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Document and Entity Information - USD ($)	12 Months Ended
Document and Entity Information - USD ($)	Dec. 31, 2014	Feb. 26, 2015	Jun. 30, 2014
Document Information [Line Items]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2014
Document Fiscal Year Focus	2014
Document Fiscal Period Focus	FY
Trading Symbol	MPW
Entity Registrant Name	MEDICAL PROPERTIES TRUST INC
Entity Central Index Key	0001287865
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	Yes
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		208,698,380
Entity Public Float			$ 2,283,300,069
MPT Operating Partnership, L.P. [Member]
Document Information [Line Items]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2014
Document Fiscal Year Focus	2014
Document Fiscal Period Focus	FY
Entity Registrant Name	MPT Operating Partnership, L.P.
Entity Central Index Key	0001524607
Current Fiscal Year End Date	--12-31
Entity Filer Category	Non-accelerated Filer

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2014	Dec. 31, 2013
Real estate assets
Land	$ 192,551	$ 154,858
Buildings and improvements	1,848,176	1,578,336
Construction in progress and other	23,163	41,771
Intangible lease assets	108,885	90,490
Net investment in direct financing leases	439,516	431,024
Mortgage loans	397,594	388,756
Gross investment in real estate assets	3,009,885	2,685,235
Accumulated depreciation	(181,441)	(144,235)
Accumulated amortization	(21,186)	(15,541)
Net investment in real estate assets	2,807,258	2,525,459
Cash and cash equivalents	144,541	45,979
Interest and rent receivables	41,137	58,565
Straight-line rent receivables	59,128	45,829
Other loans	573,167	160,990
Other assets	122,105	67,873
Total Assets	3,747,336	2,904,695
Liabilities
Debt, net	2,201,654	1,421,681
Accounts payable and accrued expenses	112,623	94,290
Deferred revenue	27,207	24,114
Lease deposits and other obligations to tenants	23,805	20,402
Total liabilities	2,365,289	1,560,487
Commitments and Contingencies
Equity / Capital
Preferred stock, $0.001 par value. Authorized 10,000 shares; no shares outstanding
Common stock, $0.001 par value. Authorized 250,000 shares; issued and outstanding - 172,743 shares at December 31, 2014 and 161,310 shares at December 31, 2013	172	161
Limited Partners:
Additional paid-in capital	1,765,381	1,618,054
Distributions in excess of net income	(361,330)	(264,804)
Accumulated other comprehensive loss	(21,914)	(8,941)
Treasury shares, at cost	(262)	(262)
Total Equity / Capital	1,382,047	1,344,208
Total Liabilities and Equity / Capital	3,747,336	2,904,695
MPT Operating Partnership, L.P. [Member]
Real estate assets
Land	192,551	154,858
Buildings and improvements	1,848,176	1,578,336
Construction in progress and other	23,163	41,771
Intangible lease assets	108,885	90,490
Net investment in direct financing leases	439,516	431,024
Mortgage loans	397,594	388,756
Gross investment in real estate assets	3,009,885	2,685,235
Accumulated depreciation	(181,441)	(144,235)
Accumulated amortization	(21,186)	(15,541)
Net investment in real estate assets	2,807,258	2,525,459
Cash and cash equivalents	144,541	45,979
Interest and rent receivables	41,137	58,565
Straight-line rent receivables	59,128	45,829
Other loans	573,167	160,990
Other assets	122,105	67,873
Total Assets	3,747,336	2,904,695
Liabilities
Debt, net	2,201,654	1,421,681
Accounts payable and accrued expenses	74,195	58,538
Deferred revenue	27,207	24,114
Lease deposits and other obligations to tenants	23,805	20,402
Payable due to Medical Properties Trust, Inc.	38,038	35,362
Total liabilities	2,364,899	1,560,097
Commitments and Contingencies
Limited Partners:
Accumulated other comprehensive loss	(21,914)	(8,941)
Total Equity / Capital	1,382,437	1,344,598
Total Liabilities and Equity / Capital	3,747,336	2,904,695
MPT Operating Partnership, L.P. [Member] \| Common Units [Member]
Limited Partners:
Limited Partners Capital	1,390,296	1,339,998
MPT Operating Partnership, L.P. [Member] \| General Partner [Member]
Equity / Capital
General partner - issued and outstanding - 1,722 units at December 31, 2014 and 1,608 units at December 31, 2013	$ 14,055	$ 13,541

Consolidated Balance Sheets (Parenthetical) - $ / shares	Dec. 31, 2014	Dec. 31, 2013
Preferred stock, par value	$ 0.001	$ 0.001
Preferred stock, shares authorized	10,000,000	10,000,000
Preferred stock, shares outstanding	0	0
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	250,000,000	250,000,000
Common stock, shares issued	172,743,000	161,310,000
Common stock, shares outstanding	172,743,000	161,310,000
General Partner [Member] \| MPT Operating Partnership, L.P. [Member]
General partner, units issued	1,722,000	1,608,000
General partner, units outstanding	1,722,000	1,608,000
LTIP Units [Member] \| MPT Operating Partnership, L.P. [Member]
LTIP Units, shares issued	292,000	292,000
LTIP Units, shares outstanding	292,000	292,000
Common Units [Member] \| MPT Operating Partnership, L.P. [Member]
Limited Partners, units issued	171,021,000	159,702,000
Limited Partners, units outstanding	171,021,000	159,702,000

Consolidated Statements of Net Income - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Revenues
Rent billed	$ 187,018	$ 132,578	$ 119,883
Straight-line rent	13,507	10,706	7,911
Income from direct financing leases	49,155	40,830	21,728
Interest and fee income	62,852	58,409	48,603
Total revenues	312,532	242,523	198,125
Expenses
Real estate depreciation and amortization	53,938	36,978	32,815
Impairment charges	50,128
Property-related	1,851	2,450	1,477
Acquisition expenses	26,389	19,494	5,420
General and administrative	37,274	30,063	28,562
Total operating expense	169,580	88,985	68,274
Operating income	142,952	153,538	129,851
Other income (expense)
Interest and other (expense) income	5,481	(319)	(1,662)
Earnings from equity and other interests	2,559	3,554	2,943
Debt refinancing and unutilized financings expense	(1,698)
Interest expense	(98,156)	(66,746)	(58,243)
Income tax expense	(340)	(726)	(19)
Net other expenses	(92,154)	(64,237)	(56,981)
Income from continuing operations	50,798	89,301	72,870
Income (loss) from discontinued operations	(2)	7,914	17,207
Net income	50,796	97,215	90,077
Net income attributable to non-controlling interests	(274)	(224)	(177)
Net income attributable to MPT common stockholders	$ 50,522	$ 96,991	$ 89,900
Earnings per share / unit - basic
Income from continuing operations attributable to MPT common stockholders	$ 0.29	$ 0.59	$ 0.54
Income (loss) from discontinued operations attributable to MPT common stockholders		0.05	0.13
Net income attributable to MPT common stockholders	$ 0.29	$ 0.64	$ 0.67
Weighted average shares (units) outstanding - basic	169,999	151,439	132,331
Earnings per share / unit - diluted
Income from continuing operations attributable to MPT common stockholders	$ 0.29	$ 0.58	$ 0.54
Income (loss) from discontinued operations attributable to MPT common stockholders		0.05	0.13
Net income attributable to MPT common stockholders	$ 0.29	$ 0.63	$ 0.67
Weighted average shares (units) outstanding - diluted	170,540	152,598	132,333
MPT Operating Partnership, L.P. [Member]
Revenues
Rent billed	$ 187,018	$ 132,578	$ 119,883
Straight-line rent	13,507	10,706	7,911
Income from direct financing leases	49,155	40,830	21,728
Interest and fee income	62,852	58,409	48,603
Total revenues	312,532	242,523	198,125
Expenses
Real estate depreciation and amortization	53,938	36,978	32,815
Impairment charges	50,128
Property-related	1,851	2,450	1,477
Acquisition expenses	26,389	19,494	5,420
General and administrative	37,274	30,063	28,562
Total operating expense	169,580	88,985	68,274
Operating income	142,952	153,538	129,851
Other income (expense)
Interest and other (expense) income	5,481	(319)	(1,662)
Earnings from equity and other interests	2,559	3,554	2,943
Debt refinancing and unutilized financings expense	(1,698)
Interest expense	(98,156)	(66,746)	(58,243)
Income tax expense	(340)	(726)	(19)
Net other expenses	(92,154)	(64,237)	(56,981)
Income from continuing operations	50,798	89,301	72,870
Income (loss) from discontinued operations	(2)	7,914	17,207
Net income	50,796	97,215	90,077
Net income attributable to non-controlling interests	(274)	(224)	(177)
Net income attributable to MPT common stockholders	$ 50,522	$ 96,991	$ 89,900
Earnings per share / unit - basic
Income from continuing operations attributable to MPT common stockholders	$ 0.29	$ 0.59	$ 0.54
Income (loss) from discontinued operations attributable to MPT common stockholders		0.05	0.13
Net income attributable to MPT common stockholders	$ 0.29	$ 0.64	$ 0.67
Weighted average shares (units) outstanding - basic	169,999	151,439	132,331
Earnings per share / unit - diluted
Income from continuing operations attributable to MPT common stockholders	$ 0.29	$ 0.58	$ 0.54
Income (loss) from discontinued operations attributable to MPT common stockholders		0.05	0.13
Net income attributable to MPT common stockholders	$ 0.29	$ 0.63	$ 0.67
Weighted average shares (units) outstanding - diluted	170,540	152,598	132,333

Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Net income	$ 50,796	$ 97,215	$ 90,077
Other comprehensive income (loss):
Unrealized gain (loss) on interest rate swap	2,964	3,474	(251)
Foreign currency translation (loss) gain	(15,937)	67
Total comprehensive income	37,823	100,756	89,826
Comprehensive income attributable to non-controlling interests	(274)	(224)	(177)
Comprehensive income attributable to MPT common stockholders (Operating Partnership partners)	37,549	100,532	89,649
MPT Operating Partnership, L.P. [Member]
Net income	50,796	97,215	90,077
Other comprehensive income (loss):
Unrealized gain (loss) on interest rate swap	2,964	3,474	(251)
Foreign currency translation (loss) gain	(15,937)	67
Total comprehensive income	37,823	100,756	89,826
Comprehensive income attributable to non-controlling interests	(274)	(224)	(177)
Comprehensive income attributable to MPT common stockholders (Operating Partnership partners)	$ 37,549	$ 100,532	$ 89,649

Consolidated Statements of Equity / Capital - USD ($) shares in Thousands, $ in Thousands	Total	Additional Paid-in Capital [Member]	Distributions in Excess of Net Income [Member]	Treasury Stock [Member]	Common Par Value [Member]	Accumulated Other Comprehensive Loss [Member]	Non- Controlling Interests [Member]	MPT Operating Partnership, L.P. [Member]	MPT Operating Partnership, L.P. [Member] Accumulated Other Comprehensive Loss [Member]	MPT Operating Partnership, L.P. [Member] Non- Controlling Interests [Member]	MPT Operating Partnership, L.P. [Member] General Partner [Member]	MPT Operating Partnership, L.P. [Member] Limited Partner [Member] Common Par Value [Member]	MPT Operating Partnership, L.P. [Member] Limited Partner [Member] Long Term Incentive Plan [Member]
Beginning balance (in shares) at Dec. 31, 2011					110,786						1,107	109,679	150
Beginning balance at Dec. 31, 2011	$ 828,815	$ 1,055,256	$ (214,059)	$ (262)	$ 111	$ (12,231)		$ 829,205	$ (12,231)		$ 8,418	$ 833,018
Net income	90,077		89,900				$ 177	90,077		$ 177	899	88,733	$ 268
Unrealized gain (loss) on interest rate swaps	(251)					(251)		(251)	(251)
Stock (Unit) vesting and amortization of stock (unit)-based compensation	7,637	7,636			$ 1			7,637			$ 76	$ 7,561
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)					854						4	850	71
Distributions to non-controlling interests	(177)						(177)	(177)		(177)
Proceeds from offering (net of offering costs)	233,048	233,024			$ 24			233,048			$ 2,331	$ 230,717
Proceeds from offering (net of offering costs) (shares)					24,695						246	24,449
Dividends (Distributions) declared ($0.80 in 2012, $0.81 in 2013 and $0.84 in 20134 per common share / unit)	(109,335)		(109,335)					(109,335)			$ (1,094)	$ (107,973)	$ (268)
Ending balance (in shares) at Dec. 31, 2012					136,335						1,357	134,978	221
Ending balance at Dec. 31, 2012	1,049,814	1,295,916	(233,494)	(262)	$ 136	(12,482)		1,050,204	(12,482)		$ 10,630	$ 1,052,056
Net income	97,215		96,991				224	97,215		224	972	95,748	$ 271
Unrealized gain (loss) on interest rate swaps	3,474					3,474		3,474	3,474
Foreign currency translation gain (loss)	67					67		67	67
Stock (Unit) vesting and amortization of stock (unit)-based compensation	8,833	8,832			$ 1			8,833			$ 88	$ 8,745
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)					811						9	802	71
Distributions to non-controlling interests	(224)						(224)	(224)		(224)
Proceeds from offering (net of offering costs)	313,330	313,306			$ 24			313,330			$ 3,133	$ 310,197
Proceeds from offering (net of offering costs) (shares)					24,164						242	23,922
Dividends (Distributions) declared ($0.80 in 2012, $0.81 in 2013 and $0.84 in 20134 per common share / unit)	(128,301)		(128,301)					(128,301)			$ (1,282)	$ (126,748)	$ (271)
Ending balance (in shares) at Dec. 31, 2013					161,310						1,608	159,702	292
Ending balance at Dec. 31, 2013	1,344,208	1,618,054	(264,804)	(262)	$ 161	(8,941)		1,344,598	(8,941)		$ 13,541	$ 1,339,998
Net income	50,796		50,522				274	50,796		274	508	49,769	$ 245
Unrealized gain (loss) on interest rate swaps	2,964					2,964		2,964	2,964
Foreign currency translation gain (loss)	(15,937)					(15,937)		(15,937)	(15,937)
Stock (Unit) vesting and amortization of stock (unit)-based compensation	9,165	9,165						9,165			$ 92	$ 9,073
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)					777						8	769
Distributions to non-controlling interests	(274)						$ (274)	(274)		$ (274)
Proceeds from offering (net of offering costs)	138,173	138,162			$ 11			138,173			$ 1,382	$ 136,791
Proceeds from offering (net of offering costs) (shares)					10,656						106	10,550
Dividends (Distributions) declared ($0.80 in 2012, $0.81 in 2013 and $0.84 in 20134 per common share / unit)	(147,048)		(147,048)					(147,048)			$ (1,468)	$ (145,335)	$ (245)
Ending balance (in shares) at Dec. 31, 2014					172,743						1,722	171,021	292
Ending balance at Dec. 31, 2014	$ 1,382,047	$ 1,765,381	$ (361,330)	$ (262)	$ 172	$ (21,914)		$ 1,382,437	$ (21,914)		$ 14,055	$ 1,390,296

Consolidated Statements of Equity / Capital (Parenthetical) - $ / shares	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Dividends (Distributions) declared per common share / unit	$ 0.84	$ 0.81	$ 0.8
MPT Operating Partnership, L.P. [Member]
Dividends (Distributions) declared per common share / unit	$ 0.84	$ 0.81	$ 0.80

