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Document and Entity Information - shares	3 Months Ended
Document and Entity Information - shares	Mar. 31, 2014	May 08, 2014
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2014
Document Fiscal Year Focus	2014
Document Fiscal Period Focus	Q1
Trading Symbol	MPW
Entity Registrant Name	MEDICAL PROPERTIES TRUST INC.
Entity Central Index Key	0001287865
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		172,441,948
MPT Operating Partnership, L.P. [Member]
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2014
Document Fiscal Year Focus	2014
Document Fiscal Period Focus	Q1
Entity Registrant Name	MPT Operating Partnership, L.P.
Entity Central Index Key	0001524607
Current Fiscal Year End Date	--12-31
Entity Filer Category	Non-accelerated Filer

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2014	Dec. 31, 2013
Real estate assets
Land, buildings and improvements, and intangible lease assets	$ 2,008,422	$ 1,865,455
Mortgage loans	388,650	388,650
Net investment in direct financing leases	432,657	431,024
Gross investment in real estate assets	2,829,729	2,685,129
Accumulated depreciation and amortization	(173,475)	(159,776)
Net investment in real estate assets	2,656,254	2,525,353
Cash and cash equivalents	50,309	45,979
Interest and rent receivables	63,174	58,499
Straight-line rent receivables	48,023	45,829
Other loans	141,552	160,990
Other assets	67,280	67,920
Total Assets	3,026,592	2,904,570
Liabilities
Debt, net	1,472,045	1,421,681
Accounts payable and accrued expenses	74,184	94,311
Deferred revenue	25,419	23,787
Lease deposits and other obligations to tenants	23,964	20,583
Total liabilities	1,595,612	1,560,362
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 - 170,213 shares at March 31, 2014, and 161,310 shares at December 31, 2013	170	161
Limited Partners:
Additional paid in capital	1,732,916	1,618,054
Distributions in excess of net income	(293,596)	(264,804)
Accumulated other comprehensive loss	(8,248)	(8,941)
Treasury shares, at cost	(262)	(262)
Total Equity / Capital	1,430,980	1,344,208
Total Liabilities and Equity / Capital	3,026,592	2,904,570
MPT Operating Partnership, L.P. [Member]
Real estate assets
Land, buildings and improvements, and intangible lease assets	2,008,422	1,865,455
Mortgage loans	388,650	388,650
Net investment in direct financing leases	432,657	431,024
Gross investment in real estate assets	2,829,729	2,685,129
Accumulated depreciation and amortization	(173,475)	(159,776)
Net investment in real estate assets	2,656,254	2,525,353
Cash and cash equivalents	50,309	45,979
Interest and rent receivables	63,174	58,499
Straight-line rent receivables	48,023	45,829
Other loans	141,552	160,990
Other assets	67,280	67,920
Total Assets	3,026,592	2,904,570
Liabilities
Debt, net	1,472,045	1,421,681
Accounts payable and accrued expenses	38,274	58,559
Deferred revenue	25,419	23,787
Lease deposits and other obligations to tenants	23,964	20,583
Payable due to Medical Properties Trust, Inc.	35,520	35,362
Total liabilities	1,595,222	1,559,972
Limited Partners:
Accumulated other comprehensive loss	(8,248)	(8,941)
Total Equity / Capital	1,431,370	1,344,598
Total Liabilities and Equity / Capital	3,026,592	2,904,570
MPT Operating Partnership, L.P. [Member] \| Common Units [Member]
Limited Partners:
Limited Partners Capital	1,425,215	1,339,998
MPT Operating Partnership, L.P. [Member] \| General Partner [Member]
Equity / Capital
General Partner - issued and outstanding - 1,697 units at March 31, 2014 and 1,608 units at December 31, 2013	14,403	13,541
MPT Operating Partnership, L.P. [Member] \| LTIP Units [Member]
Limited Partners:
Limited Partners Capital

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares shares in Thousands	Mar. 31, 2014	Dec. 31, 2013
Preferred stock, par value	$ 0.001	$ 0.001
Preferred stock, shares authorized	10,000	10,000
Preferred stock, shares outstanding	0	0
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	250,000	250,000
Common stock, shares issued	170,213	161,310
Common stock, shares outstanding	170,213	161,310
MPT Operating Partnership, L.P. [Member] \| General Partner [Member]
General partner, units issued	1,697	1,608
General partner, units outstanding	1,697	1,608
MPT Operating Partnership, L.P. [Member] \| LTIP Units [Member]
LTIP Units, shares issued	363	292
LTIP Units, shares outstanding	363	292
MPT Operating Partnership, L.P. [Member] \| Common Units [Member]
Limited Partners, units issued	168,516	159,702
Limited Partners, units outstanding	168,516	159,702

Condensed Consolidated Statements of Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Revenues
Rent billed	$ 42,957	$ 31,499
Straight-line rent	2,148	2,651
Income from direct financing leases	12,215	8,756
Interest and fee income	15,769	14,707
Total revenues	73,089	57,613
Expenses
Real estate depreciation and amortization	13,690	8,469
Loan impairment charge	20,496
Property-related	738	409
General and administrative	8,959	7,766
Acquisition expenses	512	191
Total operating expenses	44,395	16,835
Operating income	28,694	40,778
Other income (expense)
Other income (expense)	(50)	(225)
Earnings from equity and other interests	220	492
Interest expense	(21,612)	(15,424)
Income tax benefit (expense)	57	(52)
Net other expense	(21,385)	(15,209)
Income (loss) from continuing operations	7,309	25,569
Income (loss) from discontinued operations	(2)	641
Net income	7,307	26,210
Net income (loss) attributable to non-controlling interests	(66)	(54)
Net income attributable to MPT common stockholders	$ 7,241	$ 26,156
Earnings per common share / units - basic
Income from continuing operations attributable to MPT common stockholders (Operating Partnership partners)	$ 0.04	$ 0.18
Income from discontinued operations attributable to MPT common stockholders (Operating Partnership partners)		0.01
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.04	$ 0.19
Weighted average shares (units) outstanding - basic	163,973	140,347
Earnings per common share / units - diluted
Income from continuing operations attributable to MPT common stockholders (Operating Partnership partners)	$ 0.04	$ 0.18
Income from discontinued operations attributable to MPT common stockholders / Operating Partnership partners
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.04	$ 0.18
Weighted average shares (units) outstanding - diluted	164,549	141,526
Dividends declared per common share / unit	$ 0.21	$ 0.20
MPT Operating Partnership, L.P. [Member]
Revenues
Rent billed	$ 42,957	$ 31,499
Straight-line rent	2,148	2,651
Income from direct financing leases	12,215	8,756
Interest and fee income	15,769	14,707
Total revenues	73,089	57,613
Expenses
Real estate depreciation and amortization	13,690	8,469
Loan impairment charge	20,496
Property-related	738	409
General and administrative	8,959	7,766
Acquisition expenses	512	191
Total operating expenses	44,395	16,835
Operating income	28,694	40,778
Other income (expense)
Other income (expense)	(50)	(225)
Earnings from equity and other interests	220	492
Interest expense	(21,612)	(15,424)
Income tax benefit (expense)	57	(52)
Net other expense	(21,385)	(15,209)
Income (loss) from continuing operations	7,309	25,569
Income (loss) from discontinued operations	(2)	641
Net income	7,307	26,210
Net income (loss) attributable to non-controlling interests	(66)	(54)
Net income attributable to MPT common stockholders	$ 7,241	$ 26,156
Earnings per common share / units - basic
Income from continuing operations attributable to MPT common stockholders (Operating Partnership partners)	$ 0.04	$ 0.18
Income from discontinued operations attributable to MPT common stockholders (Operating Partnership partners)		0.01
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.04	$ 0.19
Weighted average shares (units) outstanding - basic	163,973	140,347
Earnings per common share / units - diluted
Income from continuing operations attributable to MPT common stockholders (Operating Partnership partners)	$ 0.04	$ 0.18
Income from discontinued operations attributable to MPT common stockholders / Operating Partnership partners
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.04	$ 0.18
Weighted average shares (units) outstanding - diluted	164,549	141,526
Dividends declared per common share / unit	$ 0.21	$ 0.20

Condensed Consolidated Statements of Comprehensive Income (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Net income	$ 7,307	$ 26,210
Other comprehensive income (loss):
Unrealized gain on interest rate swap	721	827
Foreign currency translation loss	(28)
Total comprehensive income	8,000	27,037
Comprehensive income attributable to non-controlling interests	(66)	(54)
Comprehensive income (loss) attributable to MPT common stockholders (Operating Partnership partners)	7,934	26,983
MPT Operating Partnership, L.P. [Member]
Net income	7,307	26,210
Other comprehensive income (loss):
Unrealized gain on interest rate swap	721	827
Foreign currency translation loss	(28)
Total comprehensive income	8,000	27,037
Comprehensive income attributable to non-controlling interests	(66)	(54)
Comprehensive income (loss) attributable to MPT common stockholders (Operating Partnership partners)	$ 7,934	$ 26,983

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Operating activities
Net income	$ 7,307	$ 26,210
Adjustments to reconcile net income to net cash provided by operating activities
Depreciation and amortization	13,972	8,929
Direct financing lease (interest) accretion	(1,604)	(1,232)
Straight-line rent revenue	(3,099)	(2,661)
Straight-line rent write-off	950
Provision for uncollectible loans	20,354
Share-based compensation	2,287	1,919
Amortization and write-off of deferred financing costs and debt discount	1,049	897
Other adjustments	1,381	(673)
Changes in:
Accounts payable and accrued expenses	(19,641)	(1,788)
Interest and rent receivable	(4,674)	(4,550)
Net cash provided by operating activities	18,282	27,051
Investing activities
Cash paid for acquisitions and other related investments	(115,000)
Principal received on loans receivable	1,469	2,090
Investments in loans receivable	(2,385)	(800)
Construction in progress and other	(27,925)	(13,526)
Net cash used for investing activities	(143,841)	(12,236)
Financing activities
Revolving credit facilities, net	50,000	(125,000)
Payments of term debt	(68)	(64)
Distributions paid	(35,778)	(27,786)
Proceeds from sale of common shares / units, net of offering costs	112,583	172,914
Lease deposits and other obligations to tenants	3,380	3,549
Debt issuance costs paid and other financing activities	(241)	(64)
Net cash provided by (used in) financing activities	129,876	23,549
Increase in cash and cash equivalents for period	4,317	38,364
Effect of exchange rate changes	13
Cash and cash equivalents at beginning of period	45,979	37,311
Cash and cash equivalents at end of period	50,309	75,675
Interest paid	22,613	10,162
Supplemental schedule of non-cash financing activities:
Distributions declared, unpaid	36,032	30,060
MPT Operating Partnership, L.P. [Member]
Operating activities
Net income	7,307	26,210
Adjustments to reconcile net income to net cash provided by operating activities
Depreciation and amortization	13,972	8,929
Direct financing lease (interest) accretion	(1,604)	(1,232)
Straight-line rent revenue	(3,099)	(2,661)
Straight-line rent write-off	950
Provision for uncollectible loans	20,354
Share-based compensation	2,287	1,919
Amortization and write-off of deferred financing costs and debt discount	1,049	897
Other adjustments	1,381	(673)
Changes in:
Accounts payable and accrued expenses	(4,674)	(1,788)
Interest and rent receivable	(19,641)	(4,550)
Net cash provided by operating activities	18,282	27,051
Investing activities
Cash paid for acquisitions and other related investments	(115,000)
Principal received on loans receivable	1,469	2,090
Investments in loans receivable	(2,385)	(800)
Construction in progress and other	(27,925)	(13,526)
Net cash used for investing activities	(143,841)	(12,236)
Financing activities
Revolving credit facilities, net	50,000	(125,000)
Payments of term debt	(68)	(64)
Distributions paid	(35,778)	(27,786)
Proceeds from sale of common shares / units, net of offering costs	112,583	172,914
Lease deposits and other obligations to tenants	3,380	3,549
Debt issuance costs paid and other financing activities	(241)	(64)
Net cash provided by (used in) financing activities	129,876	23,549
Increase in cash and cash equivalents for period	4,317	38,364
Effect of exchange rate changes	13
Cash and cash equivalents at beginning of period	45,979	37,311
Cash and cash equivalents at end of period	50,309	75,675
Interest paid	22,613	10,162
Supplemental schedule of non-cash financing activities:
Distributions declared, unpaid	$ 36,032	$ 30,060

Organization	3 Months Ended
Organization	Mar. 31, 2014
Accounting Policies [Abstract]
Organization	1. Organization Medical Properties Trust, Inc., a Maryland corporation, was formed on August 27, 2003, under the Maryland General Corporation Law for the purpose of engaging in the business of investing in, owning, and leasing commercial real estate. Our operating partnership subsidiary, MPT Operating Partnership, L.P., (the “Operating Partnership”) through which we conduct all of our operations, was formed in September 2003. Through another wholly-owned subsidiary, Medical Properties Trust, LLC, we are the sole general partner of the Operating Partnership. At present, we directly own substantially all of the limited partnership interests in the Operating Partnership and have elected to report our required disclosures and that of the Operating Partnership on a combined basis except where material differences exist. We have operated as a real estate investment trust (“REIT”) since April 6, 2004, and 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.

