change (such as entering into new transactions including working capital loans, equity investments, etc), we will adjust this valuation allowance accordingly.

We have met the annual REIT distribution requirements by payment of at least 90% of our estimated taxable income in 2013, 2012, and 2011. 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,
	2013		2012		2011
Common share distribution	$	0.800000	$	0.800000	$	0.800000
Ordinary income		0.599384		0.601216		0.300844
Capital gains(1)		0.046380		0.117584		0.031396
Unrecaptured Sec. 1250 gain		0.026512		0.086976		0.031396
Return of capital		0.154236		0.081200		0.467760
Allocable to next year		—		—		—

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

MPT Operating Partnership, L.P.

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

Earnings Per Share/Unit

12 Months Ended

Dec. 31, 2013

Earnings Per Share [Abstract]

Earnings Per Share/Unit

6.	Earnings Per Share/Unit

Medical Properties Trust, Inc.

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


	For the Years Ended December 31,
	2013			2012			2011
Numerator:
Income from continuing operations	$	89,301		$	72,870		$	12,120
Non-controlling interests’ share in continuing operations		(224	)		(177	)		(178	)
Participating securities’ share in earnings		(729	)		(887	)		(1,090	)

Income from continuing operations, less participating securities’ share in earnings		88,348			71,806			10,852
Income from discontinued operations attributable to MPT common stockholders		7,914			17,207			14,594

Net income, less participating securities’ share in earnings	$	96,262		$	89,013		$	25,446

Denominator:
Basic weighted-average common shares		151,439			132,331			110,623
Dilutive potential common shares		1,159			2			6

Diluted weighted-average common shares		152,598			132,333			110,629

MPT Operating Partnership, L.P.

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


	For the Years Ended December 31,
	2013			2012			2011
Numerator:
Income from continuing operations	$	89,301		$	72,870		$	12,137
Non-controlling interests’ share in continuing operations		(244	)		(177	)		(178	)
Participating securities’ share in earnings		(729	)		(887	)		(1,090	)

Income from continuing operations, less participating securities’ share in earnings		88,328			71,806			10,869
Income from discontinued operations attributable to MPT Operating Partnership partners		7,914			17,207			14,594

Net income, less participating securities’ share in earnings	$	96,242		$	89,013		$	25,463

Denominator:
Basic weighted-average units		151,439			132,331			110,623
Dilutive potential units		1,159			2			6

Diluted weighted-average units		152,598			132,333			110,629

For each of the years ended December 31, 2012 and 2011, approximately 0.1 million of options were excluded from the diluted earnings per share/unit calculation as they were not determined to be dilutive.

Stock Awards

12 Months Ended

Dec. 31, 2013

Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]

Stock Awards

7.	Stock Awards

Stock Awards

Our Equity Incentive Plan authorizes the issuance of common stock options, restricted stock, restricted stock units, deferred stock units, stock appreciation rights, performance units and awards of interests in our Operating Partnership. Our Equity Incentive Plan is administered by the Compensation Committee of the Board of Directors. We have reserved 7,643,651 shares of common stock for awards under the Equity Incentive Plan and 7,643,651 shares remain available for future stock awards as of December 31, 2013. The Equity Incentive Plan contains a limit of 5,000,000 shares as the maximum number of shares of common stock that may be awarded to an individual in any fiscal year. Awards under the Equity Incentive Plan are subject to forfeiture due to termination of employment prior to vesting. In the event of a change in control, outstanding and unvested options will immediately vest, unless otherwise provided in the participant’s award or employment agreement, and restricted stock, restricted stock units, deferred stock units and other stock-based awards will vest if so provided in the participant’s award agreement. The term of the awards is set by the Compensation Committee, though Incentive Stock Options may not have terms of more than ten years. Forfeited awards are returned to the Equity Incentive Plan and are then available to be re-issued as future awards. For each share of common stock issued by Medical Properties Trust, Inc. pursuant to its Equity Incentive Plan, the Operating Partnership issues a corresponding number of operating partnership units.

The following awards have been granted pursuant to our Equity Incentive Plan (and its predecesor plan):

Stock Options

At December 31, 2013, we had 20,000 options outstanding and exercisable, with a weighted-average exercise price of $10.00 per option. The intrinsic value of options exercisable and outstanding at December 31, 2013, is $-0-. In 2013, 40,000 options were exercised, while 20,000 options were settled for cash in 2011. No options were granted in 2013, 2012, or 2011. The weighted average remaining contractual term of options exercisable and outstanding is 0.3 years.

Restricted Equity Awards

Other stock-based awards are in the form of service-based awards and performance-based awards. The service-based awards vest as the employee provides the required service (typically three to five years). Service based awards are valued at the average price per share of common stock on the date of grant. In 2013, 2012, and 2011, the Compensation Committee granted awards to employees which vest based on us achieving certain total shareholder returns or comparisons of our total shareholder returns to peer total return indices. Generally, dividends are not paid on these performance awards until the award is earned. See below for details of such grants:

2013 performance awards - The 2013 performance awards were granted in three parts:

Approximately 27% of the 2013 performance awards were based on us achieving a simple 8.5% annual total shareholder return over a three year period; however, the award contained both carry forward and carry back provisions through December 31, 2017. None of these shares may be sold for two years after they have vested. The fair value of this award was estimated on the date of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 0.72%; expected volatility of 27%; expected dividend yield of 8.0%; and expected service period of 3 years.

Approximately 36% of the 2013 performance awards were based on us achieving a cumulative total shareholder return from January 1, 2013 to December 31, 2015. The minimum total shareholder return needed to earn a portion of this award is 25.5% with 100% of the award earned if our total shareholder return reaches 33.5%. If any shares are earned from this award, the shares will vest in equal annual amounts on December 31, 2015, 2016 and 2017. The fair value of this award was estimated on the date of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 0.38%; expected volatility of 28%; expected dividend yield of 8.0%; and expected service period of 5 years.

The remainder of the 2013 performance awards will be earned if our total shareholder return outpaces that of the MSCI U.S. REIT Index (“Index”) over the cumulative period from January 1, 2013 to December 31, 2015. Our total shareholder return must exceed that of the Index to earn the minimum number of shares under this award, while it must exceed the Index by 6% to earn 100% of the award. If any shares are earned from this award, the shares will vest in equal annual amounts on December 31, 2015, 2016 and 2017. The fair value of this award was estimated on the date of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 0.38%; expected volatility of 28%; expected dividend yield of 8.0%; and expected service period of 5 years.

There were 68,086 of the 2013 performance awards earned and vested in 2013. At December 31, 2013, we have 686,169 of 2013 performance awards remaining to be earned.

2012 performance awards - The 2012 performance awards were granted in three parts:

Approximately 30% of the 2012 performance awards were based on us achieving a simple 9.0% annual total shareholder return over a three year period; however, the award contains both carry forward and carry back provisions through December 31, 2016. The fair value of this award was estimated on the date of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 0.93%; expected volatility of 34%; expected dividend yield of 8.6%; and expected service period of 4 years.

Approximately 35% of the 2012 performance awards were based on us achieving a cumulative total shareholder return from January 1, 2012 to December 31, 2014. The minimum total shareholder return needed to earn a portion of this award is 27% with 100% of the award earned if our total shareholder return reaches 35%. If any shares are earned from this award, the shares will vest in equal annual amounts on January 1, 2015, 2016 and 2017. The fair value of this award was estimated on the date of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 0.43%; expected volatility of 35%; expected dividend yield of 8.6%; and expected service period of 5 years.

The remainder of the 2012 performance awards will be earned if our total shareholder return outpaces that of the Index over the cumulative period from January 1, 2012 to December 31, 2014. Our total shareholder return must exceed that of the Index to earn the minimum number of shares under this award, while it must exceed the Index by 6% to earn 100% of the award. If any shares are earned from this award, the shares will vest in equal annual amounts on January 1, 2015, 2016 and 2017. The fair value of this award was estimated on the date of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 0.43%; expected volatility of 35%; expected dividend yield of 8.6%; and expected service period of 5 years.

There were 84,188 of the 2012 performance awards earned and vested in 2013 and 2,599 forfeited in 2013. There were 84,188 of the 2012 performance awards earned and vested in 2012 and 5,718 forfeited in 2012. At December 31, 2013, we have 725,666 of 2012 performance awards remaining to be earned.

2011 performance awards - The 2011 performance awards were granted in three parts:

Approximately 30% of the 2011 performance awards were based on us achieving a simple 9.0% annual total shareholder return over a three year period; however, the award contained both carry forward and carry back provisions through December 31, 2015. The fair value of this award was estimated on the date of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 2.07%; expected volatility of 33%; expected dividend yield of 8.5%; and expected service period of 4 years.

Approximately 18% of the 2011 performance awards were based on us achieving a cumulative total shareholder return from January 1, 2011 to December 31, 2013. The minimum total shareholder return needed to earn a portion of this award is 27% with 100% of the award earned if our total shareholder return reaches 39%. If any shares are earned from this award, the shares will vest in equal annual amounts on January 1, 2014, 2015 and 2016. The fair value of this award was estimated on the date of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 1.07%; expected volatility of 34%; expected dividend yield of 8.5%; and expected service period of 5 years.

The remainder of the 2011 performance awards will be earned if our total shareholder return outpaces that of the Index over the cumulative period from January 1, 2011 to December 31, 2013. Our total shareholder return must exceed that of the Index to earn the minimum number of shares under this award, while it must exceed the Index by 12% to earn 100% of the award. If any shares are earned from this award, the shares will vest in equal annual amounts on January 1, 2014, 2015 and 2016. The fair value of this award was estimated on the date of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 1.07%; expected volatility of 34%; expected dividend yield of 8.5%; and expected service period of 5 years.

There were 81,359 and 155,162 of the 2011 performance awards earned and vested in 2013 and 2012, respectively, but none in 2011. In 2013, 8,062 shares were forfeited, while 14,456 shares were forfeited in 2012. At December 31, 2013, we have 587,344 of 2011 performance awards that have been earned but not vested.

The following summarizes restricted equity award activity in 2013 and 2012 (which includes awards granted in 2013, 2012, 2011, and any applicable prior years), respectively:

For the Year Ended December 31, 2013:


	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		466,883		$	10.72		1,879,889		$	6.48
Awarded		240,425		$	12.26		754,255		$	6.13
Vested		(381,309	)	$	11.15		(386,446	)	$	8.27
Forfeited		—		$	—		(248,519	)	$	11.03

Nonvested awards at end of year		325,999		$	11.36		1,999,179		$	5.44

For the Year Ended December 31, 2012:


	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		603,980		$	11.02		1,511,397		$	7.60
Awarded		275,464		$	10.14		902,359		$	5.81
Vested		(410,261	)	$	10.78		(513,693	)	$	8.63
Forfeited		(2,300	)	$	10.24		(20,174	)	$	5.45

Nonvested awards at end of year		466,883		$	10.72		1,879,889		$	6.48

The value of stock-based awards is charged to compensation expense over the vesting periods. In the years ended December 31, 2013, 2012 and 2011, we recorded $8.8 million, $7.6 million, and $7.0 million respectively, of non-cash compensation expense. The remaining unrecognized cost from restricted equity awards at December 31, 2013, is $10.1 million and will be recognized over a weighted average period of 2.5 years. Restricted equity awards which vested in 2013, 2012, and 2011 had a value of $9.2 million, $9.2 million, and $6.1 million, respectively.

Commitments and Contingencies

12 Months Ended

Dec. 31, 2013

Commitments And Contingencies Disclosure [Abstract]

Commitments and Contingencies

8.	Commitments and Contingencies

Commitments

Our operating leases primarily consist of ground leases on which certain of our facilities or other related property reside along with corporate office and equipment leases. These ground leases are long-term leases (almost all having terms for approximately 50 years or more), some contain escalation provisions and one contains a purchase option. Properties subject to these ground leases are subleased to our tenants. Lease and rental expense (which is recorded on the straight-line method) for 2013, 2012 and 2011, respectively, were $2,304,461, $2,195,835, and $1,994,565, which was offset by sublease rental income of $512,503, $492,095, and $443,829 for 2013, 2012, and 2011, respectively.

Fixed minimum payments due under operating leases with non-cancelable terms of more than one year at December 31, 2013 are as follows: (amounts in thousands)


2014	$	2,471
2015		2,644
2016		2,659
2017		2,620
2018		2,614
Thereafter		37,213

	$	50,221

The total amount to be received in the future from non-cancellable subleases at December 31, 2013, is $30.1 million.

Contingencies

We are a party to various legal proceedings incidental to our business. In the opinion of management, after consultation with legal counsel, the ultimate liability, if any, with respect to those proceedings is not presently expected to materially affect our financial position, results of operations or cash flows.

Common Stock/Partner's Capital

12 Months Ended

Dec. 31, 2013

Text Block [Abstract]

Common Stock/Partner's Capital

9.	Common Stock/Partner’s Capital

Medical Properties Trust, Inc.

On August 20, 2013, we completed an offering of 11,500,000 shares of common stock (including 1,500,000 shares sold pursuant to the exercise in full of the underwriters’ option to purchase additional shares) at a price of $12.75 per share, resulting in net proceeds (after underwriting discount and expenses) of $140.4 million. These proceeds were used to fund the acquisition of the three IASIS properties more fully described in Note 3.

On February 28, 2013, we completed an offering of 12,650,000 shares of our common stock (including 1,650,000 shares sold pursuant to the exercise in full of the underwriters’ option to purchase additional shares) at a price of $14.25 per share, resulting in net proceeds (after underwriting discount and expenses) of $172.9 million. A portion of the net proceeds from this offering were used to pay down our revolving credit facility.

To help fund the 2012 acquisitions disclosed in Note 3, on February 7, 2012, we completed an offering of 23,575,000 shares of our common stock (including 3,075,000 shares sold pursuant to the exercise in full of the underwriters’ overallotment option) at a price of $9.75 per share, resulting in net proceeds (after underwriting discount) of $220.1 million.

In November 2009, we put an at-the-market equity offering program in place, giving us the ability to sell up to $50 million of stock. During the fourth quarter 2012, we sold 1.1 million shares of our common stock under our at-the-market equity offering program, at an average price of $11.84 per share resulting in total proceeds, net of a 2% commission, of $13.2 million. In January 2014, we replaced this at-the-market offering program with a similar program but increased the size to up to $250 million of stock with a commission of 1.25% (of which $12.5 million has been sold as of February 28, 2014).

In February 2012, we filed Articles of Amendment to our charter with the Maryland State Department of Assessments and Taxation increasing the number of authorized shares of common stock, par value $0.001 per share available for issuance from 150,000,000 to 250,000,000.

MPT Operating Partnership, L.P.

The Operating Partnership is made up of a general partner, Medical Properties Trust, LLC (“General Partner”) and limited partners, including the Company (which owns 100% of the General Partner) and three other partners. By virtue of its ownership of the General Partner, the Company has a 99.8% ownership interest in Operating Partnership via its ownership of all the common units. The remaining ownership interest is held by the two employees and one director via their ownership of LTIP units. These LTIP units were issued to the employees pursuant to the 2007 Multi-Year Incentive Plan, which is part of the Equity Incentive Plan discussed in Note 7 and once vested in accordance with their award agreement, may be converted to common units per the Second Amended and Restated Agreement of Limited Partnership of MPT Operating Partnership, L.P. (“Operating Partnership Agreement”).

In regards to distributions, the Operating Partnership shall distribute cash at such times and in such amounts as are determined by the General Partner in its sole and absolute discretion, to common unit holders who are common unit holders on the record date. However, per the Operating Partnership Agreement, the General Partner shall use its reasonable efforts to cause the Operating Partnership to distribute amounts sufficient to enable the Company to pay stockholder dividends that will allow the Company to (i) meet its distribution requirement for qualification as a REIT and (ii) avoid any federal income or excise tax liability imposed by the Internal Revenue Code, other than to the extent the Company elects to retain and pay income tax on its net capital gain. In accordance with the Operating Partnership Agreement, LTIP units are treated as common units for distribution purposes.

The Operating Partnership’s net income will generally be allocated first to the General Partner to the extent of any cumulative losses and then to the limited partners in accordance with their respective percentage interests in the common units issued by the Operating Partnership. Any losses of the Operating Partnership will generally be allocated first to the limited partners until their capital account is zero and then to the General Partner. In accordance with the Operating Partnership Agreement, LTIP units are treated as common units for purposes of income and loss allocations. Limited partners have the right to require the Operating Partnership to redeem part or all of their common units. It is at the Operating Partnership’s discretion to redeem such common units for cash based on the fair market value of an equivalent number of shares of the Company’s common stock at the time of redemption or, alternatively, redeem the common units for shares of the Company’s common stock on a one-for-one basis, subject to adjustment in the event of stock splits, stock dividends, or similar events. In order for LTIP units to be redeemed, they must first be converted to common units and then must wait two years from the issuance of the LTIP units to be redeemed.

For each share of common stock issued by Medical Properties Trust, Inc., the Operating Partnership issues a corresponding number of operating partnership units.

Fair Value of Financial Instruments

12 Months Ended

Dec. 31, 2013

Fair Value Disclosures [Abstract]

Fair Value of Financial Instruments

10.

Fair Value of Financial Instruments

We have various assets and liabilities that are considered financial instruments. We estimate that the carrying value of cash and cash equivalents, and accounts payable and accrued expenses approximate their fair values. Included in our accounts payable and accrued expenses are our interest rate swaps, which are recorded at fair value based on Level 2 observable market assumptions using standardized derivative pricing models. We estimate the fair value of our interest and rent receivables using Level 2 inputs such as discounting the estimated future cash flows using the current rates at which similar receivables would be made to others with similar credit ratings and for the same remaining maturities. The fair value of our mortgage loans and working capital loans are estimated by using Level 2 inputs (except for the Monroe loan for which we use Level 3 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 exchangeable notes (for 2012 only) and 2011, 2012 and 2013 Senior Unsecured Notes, using Level 2 inputs such as quotes from securities dealers and market makers. We estimate the fair value of our 2006 Senior Unsecured Notes, revolving credit facilities, and term loans using Level 2 inputs based on the present value of future payments, discounted at a rate which we consider appropriate for such debt.

Fair value estimates are made at a specific point in time, are subjective in nature, and involve uncertainties and matters of significant judgment. Settlement of such fair value amounts may not be possible and may not be a prudent management decision. The following table summarizes fair value estimates for our financial instruments (in thousands):


	December 31, 2013						December 31, 2012
Asset (Liability)	Book Value			Fair Value			Book Value			Fair Value
Interest and rent receivables	$	58,499		$	44,349		$	45,289		$	36,700
Loans(1)		351,607			358,277			334,693			335,595
Debt, net		(1,421,681	)		(1,486,090	)		(1,025,160	)		(1,082,333	)

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

Items Measured at Fair Value on a Recurring Basis

Our equity interest in Ernest and related loans, as discussed in Note 2, are being measured at fair value on a recurring basis as we elected to account for these investments using the fair value option method. We have elected to account for these investments at fair value due to the size of the investments and because we believe this method is more reflective of current values. We have not made a similar election for other equity interests or loans in or prior to 2013.

At December 31, 2013. these amounts were as follows (in thousands):


Asset (Liability)	Fair Value		Cost		Asset Type Classification
Mortgage loans	$	100,000	$	100,000	Mortgage loans
Acquisition loan		98,033		98,033	Other loans
Equity investments		3,300		3,300	Other assets

	$	201,333	$	201,333

Our mortgage loans with Ernest are recorded at fair value based on Level 3 inputs by discounting the estimated cash flows using the market rates which similar loans would be made to borrowers with similar credit ratings and the same remaining maturities. Our acquisition loan and equity investments in Ernest 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 forecast assumptions associated with the investee. We classify these loans and equity investments as Level 3, as we use certain unobservable inputs to the valuation methodology that are significant to the fair value measurement, and the valuation requires management judgment due to the absence of quoted market prices. For these cash flow models, our observable inputs include use of a capitalization rate, discount rate (which is based on a weighted-average cost of capital), and market interest rates, and our unobservable input includes an adjustment for a lack of marketability discount (“DLOM”) on our equity investment of 40% at December 31, 2013.

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

In arriving at the DLOM, we started with a DLOM range based on the results of studies supporting valuation discounts for other transactions or structures without a public market. To select the appropriate DLOM within the range, we then considered many qualitative factors including the percent of control, the nature of the underlying investee’s business along with our rights as an investor pursuant to the operating agreement, the size of investment, expected holding period, number of shareholders, access to capital marketplace, etc. To illustrate the effect of movements in the DLOM, we performed a sensitivity analysis below by using basis point variations (dollars in thousands):


Basis Point Change in Marketability Discount		Estimated Increase (Decrease) In Fair Value
+100 basis points		$(320)
- 100 basis points		320

Because the fair value of Ernest investments noted above approximate their original cost, we did not recognize any unrealized gains/losses during 2013 or 2012. To date, we have not received any distribution payments from our equity investment in Ernest.

Discontinued Operations And Disposal Groups [Abstract]

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

Discontinued Operations

12 Months Ended

Dec. 31, 2013

Discontinued Operations

11.

Discontinued Operations

As more fully discussed in Note 3 under the heading “Disposals”, we sold three properties in 2013, five properties in 2012, and two properties in 2011. We have classified current and prior year activity related to these transactions, along with the related operating results of the facilities prior to these transactions taking place, as discontinued operations. In addition, we have reclassified the related real estate assets to Real Estate Held for Sale in all prior periods. Real estate held for sale of $25.5 million in 2012 includes $1.9 million of land, $26.7 million of building, $0.8 million of intangible lease assets, $3.5 million of accumulated depreciation, $0.4 million of accumulated amortization.

The following table presents the results of discontinued operations for the years ended December 31, 2013, 2012 and 2011 (in thousands except per share/unit amounts):


	For the Years Ended December 31,
	2013		2012		2011
Revenues	$	988	$	3,470	$	14,531
Gain on sale		7,659		16,369		5,431
Income from discontinued operations		7,914		17,207		14,594
Income from discontinued operations — diluted per share/unit	$	0.05	$	0.13	$	0.12

Quarterly Financial Information Disclosure [Abstract]

The entire disclosure for the facts and circumstances leading to the completed or expected disposal, manner and timing of disposal, the gain (loss) recognized in the income statement and the income statement caption that includes that gain (loss), amounts of revenues and pretax profit or loss reported in discontinued operations, the segment in which the disposal group was reported, and the classification (whether sold or classified as held for sale) and carrying value of the assets and liabilities comprising the disposal group. Includes all disposal groups, including those classified as components of the entity (discontinued operations).

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 2
-URI http://asc.fasb.org/extlink&oid=6360339&loc=d3e1436-107760

Reference 2: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 1
-URI http://asc.fasb.org/extlink&oid=6360339&loc=d3e1361-107760

Reference 3: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=6360339&loc=d3e1474-107760

Reference 4: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 5
-URI http://asc.fasb.org/extlink&oid=6360339&loc=d3e1510-107760

Reference 5: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 45
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=6892542&loc=d3e957-107759

Reference 6: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 45
-Paragraph 5
-URI http://asc.fasb.org/extlink&oid=6892542&loc=d3e1020-107759

Reference 7: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 45
-Paragraph 4
-URI http://asc.fasb.org/extlink&oid=6892542&loc=d3e1012-107759

Reference 8: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 360
-SubTopic 10
-Section 45
-Paragraph 5
-URI http://asc.fasb.org/extlink&oid=8077374&loc=d3e2443-110228

Reference 9: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 360
-SubTopic 10
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=6391110&loc=d3e2941-110230

+ Details

Quarterly Financial Data (unaudited)

12 Months Ended

Dec. 31, 2013

Quarterly Financial Data (unaudited)

12. Quarterly Financial Data (unaudited)

As disclosed in Note 11, we sold properties during 2013 resulting in the reclassification of those properties current and prior year results to discontinued operations. The quarterly data presented below reflects these reclassifications.

Medical Properties Trust, Inc.

The following is a summary of the unaudited quarterly financial information for the years ended December 31, 2013 and 2012: (amounts in thousands, except for per share data)


	For the Three Month Periods in 2013 Ended
	March 31		June 30		September 30		December 31
Revenues	$	57,614	$	57,124	$	60,106	$	67,679
Income from continuing operations		25,570		25,031		25,391		13,309
Income from discontinued operations		640		2,374		312		4,588
Net income		26,210		27,405		25,703		17,897
Net income attributable to MPT common stockholders		26,156		27,348		25,648		17,839
Net income attributable to MPT common stockholders per share — basic	$	0.19	$	0.18	$	0.16	$	0.11
Weighted average shares outstanding — basic		140,347		149,509		154,758		161,143
Net income attributable to MPT common stockholders per share — diluted	$	0.18	$	0.18	$	0.16	$	0.11
Weighted average shares outstanding — diluted		141,526		151,056		155,969		161,840


	For the Three Month Periods in 2012 Ended
	March 31		June 30		September 30		December 31
Revenues	$	40,455	$	48,569	$	52,504	$	56,597
Income (loss) from continuing operations		8,294		18,718		22,594		23,264
Income from discontinued operations		2,312		642		8,914		5,339
Net income		10,606		19,360		31,508		28,603
Net income attributable to MPT common stockholders		10,564		19,316		31,464		28,556
Net income attributable to MPT common stockholders per share — basic	$	0.08	$	0.14	$	0.23	$	0.21
Weighted average shares outstanding — basic		124,906		134,715		134,781		134,923
Net income attributable to MPT common stockholders per share — diluted	$	0.08	$	0.14	$	0.23	$	0.21
Weighted average shares outstanding — diluted		124,906		134,715		134,782		134,930

MPT Operating Partnership, L.P.

The following is a summary of the unaudited quarterly financial information for the years ended December 31, 2013 and 2012: (amounts in thousands, except for per unit data)


	For the Three Month Periods in 2013 Ended
	March 31		June 30		September 30		December 31
Revenues	$	57,614	$	57,124	$	60,106	$	67,679
Income from continuing operations		25,570		25,031		25,391		13,309
Income from discontinued operations		640		2,374		312		4,588
Net income		26,210		27,405		25,703		17,897
Net income attributable to MPT Operating Partnership partners		26,156		27,348		25,648		17,839
Net income attributable to MPT Operating Partnership partners per unit — basic	$	0.19	$	0.18	$	0.16	$	0.11
Weighted average units outstanding — basic		140,347		149,509		154,758		161,143
Net income attributable to MPT Operating Partnership partners per unit — diluted	$	0.18	$	0.18	$	0.16	$	0.11
Weighted average units outstanding — diluted		141,526		151,056		155,969		161,840


	For the Three Month Periods in 2012 Ended
	March 31		June 30		September 30		December 31
Revenues	$	40,455	$	48,569	$	52,504	$	56,597
Income from continuing operations		8,294		18,718		22,594		23,264
Income from discontinued operations		2,312		642		8,914		5,339
Net income		10,606		19,360		31,508		28,603
Net income attributable to MPT Operating Partnership partners		10,564		19,316		31,464		28,556
Net income attributable to MPT Operating Partnership partners per unit — basic	$	0.08	$	0.14	$	0.23	$	0.21
Weighted average units outstanding — basic		124,906		134,715		134,781		134,923
Net income attributable to MPT Operating Partnership partners per unit — diluted	$	0.08	$	0.14	$	0.23	$	0.21
Weighted average units outstanding — diluted		124,906		134,715		134,782		134,930

Condensed Consolidating Financial Information

12 Months Ended

Dec. 31, 2013

Condensed Financial Information Of Parent Company Only Disclosure [Abstract]

Condensed Consolidating Financial Information

13.