Consolidated Statements of Cash Flows $ in Thousands	12 Months Ended
Consolidated Statements of Cash Flows $ in Thousands	Dec. 31, 2014 USD ($)	Dec. 31, 2013 USD ($)	Dec. 31, 2012 USD ($)
Operating activities
Net income (loss)	$ 50,796	$ 97,215	$ 90,077
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	55,162	38,818	35,593
Amortization and write-off of deferred financing costs and debt discount	5,105	3,559	3,457
Direct financing lease interest accretion	(6,701)	(5,774)	(3,104)
Straight-line rent revenue	(16,325)	(11,265)	(8,309)
Share (Unit)-based compensation expense	9,165	8,833	7,637
(Gain) loss from sale of real estate	(2,857)	(7,659)	(16,369)
Impairment charges	50,128
Straight-line rent write-off	2,818	1,457	6,456
Other adjustments	520	(70)	538
Decrease (increase) in:
Interest and rent receivable	(3,856)	(13,211)	(17,261)
Other assets	764	1,855	91
Accounts payable and accrued expenses	6,209	23,867	9,201
Deferred revenue	(485)	3,177	(2,698)
Net cash provided by operating activities	150,443	140,802	105,309
Investing activities
Cash paid for acquisitions and other related investments	(767,696)	(654,922)	(621,490)
Net proceeds from sale of real estate	34,649	32,409	71,202
Principal received on loans receivable	11,265	7,249	10,931
Investment in loans receivable	(12,782)	(3,746)	(1,293)
Construction in progress	(102,333)	(41,452)	(44,570)
Other investments, net	(13,126)	(52,115)	(31,908)
Net cash (used for) provided by investing activities	(850,023)	(712,577)	(617,128)
Financing activities
Additions to term debt	425,000	424,580	300,000
Payments of term debt	(100,266)	(11,249)	(232)
Payment of deferred financing costs	(14,496)	(9,760)	(6,247)
Revolving credit facilities, net	490,625	(20,000)	35,400
Distributions paid	(144,365)	(120,309)	(103,952)
Lease deposits and other obligations to tenants	7,892	3,231	(11,436)
Proceeds from sale of common shares/units, net of offering costs	138,173	313,330	233,048
Other			(177)
Net cash provided by financing activities	802,563	579,823	446,404
Increase (decrease) in cash and cash equivalents for the year	102,983	8,048	(65,415)
Effect of exchange rate changes	(4,421)	620
Cash and cash equivalents at beginning of year	45,979	37,311	102,726
Cash and cash equivalents at end of year	144,541	45,979	37,311
Interest paid, including capitalized interest of $1,860 in 2014, $1,729 in 2013, and $1,596 in 2012	91,890	58,110	51,440
Supplemental schedule of non-cash investing activities:
Loan conversion to equity interest			1,648
Mortgage loan issued from sale of real estate	12,500		3,650
Supplemental schedule of non-cash financing activities:
Dividends declared, not paid	38,461	35,778	27,786
MPT Operating Partnership, L.P. [Member]
Operating activities
Net income (loss)	50,796	97,215	90,077
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	55,162	38,818	35,593
Amortization and write-off of deferred financing costs and debt discount	5,105	3,559	3,457
Direct financing lease interest accretion	(6,701)	(5,774)	(3,104)
Straight-line rent revenue	(16,325)	(11,265)	(8,309)
Share (Unit)-based compensation expense	9,165	8,833	7,637
(Gain) loss from sale of real estate	(2,857)	(7,659)	(16,369)
Impairment charges	50,128
Straight-line rent write-off	2,818	1,457	6,456
Other adjustments	520	(70)	538
Decrease (increase) in:
Interest and rent receivable	(3,856)	(13,211)	(17,261)
Other assets	764	1,855	91
Accounts payable and accrued expenses	6,209	23,867	9,201
Deferred revenue	(485)	3,177	(2,698)
Net cash provided by operating activities	150,443	140,802	105,309
Investing activities
Cash paid for acquisitions and other related investments	(767,696)	(654,922)	(621,490)
Net proceeds from sale of real estate	34,649	32,409	71,202
Principal received on loans receivable	11,265	7,249	10,931
Investment in loans receivable	(12,782)	(3,746)	(1,293)
Construction in progress	(102,333)	(41,452)	(44,570)
Other investments, net	(13,126)	(52,115)	(31,908)
Net cash (used for) provided by investing activities	(850,023)	(712,577)	(617,128)
Financing activities
Additions to term debt	425,000	424,580	300,000
Payments of term debt	(100,266)	(11,249)	(232)
Payment of deferred financing costs	(14,496)	(9,760)	(6,247)
Revolving credit facilities, net	490,625	(20,000)	35,400
Distributions paid	(144,365)	(120,309)	(103,952)
Lease deposits and other obligations to tenants	7,892	3,231	(11,436)
Proceeds from sale of common shares/units, net of offering costs	138,173	313,330	233,048
Other			(177)
Net cash provided by financing activities	802,563	579,823	446,404
Increase (decrease) in cash and cash equivalents for the year	102,983	8,048	(65,415)
Effect of exchange rate changes	(4,421)	620
Cash and cash equivalents at beginning of year	45,979	37,311	102,726
Cash and cash equivalents at end of year	144,541	45,979	37,311
Interest paid, including capitalized interest of $1,860 in 2014, $1,729 in 2013, and $1,596 in 2012	91,890	58,110	51,440
Supplemental schedule of non-cash investing activities:
Loan conversion to equity interest			1,648
Mortgage loan issued from sale of real estate	12,500		3,650
Supplemental schedule of non-cash financing activities:
Dividends declared, not paid	$ 38,461	$ 35,778	$ 27,786

Consolidated Statements of Cash Flows (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Interest paid, capitalized	$ 1,860	$ 1,729	$ 1,596
MPT Operating Partnership, L.P. [Member]
Interest paid, capitalized	$ 1,860	$ 1,729	$ 1,596

Organization

12 Months Ended

Dec. 31, 2014

Accounting Policies [Abstract]

Organization

1.	Organization

Medical Properties Trust, Inc., a Maryland corporation, was formed on August 27, 2003, under the General Corporation Law of Maryland for the purpose of engaging in the business of investing in, owning, and leasing healthcare 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 generally 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.

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.

Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2014

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

2.	Summary of Significant Accounting Policies

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

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

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

At December 31, 2014, we had loans and/or equity investments in certain VIEs, which are also tenants of our facilities (including but not limited to Ernest and Vibra). We have determined that we are not the primary beneficiary of these VIEs. The carrying value and classification of the related assets and maximum exposure to loss as a result of our involvement with these VIEs are presented below at December 31, 2014 (in thousands):


VIE Type	Maximum Loss Exposure(1)		Asset Type Classification	Carrying Amount(2)
Loans, net		$257,208	Mortgage and other loans	$	207,617
Equity investments		$ 53,542	Other assets	$	5,490

(1)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Depreciation is calculated on the straight-line method over the useful lives of the related real estate and other assets. Our weighted-average useful lives at December 31, 2014 are as follows:


Buildings and improvements			37.9 years
Tenant lease intangibles			17.9 years
Leasehold improvements			22.3 years
Furniture, equipment and other			6.5 years

Losses from Rent Receivables: For all leases, we continuously monitor the performance of our existing tenants including, but not limited to: admission levels and surgery/procedure volumes by type; current operating margins; ratio of our tenant’s operating margins both to facility rent and to facility rent plus other fixed costs; trends in revenue and patient mix; and the effect of evolving healthcare regulations on tenant’s profitability and liquidity.

Losses from Operating Lease Receivables: We utilize the information above along with the tenant’s payment and default history in evaluating (on a property-by-property basis) whether or not a provision for losses on outstanding rent receivables is needed. A provision for losses on rent receivables (including straight-line rent receivables) is ultimately recorded when it becomes probable that the receivable will not be collected in full. The provision is an amount which reduces the receivable to its estimated net realizable value based on a determination of the eventual amounts to be collected either from the debtor or from existing collateral, if any.

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

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

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

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

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

Our financial statements include the operations of taxable REIT subsidiaries (“TRS”), including MPT Development Services, Inc. (“MDS”) and MPT Covington TRS, Inc. (“CVT”), along with around 30 others, which are single member LLCs that are disregarded for tax purposes and are reflected in the tax returns of MDS. Our TRS entities are not entitled to a dividends paid deduction and are subject to federal, state, and local income taxes. Our TRS entities are authorized to provide property development, leasing, and management services for third-party owned properties, and they make loans to and/or investments in our lessees.

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

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

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

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

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

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

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

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

•

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

•

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

•

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

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

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

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

Recent Accounting Developments: In 2014, the FASB issued Accounting Standards Update (“ASU”) 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 property disposals as discontinued operations in the future — such as with the La Palma and Bucks property disposals in 2014.

In May 2014, the FASB issued ASU 2014-09, Revenue from Contracts with Customers (Topic 606) (“ASU 2014-09”). ASU 2014-09 is a comprehensive new revenue recognition model requiring a company to recognize revenue to depict the transfer of goods or services to a customer at an amount reflecting the consideration it expects to receive in exchange for those goods or services. In adopting ASU 2014-09, companies may use either a full retrospective or a modified retrospective approach. Additionally, this guidance requires improved disclosures regarding the nature, amount, timing and uncertainty of revenue and cash flows arising from contracts with customers. ASU 2014-09 is effective for the first interim period within annual reporting periods beginning after December 15, 2016, and early adoption is not permitted. We are currently in the process of evaluating the impact the adoption of ASU 2014-09 will have on our financial position and results of operations.

In January 2015, the FASB issued ASU No. 2015-1, Simplifying Income Statement Presentation by Eliminating the Concept of Extraordinary Items (“ASU 2015-01”). ASU 2015-01 eliminates from GAAP the concept of extraordinary items. ASU 2015-01 is effective for fiscal years and interim periods beginning after December 15, 2015. We early adopted ASU 2015-01 as of December 31, 2014; the adoption of ASU 2015-01 did not have a material impact on our consolidated financial position or results of 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.

Real Estate and Loans Receivable

12 Months Ended

Dec. 31, 2014

Text Block [Abstract]

Real Estate and Loans Receivable

3.	Real Estate and Loans Receivable

Acquisitions

We acquired the following assets:


	2014		2013		2012
Assets Acquired		(in thousands)
Land	$	22,569	$	41,473	$	518
Building		241,242		439,030		8,942
Intangible lease assets — subject to amortization (weighted average useful life of 18.2 years in 2014, 21.0 years in 2013 and 15.0 years in 2012)		22,513		38,589		1,040
Net investments in direct financing leases		—		110,580		310,000
Mortgage loans		—		20,000		200,000
Other loans		447,664		5,250		95,690
Other assets		33,708		—		5,300

Total assets acquired	$	767,696	$	654,922	$	621,490

2014 Activity

Median Transaction

On October 15, 2014, we entered into definitive agreements pursuant to which we will acquire substantially all the real estate assets of Median Kliniken S.à r.l. (“Median”), a German provider of post-acute and acute rehabilitation services, for an aggregate purchase price of approximately €705 million, (or $881 million based on exchange rates at that time). The portfolio includes 38 rehabilitation hospitals and two acute care hospitals located across 11 states in the Federal Republic of Germany.

The transaction is structured using a two step process in partnership with affiliates of Waterland Private Equity Fund V C.V. (“Waterland”). In the first step, which was completed on December 15, 2014, an affiliate of Waterland acquired 94.9% of the outstanding equity interest in Median pursuant to a stock purchase agreement with Median’s current owners. We indirectly acquired the remaining 5.1% of the outstanding equity interest and provided or committed to provide interim acquisition loans to Waterland and Median in aggregate amounts of approximately €425 million ($531 million), of which €349 million had been advanced at December 31, 2014. These interim loans we make will bear interest at a rate similar to the initial lease rate under the planned sale and leaseback transactions described below.

In a series of transactions we expect will be completed in early 2015, we will acquire substantially all of Median’s real estate assets under a sale and leaseback transaction. We will either assume or novate any third party debt attributable to the real estate assets acquired or provide the cash required to repay the third party debt. The purchase price we are required to pay for the real estate assets will be offset, pro rata, against amounts of debt that we assume or have provided cash to repay, and/or against the amounts of loans previously made. The sale and leaseback transactions are subject to customary real estate, regulatory and other closing conditions, including waiver of any statutory pre-emption rights by local municipalities. To the extent we are unable to acquire the entire Median portfolio as contemplated, we will have a right of first refusal with regard to any new real estate properties owned or acquired by Median.

Upon our acquisition of the real estate assets, we will lease them back to Median under a 27 year master lease, with annual escalators at the greater of one percent or 70% of the German consumer price index.

An affiliate of Waterland controls RHM Klinik-und Altenheimbetriebe GmbH & Co. KG (“RHM”), the operator and lessee of the other German facilities that we own.

In the fourth quarter of 2014, we acquired three RHM rehabilitation facilities in Germany for an aggregate purchase price of €63.6 million (approximately $81 million) including approximately €3.0 million (or approximately $3.6 million) of transfer and other taxes that have been expensed as acquisition costs. These facilities include: Bad Mergentheim (211 beds), Bad Tolz (248 beds), and Bad Liebenstein (271 beds). All three properties are included under our existing master lease agreement with RHM as described below.

On October 31, 2014, we acquired a 237-bed acute care hospital, associated medical office buildings, and a behavioral health facility in Sherman, Texas for $32.5 million. Alecto Healthcare Services (“Alecto”) is the tenant and operator pursuant to a 15-year lease agreement with three five-year extension options. In addition we agreed to fund a working capital loan up to $7.5 million, all of which was funded at December 31, 2014, and we obtained a 20% interest in the operator of the facility.

On September 19, 2014, we acquired an acute care hospital in Fairmont, West Virginia for an aggregate purchase price of $15 million from Alecto. The facility was simultaneously leased back to the seller under a 15-year initial term with three five-year extension options. In addition, we made a $5 million working capital loan to the tenant with a five year term and a commitment to fund up to $5 million in capital improvements. Finally, we obtained a 20% interest in the operator of this facility.

On July 1, 2014, we acquired an acute care hospital in Peasedown St. John, United Kingdom from Circle Health Ltd., through its subsidiary Circle Hospital (Bath) Ltd. The sale/leaseback transaction, excluding any transfer taxes, is valued at approximately £28.3 million (or approximately $48.0 million based on exchange rates at that time). The lease has an initial term of 15-years with a tenant option to extend the lease for an additional 15 years. The lease includes annual rent increases, which will equal the year-over-year change in the retail price index with a floor of 2% and a cap of 5%. With the transaction, we incurred approximately £1.1 million (approximately $1.9 million) of transfer and other taxes that have been expensed as acquisition costs.

On March 31, 2014, we acquired a general acute care hospital and an adjacent parcel of land 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.

From the respective acquisition dates in 2014 through that year end, the 2014 acquisitions contributed $12.4 million and $8.7 million of revenue and income (excluding related acquisition and financing expenses) for the period ended December 31, 2014. In addition, we incurred $26.4 million of acquisition related expenses in 2014, of which $25.2 million (including $5.8 million in transfer taxes as part of our RHM, Circle, and Median transactions) related to acquisitions consummated as of December 31, 2014.

The purchase price allocations attributable to the 2014 acquisitions are preliminary. When all relevant information is obtained, resulting changes, if any, to our provisional purchase price allocation will be retrospectively adjusted to reflect new information obtained about the facts and circumstances that existed as of the respective acquisition dates that, if known, would have affected the measurement of the amounts recognized as of those dates.

2013 Activity

RHM Portfolio Acquisition

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

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

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

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

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

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

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

2012 Activity

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

Real Estate Acquisition and Mortgage Loan Financing

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

Acquisition Loan and Equity Contribution

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

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

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

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

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

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

Pro Forma Information

The following unaudited supplemental pro forma operating data is presented for the year ended December 31, 2014 and 2012, as if each acquisition was completed on January 1, 2013. The unaudited supplemental pro forma operating data is not necessarily indicative of what the actual results of operations would have been assuming the transactions had been completed as set forth above, nor do they purport to represent our results of operations for future periods (in thousands, except per share amounts).


	For the Year Ended December 31,
	(Unaudited)
	2014		2013
Total revenues	$	329,258	$	315,780
Net income		67,150		144,545
Net income per share/unit	$	0.38	$	0.84

Development Activities

During 2014, we completed construction and began recording rental income on the following 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.

•

Oakleaf Surgical Hospital — This $30.5 million acute care facility located in Altoona, Wisconsin. This facility is leased to National Surgical Hospitals for 15 years and contains two renewal options of five years each plus an additional option for nearly another five years, and the rent increases annually based on changes in the consumer price-index.

•

First Choice ER (a subsidiary of Adeptus Health) — We completed 17 acute care facilities for this tenant during 2014 totaling approximately $83.0 million. These facilities are leased pursuant to the master lease entered into in 2013.

On August 15, 2014 we executed a binding $8.7 million agreement with Health Care Authority for University of Alabama Birmingham (UAB) Medical West, an Affiliate of UAB Health System for the development of a freestanding emergency department and a medical office building. The facilities will be leased to Medical West under 15 year initial lease terms with four extension options of five years each.

On July 29, 2014, we executed a binding $150 million agreement with Adeptus Health for the development of acute care hospitals and free-standing emergency departments. These facilities will be leased to Adeptus Health pursuant to a new master lease agreement that has a 15-year initial term with three extension options of five years each that provides for annual rent increases based on changes in the consumer price index with a 2% minimum. This new master lease agreement is cross-defaulted with the original master lease executed with First Choice ER in 2013. We began construction on seven of these facilities in the 2014 second half pursuant to the master funding and development agreement.

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

Property

Location

Property Type

Operator

Commitment

Costs Incurred
as of
12/31/14

Estimated
Completion
Date

UAB Medical West

Hoover, AL

Acute Care Hospital & MOB

Medical West, an
affiliate of UAB

8,653

1,973

2Q 2015

First Choice ER- Summerwood

Houston, TX

Acute Care Hospital

Adeptus Health

6,015

2,560

2Q 2015

First Choice ER- Ft. Worth Avondale – Haslet

Ft. Worth, TX

Acute Care Hospital

Adeptus Health

4,780

871

2Q 2015

First Choice ER- Carrollton

Carrollton, TX

Acute Care Hospital

Adeptus Health

35,820

15,629

3Q 2015

First Choice ER- Chandler

Chandler, AZ

Acute Care Hospital

Adeptus Health

5,049

895

3Q 2015

First Choice ER- Converse

Converse, TX

Acute Care Hospital

Adeptus Health

5,754

1,141

3Q 2015

First Choice ER- Denver 48^th

Denver, CO

Acute Care Hospital

Adeptus Health

5,123

3Q 2015

First Choice ER- McKinney

McKinney, TX

Acute Care Hospital

Adeptus Health

4,750

3Q 2015

First Choice Emergency Rooms

Various

Acute Care Hospital

Adeptus Health

84,423

—

Various

160,367

23,163

Disposals

2014 Activity

On December 31, 2014, we sold our La Palma facility for $12.5 million, resulting in a gain of $2.9 million. Due to this sale, we wrote-off $1.3 million of straight-line rent receivables.

On May 20, 2014, the tenant of our Bucks facility gave notice of their intent to exercise the lease’s purchase option. Pursuant to this purchase option, the tenant acquired the facility on August 6, 2014 for $35 million. We wrote down this facility to fair market value less cost to sell, resulting in a $3.1 million real estate impairment charge in the 2014 second quarter.

The sale of the Bucks and La Palma facilities was not a strategic shift in our operations, and therefore the results of the Bucks and La Palma operations have not been reclassified as discontinued operations.

2013 Activity

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

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

2012 Activity

On December 27, 2012, we sold our Huntington Beach facility for $12.5 million, resulting in a gain of $1.9 million. Due to this sale, we wrote-off $0.7 million of straight-line rent receivable. Due to this sale, we wrote-off $1.3 million of straight line rent receivables.

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

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

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

For each of the disposals in 2013 and 2012 (which occurred prior to the accounting changed discussed in Note 1 under the heading “Recent Accounting Developments”), the operating results of these facilities for the current and all prior periods have been included in discontinued operations.

Intangible Assets

At December 31, 2014 and 2013, our intangible lease assets were $108.9 million ($87.7 million, net of accumulated amortization) and $90.5 million ($74.9 million, net of accumulated amortization), respectively.