- Definition

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

+ References

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+ Details

Summary of Significant Accounting Policies

3 Months Ended

Mar. 31, 2014

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

2. Summary of Significant Accounting Policies

Unaudited Interim Condensed Consolidated Financial Statements: The accompanying unaudited interim condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States for interim financial information, including rules and regulations of the Securities and Exchange Commission. Accordingly, they do not include all of the information and footnotes required by generally accepted accounting principles for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair presentation have been included. Operating results for the three month period ended March 31, 2014, are not necessarily indicative of the results that may be expected for the year ending December 31, 2014. The condensed consolidated balance sheet at December 31, 2013 has been derived from the audited financial statements at that date but does not include all of the information and footnotes required by accounting principles generally accepted in the United States for complete financial statements.

For information about significant accounting policies, refer to the consolidated financial statements and footnotes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2013. During the three months ended March 31, 2014, there were no material changes to these policies, except as noted below with respect to discontinued operations.

Reclassifications: Certain reclassifications have been made to the condensed consolidated financial statements to conform to the 2014 consolidated financial statement presentation. These reclassifications had no impact on stockholders’ equity or net income.

Recent Accounting Development: In 2014, the FASB issued Accounting Standards Update 2014-08, Reporting Discontinued Operations and Disclosures of Disposals of Components of an Entity (“ASU 2014-08”), which raises the threshold for disposals to qualify as discontinued operations. A discontinued operation is defined as: (1) a component of an entity or group of components that has been disposed of or classified as held for sale and represents a strategic shift that has or will have a major effect on an entity’s operations and financial results; or (2) an acquired business that is classified as held for sale on the acquisition date. ASU 2014-08 also requires additional disclosures regarding discontinued operations, as well as material disposals that do not meet the definition of discontinued operations. We adopted ASU 2014-08 for the quarter ended March 31, 2014. The application of this guidance is prospective from the date of adoption and should result in our not generally having to reflect single property disposals as discontinued operations in the future.

Variable Interest Entities

At March 31, 2014, we had loans to and/or equity investments in several variable interest entities (“VIEs”) for which we are not the primary beneficiary. The carrying value and classification of the related assets and maximum exposure to loss as a result of our involvement with these VIEs are presented below at March 31, 2014 (in thousands):


VIE Type	Maximum Loss Exposure(1)		Asset Type Classification	Carrying Amount(2)
Loans, net	$	268,881	Mortgage and other loans	$	210,523
Equity investments	$	18,827	Other assets	$	5,040

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

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

For the VIE types above, we do not consolidate the VIE because we do not have the ability to control the activities (such as the day-to-day healthcare operations of our borrower or investee) that most significantly impact the VIE’s economic performance. As of March 31, 2014, 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.

Real Estate and Lending Activities

3 Months Ended

Mar. 31, 2014

Leases [Abstract]

Real Estate and Lending Activities

3. Real Estate and Lending Activities

Acquisitions

On March 31, 2014, we acquired a general acute care hospital and an adjacent parcel for an aggregate purchase price of $115 million from a joint venture of LHP Hospital Group, Inc. and Hackensack University Medical Center Mountainside. The facility was simultaneously leased back to the seller under a lease with a 15-year initial term with a 3-year extension option, followed by a further 12-year extension option at fair market value. The lease provides for consumer price-indexed annual rent increases, subject to a specified floor and ceiling. The lease includes a customary right of first refusal with respect to a subsequent proposed sale of the facility.

With this transaction we acquired the following assets:


	2014
Assets Acquired
Land	$	8,515
Building		99,602
Intangible lease assets — subject to amortization (weighted average useful life 15 years)		6,883

Total assets acquired	$	115,000
Total liabilities assumed		—

Net assets acquired	$	115,000

The purchase price allocation attributable to the facility acquired in the 2014 first quarter along with the facilities acquired from IASIS and RHM in the 2013 third and fourth quarters is preliminary as we are waiting on additional information to perform our final analysis. When all relevant information is obtained, and if changes to our provisional purchase price allocation are needed, we will retrospectively adjust to reflect the new information obtained about the facts and circumstances that existed as of the respective acquisition date that, if known, would have affected the measurement of the amounts recognized as of that date.

Development Activities

During the 2014 first quarter, we completed construction and began recording rental income on the following three facilities:

•

Northern Utah Rehabilitation Hospital – This $19 million inpatient rehabilitation facility located in South Ogden, Utah is leased to Ernest pursuant to the 2012 master lease.

•

First Choice ER – Nacogdoches – This is a $5 million acute care facility located in San Antonio, Texas and is leased to First Choice ER pursuant to the master lease entered into in 2013.

•

First Choice ER – Alvin – This is a $5 million acute care facility located in Houston, Texas and is leased to First Choice ER pursuant to the master lease entered into in 2013.

In the first quarter of 2014, we began construction on 9 additional facilities pursuant to the master funding and development agreement with First Choice ER.

In regards to our Twelve Oaks facility, approximately 55% of this facility is being occupied, 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
March 31,
2014

Estimated
Completion
Date

Oakleaf Surgical Hospital

Altoona, WI

Acute Care Hospital

National Surgical Hospitals

33,500

22,780

3Q 2014

First Choice ER - Brodie

Austin, TX

Acute Care Hospital

First Choice ER, LLC

5,466

2,829

2Q 2014

First Choice ER - Briar Forest

Houston, TX

Acute Care Hospital

First Choice ER, LLC

5,844

1,595

3Q 2014

First Choice ER - Cedar Hill

Cedar Hill, TX

Acute Care Hospital

First Choice ER, LLC

5,769

1,710

3Q 2014

First Choice ER- Firestone

Firestone, CO

Acute Care Hospital

First Choice ER, LLC

5,173

1,699

3Q 2014

First Choice ER - Allen

Allen, TX

Acute Care Hospital

First Choice ER, LLC

6,187

2,042

3Q 2014

First Choice ER - Frisco

Frisco, TX

Acute Care Hospital

First Choice ER, LLC

5,893

2,060

3Q 2014

First Choice ER - Broomfield

Broomfield, CO

Acute Care Hospital

First Choice ER, LLC

5,238

1,118

3Q 2014

First Choice ER - Spring

Spring, TX

Acute Care Hospital

First Choice ER, LLC

5,804

1,804

3Q 2014

First Choice ER - North Gate

Colorado Springs, CO

Acute Care Hospital

First Choice ER, LLC

5,249

896

3Q 2014

First Choice ER - Fountain

Fountain, CO

Acute Care Hospital

First Choice ER, LLC

6,194

1,558

3Q 2014

First Choice ER - Missouri City (Sienna)

Houston, TX

Acute Care Hospital

First Choice ER, LLC

5,394

1,062

3Q 2014

First Choice ER - Pearland

Pearland, TX

Acute Care Hospital

First Choice ER, LLC

5,691

1,403

4Q 2014

First Choice ER - Thornton

Thornton, CO

Acute Care Hospital

First Choice ER, LLC

6,029

1,400

4Q 2014

First Choice - ER

Various

Acute Care Hospital

First Choice ER, LLC

10,615

—

118,046

43,956

Leasing Operations

All of our leases are accounted for as operating leases except for the master lease of 13 Ernest facilities and five Prime facilities which are accounted for as direct financing leases (“DFLs”). The components of our net investment in DFLs consisted of the following (dollars in thousands):


	As of March 31, 2014			As of December 31, 2013
Minimum lease payments receivable	$	1,637,092		$	1,647,567
Estimated residual values		211,888			211,863
Less: Unearned income		(1,416,323	)		(1,428,406	)

Net investment in direct financing leases	$	432,657		$	431,024

Monroe Facility

As of March 31, 2014 and December 31, 2013, our net investment (exclusive of the related real estate) in Monroe was as follows:


	As of March 31, 2014			As of December 31, 2013
Loans	$	33,726		$	31,341
Less: Loan impairment reserve		(32,354	)		(12,000	)
Loans, net		1,372			19,341

Interest, rent and other receivables*		20,992			20,972

Net investment	$	22,364		$	40,313

Includes approximately $ 6 million of interest receivables that are significantly more than 90 days past due

The operator of our Monroe facility has not made all payments required by the real estate lease agreement and working capital loan agreement, and we have deemed the loan to be impaired. During 2010, we recorded a $12 million impairment charge on the working capital loan and fully reserved for unbilled straight-line rent receivables as well. Since 2010, we have not recognized any interest income on the Monroe loan and have not recorded any unbilled rent revenue. In addition, we stopped recording billed rental revenue on April 1, 2013, until we begin receiving cash payments.

During the first quarter of 2014, we commenced and have recently executed a non-binding letter of intent with a third party with respect to a restructuring of our investment in the form of a new joint venture that would acquire the real estate of our Monroe facility and related assets in exchange for a combination of cash and promissory notes. We will also be entitled to additional cash, if any, generated from our share in the new joint venture’s operations (but not be liable to fund any losses or other cash needs) during its first five years of operations. While we expect the transaction to close during the second half of 2014, the transaction is contingent upon, among other things, the negotiation and execution of definitive agreements and the completion of satisfactory due diligence, and we cannot assure you that it will be consummated on the terms described above or at all. Based on these new developments and the current fair value of the loan’s underlying collateral (using Level 2 inputs), we believe an additional reserve on our loan is needed and as a result we recorded an approximate $20.5 million impairment charge in the 2014 first quarter. If the transaction is not completed as currently expected or if the terms of such anticipated transaction change, further impairment charges could be incurred.

Florence facility

On March 6, 2013, the tenant of our facility in Phoenix, Arizona filed for Chapter 11 bankruptcy; but continues to pay rent. We have a letter of credit for approximately $1.2 million to cover any rent and other monetary payments not made. Although no assurances can be made that we will not have any impairment charges in the future, we believe our real estate investment in Florence of approximately $28 million at March 31, 2014, is fully recoverable.

Gilbert facility

In the first quarter of 2014, the tenant of our facility in Gilbert, Arizona filed for Chapter 11 bankruptcy; we sent notice of termination of the lease prior to the bankruptcy filing. As a result of the lease terminating, we recorded an accrual charge of approximately $1 million to reserve against the straight-line rent receivables. In addition, we accelerated the amortization of the related lease intangible asset resulting in $1.1 million of additional expense in the 2014 first quarter. At March 31, 2014, we have $0.1 million of outstanding receivables, which we believe are collectible. 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 real estate investment in Gilbert of approximately $14 million at March 31, 2014, is fully recoverable.

Loans

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


	As of March 31, 2014		As of December 31, 2013
Mortgage loans	$	388,650	$	388,650
Acquisition loans		103,016		103,266
Working capital and other loans		35,184		54,372
Convertible loan		3,352		3,352

	$	530,202	$	549,640

The decrease in our working capital and other loans is due to the $20 million impairment charge incurred on our Monroe loan during the 2014 first quarter – see Note 3 for further discussion.

On March 1, 2012, pursuant to our convertible note agreement, we converted $1.7 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 March 31, 2014, $3.3 million remains outstanding on the convertible note, and we retain the option, subject to regulatory approvals, to convert this remainder into 15.1% of equity interest in the operator.

Concentrations of Credit Risk

For the three months ended March 31, 2014 and 2013, revenue from affiliates of Ernest (including rent and interest from mortgage and acquisition loans) accounted for 19.5% and 20.5% of total revenue, respectively. From an investment concentration perspective, Ernest represented 15.8% and 15.9% of our total assets at March 31, 2014 and December 31, 2013, respectively.

For the three months ended March 31, 2014 and 2013, revenue from affiliates of Prime (including rent and interest from mortgage loans) accounted for 29.1% and 31.4%, respectively, of total revenue. From an investment concentration perspective, Prime represented 23.5% and 24.5% of our total assets at March 31, 2014 and December 31, 2013, respectively.

On an individual property basis, we had no investment of any single property greater than 4% of our total assets as of March 31, 2014.

From a geographic perspective, investments located in California represented 17.9% of our total assets at March 31, 2014, down from 18.7% at December 31, 2013. Investments located in Texas represented 22.0% of our total assets at March 31, 2014, down slightly from 22.7% at December 31, 2013. In addition, we further expanded our portfolio into Europe with the RHM portfolio acquisition in 2013, which represents less than 8% of total assets at March 31, 2014.

Debt

3 Months Ended

Mar. 31, 2014

Debt Disclosure [Abstract]

Debt

4. Debt

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


	As of March 31, 2014					As of December 31, 2013
	Balance		Interest Rate			Balance		Interest Rate
Revolving credit facility	$	155,000		Variable		$	105,000		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	%		350,000		6.375	%
Unamortized premium		2,785					2,873

		352,785					352,873


2013 Senior Unsecured Notes (A)		275,380		5.75	%		274,860		5.75	%
Term loans		113,880		Various			113,948		Various

	$	1,472,045				$	1,421,681

(A)

These notes are Euro-denominated and reflect the exchange rate at March 31, 2014.

As of March 31, 2014, principal payments due on our debt (which exclude the effects of any premium recorded) are as follows (in thousands):


2014	$	198
2015		155,283
2016		225,299
2017		320
2018		12,781
Thereafter		1,075,379

Total	$	1,469,260

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 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 our 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%. The fair value of the interest rate swaps was $8.3 million and $9.0 million as of March 31, 2014 and December 31, 2013, respectively, which is reflected in accounts payable and accrued expenses on the consolidated balance sheets.

We designated 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 effect earnings, while any ineffective portion is recorded through earnings immediately. We did not have any hedge ineffectiveness in the periods; therefore, there was no income statement effect recorded during the three month periods ended March 31, 2014 or 2013. 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 March 31, 2014 and December 31, 2013, we had $4.5 million and $5.0 million, respectively, posted as collateral, which is currently reflected in other assets on our consolidated balance sheets.