Condensed Consolidating Financial Information

The following tables present the condensed consolidating financial information for (a) Medical Properties Trust, Inc. (“Parent” and a guarantor to our 2011, 2012, and 2013 Senior Unsecured Notes), (b) MPT Operating Partnership, L.P. and MPT Finance Corporation (“Subsidiary Issuer”), (c) on a combined basis, the guarantors of our 2011, 2012 and 2013 Senior Unsecured Notes (“Subsidiary Guarantors”), and (d) on a combined basis, the non-guarantor subsidiaries (“Non-Guarantor Subsidiaries”). Separate financial statements of the Subsidiary Guarantors are not presented because the guarantee by each 100% owned Subsidiary Guarantor is joint and several and we believe separate financial statements and other disclosures regarding the Subsidiary Guarantors are not material to investors. Furthermore, there are no significant legal restrictions on the Parent’s ability to obtain funds from its subsidiaries by dividend or loan.

The guarantees by the Subsidiary Guarantors may be released and discharged upon: (1) any sale, exchange or transfer of all of the capital stock of a Subsidiary Guarantor; (2) the merger or consolidation of a Subsidiary Guarantor with a Subsidiary Issuer or any other Subsidiary Guarantor; (3) the proper designation of any Subsidiary Guarantor by the Subsidiary Issuers as “unrestricted” for covenant purposes under the indenture governing the 2011, 2012, and 2013 Senior Unsecured Notes; (4) the legal defeasance or covenant defeasance or satisfaction and discharge of the indenture; (5) a liquidation or dissolution of a Subsidiary Guarantor permitted under the indenture governing the 2011, 2012 and 2013 Senior Unsecured Notes; or (6) the release or discharge of the Subsidiary Guarantor from its guarantee obligations under our revolving credit facility.

Subsequent to December 31, 2012, certain of our subsidiaries were re-designated as non-guarantors of our 2011, 2012 and 2013 Senior Unsecured Notes, as the underlying properties were sold in 2013 (such subsidiaries were guarantors prior to 2013). With these re-designations, we have restated the 2012 and 2011 consolidating financial information below to reflect these changes.

In the second quarter of 2013, we revised our condensed consolidating balance sheets as of December 31, 2012 and 2011 to adjust negative net intercompany receivables (payable) balances from Total Assets to Total Liabilities. The impact of this revision was to increase total assets (and, correspondingly increase total liabilities) as of December 31, 2012 for Subsidiary Guarantors by $997.2 million and also to increase total assets (and, correspondingly increase total liabilities) for Non-Guarantor Subsidiaries by $404.1 million with an offset to Eliminations. In addition, we revised our condensed consolidating statements of cash flows for the years ended December 31, 2012 and 2011 to adjust the classification of cash flows related to intercompany transactions. For the year ended December 31, 2012, these adjustments had the effect of a) increasing net cash provided by investing activities and decreasing net cash provided by financing activities for the Parent and Subsidiary Issuers by $129.4 million and $501.8 million, respectively, and b) decreasing net cash provided by investing activities and increasing net cash provided by financing activities for the Subsidiary Guarantors and the Non-Guarantor Subsidiaries by $365.8 million and $136.1 million, respectively, with an offset to Eliminations. For the year ended December 31, 2011, these adjustments had the effect of a) increasing net cash provided by investing activities and decreasing net cash provided by financing activities for the Subsidiary Issuers and Non-Guarantor Subsidiaries by $92.1 million and $22.4 million, respectively, and b) decreasing net cash provided by investing activities and increasing net cash provided by financing activities for the Parent and Subsidiary Guarantors by $89.6 million and $114.2 million, respectively, with an offset to Eliminations. These revisions are not material to the related financial statements for any prior periods and had no impact on our consolidated balance sheet or consolidated statement of cash flows. As prior period financial information is presented in future filings, we will similarly revise the condensed consolidating statements of cash flows for comparative periods presented in future filings.

Condensed Consolidated Balance Sheets

December 31, 2013

(in thousands)


	Parent		Subsidiary Issuers		Subsidiary Guarantors			Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Assets
Real estate assets
Land, buildings and improvements and intangible lease assets	$	—	$	—	$	1,795,084		$	70,371		$	—		$	1,865,455
Net investment in direct financing leases		—		—		212,543			218,481			—			431,024
Mortgage loans		—		—		268,650			120,000			—			388,650

Gross investment in real estate assets		—		—		2,276,277			408,852			—			2,685,129
Accumulated depreciation and amortization		—		—		(151,624	)		(8,152	)		—			(159,776	)

Net investment in real estate assets		—		—		2,124,653			400,700			—			2,525,353
Cash and cash equivalents		—		18,815		27,094			70			—			45,979
Interest and rent receivables		—		336		31,324			26,839			—			58,499
Straight-line rent receivables		—		—		37,015			8,814			—			45,829
Other loans		—		178		1,100			159,712			—			160,990
Net intercompany receivable		35,363		1,907,474		—			—			(1,942,837	)		—
Investment in subsidiaries		1,344,598		825,153		42,407			—			(2,212,158	)		—
Other assets		—		37,311		1,168			29,441			—			67,920

Total Assets	$	1,379,961	$	2,789,267	$	2,264,761		$	625,576		$	(4,154,995	)	$	2,904,570

Liabilities and Equity
Liabilities
Debt, net	$	—	$	1,407,733	$	—		$	13,948		$	—		$	1,421,681
Accounts payable and accrued expenses		35,753		36,887		20,367			1,304			—			94,311
Net intercompany payable		—		—		1,538,934			403,903			(1,942,837	)		—
Deferred revenue		—		49		17,772			5,966			—			23,787
Lease deposits and other obligations to tenants		—		—		17,964			2,619			—			20,583

Total liabilities		35,753		1,444,669		1,595,037			427,740			(1,942,837	)		1,560,362

Total Equity		1,344,208		1,344,598		669,724			197,836			(2,212,158	)		1,344,208

Total Liabilities and Equity	$	1,379,961	$	2,789,267	$	2,264,761		$	625,576		$	(4,154,995	)	$	2,904,570

Condensed Consolidated Statements of Income

For the Year Ended December 31, 2013

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors			Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Revenues
Rent billed	$	—		$	—		$	124,651		$	20,028		$	(12,101	)	$	132,578
Straight-line rent		—			—			8,438			2,268			—			10,706
Income from direct financing leases		—			—			38,522			22,577			(20,269	)		40,830
Interest and fee income		—			21,797			38,696			29,834			(31,918	)		58,409

Total revenues		—			21,797			210,307			74,707			(64,288	)		242,523
Expenses
Real estate depreciation and amortization		—			—			35,277			1,701			—			36,978
Property-related		—			601			1,356			32,863			(32,370	)		2,450
Acquisition expenses		—			7,356			12,138			—			—			19,494
General and administrative		—			29,033			375			655			—			30,063

Total operating expenses		—			36,990			49,146			35,219			(32,370	)		88,985

Operating income		—			(15,193	)		161,161			39,488			(31,918	)		153,538
Other income (expense)
Interest and other (expense) income		—			(110	)		—			(209	)		—			(319	)
Earnings from equity and other interests		—			—			948			2,606			—			3,554
Interest expense		—			(67,484	)		(1,912	)		(29,268	)		31,918			(66,746	)
Income tax expense		—			—			(158	)		(568	)		—			(726	)

Net other expense		—			(67,594	)		(1,122	)		(27,439	)		31,918			(64,237	)

Income (loss) from continuing operations		—			(82,787	)		160,039			12,049			—			89,301
Income (loss) from discontinued operations		—			—			(4	)		7,918			—			7,914

Equity in earnings of consolidated subsidiaries net of income taxes		97,215			180,002			4,477			—			(281,694	)		—

Net income (loss)		97,215			97,215			164,512			19,967			(281,694	)		97,215
Net income (loss) attributable to non-controlling interests		(224	)		(224	)		—			—			224			(224	)

Net income attributable to MPT common stockholders	$	96,991		$	96,991		$	164,512		$	19,967		$	(281,470	)	$	96,991

Condensed Consolidated Statements of Comprehensive Income (Loss)

For the Year Ended December 31, 2013

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors		Non-Guarantor Subsidiaries		Eliminations			Total Consolidated
Net income	$	97,215		$	97,215		$	164,512	$	19,967	$	(281,694	)	$	97,215
Other comprehensive income (loss):
Unrealized gain (loss) on interest rate swap		3,474			3,474			—		—		(3,474	)		3,474
Foreign currency translation gain (loss)		67			67			—		—		(67	)		67

Total comprehensive income		100,756			100,756			164,512		19,967		(285,235	)		100,756
Comprehensive income attributable to non-controlling interests		(224	)		(224	)		—		—		224			(224	)

Comprehensive income attributable to MPT common stockholders	$	100,532		$	100,532		$	164,512	$	19,967	($	285,011	)	$	100,532

Condensed Consolidated Statements of Cash Flows

For the Year Ended December 31, 2013

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors			Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Operating Activities
Net cash provided by (used in) operating activities	$	4		$	(53,846	)	$	196,883		$	(2,240	)	$	—		$	140,801
Investing Activities
Cash paid for acquisitions and other related investments		—			—			(619,092	)		(35,830	)		—			(654,922	)
Net proceeds from sales of real estate		—			—			—			32,409			—			32,409
Principal received on loans receivable		—			—			—			7,249			—			7,249
Investments in loans receivable		—			—			(1,100	)		(2,646	)		—			(3,746	)
Construction in progress and other		—			136			(94,737	)		1,034			—			(93,567	)

Net cash provided by (used in) investing activities		—			136			(714,929	)		2,216			—			(712,577	)

Financing Activities
Additions to term debt		—			424,580			—			—			—			424,580
Payments of term debt		—			(11,000	)		—			(249	)		—			(11,249	)
Revolving credit facilities, net		—			(20,000	)		—			—			—			(20,000	)
Distributions paid		(120,038	)		(120,309	)		—			—			120,038			(120,309	)
Lease deposits and other obligations to tenants		—			—			1,606			1,625			—			3,231
Net payments relating to intercompany financing		(193,297	)		(539,776	)		541,325			(1,545	)		193,293			—
Proceeds from sale of common shares, net of offering costs		313,331			313,331			—			—			(313,331	)		313,331
Debt issuance costs paid and other financing activities		—			(9,760	)		—			—			—			(9,760	)

Net cash provided by (used in) financing activities		(4	)		37,066			542,931			(169	)		—			579,824

Increase (decrease) in cash and cash equivalents for period		—			(16,644	)		24,885			(193	)		—			8,048
Effect of exchange rate changes		—			(24	)		644			—			—			620
Cash and cash equivalents at beginning of period		—			35,483			1,565			263			—			37,311

Cash and cash equivalents at end of period	$	—		$	18,815		$	27,094		$	70		$	—		$	45,979

Condensed Consolidated Balance Sheets

December 31, 2012

(in thousands)


	Parent		Subsidiary Issuers		Subsidiary Guarantors			Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Assets
Real estate assets
Land, buildings and improvements and intangible lease assets	$	—	$	28	$	1,185,265		$	65,947		$	—		$	1,251,240
Real estate held for sale		—		—		—			25,537			—			25,537
Net investment in direct financing leases		—		—		110,155			204,257			—			314,412
Mortgage loans		—		—		268,650			100,000			—			368,650

Gross investment in real estate assets		—		28		1,564,070			395,741			—			1,959,839
Accumulated depreciation and amortization		—		—		(116,344	)		(6,452	)		—			(122,796	)

Net investment in real estate assets		—		28		1,447,726			389,289			—			1,837,043
Cash and cash equivalents		—		35,483		1,565			263			—			37,311
Interest and rent receivables		—		212		29,150			15,927			—			45,289
Straight-line rent receivables		—		—		28,416			7,444			—			35,860
Other loans		—		177		—			159,066			—			159,243
Net intercompany receivable		27,393		1,373,941		—			—			(1,401,334	)		—
Investment in subsidiaries		1,050,204		647,029		42,666			—			(1,739,899	)		—
Other assets		—		31,097		1,522			31,521			—			64,140

Total Assets	$	1,077,597	$	2,087,967	$	1,551,045		$	603,510		$	(3,141,233	)	$	2,178,886

Liabilities and Equity
Liabilities
Debt, net	$	—	$	1,010,962	$	—		$	14,198		$	—		$	1,025,160
Accounts payable and accrued expenses		27,783		26,658		10,492			1,028			—			65,961
Net intercompany payable		—		—		997,231			404,103			(1,401,334	)		—
Deferred revenue		—		143		19,431			1,035			—			20,609
Lease deposits and other obligations to tenants		—		—		16,357			985			—			17,342

Total liabilities		27,783		1,037,763		1,043,511			421,349			(1,401,334	)		1,129,072

Total Equity		1,049,814		1,050,204		507,534			182,161			(1,739,899	)		1,049,814

Total Liabilities and Equity	$	1,077,597	$	2,087,967	$	1,551,045		$	603,510		$	(3,141,233	)	$	2,178,886

Condensed Consolidated Statements of Income

For the Year Ended December 31, 2012

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors		Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Revenues
Rent billed	$	—		$	—		$	112,573	$	16,619		$	(9,309	)	$	119,883
Straight-line rent		—			—			6,429		1,482			—			7,911
Income from direct financing leases		—			—			19,870		18,090			(16,232	)		21,728
Interest and fee income		—			18,341			29,606		25,387			(24,731	)		48,603

Total revenues		—			18,341			168,478		61,578			(50,272	)		198,125
Expenses
Real estate depreciation and amortization		—			—			31,115		1,700			—			32,815
Property-related		—			495			816		25,707			(25,541	)		1,477
Acquisition expenses		—			5,420			—		—			—			5,420
General and administrative		—			26,018			—		2,544			—			28,562

Total operating expenses		—			31,933			31,931		29,951			(25,541	)		68,274

Operating income		—			(13,592	)		136,547		31,627			(24,731	)		129,851
Other income (expense)
Interest and other (expense) income		—			(69	)		—		(1,593	)		—			(1,662	)
Earnings from equity and other interests		—			—			1,061		1,882			—			2,943
Interest expense		—			(58,729	)		1,408		(25,653	)		24,731			(58,243	)
Income tax expense		—			—			—		(19	)		—			(19	)

Net other expense		—			(58,798	)		2,469		(25,383	)		24,731			(56,981	)

Income (loss) from continuing operations		—			(72,390	)		139,016		6,244			—			72,870
Income (loss) from discontinued operations		—			—			103		17,104			—			17,207

Equity in earnings of consolidated subsidiaries net of income taxes		90,077			162,467			4,481		—			(257,025	)		—

Net income (loss)		90,077			90,077			143,600		23,348			(257,025	)		90,077
Net income (loss) attributable to non-controlling interests		(177	)		(177	)		—		—			177			(177	)

Net income attributable to MPT common stockholders	$	89,900		$	89,900		$	143,600	$	23,348		$	(256,848	)	$	89,900

Condensed Consolidated Statements of Comprehensive Income (Loss)

For the Year Ended December 31, 2012

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors		Non-Guarantor Subsidiaries		Eliminations			Total Consolidated
Net income	$	90,077		$	90,077		$	143,600	$	23,348	$	(257,025	)	$	90,077
Other comprehensive income:
Unrealized loss on interest rate swap		(251	)		(251	)		—		—		251			(251	)

Total comprehensive income		89,826			89,826			143,600		23,348		(256,774	)		89,826
Comprehensive income attributable to non-controlling interests		(177	)		(177	)		—		—		177			(177	)

Comprehensive income attributable to MPT common stockholders	$	89,649		$	89,649		$	143,600	$	23,348	($	256,597	)	$	89,649

Condensed Consolidated Statements of Cash Flows

For the Year Ended December 31, 2012

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors			Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Operating Activities
Net cash provided by (used in) operating activities	$	57		$	(61,002	)	$	165,454		$	800		$	—		$	105,309

Investing Activities
Cash paid for acquisitions and other related investments		—			—			(420,500	)		(200,990	)		—			(621,490	)
Net proceeds from sales of real estate		—			—			—			71,202			—			71,202
Principal received on loans receivable		—			—			5,491			5,440			—			10,931
Investments in loans receivable		—			—			—			(1,293	)		—			(1,293	)
Construction in progress and other		—			(578	)		(66,467	)		(9,433	)		—			(76,478	)

Net cash provided by (used in) investing activities		—			(578	)		(481,476	)		(135,074	)		—			(617,128	)

Financing Activities
Additions to term debt		—			300,000			—			—			—			300,000
Payments of term debt		—			—			—			(232	)		—			(232	)
Revolving credit facilities, net		—			75,000			(39,600	)		—			—			35,400
Distributions paid		(103,684	)		(103,952	)		—			—			103,684			(103,952	)
Lease deposits and other obligations to tenants		—			—			(10,031	)		(1,405	)		—			(11,436	)
Net payments relating to intercompany financing		(129,421	)		(501,839	)		365,809			136,087			129,364			—
Proceeds from sale of common shares, net of offering costs		233,048			233,048			—			—			(233,048	)		233,048
Debt issuance costs paid and other financing activities		—			(6,424	)		—			—			—			(6,424	)

Net cash provided by (used in) financing activities		(57	)		(4,167	)		316,178			134,450			—			446,404

Increase (decrease) in cash and cash equivalents for period		—			(65,747	)		156			176			—			(65,415	)
Cash and cash equivalents at beginning of period		—			101,230			1,409			87			—			102,726

Cash and cash equivalents at end of period	$	—		$	35,483		$	1,565		$	263		$	—		$	37,311

Condensed Consolidated Statements of Income

For the Year Ended December 31, 2011

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors			Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Revenues
Rent billed	$	—		$	—		$	99,494		$	9,286		$	(3,092	)	$	105,688
Straight-line rent		—			—			3,515			1,762			—			5,277
Interest and fee income		—			6,124			17,543			3,926			(6,236	)		21,357

Total revenues		—			6,124			120,552			14,974			(9,328	)		132,322
Expenses
Real estate depreciation and amortization		—			—			28,489			1,658			—			30,147
Property-related		—			217			458			3,141			(3,092	)		724
Acquisition expenses		—			3,713			—			471			—			4,184
General and administrative		17			23,914			—			3,160			—			27,091

Total operating expenses		17			27,844			28,947			8,430			(3,092	)		62,146

Operating income		(17	)		(21,720	)		91,605			6,544			(6,236	)		70,176
Other income (expense)
Interest and other (expense) income		—			26			2			(10	)		—			18
Earnings from equity and other interests		—			—			345			(267	)		—			78
Debt refinancing costs		—			(14,109	)		(105	)		—			—			(14,214	)
Interest expense		—			(43,063	)		139			(7,122	)		6,236			(43,810	)
Income tax expense		—			—			—			(128	)		—			(128	)

Net other expense		—			(57,146	)		381			(7,527	)		6,236			(58,056	)

Income (loss) from continuing operations		(17	)		(78,866	)		91,986			(983	)		—			12,120
Income (loss) from discontinued operations		—			—			(1,969	)		16,563			—			14,594

Equity in earnings of consolidated subsidiaries net of income taxes		26,731			105,597			4,578			—			(136,906	)		—

Net income		26,714			26,731			94,595			15,580			(136,906	)		26,714
Net income attributable to non-controlling interests		(178	)		(178	)		—			—			178			(178	)

Net income attributable to MPT common stockholders	$	26,536		$	26,553		$	94,595		$	15,580		$	(136,728	)	$	26,536

Condensed Consolidated Statements of Comprehensive Income (Loss)

For the Year Ended December 31, 2011

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors		Non-Guarantor Subsidiaries		Eliminations			Total Consolidated
Net income	$	26,714		$	26,731		$	94,595	$	15,580	$	(136,906	)	$	26,714
Other comprehensive income:
Unrealized loss on interest rate swap		(8,590	)		(8,590	)		—		—		8,590			(8,590	)

Total comprehensive income		18,124			18,141			94,595		15,580		(128,316	)		18,124
Comprehensive income attributable to non-controlling interests		(178	)		(178	)		—		—		178			(178	)

Comprehensive income attributable to MPT common stockholders	$	17,946		$	17,963		$	94,595	$	15,580	$	(128,138	)	$	17,946

Condensed Consolidated Statements of Cash Flows

For the Year Ended December 31, 2011

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors			Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Operating Activities
Net cash provided by (used in) operating activities	$	(209	)	$	(48,779	)	$	109,329		$	18,929		$	—		$	79,270
Investing Activities
Cash paid for acquisitions and other related investments		—			—			(241,626	)		(37,337	)		—			(278,963	)
Net proceeds from sales of real estate		—			—			—			41,130			—			41,130
Principal received on loans receivable		—			—			230			4,059			—			4,289
Investments in loans receivable		—			—			(230	)		(631	)		—			(861	)
Construction in progress and other		—			(6,466	)		(24,081	)		(669	)		—			(31,216	)

Net cash provided by (used in) investing activities		—			(6,466	)		(265,707	)		6,552			—			(265,621	)
Financing Activities
Additions to term debt		—			450,000			—			—			—			450,000
Payments of term debt		—			(237,666	)		(8,433	)		(163	)		—			(246,262	)
Revolving credit facilities, net		—			50,000			39,600			—			—			89,600
Distributions paid		(89,342	)		(89,601	)		—			—			89,342			(89,601	)
Lease deposits and other obligations to tenants		—			—			10,986			(2,365	)		—			8,621
Net payments relating to intercompany financing		89,551			(92,052	)		114,247			(22,404	)		(89,342	)		—
Debt issuance costs paid and other financing activities		—			(21,028	)		—			(661	)		—			(21,689	)

Net cash provided by (used in) financing activities		209			59,653			156,400			(25,593	)		—			190,669

Increase (decrease) in cash and cash equivalents for period		—			4,408			22			(112	)		—			4,318
Cash and cash equivalents at beginning of period		—			96,822			1,387			199			—			98,408

Cash and cash equivalents at end of period	$	—		$	101,230		$	1,409		$	87		$	—		$	102,726

Valuation and Qualifying Accounts

12 Months Ended

Dec. 31, 2013

Valuation And Qualifying Accounts [Abstract]

Valuation and Qualifying Accounts

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

Schedule II: Valuation and Qualifying Accounts

December 31, 2013


			Additions			Deduction,
Year Ended December 31,	Balance at Beginning of Year(1)		Charged Against Operations(1)			Net Recoveries/ Writeoffs(1)			Balance at End of Year(1)
	(In thousands)
2013	$	34,769	$	9,397	(2)	$	(2,593	)	$	41,573

2012	$	32,618	$	4,540	(4)	$	(2,389	)	$	34,769

2011	$	23,926	$	8,692	(3)	$	(—	)	$	32,618

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

(2)	Includes $4.8 million and $2.7 million in rent and interest reserves, respectively, related to our Monroe properties along with $1.9 million to fully reserve for the net deferred tax asset of certain German subsidiaries.

(3)	Includes $3.7 million and $2.9 million in rent and interest reserves, respectively, related to our Denham Springs and Monroe properties and $2.1 million to fully reserve for the net deferred tax asset of one of our taxable REIT subsidiaries.

(4)	Includes $1.6 million and $2.9 million in rent and interest reserves, respectively, related to our Monroe properties.

SCHEDULE III - REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION

12 Months Ended

Dec. 31, 2013

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, 2013


Location	Type of Property	Initial Costs				Additions Subsequent to Acquisition					Cost at December 31, 2013						Accumu- lated Depreci- ation		Encum- brances		Date of Constr- uction		Date Acquired		Life on which depreci- ation in latest income state- ments is computed (Years)