We recorded amortization expense related to intangible lease assets of $7.0 million, $4.0 million, and $3.9 million in 2014, 2013, and 2012, respectively, and expect to recognize amortization expense from existing lease intangible assets as follows: (amounts in thousands)


For the Year Ended December 31:
2015	$	6,438
2016		6,397
2017		6,387
2018		6,326
2019		6,271

As of December 31, 2014, capitalized lease intangibles have a weighted average remaining life of 17.9 years.

Leasing Operations

All of our leases are accounted for as operating leases except we are accounting for 14 Ernest facilities and five Prime facilities as DFLs. The components of our net investment in DFLs consisted of the following (dollars in thousands):


	As of December 31, 2014
Minimum lease payments receivable	$	1,607,024
Estimated residual values		211,888
Less unearned income		(1,379,396	)

Net investment in direct financing leases	$	439,516

Minimum rental payments due to us in future periods under operating leases and DFLs, which have non-cancelable terms extending beyond one year at December 31, 2014, are as follows: (amounts in thousands)


	Total Under Operating Leases		Total Under DFLs		Total
2015	$	196,864	$	43,386	$	240,250
2016		198,265		44,254		242,519
2017		198,807		45,139		243,946
2018		199,728		46,041		245,769
2019		199,857		46,962		246,819
Thereafter		1,838,346		380,743		2,219,089

	$	2,831,867	$	606,525	$	3,438,392

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

Monroe Facility

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


	As of December 31, 2014		As of December 31, 2013
Loans	$	—	$	31,341
Less: Loan impairment reserve		—		(12,000	)

Loans, net		—		19,341
Interest, rent and other receivables		—		20,972

Net investment	$	—	$	40,313

Due to the performance and cash flow shortages of the previous tenant, we stopped recording interest income on the Monroe loan and unbilled rent revenue in 2010. In addition, we stopped recording billed rental revenue on this property in April 1, 2013. During 2014, the previous operator of our Monroe facility continued to underperform and became further behind on payments to us as required by the real estate lease agreement and working capital loan agreement. In August 2014, this operator filed for bankruptcy. As part of the bankruptcy process and to help with a smoother transition of the property to a new operator, we agreed to provide up to $5 million in debtor-in-possession financing of which all was funded by December 31, 2014. Based on these new developments and the fair value of our real estate and the underlying collateral of our loan (using Level 2 inputs), we recorded a $47.0 million impairment charge in 2014.

Effective December 31, 2014, the bankruptcy court approved the purchase by Prime of the assets of the prior operator. Prime, will lease the facility from us pursuant to terms under an existing master lease. The initial annual lease payment is approximately $2.5 million, and Prime is current on its rent through February 2015. At December 31, 2014, our investment in Monroe is approximately $36 million, which we believe is fully recoverable.

Florence facility

On March 6, 2013, the tenant of our $27.4 million facility in Phoenix, Arizona filed for Chapter 11 bankruptcy. At December 31, 2014, we have approximately $1.0 million of receivables outstanding but the tenant continues to pay us in accordance with bankruptcy orders. In addition, we have a letter of credit for approximately $1.2 million to cover any rent and other monetary payments not paid. We have entered into a non-binding letter of intent with the stalking horse bidder for the assumption of the existing lease, with certain non-monetary amendments. Although no assurances can be made that we will not have any impairment charges in the future, we believe our investment in Florence at December 31, 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; however, we sent notice of termination of the lease prior to the bankruptcy filing. As a result of the lease terminating, we recorded a 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. The tenant has continued to perform its monetary obligations and we have agreed to the terms of an amended lease upon the tenant’s bankruptcy exit. At December 31, 2014, we have no outstanding receivables. 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 $14.1 million at December 31, 2014, is fully recoverable.

Loans

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


	As of December 31, 2014					As of December 31, 2013
	Balance		Weighted Average Interest Rate			Balance		Weighted Average Interest Rate
Mortgage loans	$	397,594		10.5	%	$	388,756		10.0	%
Acquisition loans		525,136		9.3	%		109,655		14.7	%
Working capital and other loans		48,031		10.4	%		51,335		10.8	%

	$	970,761				$	549,746

Our mortgage loans cover eight of our properties with three operators.

Other loans typically consist of loans to our tenants for acquisitions and working capital purposes. At December 31, 2014, acquisition loans includes our $97.5 million loan to Ernest plus $422.5 million related to the Median transaction in 2014.

On March 1, 2012, pursuant to our convertible note agreement, we converted $1.6 million of our $5.0 million convertible note into a 9.9% equity interest in the operator of our Hoboken University Medical Center facility. At December 31, 2014, $3.4 million remains outstanding on the convertible note, and we retain the option, to convert this remainder into an additional 15.1% equity interest in the operator.

Concentration of Credit Risks

For the years ended December 31, 2014 and 2013, revenue from affiliates of Prime (including rent and interest from mortgage loans) accounted for 26.9% and 32.0%, respectively, of total revenue. From an investment concentration perspective, Prime represented 20.0% and 24.5% of our total assets at December 31, 2014 and December 31, 2013, respectively.

For the year ended December 31, 2014 and 2013, revenue from affiliates of Ernest (including rent and interest from mortgage and acquisition loans) accounted for 18.3% and 20.2% of total revenue, respectively. From an investment concentration perspective, Ernest represented 13.0% and 15.9% of our total assets at December 31, 2014 and December 31, 2013, respectively.

For the year ended December 31, 2014, Median represented 11.3% of our total assets at December 31, 2014.

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

From a global geographic perspective, approximately 80% of our total assets are in the United States while 20% reside in Europe as of December 31, 2014, up from 9% in 2013. Revenue from our European investments was $26.0 million and $1.8 million in 2014 and 2013, respectively.

From a United States geographic perspective, investments located in California represented 14.6% of our total assets at December 31, 2014, down from 18.7% in the prior year. Investments located in Texas represented 20.2% of our total assets at December 31, 2014, down from 22.7% in the prior year.

Related Party Transactions

Lease and interest revenue earned from tenants in which we have an equity interest in were $101.8 million, $70.0 million and $54.3 million in 2014, 2013 and 2012, respectively.

Debt

12 Months Ended

Dec. 31, 2014

Debt Disclosure [Abstract]

Debt

Debt

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


	As of December 31, 2014					As of December 31, 2013
	Balance		Interest Rate			Balance		Interest Rate
Revolving credit facility	$	593,490		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		2,522					2,873

		352,522					352,873
2013 Senior Unsecured Notes(A)		241,960		5.75	%		274,860		5.75	%
2014 Senior Unsecured Notes		300,000		5.50	%		—
Term loans		138,682		Various			113,948		Various

	$	2,201,654				$	1,421,681

As of December 31, 2014, principal payments due on our debt (which exclude the effects of any discounts or premiums recorded) are as follows:


2015	$	283
2016		125,298
2017		320
2018		606,271
2019		125,000
Thereafter		1,341,960

Total	$	2,199,132

(A)	These notes are Euro-denominated and reflect the exchange rates at December 31, 2014 and 2013, respectively.

Revolving Credit Facility

On June 19, 2014, we closed on a $900 million senior unsecured credit facility (the “Credit Facility”). The Credit Facility was comprised of a $775 million senior unsecured revolving credit facility (the “Revolving credit facility”) and a $125 million senior unsecured term loan facility (the “Term Loan”). The Credit Facility had an accordion feature that allowed us to expand the size of the facility by up to $250 million through increases to the Revolving credit facility, Term Loan, both or as a separate term loan tranche. The Credit Facility replaced our previous $400 million unsecured revolving credit facility and $100 million unsecured term loan. This transaction resulted in a refinancing charge of approximately $0.3 million in the 2014 second quarter.

On October 17, 2014, we entered into an amendment to our Credit Facility to exercise the $250 million accordion on the Revolving credit facility. This amendment increased the Credit Facility to $1.15 billion and added a new accordion feature that allows us to expand our credit facility by another $400 million.

The Revolving credit facility matures in June 2018 and can be extended for an additional 12 months at our option. The Revolving credit facility’s interest rate was (1) the higher of the “prime rate”, federal funds rate plus 0.50%, or Eurodollar rate plus 1.00%, plus a spread that was adjustable from 0.70% to 1.25% based on current total leverage, or (2) LIBOR plus a spread that was adjustable from 1.70% to 2.25% based on current total leverage. In addition to interest expense, we were required to pay a quarterly commitment fee on the undrawn portion of the revolving credit facility, ranging from 0.25% to 0.35% per year.

In November 2014, we received an upgrade to our credit rating resulting in an improvement in our interest rate spreads and commitment fee rates. Effective December 10, 2014, the Revolving credit facility’s interest rate is (1) the higher of the “prime rate”, federal funds rate plus 0.50%, or Eurodollar rate plus 1.00% plus a fixed spread of 0.40% or (2) LIBOR plus a fixed spread of 1.40%. In regards to commitment fees, we now pay based on the total facility at a rate of 0.30% per year.

At December 31, 2014 and 2013, we had $593.5 million and $105.0 million, respectively, outstanding on the Revolving credit facility.

At December 31, 2014, our availability under our Revolving credit facility was approximately $432 million. The weighted average interest rate on this facility was 2.2% and 3.2% for 2014 and 2013, respectively.

2014 Senior Unsecured Notes

On April 17, 2014, we completed a $300 million senior unsecured notes offering (“2014 Senior Unsecured Notes”). Interest on the notes is payable semi-annually on May 1 and November 1 of each year. The 2014 Senior Unsecured Notes 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 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. 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.

2013 Senior Unsecured Notes

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

2012 Senior Unsecured Notes

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

2011 Senior Unsecured Notes

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

2006 Senior Unsecured Notes

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

During the second quarter 2010, we entered into an interest rate swap to manage our exposure to variable interest rates by fixing $65 million of our $125 million 2006 Senior Unsecured Notes, which started July 31, 2011 (date on which the interest rate turned variable) through maturity date (or July 2016), at a rate of 5.507%. We also entered into an interest rate swap to fix $60 million of 2006 Senior Unsecured Notes which started October 31, 2011 (date on which the related interest rate turned variable) through the maturity date (or October 2016) at a rate of 5.675%. At December 31, 2014 and 2013, the fair value of the interest rate swaps was $6.0 million and $9.0 million, respectively, which is reflected in accounts payable and accrued expenses on the consolidated balance sheets.

We account for our interest rate swaps as cash flow hedges. Accordingly, the effective portion of changes in the fair value of our swaps is recorded as a component of accumulated other comprehensive income/loss on the balance sheet and reclassified into earnings in the same period, or periods, during which the hedged transactions effects earnings, while any ineffective portion is recorded through earnings immediately. We did not have any hedge ineffectiveness from inception of our interest rate swaps through December 31, 2014 and therefore, there was no income statement effect recorded during the years ended December 31, 2014, 2013, and 2012. We do not expect any of the current losses included in accumulated other comprehensive loss to be reclassified into earnings in the next 12 months. At December 31, 2014 and 2013, we have posted $3.3 million and $5.0 million of collateral related to our interest rate swaps, respectively, which is reflected in other assets on our consolidated balance sheets.

Term Loans

As noted previously, we closed on the 2014 Term Loan for $125 million in the second quarter of 2014. The Term Loan matures in June 2019. The Term Loan’s initial interest rate was (1) the higher of the “prime rate”, federal funds rate plus 0.50%, or Eurodollar rate plus 1.00%, plus a spread that was adjustable from 0.60% to 1.20% based on current total leverage, or (2) LIBOR plus a spread that was adjustable from 1.60% to 2.20% based on current total leverage. With the upgrade to our credit rating as discussed above, the Term Loan’s interest rate, effective December 10, 2014, improved to (1) the higher of the “prime rate”, federal funds rate plus 0.50%, or Euro dollar rate plus 1.00% plus a fixed spread of 0.65%, or (2) LIBOR plus a fixed spread of 1.65%. At December 31, 2014 and 2013, the interest rate in effect was 1.82% and 2.43%, respectively.

In connection with our acquisition of the Northland LTACH Hospital on February 14, 2011, we assumed a $14.6 million mortgage. The Northland mortgage loan requires monthly principal and interest payments based on a 30-year amortization period. The Northland mortgage loan has a fixed interest rate of 6.2%, matures on January 1, 2018 and can be prepaid after January 1, 2013, subject to a certain prepayment premium. At December 31, 2014, the remaining balance on this term loan was $13.7 million. The loan was collateralized by the real estate of the Northland LTACH Hospital, which had a net book value of $17.5 million and $18.0 million at December 31, 2014 and 2013, respectively.

Other Commitments

At December 31, 2014, we had commitments from a syndicate of lenders for a senior unsecured interim bridge loan facility with availability of up to $215 million. This facility served as a back stop for the partial financing of step 1 of the Median transaction. We recorded $1.4 million of expense in 2014 related to the fees incurred on this facility that was never utilized and expired in January 2015.

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

Income Taxes

12 Months Ended

Dec. 31, 2014

Income Tax Disclosure [Abstract]

Income Taxes

5.	Income Taxes

Medical Properties Trust, Inc.

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

From our taxable REIT subsidiaries and our foreign operations, we incurred income tax expenses as follows (in thousands):


	For the years ended December 31,
	2014			2013		2012
Current income tax (benefit) expense:
Domestic	$	114		$	358	$	(44	)
Foreign		225			158		—

		339			516		(44	)
Deferred income tax (benefit) expense
Domestic		(23	)		210		63
Foreign		24			—		—

		1			210		63

Income tax (benefit) expense	$	340		$	726	$	19

The foreign provision (benefit) for income taxes is based on foreign loss before income taxes of $7.5 million in 2014 as compared with foreign loss before income taxes of $12.9 million in 2013 (primarily due to the real estate transfer taxes expensed in these periods).

The domestic provision (benefit) for income taxes is based on loss before income taxes of $20.9 million in 2014 from our taxable REIT subsidiaries (primarily due to impairment charges related to Monroe working capital loan) as compared with income before income taxes of $7.6 million in 2013 from our taxable REIT subsidiaries, and income before income taxes of $0.1 million in 2012 from our taxable REIT subsidiaries.

At December 31, 2014 and 2013, components of our deferred tax assets and liabilities were as follows (in thousands):


	2014			2013
Deferred tax liabilities:
Property and equipment	$	—		$	(2,560	)
Unbilled rent		(2,070	)		(610	)
Partnership investments		(3,468	)		—
Other		(3,759	)		(2,313	)

Total deferred tax liabilities	$	(9,297	)	$	(5,483	)

Deferred tax assets:
Loan loss and other reserves	$	—		$	7.751
Operating loss and interest deduction carry forwards		19,546			2,283
Property and equipment		2,373			—
Partnership investments		—			805
Other		3,971			2,256

Total deferred tax assets		25,890			13,095
Valuation allowance		(16,831	)		(7,843	)

Total net deferred tax assets	$	9,059		$	5,252

Net deferred tax (liability)	$	(238	)	$	(231	)

At December 31, 2014, we had U.S. federal and state NOLs of $50.7 million and $121.8 million, respectively, that expire in 2021 through 2034. At December 31, 2014, we had foreign NOLs of $6.7 million that may be carried forward indefinitely.

At December 31, 2014, we had U.S. federal alternative minimum tax credits of $0.1 million that may be carried forward indefinitely.

In 2014, our valuation allowance increased by $8.9 million as a result of book losses sustained by both our foreign subsidiaries as the result of significant acquisition expenses incurred and certain of our domestic taxable REIT subsidiaries. We believe (based on cumulative losses and potential of future taxable income) that we should reserve for our net deferred tax assets. We will continue to monitor this valuation allowance and, if circumstances change (such as entering into new transactions including working capital loans, equity investments, etc), we will adjust this valuation allowance accordingly.

A reconciliation of the income tax expense at the statutory income tax rate and the effective tax rate for income from continuing operations before income taxes for the years ended December 31, 2014, 2013, and 2012 is as follows (in thousands):


	2014			2013			2012
Income from continuing operations (before-tax)	$	51,138		$	90,027		$	72,889
Income tax at the US statutory federal rate (35%)		17,898			31,509			25,511
Rate differential		1,145			2,380			—
State income taxes, net of federal benefit		(337	)		271			(8	)
Dividends paid deduction		(27,873	)		(33,345	)		(25,454	)
Change in valuation allowance		8.988			(697	)		—
Other items, net		519			608			(30	)

Total income tax expense	$	340		$	726		$	19

We have no liabilities for uncertain tax positions as of December 31, 2014 and 2013. We recognize interest and penalties related to unrecognized tax positions in income tax expense. We do not currently anticipate that the total amount of unrecognized tax positions will significantly increase or decrease in the next twelve months.

We have met the annual REIT distribution requirements by payment of at least 90% of our estimated taxable income in 2014, 2013, and 2012. Earnings and profits, which determine the taxability of such distributions, will differ from net income reported for financial reporting purposes due primarily to differences in cost basis, differences in the estimated useful lives used to compute depreciation, and differences between the allocation of our net income and loss for financial reporting purposes and for tax reporting purposes.

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


	For the Years Ended December 31,
	2014		2013		2012
Common share distribution	$	0.840000	$	0.800000	$	0.800000
Ordinary income		0.520692		0.599384		0.601216
Capital gains(1)		0.000276		0.046380		0.117584
Unrecaptured Sec. 1250 gain		0.000276		0.026512		0.086976
Return of capital		0.319032		0.154236		0.081200
Allocable to next year		—		—		—

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

MPT Operating Partnership, L.P.

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

Earnings Per Share/Unit

12 Months Ended

Dec. 31, 2014

Earnings Per Share [Abstract]

Earnings Per Share/Unit

6.	Earnings Per Share/Unit

Medical Properties Trust, Inc.