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 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 March 31, 2014, the dividend restriction was 95% of normalized adjusted FFO. The indentures governing our 2011, 2012 and 2013 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, 2012 and 2013 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 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 March 31, 2014, we were in compliance with all such financial and operating covenants.

Common Stock/Partner's Capital	3 Months Ended
Common Stock/Partner's Capital	Mar. 31, 2014
Text Block [Abstract]
Common Stock/Partner's Capital	5. Common Stock/Partner’s Capital Medical Properties Trust, Inc. On March 11, 2014, we completed an underwritten public offering of 7.7 million shares of our common stock, resulting in net proceeds of approximately $100.2 million, after deducting estimated offering expenses. We also granted the underwriters a 30-day option to purchase up to an additional 1.2 million shares of common stock. The option, which was exercised in full, closed on April 8, 2014 and resulted in additional net proceeds of approximately $16 million. In January 2014, we put an at-the-market equity offering program in place, giving us the ability to sell up to $250 million of stock with a commission of 1.25%. During the 2014 first quarter, we sold 0.9 million shares of our common stock under our at-the-market equity offering program, at an average price of $13.21 per share resulting in total proceeds, net of commission, of $12.3 million. On February 28, 2013, we completed an offering of 12.7 million shares of our common stock (including 1.7 million 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. MPT Operating Partnership, L.P. At March 31, 2014, the Company has a 99.8% ownership interest in the Operating Partnership with the remainder owned by three other partners, two of whom are employees and one of whom is a director. During the three months ended March 31, 2014 and 2013, the partnership issued 8.6 million and 12.7 million units, respectively, in direct response to the common stock offerings by Medical Properties Trust, Inc.

Stock Awards	3 Months Ended
Stock Awards	Mar. 31, 2014
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock Awards	6. Stock Awards We adopted the 2013 Equity Incentive Plan (the “Equity Incentive Plan”) during second quarter of 2013, which authorizes the issuance of common stock options, restricted stock, restricted stock units, deferred stock units, stock appreciation rights, performance units and awards of interests in our Operating Partnership. The Equity Incentive Plan is administered by the Compensation Committee of the Board of Directors. We have reserved 7,643,651 shares of common stock for awards under the Equity Incentive Plan for which 6,451,291 shares remain available for future stock awards as of March 31, 2014. We awarded the following during the 2014 and 2013 first quarters: Time-based awards—We granted 338,484 and 258,736 shares in 2014 and 2013, respectively, of time-based restricted stock to management, independent directors and certain employees. These awards vest quarterly based on service, over three years, in equal amounts. Performance-based awards—Our management team and certain employees were awarded 317,254 and 222,566 performance based awards in 2014 and 2013, respectively. These awards vest ratably over a three year period based on the achievement of certain total shareholder return measures, with a carry-back and carry-forward provision through December 31, 2017 (for the 2013 awards) and December 31, 2018 (for the 2014 awards). Dividends on these awards are paid only upon achievement of the performance measures. Multi-year Performance-based awards—We awarded 500,000 and 550,000 shares in 2014 and 2013, respectively, of multi-year performance-based awards to management. These shares are subject to three-year cumulative performance hurdles based on measures of total shareholder return. At the end of the three-year performance period, any earned shares will be subject to an additional two years of ratable time-based vesting on an annual basis. Dividends are paid on these shares only upon achievement of the performance measures.

Fair Value of Financial Instruments

3 Months Ended

Mar. 31, 2014

Fair Value Disclosures [Abstract]

Fair Value of Financial Instruments

7. Fair Value of Financial Instruments

We have various assets and liabilities that are considered financial instruments. We estimate that the carrying value of cash and cash equivalents, and accounts payable and accrued expenses approximate their fair values. 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 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 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):


	March 31, 2014						December 31, 2013
Asset (Liability)	Book Value			Fair Value			Book Value			Fair Value
Interest and rent receivables	$	63,174		$	62,901		$	58,499		$	44,349
Loans (1)		332,419			348,495			351,607			358,277
Debt, net		(1,472,045	)		(1,553,093	)		(1,421,681	)		(1,486,090	)

(1)	Excludes loans related to the 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, which were acquired in 2012, 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.

At March 31, 2014, these amounts were as follows (in thousands):


Asset Type	Fair Value		Cost		Asset Type Classification
Mortgage loans	$	100,000	$	100,000	Mortgage loans
Acquisition loan		97,783		97,783	Other loans
Equity investments		3,300		3,300	Other assets

	$	201,083	$	201,083

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 marketability discount (“DLOM”) on our equity investment of 40% at March 31, 2014.

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	$	(344	)
- 100 basis points		344

Because the fair value of Ernest investments noted above approximate their original cost, we did not recognize any unrealized gains/losses during the first quarter of 2014.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Discontinued Operations

3 Months Ended

Mar. 31, 2014

Discontinued Operations And Disposal Groups [Abstract]

Discontinued Operations

8. Discontinued Operations

The following table presents the results of discontinued operations, which include the revenue and expenses of facilities disposed of in 2013, for the three months ended March 31, 2014 and 2013 (dollar amounts in thousands except per share/unit amounts):


	For the Three Months Ended March 31,
	2014			2013
Revenues	$	—		$	828
Income (loss)		(2	)		641
Earnings per share/unit — diluted	$	—		$	—

- Definition

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
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-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 1
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Reference 3: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
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-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
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-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 45
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-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
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-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
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-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
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-Section 50
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-URI http://asc.fasb.org/extlink&oid=6391110&loc=d3e2941-110230

+ Details

Earnings Per Share

3 Months Ended

Mar. 31, 2014

Earnings Per Share [Abstract]

Earnings Per Share

9. Earnings Per Share

Medical Properties Trust, Inc.

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


	For the Three Months Ended March 31,
	2014			2013
Numerator:
Income from continuing operations	$	7,309		$	25,569
Non-controlling interests’ share in continuing operations		(66	)		(54	)
Participating securities’ share in earnings		(209	)		(193	)

Income from continuing operations, less participating securities’ share in earnings		7,034			25,322
Income (loss) from discontinued operations attributable to MPT common stockholders		(2	)		641

Net income, less participating securities’ share in earnings	$	7,032		$	25,963


	For the Three Months Ended March 31,
	2014		2013
Denominator:
Basic weighted-average common shares		163,973		140,347
Dilutive potential common shares		576		1,179

Dilutive weighted-average common shares		164,549		141,526

MPT Operating Partnership, L.P.

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


	For the Three Months Ended March 31,
	2014			2013
Numerator:
Income from continuing operations	$	7,309		$	25,569
Non-controlling interests’ share in continuing operations		(66	)		(54	)
Participating securities’ share in earnings		(209	)		(193	)

Income from continuing operations, less participating securities’ share in earnings		7,034			25,322
Income (loss) from discontinued operations attributable to MPT Operating Partnership partners		(2	)		641

Net income, less participating securities’ share in earnings	$	7,032		$	25,963

Denominator:
Basic weighted-average units		163,973			140,347
Dilutive potential units		576			1,179

Diluted weighted-average units		164,549			141,526

Contingencies	3 Months Ended
Contingencies	Mar. 31, 2014
Commitments And Contingencies Disclosure [Abstract]
Contingencies	10. Contingencies We are a party to various legal proceedings incidental to our business. In the opinion of management, after consultation with legal counsel, the ultimate liability, if any, with respect to those proceedings is not presently expected to materially affect our financial position, results of operations or cash flows.

Subsequent Events	3 Months Ended
Subsequent Events	Mar. 31, 2014
Subsequent Events [Abstract]
Subsequent Events	11. Subsequent Events On April 17, 2014, we completed a $300 million senior unsecured notes offering (“2014 Senior Unsecured Notes”). Interest on the Notes will be payable semi-annually on May 1 and November 1 of each year, commencing on November 1, 2014. The 2014 Senior Unsecured Notes will pay interest in cash at a rate of 5.50% per year. The Notes mature on May 1, 2024. We may redeem some or all of the 2014 Senior Unsecured Notes at any time prior to May 1, 2019 at a “make-whole” redemption price. On or after May 1, 2019, 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 May 1, 2017, we may redeem up to 35% of the aggregate principal amount of the 2014 Senior Unsecured Notes using the proceeds of one or more equity offerings. The 2014 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 2014 Senior Unsecured Notes may require us to repurchase some or all of our 2014 Senior Unsecured Notes at a repurchase price equal to 101% of the aggregate principal amount of the 2014 Senior Unsecured Notes plus accrued and unpaid interest to the date of purchase.

Condensed Consolidating Financial Information

3 Months Ended

Mar. 31, 2014

Condensed Financial Information Of Parent Company Only Disclosure [Abstract]

Condensed Consolidating Financial Information

12. 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 Issuers”), (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 March 31, 2013, 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. In addition, certain of our subsidiaries previously classified as non-guarantors are guarantors as of March 31, 2014. With these re-designations, we have restated the 2013 consolidating financial information below to reflect these changes.

Condensed Consolidated Balance Sheets

March 31, 2014

(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	$	—	$	—		$	1,940,880		$	67,542		$	—		$	2,008,422
Net investment in direct financing leases		—		—			213,244			219,413						432,657
Mortgage loans		—		—			288,650			100,000			—			388,650

Gross investment in real estate assets		—		—			2,442,774			386,955			—			2,829,729
Accumulated depreciation and amortization		—		—			(164,898	)		(8,577	)		—			(173,475	)

Net investment in real estate assets		—		—			2,277,876			378,378			—			2,656,254
Cash and cash equivalents		—		31,104			18,564			641			—			50,309
Interest and rent receivables		—		537			32,735			29,902			—			63,174
Straight-line rent receivables		—		—			38,416			9,607			—			48,023
Other loans		—		178			1,100			140,274			—			141,552
Net intercompany receivable		35,608		1,999,835			—			—			(2,035,443	)		—
Investment in subsidiaries		1,431,370		851,636			42,326			—			(2,325,332	)		—
Other assets		—		36,088			1,169			30,023			—			67,280

Total Assets	$	1,466,978	$	2,919,378		$	2,412,186		$	588,825		$	(4,360,775	)	$	3,026,592

Liabilities and Equity
Liabilities
Debt, net	$	—	$	1,458,165		$	—		$	13,880		$	—		$	1,472,045
Accounts payable and accrued expenses		35,998		29,974			7,713			499			—			74,184
Net intercompany payable		—		—			1,649,895			385,548			(2,035,443	)		—
Deferred revenue		—		(131	)		19,373			6,177			—			25,419
Lease deposits and other obligations to tenants		—		—			20,265			3,699			—			23,964

Total liabilities		35,998		1,488,008			1,697,246			409,803			(2,035,443	)		1,595,612

Total Equity		1,430,980		1,431,370			714,940			179,022			(2,325,332	)		1,430,980

Total Liabilities and Equity	$	1,466,978	$	2,919,378		$	2,412,186		$	588,825		$	(4,360,775	)	$	3,026,592

Condensed Consolidated Statements of Income

For the Year Ended March 31, 2014

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors			Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Revenues
Rent billed	$	—		$	—		$	40,975		$	5,660		$	(3,678	)	$	42,957
Straight-line rent		—			—			1,357			791			—			2,148
Income from direct financing leases		—			—			11,609			5,872			(5,266	)		12,215
Interest and fee income		—			10,132			15,255			7,858			(17,476	)		15,769

Total revenues		—			10,132			69,196			20,181			(26,420	)		73,089
Expenses
Real estate depreciation and amortization		—			—			13,265			425			—			13,690
Impairment charge		—			—			—			20,496			—			20,496
Property-related		—			172			432			9,078			(8,944	)		738
Acquisition expenses		—			375			137			—			—			512
General and administrative		—			8,149			201			609			—			8,959

Total operating expenses		—			8,696			14,035			30,608			(8,944	)		44,395

Operating income		—			1,436			55,161			(10,427	)		(17,476	)		28,694
Other income (expense)
Other income (expense)		—			(46	)		—			(4	)		—			(50	)
Earnings from equity and other interests		—			—			—			220			—			220
Interest expense		—			(21,823	)		(9,919	)		(7,346	)		17,476			(21,612	)
Income tax (expense) benefit		—			—			65			(8	)		—			57

Net other expense		—			(21,869	)		(9,854	)		(7,138	)		17,476			(21,385	)

Income (loss) from continuing operations		—			(20,433	)		45,307			(17,565	)		—			7,309
Loss from discontinued operations		—			—			—			(2	)		—			(2	)

Equity in earnings of consolidated subsidiaries net of income taxes		7,307			27,740			1,121			—			(36,168	)		—

Net income (loss)		7,307			7,307			46,428			(17,567	)		(36,168	)		7,307
Net income (loss) attributable to non-controlling interests		(66	)		(66	)		—			—			66			(66	)

Net income attributable to MPT common stockholders	$	7,241		$	7,241		$	46,428		$	(17,567	)	$	(36,102	)	$	7,241

Condensed Consolidated Statements of Comprehensive Income

For the Year Ended March 31, 2014

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors		Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Net income	$	7,307		$	7,307		$	46,428	$	(17,567	)	$	(36,168	)	$	7,307
Other comprehensive income:
Unrealized gain on interest rate swap		721			721			—		—			(721	)		721
Foreign currency translation loss		(28	)		(28	)		—		—			28			(28	)

Total comprehensive income		8,000			8,000			46,428		(17,567	)		(36,861	)		8,000
Comprehensive income attributable to non-controlling interests		(66	)		(66	)		—		—			66			(66	)