		Land		Buildings		Improve- ments		Carrying Costs			Land		Buildings		Total
	(Amounts in thousands)
Baden-Wurttemburg, Germany	Rehabilitation hospital	$	—	$	11,968	$	—	$	—		$	—	$	11,968	$	11,968	$	29				1994		November 29, 2013		40
Saxony, Germany	Rehabilitation hospital		471		25,956		—		—			471		25,956		26,427		73				1996		November 29, 2013		40
Rhineland-Pflaz, Germany	Rehabilitation hospital		4,017		18,989		—		—			4,017		18,989		23,006		48				1960		November 29, 2013		40
Brandenburg, Germany	Rehabilitation hospital		438		22,615		—		—			438		22,615		23,053		68				1994		November 29, 2013		40
Hesse, Germany	Rehabilitation hospital		116		6,625		—		—			116		6,625		6,741		19				1981		November 29, 2013		40
Hesse, Germany	Rehabilitation hospital		3,894		18,730		—		—			3,894		18,730		22,624		53				1977		November 29, 2013		40
Rhineland-Pflaz, Germany	Rehabilitation hospital		—		37,579		—		—			—		37,579		37,579		103				1992		November 29, 2013		40
Saxony, Germany	Rehabilitation hospital		682		18,907		—		—			682		18,907		19,589		48				1904, 1995		November 29, 2013		40
Rhineland-Pflaz, Germany	Rehabilitation hospital		921		8,281		—		—			921		8,281		9,202		21				1980		November 29, 2013		40
Rhineland-Pflaz, Germany	Rehabilitation hospital		7,382		20,382		—		—			7,382		20,382		27,764		67				1930		November 29, 2013		40
Baden-Wurttemburg, Germany	Rehabilitation hospital		4,327		7,372		—		—			4,327		7,372		11,699		25				1986		November 29, 2013		40
Little Elm, TX	Acute care general hospital		1,241		2,963		—		—			1,241		2,963		4,204		6				2013		December 1, 2013		40
Port Arthur, TX	Acute care general hospital		2,178		74,225		—		—			2,178		74,225		76,403		464				2005		September 26, 2013		40
West Monroe, LA	Acute care general hospital		10,555		71,429		—		—			10,555		71,429		81,984		449				1962		September 26, 2013		40
Hausman, TX	Acute care general hospital		1,500		8,958		—		—			1,500		8,958		10,458		169				2013		March 1, 2013		40
Lafayette, IN	Rehabilitation hospital		800		14,968		—		—			800		14,968		15,768		328				2013		February 1, 2013		40
Mesa, AZ	Acute care general hospital		3,875		101,248		—		—			3,875		101,248		105,123		633				2007		September 26, 2013		40
Overlook, TX	Acute care general hospital		2,452		9,666		—		—			2,452		9,666		12,118		203				2012		February 1, 2013		40
Post Falls, ID	Rehabilitation hospital		417		12,175		—		—			417		12,175		12,592		25				2013		December 31, 2013		40
Spartanburg, SC	Rehabilitation hospital		1,135		15,717		—		—			1,135		15,717		16,852		145				2013		August 1, 2013		40
Victoria, TX	Rehabilitation hospital		—		9,355		—		—			—		9,355		9,355		—				2013		December 31, 2013		40
Covington, LA	Long term acute care hospital		821		10,238		—		14			821		10,252		11,073		2,200		—		1984		June 9, 2005		40
Redding, CA	Long term acute care hospital		—		19,952		—		4,361			1,629		22,684		24,313		4,621		—		1991		June 30, 2005		40
Bloomington, IN	Acute care general hospital		2,457		31,209		—		408			2,576		31,498		34,074		5,800		—		2006		August 8, 2006		40
Dallas, TX	Long term acute care hospital		1,000		13,589		—		368			1,421		13,536		14,957		2,481		—		2006		September 5, 2006		40
La Palma, CA	Acute care general hospital		937		10,907		—		3			937		10,910		11,847		1,954		—		1971		November 8, 2006		40
Anaheim, CA	Acute care general hospital		1,875		21,814		—		10			1,875		21,824		23,699		3,910		—		1964		November 8, 2006		40
Luling, TX	Long term acute care hospital		811		9,345		—		—			811		9,345		10,156		1,655		—		2002		December 1, 2006		40
Victoria, TX	Long term acute care hospital		625		7,197		—		—			625		7,197		7,822		1,275		—		1998		December 1, 2006		40
Houston, TX	Acute care general hospital		4,757		56,238		—		1,259			5,464		56,790		62,254		10,006		41,200		2006		December 1, 2006		40
Bensalem, PA	Acute care general hospital		6,911		38,185		—		(353	)		6,911		37,832		44,743		6,602		—		2006		March 19, 2007		40
Portland, OR	Long term acute care hospital		3,085		17,859		—		2,559			3,071		20,432		23,503		3,356		—		1964		April 18, 2007		40
San Diego, CA	Acute care general hospital		6,550		15,653		—		77			6,550		15,730		22,280		2,619		—		1964		May 9, 2007		40
Redding, CA	Acute care general hospital		1,555		53,863		—		13			1,555		53,876		55,431		8,653		—		1974		August 10, 2007		40
Houston, TX	Acute care general hospital		3,501		34,530		7,433		12,468			3,274		54,658		57,932		4,948		—		1960		August 10, 2007		40
Bennettsville, SC	Acute care general hospital		794		15,772		—		—			794		15,772		16,566		2,268		—		1984		April 1, 2008		40
Bossier City, LA	Long term acute care hospital		900		17,818		—		—			900		17,818		18,718		2,559		—		1982		April 1, 2008		40
Bristol, CT	Wellness Center		485		2,267		—		—			485		2,267		2,752		1,047		—		1975		April 22, 2008		10
Cheraw, SC	Acute care general hospital		657		19,576		—		—			657		19,576		20,233		2,814		—		1982		April 1, 2008		40
Detroit, MI	Long term acute care hospital		1,220		8,687		—		(365	)		1,220		8,322		9,542		1,243		—		1956		May 22, 2008		40
Enfield, CT	Wellness Center		384		2,257		—		—			384		2,257		2,641		1,043		—		1974		April 22, 2008		10
Fort Lauderdale, FL	Rehabilitation hospital		3,499		21,939		—		1			3,499		21,940		25,439		3,114		—		1985		April 22, 2008		40
Garden Grove, CA	Acute care general hospital		5,502		10,748		—		51			5,502		10,799		16,301		1,385		—		1982		November 25, 2008		40
Garden Grove, CA	Medical Office Building		862		7,888		—		28			862		7,916		8,778		1,007		—		1982		November 25, 2008		40
Idaho Falls, ID	Acute care general hospital		1,822		37,467		—		4,665			1,822		42,132		43,954		5,913		—		2002		April 1, 2008		40
Newington, CT	Wellness Center		270		1,615		—		—			270		1,615		1,885		748		—		1979		April 22, 2008		10
Petersburg, VA	Rehabilitation hospital		1,302		9,121		—		—			1,302		9,121		10,423		1,254		—		2006		July 1, 2008		40
West Valley City, UT	Acute care general hospital		5,516		58,314		—		—			5,516		58,314		63,830		8,278		—		1980		April 22, 2008		40
Poplar Bluff, MO	Acute care general hospital		2,659		38,694		—		1			2,660		38,694		41,354		5,493		—		1980		April 22, 2008		40
East Providence, RI	Wellness Center		209		1,265		—		—			209		1,265		1,474		586		—		1979		April 22, 2008		10
San Dimas, CA	Acute care general hospital		6,160		6,839		—		34			6,160		6,873		13,033		874		—		1972		November 25, 2008		40
San Dimas, CA	Medical Office Building		1,915		5,085		—		18			1,915		5,103		7,018		650		—		1979		November 25, 2008		40
West Springfield, MA	Wellness Center		583		3,185		—		—			583		3,185		3,768		1,475		—		1976		April 22, 2008		10
Warwick, RI	Wellness Center		1,265		759		—		—			1,265		759		2,024		351		—		1979		April 22, 2008		10
Wichita, KS	Rehabilitation hospital		1,019		18,373		—		1			1,019		18,374		19,393		2,641		8,678		1992		April 4, 2008		40
Addison, TX	Rehabilitation hospital		2,013		22,531		—		—			2,013		22,531		24,544		1,971				2008		June 17, 2010		40
Shenandoah, TX	Rehabilitation hospital		2,033		21,943		—		—			2,033		21,943		23,976		1,920				2008		June 17, 2010		40
Richardson, TX	Rehabilitation hospital		2,219		17,419		—		—			2,219		17,419		19,638		1,524				2008		June 17, 2010		40
Hill County, TX	Acute care general hospital		1,120		17,882		—		—			1,120		17,882		19,002		3,897				1980		September 17, 2010		40
Webster, TX	Long term acute care hospital		663		33,751		—		—			663		33,751		34,414		2,531				2004		December 21, 2010		40
Tomball, TX	Long term acute care hospital		1,298		23,982		—		—			1,298		23,982		25,280		1,799				2005		December 21, 2010		40
Gilbert, AZ	Acute care general hospital		150		15,553		—		—			150		15,553		15,703		1,166				2005		January 4, 2011		40
Corinth, TX	Long term acute care hospital		1,288		21,175		313		—			1,601		21,175		22,776		1,570				2008		January 31, 2011		40
Bayonne, NJ	Acute care general hospital		2,003		51,495		—		—			2,003		51,495		53,498		7,510				1918		February 4, 2011		20
San Diego, CA	Acute care general hospital		12,663		52,432		—		—			12,663		52,432		65,095		3,823				1973		February 9, 2011		40
Northland, MO	Long term acute care hospital		834		17,182		—		—			834		17,182		18,016		1,253				2007		February 14, 2011		40
DeSoto, TX	Long term acute care hospital		1,067		10,701		86		8			1,161		10,701		11,862		655				2008		July 18, 2011		40
New Braunfels, TX	Long term acute care hospital		1,100		7,883		—		—			1,100		7,883		8,983		443				2007		September 30, 2011		40
Hoboken, NJ	Acute care general hospital		1,387		44,351		—		—			1,387		44,351		45,738		4,730				1863		November 4, 2011		20
Florence, AZ	Acute care general hospital		900		28,462		—		—			900		28,462		29,362		1,236				2012		November 4, 2010		40
Hammond, LA	Long term acute care hospital		519		8,941		—		—			519		8,941		9,460		242				2003		December 14, 2012		40
San Antonio, TX	Acute care general hospital		2,248		5,880		—		—			2,249		5,879		8,128		166				2012		October 14, 2011		40

		$	151,814	$	1,547,919	$	7,832	$	25,629		$	154,858	$	1,578,336	$	1,733,194	$	144,235	$	49,878

The changes in total real estate assets including real estate held for sale but excluding construction in progress, intangible lease asset, investment in direct financing leases, and mortgage loans for the years ended (in thousands):


	December 31, 2013			December 31, 2012			December 31, 2011
COST
Balance at beginning of period	$	1,189,552		$	1,191,096		$	990,635
Acquisitions		483,162			9,460			240,474
Transfers from construction in progress		81,347			37,174			—
Additions		7,749			19,971			1,011
Dispositions		(28,616	)		(68,149	)		(40,460	)
Other		—			—			(564	)

Balance at end of period	$	1,733,194		$	1,189,552	(3)	$	1,191,096	(1)

The changes in accumulated depreciation including real estate assets held for sale for the years ended (in thousands):


	December 31, 2013			December 31, 2012			December 31, 2011
ACCUMULATED DEPRECIATION
Balance at beginning of period	$	114,399		$	93,430		$	68,662
Depreciation		33,349			31,026			29,523
Depreciation on disposed property		(3,513	)		(10,057	)		(4,755	)

Balance at end of period	$	144,235		$	114,399	(4)	$	93,430	(2)

(1)	Includes real estate cost included in real estate held for sale of $96,766 at December 31, 2011. Excludes intangible lease assets that are included in real estate held for sale of $3,012 for 2011.

(2)	Includes accumulated depreciation in real estate held for sale of $11,807 for 2011. Excludes accumulated amortization related to intangible lease assets that are included in real estate held for sale of $1,949 for 2011.

(3)	Includes real estate cost included in real estate held for sale of $28,617 at December 31, 2012. Excludes intangible lease assets that are included in real estate held for sale of $858 for 2012.

(4)	Includes in accumulated depreciation in real estate held for sale of $3,511 for 2012. Excludes accumulated amortization related to intangible lease assets that are included in real estate held for sale of $426 for 2012.

(5)	The aggregate cost for federal income tax purposes is $2,155,240.

SCHEDULE IV - MORTGAGE LOANS ON REAL ESTATE

12 Months Ended

Dec. 31, 2013

Mortgage Loans On Real Estate [Abstract]

SCHEDULE IV - MORTGAGE LOANS ON REAL ESTATE

SCHEDULE IV — MORTGAGE LOANS ON REAL ESTATE

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


Column A	Column B			Column C		Column D	Column E			Column F		Column G(3)		Column H
Description	Interest Rate			Final Maturity Date		Periodic Payment Terms	Prior Liens			Face Amount of Mortgages		Carrying Amount of Mortgages		Principal Amount of Loans Subject to Delinquent Principal or Interest
	(Dollar amounts in thousands)
Long-term first mortgage loan:						Payable in monthly installments of interest plus principal payable in full at maturity
Desert Valley Hospital		10.7	%		2022			(1	)	$	70,000	$	70,000		(2	)
Desert Valley Hospital		11.3	%		2022			(1	)		20,000		20,000		(2	)
Chino Valley Medical Center		10.7	%		2022			(1	)		50,000		50,000		(2	)
Paradise Valley Hospital		10.3	%		2022			(1	)		25,000		25,000		(2	)
Ernest Mortgage Loan(4)		9.2	%		2032			(1	)		100,000		100,000		(2	)
Centinela Hospital Medical Center		10.5	%		2022			(1	)		100,000		100,000		(2	)
Olympia Medical Center		11.0	%		2024			(1	)		20,000		20,000		(2	)
Denham Springs LTACH		6.0	%		2014			(1	)		3,650		3,650		(2	)

										$	388,650	$	388,650

(1)	There were no prior liens on loans as of December 31, 2013.

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

(3)	The aggregate cost for Federal income tax purposes is $388,650.

(4)	Mortgage loans on four properties.

Changes in mortgage loans for the years ended December 31, 2013, 2012, and 2011 are summarized as follows:


	Year Ended December 31,
	2013		2012		2011
	(Dollar amounts in thousands)
Balance at beginning of year	$	368,650	$	165,000	$	165,000
Additions during year:
New mortgage loans and additional advances on existing loans		20,000		203,650		—

		388,650		368,650		165,000

Deductions during year:
Collection of principal		—		—		—

		—		—		—

Balance at end of year	$	388,650	$	368,650	$	165,000

Summary of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2013

Principles of Consolidation

Use of Estimates


VIE Type	Maximum Loss Exposure(1)		Asset Type Classification	Carrying Amount(2)
Loans, net		$283,273	Mortgage and other loans	$	228,996
Equity investments		$ 19,308	Other assets	$	5,198

(1)

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

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

Investments in Unconsolidated Entities

Cash and Cash Equivalents

Revenue Recognition

Acquired Real Estate Purchase Price Allocation

Real Estate and Depreciation

Depreciation is calculated on the straight-line method over the weighted average useful lives of the related real estate and other assets, as follows:


Buildings and improvements			38.2 years
Tenant lease intangibles			18.6 years
Leasehold improvements			22.2 years
Furniture, equipment and other			9.4 years

Losses from Rent Receivables

Loans

Earnings Per Share/Units

Income Taxes

Stock-Based Compensation

Deferred Costs

Foreign Currency Translation and Transactions

Derivative Financial Investments and Hedging Activities

Fair Value Measurement

•

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

•

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

Recent Accounting Developments

Reclassifications

Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2013

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

The carrying value and classification of the related assets and maximum exposure to loss as a result of our involvement with these VIEs are presented below at December 31, 2013 (in thousands):


VIE Type	Maximum Loss Exposure(1)		Asset Type Classification	Carrying Amount(2)
Loans, net		$283,273	Mortgage and other loans	$	228,996
Equity investments		$ 19,308	Other assets	$	5,198

Useful Lives of Related Real Estate and Other Assets

Depreciation is calculated on the straight-line method over the weighted average useful lives of the related real estate and other assets, as follows:


Buildings and improvements			38.2 years
Tenant lease intangibles			18.6 years
Leasehold improvements			22.2 years
Furniture, equipment and other			9.4 years

Supplemental Pro Forma Earnings Adjusted to Exclude Acquisition-Related Costs

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

+ References + Details

Real Estate and Loans Receivable (Tables)

12 Months Ended

Dec. 31, 2013

Text Block [Abstract]

Assets Acquired

We acquired the following assets:


	2013		2012		2011
Assets Acquired		(in thousands)
Land	$	41,473	$	518	$	19,705
Building		439,030		8,942		220,769
Intangible lease assets — subject to amortization (weighted average useful life 21.0 years in 2013, 15.0 years in 2012 and 13.9 years in 2011)		38,589		1,040		20,630
Net investments in direct financing leases		110,580		310,000		—
Mortgage loans		20,000		200,000		—
Other loans		5,250		95,690		27,283
Equity investments		—		5,300		5,168

Total assets acquired	$	654,922	$	621,490	$	293,555
Total liabilities assumed		—		—		(14,592	)

Net assets acquired	$	654,922	$	621,490	$	278,963


	2013		2012
	(Amounts in thousands except per share/unit amounts)
Total revenues	$	288,159	$	280,539
Net income		133,258		135,402
Net income per share/unit	$	0.82	$	0.85

Summary of Status Update on Current Development Projects

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

Property

Location

Property Type

Operator

Commitment

Costs Incurred
as of
12/31/13

Estimated
Completion
Date

First Choice ER- Nacogdoches

San Antonio, TX

Acute Care Hospital

First Choice ER, LLC

5,100

2,681

1Q 2014

First Choice ER- Brodie

Austin, TX

Acute Care Hospital

First Choice ER, LLC

5,470

1,950

2Q 2014

First Choice ER- Alvin

Houston, TX

Acute Care Hospital

First Choice ER, LLC

5,240

1,328

2Q 2014

Northern Utah Rehabilitation Hospital

South Ogden, UT

Inpatient Rehabilitation Hospital

Ernest Health, Inc.

19,153

16,391

2Q 2014

First Choice ER- Briar Forest

Houston, TX

Acute Care Hospital

First Choice ER, LLC

5,833

1,386

3Q 2014

First Choice ER- Cedar Hill

Cedar Hill, TX

Acute Care Hospital

First Choice ER, LLC

5,768

1,167

3Q 2014

First Choice ER- Firestone

Firestone, CO

Acute Care Hospital

First Choice ER, LLC

5,172

544

3Q 2014

Oakleaf Surgical Hospital

Altoona, WI

Acute Care Hospital

National Surgical
Hospitals

33,500

16,324

3Q 2014

First Choice Emergency Rooms

Various

Acute Care Hospital

First Choice

62,217

—

Various

147,453

41,771

Amortization Expense from Lease Intangible Assets

Amortization expense from existing lease intangible assets as follows: (amounts in thousands)


For the Year Ended December 31:
2014	$	5,086
2015		4,896
2016		4,855
2017		4,845
2018		4,784

Components of Net Investment in Direct Financing Leases

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


	As of December 31, 2013
Minimum lease payments receivable	$	1,647,567
Estimated residual values		211,863
Less unearned income		(1,428,406	)

Net investment in direct financing leases	$	431,024

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


	Total Under Operating Leases		Total Under DFLs		Total
2014	$	166,602	$	42,535	$	209,137
2015		164,754		43,386		208,140
2016		165,517		44,254		209,771
2017		165,418		45,139		210,557
2018		165,679		46,041		211,720
Thereafter		1,536,759		601,981		2,138,740

	$	2,364,729	$	823,336	$	3,188,065

Summary of Loans

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


	As of December 31, 2013					As of December 31, 2012
	Balance		Weighted Average Interest Rate			Balance		Weighted Average Interest Rate
Mortgage loans	$	388,650		10.2	%	$	368,650		10.0	%
Acquisition loans		103,266		14.5	%		98,433		14.7	%
Working capital and other loans		57,724		10.9	%		60,810		10.8	%

	$	549,640				$	527,893

Debt (Tables)

12 Months Ended

Dec. 31, 2013

Debt Disclosure [Abstract]

Summary of Debt

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


	As of December 31, 2013					As of December 31, 2012
	Balance		Interest Rate			Balance			Interest Rate
Revolving credit facility	$	105,000		Variable		$	125,000			Variable
2006 Senior Unsecured Notes		125,000		Various			125,000			Various
2011 Senior Unsecured Notes		450,000		6.875	%		450,000			6.875	%
2012 Senior Unsecured Notes:
Principal amount		350,000		6.375	%		200,000			6.375	%
Unamortized premium		2,873					—

		352,873					200,000
Exchangeable senior notes:
Principal amount		—					11,000			9.250	%
Unamortized discount		—					(37	)

		—					10,963
2013 Senior Unsecured Notes		274,860		5.75	%		—

Term loans		113,948		Various			114,197			Various

	$	1,421,681				$	1,025,160

Principal Payments Due for Debt

As of December 31, 2013, principal payments due on our debt (which exclude the effects of any discounts or premiums recorded) are as follows: (A)


2014	$	265
2015		105,283
2016		225,299
2017		320
2018		12,781
Thereafter		1,074,860

Total	$	1,418,808

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2013

Income Tax Disclosure [Abstract]

Schedule of Income Tax Expense


	For the Years Ended December 31,
	2013		2012		2011
Domestic	$	568	$	19	$	128
Foreign		158		—		—

	$	726	$	19	$	128

Schedule of Deferred Tax Assets And Liablities

At December 31, 2013 and 2012, components of our deferred tax assets and liabilities were as follows (in thousands):


	2013			2012
Deferred tax liabilities:
Property and equipment	$	(2,870	)	$	(2,370	)
Other		(2,923	)		(1,673	)

Total deferred tax liabilities		(5,793	)		(4,043	)

Deferred tax assets:
Loan loss and other reserves		7,751			7,218
Operating loss and interest deduction carry forwards		2,283			3,938
Other		3,371			1,261

Total deferred tax assets		13,405			12,417
Valuation allowance		(7,843	)		(8,540	)

Net deferred tax (liability)	$	(231	)	$	(166	)

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,
	2013		2012		2011
Common share distribution	$	0.800000	$	0.800000	$	0.800000
Ordinary income		0.599384		0.601216		0.300844
Capital gains(1)		0.046380		0.117584		0.031396
Unrecaptured Sec. 1250 gain		0.026512		0.086976		0.031396
Return of capital		0.154236		0.081200		0.467760
Allocable to next year		—		—		—

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

Earnings Per Share/Unit (Tables)

12 Months Ended

Dec. 31, 2013

Earnings Per Share [Abstract]

Calculation of Earnings Per Share

Medical Properties Trust, Inc.

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


	For the Years Ended December 31,
	2013			2012			2011
Numerator:
Income from continuing operations	$	89,301		$	72,870		$	12,120
Non-controlling interests’ share in continuing operations		(224	)		(177	)		(178	)
Participating securities’ share in earnings		(729	)		(887	)		(1,090	)

Income from continuing operations, less participating securities’ share in earnings		88,348			71,806			10,852
Income from discontinued operations attributable to MPT common stockholders		7,914			17,207			14,594

Net income, less participating securities’ share in earnings	$	96,262		$	89,013		$	25,446

Denominator:
Basic weighted-average common shares		151,439			132,331			110,623
Dilutive potential common shares		1,159			2			6

Diluted weighted-average common shares		152,598			132,333			110,629

MPT Operating Partnership, L.P.

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


	For the Years Ended December 31,
	2013			2012			2011
Numerator:
Income from continuing operations	$	89,301		$	72,870		$	12,137
Non-controlling interests’ share in continuing operations		(244	)		(177	)		(178	)
Participating securities’ share in earnings		(729	)		(887	)		(1,090	)

Income from continuing operations, less participating securities’ share in earnings		88,328			71,806			10,869
Income from discontinued operations attributable to MPT Operating Partnership partners		7,914			17,207			14,594

Net income, less participating securities’ share in earnings	$	96,242		$	89,013		$	25,463

Denominator:
Basic weighted-average units		151,439			132,331			110,623
Dilutive potential units		1,159			2			6

Diluted weighted-average units		152,598			132,333			110,629

Stock Awards (Tables)

12 Months Ended

Dec. 31, 2013

Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]

Restricted Equity Awards Activity

The following summarizes restricted equity award activity in 2013 and 2012 (which includes awards granted in 2013, 2012, 2011, and any applicable prior years), respectively:

For the Year Ended December 31, 2013:


	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		466,883		$	10.72		1,879,889		$	6.48
Awarded		240,425		$	12.26		754,255		$	6.13
Vested		(381,309	)	$	11.15		(386,446	)	$	8.27
Forfeited		—		$	—		(248,519	)	$	11.03

Nonvested awards at end of year		325,999		$	11.36		1,999,179		$	5.44

For the Year Ended December 31, 2012:


	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		603,980		$	11.02		1,511,397		$	7.60
Awarded		275,464		$	10.14		902,359		$	5.81
Vested		(410,261	)	$	10.78		(513,693	)	$	8.63
Forfeited		(2,300	)	$	10.24		(20,174	)	$	5.45

Nonvested awards at end of year		466,883		$	10.72		1,879,889		$	6.48

Commitments and Contingencies (Tables)

12 Months Ended

Dec. 31, 2013

Commitments And Contingencies Disclosure [Abstract]

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

Fixed minimum payments due under operating leases with non-cancelable terms of more than one year at December 31, 2013 are as follows: (amounts in thousands)


2014	$	2,471
2015		2,644
2016		2,659
2017		2,620
2018		2,614
Thereafter		37,213

	$	50,221

Fair Value of Financial Instruments (Tables)

12 Months Ended

Dec. 31, 2013

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, 2013						December 31, 2012
Asset (Liability)	Book Value			Fair Value			Book Value			Fair Value
Interest and rent receivables	$	58,499		$	44,349		$	45,289		$	36,700
Loans(1)		351,607			358,277			334,693			335,595
Debt, net		(1,421,681	)		(1,486,090	)		(1,025,160	)		(1,082,333	)

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

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

At December 31, 2013. these amounts were as follows (in thousands):


Asset (Liability)	Fair Value		Cost		Asset Type Classification
Mortgage loans	$	100,000	$	100,000	Mortgage loans
Acquisition loan		98,033		98,033	Other loans
Equity investments		3,300		3,300	Other assets

	$	201,333	$	201,333

Summary Showing Sensitivity Analysis by Using Basis Point Variations

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


Basis Point Change in Marketability Discount		Estimated Increase (Decrease) In Fair Value
+100 basis points		$(320)
- 100 basis points		320

Discontinued Operations (Tables)

12 Months Ended

Dec. 31, 2013

Discontinued Operations And Disposal Groups [Abstract]

Discontinued Operations

The following table presents the results of discontinued operations for the years ended December 31, 2013, 2012 and 2011 (in thousands except per share/unit amounts):


	For the Years Ended December 31,
	2013		2012		2011
Revenues	$	988	$	3,470	$	14,531
Gain on sale		7,659		16,369		5,431
Income from discontinued operations		7,914		17,207		14,594
Income from discontinued operations — diluted per share/unit	$	0.05	$	0.13	$	0.12

Medical Properties Trust, Inc. [Member]

Tabular disclosure of disposal groups, which may include the gain (loss) recognized in the income statement and the income statement caption that includes that gain (loss), amounts of revenues and pretax profit or loss reported in discontinued operations, the classification and carrying value of the assets and liabilities comprising the disposal group, and the segment in which the disposal group was reported. Also may include the amount of adjustments to amounts previously reported in discontinued operations such as resolution of contingencies arising from the disposal transaction or the operations of the component prior to disposal.