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


	For the Years Ended December 31,
	2014			2013			2012
Numerator:
Income from continuing operations	$	50,798		$	89,301		$	72,870
Non-controlling interests’ share in continuing operations		(274	)		(224	)		(177	)
Participating securities’ share in earnings		(894	)		(729	)		(887	)

Income from continuing operations, less participating securities’ share in earnings		49,630			88,348			71,806
Income (loss) from discontinued operations attributable to MPT common stockholders		(2	)		7,914			17,207

Net income, less participating securities’ share in earnings	$	49,628		$	96,262		$	89,013

Denominator:
Basic weighted-average common shares		169,999			151,439			132,331
Dilutive potential common shares		541			1,159			2

Diluted weighted-average common shares		170,540			152,598			132,333

MPT Operating Partnership, L.P.

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


	For the Years Ended December 31,
	2014			2013			2012
Numerator:
Income from continuing operations	$	50,798		$	89,301		$	72,870
Non-controlling interests’ share in continuing operations		(274	)		(224	)		(177	)
Participating securities’ share in earnings		(894	)		(729	)		(887	)

Income from continuing operations, less participating securities’ share in earnings		49,630			88,348			71,806
Income (loss) from discontinued operations attributable to MPT Operating Partnership partners		(2	)		7,914			17,207

Net income, less participating securities’ share in earnings	$	49,628		$	96,262		$	89,013

Denominator:
Basic weighted-average units		169,999			151,439			132,331
Dilutive potential units		541			1,159			2

Diluted weighted-average units		170,540			152,598			132,333

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

Stock Awards

12 Months Ended

Dec. 31, 2014

Disclosure of Compensation Related Costs, Share-based Payments [Abstract]

Stock Awards

7.	Stock Awards

Stock Awards

Our Equity Incentive Plan authorizes the issuance of common stock options, restricted stock, restricted stock units, deferred stock units, stock appreciation rights, performance units and awards of interests in our Operating Partnership. Our Equity Incentive Plan is administered by the Compensation Committee of the Board of Directors. We have reserved 7,643,651 shares of common stock for awards under the Equity Incentive Plan and 6,316,151 shares remain available for future stock awards as of December 31, 2014. The Equity Incentive Plan contains a limit of 5,000,000 shares as the maximum number of shares of common stock that may be awarded to an individual in any fiscal year. Awards under the Equity Incentive Plan are subject to forfeiture due to termination of employment prior to vesting. In the event of a change in control, outstanding and unvested options will immediately vest, unless otherwise provided in the participant’s award or employment agreement, and restricted stock, restricted stock units, deferred stock units and other stock-based awards will vest if so provided in the participant’s award agreement. The term of the awards is set by the Compensation Committee, though Incentive Stock Options may not have terms of more than ten years. Forfeited awards are returned to the Equity Incentive Plan and are then available to be re-issued as future awards. For each share of common stock issued by Medical Properties Trust, Inc. pursuant to its Equity Incentive Plan, the Operating Partnership issues a corresponding number of operating partnership units.

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

Stock Options

At December 31, 2014, we had no options outstanding and exercisable. In 2014, 20,000 options were exercised. No options were granted in 2014, 2013, or 2012.

Restricted Equity Awards

These stock-based awards are in the form of service-based awards and performance-based awards. The service-based awards vest as the employee provides the required service (typically three to five years). Service based awards are valued at the average price per share of common stock on the date of grant. In 2014, 2013, and 2012, the Compensation Committee granted awards to employees which vest based on us achieving certain total shareholder returns or comparisons of our total shareholder returns to peer total return indices. Generally, dividends are not paid on these performance awards until the award is earned. See below for details of such grants:

2014 performance awards - The 2014 performance awards were granted in three parts:

Approximately 40% of the 2014 performance awards were based on us achieving a simple 9.0% annual total shareholder return over a three year period; however, the award contained both carry forward and carry back provisions through December 31, 2018. The fair value of this award was estimated on the date of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 1.7%; expected volatility of 27%; expected dividend yield of 8.0%; and expected service period of 3 years.

Approximately 30% of the 2014 performance awards were based on us achieving a cumulative total shareholder return from January 1, 2014 to December 31, 2016. The minimum total shareholder return needed to earn a portion of this award is 27.0% with 100% of the award earned if our total shareholder return reaches 35.0%. If any shares are earned from this award, the shares will vest in equal annual amounts on December 31, 2016, 2017 and 2018. The fair value of this award was estimated on the date of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 0.8%; expected volatility of 27%; expected dividend yield of 8.0%; and expected service period of 5 years.

The remainder of the 2014 performance awards will be earned if our total shareholder return outpaces that of the MSCI U.S. REIT Index (“Index”) over the cumulative period from January 1, 2014 to December 31, 2016. Our total shareholder return must exceed that of the Index to earn the minimum number of shares under this award, while it must exceed the Index by 6% to earn 100% of the award. If any shares are earned from this award, the shares will vest in equal annual amounts on December 31, 2016, 2017 and 2018. The fair value of this award was estimated on the date of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 0.8%; expected volatility of 27%; expected dividend yield of 8.0%; and expected service period of 5 years.

There were 108,261 of the 2014 performance awards earned and vested in 2014. At December 31, 2014, we have 776,562 of 2014 performance awards remaining to be earned.

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

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

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

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

There were 80,293 of the 2013 performance awards earned and vested in 2014. There were 68,086 of the 2013 performance awards earned and vested in 2013. At December 31, 2014, we have 624,187 of 2013 performance awards remaining to be earned.

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

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

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

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

There were 84,190 of the 2012 performance awards earned and vested in 2014. There were 84,188 of the 2012 performance awards earned and vested in 2013 and 2,599 forfeited in 2013. There were 84,188 of the 2012 performance awards earned and vested in 2012 and 5,718 forfeited in 2012. At December 31, 2014, we have 641,476 of 2012 performance awards remaining to be earned.

The following summarizes restricted equity award activity in 2014 and 2013 (which includes awards granted in 2014, 2013, 2012, and any applicable prior years), respectively:

For the Year Ended December 31, 2014:


	Vesting Based on Service					Vesting Based on Market/Performance Conditions
	Shares			Weighted Average Value at Award Date		Shares			Weighted Average Value at Award Date
Nonvested awards at beginning of the year		325,999		$	11.36		1,999,179		$	5.44
Awarded		424,366		$	12.21		903,134		$	7.57
Vested		(298,102	)	$	11.43		(473,795	)	$	7.60
Forfeited		—		$	—		—		$	—

Nonvested awards at end of year		452,263		$	12.11		2,428,518		$	5.81

For the Year Ended December 31, 2013:


	Vesting Based on Service					Vesting Based on Market/Performance Conditions
	Shares			Weighted Average Value at Award Date		Shares			Weighted Average Value at Award Date
Nonvested awards at beginning of the year		466,883		$	10.72		1,879,889		$	6.48
Awarded		240,425		$	12.26		754,255		$	6.13
Vested		(381,309	)	$	11.15		(386,446	)	$	8.27
Forfeited		—		$	—		(248,519	)	$	11.03

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

The value of stock-based awards is charged to compensation expense over the vesting periods. In the years ended December 31, 2014, 2013 and 2012, we recorded $9.2 million, $8.8 million, and $7.6 million, respectively, of non-cash compensation expense. The remaining unrecognized cost from restricted equity awards at December 31, 2014, is $12.4 million and will be recognized over a weighted average period of 2.4 years. Restricted equity awards which vested in 2014, 2013 and 2012 had a value of $10.2 million, $9.2 million, and $9.2 million, respectively.

Commitments and Contingencies

12 Months Ended

Dec. 31, 2014

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

.	Commitments and Contingencies

Commitments

Our operating leases primarily consist of ground leases on which certain of our facilities or other related property reside along with corporate office and equipment leases. These ground leases are long-term leases (almost all having terms for approximately 50 years or more), some contain escalation provisions and one contains a purchase option. Properties subject to these ground leases are subleased to our tenants. Lease and rental expense (which is recorded on the straight-line method) for 2014, 2013 and 2012, respectively, were $2,321,790, $2,304,461, and $2,195,835, which was offset by sublease rental income of $192,098, $512,503, and $492,095 for 2014, 2013, and 2012, respectively.

Fixed minimum payments due under operating leases with non-cancelable terms of more than one year at December 31, 2014 are as follows: (amounts in thousands)


2015	$	3,415
2016		3,434
2017		3,443
2018		3,436
2019		3,055
Thereafter		84,759

	$	101,542

The total amount to be received in the future from non-cancellable subleases at December 31, 2014, is $86.5 million.

Contingencies

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

Common Stock/Partner's Capital

12 Months Ended

Dec. 31, 2014

Equity [Abstract]

Common Stock/Partner's Capital

9.	Common Stock/Partner’s Capital

2014 Activity

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 2014, we sold 1.7 million shares of our common stock under our at-the-market equity offering program, at an average price of $13.56 per share resulting in total proceeds, net of commission, of $22.6 million.

2013 Activity

On August 20, 2013, we completed an offering of 11.5 million shares of common stock (including 1.5 million shares sold pursuant to the exercise in full of the underwriters’ option to purchase additional shares) at a price of $12.75 per share, resulting in net proceeds (after underwriting discount and expenses) of $140.4 million.

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.

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

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

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

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

Fair Value of Financial Instruments

12 Months Ended

Dec. 31, 2014

Fair Value Disclosures [Abstract]

Fair Value of Financial Instruments

10.

Fair Value of Financial Instruments

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

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


	December 31, 2014						December 31, 2013
Asset (Liability)	Book Value			Fair Value			Book Value			Fair Value
Interest and rent receivables	$	41,137		$	41,005		$	58,565		$	44,415
Loans(1)		773,311			803,824			351,713			358,383
Debt, net		(2,201,654	)		(2,285,727	)		(1,421,681	)		(1,486,090	)

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

Items Measured at Fair Value on a Recurring Basis

Our equity interest in Ernest and related loans, as discussed in Note 2, are being measured at fair value on a recurring basis as we elected to account for these investments using the fair value option method. We have elected to account for these investments at fair value due to the size of the investments and because we believe this method is more reflective of current values. We have not made a similar election for other equity interests or loans in or prior to 2014.

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


Asset (Liability)	Fair Value		Cost		Asset Type Classification
Mortgage loan	$	100,000	$	100,000	Mortgage loans
Acquisition loans		97,450		97,450	Other loans
Equity investment		3,300		3,300	Other assets

	$	200,750	$	200,750

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 loans 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 December 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	$	(451	)
- 100 basis points	$	451

Because the fair value of Ernest investments noted above approximate their original cost, we did not recognize any unrealized gains/losses during 2014, 2013, or 2012. To date, we have not received any distribution payments from our equity investment in Ernest.

- 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

12 Months Ended

Dec. 31, 2014

Discontinued Operations and Disposal Groups [Abstract]

Discontinued Operations

11.

Discontinued Operations

The following table presents the results of discontinued operations, which include the revenue and expenses of facilities disposed of prior to 2014 for the year ended December 31, 2014, 2013, and 2012 ( amounts in thousands except per share/unit data):


	For the Years Ended December 31,
	2014			2013		2012
Revenues	$	—		$	988	$	3,470
Gain on sale		—			7,659		16,369
Income (loss) from discontinued operations		(2	)		7,914		17,207
Income from discontinued operations — diluted per share/unit	$	—		$	0.05	$	0.13

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

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

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

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

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

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

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

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

+ Details

Other Assets

12 Months Ended

Dec. 31, 2014

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

Other Assets

12.

Other Assets

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


	At December 31,
	2014		2013
Debt issue costs, net	$	35,324	$	27,180
Other corporate assets		28,197		20,337
Prepaids and other assets		58,584		20,356

Total other assets	$	122,105	$	67,873

Other corporate assets include leasehold improvements associated with our corporate office space, furniture and fixtures, equipment, software, deposits, etc. Included in prepaids and other assets is prepaid insurance, prepaid taxes, lease inducements made to tenants (such as the $5 million inducement made to Prime in 2014 related to their taking over the management of the Monroe facility), and our equity interests in our tenants (which is up this year due to new investments made along with income earned from these equity interests — see Note 3 for further details).

Quarterly Financial Data (unaudited)

12 Months Ended

Dec. 31, 2014

Quarterly Financial Information Disclosure [Abstract]

Quarterly Financial Data (unaudited)

13. Quarterly Financial Data (unaudited)

Medical Properties Trust, Inc.

The following is a summary of the unaudited quarterly financial information for the years ended December 31, 2014 and 2013: (amounts in thousands, except for per share data)


	For the Three Month Periods in 2014 Ended
	March 31			June 30			September 30		December 31
Revenues	$	73,089		$	76,560		$	80,777	$	82,106
Income (loss) from continuing operations		7,309			(203	)		28,663		15,029
Income (loss) from discontinued operations		(2	)		—			—		—
Net income		7,307			(203	)		28,663		15,029
Net income attributable to MPT common stockholders		7,241			(203	)		28,537		14,947
Net income attributable to MPT common stockholders per share — basic	$	0.04		$	—		$	0.16	$	0.08
Weighted average shares outstanding — basic		163,973			171,718			171,893		172,411
Net income attributable to MPT common stockholders per share — diluted	$	0.04		$	—		$	0.16	$	0.08
Weighted average shares outstanding — diluted		164,549			171,718			172,639		172,604


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

MPT Operating Partnership, L.P.

The following is a summary of the unaudited quarterly financial information for the years ended December 31, 2014 and 2013: (amounts in thousands, except for per unit data)


	For the Three Month Periods in 2014 Ended
	March 31			June 30			September 30		December 31
Revenues	$	73,089		$	76,560		$	80,777	$	82,106
Income (loss) from continuing operations		7,309			(203	)		28,663		15,029
Income (loss) from discontinued operations		(2	)		—			—		—
Net income (loss)		7,307			(203	)		28,663		15,029
Net income attributable to MPT Operating Partnership partners		7,241			(203	)		28,537		14,948
Net income attributable to MPT Operating Partnership partners per unit — basic	$	0.04		$	—		$	0.16	$	0.08
Weighted average units outstanding — basic		163,973			171,718			171,893		172,411
Net income attributable to MPT Operating Partnership partners per unit — diluted	$	0.04		$	—		$	0.16	$	0.08
Weighted average units outstanding — diluted		164,549			171,718			172,639		172,604


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

Subsequent Events

12 Months Ended

Dec. 31, 2014

Subsequent Events [Abstract]

Subsequent Events

14.

Subsequent Events

On January 14, 2015, we completed an underwritten public offering of 34.5 million shares (including the exercise of the underwriters’ 30-day option to purchase an additional 4.5 million shares) of our common stock, resulting in net proceeds of approximately $480 million, after deducting estimated offering expenses.

Valuation and Qualifying Accounts

12 Months Ended

Dec. 31, 2014

Valuation and Qualifying Accounts [Abstract]

Valuation and Qualifying Accounts

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

Schedule II: Valuation and Qualifying Accounts

December 31, 2014


			Additions			Deductions,
Year Ended December 31,	Balance at Beginning of Year(1)		Charged Against Operations(1)			Net Recoveries/ Writeoffs(1)			Balance at End of Year(1)
	(In thousands)
2014	$	41,573	$	65,512	(2)	$	(86,956	)(5)	$	20,129

2013	$	34,769	$	9,397	(3)	$	(2,593	)	$	41,573

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

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

(2)

Includes the $47 million of impairment charges related to the Monroe property, $9.5 million of rent and interest reserves primarily related to the Monroe property (prior to change in operators — see note 3 to Item 8 of the Form 10-K for further details), and approximately $9 million increase in the valuation allowance to fully reserve our net deferred tax assets.

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

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

(5)	Writeoffs of loans and other receivables related to the Monroe facility due to change in operators.