Comprehensive income attributable to MPT common stockholders	$	7,934		$	7,934		$	46,428	$	(17,567	)	$	(36,795	)	$	7,934

Condensed Consolidated Statements of Cash Flows

For the Year Ended March 31, 2014

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors			Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Operating Activities
Net cash provided by (used in) operating activities	$	234		$	(23,272	)	$	43,606		$	(2,286	)	$	—		$	18,282
Investing Activities
Cash paid for acquisitions and other related investments		—			—			(115,000	)		—			—			(115,000	)
Principal received on loans receivable		—			—			—			1,469			—			1,469
Investments in loans receivable		—			—			—			(2,385	)		—			(2,385	)
Construction in progress and other		—			205			(27,303	)		(827	)		—			(27,925	)

Net cash provided by (used in) investing activities		—			205			(142,303	)		(1,743	)		—			(143,841	)
Financing Activities
Revolving credit facilities, net		—			50,000			—			—			—			50,000
Payments of term debt		—			—			—			(68	)		—			(68	)
Distributions paid		(35,717	)		(35,778	)		—			—			35,717			(35,778	)
Lease deposits and other obligations to tenants		—			—			1,970			1,410			—			3,380
Net payments relating to intercompany financing		(77,100	)		(91,208	)		88,184			3,258			76,866			—
Proceeds from sale of common shares, net of offering costs		112,583			112,583			—			—			(112,583	)		112,583
Debt issuance costs paid and other financing activities		—			(241	)		—			—			—			(241	)

Net cash provided by (used in) financing activities		(234	)		35,356			90,154			4,600			—			129,876

Increase (decrease) in cash and cash equivalents for period		—			12,289			(8,543	)		571			—			4,317
Effect of exchange rate changes		—			—			13			—			—			13
Cash and cash equivalents at beginning of period		—			18,815			27,094			70			—			45,979

Cash and cash equivalents at end of period	$	—		$	31,104		$	18,564		$	641		$	—		$	50,309

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	$	—	$	—	$	1,796,411		$	69,044		$	—		$	1,865,455
Net investment in direct financing leases		—		—		212,543			218,481						431,024
Mortgage loans		—		—		288,650			100,000			—			388,650

Gross investment in real estate assets		—		—		2,297,604			387,525			—			2,685,129
Accumulated depreciation and amortization		—		—		(151,624	)		(8,152	)		—			(159,776	)

Net investment in real estate assets		—		—		2,145,980			379,373			—			2,525,353
Cash and cash equivalents		—		18,815		27,094			70			—			45,979
Interest and rent receivables		—		336		31,462			26,701			—			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		1,165			29,444			—			67,920

Total Assets	$	1,379,961	$	2,789,267	$	2,286,223		$	604,114		$	(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		20,522			1,149			—			94,311
Net intercompany payable		—		—		1,560,039			382,798			(1,942,837	)		—
Deferred revenue		—		49		17,785			5,953			—			23,787
Lease deposits and other obligations to tenants		—		—		18,139			2,444			—			20,583

Total liabilities		35,753		1,444,669		1,616,485			406,292			(1,942,837	)		1,560,362

Total Equity		1,344,208		1,344,598		669,738			197,822			(2,212,158	)		1,344,208

Total Liabilities and Equity	$	1,379,961	$	2,789,267	$	2,286,223		$	604,114		$	(4,154,995	)	$	2,904,570

Condensed Consolidated Statements of Income

For the Year Ended March 31, 2013

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors			Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Revenues
Rent billed	$	—		$	—		$	29,630		$	4,504		$	(2,635	)	$	31,499
Straight-line rent		—			—			2,277			374			—			2,651
Income from direct financing leases		—			—			8,204			5,485			(4,933	)		8,756
Interest and fee income		—			5,057			9,208			7,531			(7,089	)		14,707

Total revenues		—			5,057			49,319			17,894			(14,657	)		57,613
Expenses
Real estate depreciation and amortization		—			—			8,044			425			—			8,469
Property-related		—			172			190			7,616			(7,569	)		409
Acquisition expenses		—			191			—			—			—			191
General and administrative		—			6,744			—			1,022			—			7,766

Total operating expenses		—			7,107			8,234			9,063			(7,569	)		16,835

Operating income		—			(2,050	)		41,085			8,831			(7,088	)		40,778
Other income (expense)
Other income (expense)		—			(22	)		(2,635	)		(204	)		2,636			(225	)
Earnings from equity and other interests		—			—			—			492			—			492
Interest expense		—			(15,517	)		2,946			(7,305	)		4,452			(15,424	)
Income tax expense		—			—			—			(52	)		—			(52	)

Net other (expense) income		—			(15,539	)		311			(7,069	)		7,088			(15,209	)

Income (loss) from continuing operations		—			(17,589	)		41,396			1,762			—			25,569
Income (loss) from discontinued operations		—			—			(4	)		645			—			641

Equity in earnings of consolidated subsidiaries net of income taxes		26,210			43,799			1,121			—			(71,130	)		—

Net income (loss)		26,210			26,210			42,513			2,407			(71,130	)		26,210
Net income (loss) attributable to non-controlling interests		(54	)		(54	)		—			—			54			(54	)

Net income attributable to MPT common stockholders	$	26,156		$	26,156		$	42,513		$	2,407		$	(71,076	)	$	26,156

Condensed Consolidated Statements of Comprehensive Income

For the Year Ended March 31, 2013

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors		Non-Guarantor Subsidiaries		Eliminations			Total Consolidated
Net income	$	26,210		$	26,210		$	42,513	$	2,407	$	(71,130	)	$	26,210
Other comprehensive income:
Unrealized gain on interest rate swap		827			827			—		—		(827	)		827

Total comprehensive income		27,037			27,037			42,513		2,407		(71,957	)		27,037
Comprehensive income attributable to non-controlling interests		(54	)		(54	)		—		—		54			(54	)

Comprehensive income attributable to MPT common stockholders	$	26,983		$	26,983		$	42,513	$	2,407	$	(71,903	)	$	26,983

Condensed Consolidated Statements of Cash Flows

For the Year Ended March 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	$	213		$	(9,099	)	$	36,434		$	(497	)	$	—		$	27,051
Investing Activities
Principal received on loans receivable		—			—			—			2,090			—			2,090
Investments in loans receivable		—			—			—			(800	)		—			(800	)
Construction in progress and other		—			331			(13,245	)		(612	)		—			(13,526	)

Net cash provided by (used in) investing activities		—			331			(13,245	)		678			—			(12,236	)
Financing Activities
Payments of term debt		—			—			—			(64	)		—			(64	)
Revolving credit facilities, net		—			(125,000	)		—			—			—			(125,000	)
Distributions paid		(27,719	)		(27,786	)		—			—			27,719			(27,786	)
Lease deposits and other obligations to tenants		—			—			921			2,628			—			3,549
Net payments relating to intercompany financing		(145,408	)		27,048			(24,109	)		(2,726	)		145,195			—
Proceeds from sale of common shares, net of offering costs		172,914			172,914			—			—			(172,914	)		172,914
Debt issuance costs paid and other financing activities		—			(64	)		—			—			—			(64	)

Net cash provided by (used in) financing activities		(213	)		47,112			(23,188	)		(162	)		—			23,549

Increase (decrease) in cash and cash equivalents for period		—			38,344			1			19			—			38,364
Cash and cash equivalents at beginning of period		—			35,483			1,565			263			—			37,311

Cash and cash equivalents at end of period	$	—		$	73,827		$	1,566		$	282		$	—		$	75,675

Summary of Significant Accounting Policies (Policies)

3 Months Ended

Mar. 31, 2014

Accounting Policies [Abstract]

Unaudited Interim Condensed Consolidated Financial Statements

For information about significant accounting policies, refer to the consolidated financial statements and footnotes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2013. During the three months ended March 31, 2014, there were no material changes to these policies except as noted below with respect to discontinued operations.

Reclassifications

Recent Accounting Development

Variable Interest Entities

Variable Interest Entities


VIE Type	Maximum Loss Exposure(1)		Asset Type Classification	Carrying Amount(2)
Loans, net	$	268,881	Mortgage and other loans	$	210,523
Equity investments	$	18,827	Other assets	$	5,040

(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.

- Definition

Disclosure of accounting policy regarding (1) the principles it follows in consolidating or combining the separate financial statements, including the principles followed in determining the inclusion or exclusion of subsidiaries or other entities in the consolidated or combined financial statements and (2) its treatment of interests (for example, common stock, a partnership interest or other means of exerting influence) in other entities, for example consolidation or use of the equity or cost methods of accounting. The accounting policy may also address the accounting treatment for intercompany accounts and transactions, noncontrolling interest, and the income statement treatment in consolidation for issuances of stock by a subsidiary.

+ References + Details

- Definition

Disclosure of accounting policy for consolidation to describe the significant judgments and assumptions made in determining whether a variable interest held by the entity requires the variable interest entity to be consolidated and (or) disclose information about its involvement with the variable interest entity; the methodology used by the entity for determining whether or not it is the primary beneficiary of the variable interest entity; and the significant factors considered and judgments made in determining that the power to direct the activities that significantly impact the economic performance of the variable interest entity are shared (as defined).

+ References + Details

Summary of Significant Accounting Policies (Tables)

3 Months Ended

Mar. 31, 2014

Accounting Policies [Abstract]

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

The carrying value and classification of the related assets and maximum exposure to loss as a result of our involvement with these VIEs are presented below at March 31, 2014 (in thousands):


VIE Type	Maximum Loss Exposure(1)		Asset Type Classification	Carrying Amount(2)
Loans, net	$	268,881	Mortgage and other loans	$	210,523
Equity investments	$	18,827	Other assets	$	5,040

(1)

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

- Definition

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

+ References + Details

Real Estate and Lending Activities (Tables)

3 Months Ended

Mar. 31, 2014

Leases [Abstract]

Assets Acquired

With this transaction we acquired the following assets:


	2014
Assets Acquired
Land	$	8,515
Building		99,602
Intangible lease assets — subject to amortization (weighted average useful life 15 years)		6,883

Total assets acquired	$	115,000
Total liabilities assumed		—

Net assets acquired	$	115,000

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
March 31,
2014

Estimated
Completion
Date

Oakleaf Surgical Hospital

Altoona, WI

Acute Care Hospital

National Surgical Hospitals

33,500

22,780

3Q 2014

First Choice ER - Brodie

Austin, TX

Acute Care Hospital

First Choice ER, LLC

5,466

2,829

2Q 2014

First Choice ER - Briar Forest

Houston, TX

Acute Care Hospital

First Choice ER, LLC

5,844

1,595

3Q 2014

First Choice ER - Cedar Hill

Cedar Hill, TX

Acute Care Hospital

First Choice ER, LLC

5,769

1,710

3Q 2014

First Choice ER- Firestone

Firestone, CO

Acute Care Hospital

First Choice ER, LLC

5,173

1,699

3Q 2014

First Choice ER - Allen

Allen, TX

Acute Care Hospital

First Choice ER, LLC

6,187

2,042

3Q 2014

First Choice ER - Frisco

Frisco, TX

Acute Care Hospital

First Choice ER, LLC

5,893

2,060

3Q 2014

First Choice ER - Broomfield

Broomfield, CO

Acute Care Hospital

First Choice ER, LLC

5,238

1,118

3Q 2014

First Choice ER - Spring

Spring, TX

Acute Care Hospital

First Choice ER, LLC

5,804

1,804

3Q 2014

First Choice ER - North Gate

Colorado Springs, CO

Acute Care Hospital

First Choice ER, LLC

5,249

896

3Q 2014

First Choice ER - Fountain

Fountain, CO

Acute Care Hospital

First Choice ER, LLC

6,194

1,558

3Q 2014

First Choice ER - Missouri City (Sienna)

Houston, TX

Acute Care Hospital

First Choice ER, LLC

5,394

1,062

3Q 2014

First Choice ER - Pearland

Pearland, TX

Acute Care Hospital

First Choice ER, LLC

5,691

1,403

4Q 2014

First Choice ER - Thornton

Thornton, CO

Acute Care Hospital

First Choice ER, LLC

6,029

1,400

4Q 2014

First Choice - ER

Various

Acute Care Hospital

First Choice ER, LLC

10,615

—

118,046

43,956

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 March 31, 2014			As of December 31, 2013
Minimum lease payments receivable	$	1,637,092		$	1,647,567
Estimated residual values		211,888			211,863
Less: Unearned income		(1,416,323	)		(1,428,406	)

Net investment in direct financing leases	$	432,657		$	431,024

Net Investment Under Monroe Facility

As of March 31, 2014 and December 31, 2013, our net investment (exclusive of the related real estate) in Monroe was as follows:


	As of March 31, 2014			As of December 31, 2013
Loans	$	33,726		$	31,341
Less: Loan impairment reserve		(32,354	)		(12,000	)
Loans, net		1,372			19,341

Interest, rent and other receivables*		20,992			20,972

Net investment	$	22,364		$	40,313

Includes approximately $ 6 million of interest receivables that are significantly more than 90 days past due

Summary of Loans

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


	As of March 31, 2014		As of December 31, 2013
Mortgage loans	$	388,650	$	388,650
Acquisition loans		103,016		103,266
Working capital and other loans		35,184		54,372
Convertible loan		3,352		3,352

	$	530,202	$	549,640

Debt (Tables)

3 Months Ended

Mar. 31, 2014

Debt Disclosure [Abstract]

Summary of Debt

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


	As of March 31, 2014					As of December 31, 2013
	Balance		Interest Rate			Balance		Interest Rate
Revolving credit facility	$	155,000		Variable		$	105,000		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	%		350,000		6.375	%
Unamortized premium		2,785					2,873

		352,785					352,873


2013 Senior Unsecured Notes (A)		275,380		5.75	%		274,860		5.75	%
Term loans		113,880		Various			113,948		Various

	$	1,472,045				$	1,421,681

(A)

These notes are Euro-denominated and reflect the exchange rate at March 31, 2014.