+ References + Details

Quarterly Financial Data (unaudited) (Tables)

12 Months Ended

Dec. 31, 2013

Unaudited Quarterly Financial Information

The following is a summary of the unaudited quarterly financial information for the years ended December 31, 2013 and 2012: (amounts in thousands, except for per share data)


	For the Three Month Periods in 2013 Ended
	March 31		June 30		September 30		December 31
Revenues	$	57,614	$	57,124	$	60,106	$	67,679
Income from continuing operations		25,570		25,031		25,391		13,309
Income from discontinued operations		640		2,374		312		4,588
Net income		26,210		27,405		25,703		17,897
Net income attributable to MPT common stockholders		26,156		27,348		25,648		17,839
Net income attributable to MPT common stockholders per share — basic	$	0.19	$	0.18	$	0.16	$	0.11
Weighted average shares outstanding — basic		140,347		149,509		154,758		161,143
Net income attributable to MPT common stockholders per share — diluted	$	0.18	$	0.18	$	0.16	$	0.11
Weighted average shares outstanding — diluted		141,526		151,056		155,969		161,840


	For the Three Month Periods in 2012 Ended
	March 31		June 30		September 30		December 31
Revenues	$	40,455	$	48,569	$	52,504	$	56,597
Income (loss) from continuing operations		8,294		18,718		22,594		23,264
Income from discontinued operations		2,312		642		8,914		5,339
Net income		10,606		19,360		31,508		28,603
Net income attributable to MPT common stockholders		10,564		19,316		31,464		28,556
Net income attributable to MPT common stockholders per share — basic	$	0.08	$	0.14	$	0.23	$	0.21
Weighted average shares outstanding — basic		124,906		134,715		134,781		134,923
Net income attributable to MPT common stockholders per share — diluted	$	0.08	$	0.14	$	0.23	$	0.21
Weighted average shares outstanding — diluted		124,906		134,715		134,782		134,930

MPT Operating Partnership, L.P. [Member]

Unaudited Quarterly Financial Information

The following is a summary of the unaudited quarterly financial information for the years ended December 31, 2013 and 2012: (amounts in thousands, except for per unit data)


	For the Three Month Periods in 2013 Ended
	March 31		June 30		September 30		December 31
Revenues	$	57,614	$	57,124	$	60,106	$	67,679
Income from continuing operations		25,570		25,031		25,391		13,309
Income from discontinued operations		640		2,374		312		4,588
Net income		26,210		27,405		25,703		17,897
Net income attributable to MPT Operating Partnership partners		26,156		27,348		25,648		17,839
Net income attributable to MPT Operating Partnership partners per unit — basic	$	0.19	$	0.18	$	0.16	$	0.11
Weighted average units outstanding — basic		140,347		149,509		154,758		161,143
Net income attributable to MPT Operating Partnership partners per unit — diluted	$	0.18	$	0.18	$	0.16	$	0.11
Weighted average units outstanding — diluted		141,526		151,056		155,969		161,840


	For the Three Month Periods in 2012 Ended
	March 31		June 30		September 30		December 31
Revenues	$	40,455	$	48,569	$	52,504	$	56,597
Income from continuing operations		8,294		18,718		22,594		23,264
Income from discontinued operations		2,312		642		8,914		5,339
Net income		10,606		19,360		31,508		28,603
Net income attributable to MPT Operating Partnership partners		10,564		19,316		31,464		28,556
Net income attributable to MPT Operating Partnership partners per unit — basic	$	0.08	$	0.14	$	0.23	$	0.21
Weighted average units outstanding — basic		124,906		134,715		134,781		134,923
Net income attributable to MPT Operating Partnership partners per unit — diluted	$	0.08	$	0.14	$	0.23	$	0.21
Weighted average units outstanding — diluted		124,906		134,715		134,782		134,930

Condensed Consolidating Financial Information (Tables)

12 Months Ended

Dec. 31, 2013

Condensed Financial Information Of Parent Company Only Disclosure [Abstract]

Condensed Consolidated Balance Sheets

Condensed Consolidated Balance Sheets

December 31, 2013

(in thousands)


	Parent		Subsidiary Issuers		Subsidiary Guarantors			Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Assets
Real estate assets
Land, buildings and improvements and intangible lease assets	$	—	$	—	$	1,795,084		$	70,371		$	—		$	1,865,455
Net investment in direct financing leases		—		—		212,543			218,481			—			431,024
Mortgage loans		—		—		268,650			120,000			—			388,650

Gross investment in real estate assets		—		—		2,276,277			408,852			—			2,685,129
Accumulated depreciation and amortization		—		—		(151,624	)		(8,152	)		—			(159,776	)

Net investment in real estate assets		—		—		2,124,653			400,700			—			2,525,353
Cash and cash equivalents		—		18,815		27,094			70			—			45,979
Interest and rent receivables		—		336		31,324			26,839			—			58,499
Straight-line rent receivables		—		—		37,015			8,814			—			45,829
Other loans		—		178		1,100			159,712			—			160,990
Net intercompany receivable		35,363		1,907,474		—			—			(1,942,837	)		—
Investment in subsidiaries		1,344,598		825,153		42,407			—			(2,212,158	)		—
Other assets		—		37,311		1,168			29,441			—			67,920

Total Assets	$	1,379,961	$	2,789,267	$	2,264,761		$	625,576		$	(4,154,995	)	$	2,904,570

Liabilities and Equity
Liabilities
Debt, net	$	—	$	1,407,733	$	—		$	13,948		$	—		$	1,421,681
Accounts payable and accrued expenses		35,753		36,887		20,367			1,304			—			94,311
Net intercompany payable		—		—		1,538,934			403,903			(1,942,837	)		—
Deferred revenue		—		49		17,772			5,966			—			23,787
Lease deposits and other obligations to tenants		—		—		17,964			2,619			—			20,583

Total liabilities		35,753		1,444,669		1,595,037			427,740			(1,942,837	)		1,560,362

Total Equity		1,344,208		1,344,598		669,724			197,836			(2,212,158	)		1,344,208

Total Liabilities and Equity	$	1,379,961	$	2,789,267	$	2,264,761		$	625,576		$	(4,154,995	)	$	2,904,570

Condensed Consolidated Balance Sheets

December 31, 2012

(in thousands)


	Parent		Subsidiary Issuers		Subsidiary Guarantors			Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Assets
Real estate assets
Land, buildings and improvements and intangible lease assets	$	—	$	28	$	1,185,265		$	65,947		$	—		$	1,251,240
Real estate held for sale		—		—		—			25,537			—			25,537
Net investment in direct financing leases		—		—		110,155			204,257			—			314,412
Mortgage loans		—		—		268,650			100,000			—			368,650

Gross investment in real estate assets		—		28		1,564,070			395,741			—			1,959,839
Accumulated depreciation and amortization		—		—		(116,344	)		(6,452	)		—			(122,796	)

Net investment in real estate assets		—		28		1,447,726			389,289			—			1,837,043
Cash and cash equivalents		—		35,483		1,565			263			—			37,311
Interest and rent receivables		—		212		29,150			15,927			—			45,289
Straight-line rent receivables		—		—		28,416			7,444			—			35,860
Other loans		—		177		—			159,066			—			159,243
Net intercompany receivable		27,393		1,373,941		—			—			(1,401,334	)		—
Investment in subsidiaries		1,050,204		647,029		42,666			—			(1,739,899	)		—
Other assets		—		31,097		1,522			31,521			—			64,140

Total Assets	$	1,077,597	$	2,087,967	$	1,551,045		$	603,510		$	(3,141,233	)	$	2,178,886

Liabilities and Equity
Liabilities
Debt, net	$	—	$	1,010,962	$	—		$	14,198		$	—		$	1,025,160
Accounts payable and accrued expenses		27,783		26,658		10,492			1,028			—			65,961
Net intercompany payable		—		—		997,231			404,103			(1,401,334	)		—
Deferred revenue		—		143		19,431			1,035			—			20,609
Lease deposits and other obligations to tenants		—		—		16,357			985			—			17,342

Total liabilities		27,783		1,037,763		1,043,511			421,349			(1,401,334	)		1,129,072

Total Equity		1,049,814		1,050,204		507,534			182,161			(1,739,899	)		1,049,814

Total Liabilities and Equity	$	1,077,597	$	2,087,967	$	1,551,045		$	603,510		$	(3,141,233	)	$	2,178,886

Condensed Consolidated Statements of Income

Condensed Consolidated Statements of Income

For the Year Ended December 31, 2013

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors			Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Revenues
Rent billed	$	—		$	—		$	124,651		$	20,028		$	(12,101	)	$	132,578
Straight-line rent		—			—			8,438			2,268			—			10,706
Income from direct financing leases		—			—			38,522			22,577			(20,269	)		40,830
Interest and fee income		—			21,797			38,696			29,834			(31,918	)		58,409

Total revenues		—			21,797			210,307			74,707			(64,288	)		242,523
Expenses
Real estate depreciation and amortization		—			—			35,277			1,701			—			36,978
Property-related		—			601			1,356			32,863			(32,370	)		2,450
Acquisition expenses		—			7,356			12,138			—			—			19,494
General and administrative		—			29,033			375			655			—			30,063

Total operating expenses		—			36,990			49,146			35,219			(32,370	)		88,985

Operating income		—			(15,193	)		161,161			39,488			(31,918	)		153,538
Other income (expense)
Interest and other (expense) income		—			(110	)		—			(209	)		—			(319	)
Earnings from equity and other interests		—			—			948			2,606			—			3,554
Interest expense		—			(67,484	)		(1,912	)		(29,268	)		31,918			(66,746	)
Income tax expense		—			—			(158	)		(568	)		—			(726	)

Net other expense		—			(67,594	)		(1,122	)		(27,439	)		31,918			(64,237	)

Income (loss) from continuing operations		—			(82,787	)		160,039			12,049			—			89,301
Income (loss) from discontinued operations		—			—			(4	)		7,918			—			7,914

Equity in earnings of consolidated subsidiaries net of income taxes		97,215			180,002			4,477			—			(281,694	)		—

Net income (loss)		97,215			97,215			164,512			19,967			(281,694	)		97,215
Net income (loss) attributable to non-controlling interests		(224	)		(224	)		—			—			224			(224	)

Net income attributable to MPT common stockholders	$	96,991		$	96,991		$	164,512		$	19,967		$	(281,470	)	$	96,991

Condensed Consolidated Statements of Income

For the Year Ended December 31, 2012

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors		Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Revenues
Rent billed	$	—		$	—		$	112,573	$	16,619		$	(9,309	)	$	119,883
Straight-line rent		—			—			6,429		1,482			—			7,911
Income from direct financing leases		—			—			19,870		18,090			(16,232	)		21,728
Interest and fee income		—			18,341			29,606		25,387			(24,731	)		48,603

Total revenues		—			18,341			168,478		61,578			(50,272	)		198,125
Expenses
Real estate depreciation and amortization		—			—			31,115		1,700			—			32,815
Property-related		—			495			816		25,707			(25,541	)		1,477
Acquisition expenses		—			5,420			—		—			—			5,420
General and administrative		—			26,018			—		2,544			—			28,562

Total operating expenses		—			31,933			31,931		29,951			(25,541	)		68,274

Operating income		—			(13,592	)		136,547		31,627			(24,731	)		129,851
Other income (expense)
Interest and other (expense) income		—			(69	)		—		(1,593	)		—			(1,662	)
Earnings from equity and other interests		—			—			1,061		1,882			—			2,943
Interest expense		—			(58,729	)		1,408		(25,653	)		24,731			(58,243	)
Income tax expense		—			—			—		(19	)		—			(19	)

Net other expense		—			(58,798	)		2,469		(25,383	)		24,731			(56,981	)

Income (loss) from continuing operations		—			(72,390	)		139,016		6,244			—			72,870
Income (loss) from discontinued operations		—			—			103		17,104			—			17,207

Equity in earnings of consolidated subsidiaries net of income taxes		90,077			162,467			4,481		—			(257,025	)		—

Net income (loss)		90,077			90,077			143,600		23,348			(257,025	)		90,077
Net income (loss) attributable to non-controlling interests		(177	)		(177	)		—		—			177			(177	)

Net income attributable to MPT common stockholders	$	89,900		$	89,900		$	143,600	$	23,348		$	(256,848	)	$	89,900

Condensed Consolidated Statements of Income

For the Year Ended December 31, 2011

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors			Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Revenues
Rent billed	$	—		$	—		$	99,494		$	9,286		$	(3,092	)	$	105,688
Straight-line rent		—			—			3,515			1,762			—			5,277
Interest and fee income		—			6,124			17,543			3,926			(6,236	)		21,357

Total revenues		—			6,124			120,552			14,974			(9,328	)		132,322
Expenses
Real estate depreciation and amortization		—			—			28,489			1,658			—			30,147
Property-related		—			217			458			3,141			(3,092	)		724
Acquisition expenses		—			3,713			—			471			—			4,184
General and administrative		17			23,914			—			3,160			—			27,091

Total operating expenses		17			27,844			28,947			8,430			(3,092	)		62,146

Operating income		(17	)		(21,720	)		91,605			6,544			(6,236	)		70,176
Other income (expense)
Interest and other (expense) income		—			26			2			(10	)		—			18
Earnings from equity and other interests		—			—			345			(267	)		—			78
Debt refinancing costs		—			(14,109	)		(105	)		—			—			(14,214	)
Interest expense		—			(43,063	)		139			(7,122	)		6,236			(43,810	)
Income tax expense		—			—			—			(128	)		—			(128	)

Net other expense		—			(57,146	)		381			(7,527	)		6,236			(58,056	)

Income (loss) from continuing operations		(17	)		(78,866	)		91,986			(983	)		—			12,120
Income (loss) from discontinued operations		—			—			(1,969	)		16,563			—			14,594

Equity in earnings of consolidated subsidiaries net of income taxes		26,731			105,597			4,578			—			(136,906	)		—

Net income		26,714			26,731			94,595			15,580			(136,906	)		26,714
Net income attributable to non-controlling interests		(178	)		(178	)		—			—			178			(178	)

Net income attributable to MPT common stockholders	$	26,536		$	26,553		$	94,595		$	15,580		$	(136,728	)	$	26,536

Condensed Consolidated Statements of Comprehensive Income (Loss)

Condensed Consolidated Statements of Comprehensive Income (Loss)

For the Year Ended December 31, 2013

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors		Non-Guarantor Subsidiaries		Eliminations			Total Consolidated
Net income	$	97,215		$	97,215		$	164,512	$	19,967	$	(281,694	)	$	97,215
Other comprehensive income (loss):
Unrealized gain (loss) on interest rate swap		3,474			3,474			—		—		(3,474	)		3,474
Foreign currency translation gain (loss)		67			67			—		—		(67	)		67

Total comprehensive income		100,756			100,756			164,512		19,967		(285,235	)		100,756
Comprehensive income attributable to non-controlling interests		(224	)		(224	)		—		—		224			(224	)

Comprehensive income attributable to MPT common stockholders	$	100,532		$	100,532		$	164,512	$	19,967	($	285,011	)	$	100,532

Condensed Consolidated Statements of Comprehensive Income (Loss)

For the Year Ended December 31, 2012

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors		Non-Guarantor Subsidiaries		Eliminations			Total Consolidated
Net income	$	90,077		$	90,077		$	143,600	$	23,348	$	(257,025	)	$	90,077
Other comprehensive income:
Unrealized loss on interest rate swap		(251	)		(251	)		—		—		251			(251	)

Total comprehensive income		89,826			89,826			143,600		23,348		(256,774	)		89,826
Comprehensive income attributable to non-controlling interests		(177	)		(177	)		—		—		177			(177	)

Comprehensive income attributable to MPT common stockholders	$	89,649		$	89,649		$	143,600	$	23,348	($	256,597	)	$	89,649

Condensed Consolidated Statements of Comprehensive Income (Loss)

For the Year Ended December 31, 2011

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors		Non-Guarantor Subsidiaries		Eliminations			Total Consolidated
Net income	$	26,714		$	26,731		$	94,595	$	15,580	$	(136,906	)	$	26,714
Other comprehensive income:
Unrealized loss on interest rate swap		(8,590	)		(8,590	)		—		—		8,590			(8,590	)

Total comprehensive income		18,124			18,141			94,595		15,580		(128,316	)		18,124
Comprehensive income attributable to non-controlling interests		(178	)		(178	)		—		—		178			(178	)

Comprehensive income attributable to MPT common stockholders	$	17,946		$	17,963		$	94,595	$	15,580	$	(128,138	)	$	17,946

Condensed Consolidated Statements of Cash Flows

Condensed Consolidated Statements of Cash Flows

For the Year Ended December 31, 2013

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors			Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Operating Activities
Net cash provided by (used in) operating activities	$	4		$	(53,846	)	$	196,883		$	(2,240	)	$	—		$	140,801
Investing Activities
Cash paid for acquisitions and other related investments		—			—			(619,092	)		(35,830	)		—			(654,922	)
Net proceeds from sales of real estate		—			—			—			32,409			—			32,409
Principal received on loans receivable		—			—			—			7,249			—			7,249
Investments in loans receivable		—			—			(1,100	)		(2,646	)		—			(3,746	)
Construction in progress and other		—			136			(94,737	)		1,034			—			(93,567	)

Net cash provided by (used in) investing activities		—			136			(714,929	)		2,216			—			(712,577	)

Financing Activities
Additions to term debt		—			424,580			—			—			—			424,580
Payments of term debt		—			(11,000	)		—			(249	)		—			(11,249	)
Revolving credit facilities, net		—			(20,000	)		—			—			—			(20,000	)
Distributions paid		(120,038	)		(120,309	)		—			—			120,038			(120,309	)
Lease deposits and other obligations to tenants		—			—			1,606			1,625			—			3,231
Net payments relating to intercompany financing		(193,297	)		(539,776	)		541,325			(1,545	)		193,293			—
Proceeds from sale of common shares, net of offering costs		313,331			313,331			—			—			(313,331	)		313,331
Debt issuance costs paid and other financing activities		—			(9,760	)		—			—			—			(9,760	)

Net cash provided by (used in) financing activities		(4	)		37,066			542,931			(169	)		—			579,824

Increase (decrease) in cash and cash equivalents for period		—			(16,644	)		24,885			(193	)		—			8,048
Effect of exchange rate changes		—			(24	)		644			—			—			620
Cash and cash equivalents at beginning of period		—			35,483			1,565			263			—			37,311

Cash and cash equivalents at end of period	$	—		$	18,815		$	27,094		$	70		$	—		$	45,979

Condensed Consolidated Statements of Cash Flows

For the Year Ended December 31, 2012

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors			Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Operating Activities
Net cash provided by (used in) operating activities	$	57		$	(61,002	)	$	165,454		$	800		$	—		$	105,309

Investing Activities
Cash paid for acquisitions and other related investments		—			—			(420,500	)		(200,990	)		—			(621,490	)
Net proceeds from sales of real estate		—			—			—			71,202			—			71,202
Principal received on loans receivable		—			—			5,491			5,440			—			10,931
Investments in loans receivable		—			—			—			(1,293	)		—			(1,293	)
Construction in progress and other		—			(578	)		(66,467	)		(9,433	)		—			(76,478	)

Net cash provided by (used in) investing activities		—			(578	)		(481,476	)		(135,074	)		—			(617,128	)

Financing Activities
Additions to term debt		—			300,000			—			—			—			300,000
Payments of term debt		—			—			—			(232	)		—			(232	)
Revolving credit facilities, net		—			75,000			(39,600	)		—			—			35,400
Distributions paid		(103,684	)		(103,952	)		—			—			103,684			(103,952	)
Lease deposits and other obligations to tenants		—			—			(10,031	)		(1,405	)		—			(11,436	)
Net payments relating to intercompany financing		(129,421	)		(501,839	)		365,809			136,087			129,364			—
Proceeds from sale of common shares, net of offering costs		233,048			233,048			—			—			(233,048	)		233,048
Debt issuance costs paid and other financing activities		—			(6,424	)		—			—			—			(6,424	)

Net cash provided by (used in) financing activities		(57	)		(4,167	)		316,178			134,450			—			446,404

Increase (decrease) in cash and cash equivalents for period		—			(65,747	)		156			176			—			(65,415	)
Cash and cash equivalents at beginning of period		—			101,230			1,409			87			—			102,726

Cash and cash equivalents at end of period	$	—		$	35,483		$	1,565		$	263		$	—		$	37,311

Condensed Consolidated Statements of Cash Flows

For the Year Ended December 31, 2011

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors			Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Operating Activities
Net cash provided by (used in) operating activities	$	(209	)	$	(48,779	)	$	109,329		$	18,929		$	—		$	79,270
Investing Activities
Cash paid for acquisitions and other related investments		—			—			(241,626	)		(37,337	)		—			(278,963	)
Net proceeds from sales of real estate		—			—			—			41,130			—			41,130
Principal received on loans receivable		—			—			230			4,059			—			4,289
Investments in loans receivable		—			—			(230	)		(631	)		—			(861	)
Construction in progress and other		—			(6,466	)		(24,081	)		(669	)		—			(31,216	)

Net cash provided by (used in) investing activities		—			(6,466	)		(265,707	)		6,552			—			(265,621	)
Financing Activities
Additions to term debt		—			450,000			—			—			—			450,000
Payments of term debt		—			(237,666	)		(8,433	)		(163	)		—			(246,262	)
Revolving credit facilities, net		—			50,000			39,600			—			—			89,600
Distributions paid		(89,342	)		(89,601	)		—			—			89,342			(89,601	)
Lease deposits and other obligations to tenants		—			—			10,986			(2,365	)		—			8,621
Net payments relating to intercompany financing		89,551			(92,052	)		114,247			(22,404	)		(89,342	)		—
Debt issuance costs paid and other financing activities		—			(21,028	)		—			(661	)		—			(21,689	)

Net cash provided by (used in) financing activities		209			59,653			156,400			(25,593	)		—			190,669

Increase (decrease) in cash and cash equivalents for period		—			4,408			22			(112	)		—			4,318
Cash and cash equivalents at beginning of period		—			96,822			1,387			199			—			98,408

Cash and cash equivalents at end of period	$	—		$	101,230		$	1,409		$	87		$	—		$	102,726

Summary of Significant Accounting Policies - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2013 yr mo	Dec. 31, 2012	Dec. 31, 2011
Summary Of Significant Accounting Policies [Line Items]
Equity method investment, ownership percentage	100.00%
Expected lease-up periods for estimating lost rentals, in months \| mo	6
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 \| yr	4
Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Stock award vesting period in years, maximum	10 years
Time-Based Awards [Member]
Summary Of Significant Accounting Policies [Line Items]
Stock award vesting period in years, maximum	3 years
Market Conditions Based Awards [Member] \| Minimum [Member]
Summary Of Significant Accounting Policies [Line Items]
Stock award vesting period in years, maximum	3 years
Market Conditions Based Awards [Member] \| Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Stock award vesting period in years, maximum	5 years

Summary of Significant Accounting Policies - Carrying Value and Classification of Related Assets and Maximum Exposure to Loss (Detail) $ in Thousands	Dec. 31, 2013 USD ($)
Loans, net [Member]
Variable Interest Entity [Line Items]
Maximum Loss Exposure	$ 283,273
Equity investments [Member]
Variable Interest Entity [Line Items]
Maximum Loss Exposure	19,308
Mortgage and other loans [Member]
Variable Interest Entity [Line Items]
Carrying Amount	228,996
Other assets [Member]
Variable Interest Entity [Line Items]
Carrying Amount	$ 5,198

Summary of Significant Accounting Policies - Useful Lives of Related Real Estate and Other Assets (Detail)	12 Months Ended
	Dec. 31, 2013
Buildings and improvements [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	38 years 2 months 12 days
Tenant lease intangibles [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	18 years 7 months 6 days
Leasehold improvements [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	22 years 2 months 12 days
Furniture, equipment and other [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	9 years 4 months 24 days

Real Estate and Loans Receivable - Assets Acquired (Detail) - USD ($) $ in Thousands	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Significant Acquisitions and Disposals [Line Items]
Total assets acquired	$ 654,922	$ 621,490	$ 293,555
Total liabilities assumed			(14,592)
Net assets acquired	654,922	621,490	278,963
Land [Member]
Significant Acquisitions and Disposals [Line Items]
Total assets acquired	41,473	518	19,705
Building [Member]
Significant Acquisitions and Disposals [Line Items]
Total assets acquired	439,030	8,942	220,769
Intangible lease assets - subject to amortization [Member]
Significant Acquisitions and Disposals [Line Items]
Total assets acquired	38,589	1,040	20,630
Net investments in direct financing leases [Member]
Significant Acquisitions and Disposals [Line Items]
Total assets acquired	110,580	310,000
Mortgage loans [Member]
Significant Acquisitions and Disposals [Line Items]
Total assets acquired	20,000	200,000
Working capital and other loans [Member]
Significant Acquisitions and Disposals [Line Items]
Total assets acquired	$ 5,250	95,690	27,283
Equity investments [Member]
Significant Acquisitions and Disposals [Line Items]
Total assets acquired		$ 5,300	$ 5,168

Real Estate and Loans Receivable - Assets Acquired (Parenthetical) (Detail)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Intangible lease assets - subject to amortization [Member]
Significant Acquisitions and Disposals [Line Items]
Weighted average useful life of acquired intangible lease assets (in years)	21 years	15 years	13 years 10 months 24 days

Real Estate and Loans Receivable - 2013 Activity - Additional Information (Detail)
€ in Millions

12 Months Ended

Dec. 12, 2013

USD ($)

RenewalOptions

Nov. 29, 2013

USD ($)

Sep. 26, 2013

USD ($)

Contract

Facility

Jun. 11, 2013

USD ($)

RenewalOptions

Hospital

Dec. 31, 2013

USD ($)

Bed

Dec. 31, 2012

USD ($)

Dec. 31, 2011

USD ($)

Nov. 29, 2013

EUR (€)

Jul. 18, 2013

USD ($)

Jun. 13, 2012

Bed

May 04, 2012

Bed

Dec. 31, 2010

USD ($)

Significant Acquisitions and Disposals [Line Items]

Real estate assets gross

$ 1,733,194,000

$ 1,189,552,000

^[1]

$ 1,191,096,000

^[2]

$ 990,635,000

Improvement costs

1,578,336,000

1,052,479,000

Mortgage financing

20,000,000

203,650,000

Number of beds | Bed

Income contributed by the acquired entity

133,258,000

135,402,000

Acquisition related costs

19,494,000

$ 5,420,000

$ 4,184,000

Ernest [Member]

Significant Acquisitions and Disposals [Line Items]

Number of beds | Bed

Non U S [Member]

Significant Acquisitions and Disposals [Line Items]

Real estate assets gross

240,500,000

Revenue from real estate assets

1,800,000

2013 Activity [Member]

Significant Acquisitions and Disposals [Line Items]

Mortgage financing

$ 20,000,000

2013 Activity [Member] | Corpus Christi Rehabilitation Hospital [Member]

Significant Acquisitions and Disposals [Line Items]

2013 Activity [Member] | Corpus Christi Rehabilitation Hospital [Member] | Commitment [Member]

$ 10,500,000

Significant Acquisitions and Disposals [Line Items]

2013 Activity [Member] | Ernest [Member]

$ 500,000

Significant Acquisitions and Disposals [Line Items]

Term of lease extensions, Years

20 years

5 years

Loan on property

$ 5.3

2013 Activity [Member] | RHM Portfolio Acquisition [Member]

Significant Acquisitions and Disposals [Line Items]

Applicable transfer taxes on purchase price | €

$ 237,800,000

€ 175.0

€ 9.0

Cumulative increases in the German consumer price index

27 years

70.00%

2013 Activity [Member] | Dallas Medical Center [Member]

Significant Acquisitions and Disposals [Line Items]

Purchase price of real estate

10 years

$ 25,000,000

Number of lease extensions options in current lease contract | RenewalOptions

Term of lease extensions, Years

5 years

2013 Activity [Member] | Kansas [Member]

Significant Acquisitions and Disposals [Line Items]

$ 75,000,000

Number of lease extensions options in current lease contract | RenewalOptions

10 years

Term of lease extensions, Years

5 years

Number of facilities acquired | Hospital

2013 Activity [Member] | Minimum [Member] | Ernest [Member]

2.00%

Significant Acquisitions and Disposals [Line Items]

2013 Activity [Member] | Maximum [Member] | Ernest [Member]

2.00%

Significant Acquisitions and Disposals [Line Items]

2013 Activity [Member] | From 2015 through 2017 [Member] | RHM Portfolio Acquisition [Member]

5.00%

Significant Acquisitions and Disposals [Line Items]

Rent escalations percentage

2.00%

2013 Activity [Member] | After 2017 [Member] | RHM Portfolio Acquisition [Member]

Significant Acquisitions and Disposals [Line Items]

Rent escalations percentage

0.50%

2013 Activity [Member] | Acute Care Iasis Hospital [Member]

Significant Acquisitions and Disposals [Line Items]

Number of lease extensions options in current lease contract | Contract

$ 281,300,000

Number of facilities acquired | Facility

Improvement costs

$ 2,000,000

Initial leaseback term

15 years

Lease renewal option

5 years

Lease maturity year

2019

Extended lease maturity year

2028

2013 Activity [Member] | Acute Care Iasis Hospital [Member] | Maximum [Member]

Significant Acquisitions and Disposals [Line Items]

2013 Activity [Member] | Business Acquisitions [Member]

2.50%

Significant Acquisitions and Disposals [Line Items]

Revenue contributed by the acquired entity

$ 13,600,000

Income contributed by the acquired entity

10,600,000

Acquisition related costs

19,500,000

$ 18,000,000

2013 Activity [Member] | Olympia Medical Center [Member]

Significant Acquisitions and Disposals [Line Items]

Number of beds | Bed

204

[1]	Includes real estate cost included in real estate held for sale of $28,617 at December 31, 2012. Excludes intangible lease assets that are included in real estate held for sale of $858 for 2012.
[2]	Includes real estate cost included in real estate held for sale of $96,766 at December 31, 2011. Excludes intangible lease assets that are included in real estate held for sale of $3,012 for 2011.