SCHEDULE III - REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION

12 Months Ended

Dec. 31, 2014

SEC Schedule III, Real Estate and Accumulated Depreciation Disclosure [Abstract]

SCHEDULE III - REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION

SCHEDULE III — REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION

December 31, 2014


		Initial Costs				Additions Subsequent to Acquisition						Cost at December 31, 2014						Accumu- lated Depreci- ation		Encum- brances		Date of Constr- uction		Date Acquired		Life on which depreci- ation in latest income state- ments is computed (Years)
Location	Type of Property	Land		Buildings		Improv- ements			Carrying Costs			Land		Buildings		Total		Accumu- lated Depreci- ation		Encum- brances		Date of Constr- uction		Date Acquired
(Amounts in thousands)
Baden-Wurttemburg, Germany	Rehabilitation hospital		$—		$10,536		$—			$—			$—		$10,536		$10,536		$285		$—		1994		November 30, 2013		40
Saxony, Germany	Rehabilitation hospital		415		22,849		—			—			415		22,849		23,264		619		—		1996		November 30, 2013		40
Rhineland-Pflaz, Germany	Rehabilitation hospital		3,536		16,716		—			—			3,536		16,716		20,252		453		—		1960		November 30, 2013		40
Brandenburg, Germany	Rehabilitation hospital		386		19,908		—			—			386		19,908		20,294		539		—		1994		November 30, 2013		40
Hesse, Germany	Rehabilitation hospital		102		5,832		—			—			102		5,832		5,934		158		—		1981		November 30, 2013		40
Hesse, Germany	Rehabilitation hospital		3,428		16,488		—			—			3,428		16,488		19,916		447		—		1977		November 30, 2013		40
Rhineland-Pflaz, Germany	Rehabilitation hospital		—		33,081		—			—			—		33,081		33,081		896		—		1992		November 30, 2013		40
Saxony, Germany	Rehabilitation hospital		600		16,644		—			—			600		16,644		17,244		451		—		1904, 1995		November 30, 2013		40
Rhineland-Pflaz, Germany	Rehabilitation hospital		811		7,290		—			—			811		7,290		8,101		197		—		1980		November 30, 2013		40
Rhineland-Pflaz, Germany	Rehabilitation hospital		6,498		17,942		—			—			6,498		17,942		24,440		486		—		1930		November 30, 2013		40
Baden-Wurttemburg, Germany	Rehabilitation hospital		3,809		6,490		—			—			3,809		6,490		10,299		176		—		1986		November 30, 2013		40
Bavaria, Germany	Rehabilitation hospital		2,455		10,352		216			—			2,455		10,568		13,023		22		—		1974		November 19, 2014		40
Thuringia, Germany	Rehabilitation hospital		1,788		37,772		—			—			1,788		37,772		39,560		157		—		1954, 1992		November 5, 2014		40
Baden-Wurttemburg, Germany	Rehabilitation hospital		382		13,806		250			—			382		14,056		14,438		29		—		1988, 1995		December 11, 2014		40
Bath, UK	Acute care general hospital		3,232		36,614		—			—			3,232		36,614		39,846		458		—		2008, 2009		July 1, 2014		40
Houston, TX	Acute care general hospital		3,501		34,530		8,477			12,468			3,274		55,702		58,976		6,432		—		1960		August 10, 2007		40
Allen, TX	Freestanding ER		1,550		3,847		—			—			1,550		3,847		5,397		47		—		2014		July 14, 2014		40
San Diego, CA	Acute care general hospital		12,663		52,432		—			—			12,663		52,432		65,095		5,134		—		1973		February 9, 2011		40
Alvin, TX	Freestanding ER		105		4,087		—			—			105		4,087		4,192		53		—		2014		March 19, 2014		40
Bayonne, NJ	Acute care general hospital		2,003		51,495		—			—			2,003		51,495		53,498		10,084		—		1918		February 4, 2011		20
Bennettsville, SC	Acute care general hospital		794		15,772		—			—			794		15,772		16,566		2,662		—		1984		April 1, 2008		40
Bossier City, LA	Long term acute care hospital		900		17,818		—			—			900		17,818		18,718		3,004		—		1982		April 1, 2008		40
Bristol, CT	Wellness Center		485		2,267		—			—			485		2,267		2,752		1,253		—		1975		April 22, 2008		10
Austin, TX	Freestanding ER		1,140		3,909		—			—			1,140		3,909		5,049		64		—		2014		May 29, 2014		40
Broomfield, CO	Freestanding ER		825		3,116		—			—			825		3,116		3,941		39		—		2014		July 3, 2014		40
Cedar Hill. TX	Freestanding ER		1,122		3,583		—			—			1,122		3,583		4,705		50		—		2014		June 23, 2014		40
Spring, TX	Freestanding ER		1,310		3,513		—			—			1,310		3,513		4,823		40		—		2014		July 15, 2014		40
Cheraw, SC	Acute care general hospital		657		19,576		—			—			657		19,576		20,233		3,303		—		1982		April 1, 2008		40
Webster, TX	Long term acute care hospital		663		33,751		—			—			663		33,751		34,414		3,375		—		2004		December 21, 2010		40
Commerce City, TX	Freestanding ER		707		3,518		—			—			707		3,518		4,225		6		—		2014		December 11, 2014		40
Corinth, TX	Long term acute care hospital		1,288		21,175		313			—			1,601		21,175		22,776		2,120		—		2008		January 31, 2011		40
Covington, LA	Long term acute care hospital		821		10,238		—			14			821		10,252		11,073		2,456		—		1984		June 9, 2005		40
Dallas, TX	Long term acute care hospital		1,000		13,589		—			368			1,421		13,536		14,957		2,820		—		2006		September 5, 2006		40
DeSoto, TX	Long term acute care hospital		1,067		10,701		86			8			1,161		10,701		11,862		929		—		2008		July 18, 2011		40
Detroit, MI	Long term acute care hospital		1,220		8,687		—			(365	)		1,220		8,322		9,542		1,449		—		1956		May 22, 2008		40
Dulles, TX	Freestanding ER		1,076		3,384		—			—			1,076		3,384		4,460		28		—		2014		September 12, 2014		40
Houston, TX	Freestanding ER		1,345		3,668		—			—			1,345		3,668		5,013		53		—		2014		June 20, 2014		40
Enfield, CT	Wellness Center		384		2,257		—			—			384		2,257		2,641		1,248		—		1974		April 22, 2008		10
East Providence, RI	Wellness Center		209		1,265		—			—			209		1,265		1,474		701		—		1979		April 22, 2008		10
Fairmont, CA	Acute care general hospital		1,000		12,301		277			—			1,277		12,301		13,578		95		—		1939, 1972, 1985		September 19, 2014		40
Firestone, TX	Freestanding ER		495		3,951		—			—			495		3,951		4,446		58		—		2014		June 6, 2014		40
Florence, AZ	Acute care general hospital		900		28,462		—			—			900		28,462		29,362		1,947		—		2012		November 4, 2010		40
Fort Lauderdale, FL	Rehabilitation hospital		3,499		21,939		—			1			3,499		21,940		25,439		3,664		—		1985		April 22, 2008		40
Fountain, CO	Freestanding ER		1,508		4,020		—			—			1,508		4,020		5,528		42		—		2014		July 31, 2014		40
Frisco, TX	Freestanding ER		1,500		3,863		—			—			1,500		3,863		5,363		52		—		2014		June 13, 2014		40
Garden Grove, CA	Acute care general hospital		5,502		10,748		—			51			5,502		10,799		16,301		1,655		—		1982		November 25, 2008		40
Garden Grove, CA	Medical Office Building		862		7,888		—			28			862		7,916		8,778		1,206		—		1982		November 25, 2008		40
Gilbert, AZ	Acute care general hospital		150		15,553		—			—			150		15,553		15,703		1,555		—		2005		January 4, 2011		40
Hammond, LA	Long term acute care hospital		519		8,941		—			—			519		8,941		9,460		466		—		2003		December 14, 2012		40
Hausman, TX	Acute care general hospital		1,500		8,958		—			—			1,500		8,958		10,458		386		—		2013		March 1, 2013		40
Hill County, TX	Acute care general hospital		1,120		17,882		—			—			1,120		17,882		19,002		5,095		—		1980		September 17, 2010		40
Hoboken, NJ	Acute care general hospital		1,387		44,351		—			—			1,387		44,351		45,738		6,951		—		1863		November 4, 2011		20
Idaho Falls, ID	Acute care general hospital		1,822		37,467		—			4,665			1,822		42,132		43,954		6,971		—		2002		April 1, 2008		40
Lafayette, IN	Rehabilitation hospital		800		14,968		(25	)		—			800		14,943		15,743		702		—		2013		February 1, 2013		40
Little Elm, TX	Freestanding ER		1,241		3,491		—			—			1,241		3,491		4,732		91		—		2013		December 1, 2013		40
Luling, TX	Long term acute care hospital		811		9,345		—			—			811		9,345		10,156		1,889		—		2002		December 1, 2006		40
Mesa, AZ	Acute care general hospital		4,900		97,980		2,242			—			7,142		97,980		105,122		3,249		—		2007		September 26, 2013		40
Bloomington, IN	Acute care general hospital		2,392		28,212		5,000			408			2,392		33,620		36,012		6,599		—		2006		August 8, 2006		40
Montclair, NJ	Acute care general hospital		7,900		99,632		585			—			8,485		99,632		108,117		1,897		—		1920-2000		April 1, 2014		40
San Antonio, TX	Freestanding ER		351		3,952		—			—			351		3,952		4,303		73		—		2014		January 1, 2014		40
Houston, TX	Acute care general hospital		4,757		56,238		(37	)		1,259			5,427		56,790		62,217		11,427		41,200		2006		December 1, 2006		40
New Braunfels, TX	Long term acute care hospital		1,100		7,883		—			—			1,100		7,883		8,983		640		—		2007		September 30, 2011		40
Newington, CT	Wellness Center		270		1,615		—			—			270		1,615		1,885		894		—		1979		April 22, 2008		10
Shenandoah, TX	Rehabilitation hospital		2,033		21,943		—			—			2,033		21,943		23,976		2,469		—		2008		June 17, 2010		40
Colorado Springs, CO	Freestanding ER		600		4,222		—			—			600		4,222		4,822		62		—		2014		June 5, 2014		40
Northland, MO	Long term acute care hospital		834		17,182		—			—			834		17,182		18,016		1,683		—		2007		February 14, 2011		40
Altoona, WI	Acute care general hospital		—		27,650		—			—			—		27,650		27,650		241		—		2014		August 31, 2014		40
Ogden, UT	Rehabilitation hospital		1,759		16,414		—			—			1,759		16,414		18,173		328		—		2014		March 1, 2014		40
Overlook, TX	Acute care general hospital		2,452		9,666		7			—			2,452		9,673		12,125		440		—		2012		February 1, 2013		40
San Diego, CA	Acute care general hospital		6,550		15,653		—			77			6,550		15,730		22,280		3,013		—		1964		May 9, 2007		40
Pearland, TX	Freestanding ER		1,075		3,272		—			—			1,075		3,272		4,347		27		—		2014		September 8, 2014		40
Petersburg, VA	Rehabilitation hospital		1,302		9,121		—			—			1,302		9,121		10,423		1,482		—		2006		July 1, 2008		40
Poplar Bluff, MO	Acute care general hospital		2,659		38,694		—			1			2,660		38,694		41,354		6,462		—		1980		April 22, 2008		40
Port Arthur, TX	Acute care general hospital		3,000		72,341		1,062			—			4,062		72,341		76,403		2,349		—		2005		September 26, 2013		40
Portland, OR	Long term acute care hospital		3,085		17,859		—			2,559			3,071		20,432		23,503		3,869		—		1964		April 18, 2007		40
Post Falls, ID	Rehabilitation hospital		417		12,175		1,905			—			767		13,730		14,497		352		—		2013		December 31, 2013		40
Redding, CA	Acute care general hospital		1,555		53,863		—			13			1,555		53,876		55,431		9,999		—		1974		August 10, 2007		40
Redding, CA	Long term acute care hospital		—		19,952		—			4,361			1,629		22,684		24,313		5,189		—		1991		June 30, 2005		40
Richardson, TX	Rehabilitation hospital		2,219		17,419		—			—			2,219		17,419		19,638		1,960		—		2008		June 17, 2010		40
Addison, TX	Rehabilitation hospital		2,013		22,531		—			—			2,013		22,531		24,544		2,535		—		2008		June 17, 2010		40
San Dimas, CA	Acute care general hospital		6,160		6,839		—			34			6,160		6,873		13,033		1,046		—		1972		November 25, 2008		40
San Dimas, CA	Medical Office Building		1,915		5,085		—			18			1,915		5,103		7,018		778		—		1979		November 25, 2008		40
Sherman, TX	Acute care general hospital		4,491		24,802		—			—			4,491		24,802		29,293		109		—		1913, 1960-2010		October 31, 2014		40
Sienna, TX	Freestanding ER		999		3,562		—			—			999		3,562		4,561		37		—		2014		August 20, 2014		40
Spartanburg, SC	Rehabilitation hospital		1,135		15,717		—			—			1,135		15,717		16,852		538		—		2013		August 1, 2013		40
Thornton, CO	Freestanding ER		1,350		3,793		—			—			1,350		3,793		5,143		32		—		2014		August 29, 2014		40
Tomball, TX	Long term acute care hospital		1,299		23,982		—			—			1,299		23,982		25,281		2,398		—		2005		December 21, 2010		40
Victoria, TX	Long term acute care hospital		625		7,197		—			—			625		7,197		7,822		1,454		—		1998		December 1, 2006		40
Victoria, TX	Rehabilitation hospital		—		10,412		—			—			—		10,412		10,412		254		—		2013		December 31, 2013		40
Anaheim, CA	Acute care general hospital		1,875		21,814		—			10			1,875		21,824		23,699		4,455		—		1964		November 8, 2006		40
Warwick, RI	Wellness Center		1,265		759		—			—			1,265		759		2,024		420		—		1979		April 22, 2008		10
West Monroe, LA	Acute care general hospital		12,000		69,433		552			—			12,552		69,433		81,985		2,216		—		1962		September 26, 2013		40
San Antonio, TX	Acute care general hospital		2,248		5,880		—			—			2,248		5,880		8,128		314		—		2012		October 14, 2011		40
West Valley City, UT	Acute care general hospital		5,516		58,314		—			—			5,516		58,314		63,830		9,738		—		1980		April 22, 2008		40
Wichita, KS	Rehabilitation hospital		1,019		18,373		—			1			1,019		18,374		19,393		3,100		8,678		1992		April 4, 2008		40
West Springfield, MA	Wellness Center		583		3,185		—			—			583		3,185		3,768		1,765		—		1976		April 22, 2008		10

		$	184,596	$	1,809,242	$	20,910		$	25,979		$	192,551	$	1,848,176	$	2,040,727	$	181,441	$	49,878

The changes in total real estate assets excluding construction in progress, intangible lease asset, investment in direct financing leases, and mortgage loans were as follows for the years ended:


	December 31, 2014			December 31, 2013			December 31, 2012
COST
Balance at beginning of period	$	1,733,194		$	1,189,552		$	1,191,096
Acquisitions		263,811			480,503			9,460
Transfers from construction in progress		41,772			81,347			37,174
Additions		84,831			7,749			19,971
Dispositions		(56,590	)		(28,616	)		(68,149	)
Other		(26,291	)		2659			—

Balance at end of period	$	2,040,727		$	1,733,194		$	1,189,552

The changes in accumulated depreciation were as follows for the years ended:


	December 31, 2014			December 31, 2013			December 31, 2012
ACCUMULATED DEPRECIATION
Balance at beginning of period	$	144,235		$	114,399		$	93,430
Depreciation		46,935			33,349			31,026
Depreciation on disposed property		(9,213	)		(3,513	)		(10,057	)
Other		(516	)		—			—

Balance at end of period	$	181,441		$	144,235		$	114,399

SCHEDULE IV - MORTGAGE LOANS ON REAL ESTATE

12 Months Ended

Dec. 31, 2014

Mortgage Loans on Real Estate [Abstract]

SCHEDULE IV - MORTGAGE LOANS ON REAL ESTATE

SCHEDULE IV — MORTGAGE LOANS ON REAL ESTATE

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


Column A	Column B			Column C		Column D	Column E			Column F		Column G(3)		Column H
Description	Interest Rate			Final Maturity Date		Periodic Payment Terms	Prior Liens			Face Amount of Mortgages		Carrying Amount of Mortgages		Principal Amount of Loans Subject to Delinquent Principal or Interest
	(Dollar amounts in thousands)
Long-term first mortgage loan:						Payable in monthly installments of interest plus principal payable in full at maturity
Desert Valley Hospital		10.9	%		2022			(1	)	$	70,000	$	70,000		(2	)
Desert Valley Hospital		11.5	%		2022			(1	)		20,000		20,000		(2	)
Desert Valley Hospital		11.5	%		2015			(1	)		12,500		12,500		(2	)
Chino Valley Medical Center		10.9	%		2022			(1	)		50,000		50,000		(2	)
Paradise Valley Hospital		10.4	%		2022			(1	)		25,000		25,000		(2	)
Ernest Mortgage Loan(4)		9.4	%		2032			(1	)		100,000		100,000		(2	)
Centinela Hospital Medical Center		10.8	%		2022			(1	)		100,000		100,000		(2	)
Olympia Medical Center		11.0	%		2024			(1	)		20,000		20,000		(2	)

										$	397,500	$	397,500		(5	)

(1)	There were no prior liens on loans as of December 31, 2014.

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

(3)	The aggregate cost for Federal income tax purposes is $397,500.

(4)	Mortgage loans covering four properties.

(5)	Excludes unamortized loan issue costs of $0.1 million at December 31, 2014.