Principal Payments Due for Debt

As of March 31, 2014, principal payments due on our debt (which exclude the effects of any premium recorded) are as follows (in thousands):


2014	$	198
2015		155,283
2016		225,299
2017		320
2018		12,781
Thereafter		1,075,379

Total	$	1,469,260

Fair Value of Financial Instruments (Tables)

3 Months Ended

Mar. 31, 2014

Fair Value Disclosures [Abstract]

Summary of Fair Value Information of Financial Instruments

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


	March 31, 2014						December 31, 2013
Asset (Liability)	Book Value			Fair Value			Book Value			Fair Value
Interest and rent receivables	$	63,174		$	62,901		$	58,499		$	44,349
Loans (1)		332,419			348,495			351,607			358,277
Debt, net		(1,472,045	)		(1,553,093	)		(1,421,681	)		(1,486,090	)

(1)	Excludes loans related to the 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 March 31, 2014, these amounts were as follows (in thousands):


Asset Type	Fair Value		Cost		Asset Type Classification
Mortgage loans	$	100,000	$	100,000	Mortgage loans
Acquisition loan		97,783		97,783	Other loans
Equity investments		3,300		3,300	Other assets

	$	201,083	$	201,083

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	$	(344	)
- 100 basis points		344

Discontinued Operations (Tables)

3 Months Ended

Mar. 31, 2014

Discontinued Operations And Disposal Groups [Abstract]

Discontinued Operations Including Revenue and Expenses of Previously Owned Facilities


	For the Three Months Ended March 31,
	2014			2013
Revenues	$	—		$	828
Income (loss)		(2	)		641
Earnings per share/unit — diluted	$	—		$	—

- Definition

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

Earnings Per Share (Tables)

3 Months Ended

Mar. 31, 2014

Earnings Per Share [Abstract]

Calculation of Earnings Per Share

Medical Properties Trust, Inc.

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


	For the Three Months Ended March 31,
	2014			2013
Numerator:
Income from continuing operations	$	7,309		$	25,569
Non-controlling interests’ share in continuing operations		(66	)		(54	)
Participating securities’ share in earnings		(209	)		(193	)

Income from continuing operations, less participating securities’ share in earnings		7,034			25,322
Income (loss) from discontinued operations attributable to MPT common stockholders		(2	)		641

Net income, less participating securities’ share in earnings	$	7,032		$	25,963


	For the Three Months Ended March 31,
	2014		2013
Denominator:
Basic weighted-average common shares		163,973		140,347
Dilutive potential common shares		576		1,179

Dilutive weighted-average common shares		164,549		141,526

MPT Operating Partnership, L.P.

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


	For the Three Months Ended March 31,
	2014			2013
Numerator:
Income from continuing operations	$	7,309		$	25,569
Non-controlling interests’ share in continuing operations		(66	)		(54	)
Participating securities’ share in earnings		(209	)		(193	)

Income from continuing operations, less participating securities’ share in earnings		7,034			25,322
Income (loss) from discontinued operations attributable to MPT Operating Partnership partners		(2	)		641

Net income, less participating securities’ share in earnings	$	7,032		$	25,963

Denominator:
Basic weighted-average units		163,973			140,347
Dilutive potential units		576			1,179

Diluted weighted-average units		164,549			141,526

Condensed Consolidating Financial Information (Tables)

3 Months Ended

Mar. 31, 2014

Condensed Financial Information Of Parent Company Only Disclosure [Abstract]

Condensed Consolidated Balance Sheets

Condensed Consolidated Balance Sheets

March 31, 2014

(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	$	—	$	—		$	1,940,880		$	67,542		$	—		$	2,008,422
Net investment in direct financing leases		—		—			213,244			219,413						432,657
Mortgage loans		—		—			288,650			100,000			—			388,650

Gross investment in real estate assets		—		—			2,442,774			386,955			—			2,829,729
Accumulated depreciation and amortization		—		—			(164,898	)		(8,577	)		—			(173,475	)

Net investment in real estate assets		—		—			2,277,876			378,378			—			2,656,254
Cash and cash equivalents		—		31,104			18,564			641			—			50,309
Interest and rent receivables		—		537			32,735			29,902			—			63,174
Straight-line rent receivables		—		—			38,416			9,607			—			48,023
Other loans		—		178			1,100			140,274			—			141,552
Net intercompany receivable		35,608		1,999,835			—			—			(2,035,443	)		—
Investment in subsidiaries		1,431,370		851,636			42,326			—			(2,325,332	)		—
Other assets		—		36,088			1,169			30,023			—			67,280

Total Assets	$	1,466,978	$	2,919,378		$	2,412,186		$	588,825		$	(4,360,775	)	$	3,026,592

Liabilities and Equity
Liabilities
Debt, net	$	—	$	1,458,165		$	—		$	13,880		$	—		$	1,472,045
Accounts payable and accrued expenses		35,998		29,974			7,713			499			—			74,184
Net intercompany payable		—		—			1,649,895			385,548			(2,035,443	)		—
Deferred revenue		—		(131	)		19,373			6,177			—			25,419
Lease deposits and other obligations to tenants		—		—			20,265			3,699			—			23,964

Total liabilities		35,998		1,488,008			1,697,246			409,803			(2,035,443	)		1,595,612

Total Equity		1,430,980		1,431,370			714,940			179,022			(2,325,332	)		1,430,980

Total Liabilities and Equity	$	1,466,978	$	2,919,378		$	2,412,186		$	588,825		$	(4,360,775	)	$	3,026,592

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	$	—	$	—	$	1,796,411		$	69,044		$	—		$	1,865,455
Net investment in direct financing leases		—		—		212,543			218,481						431,024
Mortgage loans		—		—		288,650			100,000			—			388,650

Gross investment in real estate assets		—		—		2,297,604			387,525			—			2,685,129
Accumulated depreciation and amortization		—		—		(151,624	)		(8,152	)		—			(159,776	)

Net investment in real estate assets		—		—		2,145,980			379,373			—			2,525,353
Cash and cash equivalents		—		18,815		27,094			70			—			45,979
Interest and rent receivables		—		336		31,462			26,701			—			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		1,165			29,444			—			67,920

Total Assets	$	1,379,961	$	2,789,267	$	2,286,223		$	604,114		$	(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		20,522			1,149			—			94,311
Net intercompany payable		—		—		1,560,039			382,798			(1,942,837	)		—
Deferred revenue		—		49		17,785			5,953			—			23,787
Lease deposits and other obligations to tenants		—		—		18,139			2,444			—			20,583

Total liabilities		35,753		1,444,669		1,616,485			406,292			(1,942,837	)		1,560,362

Total Equity		1,344,208		1,344,598		669,738			197,822			(2,212,158	)		1,344,208

Total Liabilities and Equity	$	1,379,961	$	2,789,267	$	2,286,223		$	604,114		$	(4,154,995	)	$	2,904,570

Condensed Consolidated Statements of Income

Condensed Consolidated Statements of Income

For the Year Ended March 31, 2014

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors			Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Revenues
Rent billed	$	—		$	—		$	40,975		$	5,660		$	(3,678	)	$	42,957
Straight-line rent		—			—			1,357			791			—			2,148
Income from direct financing leases		—			—			11,609			5,872			(5,266	)		12,215
Interest and fee income		—			10,132			15,255			7,858			(17,476	)		15,769

Total revenues		—			10,132			69,196			20,181			(26,420	)		73,089
Expenses
Real estate depreciation and amortization		—			—			13,265			425			—			13,690
Impairment charge		—			—			—			20,496			—			20,496
Property-related		—			172			432			9,078			(8,944	)		738
Acquisition expenses		—			375			137			—			—			512
General and administrative		—			8,149			201			609			—			8,959

Total operating expenses		—			8,696			14,035			30,608			(8,944	)		44,395

Operating income		—			1,436			55,161			(10,427	)		(17,476	)		28,694
Other income (expense)
Other income (expense)		—			(46	)		—			(4	)		—			(50	)
Earnings from equity and other interests		—			—			—			220			—			220
Interest expense		—			(21,823	)		(9,919	)		(7,346	)		17,476			(21,612	)
Income tax (expense) benefit		—			—			65			(8	)		—			57

Net other expense		—			(21,869	)		(9,854	)		(7,138	)		17,476			(21,385	)

Income (loss) from continuing operations		—			(20,433	)		45,307			(17,565	)		—			7,309
Loss from discontinued operations		—			—			—			(2	)		—			(2	)

Equity in earnings of consolidated subsidiaries net of income taxes		7,307			27,740			1,121			—			(36,168	)		—

Net income (loss)		7,307			7,307			46,428			(17,567	)		(36,168	)		7,307
Net income (loss) attributable to non-controlling interests		(66	)		(66	)		—			—			66			(66	)

Net income attributable to MPT common stockholders	$	7,241		$	7,241		$	46,428		$	(17,567	)	$	(36,102	)	$	7,241

Condensed Consolidated Statements of Income

For the Year Ended March 31, 2013

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors			Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Revenues
Rent billed	$	—		$	—		$	29,630		$	4,504		$	(2,635	)	$	31,499
Straight-line rent		—			—			2,277			374			—			2,651
Income from direct financing leases		—			—			8,204			5,485			(4,933	)		8,756
Interest and fee income		—			5,057			9,208			7,531			(7,089	)		14,707

Total revenues		—			5,057			49,319			17,894			(14,657	)		57,613
Expenses
Real estate depreciation and amortization		—			—			8,044			425			—			8,469
Property-related		—			172			190			7,616			(7,569	)		409
Acquisition expenses		—			191			—			—			—			191
General and administrative		—			6,744			—			1,022			—			7,766

Total operating expenses		—			7,107			8,234			9,063			(7,569	)		16,835

Operating income		—			(2,050	)		41,085			8,831			(7,088	)		40,778
Other income (expense)
Other income (expense)		—			(22	)		(2,635	)		(204	)		2,636			(225	)
Earnings from equity and other interests		—			—			—			492			—			492
Interest expense		—			(15,517	)		2,946			(7,305	)		4,452			(15,424	)
Income tax expense		—			—			—			(52	)		—			(52	)

Net other (expense) income		—			(15,539	)		311			(7,069	)		7,088			(15,209	)

Income (loss) from continuing operations		—			(17,589	)		41,396			1,762			—			25,569
Income (loss) from discontinued operations		—			—			(4	)		645			—			641

Equity in earnings of consolidated subsidiaries net of income taxes		26,210			43,799			1,121			—			(71,130	)		—

Net income (loss)		26,210			26,210			42,513			2,407			(71,130	)		26,210
Net income (loss) attributable to non-controlling interests		(54	)		(54	)		—			—			54			(54	)

Net income attributable to MPT common stockholders	$	26,156		$	26,156		$	42,513		$	2,407		$	(71,076	)	$	26,156

Condensed Consolidated Statements of Comprehensive Income

Condensed Consolidated Statements of Comprehensive Income

For the Year Ended March 31, 2014

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors		Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Net income	$	7,307		$	7,307		$	46,428	$	(17,567	)	$	(36,168	)	$	7,307
Other comprehensive income:
Unrealized gain on interest rate swap		721			721			—		—			(721	)		721
Foreign currency translation loss		(28	)		(28	)		—		—			28			(28	)

Total comprehensive income		8,000			8,000			46,428		(17,567	)		(36,861	)		8,000
Comprehensive income attributable to non-controlling interests		(66	)		(66	)		—		—			66			(66	)

Comprehensive income attributable to MPT common stockholders	$	7,934		$	7,934		$	46,428	$	(17,567	)	$	(36,795	)	$	7,934

Condensed Consolidated Statements of Comprehensive Income

For the Year Ended March 31, 2013

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors		Non-Guarantor Subsidiaries		Eliminations			Total Consolidated
Net income	$	26,210		$	26,210		$	42,513	$	2,407	$	(71,130	)	$	26,210
Other comprehensive income:
Unrealized gain on interest rate swap		827			827			—		—		(827	)		827

Total comprehensive income		27,037			27,037			42,513		2,407		(71,957	)		27,037
Comprehensive income attributable to non-controlling interests		(54	)		(54	)		—		—		54			(54	)

Comprehensive income attributable to MPT common stockholders	$	26,983		$	26,983		$	42,513	$	2,407	$	(71,903	)	$	26,983

Condensed Consolidated Statements of Cash Flows

Condensed Consolidated Statements of Cash Flows

For the Year Ended March 31, 2014

(in thousands)


	Parent			Subsidiary Issuers			Subsidiary Guarantors			Non-Guarantor Subsidiaries			Eliminations			Total Consolidated
Operating Activities
Net cash provided by (used in) operating activities	$	234		$	(23,272	)	$	43,606		$	(2,286	)	$	—		$	18,282
Investing Activities
Cash paid for acquisitions and other related investments		—			—			(115,000	)		—			—			(115,000	)
Principal received on loans receivable		—			—			—			1,469			—			1,469
Investments in loans receivable		—			—			—			(2,385	)		—			(2,385	)
Construction in progress and other		—			205			(27,303	)		(827	)		—			(27,925	)