Real Estate and Loans Receivable - 2012 Activity - Additional Information (Detail) $ in Thousands				12 Months Ended
	Dec. 14, 2012 USD ($) Bed Contract	Sep. 19, 2012 USD ($) Bed	Jul. 03, 2012 USD ($) Property	Dec. 31, 2013 USD ($) Contract State Facility	Dec. 31, 2012 USD ($)	Dec. 31, 2011 USD ($)	Feb. 29, 2012 USD ($)
Significant Acquisitions and Disposals [Line Items]
New mortgage loan funded
Ownership interest in equity				100.00%
Income contributed by the acquired entity				$ 133,258	$ 135,402
Acquisition related costs				19,494	5,420	$ 4,184
2012 Activity [Member]
Significant Acquisitions and Disposals [Line Items]
Aggregate purchase price				$ 200,000
Term of lease, years				20 years
Number of lease extension options in current lease contract \| Contract				3
Term of lease extension, years				5 years
Percentage of rental rate				9.00%
Loan secured by mortgage interest				$ 100,000
2012 Activity [Member] \| Maximum [Member] \| Ceiling [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of rental rate				5.00%
2012 Activity [Member] \| Minimum [Member] \| Floor Rate [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of rental rate				2.00%
2012 Activity [Member] \| Rehabilitation Hospital [Member]
Significant Acquisitions and Disposals [Line Items]
Number of facilities acquired \| Facility				5
2012 Activity [Member] \| Business Acquisitions [Member]
Significant Acquisitions and Disposals [Line Items]
Revenue contributed by the acquired entity					46,300
Income contributed by the acquired entity					46,100
Acquisition related costs					5,400
Acquisition-related costs on consummated deals					$ 5,100
2012 Activity [Member] \| Ernest [Member]
Significant Acquisitions and Disposals [Line Items]
Combined purchase price and investment amount							$ 396,500
Total investment				$ 96,500
Acquisition loan made				$ 93,200
Preferential rate of return on loan amount				15.00%
Coupon payable in cash in, thereafter				10.00%
Agreement terms				Although there are provisions in the loan agreement that are expected to result in full payment of the 15% preference when funds are sufficient. Any of the 15% in excess of the minimum that is not paid may be accrued and paid upon the occurrence of a capital or liquidity event and is payable at maturity. The loan may be prepaid without penalty at any time.
2012 Activity [Member] \| Ernest [Member] \| Key Management Personnel [Member]
Significant Acquisitions and Disposals [Line Items]
Capital contribution				$ 3,300
2012 Activity [Member] \| Ernest [Member] \| Minimum [Member]
Significant Acquisitions and Disposals [Line Items]
Coupon payable in cash, year one				6.00%
Coupon payable in cash, year two				7.00%
2012 Activity [Member] \| Acute Care Facility [Member]
Significant Acquisitions and Disposals [Line Items]
Number of facilities acquired \| Facility				7
Number of states \| State				7
Term of lease, years	15 years
Number of lease extension options in current lease contract \| Contract	3
Term of lease extension, years	5 years
Number of beds acquired \| Bed	40
Business acquisition cost of acquired entity	$ 10,500
Payments to acquire equity method investments	$ 2,000
Ownership interest in equity	25.00%
Working capital loan to the joint venture	$ 2,500
Date of properties acquired	Dec. 14, 2012
2012 Activity [Member] \| Acute Care Facility [Member] \| Maximum [Member]
Significant Acquisitions and Disposals [Line Items]
Revolving loan	$ 2,000
2012 Activity [Member] \| Prime Health Care Services [Member]
Significant Acquisitions and Disposals [Line Items]
Number of beds at Centinela Hospital Medical Center used to secure loan \| Property			369
Maturity of mortgage loan			Dec. 31, 2022
2012 Activity [Member] \| Prime Health Care Services [Member] \| Loans, net [Member]
Significant Acquisitions and Disposals [Line Items]
New mortgage loan funded			$ 100,000
2012 Activity [Member] \| St. Mary's Regional Medical Center [Member] \| Series of Individually Immaterial Business Acquisitions [Member]
Significant Acquisitions and Disposals [Line Items]
Number of beds acquired \| Bed		380
Business acquisition cost of acquired entity		$ 80,000
2012 Activity [Member] \| Roxborough Memorial Hospital [Member] \| Series of Individually Immaterial Business Acquisitions [Member]
Significant Acquisitions and Disposals [Line Items]
Number of beds acquired \| Bed		140
Business acquisition cost of acquired entity		$ 30,000

Real Estate and Loans Receivable - 2011 Activity - Additional Information (Detail) $ in Thousands										12 Months Ended
	Nov. 04, 2011 USD ($) Bed	Oct. 14, 2011 USD ($) Hospital	Sep. 30, 2011 USD ($) Bed	Jul. 18, 2011 USD ($) Bed	Feb. 14, 2011 USD ($) Bed	Feb. 09, 2011 USD ($) Bed	Feb. 04, 2011 USD ($) Bed	Jan. 31, 2011 USD ($) Bed Contract	Jan. 04, 2011 USD ($) Bed yr	Dec. 31, 2013 USD ($) Contract Property	Dec. 31, 2012 USD ($)	Dec. 31, 2011 USD ($)	Dec. 31, 2010 USD ($)
Significant Acquisitions and Disposals [Line Items]
Ownership interest in equity										100.00%
Existing mortgage loan										$ 368,650	$ 368,650	$ 165,000	$ 165,000
Income contributed by the acquired entity										133,258	135,402
Acquisition related cost										$ 19,494	5,420	4,184
2011 Activity [Member] \| Hoboken, NJ [Member]
Significant Acquisitions and Disposals [Line Items]
Number of beds acquired \| Bed	350
Number of lease extension options in current lease contract \| Contract										6
Term of lease extension, years										5 years
Ownership interest in equity	100.00%
Term of lease, years										15 years
Business acquisition cost of acquired entity	$ 75,000
Business acquisition cost of acquired entity	50,000
Working capital loan outstanding											15,100
Funding of convertible note	$ 5,000
Option to acquire percentage of hospital operator	25.00%
2011 Activity [Member] \| Maximum [Member] \| Hoboken, NJ [Member]
Significant Acquisitions and Disposals [Line Items]
Working capital loan to the joint venture	$ 20,000
2011 Activity [Member] \| Vibra Specialty Hospital [Member]
Significant Acquisitions and Disposals [Line Items]
Number of beds acquired \| Bed				40
Business acquisition cost of acquired entity				$ 13,000
Date of properties acquired										Jul. 18, 2011
Number of lease extension options in current lease contract										3
Payments to acquire equity method investments				$ 2,500
Ownership interest in equity				25.00%
Term of lease, years										15 years
2011 Activity [Member] \| Vibra Specialty Hospital [Member] \| Maximum [Member]
Significant Acquisitions and Disposals [Line Items]
Term of lease extension, years										5 years
2011 Activity [Member] \| Acute Care Facility [Member]
Significant Acquisitions and Disposals [Line Items]
Number of beds acquired \| Bed			40
Date of properties acquired										Sep. 30, 2011
Number of lease extension options in current lease contract \| Contract										3
Term of lease extension, years										5 years
Payments to acquire equity method investments			$ 1,400
Ownership interest in equity			25.00%
Working capital loan to the joint venture			$ 2,000
Term of lease, years										15 years
Business acquisition cost of acquired entity			$ 10,000
2011 Activity [Member] \| Acute Care Hospitals [Member]
Significant Acquisitions and Disposals [Line Items]
Number of lease extension options in current lease contract \| Contract										3
Term of lease extension, years										5 years
Term of lease, years										15 years
Business acquisition cost of acquired entity		$ 30,000
Number of leased hospital \| Hospital		3
2011 Activity [Member] \| Acute Care Hospitals [Member] \| Minimum [Member]
Significant Acquisitions and Disposals [Line Items]
Rent escalations percentage										1.00%
2011 Activity [Member] \| Acute Care Hospitals [Member] \| Maximum [Member]
Significant Acquisitions and Disposals [Line Items]
Rent escalations percentage										3.00%
Agreement entry date										Oct. 14, 2011
2011 Activity [Member] \| Series of Individually Immaterial Business Acquisitions [Member]
Significant Acquisitions and Disposals [Line Items]
Ownership interest in equity								51.00%
Working capital loan to the joint venture								$ 5,200
Retained ownership in operating entity								49.00%
2011 Activity [Member] \| Series of Individually Immaterial Business Acquisitions [Member] \| Gilbert Hospital [Member]
Significant Acquisitions and Disposals [Line Items]
Number of beds acquired \| Bed									19
Age of real estate acquired \| yr									4
Business acquisition cost of acquired entity									$ 17,100
Date of properties acquired										Jan. 04, 2011
Lease expiration date									2022-05
Number of lease extension options in current lease contract										3
Term of lease extension, years										5 years
Rent escalations percentage										2.50%
2011 Activity [Member] \| Series of Individually Immaterial Business Acquisitions [Member] \| Atrium Medical Center [Member]
Significant Acquisitions and Disposals [Line Items]
Number of beds acquired \| Bed								60
Business acquisition cost of acquired entity								$ 23,500
Date of properties acquired								Jan. 31, 2011
Lease expiration date								2024-06
Number of lease extension options in current lease contract \| Contract								2
Term of lease extension, years								10 years
Date of construction								2009
2011 Activity [Member] \| Series of Individually Immaterial Business Acquisitions [Member] \| Atrium Medical Center [Member] \| Minimum [Member]
Significant Acquisitions and Disposals [Line Items]
Rent escalations percentage								1.00%
2011 Activity [Member] \| Series of Individually Immaterial Business Acquisitions [Member] \| Atrium Medical Center [Member] \| Maximum [Member]
Significant Acquisitions and Disposals [Line Items]
Rent escalations percentage								5.00%
2011 Activity [Member] \| Series of Individually Immaterial Business Acquisitions [Member] \| Vibra [Member]
Significant Acquisitions and Disposals [Line Items]
Payments to acquire equity method investments								$ 1,300
Ownership interest in equity								19.00%
2011 Activity [Member] \| Series of Individually Immaterial Business Acquisitions [Member] \| Bayonne Medical Center [Member]
Significant Acquisitions and Disposals [Line Items]
Number of beds acquired \| Bed							278
Business acquisition cost of acquired entity							$ 58,000
Date of properties acquired										Feb. 04, 2011
Number of lease extension options in current lease contract							6
Term of lease extension, years										5 years
Term of lease, years										15 years
Number of stories in building \| Property										6
2011 Activity [Member] \| Series of Individually Immaterial Business Acquisitions [Member] \| Alvarado Hospital [Member]
Significant Acquisitions and Disposals [Line Items]
Number of beds acquired \| Bed						306
Business acquisition cost of acquired entity						$ 70,000
Date of properties acquired										Feb. 09, 2011
2011 Activity [Member] \| Series of Individually Immaterial Business Acquisitions [Member] \| Northland Ltach Hospital [Member]
Significant Acquisitions and Disposals [Line Items]
Number of beds acquired \| Bed					35
Business acquisition cost of acquired entity					$ 19,500
Date of properties acquired										Feb. 14, 2011
Number of lease extension options in current lease contract										3
Term of lease extension, years										5 years
Rent escalations percentage										2.75%
Lease expiration year					2028
Construction completion date					2008-04
Existing mortgage loan										$ 15,000
Mortgage loan, maturity date										2018-01
2011 Activity [Member] \| Business Acquisitions [Member] \| Hoboken, NJ [Member]
Significant Acquisitions and Disposals [Line Items]
Revenue contributed by the acquired entity											21,200
Income contributed by the acquired entity											14,100
Acquisition related cost										$ 18,000	5,100	$ 4,200
Acquisition-related costs on consummated deals											$ 1,900

Real Estate and Loans Receivable - Supplemental Pro Forma Earnings Adjusted to Exclude Acquisition-Related Costs (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012
Business Combinations [Abstract]
Total revenues	$ 288,159	$ 280,539
Net income	$ 133,258	$ 135,402
Net income per share/unit	$ 0.82	$ 0.85

Real Estate and Loans Receivable - Development Activities - Additional Information (Detail) $ in Millions					9 Months Ended	12 Months Ended
	May 20, 2013 USD ($)	Mar. 04, 2013 USD ($)	Dec. 20, 2012 USD ($)	Oct. 02, 2012 USD ($)	Jun. 11, 2013 USD ($) Room	Dec. 31, 2013 USD ($)	Jun. 13, 2012 USD ($) Bed	May 04, 2012 Bed	Mar. 02, 2012 USD ($)
Significant Acquisitions and Disposals [Line Items]
Number of beds \| Bed								26
Cost of land and building						$ 9.4
Florence, AZ [Member]
Significant Acquisitions and Disposals [Line Items]
Cost of land and building									$ 30.0
Lease agreement									25 years
Location Various [Member]
Significant Acquisitions and Disposals [Line Items]
Estimated total development cost			$ 33.5
Ernest [Member]
Significant Acquisitions and Disposals [Line Items]
Total development cost on inpatient rehabiliation hospital				$ 16.9
Number of beds \| Bed							40
Cost of land and building							$ 15.7
Development Activities [Member]
Significant Acquisitions and Disposals [Line Items]
Estimated total development cost, funded						$ 9.1
Development Activities [Member] \| Twelve Oaks Facility [Member]
Significant Acquisitions and Disposals [Line Items]
Lease agreement						15 years
Facility partially occupied date						Jan. 23, 2013
Percentage of facility partially occupied						55.00%
Development Activities [Member] \| First Choice [Member]
Significant Acquisitions and Disposals [Line Items]
Number of freestanding emergency room facility \| Room					25
Estimated total development cost, funded					$ 100.0
Development Activities [Member] \| Location Houston, TX [Member]
Significant Acquisitions and Disposals [Line Items]
Estimated total development cost						$ 37.8
Development Activities [Member] \| Emergency Room Facility One [Member]
Significant Acquisitions and Disposals [Line Items]
Expected facility completion date						Fourth quarter of 2013
Development Activities [Member] \| Emergency Room Facility Two [Member]
Significant Acquisitions and Disposals [Line Items]
Expected facility completion date						2014
Development Activities [Member] \| Rehabilitation Facility in South Ogden [Member]
Significant Acquisitions and Disposals [Line Items]
Estimated total development cost, funded						$ 16.4
Estimated total development cost	$ 19.2
Expected facility completion date						Second quarter of 2014
Development Activities [Member] \| Rehabilitation Facility in Post Falls, Idaho [Member]
Significant Acquisitions and Disposals [Line Items]
Estimated total development cost		$ 14.4

Real Estate and Loans Receivable - Summary of Status Update on Current Development Projects (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2013 USD ($)
Business Acquisition [Line Items]
Original Commitment	$ 147,453
Costs Incurred as of December 31, 2013	41,771
Property First Choice ER- Nacogdoches [Member] \| Location San Antonio, TX [Member] \| Property Type Acute Care Hospital [Member] \| Operator First Choice ER, LLC [Member]
Business Acquisition [Line Items]
Original Commitment	5,100
Costs Incurred as of December 31, 2013	$ 2,681
Estimated Completion Date	1Q 2014
Property First Choice ER - Brodie [Member] \| Location Austin, TX [Member] \| Property Type Acute Care Hospital [Member] \| Operator First Choice ER, LLC [Member]
Business Acquisition [Line Items]
Original Commitment	$ 5,470
Costs Incurred as of December 31, 2013	$ 1,950
Estimated Completion Date	2Q 2014
Property First Choice ER- Alvin [Member] \| Location Houston, TX [Member] \| Property Type Acute Care Hospital [Member] \| Operator First Choice ER, LLC [Member]
Business Acquisition [Line Items]
Original Commitment	$ 5,240
Costs Incurred as of December 31, 2013	$ 1,328
Estimated Completion Date	2Q 2014
Property Northern Utah Rehabilitation Hospital [Member] \| Location South Ogden, UT [Member] \| Property Type Inpatient Rehabilitation Hospital [Member] \| Operator Ernest Health, Inc. [Member]
Business Acquisition [Line Items]
Original Commitment	$ 19,153
Costs Incurred as of December 31, 2013	$ 16,391
Estimated Completion Date	2Q 2014
Property First Choice ER- Briar Forest [Member] \| Location Houston, TX [Member] \| Property Type Acute Care Hospital [Member] \| Operator First Choice ER, LLC [Member]
Business Acquisition [Line Items]
Original Commitment	$ 5,833
Costs Incurred as of December 31, 2013	$ 1,386
Estimated Completion Date	3Q 2014
Property First Choice ER- Cedar Hill [Member] \| Location Cedar Hill, TX [Member] \| Property Type Acute Care Hospital [Member] \| Operator First Choice ER, LLC [Member]
Business Acquisition [Line Items]
Original Commitment	$ 5,768
Costs Incurred as of December 31, 2013	$ 1,167
Estimated Completion Date	3Q 2014
Property First Choice ER- Firestone [Member] \| Location Firestone, CO [Member] \| Property Type Acute Care Hospital [Member] \| Operator First Choice ER, LLC [Member]
Business Acquisition [Line Items]
Original Commitment	$ 5,172
Costs Incurred as of December 31, 2013	$ 544
Estimated Completion Date	3Q 2014
Property Oakleaf Surgical Hospital [Member] \| LocationAltoona, WI [Member] \| Property Type Acute Care Hospital [Member] \| Operator National Surgical Hospitals [Member]
Business Acquisition [Line Items]
Original Commitment	$ 33,500
Costs Incurred as of December 31, 2013	$ 16,324
Estimated Completion Date	3Q 2014
Property First Choice Emergency Rooms [Member] \| Location Various [Member] \| Property Type Acute Care Hospital [Member] \| Operator First Choice [Member]
Business Acquisition [Line Items]
Original Commitment	$ 62,217
Costs Incurred as of December 31, 2013
Estimated Completion Date	Various

Real Estate and Loans Receivable - Disposals - Additional Information (Detail) - USD ($) $ in Thousands									3 Months Ended		12 Months Ended
	Nov. 27, 2013	Apr. 17, 2013	Dec. 27, 2012	Oct. 22, 2012	Sep. 28, 2012	Aug. 21, 2012	Jun. 15, 2012	Dec. 30, 2011	Dec. 31, 2012	Sep. 30, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Significant Acquisitions and Disposals [Line Items]
Proceeds from sale of real estate											$ 32,409	$ 71,202	$ 41,130
Disposals [Member]
Significant Acquisitions and Disposals [Line Items]
Proceeds from sale of real estate										$ 42,000
Disposals [Member] \| Huntington [Member]
Significant Acquisitions and Disposals [Line Items]
Proceeds from sale of real estate			$ 12,500
Gain (loss) on sale of real estate			1,900
Straight-line rent write-off			$ 700
Disposals [Member] \| Thornton [Member]
Significant Acquisitions and Disposals [Line Items]
Gain (loss) on sale of real estate					$ 8,400
Straight-line rent write-off					$ 1,600
Disposals [Member] \| New Bedford [Member]
Significant Acquisitions and Disposals [Line Items]
Gain (loss) on sale of real estate				$ 7,200
Straight-line rent write-off									$ 4,100
Disposals [Member] \| Denham Springs LTACH [Member]
Significant Acquisitions and Disposals [Line Items]
Proceeds from sale of real estate						$ 5,200
Gain (loss) on sale of real estate						$ 300
Disposals [Member] \| HealthSouth Rehabilitation Hospital of Fayetteville [Member]
Significant Acquisitions and Disposals [Line Items]
Proceeds from sale of real estate							$ 16,000
Gain (loss) on sale of real estate							$ (1,400)
Disposals [Member] \| Mountain View Regional Rehabilitation Hospital [Member]
Significant Acquisitions and Disposals [Line Items]
Proceeds from sale of real estate													21,100
Gain (loss) on sale of real estate													$ 2,300
Disposals [Member] \| Sherman Oaks Hospital [Member]
Significant Acquisitions and Disposals [Line Items]
Proceeds from sale of real estate								$ 20,000
Gain (loss) on sale of real estate								3,100
Straight-line rent write-off								$ 1,200
Disposals [Member] \| San Antonio, TX [Member]
Significant Acquisitions and Disposals [Line Items]
Proceeds from sale of real estate	$ 14,000
Gain (loss) on sale of real estate	$ 5,600
Disposals [Member] \| Summit Hospital of Southeast Arizona and Summit Hospital of Southeast Texas [Member]
Significant Acquisitions and Disposals [Line Items]
Proceeds from sale of real estate		$ 18,500
Gain (loss) on sale of real estate		$ 2,100

Real Estate and Loans Receivable - Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Significant Acquisitions and Disposals [Line Items]
Intangible lease assets	$ 90,490	$ 51,966
Intangible Assets [Member]
Significant Acquisitions and Disposals [Line Items]
Intangible lease assets	90,500	52,000
Accumulated amortization, net	75,000	40,100
Amortization expense related to intangible lease assets	$ 4,000	$ 3,900	$ 5,200
Capitalized lease intangibles, weighted average life (in years)	18 years 7 months 6 days

Real Estate and Loans Receivable - Amortization Expense from Existing Lease Intangible Assets (Detail) $ in Thousands	Dec. 31, 2013 USD ($)
Business Combinations [Abstract]
2014	$ 5,086
2015	4,896
2016	4,855
2017	4,845
2018	$ 4,784

Real Estate and Loans Receivable - Components of Net Investment in Direct Financing Leases (Detail) - USD ($) $ in Thousands	Dec. 31, 2013	Dec. 31, 2012
Business Combinations [Abstract]
Minimum lease payments receivable	$ 1,647,567
Estimated residual values	211,863
Less unearned income	(1,428,406)
Net investment in direct financing leases	$ 431,024	$ 314,412

Real Estate and Loans Receivable - Minimum Rental Payments Due in Future Period under Operating Leases and Direct Finance Leases which have Non-Cancelable Terms (Detail) $ in Thousands	Dec. 31, 2013 USD ($)
Leases User Charges And Commitments [Line Items]
2014	$ 2,471
2015	2,644
2016	2,659
2017	2,620
2018	2,614
Thereafter	37,213
Minimum rental payments, total	50,221
Minimum Rental Payments [Member]
Leases User Charges And Commitments [Line Items]
2014	209,137
2015	208,140
2016	209,771
2017	210,557
2018	211,720
Thereafter	2,138,740
Minimum rental payments, total	3,188,065
Minimum Rental Payments [Member] \| Operating Leases [Member]
Leases User Charges And Commitments [Line Items]
2014	166,602
2015	164,754
2016	165,517
2017	165,418
2018	165,679
Thereafter	1,536,759
Minimum rental payments, total	2,364,729
Minimum Rental Payments [Member] \| Direct Financing Leases [Member]
Leases User Charges And Commitments [Line Items]
2014	42,535
2015	43,386
2016	44,254
2017	45,139
2018	46,041
Thereafter	601,981
Minimum rental payments, total	$ 823,336

Real Estate and Loans Receivable - Leasing Operations - Additional Information (Detail) - Leasing Operations [Member] - USD ($) $ in Millions		3 Months Ended	12 Months Ended
	Jul. 03, 2012	Dec. 31, 2011	Dec. 31, 2013
Prime Health Care Services [Member]
Significant Acquisitions and Disposals [Line Items]
Master lease term			10 years
Master lease agreements, number of renewal options	2
Master lease, optional lease term			5 years
Lease escalation percentage	100.00%
LTACH Facility [Member]
Significant Acquisitions and Disposals [Line Items]
Wrote off in related straight-line rent receivables		$ 1.3
Amortization expense related to intangible lease assets		$ 0.6

Real Estate and Loans Receivable - Monroe Facility - Additional Information (Detail) - USD ($) $ in Thousands	1 Months Ended	12 Months Ended
	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2010	Dec. 31, 2012	Dec. 31, 2011
Significant Acquisitions and Disposals [Line Items]
Existing mortgage loan		$ 368,650	$ 165,000	$ 368,650	$ 165,000
Olympia Medical Center [Member]
Significant Acquisitions and Disposals [Line Items]
Existing mortgage loan		$ 20,000
Monroe Facility [Member]
Significant Acquisitions and Disposals [Line Items]
Amount of convertible note converted into equity interest	$ 1,600
Convertible note	$ 5,000
Percentage of equity shares from convertible debt	9.90%	15.10%
Remaining convertible debt after conversion of part of debt		$ 3,400
Monroe Facility [Member] \| Scenario, Forecast [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of equity shares from convertible debt		15.10%
Monroe Facility [Member] \| Ernest Transaction and Other Acquisitions [Member]
Significant Acquisitions and Disposals [Line Items]
Existing mortgage loan		$ 98,000
Working capital loan outstanding		19,100
Monroe Facility [Member] \| Monroe Hospital [Member]
Significant Acquisitions and Disposals [Line Items]
Lease advance		31,100
Operating leases rent, interest and other charges outstanding		21,000
Advanced amount of working capital loan agreement		1,200
Interest receivables		$ 6,000
Impairment of working capital loan recognized			12,000
Straight line rent receivables write-off			$ 2,500
Number of days past due		90 days
Net investment to maximum exposure		$ 40,300
Impairment of working capital loan estimation-patient receivables considered for first priority secured interest		4,000
Impairment of working capital loan estimation-cash balance considered for first priority secured interest		$ 100

Real Estate and Loans Receivable - Florence Facility - Additional Information (Detail) - Florence acute care facility - USD ($) $ in Millions	Dec. 31, 2013	Mar. 06, 2013
Significant Acquisitions and Disposals [Line Items]
Business acquisition cost of acquired entity		$ 29.4
Rent receivables	$ 0.8
Letter of Credit
Significant Acquisitions and Disposals [Line Items]
Letter of credit outstanding	$ 1.2

Real Estate and Loans Receivable - Gilbert Facility - Additional Information (Detail) - Gilbert, AZ [Member] $ in Millions	Dec. 31, 2013 USD ($)
Significant Acquisitions and Disposals [Line Items]
Business acquisition cost of acquired entity	$ 17.1
Rent receivables	$ 0.9

Real Estate and Loans Receivable - Summary of Loans (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012
Loans [Line Items]
Loans, Balance	$ 549,640	$ 527,893
Mortgage loans [Member]
Loans [Line Items]
Loans, Balance	$ 388,650	$ 368,650
Loans, Weighted Average Interest Rate	10.20%	10.00%
Acquisition loans [Member]
Loans [Line Items]
Loans, Balance	$ 103,266	$ 98,433
Loans, Weighted Average Interest Rate	14.50%	14.70%
Working capital and other loans [Member]
Loans [Line Items]
Loans, Balance	$ 57,724	$ 60,810
Loans, Weighted Average Interest Rate	10.90%	10.80%

Real Estate and Loans Receivable - Concentration of Credit Risks and Related Party Transactions - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Concentration of Credit Risks [Member]
Significant Acquisitions and Disposals [Line Items]
Maximum percentage of entity's total assets invested on single property	4.00%
Concentration of Credit Risks [Member] \| California [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of total assets accounted	24.00%
Percentage of gross assets accounted	18.70%
Concentration of Credit Risks [Member] \| Texas[Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of total assets accounted	23.60%
Percentage of gross assets accounted	22.70%
Concentration of Credit Risks [Member] \| Minimum [Member] \| European
Significant Acquisitions and Disposals [Line Items]
Percentage of total assets accounted	9.00%
Concentration of Credit Risks [Member] \| Prime Health Care Services [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of entity revenue from affiliates	32.00%	27.30%
Percentage of total assets accounted	24.50%	27.90%
Concentration of Credit Risks [Member] \| Ernest [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of entity revenue from affiliates	20.20%	18.60%
Percentage of total assets accounted	15.90%	18.20%
Related Party Transactions [Member]
Significant Acquisitions and Disposals [Line Items]
Lease and interest revenue earned from tenants	$ 70.0	$ 54.3	$ 5.5

Debt - Summary of Debt (Detail) - USD ($) $ in Thousands	12 Months Ended
Debt - Summary of Debt (Detail) - USD ($) $ in Thousands	Dec. 31, 2013	Dec. 31, 2012	Oct. 10, 2013	Aug. 20, 2013	Feb. 17, 2012	Jul. 30, 2011	Apr. 26, 2011
Debt Instrument [Line Items]
Debt	$ 1,421,681	$ 1,025,160
Revolving credit facilities [Member]
Debt Instrument [Line Items]
Interest rate	Variable	Variable
Principal amount	$ 105,000	$ 125,000
2006 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Interest rate	Various	Various
Unsecured senior notes, interest rate						7.871%
Principal amount	$ 125,000	$ 125,000
2011 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Unsecured senior notes, interest rate	6.875%	6.875%					6.875%
Principal amount	$ 450,000	$ 450,000					$ 450,000
2012 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Unsecured senior notes, interest rate	6.375%	6.375%		6.375%	6.375%
Principal amount	$ 350,000	$ 200,000
Unamortized discount	2,873
Debt instrument, net	352,873	$ 200,000
Exchangeable senior notes [Member]
Debt Instrument [Line Items]
Unsecured senior notes, interest rate		9.25%
Principal amount		$ 11,000
Unamortized discount		(37)
Debt instrument, net		$ 10,963
2013 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Debt instrument, net	$ 274,860
Term loans [Member]
Debt Instrument [Line Items]
Interest rate	Various	Various
Unsecured senior notes, interest rate		6.20%
Principal amount		$ 13,900
Debt instrument, net	$ 113,948	$ 114,197
2013 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Unsecured senior notes, interest rate	5.75%		5.75%