Changes in mortgage loans (excluding unamortized loan issue costs) for the years ended December 31, 2014, 2013, and 2012 are summarized as follows:


	Year Ended December 31,
	2014			2013		2012
	(Dollar amounts in thousands)
Balance at beginning of year	$	388,650		$	368,650	$	165,000
Additions during year:
New mortgage loans and additional advances on existing loans		12,500			20,000		203,650

		401,150			388,650		368,650

Deductions during year:
Collection of principal		(3,650	)		—		—

		(3,650	)		—		—

Balance at end of year	$	397,500		$	388,650	$	368,650

Summary of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2014

Accounting Policies [Abstract]

Use of Estimates

Principles of Consolidation


VIE Type	Maximum Loss Exposure(1)		Asset Type Classification	Carrying Amount(2)
Loans, net		$257,208	Mortgage and other loans	$	207,617
Equity investments		$ 53,542	Other assets	$	5,490

(1)

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

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

Investments in Unconsolidated Entities

Cash and Cash Equivalents

Revenue Recognition

Acquired Real Estate Purchase Price Allocation

Real Estate and Depreciation

Depreciation is calculated on the straight-line method over the useful lives of the related real estate and other assets. Our weighted-average useful lives at December 31, 2014 are as follows:


Buildings and improvements			37.9 years
Tenant lease intangibles			17.9 years
Leasehold improvements			22.3 years
Furniture, equipment and other			6.5 years

Losses from Rent Receivables

Loans

Earnings Per Share/Units

Income Taxes

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

Stock-Based Compensation

Deferred Costs

Foreign Currency Translation and Transactions

Derivative Financial Investments and Hedging Activities

Fair Value Measurement

•

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

•

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

Recent Accounting Developments

Reclassifications

Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 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 December 31, 2014 (in thousands):


VIE Type	Maximum Loss Exposure(1)		Asset Type Classification	Carrying Amount(2)
Loans, net		$257,208	Mortgage and other loans	$	207,617
Equity investments		$ 53,542	Other assets	$	5,490

(1)

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

Weighted Average Useful Lives of Related Real Estate and Other Assets

Depreciation is calculated on the straight-line method over the useful lives of the related real estate and other assets. Our weighted-average useful lives at December 31, 2014 are as follows:


Buildings and improvements			37.9 years
Tenant lease intangibles			17.9 years
Leasehold improvements			22.3 years
Furniture, equipment and other			6.5 years

- 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 Loans Receivable (Tables)

12 Months Ended

Dec. 31, 2014

Text Block [Abstract]

Assets Acquired

We acquired the following assets:


	2014		2013		2012
Assets Acquired		(in thousands)
Land	$	22,569	$	41,473	$	518
Building		241,242		439,030		8,942
Intangible lease assets — subject to amortization (weighted average useful life of 18.2 years in 2014, 21.0 years in 2013 and 15.0 years in 2012)		22,513		38,589		1,040
Net investments in direct financing leases		—		110,580		310,000
Mortgage loans		—		20,000		200,000
Other loans		447,664		5,250		95,690
Other assets		33,708		—		5,300

Total assets acquired	$	767,696	$	654,922	$	621,490

Schedule of Unaudited Supplemental Pro Forma Operating Data

The following unaudited supplemental pro forma operating data is presented for the year ended December 31, 2014 and 2012, as if each acquisition was completed on January 1, 2013


	For the Year Ended December 31,
	(Unaudited)
	2014		2013
Total revenues	$	329,258	$	315,780
Net income		67,150		144,545
Net income per share/unit	$	0.38	$	0.84

Summary of Status Update on Current Development Projects

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

Property

Location

Property Type

Operator

Commitment

Costs Incurred
as of
12/31/14

Estimated
Completion
Date

UAB Medical West

Hoover, AL

Acute Care Hospital & MOB

Medical West, an
affiliate of UAB

8,653

1,973

2Q 2015

First Choice ER- Summerwood

Houston, TX

Acute Care Hospital

Adeptus Health

6,015

2,560

2Q 2015

First Choice ER- Ft. Worth Avondale – Haslet

Ft. Worth, TX

Acute Care Hospital

Adeptus Health

4,780

871

2Q 2015

First Choice ER- Carrollton

Carrollton, TX

Acute Care Hospital

Adeptus Health

35,820

15,629

3Q 2015

First Choice ER- Chandler

Chandler, AZ

Acute Care Hospital

Adeptus Health

5,049

895

3Q 2015

First Choice ER- Converse

Converse, TX

Acute Care Hospital

Adeptus Health

5,754

1,141

3Q 2015

First Choice ER- Denver 48^th

Denver, CO

Acute Care Hospital

Adeptus Health

5,123

3Q 2015

First Choice ER- McKinney

McKinney, TX

Acute Care Hospital

Adeptus Health

4,750

3Q 2015

First Choice Emergency Rooms

Various

Acute Care Hospital

Adeptus Health

84,423

—

Various

160,367

23,163

Amortization Expense from Existing Lease Intangible Assets


For the Year Ended December 31:
2015	$	6,438
2016		6,397
2017		6,387
2018		6,326
2019		6,271

Components of Net Investment in Direct Financing Leases

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


	As of December 31, 2014
Minimum lease payments receivable	$	1,607,024
Estimated residual values		211,888
Less unearned income		(1,379,396	)

Net investment in direct financing leases	$	439,516

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

Minimum rental payments due to us in future periods under operating leases and DFL, which have non-cancelable terms extending beyond one year at December 31, 2014, are as follows: (amounts in thousands)


	Total Under Operating Leases		Total Under DFLs		Total
2015	$	196,864	$	43,386	$	240,250
2016		198,265		44,254		242,519
2017		198,807		45,139		243,946
2018		199,728		46,041		245,769
2019		199,857		46,962		246,819
Thereafter		1,838,346		380,743		2,219,089

	$	2,831,867	$	606,525	$	3,438,392

Net Investment Under Monroe Facility

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


	As of December 31, 2014		As of December 31, 2013
Loans	$	—	$	31,341
Less: Loan impairment reserve		—		(12,000	)

Loans, net		—		19,341
Interest, rent and other receivables		—		20,972

Net investment	$	—	$	40,313

Summary of Loans

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


	As of December 31, 2014					As of December 31, 2013
	Balance		Weighted Average Interest Rate			Balance		Weighted Average Interest Rate
Mortgage loans	$	397,594		10.5	%	$	388,756		10.0	%
Acquisition loans		525,136		9.3	%		109,655		14.7	%
Working capital and other loans		48,031		10.4	%		51,335		10.8	%

	$	970,761				$	549,746

Debt (Tables)

12 Months Ended

Dec. 31, 2014

Debt Disclosure [Abstract]

Summary of Debt

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


	As of December 31, 2014					As of December 31, 2013
	Balance		Interest Rate			Balance		Interest Rate
Revolving credit facility	$	593,490		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		2,522					2,873

		352,522					352,873
2013 Senior Unsecured Notes(A)		241,960		5.75	%		274,860		5.75	%
2014 Senior Unsecured Notes		300,000		5.50	%		—
Term loans		138,682		Various			113,948		Various

	$	2,201,654				$	1,421,681

Principal Payments Due for Debt

As of December 31, 2014, principal payments due on our debt (which exclude the effects of any discounts or premiums recorded) are as follows:


2015	$	283
2016		125,298
2017		320
2018		606,271
2019		125,000
Thereafter		1,341,960

Total	$	2,199,132

(A)	These notes are Euro-denominated and reflect the exchange rates at December 31, 2014 and 2013, respectively.

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2014

Income Tax Disclosure [Abstract]

Schedule of Income Tax Expense

From our taxable REIT subsidiaries and our foreign operations (which realized a $7.5 million loss before income taxes in 2014 primarily due to the real estate transfer taxes), we incurred income tax expenses as follows (in thousands):


	For the years ended December 31,
	2014			2013		2012
Current income tax (benefit) expense:
Domestic	$	114		$	358	$	(44	)
Foreign		225			158		—

		339			516		(44	)
Deferred income tax (benefit) expense
Domestic		(23	)		210		63
Foreign		24			—		—

		1			210		63
Income tax (benefit) expense	$	340		$	726	$	19

Schedule of Deferred Tax Assets and Liablities

At December 31, 2014 and 2013, components of our deferred tax assets and liabilities were as follows (in thousands):


	2014			2013
Deferred tax liabilities:
Property and equipment	$	—		$	(2,560	)
Unbilled rent		(2,070	)		(610	)
Partnership investments		(3,468	)		—
Other		(3,759	)		(2,313	)

Total deferred tax liabilities	$	(9,297	)	$	(5,483	)

Deferred tax assets:
Loan loss and other reserves	$	—		$	7751
Operating loss and interest deduction carry forwards		19,546			2,283
Property and equipment		2,373			—
Partnership investments		—			805
Other		3,971			2,256

Total deferred tax assets		25,890			13,095
Valuation allowance		(16,831	)		(7,843	)

Total net deferred tax assets	$	9,059		$	5,252

Net deferred tax (liability)	$	(238	)	$	(231	)

Summary of Reconciliation of the Income Tax Expense at the Statutory Income Tax Rate and the Effective Tax Rate for Income from Continuing Operations before Income Taxes


	2014			2013			2012
Income from continuing operations (before-tax)	$	51,138		$	90,027		$	72,889
Income tax at the US statutory federal rate (35%)		17,898			31,509			25,511
Rate differential		1,145			2,380			—
State income taxes, net of federal benefit		(337	)		271			(8	)
Dividends paid deduction		(27,873	)		(33,345	)		(25,454	)
Change in valuation allowance		8.988			(697	)		—
Other items, net		519			608			(30	)

Total income tax expense	$	340		$	726		$	19

Schedule of Per Share Distributions to Stockholders

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


	For the Years Ended December 31,
	2014		2013		2012
Common share distribution	$	0.840000	$	0.800000	$	0.800000
Ordinary income		0.520692		0.599384		0.601216
Capital gains(1)		0.000276		0.046380		0.117584
Unrecaptured Sec. 1250 gain		0.000276		0.026512		0.086976
Return of capital		0.319032		0.154236		0.081200
Allocable to next year		—		—		—

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

Earnings Per Share/Unit (Tables)

12 Months Ended

Dec. 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 Years Ended December 31,
	2014			2013			2012
Numerator:
Income from continuing operations	$	50,798		$	89,301		$	72,870
Non-controlling interests’ share in continuing operations		(274	)		(224	)		(177	)
Participating securities’ share in earnings		(894	)		(729	)		(887	)

Income from continuing operations, less participating securities’ share in earnings		49,630			88,348			71,806
Income (loss) from discontinued operations attributable to MPT common stockholders		(2	)		7,914			17,207

Net income, less participating securities’ share in earnings	$	49,628		$	96,262		$	89,013

Denominator:
Basic weighted-average common shares		169,999			151,439			132,331
Dilutive potential common shares		541			1,159			2

Diluted weighted-average common shares		170,540			152,598			132,333

MPT Operating Partnership, L.P.

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


	For the Years Ended December 31,
	2014			2013			2012
Numerator:
Income from continuing operations	$	50,798		$	89,301		$	72,870
Non-controlling interests’ share in continuing operations		(274	)		(224	)		(177	)
Participating securities’ share in earnings		(894	)		(729	)		(887	)

Income from continuing operations, less participating securities’ share in earnings		49,630			88,348			71,806
Income (loss) from discontinued operations attributable to MPT Operating Partnership partners		(2	)		7,914			17,207

Net income, less participating securities’ share in earnings	$	49,628		$	96,262		$	89,013

Denominator:
Basic weighted-average units		169,999			151,439			132,331
Dilutive potential units		541			1,159			2

Diluted weighted-average units		170,540			152,598			132,333

Stock Awards (Tables)

12 Months Ended

Dec. 31, 2014

Disclosure of Compensation Related Costs, Share-based Payments [Abstract]

Restricted Equity Awards Activity

The following summarizes restricted equity award activity in 2014 and 2013 (which includes awards granted in 2014, 2013, 2012, and any applicable prior years), respectively:

For the Year Ended December 31, 2014:


	Vesting Based on Service					Vesting Based on Market/Performance Conditions
	Shares			Weighted Average Value at Award Date		Shares			Weighted Average Value at Award Date
Nonvested awards at beginning of the year		325,999		$	11.36		1,999,179		$	5.44
Awarded		424,366		$	12.21		903,134		$	7.57
Vested		(298,102	)	$	11.43		(473,795	)	$	7.60
Forfeited		—		$	—		—		$	—

Nonvested awards at end of year		452,263		$	12.11		2,428,518		$	5.81

For the Year Ended December 31, 2013:


	Vesting Based on Service					Vesting Based on Market/Performance Conditions
	Shares			Weighted Average Value at Award Date		Shares			Weighted Average Value at Award Date
Nonvested awards at beginning of the year		466,883		$	10.72		1,879,889		$	6.48
Awarded		240,425		$	12.26		754,255		$	6.13
Vested		(381,309	)	$	11.15		(386,446	)	$	8.27
Forfeited		—		$	—		(248,519	)	$	11.03

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

Commitments and Contingencies (Tables)

12 Months Ended

Dec. 31, 2014

Commitments and Contingencies Disclosure [Abstract]

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

Fixed minimum payments due under operating leases with non-cancelable terms of more than one year at December 31, 2014 are as follows: (amounts in thousands)


2015	$	3,415
2016		3,434
2017		3,443
2018		3,436
2019		3,055
Thereafter		84,759

	$	101,542

Fair Value of Financial Instruments (Tables)

12 Months Ended

Dec. 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):


	December 31, 2014						December 31, 2013
Asset (Liability)	Book Value			Fair Value			Book Value			Fair Value
Interest and rent receivables	$	41,137		$	41,005		$	58,565		$	44,415
Loans(1)		773,311			803,824			351,713			358,383
Debt, net		(2,201,654	)		(2,285,727	)		(1,421,681	)		(1,486,090	)

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

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

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


Asset (Liability)	Fair Value		Cost		Asset Type Classification
Mortgage loan	$	100,000	$	100,000	Mortgage loans
Acquisition loans		97,450		97,450	Other loans
Equity investment		3,300		3,300	Other assets

	$	200,750	$	200,750

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	$	(451	)
- 100 basis points	$	451

Discontinued Operations (Tables)

12 Months Ended

Dec. 31, 2014

Discontinued Operations and Disposal Groups [Abstract]

Discontinued Operations


	For the Years Ended December 31,
	2014			2013		2012
Revenues	$	—		$	988	$	3,470
Gain on sale		—			7,659		16,369
Income (loss) from discontinued operations		(2	)		7,914		17,207
Income from discontinued operations — diluted per share/unit	$	—		$	0.05	$	0.13

- 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

Other Assets (Tables)

12 Months Ended

Dec. 31, 2014

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

Summary of Other Assets

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


	At December 31,
	2014		2013
Debt issue costs, net	$	35,324	$	27,180
Other corporate assets		28,197		20,337
Prepaids and other assets		58,584		20,356

Total other assets	$	122,105	$	67,873

Quarterly Financial Data (unaudited) (Tables)

12 Months Ended

Dec. 31, 2014

Medical Properties Trust, Inc. [Member]

Unaudited Quarterly Financial Information

The following is a summary of the unaudited quarterly financial information for the years ended December 31, 2014 and 2013: (amounts in thousands, except for per share data)


	For the Three Month Periods in 2014 Ended
	March 31			June 30			September 30		December 31
Revenues	$	73,089		$	76,560		$	80,777	$	82,106
Income (loss) from continuing operations		7,309			(203	)		28,663		15,029
Income (loss) from discontinued operations		(2	)		—			—		—
Net income		7,307			(203	)		28,663		15,029
Net income attributable to MPT common stockholders		7,241			(203	)		28,537		14,947
Net income attributable to MPT common stockholders per share — basic	$	0.04		$	—		$	0.16	$	0.08
Weighted average shares outstanding — basic		163,973			171,718			171,893		172,411
Net income attributable to MPT common stockholders per share — diluted	$	0.04		$	—		$	0.16	$	0.08
Weighted average shares outstanding — diluted		164,549			171,718			172,639		172,604


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

MPT Operating Partnership, L.P. [Member]

Unaudited Quarterly Financial Information

The following is a summary of the unaudited quarterly financial information for the years ended December 31, 2014 and 2013: (amounts in thousands, except for per unit data)


	For the Three Month Periods in 2014 Ended
	March 31			June 30			September 30		December 31
Revenues	$	73,089		$	76,560		$	80,777	$	82,106
Income (loss) from continuing operations		7,309			(203	)		28,663		15,029
Income (loss) from discontinued operations		(2	)		—			—		—
Net income (loss)		7,307			(203	)		28,663		15,029
Net income attributable to MPT Operating Partnership partners		7,241			(203	)		28,537		14,948
Net income attributable to MPT Operating Partnership partners per unit — basic	$	0.04		$	—		$	0.16	$	0.08
Weighted average units outstanding — basic		163,973			171,718			171,893		172,411
Net income attributable to MPT Operating Partnership partners per unit — diluted	$	0.04		$	—		$	0.16	$	0.08
Weighted average units outstanding — diluted		164,549			171,718			172,639		172,604


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

Summary of Significant Accounting Policies - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2014 yr mo	Dec. 31, 2013	Dec. 31, 2012
Summary Of Significant Accounting Policies [Line Items]
Equity method investment, ownership percentage	100.00%
Expected lease-up periods for estimating lost rentals, in months \| mo	6
Percentage of ordinary taxable income to be distributed for real estate investment trust qualification	90.00%	90.00%	90.00%
Number of years of federal income tax at corporate rates on failure to qualify as REIT \| yr	4
Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Stock award vesting period in years, maximum	10 years
Time-Based Awards [Member]
Summary Of Significant Accounting Policies [Line Items]
Stock award vesting period in years, maximum	3 years
Market Conditions Based Awards [Member] \| Minimum [Member]
Summary Of Significant Accounting Policies [Line Items]
Stock award vesting period in years, maximum	3 years
Market Conditions Based Awards [Member] \| Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Stock award vesting period in years, maximum	5 years

Summary of Significant Accounting Policies - Carrying Value and Classification of Related Assets and Maximum Exposure to Loss (Detail) $ in Thousands	Dec. 31, 2014 USD ($)
Mortgage and other loans [Member]
Variable Interest Entity [Line Items]
Carrying Amount	$ 207,617
Loans, net [Member]
Variable Interest Entity [Line Items]
Maximum Loss Exposure	257,208
Other assets [Member]
Variable Interest Entity [Line Items]
Carrying Amount	5,490
Equity investments [Member]
Variable Interest Entity [Line Items]
Maximum Loss Exposure	$ 53,542

Summary of Significant Accounting Policies - Weighted Average Useful Lives of Related Real Estate and Other Assets (Detail)	12 Months Ended
	Dec. 31, 2014
Buildings and improvements [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	37 years 10 months 24 days
Tenant lease intangibles [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	17 years 10 months 24 days
Leasehold improvements [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	22 years 3 months 18 days
Furniture, equipment and other [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	6 years 6 months

Real Estate and Loans Receivable - Assets Acquired (Detail) - USD ($) $ in Thousands	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Significant Acquisitions and Disposals [Line Items]
Total assets acquired	$ 767,696	$ 654,922	$ 621,490
Land [Member]
Significant Acquisitions and Disposals [Line Items]
Total assets acquired	22,569	41,473	518
Building [Member]
Significant Acquisitions and Disposals [Line Items]
Total assets acquired	241,242	439,030	8,942
Intangible lease assets - subject to amortization [Member]
Significant Acquisitions and Disposals [Line Items]
Total assets acquired	22,513	38,589	1,040
Net investments in direct financing leases [Member]
Significant Acquisitions and Disposals [Line Items]
Total assets acquired		110,580	310,000
Other loans [Member]
Significant Acquisitions and Disposals [Line Items]
Total assets acquired	447,664	5,250	95,690
Mortgage loans [Member]
Significant Acquisitions and Disposals [Line Items]
Total assets acquired		$ 20,000	200,000
Other assets [Member]
Significant Acquisitions and Disposals [Line Items]
Total assets acquired	$ 33,708		$ 5,300

Real Estate and Loans Receivable - Assets Acquired (Parenthetical) (Detail)	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Intangible lease assets - subject to amortization [Member]
Significant Acquisitions and Disposals [Line Items]
Weighted average useful life of acquired intangible lease assets (in years)	18 years 2 months 12 days	21 years	15 years