Net cash provided by (used in) investing activities		—			205			(142,303	)		(1,743	)		—			(143,841	)
Financing Activities
Revolving credit facilities, net		—			50,000			—			—			—			50,000
Payments of term debt		—			—			—			(68	)		—			(68	)
Distributions paid		(35,717	)		(35,778	)		—			—			35,717			(35,778	)
Lease deposits and other obligations to tenants		—			—			1,970			1,410			—			3,380
Net payments relating to intercompany financing		(77,100	)		(91,208	)		88,184			3,258			76,866			—
Proceeds from sale of common shares, net of offering costs		112,583			112,583			—			—			(112,583	)		112,583
Debt issuance costs paid and other financing activities		—			(241	)		—			—			—			(241	)

Net cash provided by (used in) financing activities		(234	)		35,356			90,154			4,600			—			129,876

Increase (decrease) in cash and cash equivalents for period		—			12,289			(8,543	)		571			—			4,317
Effect of exchange rate changes		—			—			13			—			—			13
Cash and cash equivalents at beginning of period		—			18,815			27,094			70			—			45,979

Cash and cash equivalents at end of period	$	—		$	31,104		$	18,564		$	641		$	—		$	50,309

Condensed Consolidated Statements of Cash Flows

For the Year Ended March 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	$	213		$	(9,099	)	$	36,434		$	(497	)	$	—		$	27,051
Investing Activities
Principal received on loans receivable		—			—			—			2,090			—			2,090
Investments in loans receivable		—			—			—			(800	)		—			(800	)
Construction in progress and other		—			331			(13,245	)		(612	)		—			(13,526	)

Net cash provided by (used in) investing activities		—			331			(13,245	)		678			—			(12,236	)
Financing Activities
Payments of term debt		—			—			—			(64	)		—			(64	)
Revolving credit facilities, net		—			(125,000	)		—			—			—			(125,000	)
Distributions paid		(27,719	)		(27,786	)		—			—			27,719			(27,786	)
Lease deposits and other obligations to tenants		—			—			921			2,628			—			3,549
Net payments relating to intercompany financing		(145,408	)		27,048			(24,109	)		(2,726	)		145,195			—
Proceeds from sale of common shares, net of offering costs		172,914			172,914			—			—			(172,914	)		172,914
Debt issuance costs paid and other financing activities		—			(64	)		—			—			—			(64	)

Net cash provided by (used in) financing activities		(213	)		47,112			(23,188	)		(162	)		—			23,549

Increase (decrease) in cash and cash equivalents for period		—			38,344			1			19			—			38,364
Cash and cash equivalents at beginning of period		—			35,483			1,565			263			—			37,311

Cash and cash equivalents at end of period	$	—		$	73,827		$	1,566		$	282		$	—		$	75,675

Summary of Significant Accounting Policies - Carrying Value and Classification of Related Assets and Maximum Exposure to Loss (Detail) $ in Thousands	Mar. 31, 2014 USD ($)
Loans, net [Member]
Variable Interest Entity [Line Items]
Maximum Loss Exposure	$ 268,881
Mortgage and other loans [Member]
Variable Interest Entity [Line Items]
Carrying Amount	210,523
Other assets [Member]
Variable Interest Entity [Line Items]
Carrying Amount	5,040
Equity investments [Member]
Variable Interest Entity [Line Items]
Maximum Loss Exposure	$ 18,827

Real Estate and Lending Activities - Acquisitions - Additional Information (Detail) - Acute Care Hospitals [Member] $ in Millions	3 Months Ended
	Mar. 31, 2014 USD ($)
Significant Acquisitions and Disposals [Line Items]
Acquisition cost	$ 115
Term of lease	15 years
Term of lease extension, years	3 years
Fair value market [Member]
Significant Acquisitions and Disposals [Line Items]
Term of lease extension, years	12 years

Real Estate and Lending Activities - Assets Acquired (Detail) $ in Thousands	Mar. 31, 2014 USD ($)
Significant Acquisitions and Disposals [Line Items]
Total assets acquired	$ 115,000
Total liabilities assumed
Net assets acquired	115,000
Land [Member]
Significant Acquisitions and Disposals [Line Items]
Total assets acquired	8,515
Building [Member]
Significant Acquisitions and Disposals [Line Items]
Total assets acquired	99,602
Intangible lease assets - subject to amortization [Member]
Significant Acquisitions and Disposals [Line Items]
Total assets acquired	$ 6,883

Real Estate and Lending Activities - Assets Acquired (Parenthetical) (Detail)	3 Months Ended
	Mar. 31, 2014
Intangible lease assets - subject to amortization [Member]
Significant Acquisitions and Disposals [Line Items]
Weighted average useful life of acquired intangible lease assets (in years)	15 years

Real Estate and Lending Activities - Development Activities - Additional Information (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2014 USD ($) Facility
Development Activities [Member] \| Twelve Oaks Facility [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of facility partially occupied	55.00%
Lease agreement	15 years
Rehabilitation Facility in South Ogden [Member] \| Development Activities [Member]
Significant Acquisitions and Disposals [Line Items]
Estimated total development cost	$ 19
Facility located in San Antonio, Texas [Member] \| Development Activities [Member]
Significant Acquisitions and Disposals [Line Items]
Estimated total development cost	5
Location Houston, TX [Member] \| Development Activities [Member]
Significant Acquisitions and Disposals [Line Items]
Estimated total development cost	$ 5
First Choice ER. [Member]
Significant Acquisitions and Disposals [Line Items]
Number of facilities under construction \| Facility	9

Real Estate and Lending Activities - Summary of Status Update on Current Development Projects (Detail) $ in Thousands	3 Months Ended
	Mar. 31, 2014 USD ($)
Business Acquisition [Line Items]
Original Commitment	$ 118,046
Costs Incurred as of March 31, 2014	43,956
Property Oakleaf Surgical Hospital [Member] \| Location Altoona, 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 March 31, 2014	$ 22,780
Estimated Completion Date	3Q 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	$ 5,466
Costs Incurred as of March 31, 2014	$ 2,829
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	$ 5,844
Costs Incurred as of March 31, 2014	$ 1,595
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	$ 5,769
Costs Incurred as of March 31, 2014	$ 1,710
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	$ 5,173
Costs Incurred as of March 31, 2014	$ 1,699
Estimated Completion Date	3Q 2014
Property First Choice ER - Allen [Member] \| Location Allen, TX [Member] \| Property Type Acute Care Hospital [Member] \| Operator First Choice ER, LLC [Member]
Business Acquisition [Line Items]
Original Commitment	$ 6,187
Costs Incurred as of March 31, 2014	$ 2,042
Estimated Completion Date	3Q 2014
Property First Choice ER - Frisco [Member] \| Location Frisco, TX [Member] \| Property Type Acute Care Hospital [Member] \| Operator First Choice ER, LLC [Member]
Business Acquisition [Line Items]
Original Commitment	$ 5,893
Costs Incurred as of March 31, 2014	$ 2,060
Estimated Completion Date	3Q 2014
Property First Choice ER - Broomfield [Member] \| Location Broomfield, CO [Member] \| Property Type Acute Care Hospital [Member] \| Operator First Choice ER, LLC [Member]
Business Acquisition [Line Items]
Original Commitment	$ 5,238
Costs Incurred as of March 31, 2014	$ 1,118
Estimated Completion Date	3Q 2014
Property First Choice ER - Spring [Member] \| Location Spring, TX [Member] \| Property Type Acute Care Hospital [Member] \| Operator First Choice ER, LLC [Member]
Business Acquisition [Line Items]
Original Commitment	$ 5,804
Costs Incurred as of March 31, 2014	$ 1,804
Estimated Completion Date	3Q 2014
Property First Choice ER - North Gate [Member] \| Location Colorado Springs, CO [Member] \| Property Type Acute Care Hospital [Member] \| Operator First Choice ER, LLC [Member]
Business Acquisition [Line Items]
Original Commitment	$ 5,249
Costs Incurred as of March 31, 2014	$ 896
Estimated Completion Date	3Q 2014
Property First Choice ER - Fountain [Member] \| Location Fountain, CO [Member] \| Property Type Acute Care Hospital [Member] \| Operator First Choice ER, LLC [Member]
Business Acquisition [Line Items]
Original Commitment	$ 6,194
Costs Incurred as of March 31, 2014	$ 1,558
Estimated Completion Date	3Q 2014
Property First Choice ER - Missouri City (Sienna) [Member] \| Location Houston, TX [Member] \| Property Type Acute Care Hospital [Member] \| Operator First Choice ER, LLC [Member]
Business Acquisition [Line Items]
Original Commitment	$ 5,394
Costs Incurred as of March 31, 2014	$ 1,062
Estimated Completion Date	3Q 2014
Property First Choice ER - Pearland [Member] \| Location Pearland, TX [Member] \| Property Type Acute Care Hospital [Member] \| Operator First Choice ER, LLC [Member]
Business Acquisition [Line Items]
Original Commitment	$ 5,691
Costs Incurred as of March 31, 2014	$ 1,403
Estimated Completion Date	4Q 2014
Property First Choice ER - Thornton [Member] \| Location Thomton, CO [Member] \| Property Type Acute Care Hospital [Member] \| Operator First Choice ER, LLC [Member]
Business Acquisition [Line Items]
Original Commitment	$ 6,029
Costs Incurred as of March 31, 2014	$ 1,400
Estimated Completion Date	4Q 2014
Property First Choice ER [Member] \| Location Various [Member] \| Property Type Acute Care Hospital [Member] \| Operator First Choice ER, LLC [Member]
Business Acquisition [Line Items]
Original Commitment	$ 10,615
Costs Incurred as of March 31, 2014

Real Estate and Lending Activities - Components of Net Investment in Direct Financing Leases (Detail) - USD ($) $ in Thousands	Mar. 31, 2014	Dec. 31, 2013
Business Combinations [Abstract]
Minimum lease payments receivable	$ 1,637,092	$ 1,647,567
Estimated residual values	211,888	211,863
Less: Unearned income	(1,416,323)	(1,428,406)
Net investment in direct financing leases	$ 432,657	$ 431,024

Real Estate and Lending Activities - Net Investment Under Monroe Facility (Detail) - Monroe Facility [Member] - USD ($) $ in Thousands	Mar. 31, 2014	Dec. 31, 2013
Investments In Loans [Line Items]
Loans	$ 33,726	$ 31,341
Less: Loan impairment reserve	(32,354)	(12,000)
Loans, net	1,372	19,341
Interest, rent and other receivables	20,992	20,972
Net investment	$ 22,364	$ 40,313

Real Estate and Lending Activities - Net Investment Under Monroe Facility (Parenthetical) (Detail) - Monroe Facility [Member] $ in Millions	3 Months Ended
	Mar. 31, 2014 USD ($)
Investments In Loans [Line Items]
Interest receivable	$ 6
Number of days past due	90 days

Real Estate and Lending Activities - Monroe Facility - Additional Information (Detail) - Monroe Facility [Member] - USD ($) $ in Millions	3 Months Ended	12 Months Ended
	Mar. 31, 2014	Dec. 31, 2010
Significant Acquisitions and Disposals [Line Items]
Impairment of working capital loan recognized		$ 12.0
Impairment charges	$ 20.5

Real Estate and Lending Activities - Florence Facility - Additional Information (Detail) - Florence acute care facility [Member] $ in Millions	Mar. 31, 2014 USD ($)
Significant Acquisitions and Disposals [Line Items]
Real estate investment	$ 28.0
Letter of Credit [Member]
Significant Acquisitions and Disposals [Line Items]
Letter of credit outstanding	$ 1.2

Real Estate and Lending Activities - Gilbert Facility - Additional Information (Detail) - Gilbert facility [Member] $ in Millions	3 Months Ended
	Mar. 31, 2014 USD ($)
Significant Acquisitions and Disposals [Line Items]
Amortization of the related lease intangible asset	$ 1.1
Outstanding rent receivables	0.1
Straight line rent receivables write-off	1.0
Real estate investment	$ 14.0

Real Estate and Lending Activities - Summary of Loans (Detail) - USD ($) $ in Thousands	Mar. 31, 2014	Dec. 31, 2013
Loans [Line Items]
Loans Receivable Net	$ 530,202	$ 549,640
Mortgage loans [Member]
Loans [Line Items]
Loans Receivable Net	388,650	388,650
Acquisition loans [Member]
Loans [Line Items]
Loans Receivable Net	103,016	103,266
Working capital and other loans [Member]
Loans [Line Items]
Loans Receivable Net	35,184	54,372
Convertible loan [Member]
Loans [Line Items]
Loans Receivable Net	$ 3,352	$ 3,352

Real Estate and Lending Activities - Loans - Additional Information (Detail) - USD ($) $ in Millions		3 Months Ended
	Mar. 01, 2012	Mar. 31, 2014
Business Combinations [Abstract]
Amount of convertible note converted into equity interest	$ 1.7
Convertible note	$ 5.0
Percentage of equity shares from convertible debt	9.90%	15.10%
Remaining convertible debt after conversion of part of debt		$ 3.3

Real Estate and Lending Activities - Concentrations of Credit Risk - Additional Information (Detail) - Concentration of Credit Risks [Member]	3 Months Ended		12 Months Ended
	Mar. 31, 2014	Mar. 31, 2013	Dec. 31, 2013
Significant Acquisitions and Disposals [Line Items]
Maximum percentage of entity's total assets invested on single property	4.00%
California [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of total assets accounted	17.90%		18.70%
Texas [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of total assets accounted	22.00%		22.70%
European [Member] \| Minimum [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of total assets accounted	8.00%
Ernest [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of entity revenue from affiliates	19.50%	20.50%
Percentage of total assets accounted	15.80%		15.90%
Prime Health Care Services [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of entity revenue from affiliates	29.10%	31.40%
Percentage of total assets accounted	23.50%		24.50%