Debt - Principal Payments Due for Debt (Detail) $ in Thousands	Dec. 31, 2013 USD ($)
Debt Disclosure [Abstract]
2014	$ 265
2015	105,283
2016	225,299
2017	320
2018	12,781
Thereafter	1,074,860
Total	$ 1,418,808

Debt - 2013 Senior Unsecured Notes - Additional Information (Detail) - 2013 Senior Unsecured Notes [Member] € in Millions, $ in Millions	Oct. 10, 2013 USD ($)	Dec. 31, 2013	Oct. 10, 2013 EUR (€)
Debt Instrument [Line Items]
Unsecured senior notes, value of offering	$ 274.9		€ 200.0
Unsecured senior notes, interest rate	5.75%	5.75%	5.75%
Debt instrument, maturity date	Oct. 01, 2020
Senior notes frequency of periodic payment	Semi-annually
Senior notes, earliest redemption date	Oct. 01, 2016
Senior notes, repurchase price percentage on principal amount plus accrued and unpaid interest	101.00%

Debt - Additional Information (Detail) € in Millions, $ in Millions		1 Months Ended		12 Months Ended
	Mar. 09, 2012 USD ($)	Mar. 09, 2012 USD ($)	Feb. 17, 2012 USD ($)	Dec. 31, 2013 USD ($)	Dec. 31, 2012 USD ($)	Dec. 31, 2011 USD ($)	Dec. 31, 2013 EUR (€)
Debt Instrument [Line Items]
Hedge ineffectiveness and income statement effect in period				$ 0.0	$ 0.0	$ 0.0
Other assets, collateral				5.0	$ 6.6
Senior Notes 6.375% Due 2022 [Member]
Debt Instrument [Line Items]
Unsecured senior notes, value of offering			$ 200.0	$ 150.0
Net proceeds, after underwriting discount			$ 196.5
Unsecured senior notes, interest rate			6.375%
Debt instrument, maturity date			Feb. 15, 2022
2012 Term Loan [Member]
Debt Instrument [Line Items]
Debt instrument, maturity date	Mar. 09, 2016
Paid off term loan	$ 100.0	$ 100.0
5.750% Senior Notes due 2020 [Member]
Debt Instrument [Line Items]
Unsecured senior notes, value of offering \| €							€ 200
Unsecured senior notes, interest rate				5.75%			5.75%

Debt - Revolving Credit Facility - Additional Information (Detail) - Unsecured Revolving Credit Facility [Member] - USD ($) $ in Millions	1 Months Ended	12 Months Ended
	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012
Debt Instrument [Line Items]
Debt instrument face amount	$ 70
Credit facilities, amount outstanding		$ 105	$ 125
Credit facility, maturity date	2015-10
Debt instrument, basis spread of interest rate		2.85%	2.85%
Revolving facility agreement, availability		$ 295
Credit facilities, weighted average interest rate		3.20%	3.20%
Federal Funds Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate	0.50%
Minimum [Member]
Debt Instrument [Line Items]
Credit facilities, amount outstanding	$ 330
Debt instrument, basis spread of interest rate	1.60%
Credit facilities, percentage of commitment fee on unused capacity	0.375%
Minimum [Member] \| London Interbank Offered Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate	2.60%
Maximum [Member]
Debt Instrument [Line Items]
Credit facilities, amount outstanding	$ 400
Debt instrument, basis spread of interest rate	2.40%
Credit facilities, percentage of commitment fee on unused capacity	0.50%
Maximum [Member] \| London Interbank Offered Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate	3.40%

Debt - 2012 Senior Unsecured Notes - Additional Information (Detail) - 2012 Senior Unsecured Notes [Member] - USD ($) $ in Millions			12 Months Ended
	Aug. 20, 2013	Feb. 17, 2012	Dec. 31, 2013	Dec. 31, 2012
Debt Instrument [Line Items]
Unsecured senior notes, value of offering	$ 150.0	$ 200.0
Unsecured senior notes, interest rate	6.375%	6.375%	6.375%	6.375%
Debt instrument, maturity date		Feb. 15, 2020	Feb. 15, 2022
Senior notes frequency of periodic payment			Semi-annually
Net proceeds, after underwriting discount	$ 150.4	$ 196.5
Senior notes, earliest redemption date			Feb. 15, 2017
Senior notes, repurchase price percentage on principal amount plus accrued and unpaid interest	101.00%	101.00%
Debt instrument redemption price	10200.00%	10200.00%
Debt instrument effective rate			5.998%

Debt - 2011 Senior Unsecured Notes - Additional Information (Detail) - 2011 Senior Unsecured Notes [Member] - USD ($) $ in Thousands	Apr. 26, 2011	Dec. 31, 2013	Dec. 31, 2012
Debt Instrument [Line Items]
Debt instrument face amount	$ 450,000	$ 450,000	$ 450,000
Interest rate	6.875%	6.875%	6.875%
Debt instrument, maturity date	May 01, 2021
Senior notes frequency of periodic payment	Semi-annually
Senior notes, earliest redemption date	May 01, 2016
Senior notes, repurchase price percentage on principal amount plus accrued and unpaid interest	101.00%

Debt - 2006 Senior Unsecured Notes - Additional Information (Detail) - USD ($) $ in Millions		1 Months Ended	3 Months Ended	7 Months Ended
	Oct. 30, 2011	Oct. 31, 2011	Jun. 30, 2010	Jul. 30, 2011	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2006
Interest Rate Contract [Member]
Debt Instrument [Line Items]
Fair value of the interest rate swaps					$ 9.0	$ 12.5
Interest Rate Contract One [Member]
Debt Instrument [Line Items]
Interest rate of interest rate derivative instrument			5.507%
Maturity date of interest rate swap			July 2016
Interest Rate Contract Two [Member]
Debt Instrument [Line Items]
Maturity date of interest rate swap		October 2016
Interest rate swap, amount fixed		$ 60.0
Interest rate of derivative instrument		5.675%
2006 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior Unsecured Notes							$ 125.0
Credit facilities, periodic payments of interest				$ 65.0
Senior notes frequency of periodic payment	Quarterly			Quarterly
Interest rate				7.871%
Unsecured senior notes, year of maturity	2016-07			2016-07
Fixed rate, minimum	7.333%
Fixed rate, maximum	7.715%
Portion of debt instrument face amount			$ 65.0
2006 Senior Unsecured Notes [Member] \| London Interbank Offered Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate	2.30%			2.30%

Debt - Exchangeable Senior Notes - Additional Information (Detail) - USD ($)	1 Months Ended
	Jul. 31, 2011	Apr. 30, 2008	Mar. 31, 2008	Dec. 31, 2013	Aug. 31, 2011
Debt Instrument [Line Items]
Unsecured senior notes, interest rate				$ 12,781,000
Exchangeable senior notes [Member]
Debt Instrument [Line Items]
Senior Notes		$ 7,000,000	$ 75,000,000		$ 1,500,000
Proceeds from senior notes		$ 6,800,000	$ 72,800,000
Percentage of outstanding notes purchased from senior unsecured notes offering	85.00%
Price of principal amount plus accrued and unpaid interest, in percentage	118.50%
Price of principal amount plus accrued and unpaid interest, in amount	$ 84,200,000
Unsecured senior notes, interest rate				$ 0.0925

Debt - Term Loans - Additional Information (Detail) $ in Millions			1 Months Ended
	Mar. 09, 2012 USD ($)	Feb. 14, 2011 USD ($) yr	Mar. 09, 2012 USD ($)	Dec. 31, 2013 USD ($)	Dec. 31, 2012 USD ($)
2012 Term Loan [Member]
Debt Instrument [Line Items]
Paid off term loan	$ 100.0		$ 100.0
Interest rate at end of period	2.43%		2.43%
Debt instrument maturity date	Mar. 09, 2016
Term loan facility, potential term extension period	1 year
Term loan facility, extension option maturity date	Mar. 09, 2017
2012 Term Loan [Member] \| London Interbank Offered Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate	2.25%
2012 Term Loan [Member] \| Federal Funds Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate	0.50%
2012 Term Loan [Member] \| Eurodollar Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate	1.00%
2012 Term Loan [Member] \| Initial Spread [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate	1.25%
Mortgages [Member]
Debt Instrument [Line Items]
Collateralized real estate property				$ 18.0	$ 18.5
Mortgages [Member] \| Northland Ltach Hospital [Member]
Debt Instrument [Line Items]
Debt instrument maturity date		Jan. 01, 2018
Liabilities acquired		$ 14.6
Amortization period \| yr		30
Interest rate		6.20%
Debt instrument earliest prepayment date		Jan. 01, 2013
Term loans [Member]
Debt Instrument [Line Items]
Debt instrument face amount					$ 13.9
Interest rate					6.20%

Debt - Covenants - Additional Information (Detail)	12 Months Ended
Debt - Covenants - Additional Information (Detail)	Dec. 31, 2013
Debt Disclosure [Abstract]
Percentage of dividends which could be paid from adjusted operating funds	95.00%
Percentage of dividends which could be paid from operation funds	95.00%
Maximum percentage of total unencumbered assets	150.00%

Income Taxes - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
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%
Loss before income taxes	$ 12.9
U.S federal NOLs	0.2
U.S. state NOLs	$ 7.6
U.S. federal and state NOLs, expiration period	2026 through 2032
Decrease in valuation allowance	$ 2.6
Increased Valuation Allowances [Member]
Income Taxes [Line Items]
Acquisition-related costs on consummated deals	$ 1.9

Income Taxes - Schedule of Income Tax Expense (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Income Tax Disclosure [Abstract]
Domestic	$ 568	$ 19	$ 128
Foreign	158
Total income tax expense	$ 726	$ 19	$ 128

Income Taxes - Schedule of Deferred Tax Assets And liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2013	Dec. 31, 2012
Deferred tax liabilities:
Property and equipment	$ (2,870)	$ (2,370)
Other	(2,923)	(1,673)
Total deferred tax liabilities	(5,793)	(4,043)
Deferred tax assets:
Loan loss and other reserves	7,751	7,218
Operating loss and interest deduction carry forwards	2,283	3,938
Other	3,371	1,261
Total deferred tax assets	13,405	12,417
Valuation allowance	(7,843)	(8,540)
Net deferred tax (liability)	$ (231)	$ (166)

Income Taxes - Schedule of Per Share Distributions to Stockholders (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Income Tax Disclosure [Abstract]
Common share distribution	$ 0.800000	$ 0.800000	$ 0.800000
Ordinary income	0.599384	0.601216	0.300844
Capital gains	0.046380	0.117584	0.031396
Unrecaptured Sec. 1250 gain	0.026512	0.086976	0.031396
Return of capital	0.154236	0.081200	0.467760
Allocable to next year

Earnings Per Share/Unit - Calculation of Earnings Per Share (Detail) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Income from continuing operations	$ 13,309	$ 25,391	$ 25,031	$ 25,570	$ 23,264	$ 22,594	$ 18,718	$ 8,294	$ 89,301	$ 72,870	$ 12,120
Non-controlling interests' share in continuing operations									(224)	(177)	(178)
Participating securities' share in earnings									(729)	(887)	(1,090)
Income from continuing operations, less participating securities' share in earnings									88,348	71,806	10,852
Income from discontinued operations attributable to MPT common stockholders									7,914	17,207	14,594
Net income, less participating securities' share in earnings									$ 96,262	$ 89,013	$ 25,446
Basic weighted-average common shares	161,143	154,758	149,509	140,347	134,923	134,781	134,715	124,906	151,439	132,331	110,623
Dilutive potential common shares									1,159	2	6
Diluted weighted-average common shares	161,840	155,969	151,056	141,526	134,930	134,782	134,715	124,906	152,598	132,333	110,629
MPT Operating Partnership, L.P. [Member]
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Income from continuing operations	$ 13,309	$ 25,391	$ 25,031	$ 25,570	$ 23,264	$ 22,594	$ 18,718	$ 8,294	$ 89,301	$ 72,870	$ 12,137
Non-controlling interests' share in continuing operations									(244)	(177)	(178)
Participating securities' share in earnings									(729)	(887)	(1,090)
Income from continuing operations, less participating securities' share in earnings									88,328	71,806	10,869
Income from discontinued operations attributable to MPT common stockholders									7,914	17,207	14,594
Net income, less participating securities' share in earnings									$ 96,242	$ 89,013	$ 25,463
Basic weighted-average common shares	161,143	154,758	149,509	140,347	134,923	134,781	134,715	124,906	151,439	132,331	110,623
Dilutive potential common shares									1,159	2	6
Diluted weighted-average common shares	161,840	155,969	151,056	141,526	134,930	134,782	134,715	124,906	152,598	132,333	110,629

Earnings Per Share/Unit - Additional Information (Detail) - shares shares in Millions	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Stock Options [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Options excluded from earnings per share/unit	0.1	0.1	0.1

Stock Awards - Additional Information (Detail)	12 Months Ended
Stock Awards - Additional Information (Detail)	Dec. 31, 2013 USD ($) yr $ / shares shares	Dec. 31, 2012 USD ($) yr shares	Dec. 31, 2011 USD ($) yr shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of stock options outstanding	20,000
Number of stock options exercisable	20,000
Stock options, weighted-average exercise price \| $ / shares	$ 10.00
Stock options, intrinsic value of options exercisable and outstanding \| $	$ 0
Stock options exercised	40,000
Stock options awarded, weighted average remaining contractual term (in years)	3 months 18 days
Number of performance awards earned and vested	68,086
Number of performance awards to be earned	686,169
Stock-based compensation expense \| $	$ 8,900,000	$ 7,600,000	$ 7,000,000
Stock-based compensation expense, unrecognized cost \| $	$ 10,100,000
Stock-based compensation expense, unrecognized cost, reorganization period (in years)	2 years 6 months
Restricted equity awards, fair value \| $	$ 9,200,000	$ 9,200,000	$ 6,100,000
Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock award vesting period (in years)	10 years
30% of 2012 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based payment award, expected volatility rate		34.00%
Stock-based awards expiration date		Dec. 31, 2016
Share based payment award, weighted average risk-free rate of return		0.93%
Common stock options awarded, dividend yield		8.60%
Percentage of performance award grant in period		30.00%
Percentage of shareholder return annually		9.00%
Percentage of shareholder return annually achieving period (in years) \| yr		3
Share-based compensation arrangement by share based payment award, expected term (in years)		4 years
35% of 2012 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based payment award, expected volatility rate		35.00%
Share based payment award, weighted average risk-free rate of return		0.43%
Common stock options awarded, dividend yield		8.60%
Percentage of performance award grant in period		35.00%
Share-based compensation arrangement by share based payment award, expected term (in years)		5 years
Percentage of performance award to be earned of shareholder return reaches shareholder limit		100.00%
35% of 2012 Performance Awards [Member] \| If any shares are earned from this award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation award vesting rights		Vest in equal annual amounts on January 1, 2015, 2016 and 2017
35% of 2012 Performance Awards [Member] \| Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned		27.00%
35% of 2012 Performance Awards [Member] \| Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned		35.00%
Remaining % of 2012 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based payment award, expected volatility rate		35.00%
Share based payment award, weighted average risk-free rate of return		0.43%
Common stock options awarded, dividend yield		8.60%
Share-based compensation arrangement by share based payment award, expected term (in years)		5 years
Percentage of performance award to be earned of shareholder return reaches shareholder limit		100.00%
Percentage of shareholder return to be earned		6.00%
Remaining % of 2012 Performance Awards [Member] \| If any shares are earned from this award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation award vesting rights		Vest in equal annual amounts on January 1, 2015, 2016 and 2017
30% of 2011 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based payment award, expected volatility rate			33.00%
Stock-based awards expiration date			Dec. 31, 2015
Share based payment award, weighted average risk-free rate of return			2.07%
Common stock options awarded, dividend yield			8.50%
Percentage of performance award grant in period			30.00%
Percentage of shareholder return annually			9.00%
Percentage of shareholder return annually achieving period (in years) \| yr			3
Share-based compensation arrangement by share based payment award, expected term (in years)			4 years
18% of 2011 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based payment award, expected volatility rate			34.00%
Share based payment award, weighted average risk-free rate of return			1.07%
Common stock options awarded, dividend yield			8.50%
Percentage of performance award grant in period			18.00%
Share-based compensation arrangement by share based payment award, expected term (in years)			5 years
Percentage of performance award to be earned of shareholder return reaches shareholder limit			100.00%
18% of 2011 Performance Awards [Member] \| If any shares are earned from this award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation award vesting rights			Vest in equal annual amounts on January 1, 2014, 2015 and 2016
18% of 2011 Performance Awards [Member] \| Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned			27.00%
18% of 2011 Performance Awards [Member] \| Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned			39.00%
Remaining % of 2011 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based payment award, expected volatility rate			34.00%
Share based payment award, weighted average risk-free rate of return			1.07%
Common stock options awarded, dividend yield			8.50%
Share-based compensation arrangement by share based payment award, expected term (in years)			5 years
Percentage of performance award to be earned of shareholder return reaches shareholder limit			100.00%
Percentage of shareholder return to be earned			12.00%
Remaining % of 2011 Performance Awards [Member] \| If any shares are earned from this award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation award vesting rights			Vest in equal annual amounts on January 1, 2014, 2015 and 2016
Settled in Cash [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of stock options settled for cash			20,000
Stock options granted	0	0	0
Stock options exercised	0	0	0
Service-Based Awards [Member] \| Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock award required service period (in years)	3 years
Service-Based Awards [Member] \| Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock award required service period (in years)	5 years
27% of 2013 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based payment award, expected volatility rate	27.00%
Stock-based awards expiration date	Dec. 31, 2017
Share based payment award, weighted average risk-free rate of return	0.72%
Common stock options awarded, dividend yield	8.00%
Percentage of performance award grant in period	27.00%
Percentage of shareholder return annually	8.50%
Percentage of shareholder return annually achieving period (in years) \| yr	3
Share-based compensation arrangement by share based payment award, expected term (in years)	3 years
Equity Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Reserved shares of common stock for awards under the Equity Incentive Plan	7,643,651
Common stock remaining for future stock awards transferred to the equity incentive plan	7,643,651
Maximum number of shares of common stock that may be awarded	5,000,000
36% of 2013 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based payment award, expected volatility rate	28.00%
Share based payment award, weighted average risk-free rate of return	0.38%
Common stock options awarded, dividend yield	8.00%
Percentage of performance award grant in period	36.00%
Share-based compensation arrangement by share based payment award, expected term (in years)	5 years
Percentage of performance award to be earned of shareholder return reaches shareholder limit	100.00%
36% of 2013 Performance Awards [Member] \| If any shares are earned from this award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation award vesting rights	Vest in equal annual amounts on December 31, 2015, 2016 and 2017
36% of 2013 Performance Awards [Member] \| Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned	25.50%
36% of 2013 Performance Awards [Member] \| Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned	33.50%
Remaining % of 2013 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based payment award, expected volatility rate	28.00%
Share based payment award, weighted average risk-free rate of return	0.38%
Common stock options awarded, dividend yield	8.00%
Share-based compensation arrangement by share based payment award, expected term (in years)	5 years
Percentage of performance award to be earned of shareholder return reaches shareholder limit	100.00%
Percentage of shareholder return to be earned	6.00%
Remaining % of 2013 Performance Awards [Member] \| If any shares are earned from this award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation award vesting rights	Vest in equal annual amounts on December 31, 2015, 2016 and 2017
2012 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of performance awards earned and vested	84,188	84,188
Number of performance awards to be earned	725,666
Number of performance awards forfeited	2,599	5,718
2011 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of performance awards earned and vested	81,359	155,162	0
Number of performance awards forfeited	8,062	14,456
Number of performance awards to be earned	587,344

Stock Awards - Restricted Equity Awards Activity (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012
Vesting Based on Service [Member]
Employee Restricted Equity Awards Vesting Activity [Line Items]
Nonvested awards at beginning of the year, Shares	466,883	603,980
Awarded, Shares	240,425	275,464
Vested, Shares	(381,309)	(410,261)
Forfeited, Shares		(2,300)
Nonvested awards at end of year, Shares	325,999	466,883
Nonvested awards at beginning of the year, Weighted Average Value at Award Date	$ 10.720	$ 11.020
Awarded, Weighted Average Value at Award Date	12.260	10.140
Vested, Weighted Average Value at Award Date	11.150	10.780
Forfeited, Weighted Average Value at Award Date		10.240
Nonvested awards at end of year, Weighted Average Value at Award Date	$ 11.360	$ 10.720
Vesting Based on Market/Performance Conditions [Member]
Employee Restricted Equity Awards Vesting Activity [Line Items]
Nonvested awards at beginning of the year, Shares	1,879,889	1,511,397
Awarded, Shares	754,255	902,359
Vested, Shares	(386,446)	(513,693)
Forfeited, Shares	(248,519)	(20,174)
Nonvested awards at end of year, Shares	1,999,179	1,879,889
Nonvested awards at beginning of the year, Weighted Average Value at Award Date	$ 6.480	$ 7.600
Awarded, Weighted Average Value at Award Date	6.130	5.810
Vested, Weighted Average Value at Award Date	8.270	8.630
Forfeited, Weighted Average Value at Award Date	11.030	5.450
Nonvested awards at end of year, Weighted Average Value at Award Date	$ 5.440	$ 6.480

Commitments and Contingencies - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Commitments And Contingencies Disclosure [Abstract]
Term of lease period	50 years or more
Lease and Rental Expenses	$ 2,304,461	$ 2,195,835	$ 1,994,565
Sublease rental income	512,503	$ 492,095	$ 443,829
Total amount to be received in the future from non-cancellable subleases	$ 30,100,000

Commitments and Contingencies - Fixed Minimum Payments Due under Operating Leases with Non-Cancelable Terms (Detail) $ in Thousands	Dec. 31, 2013 USD ($)
Commitments And Contingencies Disclosure [Abstract]
2014	$ 2,471
2015	2,644
2016	2,659
2017	2,620
2018	2,614
Thereafter	37,213
Minimum rental payments, total	$ 50,221

Common Stock/Partner's Capital - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands				1 Months Ended		3 Months Ended	12 Months Ended
	Aug. 20, 2013	Feb. 28, 2013	Feb. 07, 2012	Feb. 28, 2014	Jan. 31, 2014	Dec. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Feb. 29, 2012	Nov. 30, 2009
Class of Stock [Line Items]
Common stock, shares issued						136,335,000	136,335,000	136,335,000
Net proceed from issuance of common stock							$ 313,331	$ 233,048
Common stock, shares authorized						250,000,000	250,000,000	250,000,000	250,000,000
Common stock, par value						$ 0.001	$ 0.001	$ 0.001	$ 0.001
Ownership interest in equity							100.00%
MPT Operating Partnership, L.P. [Member]
Class of Stock [Line Items]
Net proceed from issuance of common stock							$ 313,331	$ 233,048
Percentage of ownership of general partner							100.00%
Ownership interest in equity							99.80%
Number of other partners							3
Employee [Member]
Class of Stock [Line Items]
Number of partners shared remaining ownership percentage							2
Director [Member]
Class of Stock [Line Items]
Number of partners shared remaining ownership percentage							1
Public Offering [Member]
Class of Stock [Line Items]
Common stock, shares issued	11,500,000	12,650,000	23,575,000
Underwriters' purchase of shares pursuant to over allotment	1,500,000	1,650,000	3,075,000
Public offering price for common stock per share	$ 12.75	$ 14.25	$ 9.75
Net proceed from issuance of common stock	$ 140,400	$ 172,900	$ 220,100
Market Equity Offering Program [Member]
Class of Stock [Line Items]
Common stock, shares issued						1,100,000		1,100,000
Public offering price for common stock per share						$ 11.84
Net proceed from issuance of common stock						$ 13,200
Sales commission						2.00%
Market Equity Offering Program [Member] \| Maximum [Member]
Class of Stock [Line Items]
Number of shares can be sold out										$ 50,000
Market Equity Offering Program [Member] \| Subsequent Event
Class of Stock [Line Items]
Net proceed from issuance of common stock				$ 12,500
Sales commission					1.25%
Market Equity Offering Program [Member] \| Subsequent Event \| Maximum [Member]
Class of Stock [Line Items]
Increased stock purchased amount					$ 250,000
Before Amendment [Member]
Class of Stock [Line Items]
Common stock, shares authorized									150,000,000

Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Detail) - USD ($) $ in Thousands	Dec. 31, 2013	Dec. 31, 2012
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Interest and rent receivables	$ 58,499	$ 45,289
Loans	351,607	334,693
Debt, net	(1,421,681)	(1,025,160)
Estimate of Fair Value, Fair Value Disclosure [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Interest and rent receivables	44,349	36,700
Loans	358,277	335,595
Debt, net	$ (1,486,090)	$ (1,082,333)

Fair Value of Financial Instruments - Equity Interest in Ernest and Related Loans Measured at Fair Value on Recurring Basis (Detail) $ in Thousands	Dec. 31, 2013 USD ($)
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	$ 201,333
Cost	201,333
Fair Value Measurements, Recurring [Member] \| Mortgage loans [Member] \| Mortgage Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	100,000
Cost	100,000
Fair Value Measurements, Recurring [Member] \| Acquisition loans [Member] \| Working capital and other loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	98,033
Cost	98,033
Fair Value Measurements, Recurring [Member] \| Equity investments [Member] \| Other assets [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	3,300
Cost	$ 3,300

Fair Value of Financial Instruments - Additional information (Detail)	12 Months Ended
	Dec. 31, 2013
Fair Value Disclosures [Abstract]
Adjustment for marketability discount	40.00%

Fair Value of Financial Instruments - Summary Showing Sensitivity Analysis by Using Basis Point Variations (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2013 USD ($)
+100 basis points [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated Increase (Decrease) In Fair Value of Financial Instruments	$ (320)
- 100 basis points [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated Increase (Decrease) In Fair Value of Financial Instruments	$ 320

Discontinued Operations - Additional Information (Detail) - USD ($) $ in Thousands	Dec. 31, 2013	Dec. 31, 2012
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Real estate held for sale		$ 25,537
Allowance for Doubtful Accounts, Discontinued Operations [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Real estate held for sale	$ 25,500
Allowance for Doubtful Accounts, Discontinued Operations [Member] \| Land [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Real estate held for sale	1,900
Allowance for Doubtful Accounts, Discontinued Operations [Member] \| Building [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Real estate held for sale	26,700
Allowance for Doubtful Accounts, Discontinued Operations [Member] \| Intangible Lease Assets [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Real estate held for sale	800
Allowance for Doubtful Accounts, Discontinued Operations [Member] \| Accumulated Depreciation [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Real estate held for sale	3,500
Allowance for Doubtful Accounts, Discontinued Operations [Member] \| Accumulated Amortization [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Real estate held for sale	$ 400

Discontinued Operations - Discontinued Operations (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Discontinued Operations And Disposal Groups [Abstract]
Revenues									$ 988	$ 3,470	$ 14,531
Gain on sale									7,659	16,369	5,431
Income from discontinued operations	$ 4,588	$ 312	$ 2,374	$ 640	$ 5,339	$ 8,914	$ 642	$ 2,312	$ 7,914	$ 17,207	$ 14,594
Income from discontinued operations - diluted per share/unit									$ 0.05	$ 0.13	$ 0.13