Real Estate and Loans Receivable - 2014 Activity - Additional Information (Detail) $ in Thousands, € in Millions, £ in Millions								3 Months Ended		12 Months Ended
	Dec. 15, 2014 USD ($)	Dec. 15, 2014 EUR (€)	Oct. 31, 2014 USD ($) Bed	Oct. 15, 2014 USD ($) State Facility	Sep. 19, 2014 USD ($) RenewalOptions	Jul. 01, 2014 USD ($)	Jul. 01, 2014 GBP (£)	Dec. 31, 2014 USD ($) Bed Facility	Mar. 31, 2014 USD ($)	Dec. 31, 2014 USD ($) Bed	Dec. 31, 2013 USD ($)	Dec. 31, 2012 USD ($)	Dec. 31, 2014 EUR (€) Bed	Oct. 15, 2014 EUR (€) State	Jul. 01, 2014 GBP (£)
Significant Acquisitions and Disposals [Line Items]
Acquisition related expenses										$ 26,389	$ 19,494	$ 5,420
2014 [Member]
Significant Acquisitions and Disposals [Line Items]
Acquired percentage of the outstanding equity interest	5.10%	5.10%
Initial leaseback term										27 years
2014 [Member] \| Acute Care Hospital [Member]
Significant Acquisitions and Disposals [Line Items]
Acquisition costs									$ 115,000
Term of lease, years										15 years
Term of lease extension, years										3 years
2014 [Member] \| Acute Care Hospital [Member] \| Fair value market [Member]
Significant Acquisitions and Disposals [Line Items]
Term of lease extension, years										12 years
2014 [Member] \| Median And Waterland [Member]
Significant Acquisitions and Disposals [Line Items]
Interim acquisition loans aggregate amount	$ 531,000	€ 425.0
Interim acquisition loans advanced \| €													€ 349.0
2014 [Member] \| Minimum [Member]
Significant Acquisitions and Disposals [Line Items]
Lease annual escalator percentage										1.00%
2014 [Member] \| Maximum [Member]
Significant Acquisitions and Disposals [Line Items]
Lease annual escalator percentage										70.00%
2014 [Member] \| Median Transaction [Member]
Significant Acquisitions and Disposals [Line Items]
Purchase price of acquisition				$ 881,000										€ 705.0
Number of states \| State				11										11
2014 [Member] \| Median Transaction [Member] \| Acute Care Hospital [Member]
Significant Acquisitions and Disposals [Line Items]
Number of facilities acquired \| Facility				2
2014 [Member] \| Median Transaction [Member] \| Rehabilitation Hospital [Member]
Significant Acquisitions and Disposals [Line Items]
Number of facilities acquired \| Facility				38
2014 [Member] \| Median Transaction [Member] \| Waterland [Member]
Significant Acquisitions and Disposals [Line Items]
Acquired percentage of the outstanding equity interest	94.90%	94.90%
2014 [Member] \| United Kingdom [Member] \| Circle Health Ltd. [Member]
Significant Acquisitions and Disposals [Line Items]
Acquired facility, carrying value of sale/leaseback transaction						$ 48,000									£ 28.3
Sale/leaseback transaction, initial term period										15 years
Sale/leaseback transaction, additional term period										15 years
Percentage change in annual retail price index, floor rate						2.00%									2.00%
Percentage change in annual retail price index, cap rate						5.00%									5.00%
Acquisition related expenses						$ 1,900	£ 1.1
2014 [Member] \| West Virginia [Member] \| Acute Care Hospital [Member] \| Alecto Healthcare Services [Member]
Significant Acquisitions and Disposals [Line Items]
Ownership interest, percentage					20.00%
Acquisition costs					$ 15,000
Term of lease, years										15 years
Term of lease extension, years										5 years
Number of lease extension options in current lease contract \| RenewalOptions					3
Working capital loan to the tenant					$ 5,000
Additional lease period										5 years
Additional fund committed to the tenant for capital improvements					$ 5,000
2014 [Member] \| Germany [Member] \| RHM Rehabilitation Facilities [Member]
Significant Acquisitions and Disposals [Line Items]
Purchase price of acquisition								$ 81,000		$ 81,000			63.6
Number of facilities acquired \| Facility								3
Applicable transfer taxes on purchase price								$ 3,600		$ 3,600			€ 3.0
2014 [Member] \| Germany [Member] \| Bad Mergentheim [Member] \| RHM Rehabilitation Facilities [Member]
Significant Acquisitions and Disposals [Line Items]
Number of beds \| Bed								211		211			211
2014 [Member] \| Germany [Member] \| Bad Tolz [Member] \| RHM Rehabilitation Facilities [Member]
Significant Acquisitions and Disposals [Line Items]
Number of beds \| Bed								248		248			248
2014 [Member] \| Germany [Member] \| Bad Liebenstein [Member] \| RHM Rehabilitation Facilities [Member]
Significant Acquisitions and Disposals [Line Items]
Number of beds \| Bed								271		271			271
2014 [Member] \| Sherman TX [Member]
Significant Acquisitions and Disposals [Line Items]
Purchase price of acquisition			$ 32,500
2014 [Member] \| Sherman TX [Member] \| Alecto Healthcare Services [Member]
Significant Acquisitions and Disposals [Line Items]
Initial leaseback term										15 years
Working capital loan			$ 7,500
Ownership interest, percentage			20.00%
2014 [Member] \| Sherman TX [Member] \| Acute Care Hospital [Member]
Significant Acquisitions and Disposals [Line Items]
Number of beds \| Bed			237

Real Estate and Loans Receivable - 2013 Activity - Additional Information (Detail) $ in Thousands, € in Millions				12 Months Ended
	Nov. 29, 2013 USD ($) Facility	Sep. 26, 2013 USD ($) Contract Facility	Jun. 11, 2013 USD ($) RenewalOptions Facility	Dec. 31, 2014 USD ($)	Dec. 31, 2013 USD ($) Bed	Dec. 31, 2012 USD ($)	Dec. 12, 2013 USD ($) RenewalOptions	Nov. 29, 2013 EUR (€)	Jul. 18, 2013 USD ($)
Significant Acquisitions and Disposals [Line Items]
Mortgage financing				$ 12,500	$ 20,000	$ 203,650
Income contributed by the acquired entity				67,150	144,545
Acquisition related costs				$ 26,389	19,494	$ 5,420
2013 [Member]
Significant Acquisitions and Disposals [Line Items]
Mortgage financing					20,000
2013 [Member] \| RHM Portfolio Acquisition [Member]
Significant Acquisitions and Disposals [Line Items]
Purchase price of acquisition	$ 237,800							€ 175.0
Number of facilities acquired \| Facility	11
Applicable transfer taxes on purchase price \| €								€ 9.0
Term of lease, years				27 years
Cumulative increases in the German consumer price index	70.00%
2013 [Member] \| Dallas Medical Center [Member]
Significant Acquisitions and Disposals [Line Items]
Purchase price of acquisition							$ 25,000
Term of lease, years				10 years
Number of lease extension options in current lease contract \| RenewalOptions							2
Term of lease extension, years				5 years
2013 [Member] \| Ernest Health, Inc [Member]
Significant Acquisitions and Disposals [Line Items]
Term of lease, years				20 years
2013 [Member] \| Term Loans [Member] \| Ernest Health, Inc [Member]
Significant Acquisitions and Disposals [Line Items]
Loan on property				$ 5,300
2013 [Member] \| Corpus Christi Rehabilitation Hospital [Member]
Significant Acquisitions and Disposals [Line Items]
Purchase price of acquisition									$ 10,500
2013 [Member] \| Corpus Christi Rehabilitation Hospital [Member] \| Commitment [Member]
Significant Acquisitions and Disposals [Line Items]
Purchase price of acquisition									$ 500
2013 [Member] \| Business Acquisitions [Member]
Significant Acquisitions and Disposals [Line Items]
Revenue contributed by the acquired entity					13,600
Income contributed by the acquired entity					10,600
Acquisition related costs					19,500
Acquisition-related costs on consummated deals					18,000
Acquisition related costs - transfer taxes on consummated deals					$ 12,000
2013 [Member] \| From 2015 through 2017 [Member] \| RHM Portfolio Acquisition [Member]
Significant Acquisitions and Disposals [Line Items]
Rent escalations percentage	2.00%
2013 [Member] \| After 2017 [Member] \| RHM Portfolio Acquisition [Member]
Significant Acquisitions and Disposals [Line Items]
Rent escalations percentage	0.50%
2013 [Member] \| Maximum [Member] \| Ernest Health, Inc [Member]
Significant Acquisitions and Disposals [Line Items]
Term of lease extension, years				5 years
Maximum rent increase percent				5.00%
2013 [Member] \| Minimum [Member] \| Ernest Health, Inc [Member]
Significant Acquisitions and Disposals [Line Items]
Term of lease extension, years				3 years
Maximum rent increase percent				2.00%
2013 [Member] \| Acute Care Hospital [Member] \| Kansas [Member]
Significant Acquisitions and Disposals [Line Items]
Number of facilities acquired \| Facility			2
Term of lease, years				10 years
Number of lease extension options in current lease contract \| RenewalOptions			2
Term of lease extension, years				5 years
Maximum rent increase percent			2.00%
Acquisition costs			$ 75,000
2013 [Member] \| Acute Care Hospital [Member] \| Isasis Healthcare LLC [Member]
Significant Acquisitions and Disposals [Line Items]
Purchase price of acquisition		$ 281,300
Number of facilities acquired \| Facility		3
Number of lease extension options in current lease contract \| Contract		2
Initial leaseback term				15 years
Lease renewal option				5 years
Lease maturity year				2019
Extended lease maturity year				2028
2013 [Member] \| Acute Care Hospital [Member] \| Maximum [Member] \| Isasis Healthcare LLC [Member]
Significant Acquisitions and Disposals [Line Items]
Maximum rent increase percent				2.50%
2013 [Member] \| Olympia Medical Center [Member]
Significant Acquisitions and Disposals [Line Items]
Number of beds \| Bed					204

Real Estate and Loans Receivable - 2012 Activity - Additional Information (Detail)				12 Months Ended
	Dec. 14, 2012 USD ($) Contract Bed	Sep. 19, 2012 USD ($) Bed	Jul. 03, 2012 USD ($) Property	Dec. 31, 2014 USD ($) Contract State Facility	Dec. 31, 2013 USD ($)	Dec. 31, 2012 USD ($)	Feb. 29, 2012 USD ($)
Significant Acquisitions and Disposals [Line Items]
New mortgage loan funded				$ (3,650,000)
Ownership interest in equity				100.00%
Income contributed by the acquired entity				$ 67,150,000	$ 144,545,000
Acquisition related costs				26,389,000	$ 19,494,000	$ 5,420,000
2012 [Member]
Significant Acquisitions and Disposals [Line Items]
Aggregate purchase price				$ 200,000,000
Term of lease, years				20 years
Number of lease extension options in current lease contract \| Contract				3
Term of lease extension, years				5 years
Percentage of rental rate				9.00%
Loan secured by mortgage interest				$ 100,000,000
2012 [Member] \| Maximum [Member] \| Ceiling [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of rental rate				5.00%
2012 [Member] \| Minimum [Member] \| Floor Rate [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of rental rate				2.00%
2012 [Member] \| Rehabilitation Hospital [Member]
Significant Acquisitions and Disposals [Line Items]
Number of facilities acquired \| Facility				5
2012 [Member] \| Business Acquisitions [Member]
Significant Acquisitions and Disposals [Line Items]
Revenue contributed by the acquired entity						46,300,000
Income contributed by the acquired entity						46,100,000
Acquisition related costs						5,400,000
Acquisition-related costs on consummated deals						$ 5,100,000
2012 [Member] \| Ernest Health, Inc [Member]
Significant Acquisitions and Disposals [Line Items]
Combined purchase price and investment amount							$ 396,500,000
Total investment				$ 96,500,000
Acquisition loan made				$ 93,200,000
Preferential rate of return on loan amount				15.00%
Coupon payable in cash in, thereafter				10.00%
Agreement terms				Although there are provisions in the loan agreement that are expected to result in full payment of the 15% preference when funds are sufficient. Any of the 15% in excess of the minimum that is not paid may be accrued, interest compounded, and paid upon the occurrence of a capital or liquidity event and is payable at maturity. The loan may be prepaid without penalty at any time.
2012 [Member] \| Ernest Health, Inc [Member] \| Key Management Personnel [Member]
Significant Acquisitions and Disposals [Line Items]
Capital contribution				$ 3,300,000
2012 [Member] \| Ernest Health, Inc [Member] \| Minimum [Member]
Significant Acquisitions and Disposals [Line Items]
Coupon payable in cash, year one				6.00%
Coupon payable in cash, year two				7.00%
2012 [Member] \| Acute Care Facility [Member]
Significant Acquisitions and Disposals [Line Items]
Number of facilities acquired \| Facility				7
Number of states \| State				7
Term of lease, years				15 years
Number of lease extension options in current lease contract \| Contract	3
Term of lease extension, years				5 years
Number of beds acquired \| Bed	40
Business acquisition cost of acquired entity	$ 10,500,000
Payments to acquire equity method investments	$ 2,000,000
Ownership interest in equity	25.00%
Working capital loan to the joint venture	$ 2,500,000
Date of properties acquired				Dec. 14, 2012
2012 [Member] \| Acute Care Facility [Member] \| Maximum [Member]
Significant Acquisitions and Disposals [Line Items]
Revolving loan	$ 2,000,000
2012 [Member] \| Prime Health Care Services [Member]
Significant Acquisitions and Disposals [Line Items]
Number of beds at Centinela Hospital Medical Center used to secure loan \| Property			369
Maturity of mortgage loan				Dec. 31, 2022
2012 [Member] \| Prime Health Care Services [Member] \| Loans, net [Member]
Significant Acquisitions and Disposals [Line Items]
New mortgage loan funded			$ 100,000,000
2012 [Member] \| St. Mary's Regional Medical Center [Member] \| Series of Individually Immaterial Business Acquisitions [Member]
Significant Acquisitions and Disposals [Line Items]
Number of beds acquired \| Bed		380
Business acquisition cost of acquired entity		$ 80,000,000
2012 [Member] \| Roxborough Memorial Hospital [Member] \| Series of Individually Immaterial Business Acquisitions [Member]
Significant Acquisitions and Disposals [Line Items]
Number of beds acquired \| Bed		140
Business acquisition cost of acquired entity		$ 30,000,000

Real Estate and Loans Receivable - Schedule of Unaudited Supplemental Pro Forma Operating Data (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013
Business Acquisition, Pro Forma Information [Abstract]
Total revenues	$ 329,258	$ 315,780
Net income	$ 67,150	$ 144,545
Net income per share/unit	$ 0.38	$ 0.84

Real Estate and Loans Receivable - Development Activities - Additional Information (Detail) $ in Thousands			12 Months Ended
	Aug. 15, 2014 USD ($) RenewalOptions	Jul. 29, 2014 USD ($)	Dec. 31, 2014 USD ($) RenewalOptions Facility
Significant Acquisitions and Disposals [Line Items]
Current development project			$ 160,367
Healthcare [Member]
Significant Acquisitions and Disposals [Line Items]
Term of lease, years	15 years
Number of lease extension options in current lease contract \| RenewalOptions	4
Term of lease extension, years	5 years
Agreement amount related to acquisition	$ 8,700
Development Activities [Member] \| Oakleaf Surgical Hospital [Member] \| Acute Care Hospital [Member] \| Altoona, WI [Member] \| National Surgical Hospitals [Member]
Significant Acquisitions and Disposals [Line Items]
Current development project			$ 30,500
Term of lease, years			15 years
Number of lease extension options in current lease contract \| RenewalOptions			2
Term of lease extension, years			5 years
Development Activities [Member] \| Northern Utah Rehabilitation Hospital [Member]
Significant Acquisitions and Disposals [Line Items]
Estimated total development cost			$ 19,000
Development Activities [Member] \| First Choice [Member]
Significant Acquisitions and Disposals [Line Items]
Estimated total development cost			$ 83,000
Number of facilities leased \| Facility			17
Number of facilities under construction \| Facility			1
Development Activities [Member] \| First Choice [Member] \| Minimum [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage increase in consumer price index		2.00%
Development Activities [Member] \| Adeptus Health [Member]
Significant Acquisitions and Disposals [Line Items]
Business acquisition, cost of acquired entity		$ 150,000
Sale/leaseback transaction, initial term period		15 years
Sale/leaseback transaction, additional term period		5 years