Debt - Summary of Debt (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
Debt - Summary of Debt (Detail) - USD ($) $ in Thousands	Mar. 31, 2014	Dec. 31, 2013
Debt Instrument [Line Items]
Debt	$ 1,472,045	$ 1,421,681
Debt instrument, net	$ 1,469,260
Revolving credit facility [Member]
Debt Instrument [Line Items]
Interest rate	Variable	Variable
Principal amount	$ 155,000	$ 105,000
2006 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Interest rate	Various	Various
Principal amount	$ 125,000	$ 125,000
2011 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Unsecured senior notes, interest rate	6.875%	6.875%
Principal amount	$ 450,000	$ 450,000
2012 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Unsecured senior notes, interest rate	6.375%	6.375%
Principal amount	$ 350,000	$ 350,000
Unamortized premium	2,785	2,873
Debt instrument, net	$ 352,785	$ 352,873
2013 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Unsecured senior notes, interest rate	5.75%	5.75%
Debt	$ 275,380	$ 274,860
Term loans [Member]
Debt Instrument [Line Items]
Interest rate	Various	Various
Debt	$ 113,880	$ 113,948

Debt - Principal Payments Due for Debt (Detail) $ in Thousands	Mar. 31, 2014 USD ($)
Debt Disclosure [Abstract]
2014	$ 198
2015	155,283
2016	225,299
2017	320
2018	12,781
Thereafter	1,075,379
Debt instrument, net	$ 1,469,260

Debt - Additional Information (Detail) - USD ($) $ in Millions	1 Months Ended	3 Months Ended
	Oct. 31, 2011	Mar. 31, 2014	Mar. 31, 2013	Jun. 30, 2010	Dec. 31, 2013
Debt Instrument [Line Items]
Hedge ineffectiveness and income statement effect in period		$ 0.0	$ 0.0
Other assets, collateral		$ 4.5			$ 5.0
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%
Interest Rate Contract [Member]
Debt Instrument [Line Items]
Fair value of the interest rate swaps		$ 8.3			$ 9.0
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]
Portion of debt instrument face amount				$ 65.0

Common Stock/Partner's Capital - Additional Information (Detail) $ / shares in Units, shares in Thousands, $ in Thousands			1 Months Ended	3 Months Ended
	Mar. 11, 2014 USD ($) shares	Feb. 28, 2013 USD ($) $ / shares shares	Jan. 31, 2014 USD ($)	Mar. 31, 2014 USD ($) Partner Director Employee $ / shares shares	Mar. 31, 2013 USD ($) shares	Dec. 31, 2013 shares
Class of Stock [Line Items]
Net proceed from issuance of common stock \| $				$ 112,583	$ 172,914
Common stock, shares issued \| shares				170,213		161,310
MPT Operating Partnership, L.P. [Member]
Class of Stock [Line Items]
Net proceed from issuance of common stock \| $				$ 112,583	$ 172,914
Ownership interest in equity				99.80%
Number of units sold \| shares				8,600	12,700
Number of other partners \| Partner				3
Employee [Member]
Class of Stock [Line Items]
Number of partners shared remaining ownership percentage \| Employee				2
Director [Member]
Class of Stock [Line Items]
Number of partners shared remaining ownership percentage \| Director				1
Public Offering [Member]
Class of Stock [Line Items]
Underwritten public offering of shares \| shares	7,700
Net proceed from issuance of common stock \| $	$ 100,200	$ 172,900
Additional shares purchased by underwriters \| shares	1,200	1,700
Time granted to underwriters to purchase shares				30 days
Net proceeds from additional issuance of shares \| $	$ 16,000
Common stock, shares issued \| shares		12,700
SaleOfStockPricePerShare \| $ / shares		$ 14.25
Market Equity Offering Program [Member]
Class of Stock [Line Items]
Net proceed from issuance of common stock \| $				$ 12,300
Sales commission percentage			1.25%
Common stock, shares issued \| shares				900
Market Equity Offering Program [Member] \| IPO [Member]
Class of Stock [Line Items]
Public offering price for common stock per share \| $ / shares				$ 13.21
Market Equity Offering Program [Member] \| Maximum [Member]
Class of Stock [Line Items]
Number of shares can be sold out \| $			$ 250,000

Stock Awards - Additional Information (Detail) - shares	3 Months Ended	12 Months Ended
Stock Awards - Additional Information (Detail) - shares	Mar. 31, 2014	Dec. 31, 2013
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	6,451,291
Time-Based Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share - based compensation ,shares issued	338,484	258,736
Stock awards vesting period in years	3 years
Performance-based awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share - based compensation ,shares issued	317,254	222,566
Stock awards vesting period in years	3 years
Multi-year performance-based awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share - based compensation ,shares issued	500,000	550,000
Stock awards vesting period in years	3 years

Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Detail) - USD ($) $ in Thousands	Mar. 31, 2014	Dec. 31, 2013
Fair Value Disclosures [Abstract]
Interest and rent receivables, Book value	$ 63,174	$ 58,499
Loans, Book value	332,419	351,607
Debt, net Book value	(1,472,045)	(1,421,681)
Interest and rent receivables, Fair value	62,901	44,349
Loans, Fair value	348,495	358,277
Debt, net Fair value	$ (1,553,093)	$ (1,486,090)

Fair Value of Financial Instruments - Equity Interest in Ernest and Related Loans Measured at Fair Value on Recurring Basis (Detail) $ in Thousands	Mar. 31, 2014 USD ($)
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	$ 201,083
Cost	201,083
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 loan [Member] \| Other loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	97,783
Cost	97,783
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)	3 Months Ended
	Mar. 31, 2014
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	3 Months Ended
	Mar. 31, 2014 USD ($)
+100 basis points [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated Increase (Decrease) In Fair Value of Financial Instruments	$ (344)
- 100 basis points [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated Increase (Decrease) In Fair Value of Financial Instruments	$ 344

Discontinued Operations - Discontinued Operations Include Revenue and Expenses of Previously Owned Facilities (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Discontinued Operations And Disposal Groups [Abstract]
Revenues		$ 828
Income (loss)	$ (2)	$ 641
Earnings per share/unit - diluted

Earnings Per Share - Calculation of Earnings Per Share (Detail) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Income from continuing operations	$ 7,309	$ 25,569
Non-controlling interests' share in continuing operations	(66)	(54)
Participating securities' share in earnings	(209)	(193)
Income from continuing operations, less participating securities' share in earnings	7,034	25,322
Income (loss) from discontinued operations attributable to MPT common stockholders	(2)	641
Net income, less participating securities' share in earnings	$ 7,032	$ 25,963
Basic weighted-average common shares	163,973	140,347
Dilutive potential common shares	576	1,179
Diluted weighted-average units	164,549	141,526
MPT Operating Partnership, L.P. [Member]
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Income from continuing operations	$ 7,309	$ 25,569
Non-controlling interests' share in continuing operations	(66)	(54)
Participating securities' share in earnings	(209)	(193)
Income from continuing operations, less participating securities' share in earnings	7,034	25,322
Income (loss) from discontinued operations attributable to MPT common stockholders	(2)	641
Net income, less participating securities' share in earnings	$ 7,032	$ 25,963
Basic weighted-average common shares	163,973	140,347
Dilutive potential common shares	576	1,179
Diluted weighted-average units	164,549	141,526

Subsequent Events - Additional Information (Detail) - 2014 Senior Unsecured Notes [Member] - USD ($) $ in Millions		3 Months Ended
	Apr. 17, 2014	Mar. 31, 2014
Subsequent Event [Line Items]
Debt instrument, maturity date		May 01, 2024
Senior notes frequency of periodic payment		Semi-annually
Senior notes, earliest redemption date		May 01, 2019
Notes redemption term		On or after May 1, 2019, 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 May 1, 2017, we may redeem up to 35% of the aggregate principal amount of the 2014 Senior Unsecured Notes using the proceeds of one or more equity offerings.
Subsequent Event [Member]
Subsequent Event [Line Items]
Unsecured senior notes, value of offering	$ 300
Unsecured senior notes, interest rate	5.50%
Senior notes, repurchase price percentage on principal amount plus accrued and unpaid interest	101.00%

Condensed Consolidating Financial Information - Condensed Consolidated Balance Sheets (Detail) - USD ($) $ in Thousands	Mar. 31, 2014	Dec. 31, 2013	Mar. 31, 2013	Dec. 31, 2012
Condensed Financial Statements, Captions [Line Items]
Land, buildings and improvements, and intangible lease assets	$ 2,008,422	$ 1,865,455
Net investment in direct financing leases	432,657	431,024
Mortgage loans	388,650	388,650
Gross investment in real estate assets	2,829,729	2,685,129
Accumulated depreciation and amortization	(173,475)	(159,776)
Net investment in real estate assets	2,656,254	2,525,353
Cash and cash equivalents	50,309	45,979	$ 75,675	$ 37,311
Interest and rent receivables	63,174	58,499
Straight-line rent receivables	48,023	45,829
Other loans	141,552	160,990
Net intercompany receivable
Investment in subsidiaries
Other assets	67,280	67,920
Total Assets	3,026,592	2,904,570
Debt, net	1,472,045	1,421,681
Accounts payable and accrued expenses	74,184	94,311
Net intercompany payable
Deferred revenue	25,419	23,787
Lease deposits and other obligations to tenants	23,964	20,583
Total liabilities	1,595,612	1,560,362
Total Equity	1,430,980	1,344,208
Total Liabilities and Equity	3,026,592	2,904,570
Parent [Member]
Condensed Financial Statements, Captions [Line Items]
Land, buildings and improvements, and intangible lease assets
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	35,608	35,363
Investment in subsidiaries	1,431,370	1,344,598
Other assets
Total Assets	1,466,978	1,379,961
Debt, net
Accounts payable and accrued expenses	35,998	35,753
Net intercompany payable
Deferred revenue
Lease deposits and other obligations to tenants
Total liabilities	35,998	35,753
Total Equity	1,430,980	1,344,208
Total Liabilities and Equity	1,466,978	1,379,961
Subsidiary Issuers [Member]
Condensed Financial Statements, Captions [Line Items]
Land, buildings and improvements, and intangible lease assets
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	31,104	18,815	73,827	35,483
Interest and rent receivables	537	336
Straight-line rent receivables
Other loans	178	178
Net intercompany receivable	1,999,835	1,907,474
Investment in subsidiaries	851,636	825,153
Other assets	36,088	37,311
Total Assets	2,919,378	2,789,267
Debt, net	1,458,165	1,407,733
Accounts payable and accrued expenses	29,974	36,887
Net intercompany payable
Deferred revenue	(131)	49
Lease deposits and other obligations to tenants
Total liabilities	1,488,008	1,444,669
Total Equity	1,431,370	1,344,598
Total Liabilities and Equity	2,919,378	2,789,267
Subsidiary Guarantors [Member]
Condensed Financial Statements, Captions [Line Items]
Land, buildings and improvements, and intangible lease assets	1,940,880	1,796,411
Net investment in direct financing leases	213,244	212,543
Mortgage loans	288,650	288,650
Gross investment in real estate assets	2,442,774	2,297,604
Accumulated depreciation and amortization	(164,898)	(151,624)
Net investment in real estate assets	2,277,876	2,145,980
Cash and cash equivalents	18,564	27,094	1,566	1,565
Interest and rent receivables	32,735	31,462
Straight-line rent receivables	38,416	37,015
Other loans	1,100	1,100
Net intercompany receivable
Investment in subsidiaries	42,326	42,407
Other assets	1,169	1,165
Total Assets	2,412,186	2,286,223
Debt, net
Accounts payable and accrued expenses	7,713	20,522
Net intercompany payable	1,649,895	1,560,039
Deferred revenue	19,373	17,785
Lease deposits and other obligations to tenants	20,265	18,139
Total liabilities	1,697,246	1,616,485
Total Equity	714,940	669,738
Total Liabilities and Equity	2,412,186	2,286,223
Non-Guarantor Subsidiaries [Member]
Condensed Financial Statements, Captions [Line Items]
Land, buildings and improvements, and intangible lease assets	67,542	69,044
Net investment in direct financing leases	219,413	218,481
Mortgage loans	100,000	100,000
Gross investment in real estate assets	386,955	387,525
Accumulated depreciation and amortization	(8,577)	(8,152)
Net investment in real estate assets	378,378	379,373
Cash and cash equivalents	641	70	$ 282	$ 263
Interest and rent receivables	29,902	26,701
Straight-line rent receivables	9,607	8,814
Other loans	140,274	159,712
Net intercompany receivable
Investment in subsidiaries
Other assets	30,023	29,444
Total Assets	588,825	604,114
Debt, net	13,880	13,948
Accounts payable and accrued expenses	499	1,149
Net intercompany payable	385,548	382,798
Deferred revenue	6,177	5,953
Lease deposits and other obligations to tenants	3,699	2,444
Total liabilities	409,803	406,292
Total Equity	179,022	197,822
Total Liabilities and Equity	588,825	604,114
Eliminations [Member]
Condensed Financial Statements, Captions [Line Items]
Land, buildings and improvements, and intangible lease assets
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	(2,035,443)	(1,942,837)
Investment in subsidiaries	(2,325,332)	(2,212,158)
Other assets
Total Assets	(4,360,775)	(4,154,995)
Debt, net
Accounts payable and accrued expenses
Net intercompany payable	(2,035,443)	(1,942,837)
Deferred revenue
Lease deposits and other obligations to tenants
Total liabilities	(2,035,443)	(1,942,837)
Total Equity	(2,325,332)	(2,212,158)
Total Liabilities and Equity	$ (4,360,775)	$ (4,154,995)