Quarterly Financial Data (Unaudited) - Unaudited Quarterly Financial Information (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Quarterly Financial Information [Line Items]
Revenues	$ 67,679	$ 60,106	$ 57,124	$ 57,614	$ 56,597	$ 52,504	$ 48,569	$ 40,455	$ 242,523	$ 198,125	$ 132,322
Income (loss) from continuing operations	13,309	25,391	25,031	25,570	23,264	22,594	18,718	8,294	89,301	72,870	12,120
Income from discontinued operations	4,588	312	2,374	640	5,339	8,914	642	2,312	7,914	17,207	14,594
Net income	17,897	25,703	27,405	26,210	28,603	31,508	19,360	10,606	97,215	90,077	26,714
Net income attributable to MPT common stockholders	$ 17,839	$ 25,648	$ 27,348	$ 26,156	$ 28,556	$ 31,464	$ 19,316	$ 10,564	$ 96,991	$ 89,900	$ 26,536
Net income attributable to MPT common stockholders per share - basic	$ 0.11	$ 0.16	$ 0.18	$ 0.19	$ 0.21	$ 0.23	$ 0.14	$ 0.08	$ 0.64	$ 0.67	$ 0.23
Weighted average shares outstanding - basic	161,143	154,758	149,509	140,347	134,923	134,781	134,715	124,906	151,439	132,331	110,623
Net income attributable to MPT common stockholders per share - diluted	$ 0.11	$ 0.16	$ 0.18	$ 0.18	$ 0.21	$ 0.23	$ 0.14	$ 0.08	$ 0.63	$ 0.67	$ 0.23
Weighted average shares outstanding - diluted	161,840	155,969	151,056	141,526	134,930	134,782	134,715	124,906	152,598	132,333	110,629
MPT Operating Partnership, L.P. [Member]
Quarterly Financial Information [Line Items]
Revenues	$ 67,679	$ 60,106	$ 57,124	$ 57,614	$ 56,597	$ 52,504	$ 48,569	$ 40,455	$ 242,523	$ 198,125	$ 132,322
Income (loss) from continuing operations	13,309	25,391	25,031	25,570	23,264	22,594	18,718	8,294	89,301	72,870	12,137
Income from discontinued operations	4,588	312	2,374	640	5,339	8,914	642	2,312	7,914	17,207	14,594
Net income	17,897	25,703	27,405	26,210	28,603	31,508	19,360	10,606	97,215	90,077	26,731
Net income attributable to MPT common stockholders	$ 17,839	$ 25,648	$ 27,348	$ 26,156	$ 28,556	$ 31,464	$ 19,316	$ 10,564	$ 96,991	$ 89,900	$ 26,553
Net income attributable to MPT common stockholders per share - basic	$ 0.11	$ 0.16	$ 0.18	$ 0.19	$ 0.21	$ 0.23	$ 0.14	$ 0.08	$ 0.64	$ 0.67	$ 0.23
Weighted average shares outstanding - basic	161,143	154,758	149,509	140,347	134,923	134,781	134,715	124,906	151,439	132,331	110,623
Net income attributable to MPT common stockholders per share - diluted	$ 0.11	$ 0.16	$ 0.18	$ 0.18	$ 0.21	$ 0.23	$ 0.14	$ 0.08	$ 0.63	$ 0.67	$ 0.23
Weighted average shares outstanding - diluted	161,840	155,969	151,056	141,526	134,930	134,782	134,715	124,906	152,598	132,333	110,629

Condensed Consolidating Financial Information - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Total Assets	$ 2,904,570	$ 2,178,886
Total liabilities	1,560,362	1,129,072
Parent [Member]
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Prior Period Reclassification Adjustment	129,400
Subsidiary of Common Parent [Member]
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Prior Period Reclassification Adjustment	501,800
Subsidiary Guarantors [Member]
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Prior Period Reclassification Adjustment	365,800
Subsidiary Guarantors [Member] \| Subsidiary Issuer [Member]
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Prior Period Reclassification Adjustment	92,100
Subsidiary Guarantors [Member] \| Amounts Offset [Member]
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Prior Period Reclassification Adjustment	89,600
Non-Guarantor Subsidiaries [Member]
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Prior Period Reclassification Adjustment	136,100
Non-Guarantor Subsidiaries [Member] \| Subsidiary Issuer [Member]
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Prior Period Reclassification Adjustment	22,400
Non-Guarantor Subsidiaries [Member] \| Amounts Offset [Member]
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Prior Period Reclassification Adjustment	$ 114,200
Restatement Adjustment [Member] \| Subsidiaries Guarantor
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Total Assets		997,200
Total liabilities		997,200
Restatement Adjustment [Member] \| Subsidiaries Non Guarantor
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Total Assets		404,100
Total liabilities		$ 404,100

Condensed Consolidating Financial Information - Condensed Consolidated Balance Sheets (Detail) - USD ($) $ in Thousands	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010
Condensed Financial Statements, Captions [Line Items]
Real estate held for sale		$ 25,537
Net investment in direct financing leases	$ 431,024	314,412
Mortgage loans	388,650	368,650
Gross investment in real estate assets	2,685,129	1,959,839
Net investment in real estate assets	2,525,353	1,837,043
Cash and cash equivalents	45,979	37,311	$ 102,726	$ 98,408
Interest and rent receivables	58,499	45,289
Straight-line rent receivables	45,829	35,860
Other loans	160,990	159,243
Other assets	67,920	64,140
Total Assets	2,904,570	2,178,886
Debt, net	1,421,681	1,025,160
Accounts payable and accrued expenses	94,311	65,961
Deferred revenue	23,787	20,609
Lease deposits and other obligations to tenants	20,583	17,342
Total liabilities	1,560,362	1,129,072
Total Equity	1,344,208	1,049,814
Total Liabilities and Equity	2,904,570	2,178,886
Parent [Member]
Condensed Financial Statements, Captions [Line Items]
Land, buildings and improvements and intangible lease assets
Real estate held for sale
Net investment in direct financing leases
Mortgage loans
Gross investment in real estate assets
Accumulated depreciation and amortization
Net investment in real estate assets
Cash and cash equivalents
Interest and rent receivables
Straight-line rent receivables
Other loans
Net intercompany receivable	35,363	27,393
Investment in subsidiaries	1,344,598	1,050,204
Total Assets	1,379,961	1,077,597
Debt, net
Accounts payable and accrued expenses	35,753	27,783
Net intercompany payable
Deferred revenue
Lease deposits and other obligations to tenants
Total liabilities	35,753	27,783
Total Equity	1,344,208	1,049,814
Total Liabilities and Equity	1,379,961	1,077,597
Subsidiary Issuers [Member]
Condensed Financial Statements, Captions [Line Items]
Land, buildings and improvements and intangible lease assets		28
Real estate held for sale
Net investment in direct financing leases
Mortgage loans
Gross investment in real estate assets		28
Accumulated depreciation and amortization
Net investment in real estate assets		28
Cash and cash equivalents	18,815	35,483	101,230	96,822
Interest and rent receivables	336	212
Straight-line rent receivables
Other loans	178	177
Net intercompany receivable	1,907,477	1,373,941
Investment in subsidiaries	825,153	647,029
Other assets	37,311	31,097
Total Assets	2,789,267	2,087,967
Debt, net	1,407,733	1,010,962
Accounts payable and accrued expenses	36,887	26,658
Net intercompany payable
Deferred revenue	49	143
Lease deposits and other obligations to tenants
Total liabilities	1,444,669	1,037,763
Total Equity	1,344,598	1,050,204
Total Liabilities and Equity	2,789,267	2,087,967
Subsidiary Guarantors [Member]
Condensed Financial Statements, Captions [Line Items]
Land, buildings and improvements and intangible lease assets	1,795,084	1,185,265
Real estate held for sale
Net investment in direct financing leases	212,543	110,155
Mortgage loans	268,650	268,650
Gross investment in real estate assets	2,276,277	1,564,070
Accumulated depreciation and amortization	(151,624)	(116,344)
Net investment in real estate assets	2,124,653	1,447,726
Cash and cash equivalents	27,094	1,565	1,409	1,387
Interest and rent receivables	31,324	29,150
Straight-line rent receivables	37,015	28,416
Other loans	1,100
Net intercompany receivable
Investment in subsidiaries	42,407	42,666
Other assets	1,168	1,522
Total Assets	2,264,761	1,551,045
Debt, net
Accounts payable and accrued expenses	20,367	10,492
Net intercompany payable	1,538,934	997,231
Deferred revenue	17,772	19,431
Lease deposits and other obligations to tenants	17,964	16,357
Total liabilities	1,595,037	1,043,511
Total Equity	669,724	507,534
Total Liabilities and Equity	2,264,761	1,551,045
Non-Guarantor Subsidiaries [Member]
Condensed Financial Statements, Captions [Line Items]
Land, buildings and improvements and intangible lease assets	70,371	65,947
Real estate held for sale		25,537
Net investment in direct financing leases	218,481	204,257
Mortgage loans	120,000	100,000
Gross investment in real estate assets	408,852	395,741
Accumulated depreciation and amortization	(8,152)	(6,452)
Net investment in real estate assets	400,700	389,289
Cash and cash equivalents	70	263	87	199
Interest and rent receivables	26,839	15,927
Straight-line rent receivables	8,814	7,444
Other loans	159,712	159,066
Net intercompany receivable
Investment in subsidiaries
Other assets	29,441	31,521
Total Assets	625,576	603,510
Debt, net	13,948	14,198
Accounts payable and accrued expenses	1,304	1,028
Net intercompany payable	403,903	404,103
Deferred revenue	5,966	1,035
Lease deposits and other obligations to tenants	2,619	985
Total liabilities	427,740	421,349
Total Equity	197,836	182,161
Total Liabilities and Equity	625,576	603,510
Eliminations [Member]
Condensed Financial Statements, Captions [Line Items]
Land, buildings and improvements and intangible lease assets
Real estate held for sale
Net investment in direct financing leases
Mortgage loans
Gross investment in real estate assets
Accumulated depreciation and amortization
Net investment in real estate assets
Cash and cash equivalents
Interest and rent receivables
Straight-line rent receivables
Other loans
Net intercompany receivable	(1,942,837)	(1,401,334)
Investment in subsidiaries	(2,212,158)	(1,739,899)
Total Assets	(4,154,995)	(3,141,233)
Debt, net
Accounts payable and accrued expenses
Net intercompany payable	(1,942,837)	(1,401,334)
Deferred revenue
Lease deposits and other obligations to tenants
Total liabilities	(1,942,837)	(1,401,334)
Total Equity	(2,212,158)	(1,739,899)
Total Liabilities and Equity	(4,154,995)	(3,141,233)
Total Consolidated [Member]
Condensed Financial Statements, Captions [Line Items]
Land, buildings and improvements and intangible lease assets	1,865,455	1,251,240
Real estate held for sale		25,537
Net investment in direct financing leases	431,024	314,412
Mortgage loans	388,650	368,650
Gross investment in real estate assets	2,685,129	1,959,839
Accumulated depreciation and amortization	(159,776)	(122,796)
Net investment in real estate assets	2,525,353	1,837,043
Cash and cash equivalents	45,979	37,311	$ 102,726	$ 98,408
Interest and rent receivables	58,499	45,289
Straight-line rent receivables	45,829	35,860
Other loans	160,990	159,243
Net intercompany receivable
Investment in subsidiaries
Other assets	67,920	64,140
Total Assets	2,904,570	2,178,886
Debt, net	1,421,681	1,025,160
Accounts payable and accrued expenses	94,311	65,961
Net intercompany payable
Deferred revenue	23,787	20,609
Lease deposits and other obligations to tenants	20,583	17,342
Total liabilities	1,560,362	1,129,072
Total Equity	1,344,208	1,049,814
Total Liabilities and Equity	$ 2,904,570	$ 2,178,886

Condensed Consolidating Financial Information - Condensed Consolidated Statements of Income (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Revenues
Rent billed									$ 132,578	$ 119,883	$ 105,688
Straight-line rent									10,706	7,911	5,277
Income from direct financing leases									40,830	21,728
Interest and fee income									58,409	48,603	21,357
Total revenues	$ 67,679	$ 60,106	$ 57,124	$ 57,614	$ 56,597	$ 52,504	$ 48,569	$ 40,455	242,523	198,125	132,322
Expenses
Real estate depreciation and amortization									36,978	32,815	30,147
Property-related									2,450	1,477	724
Acquisition expenses									19,494	5,420	4,184
General and administrative									30,063	28,562	27,091
Total operating expenses									88,985	68,274	62,146
Operating income									153,538	129,851	70,176
Other income (expense)
Interest and other (expense) income									(319)	(1,662)	18
Earnings from equity and other interests									3,554	2,943	78
Debt refinancing costs											(14,214)
Interest expense									(66,746)	(58,243)	(43,810)
Income tax expense									(726)	(19)	(128)
Net other expense									(64,237)	(56,981)	(58,056)
Income (loss) from continuing operations	13,309	25,391	25,031	25,570	23,264	22,594	18,718	8,294	89,301	72,870	12,120
Income (loss) from discontinued operations	4,588	312	2,374	640	5,339	8,914	642	2,312	7,914	17,207	14,594
Net income	17,897	25,703	27,405	26,210	28,603	31,508	19,360	10,606	97,215	90,077	26,714
Net income (loss) attributable to non-controlling interests									(224)	(177)	(178)
Net income attributable to MPT common stockholders	$ 17,839	$ 25,648	$ 27,348	$ 26,156	$ 28,556	$ 31,464	$ 19,316	$ 10,564	96,991	89,900	26,536
Parent [Member]
Revenues
Rent billed
Straight-line rent
Income from direct financing leases
Interest and fee income
Total revenues
Expenses
Real estate depreciation and amortization
Property-related
Acquisition expenses
General and administrative											17
Total operating expenses											17
Operating income											(17)
Other income (expense)
Interest and other (expense) income
Earnings from equity and other interests
Interest expense
Income tax expense
Net other expense
Income (loss) from continuing operations											(17)
Equity in earnings of consolidated subsidiaries net of income taxes									97,215	90,077	26,731
Net income									97,215	90,077	26,714
Net income (loss) attributable to non-controlling interests									(224)	(177)	(178)
Net income attributable to MPT common stockholders									96,991	89,900	26,536
Subsidiary Issuers [Member]
Revenues
Straight-line rent
Income from direct financing leases
Interest and fee income									21,797	18,341	6,124
Total revenues									21,797	18,341	6,124
Expenses
Real estate depreciation and amortization
Property-related									601	495	217
Acquisition expenses									7,356	5,420	3,713
General and administrative									29,033	26,018	23,914
Total operating expenses									36,990	31,933	27,844
Operating income									(15,193)	(13,592)	(21,720)
Other income (expense)
Interest and other (expense) income									(110)	(69)	26
Earnings from equity and other interests
Debt refinancing costs											(14,109)
Interest expense									(67,484)	(58,729)	(43,063)
Income tax expense
Net other expense									(67,594)	(58,798)	(57,146)
Income (loss) from continuing operations									(82,787)	(72,390)	(78,866)
Income (loss) from discontinued operations
Equity in earnings of consolidated subsidiaries net of income taxes									180,002	162,467	105,597
Net income									97,215	90,077	26,731
Net income (loss) attributable to non-controlling interests									(224)	(177)	(178)
Net income attributable to MPT common stockholders									96,991	89,900	26,553
Subsidiary Guarantors [Member]
Revenues
Rent billed									124,651	112,573	99,494
Straight-line rent									8,438	6,429	3,515
Income from direct financing leases									38,522	19,870
Interest and fee income									38,696	29,606	17,543
Total revenues									210,307	168,478	120,552
Expenses
Real estate depreciation and amortization									35,277	31,115	28,489
Property-related									1,356	816	458
Acquisition expenses									12,138
General and administrative									375
Total operating expenses									49,146	31,931	28,947
Operating income									161,161	136,547	91,605
Other income (expense)
Interest and other (expense) income											2
Earnings from equity and other interests									948	1,061	345
Debt refinancing costs											(105)
Interest expense									(1,912)	1,408	139
Income tax expense									(158)
Net other expense									(1,122)	2,469	381
Income (loss) from continuing operations									160,039	139,016	91,986
Income (loss) from discontinued operations									(4)	103	(1,969)
Equity in earnings of consolidated subsidiaries net of income taxes									4,477	4,481	4,578
Net income									164,512	143,600	15,580
Net income (loss) attributable to non-controlling interests
Net income attributable to MPT common stockholders									164,512	143,600	94,595
Non-Guarantor Subsidiaries [Member]
Revenues
Rent billed									20,028	16,619	9,286
Straight-line rent									2,268	1,482	1,762
Income from direct financing leases									22,577	18,090
Interest and fee income									29,834	25,387	3,926
Total revenues									74,707	61,578	14,974
Expenses
Real estate depreciation and amortization									1,701	1,700	1,658
Property-related									32,863	25,707	3,141
Acquisition expenses											471
General and administrative									655	2,544	3,160
Total operating expenses									35,219	29,951	8,430
Operating income									39,488	31,627	6,544
Other income (expense)
Interest and other (expense) income									(209)	(1,593)	10
Earnings from equity and other interests									2,606	1,882	(267)
Interest expense									(29,268)	(25,653)	(7,122)
Income tax expense									(568)	(19)	(128)
Net other expense									(27,439)	(25,383)	(7,527)
Income (loss) from continuing operations									12,049	6,244	(983)
Income (loss) from discontinued operations									7,918	17,104	16,563
Equity in earnings of consolidated subsidiaries net of income taxes
Net income									19,967	23,348	15,580
Net income (loss) attributable to non-controlling interests
Net income attributable to MPT common stockholders									19,967	23,348	15,580
Eliminations [Member]
Revenues
Rent billed									(12,101)	(9,309)	(3,092)
Income from direct financing leases									(20,269)	(16,232)
Interest and fee income									(31,918)	(24,731)	(6,236)
Total revenues									(64,288)	(50,272)	(9,328)
Expenses
Real estate depreciation and amortization
Property-related									(32,370)	(25,541)	(3,092)
Acquisition expenses
General and administrative
Total operating expenses									(32,370)	(25,541)	(3,092)
Operating income									(31,918)	(24,731)	(6,236)
Other income (expense)
Interest and other (expense) income
Earnings from equity and other interests
Interest expense									31,918	24,731	6,236
Income tax expense
Net other expense									31,918	24,731	6,236
Income (loss) from continuing operations
Income (loss) from discontinued operations
Equity in earnings of consolidated subsidiaries net of income taxes									(281,694)	(257,025)	(136,906)
Net income									(281,694)	(257,025)	(136,906)
Net income (loss) attributable to non-controlling interests									224	177	178
Net income attributable to MPT common stockholders									$ (281,470)	$ (256,848)	$ (136,728)

Condensed Consolidating Financial Information - Condensed Consolidated Statements of Comprehensive Income (Loss) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Comprehensive Income (Loss) [Line Items]
Net income	$ 97,215	$ 90,077	$ 26,714
Other comprehensive income (loss):
Unrealized gain (loss) on interest rate swap	3,474	(251)	(8,590)
Foreign currency translation gain (loss)	67
Total comprehensive income	100,756	89,826	18,124
Comprehensive income attributable to non-controlling interests	(224)	(177)	(178)
Comprehensive income attributable to MPT common stockholders	100,532	89,649	17,946
Parent [Member]
Comprehensive Income (Loss) [Line Items]
Net income	97,215	90,077	26,714
Other comprehensive income (loss):
Unrealized gain (loss) on interest rate swap	3,474	(251)	(8,590)
Foreign currency translation gain (loss)	67
Total comprehensive income	100,756	89,826	18,124
Comprehensive income attributable to non-controlling interests	(224)	(177)	(178)
Comprehensive income attributable to MPT common stockholders	100,532	89,649	17,946
Subsidiary Issuers [Member]
Comprehensive Income (Loss) [Line Items]
Net income	97,215	90,077	26,731
Other comprehensive income (loss):
Unrealized gain (loss) on interest rate swap	3,474	(251)	(8,590)
Foreign currency translation gain (loss)	67
Total comprehensive income	100,756	89,826	18,141
Comprehensive income attributable to non-controlling interests	(224)	(177)	(178)
Comprehensive income attributable to MPT common stockholders	100,532	89,649	17,963
Subsidiary Guarantors [Member]
Comprehensive Income (Loss) [Line Items]
Net income	164,512	143,600	15,580
Other comprehensive income (loss):
Total comprehensive income	164,512	143,600	94,595
Comprehensive income attributable to MPT common stockholders	164,512	143,600	94,595
Non-Guarantor Subsidiaries [Member]
Comprehensive Income (Loss) [Line Items]
Net income	19,967	23,348	15,580
Other comprehensive income (loss):
Total comprehensive income	19,967	23,348	15,580
Comprehensive income attributable to MPT common stockholders	19,967	23,348	15,580
Eliminations [Member]
Comprehensive Income (Loss) [Line Items]
Net income	(281,694)	(257,025)	(136,906)
Other comprehensive income (loss):
Unrealized gain (loss) on interest rate swap	(3,474)	251	8,590
Foreign currency translation gain (loss)	(67)
Total comprehensive income	(285,235)	(256,774)	(128,316)
Comprehensive income attributable to non-controlling interests	224	177	178
Comprehensive income attributable to MPT common stockholders	$ (285,011)	$ (256,597)	$ (128,138)

Condensed Consolidating Financial Information - Condensed Consolidated Statements of Cash Flows (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Operating activities
Net cash provided by (used in) operating activities	$ 140,801	$ 105,309	$ 79,270
Investing Activities
Principal received on loans receivable	7,249	10,931	4,289
Investments in loans receivable	(3,746)	(1,293)	(861)
Net cash (used for) provided by investing activities	(712,577)	(617,128)	(265,621)
Financing Activities
Additions to term debt	424,580	300,000	450,000
Payments of term debt	(11,249)	(232)	(246,262)
Revolving credit facilities, net	(20,000)	35,400	89,600
Distributions paid	(120,309)	(103,952)	(89,601)
Lease deposits and other obligations to tenants	3,231	(11,436)	8,621
Proceeds from sale of common shares, net of offering costs	313,331	233,048
Debt issuance costs paid and other financing activities		(177)	(6,235)
Net cash provided by (used in) financing activities	579,824	446,404	190,669
Increase (decrease) in cash and cash equivalents for period	8,048	(65,415)	4,318
Cash and cash equivalents at beginning of period	37,311	102,726	98,408
Cash and cash equivalents at end of period	45,979	37,311	102,726
Parent [Member]
Operating activities
Net cash provided by (used in) operating activities	4	57	(209)
Investing Activities
Cash paid for acquisitions and other related investments
Net proceeds from sales of real estate
Principal received on loans receivable
Investments in loans receivable
Construction in progress and other
Net cash (used for) provided by investing activities
Financing Activities
Additions to term debt
Payments of term debt
Revolving credit facilities, net
Distributions paid	(120,038)	(103,684)	(89,342)
Net payments relating to intercompany financing	(193,297)	(129,421)	89,551
Proceeds from sale of common shares, net of offering costs	313,331	233,048
Debt issuance costs paid and other financing activities
Net cash provided by (used in) financing activities	(4)	(57)	209
Increase (decrease) in cash and cash equivalents for period
Effect of exchange rate changes
Cash and cash equivalents at beginning of period
Cash and cash equivalents at end of period
Subsidiary Issuers [Member]
Operating activities
Net cash provided by (used in) operating activities	(53,846)	(61,002)	(48,779)
Investing Activities
Cash paid for acquisitions and other related investments
Net proceeds from sales of real estate
Principal received on loans receivable
Investments in loans receivable
Construction in progress and other	136	(578)	(6,466)
Net cash (used for) provided by investing activities	136	(578)	(6,466)
Financing Activities
Additions to term debt	424,580	300,000	450,000
Payments of term debt	(11,000)		(237,666)
Revolving credit facilities, net	(20,000)	75,000	50,000
Distributions paid	(120,309)	(103,952)	(89,601)
Net payments relating to intercompany financing	(539,776)	(501,839)	92,052
Proceeds from sale of common shares, net of offering costs	313,331	233,048
Debt issuance costs paid and other financing activities	(9,760)	(6,424)	(21,028)
Net cash provided by (used in) financing activities	37,066	(4,167)	59,653
Increase (decrease) in cash and cash equivalents for period	(16,644)	(65,747)	4,408
Effect of exchange rate changes	(24)
Cash and cash equivalents at beginning of period	35,483	101,230	96,822
Cash and cash equivalents at end of period	18,815	35,483	101,230
Subsidiary Guarantors [Member]
Operating activities
Net cash provided by (used in) operating activities	196,883	165,454	109,329
Investing Activities
Cash paid for acquisitions and other related investments	(619,092)	(420,500)	(241,626)
Net proceeds from sales of real estate
Principal received on loans receivable		5,491	230
Investments in loans receivable	(1,100)		(230)
Construction in progress and other	(94,737)	(66,467)	(24,081)
Net cash (used for) provided by investing activities	(714,929)	(481,476)	(265,707)
Financing Activities
Additions to term debt
Payments of term debt			(8,433)
Revolving credit facilities, net		(39,600)	39,600
Distributions paid
Lease deposits and other obligations to tenants	1,606	(10,031)	10,986
Net payments relating to intercompany financing	541,325	365,809	114,247
Proceeds from sale of common shares, net of offering costs
Debt issuance costs paid and other financing activities
Net cash provided by (used in) financing activities	542,931	316,178	156,400
Increase (decrease) in cash and cash equivalents for period	24,885	156	22
Effect of exchange rate changes	644
Cash and cash equivalents at beginning of period	1,565	1,409	1,387
Cash and cash equivalents at end of period	27,094	1,565	1,409
Non-Guarantor Subsidiaries [Member]
Operating activities
Net cash provided by (used in) operating activities	(2,240)	800	18,929
Investing Activities
Cash paid for acquisitions and other related investments	(35,830)	(200,990)	(37,337)
Net proceeds from sales of real estate	32,409	71,202	41,130
Principal received on loans receivable	7,249	5,440	4,059
Investments in loans receivable	(2,646)	(1,293)	(631)
Construction in progress and other	1,034	(9,433)	(669)
Net cash (used for) provided by investing activities	2,216	(135,074)	6,552
Financing Activities
Additions to term debt
Payments of term debt	(249)	(232)	(163)
Revolving credit facilities, net
Distributions paid
Lease deposits and other obligations to tenants	1,625	(1,405)	(2,365)
Net payments relating to intercompany financing	(1,545)	136,087	(22,404)
Proceeds from sale of common shares, net of offering costs
Debt issuance costs paid and other financing activities			(661)
Net cash provided by (used in) financing activities	(169)	134,450	(25,593)
Increase (decrease) in cash and cash equivalents for period	(193)	176	(112)
Effect of exchange rate changes
Cash and cash equivalents at beginning of period	263	87	199
Cash and cash equivalents at end of period	70	263	87
Eliminations [Member]
Operating activities
Net cash provided by (used in) operating activities
Investing Activities
Cash paid for acquisitions and other related investments
Net proceeds from sales of real estate
Principal received on loans receivable
Investments in loans receivable
Construction in progress and other
Net cash (used for) provided by investing activities
Financing Activities
Additions to term debt
Payments of term debt
Revolving credit facilities, net
Distributions paid	120,038	103,684	89,342
Lease deposits and other obligations to tenants
Net payments relating to intercompany financing	193,293	129,364	(89,342)
Proceeds from sale of common shares, net of offering costs	(313,331)	(233,048)
Debt issuance costs paid and other financing activities
Net cash provided by (used in) financing activities
Increase (decrease) in cash and cash equivalents for period
Effect of exchange rate changes
Cash and cash equivalents at beginning of period
Cash and cash equivalents at end of period
Total Consolidated [Member]
Operating activities
Net cash provided by (used in) operating activities	140,801	105,309	79,270
Investing Activities
Cash paid for acquisitions and other related investments	(654,922)	(621,490)	(278,963)
Net proceeds from sales of real estate	32,409	71,202	41,130
Principal received on loans receivable	7,249	10,931	4,289
Investments in loans receivable	(3,746)	(1,293)	(861)
Construction in progress and other	(93,567)	(76,478)	(31,216)
Net cash (used for) provided by investing activities	(712,577)	(617,128)	(265,621)
Financing Activities
Additions to term debt	424,580	300,000	450,000
Payments of term debt	(11,249)	(232)	(246,262)
Revolving credit facilities, net	(20,000)	35,400	89,600
Distributions paid	(120,309)	(103,952)	(89,601)
Lease deposits and other obligations to tenants	3,231	(11,436)	8,621
Net payments relating to intercompany financing
Proceeds from sale of common shares, net of offering costs	313,331	233,048
Debt issuance costs paid and other financing activities	(9,760)	(6,424)	(21,689)
Net cash provided by (used in) financing activities	579,824	446,404	190,669
Increase (decrease) in cash and cash equivalents for period	8,048	(65,415)	4,318
Effect of exchange rate changes	620
Cash and cash equivalents at beginning of period	37,311	102,726	98,408
Cash and cash equivalents at end of period	$ 45,979	$ 37,311	$ 102,726

Schedule II - Schedule of Valuation and Qualifying Accounts (Detail) - USD ($)
$ in Thousands

12 Months Ended

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2011

Valuation And Qualifying Accounts [Abstract]

Balance at Beginning of Year

^[1]

$ 34,769

$ 32,618

$ 23,926

Additions charged against operations

^[1]

9,397

^[2]

4,540

^[3]

8,692

^[4]

Net recoveries

^[1]

(2,593)

(2,389)

Balance at end of year

^[1]

$ 41,573

$ 34,769

$ 32,618

[1]	Includes allowance for doubtful accounts, straight-line rent reserves, allowance for loan losses, tax valuation allowances and other reserves.
[2]	Includes $4.8 million and $2.7 million in rent and interest reserves, respectively, related to our Monroe properties.
[3]	Includes $1.6 million and $2.9 million in rent and interest reserves, respectively, related to our Monroe properties.
[4]	Includes $3.7 million and $2.9 million in rent and interest reserves, respectively, related to our Denham Springs and Monroe properties and $2.1 million to fully reserve for the net deferred tax asset of one of our taxable REIT subsidiaries.

Schedule II - Schedule of Valuation and Qualifying Accounts (Parenthetical) (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012
Monroe Property [Member]
Rent reserves	$ 4.8	$ 1.6
Interest reserves	2.7	2.9
Acquisition-related costs on consummated deals	$ 1.9
Denham Springs, LA [Member]
Rent reserves		3.7
Interest reserves		2.9
Full reserve for net deferred tax asset		$ 2.1

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

12 Months Ended

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2011

Dec. 31, 2010

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

Encumbrances

$ 49,878

151,814

Additions subsequent to acquisition, improvements

1,547,919

7,832

Additions subsequent to acquisition, carrying costs

25,629

154,858

1,578,336

1,733,194

$ 1,189,552

^[1]

$ 1,191,096

^[2]

$ 990,635

Baden-Wurttemburg, Germany [Member]

$ 144,235

$ 110,888

^[3]

$ 93,430

^[4]

$ 68,662

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

Rehabilitation hospital

$ 4,327

7,372

4,327

7,372

11,699

$ 25

1986

Life on which depreci- ation in latest income state- ments is computed (Years)

Nov. 29, 2013

40 years

Saxony, Germany [Member]

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

Rehabilitation hospital

$ 682

18,907

682

18,907

19,589

$ 48

1995

Life on which depreci- ation in latest income state- ments is computed (Years)

Nov. 29, 2013

40 years

Rhineland-Pflaz, Germany [Member]

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

Rehabilitation hospital

$ 7,382

20,382

7,382

20,382

27,764

$ 67

1930

Life on which depreci- ation in latest income state- ments is computed (Years)

Nov. 29, 2013

40 years

Brandenburg, Germany [Member]

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

Rehabilitation hospital

$ 438

22,615

438

22,615

23,053

$ 68

1994

Life on which depreci- ation in latest income state- ments is computed (Years)

Nov. 29, 2013

40 years

Hesse, Germany [Member]

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

Rehabilitation hospital

$ 3,894

18,730

3,894

18,730

22,624

$ 53

1977

Life on which depreci- ation in latest income state- ments is computed (Years)

Nov. 29, 2013

40 years

Little Elm, TX [Member]

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

Acute care general hospital

$ 1,241

2,963

1,241

2,963

4,204

$ 6

2013

Life on which depreci- ation in latest income state- ments is computed (Years)

Dec. 01, 2013

40 years

Port Arthur, TX [Member]

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

Acute care general hospital

$ 2,178

74,225

2,178

74,225

76,403

$ 464

2005

Life on which depreci- ation in latest income state- ments is computed (Years)

Sep. 26, 2013

40 years

West Monroe, LA [Member]

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

Acute care general hospital

$ 10,555

71,429

10,555

71,429

81,984

$ 449

1962

Life on which depreci- ation in latest income state- ments is computed (Years)

Sep. 26, 2013

40 years

Hausman, TX [Member]

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

Acute care general hospital

$ 1,500

8,958

1,500

8,958

10,458

$ 169

2013

Life on which depreci- ation in latest income state- ments is computed (Years)

Mar. 01, 2013

40 years

Lafayette, IN [Member]

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

Rehabilitation hospital

$ 800

14,968

800

14,968

15,768

$ 328

2013

Life on which depreci- ation in latest income state- ments is computed (Years)

Feb. 01, 2013

40 years

Mesa, AZ [Member]

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

Acute care general hospital

$ 3,875

101,248

3,875

101,248

105,123

$ 633

2007

Life on which depreci- ation in latest income state- ments is computed (Years)

Sep. 26, 2013

40 years

Overlook, TX [Member]

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

Acute care general hospital

$ 2,452

9,666

2,452

9,666

12,118

$ 203

2012

Life on which depreci- ation in latest income state- ments is computed (Years)

Feb. 01, 2013

40 years

Post Falls, ID [Member]

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

Rehabilitation hospital

$ 417

12,175

417

12,175

12,592

$ 25

2013

Life on which depreci- ation in latest income state- ments is computed (Years)

Dec. 31, 2013

40 years

Spartanburg, SC [Member]

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

Rehabilitation hospital

$ 1,135

15,717

1,135

15,717

16,852

$ 145

2013

Life on which depreci- ation in latest income state- ments is computed (Years)

Aug. 01, 2013

40 years

Victoria, TX [Member]

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

Rehabilitation hospital

Life on which depreci- ation in latest income state- ments is computed (Years)

$ 9,355

9,355

$ 9,355

2013

Dec. 31, 2013

40 years

Covington, LA [Member]

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

Long term acute care hospital

$ 821

Additions subsequent to acquisition, carrying costs

10,238

821

10,252

11,073

$ 2,200

1984

Life on which depreci- ation in latest income state- ments is computed (Years)

Jun. 09, 2005

40 years

Redding, CA [Member]

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

Long term acute care hospital

Additions subsequent to acquisition, carrying costs

$ 19,952

4,361

1,629

22,684

24,313

$ 4,621

1991

Life on which depreci- ation in latest income state- ments is computed (Years)

Jun. 30, 2005

40 years

Bloomington, IN

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

Acute care general hospital

$ 2,457

Additions subsequent to acquisition, carrying costs

31,209

408

2,576

31,498

34,074

$ 5,800

2006

Life on which depreci- ation in latest income state- ments is computed (Years)

Aug. 08, 2006

40 years

Dallas, TX [Member]

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

Long term acute care hospital

$ 1,000

Additions subsequent to acquisition, carrying costs

13,589

368

1,421

13,536

14,957

$ 2,481

2006

Life on which depreci- ation in latest income state- ments is computed (Years)

Sep. 05, 2006

40 years

La Palma, CA [Member]

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

Acute care general hospital

$ 937

Additions subsequent to acquisition, carrying costs

10,907

937

10,910

11,847

$ 1,954

1971

Life on which depreci- ation in latest income state- ments is computed (Years)

Nov. 08, 2006

40 years

Anaheim, CA [Member]

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

Acute care general hospital

$ 1,875

Additions subsequent to acquisition, carrying costs

21,814

1,875

21,824

23,699

$ 3,910

1964

Life on which depreci- ation in latest income state- ments is computed (Years)

Nov. 08, 2006

40 years

Luling, TX [Member]

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

Long term acute care hospital

$ 811

9,345

811

9,345

10,156

$ 1,655

2002

Life on which depreci- ation in latest income state- ments is computed (Years)

Dec. 01, 2006

40 years

Victoria, TX [Member]

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

Long term acute care hospital

$ 625

7,197

625

7,197

7,822

$ 1,275

1998

Life on which depreci- ation in latest income state- ments is computed (Years)

Dec. 01, 2006

40 years

Houston, TX [Member]

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

Encumbrances

$ 41,200

Acute care general hospital

$ 4,757

Additions subsequent to acquisition, carrying costs

56,238

1,259

5,464

56,790

62,254

$ 10,006

2006

Life on which depreci- ation in latest income state- ments is computed (Years)

Dec. 01, 2006

40 years

Bensalem, PA [Member]

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

Acute care general hospital

$ 6,911

Additions subsequent to acquisition, carrying costs

38,185

(353)

6,911

37,832

44,743

$ 6,602

2006

Life on which depreci- ation in latest income state- ments is computed (Years)

Mar. 19, 2007

40 years

Portland, OR [Member]

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

Long term acute care hospital

$ 3,085

Additions subsequent to acquisition, carrying costs

17,859

2,559

3,071

20,432

23,503

$ 3,356

1964

Life on which depreci- ation in latest income state- ments is computed (Years)

Apr. 18, 2007

40 years

San Diego, CA [Member]

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

Acute care general hospital

$ 6,550

Additions subsequent to acquisition, carrying costs

15,653

6,550

15,730

22,280

$ 2,619

1964

Life on which depreci- ation in latest income state- ments is computed (Years)

May 09, 2007

40 years

Redding, CA [Member]

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

Acute care general hospital

$ 1,555

Additions subsequent to acquisition, carrying costs

53,863

1,555

53,876

55,431

$ 8,653

1974

Life on which depreci- ation in latest income state- ments is computed (Years)

Aug. 10, 2007

40 years

Houston, TX [Member]

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

Acute care general hospital

$ 3,501

Additions subsequent to acquisition, carrying costs

34,530

12,468

3,274

54,658

57,932

$ 4,948

1960

Life on which depreci- ation in latest income state- ments is computed (Years)

Aug. 10, 2007

40 years

Bennettsville, SC [Member]

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

Acute care general hospital

$ 794

15,772

794

15,772

16,566

$ 2,268

1984

Life on which depreci- ation in latest income state- ments is computed (Years)

Apr. 01, 2008

40 years

Bossier City, LA [Member]

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

Long term acute care hospital

$ 900

17,818

900

17,818

18,718

$ 2,559

1982

Life on which depreci- ation in latest income state- ments is computed (Years)

Apr. 01, 2008

40 years

Bristol, CT [Member]

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

Wellness Center

$ 485

2,267

485

2,267

2,752

$ 1,047

1975

Life on which depreci- ation in latest income state- ments is computed (Years)

Apr. 22, 2008

10 years

Cheraw, SC [Member]

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

Acute care general hospital

$ 657

19,576

657

19,576

20,233

$ 2,814

1982

Life on which depreci- ation in latest income state- ments is computed (Years)

Apr. 01, 2008

40 years

Detroit, MI [Member]

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

Long term acute care hospital

$ 1,220

Additions subsequent to acquisition, carrying costs

8,687

(365)

1,220

8,322

9,542

$ 1,243

1956

Life on which depreci- ation in latest income state- ments is computed (Years)

May 22, 2008

40 years

Enfield, CT [Member]

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

Wellness Center

$ 384

2,257

384

2,257

2,641

$ 1,043

1974

Life on which depreci- ation in latest income state- ments is computed (Years)

Apr. 22, 2008

10 years

Fort Lauderdale, FL [Member]

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

Rehabilitaion hospital

$ 3,499

Additions subsequent to acquisition, carrying costs

21,939

3,499

21,940

25,439

$ 3,114

1985

Life on which depreci- ation in latest income state- ments is computed (Years)

Apr. 22, 2008

40 years

Garden Grove, CA [Member]

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

Acute care general hospital

$ 5,502

Additions subsequent to acquisition, carrying costs

10,748

5,502

10,799

16,301

$ 1,385

1982

Life on which depreci- ation in latest income state- ments is computed (Years)

Nov. 25, 2008

40 years

Garden Grove, CA [Member]

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

Medical Office Building

$ 862

Additions subsequent to acquisition, carrying costs

7,888

862

7,916

8,778

$ 1,007

1982

Life on which depreci- ation in latest income state- ments is computed (Years)

Nov. 25, 2008

40 years

Idaho Falls, ID [Member]

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

Acute care general hospital

$ 1,822

Additions subsequent to acquisition, carrying costs

37,467

4,665

1,822

42,132

43,954

$ 5,913

2002

Life on which depreci- ation in latest income state- ments is computed (Years)

Apr. 01, 2008

40 years

Newington, CT [Member]

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

Wellness Center

$ 270

1,615

270

1,615

1,885

$ 748

1979

Life on which depreci- ation in latest income state- ments is computed (Years)

Apr. 22, 2008

10 years

Petersburg, VA [Member]

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

Rehabilitaion hospital

$ 1,302

9,121

1,302

9,121

10,423

$ 1,254

2006

Life on which depreci- ation in latest income state- ments is computed (Years)

Jul. 01, 2008

40 years

West Valley City, UT [Member]

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

Acute care general hospital

$ 5,516

58,314

5,516

58,314

63,830

$ 8,278

1980

Life on which depreci- ation in latest income state- ments is computed (Years)

Apr. 22, 2008

40 years

Poplar Bluff, MO [Member]

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

Acute care general hospital

$ 2,659

Additions subsequent to acquisition, carrying costs

38,694

2,660

38,694

41,354

$ 5,493

1980

Life on which depreci- ation in latest income state- ments is computed (Years)

Apr. 22, 2008

40 years

East Providence, RI [Member]

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

Wellness Center

$ 209

1,265

209

1,265

1,474

$ 586

1979

Life on which depreci- ation in latest income state- ments is computed (Years)

Apr. 22, 2008

10 years

San Dimas, CA [Member]

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

Acute care general hospital

$ 6,160

Additions subsequent to acquisition, carrying costs

6,839

6,160

6,873

13,033

$ 874

1972

Life on which depreci- ation in latest income state- ments is computed (Years)

Nov. 25, 2008

40 years

San Dimas, CA [Member]

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

Medical Office Building

$ 1,915

Additions subsequent to acquisition, carrying costs

5,085

1,915

5,103

7,018

$ 650

1979

Life on which depreci- ation in latest income state- ments is computed (Years)

Nov. 25, 2008

40 years

West Springfield, MA [Member]

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

Wellness Center

$ 583

3,185

583

3,185

3,768

$ 1,475

1976

Life on which depreci- ation in latest income state- ments is computed (Years)

Apr. 22, 2008

10 years

Warwick, RI [Member]

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

Wellness Center

$ 1,265

759

1,265

759

2,024

$ 351

1979

Life on which depreci- ation in latest income state- ments is computed (Years)

Apr. 22, 2008

10 years

Wichita, KS [Member]

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

Encumbrances

$ 8,678

Rehabilitaion hospital

$ 1,019

Additions subsequent to acquisition, carrying costs

18,373

1,019

18,374

19,393

$ 2,641

1992

Life on which depreci- ation in latest income state- ments is computed (Years)

Apr. 04, 2008

40 years

Addison, TX [Member]

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

Rehabilitaion hospital

$ 2,013

22,531

2,013

22,531

24,544

$ 1,971

2008

Life on which depreci- ation in latest income state- ments is computed (Years)

Jun. 17, 2010

40 years

Shenandoah, TX [Member]

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

Rehabilitaion hospital

$ 2,033

21,943

2,033

21,943

23,976

$ 1,920

2008

Life on which depreci- ation in latest income state- ments is computed (Years)

Jun. 17, 2010

40 years

Richardson, TX [Member]

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

Rehabilitaion hospital

$ 2,219

17,419

2,219

17,419

19,638

$ 1,524

2008

Life on which depreci- ation in latest income state- ments is computed (Years)

Jun. 17, 2010

40 years

Hill County, TX [Member]

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

Acute care general hospital

$ 1,120

17,882

1,120

17,882

19,002

$ 3,897

1980

Life on which depreci- ation in latest income state- ments is computed (Years)

Sep. 17, 2010

40 years

Webster, TX [Member]

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

Long term acute care hospital

$ 663

33,751

663

33,751

34,414

$ 2,531

2004

Life on which depreci- ation in latest income state- ments is computed (Years)

Dec. 21, 2010

40 years

Tomball, TX [Member]

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

Long term acute care hospital

$ 1,298

23,982

1,298

23,982

25,280

$ 1,799

2005

Life on which depreci- ation in latest income state- ments is computed (Years)

Dec. 21, 2010

40 years

Gilbert, AZ [Member]

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

Acute care general hospital

$ 150

15,553

150

15,553

15,703

$ 1,166

2005

Life on which depreci- ation in latest income state- ments is computed (Years)

Jan. 04, 2011

40 years

Corinth, TX [Member]

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

Long term acute care hospital

$ 1,288

Additions subsequent to acquisition, improvements

21,175

313

1,601

21,175

22,776

$ 1,570

2008

Life on which depreci- ation in latest income state- ments is computed (Years)

Jan. 31, 2011

40 years

Bayonne, NJ [Member]

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

Acute care general hospital

$ 2,003

51,495

2,003

51,495

53,498

$ 7,510

1918

Life on which depreci- ation in latest income state- ments is computed (Years)

Feb. 04, 2011

20 years

San Diego, CA [Member]

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

Acute care general hospital

$ 12,663

52,431

12,663

52,432

65,094

$ 3,823

1973

Life on which depreci- ation in latest income state- ments is computed (Years)

Feb. 09, 2011

40 years

Northland, MO [Member]

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

Long term acute care hospital

$ 834

17,182

834

17,182

18,016

$ 1,253

2007

Life on which depreci- ation in latest income state- ments is computed (Years)

Feb. 14, 2011

40 years

DeSoto, TX [Member]

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

Long term acute care hospital

$ 1,067

Additions subsequent to acquisition, improvements

10,701

Additions subsequent to acquisition, carrying costs

1,161

10,701

11,862

$ 655

2008

Life on which depreci- ation in latest income state- ments is computed (Years)

Jul. 18, 2011

40 years

New Braunfels, TX [Member]

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

Long term acute care hospital

$ 1,100

7,883

1,100

7,883

8,983

$ 443

2007

Life on which depreci- ation in latest income state- ments is computed (Years)

Sep. 30, 2011

40 years

Hoboken, NJ [Member]

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

Acute care general hospital

$ 1,387

44,351

1,387

44,351

45,738

$ 4,730

1863

Life on which depreci- ation in latest income state- ments is computed (Years)

Nov. 04, 2011

20 years

Florence, AZ [Member]

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

Acute care general hospital

$ 900

28,636

900

28,462

29,362

$ 1,236

2012

Life on which depreci- ation in latest income state- ments is computed (Years)

Nov. 04, 2010

40 years

Hammond, LA [Member]

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

Long term acute care hospital

$ 519

8,941

519

8,941

9,460

$ 242

2003

Life on which depreci- ation in latest income state- ments is computed (Years)

Dec. 14, 2012

40 years

San Antonio, TX [Member]

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

Acute care general hospital

$ 2,248

5,390

2,249

5,879

8,128

$ 166

2012

Life on which depreci- ation in latest income state- ments is computed (Years)

Oct. 14, 2011

40 years

1994 [Member] | Baden-Wurttemburg, Germany [Member]

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

Rehabilitation hospital

$ 11,968

11,968

11,968

$ 29

1994

Life on which depreci- ation in latest income state- ments is computed (Years)

Nov. 29, 2013

40 years

1996 [Member] | Saxony, Germany [Member]

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

Rehabilitation hospital

$ 471

25,956

471

25,956

26,427

$ 73

1996

Life on which depreci- ation in latest income state- ments is computed (Years)

Nov. 29, 2013

40 years

1960 [Member] | Rhineland-Pflaz, Germany [Member]

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

Rehabilitation hospital

$ 4,017

18,989

4,017

18,989

23,006

$ 48

1960

Life on which depreci- ation in latest income state- ments is computed (Years)

Nov. 29, 2013

40 years

1981 [Member] | Hesse, Germany [Member]

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

Rehabilitation hospital

$ 116

6,625

116

6,625

6,741

$ 19

1981

Life on which depreci- ation in latest income state- ments is computed (Years)

Nov. 29, 2013

40 years

1992 [Member] | Rhineland-Pflaz, Germany [Member]

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

Rehabilitation hospital

$ 37,579

37,579

37,579

$ 103

1992

Life on which depreci- ation in latest income state- ments is computed (Years)

Nov. 29, 2013

40 years

1904 [Member] | Saxony, Germany [Member]

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

Rehabilitation hospital

$ 682

18,907

682

18,907

19,589

$ 48

1904

Life on which depreci- ation in latest income state- ments is computed (Years)

Nov. 29, 2013

40 years

1980 [Member] | Rhineland-Pflaz, Germany [Member]

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

Rehabilitation hospital

$ 921

8,281

921

8,281

9,202

$ 21

1980

Life on which depreci- ation in latest income state- ments is computed (Years)

Nov. 29, 2013

40 years

[1]	Includes real estate cost included in real estate held for sale of $28,617 at December 31, 2012. Excludes intangible lease assets that are included in real estate held for sale of $858 for 2012.
[2]	Includes real estate cost included in real estate held for sale of $96,766 at December 31, 2011. Excludes intangible lease assets that are included in real estate held for sale of $3,012 for 2011.
[3]	Includes in accumulated depreciation in real estate held for sale of $3,511 for 2012. Excludes accumulated amortization related to intangible lease assets that are included in real estate held for sale of $426 for 2012.
[4]	Includes accumulated depreciation in real estate held for sale of $11,807 for 2011. Excludes accumulated amortization related to intangible lease assets that are included in real estate held for sale of $1,949 for 2011.

Schedule III - Changes in Total Real Estate Assets Including Real Estate Held for Sale (Detail) - USD ($)
$ in Thousands

12 Months Ended

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2011

Real Estate And Accumulated Depreciation Disclosure [Abstract]

Balance at beginning of period

$ 1,189,552

^[1]

$ 1,191,096

^[2]

$ 990,635

Acquisitions

483,162

9,460

240,474

Transfers from construction in progress

81,347

37,174

Additions

7,749

19,971

1,011

Dispositions

(28,616)

(68,149)

(40,460)

Other

(564)

Balance at end of period

$ 1,733,194

$ 1,189,552

^[1]

$ 1,191,096

^[2]

[1]	Includes real estate cost included in real estate held for sale of $28,617 at December 31, 2012. Excludes intangible lease assets that are included in real estate held for sale of $858 for 2012.
[2]	Includes real estate cost included in real estate held for sale of $96,766 at December 31, 2011. Excludes intangible lease assets that are included in real estate held for sale of $3,012 for 2011.

Schedule III - Changes in Accumulated Depreciation Including Real Estate Assets Held for Sale (Detail) - USD ($)
$ in Thousands

12 Months Ended

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2011

Real Estate And Accumulated Depreciation Disclosure [Abstract]

Balance at beginning of period

$ 110,888

^[1]

$ 93,430

^[2]

$ 68,662

Depreciation

33,349

31,026

29,523

Depreciation on disposed property

(3,513)

(10,057)

(4,755)

Balance at end of period

$ 144,235

$ 110,888

^[1]

$ 93,430

^[2]

[1]	Includes in accumulated depreciation in real estate held for sale of $3,511 for 2012. Excludes accumulated amortization related to intangible lease assets that are included in real estate held for sale of $426 for 2012.
[2]	Includes accumulated depreciation in real estate held for sale of $11,807 for 2011. Excludes accumulated amortization related to intangible lease assets that are included in real estate held for sale of $1,949 for 2011.

Schedule III - Changes in Accumulated Depreciation Including Real Estate Assets Held for Sale (Parenthetical) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2012	Dec. 31, 2011
Real Estate And Accumulated Depreciation Disclosure [Abstract]
Real estate held for sale		$ 96,766
Intangible lease assets held for sale		3,012
Accumulated depreciation of real estate held for sale		11,807
Accumulated amortization of intangible lease assets		$ 1,949
Real estate cost included in real estate held for sale	$ 28,617
Excludes intangible lease assets that are included in real estate held for sale	858
Includes in accumulated depreciation in real estate held for sale	3,511
Excludes accumulated amortization related to intangible lease assets that are included in real estate held for sale	426
Aggregate cost for federal income tax purposes	$ 2,155,240

Schedule IV - Schedule of Mortgage Loan on Real Estate (Detail)
$ in Thousands

12 Months Ended

Dec. 31, 2013

USD ($)

^[1]

388,650

Principal Amount of Loans Subject to Delinquent Principal or Interest

388,650

^[2]

^[3]

Long-Term First Mortgage Loan [Member]

Long-Term First Mortgage Loan [Member] | Desert Valley Hospital [Member]

Periodic Payment Terms

Payable in monthly installments of interest plus principal payable in full at maturity

10.70%

2022

^[1]

70,000

Principal Amount of Loans Subject to Delinquent Principal or Interest

70,000

^[2]

^[3]

Long-Term First Mortgage Loan [Member] | Desert Valley Hospital [Member]

11.30%

2022

^[1]

20,000

Principal Amount of Loans Subject to Delinquent Principal or Interest

20,000

^[2]

^[3]

Long-Term First Mortgage Loan [Member] | Chino Valley Medical Center [Member]

10.70%

2022

^[1]

50,000

Principal Amount of Loans Subject to Delinquent Principal or Interest

50,000

^[2]

^[3]

Long-Term First Mortgage Loan [Member] | Paradise Valley Hospital [Member]

10.30%

2022

^[1]

25,000

Principal Amount of Loans Subject to Delinquent Principal or Interest

25,000

^[2]

^[3]

Long-Term First Mortgage Loan [Member] | Ernest Mortgage Loan [Member]

9.20%

^[4]

2032

^[4]

^[1],[4]

100,000

^[4]

Principal Amount of Loans Subject to Delinquent Principal or Interest

100,000

^[2],[4]

^[3],[4]

Long-Term First Mortgage Loan [Member] | Centinela Hospital Medical Center [Member]

10.50%

2022

^[1]

100,000

Principal Amount of Loans Subject to Delinquent Principal or Interest

100,000

^[2]

^[3]

Long-Term First Mortgage Loan [Member] | Olympia Medical Center [Member]

11.00%

2024

^[1]

20,000

Principal Amount of Loans Subject to Delinquent Principal or Interest

20,000

^[2]

^[3]

Long-Term First Mortgage Loan [Member] | Denham Springs LTACH [Member]

6.00%

2014

^[1]

3,650