Condensed Consolidating Financial Information - Condensed Consolidated Statements of Income (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Revenues
Rent billed	$ 42,957	$ 31,499
Straight-line rent	2,148	2,651
Income from direct financing leases	12,215	8,756
Interest and fee income	15,769	14,707
Total revenues	73,089	57,613
Expenses
Real estate depreciation and amortization	13,690	8,469
Impairment charge	20,496
Property-related	738	409
Acquisition expenses	512	191
General and administrative	8,959	7,766
Total operating expenses	44,395	16,835
Operating income	28,694	40,778
Other income (expense)
Other income (expense)	(50)	(225)
Earnings from equity and other interests	220	492
Interest expense	(21,612)	(15,424)
Income tax benefit (expense)	57	(52)
Net other expense	(21,385)	(15,209)
Net other (expense) income		(15,209)
Income (loss) from continuing operations	7,309	25,569
Income (loss) from discontinued operations	(2)	641
Equity in earnings of consolidated subsidiaries net of income taxes
Net income	7,307	26,210
Net income (loss) attributable to non-controlling interests	(66)	(54)
Net income attributable to MPT common stockholders	7,241	26,156
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
Impairment charge
Property-related
Acquisition expenses
General and administrative
Total operating expenses
Operating income
Other income (expense)
Other income (expense)
Earnings from equity and other interests
Interest expense
Income tax benefit (expense)
Net other expense
Net other (expense) income
Income (loss) from continuing operations
Income (loss) from discontinued operations
Equity in earnings of consolidated subsidiaries net of income taxes	7,307	26,210
Net income	7,307	26,210
Net income (loss) attributable to non-controlling interests	(66)	(54)
Net income attributable to MPT common stockholders	7,241	26,156
Subsidiary Issuers [Member]
Revenues
Rent billed
Straight-line rent
Income from direct financing leases
Interest and fee income	10,132	5,057
Total revenues	10,132	5,057
Expenses
Real estate depreciation and amortization
Impairment charge
Property-related	172	172
Acquisition expenses	375	191
General and administrative	8,149	6,744
Total operating expenses	8,696	7,107
Operating income	1,436	(2,050)
Other income (expense)
Other income (expense)	(46)	(22)
Earnings from equity and other interests
Interest expense	(21,823)	(15,517)
Income tax benefit (expense)
Net other expense	(21,869)
Net other (expense) income		(15,539)
Income (loss) from continuing operations	(20,433)	(17,589)
Income (loss) from discontinued operations
Equity in earnings of consolidated subsidiaries net of income taxes	27,740	43,799
Net income	7,307	26,210
Net income (loss) attributable to non-controlling interests	(66)	(54)
Net income attributable to MPT common stockholders	7,241	26,156
Subsidiary Guarantors [Member]
Revenues
Rent billed	40,975	29,630
Straight-line rent	1,357	2,277
Income from direct financing leases	11,609	8,204
Interest and fee income	15,255	9,208
Total revenues	69,196	49,319
Expenses
Real estate depreciation and amortization	13,265	8,044
Impairment charge
Property-related	432	190
Acquisition expenses	137
General and administrative	201
Total operating expenses	14,035	8,234
Operating income	55,161	41,085
Other income (expense)
Other income (expense)		(2,635)
Earnings from equity and other interests
Interest expense	(9,919)	2,946
Income tax benefit (expense)	65
Net other expense	(9,854)
Net other (expense) income		311
Income (loss) from continuing operations	45,307	41,396
Income (loss) from discontinued operations		(4)
Equity in earnings of consolidated subsidiaries net of income taxes	1,121	1,121
Net income	46,428	42,513
Net income (loss) attributable to non-controlling interests
Net income attributable to MPT common stockholders	46,428	42,513
Non-Guarantor Subsidiaries [Member]
Revenues
Rent billed	5,660	4,504
Straight-line rent	791	374
Income from direct financing leases	5,872	5,485
Interest and fee income	7,858	7,531
Total revenues	20,181	17,894
Expenses
Real estate depreciation and amortization	425	425
Impairment charge	20,496
Property-related	9,078	7,616
Acquisition expenses
General and administrative	609	1,022
Total operating expenses	30,608	9,063
Operating income	(10,427)	8,831
Other income (expense)
Other income (expense)	(4)	(204)
Earnings from equity and other interests	220	492
Interest expense	(7,346)	(7,305)
Income tax benefit (expense)	(8)	(52)
Net other expense	(7,138)
Net other (expense) income		(7,069)
Income (loss) from continuing operations	(17,565)	1,762
Income (loss) from discontinued operations	(2)	645
Equity in earnings of consolidated subsidiaries net of income taxes
Net income	(17,567)	2,407
Net income (loss) attributable to non-controlling interests
Net income attributable to MPT common stockholders	(17,567)	2,407
Eliminations [Member]
Revenues
Rent billed	(3,678)	(2,635)
Straight-line rent
Income from direct financing leases	(5,266)	(4,933)
Interest and fee income	(17,476)	(7,089)
Total revenues	(26,420)	(14,657)
Expenses
Real estate depreciation and amortization
Impairment charge
Property-related	(8,944)	(7,569)
Acquisition expenses
General and administrative
Total operating expenses	(8,944)	(7,569)
Operating income	(17,476)	(7,088)
Other income (expense)
Other income (expense)		2,636
Earnings from equity and other interests
Interest expense	17,476	4,452
Income tax benefit (expense)
Net other expense	17,476
Net other (expense) income		7,088
Income (loss) from continuing operations
Income (loss) from discontinued operations
Equity in earnings of consolidated subsidiaries net of income taxes	(36,168)	(71,130)
Net income	(36,168)	(71,130)
Net income (loss) attributable to non-controlling interests	66	54
Net income attributable to MPT common stockholders	$ (36,102)	$ (71,076)

Condensed Consolidating Financial Information - Condensed Consolidated Statements of Comprehensive Income (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Comprehensive Income (Loss) [Line Items]
Net income	$ 7,307	$ 26,210
Other comprehensive income (loss):
Unrealized gain on interest rate swap	721	827
Foreign currency translation loss	(28)
Total comprehensive income	8,000	27,037
Comprehensive income attributable to non-controlling interests	(66)	(54)
Comprehensive income attributable to MPT common stockholders	7,934	26,983
Parent [Member]
Comprehensive Income (Loss) [Line Items]
Net income	7,307	26,210
Other comprehensive income (loss):
Unrealized gain on interest rate swap	721	827
Foreign currency translation loss	(28)
Total comprehensive income	8,000	27,037
Comprehensive income attributable to non-controlling interests	(66)	(54)
Comprehensive income attributable to MPT common stockholders	7,934	26,983
Subsidiary Issuers [Member]
Comprehensive Income (Loss) [Line Items]
Net income	7,307	26,210
Other comprehensive income (loss):
Unrealized gain on interest rate swap	721	827
Foreign currency translation loss	(28)
Total comprehensive income	8,000	27,037
Comprehensive income attributable to non-controlling interests	(66)	(54)
Comprehensive income attributable to MPT common stockholders	7,934	26,983
Subsidiary Guarantors [Member]
Comprehensive Income (Loss) [Line Items]
Net income	46,428	42,513
Other comprehensive income (loss):
Unrealized gain on interest rate swap
Foreign currency translation loss
Total comprehensive income	46,428	42,513
Comprehensive income attributable to non-controlling interests
Comprehensive income attributable to MPT common stockholders	46,428	42,513
Non-Guarantor Subsidiaries [Member]
Comprehensive Income (Loss) [Line Items]
Net income	(17,567)	2,407
Other comprehensive income (loss):
Unrealized gain on interest rate swap
Foreign currency translation loss
Total comprehensive income	(17,567)	2,407
Comprehensive income attributable to non-controlling interests
Comprehensive income attributable to MPT common stockholders	(17,567)	2,407
Eliminations [Member]
Comprehensive Income (Loss) [Line Items]
Net income	(36,168)	(71,130)
Other comprehensive income (loss):
Unrealized gain on interest rate swap	(721)	(827)
Foreign currency translation loss	28
Total comprehensive income	(36,861)	(71,957)
Comprehensive income attributable to non-controlling interests	66	54
Comprehensive income attributable to MPT common stockholders	$ (36,795)	$ (71,903)

Condensed Consolidating Financial Information - Condensed Consolidated Statements of Cash Flows (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Operating activities
Net cash provided by (used in) operating activities	$ 18,282	$ 27,051
Investing activities
Cash paid for acquisitions and other related investments	(115,000)
Principal received on loans receivable	1,469	2,090
Investments in loans receivable	(2,385)	(800)
Construction in progress and other	(27,925)	(13,526)
Net cash provided by (used in) investing activities	(143,841)	(12,236)
Financing activities
Revolving credit facilities, net	50,000	(125,000)
Payments of term debt	(68)	(64)
Distributions paid	(35,778)	(27,786)
Lease deposits and other obligations to tenants	3,380	3,549
Net payments relating to intercompany financing
Proceeds from sale of common shares, net of offering costs	112,583	172,914
Debt issuance costs paid and other financing activities	(241)	(64)
Net cash provided by (used in) financing activities	129,876	23,549
Increase (decrease) in cash and cash equivalents for period	4,317	38,364
Effect of exchange rate changes	13
Cash and cash equivalents at beginning of period	45,979	37,311
Cash and cash equivalents at end of period	50,309	75,675
Parent [Member]
Operating activities
Net cash provided by (used in) operating activities	234	213
Investing activities
Cash paid for acquisitions and other related investments
Principal received on loans receivable
Investments in loans receivable
Construction in progress and other
Net cash provided by (used in) investing activities
Financing activities
Revolving credit facilities, net
Payments of term debt
Distributions paid	(35,717)	(27,719)
Lease deposits and other obligations to tenants
Net payments relating to intercompany financing	(77,100)	(145,408)
Proceeds from sale of common shares, net of offering costs	112,583	172,914
Debt issuance costs paid and other financing activities
Net cash provided by (used in) financing activities	(234)	(213)
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	(23,272)	(9,099)
Investing activities
Cash paid for acquisitions and other related investments
Principal received on loans receivable
Investments in loans receivable
Construction in progress and other	205	331
Net cash provided by (used in) investing activities	205	331
Financing activities
Revolving credit facilities, net	50,000	(125,000)
Payments of term debt
Distributions paid	(35,778)	(27,786)
Lease deposits and other obligations to tenants
Net payments relating to intercompany financing	(91,208)	27,048
Proceeds from sale of common shares, net of offering costs	112,583	172,914
Debt issuance costs paid and other financing activities	(241)	(64)
Net cash provided by (used in) financing activities	35,356	47,112
Increase (decrease) in cash and cash equivalents for period	12,289	38,344
Effect of exchange rate changes
Cash and cash equivalents at beginning of period	18,815	35,483
Cash and cash equivalents at end of period	31,104	73,827
Subsidiary Guarantors [Member]
Operating activities
Net cash provided by (used in) operating activities	43,606	36,434
Investing activities
Cash paid for acquisitions and other related investments	(115,000)
Principal received on loans receivable
Investments in loans receivable
Construction in progress and other	(27,303)	(13,245)
Net cash provided by (used in) investing activities	(142,303)	(13,245)
Financing activities
Revolving credit facilities, net
Payments of term debt
Distributions paid
Lease deposits and other obligations to tenants	1,970	921
Net payments relating to intercompany financing	88,184	(24,109)
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	90,154	(23,188)
Increase (decrease) in cash and cash equivalents for period	(8,543)	1
Effect of exchange rate changes	13
Cash and cash equivalents at beginning of period	27,094	1,565
Cash and cash equivalents at end of period	18,564	1,566
Non-Guarantor Subsidiaries [Member]
Operating activities
Net cash provided by (used in) operating activities	(2,286)	(497)
Investing activities
Cash paid for acquisitions and other related investments
Principal received on loans receivable	1,469	2,090
Investments in loans receivable	(2,385)	(800)
Construction in progress and other	(827)	(612)
Net cash provided by (used in) investing activities	(1,743)	678
Financing activities
Revolving credit facilities, net
Payments of term debt	(68)	(64)
Distributions paid
Lease deposits and other obligations to tenants	1,410	2,628
Net payments relating to intercompany financing	3,258	(2,726)
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	4,600	(162)
Increase (decrease) in cash and cash equivalents for period	571	19
Effect of exchange rate changes
Cash and cash equivalents at beginning of period	70	263
Cash and cash equivalents at end of period	641	282
Eliminations [Member]
Operating activities
Net cash provided by (used in) operating activities
Investing activities
Cash paid for acquisitions and other related investments
Principal received on loans receivable
Investments in loans receivable
Construction in progress and other
Net cash provided by (used in) investing activities
Financing activities
Revolving credit facilities, net
Payments of term debt
Distributions paid	35,717	27,719
Lease deposits and other obligations to tenants
Net payments relating to intercompany financing	76,866	145,195
Proceeds from sale of common shares, net of offering costs	(112,583)	$ (172,914)
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