Real Estate and Loans Receivable - Summary of Status Update on Current Development Projects (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2014 USD ($)
Business Acquisition [Line Items]
Commitment	$ 160,367
Costs Incurred as of 12/31/2014	23,163
UAB Medical West [Member] \| Hoover AL [Member] \| Acute Care Hospital And MOB [Member] \| Medical West, an Affiliate of UAB [Member]
Business Acquisition [Line Items]
Commitment	8,653
Costs Incurred as of 12/31/2014	$ 1,973
Estimated Completion Date	2Q 2015
First Choice ER- Summerwood [Member] \| Houston, TX [Member] \| Acute Care Hospital [Member] \| Adeptus Health [Member]
Business Acquisition [Line Items]
Commitment	$ 6,015
Costs Incurred as of 12/31/2014	$ 2,560
Estimated Completion Date	2Q 2015
First Choice ER- Ft. Worth Avondale - Haslet [Member] \| Ft Worth TX [Member] \| Acute Care Hospital [Member] \| Adeptus Health [Member]
Business Acquisition [Line Items]
Commitment	$ 4,780
Costs Incurred as of 12/31/2014	$ 871
Estimated Completion Date	2Q 2015
First Choice ER- Carrollton [Member] \| Carrollton TX [Member] \| Acute Care Hospital [Member] \| Adeptus Health [Member]
Business Acquisition [Line Items]
Commitment	$ 35,820
Costs Incurred as of 12/31/2014	$ 15,629
Estimated Completion Date	3Q 2015
First Choice ER- Chandler [Member] \| Chandler AZ [Member] \| Acute Care Hospital [Member] \| Adeptus Health [Member]
Business Acquisition [Line Items]
Commitment	$ 5,049
Costs Incurred as of 12/31/2014	$ 895
Estimated Completion Date	3Q 2015
First Choice ER- Converse [Member] \| Converse TX [Member] \| Acute Care Hospital [Member] \| Adeptus Health [Member]
Business Acquisition [Line Items]
Commitment	$ 5,754
Costs Incurred as of 12/31/2014	$ 1,141
Estimated Completion Date	3Q 2015
First Choice ER- Denver 48th [Member] \| Denver, CO [Member] \| Acute Care Hospital [Member] \| Adeptus Health [Member]
Business Acquisition [Line Items]
Commitment	$ 5,123
Costs Incurred as of 12/31/2014	$ 44
Estimated Completion Date	3Q 2015
First Choice ER- McKinney [Member] \| McKinney TX [Member] \| Acute Care Hospital [Member] \| Adeptus Health [Member]
Business Acquisition [Line Items]
Commitment	$ 4,750
Costs Incurred as of 12/31/2014	$ 50
Estimated Completion Date	3Q 2015
First Choice Emergency Rooms [Member] \| Various [Member] \| Acute Care Hospital [Member] \| Adeptus Health [Member]
Business Acquisition [Line Items]
Commitment	$ 84,423
Estimated Completion Date	Various

Real Estate and Loans Receivable - Disposals - Additional Information (Detail) $ in Thousands									3 Months Ended	9 Months Ended	12 Months Ended
	May 20, 2014 USD ($)	Nov. 27, 2013 USD ($)	Apr. 17, 2013 USD ($) Hospital	Dec. 27, 2012 USD ($)	Oct. 22, 2012 USD ($)	Sep. 28, 2012 USD ($)	Aug. 21, 2012 USD ($)	Jun. 15, 2012 USD ($)	Dec. 31, 2012 USD ($)	Sep. 30, 2012 USD ($)	Dec. 31, 2014 USD ($)	Dec. 31, 2013 USD ($)	Dec. 31, 2012 USD ($)
Significant Acquisitions and Disposals [Line Items]
Proceeds from sale of real estate											$ 34,649	$ 32,409	$ 71,202
Disposals [Member]
Significant Acquisitions and Disposals [Line Items]
Proceeds from sale of real estate										$ 42,000
Acquisition costs	$ 35,000
Real estate impairment charge	$ 3,100
Disposals [Member] \| San Antonio, TX [Member]
Significant Acquisitions and Disposals [Line Items]
Proceeds from sale of real estate		$ 14,000
Gain (loss) on sale of real estate		$ 5,600
Disposals [Member] \| Summit Hospital of Southeast Arizona and Summit Hospital of Southeast Texas [Member]
Significant Acquisitions and Disposals [Line Items]
Proceeds from sale of real estate			$ 18,500
Gain (loss) on sale of real estate			$ 2,100
Number of hospitals sold \| Hospital			2
Disposals [Member] \| Thornton CO [Member]
Significant Acquisitions and Disposals [Line Items]
Gain (loss) on sale of real estate						$ 8,400
Straight-line rent write-off						$ 1,600
Disposals [Member] \| New Bedford [Member]
Significant Acquisitions and Disposals [Line Items]
Gain (loss) on sale of real estate					$ 7,200
Straight-line rent write-off									$ 4,100
Disposals [Member] \| Denham Springs LTACH [Member]
Significant Acquisitions and Disposals [Line Items]
Proceeds from sale of real estate							$ 5,200
Gain (loss) on sale of real estate							$ 300
Disposals [Member] \| HealthSouth Rehabilitation Hospital of Fayetteville [Member]
Significant Acquisitions and Disposals [Line Items]
Proceeds from sale of real estate								$ 16,000
Gain (loss) on sale of real estate								$ 1,400
Disposals [Member] \| Huntington Beach facility [Member]
Significant Acquisitions and Disposals [Line Items]
Proceeds from sale of real estate				$ 12,500
Gain (loss) on sale of real estate				1,900
Straight-line rent write-off				$ 700
Disposals [Member] \| La Palma Facility [Member]
Significant Acquisitions and Disposals [Line Items]
Proceeds from sale of real estate											12,500
Gain (loss) on sale of real estate											2,900
Straight-line rent write-off											$ 1,300

Real Estate and Loans Receivable - Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Significant Acquisitions and Disposals [Line Items]
Intangible lease assets	$ 108,885	$ 90,490
Intangible Assets [Member]
Significant Acquisitions and Disposals [Line Items]
Intangible lease assets	108,900	90,500
Accumulated amortization, net	87,700	74,900
Amortization expense related to intangible lease assets	$ 7,000	$ 4,000	$ 3,900
Capitalized lease intangibles, weighted average life (in years)	17 years 10 months 24 days

Real Estate and Loans Receivable - Amortization Expense from Existing Lease Intangible Assets (Detail) $ in Thousands	Dec. 31, 2014 USD ($)
Business Combinations [Abstract]
2015	$ 6,438
2016	6,397
2017	6,387
2018	6,326
2019	$ 6,271

Real Estate and Loans Receivable - Leasing Operations - Additional Information (Detail) - Leases		12 Months Ended
	Jul. 03, 2012	Dec. 31, 2014
Ernest Health, Inc [Member]
Significant Acquisitions and Disposals [Line Items]
Number of direct financing leases		14
Prime Facilities [Member]
Significant Acquisitions and Disposals [Line Items]
Number of direct financing leases		5
Prime Health Care Services [Member] \| Leasing Operations [Member]
Significant Acquisitions and Disposals [Line Items]
Master lease term		10 years
Master lease agreements, number of renewal options	2
Master lease, optional lease term		5 years
Lease escalation percentage	100.00%

Real Estate and Loans Receivable - Components of Net Investment in Direct Financing Leases (Detail) - USD ($) $ in Thousands	Dec. 31, 2014	Dec. 31, 2013
Business Combinations [Abstract]
Minimum lease payments receivable	$ 1,607,024
Estimated residual values	211,888
Less unearned income	(1,379,396)
Net investment in direct financing leases	$ 439,516	$ 431,024

Real Estate and Loans Receivable - Minimum Rental Payments Due under Operating Leases with Non-Cancelable Terms (Detail) $ in Thousands	Dec. 31, 2014 USD ($)
Leases User Charges And Commitments [Line Items]
2015	$ 3,415
2016	3,434
2017	3,443
2018	3,436
2019	3,055
Thereafter	84,759
Minimum rental payments, total	101,542
Minimum Rental Payments [Member]
Leases User Charges And Commitments [Line Items]
2015	240,250
2016	242,519
2017	243,946
2018	245,769
2019	246,819
Thereafter	219,089
Minimum rental payments, total	3,438,392
Minimum Rental Payments [Member] \| Operating Leases [Member]
Leases User Charges And Commitments [Line Items]
2015	196,864
2016	198,265
2017	198,807
2018	199,728
2019	199,857
Thereafter	1,838,346
Minimum rental payments, total	2,831,867
Minimum Rental Payments [Member] \| Direct Financing Leases [Member]
Leases User Charges And Commitments [Line Items]
2015	43,386
2016	44,254
2017	45,139
2018	46,041
2019	46,962
Thereafter	380,743
Minimum rental payments, total	$ 606,525

Real Estate and Lending Activities - Net Investment Under Monroe Facility (Detail) - USD ($) $ in Thousands	Dec. 31, 2014	Dec. 31, 2013
Business Combinations [Abstract]
Loans		$ 31,341
Less: Loan impairment reserve		(12,000)
Loans, net		19,341
Interest, rent and other receivables		20,972
Net investment		$ 40,313

Real Estate and Loans Receivable - Monroe Facility - Additional Information (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2014 USD ($)
Significant Acquisitions and Disposals [Line Items]
Impairment charges	$ 50,128
Monroe Properties [Member]
Significant Acquisitions and Disposals [Line Items]
Impairment charges	47,000
Lease inducements to tenants	5,000
Amount paid in settlement of bankruptcy claims	2,500
Net investment	$ 36,000

Real Estate and Loans Receivable - Florence Facility - Additional Information (Detail) - Florence acute care facility [Member] - USD ($) $ in Millions	Dec. 31, 2014	Mar. 06, 2013
Significant Acquisitions and Disposals [Line Items]
Business acquisition cost of acquired entity		$ 27.4
Outstanding rent receivables		$ 1.0
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, AZ [Member] - USD ($)	3 Months Ended
	Mar. 31, 2014	Dec. 31, 2014
Significant Acquisitions and Disposals [Line Items]
Amortization of the related lease intangible asset	$ 1,000,000
Outstanding rent receivables		$ 0
Straight line rent receivables write-off	$ 1,100,000
Real estate investment		$ 14,100,000

Real Estate and Loans Receivable - Summary of Loans (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013
Loans [Line Items]
Loans, Balance	$ 970,761	$ 549,746
Mortgage loans [Member]
Loans [Line Items]
Loans, Balance	$ 397,594	$ 388,756
Loans, Weighted Average Interest Rate	10.50%	10.00%
Working capital and other loans [Member]
Loans [Line Items]
Loans, Balance	$ 48,031	$ 51,335
Loans, Weighted Average Interest Rate	10.40%	10.80%
Acquisition loans [Member]
Loans [Line Items]
Loans, Balance	$ 525,136	$ 109,655
Loans, Weighted Average Interest Rate	9.30%	14.70%

Real Estate and Loans Receivable - Loans - Additional Information (Detail) - USD ($) $ in Thousands		12 Months Ended
	Mar. 01, 2012	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Significant Acquisitions and Disposals [Line Items]
Existing mortgage loan		$ 397,500	$ 388,650	$ 368,650	$ 165,000
Amount of convertible note converted into equity interest	$ 1,600
Convertible note	$ 5,000
Percentage of equity shares from convertible debt	9.90%	15.10%
Remaining convertible debt after conversion of part of debt		$ 3,400
Ernest Transaction and Other Acquisitions [Member]
Significant Acquisitions and Disposals [Line Items]
Existing mortgage loan		97,500
Median Transaction [Member]
Significant Acquisitions and Disposals [Line Items]
Existing mortgage loan		$ 422,500

Real Estate and Loans Receivable - Concentration of Credit Risks and Related Party Transactions - Additional Information (Detail) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2014 USD ($) Investment	Sep. 30, 2014 USD ($)	Jun. 30, 2014 USD ($)	Mar. 31, 2014 USD ($)	Dec. 31, 2013 USD ($)	Sep. 30, 2013 USD ($)	Jun. 30, 2013 USD ($)	Mar. 31, 2013 USD ($)	Dec. 31, 2014 USD ($) Investment	Dec. 31, 2013 USD ($)	Dec. 31, 2012 USD ($)
Significant Acquisitions and Disposals [Line Items]
Revenues	$ 82,106	$ 80,777	$ 76,560	$ 73,089	$ 67,679	$ 60,106	$ 57,124	$ 57,614	$ 312,532	$ 242,523	$ 198,125
European [Member]
Significant Acquisitions and Disposals [Line Items]
Revenues									26,000	1,800
Related Party Transactions [Member]
Significant Acquisitions and Disposals [Line Items]
Lease and interest revenue earned from tenants									$ 101,800	$ 70,000	$ 54,300
Concentration of Credit Risks [Member] \| Median Transaction [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of total assets accounted									11.30%
Sales Revenue, Net [Member] \| Customer Concentration Risk [Member] \| Ernest Health, Inc [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of entity revenue from affiliates									18.30%	20.20%
Sales Revenue, Net [Member] \| Customer Concentration Risk [Member] \| Prime Health Care Services [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of entity revenue from affiliates									26.90%	32.00%
Assets, Total [Member]
Significant Acquisitions and Disposals [Line Items]
Number of investment in property \| Investment	0								0
Maximum percentage of entity's total assets invested on single property	4.00%								4.00%
Assets, Total [Member] \| Customer Concentration Risk [Member] \| Ernest Health, Inc [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of entity revenue from affiliates									13.00%	15.90%
Assets, Total [Member] \| Customer Concentration Risk [Member] \| Prime Health Care Services [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of entity revenue from affiliates									20.00%	24.50%
Assets, Total [Member] \| Geographic Concentration Risk [Member] \| California [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of entity revenue from affiliates									14.60%	18.70%
Assets, Total [Member] \| Geographic Concentration Risk [Member] \| Texas [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of entity revenue from affiliates									20.20%	22.70%
Assets, Total [Member] \| Geographic Concentration Risk [Member] \| European [Member]
Significant Acquisitions and Disposals [Line Items]
Percentage of entity revenue from affiliates									20.00%	9.00%
Assets, Total [Member] \| Geographic Concentration Risk [Member] \| United States
Significant Acquisitions and Disposals [Line Items]
Percentage of entity revenue from affiliates									80.00%

Debt - Summary of Debt (Detail) - USD ($) $ in Thousands	12 Months Ended
Debt - Summary of Debt (Detail) - USD ($) $ in Thousands	Dec. 31, 2014	Dec. 31, 2013	Apr. 17, 2014
Debt Instrument [Line Items]
Principal amount	$ 2,199,132
Debt	$ 2,201,654	$ 1,421,681
2011 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	6.875%	6.875%
Debt	$ 450,000	$ 450,000
Revolving credit facility [Member]
Debt Instrument [Line Items]
Interest rate	Variable	Variable
Debt	$ 593,490	$ 105,000
2006 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Interest rate	Various	Various
Debt	$ 125,000	$ 125,000
2012 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	6.375%	6.375%
Principal amount	$ 350,000	$ 350,000
Unamortized premium	2,522	2,873
Debt	$ 352,522	$ 352,873
2013 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	5.75%	5.75%
Debt	$ 241,960	$ 274,860
2014 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	5.50%		5.50%
Debt	$ 300,000
Term Loans [Member]
Debt Instrument [Line Items]
Interest rate	Various	Various
Debt	$ 138,682	$ 113,948

Debt - Principal Payments Due for Debt (Detail) $ in Thousands	Dec. 31, 2014 USD ($)
Debt Disclosure [Abstract]
2015	$ 283
2016	125,298
2017	320
2018	606,271
2019	125,000
Thereafter	1,341,960
Total	$ 2,199,132

Debt - Revolving Credit Facility - Additional Information (Detail) - USD ($)		12 Months Ended
	Jun. 19, 2014	Dec. 31, 2014	Oct. 17, 2014	Jun. 30, 2014	Dec. 31, 2013
Debt Instrument [Line Items]
Aggregate commited size of credit facility		$ 215,000,000
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Amount of senior unsecured credit facility paid off	$ 900,000,000
Accordion to existing credit facility			$ 250,000,000
Aggregate commited size of credit facility			1,150,000,000
Revolving Credit Facility [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Accordion to existing credit facility			$ 400,000,000
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Amount of senior unsecured debt	775,000,000
Credit facilities, amount outstanding		593,500,000			$ 105,000,000
Refinancing charge				$ 300,000
Aggregate commited size of credit facility		$ 432,000,000
Debt instrument, basis spread of interest rate		0.40%
Credit facilities, percentage of commitment fee on unused capacity		0.30%
Credit facilities, weighted average interest rate		2.90%			3.20%
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member] \| Federal Funds Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate		0.50%
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member] \| Euro Dollar Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate		1.00%
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member] \| London Interbank Offered Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate		1.40%
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member] \| Minimum [Member]
Debt Instrument [Line Items]
Credit facilities, amount outstanding	400,000,000
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Credit facilities, amount outstanding	100,000,000
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member] \| Revolving Credit Facility Matures in June 2018 [Member] \| Federal Funds Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate		0.50%
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member] \| Revolving Credit Facility Matures in June 2018 [Member] \| Euro Dollar Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate		1.00%
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member] \| Revolving Credit Facility Matures in June 2018 [Member] \| Minimum [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate		0.70%
Credit facilities, percentage of commitment fee on unused capacity		0.25%
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member] \| Revolving Credit Facility Matures in June 2018 [Member] \| Minimum [Member] \| London Interbank Offered Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate		1.70%
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member] \| Revolving Credit Facility Matures in June 2018 [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate		1.25%
Credit facilities, percentage of commitment fee on unused capacity		0.35%
Revolving Credit Facility [Member] \| Unsecured Revolving Credit Facility [Member] \| Revolving Credit Facility Matures in June 2018 [Member] \| Maximum [Member] \| London Interbank Offered Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate		2.25%
Revolving Credit Facility [Member] \| Term Loans [Member]
Debt Instrument [Line Items]
Amount of senior unsecured credit facility paid off	250,000,000
Amount of senior unsecured debt	$ 125,000,000

Debt - 2014 Senior Unsecured Notes - Additional Information (Detail) - 2014 Senior Unsecured Notes [Member] - USD ($) $ in Millions	Apr. 17, 2014	Dec. 31, 2014
Debt Instrument [Line Items]
Senior unsecured notes, value of offering	$ 300
Senior notes frequency of periodic payment	Semi-annually
Senior unsecured notes, interest rate	5.50%	5.50%
Debt instrument, maturity date	May 01, 2014
Senior notes, earliest redemption date	May 01, 2019
Senior unsecured notes, redemption percentage on principal amount	35.00%
Senior unsecured notes, repurchase price percentage on principal amount plus accrued and unpaid interest	101.00%

Debt - 2013 Senior Unsecured Notes - Additional Information (Detail) - 2013 Senior Unsecured Notes [Member] - EUR (€) € in Millions	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Oct. 10, 2013
Debt Instrument [Line Items]
Senior unsecured notes, value of offering			€ 200
Senior unsecured notes, interest rate	5.75%	5.75%
Senior notes frequency of periodic payment	Semi-annually
Debt instrument, maturity date	Oct. 01, 2020
Senior notes, earliest redemption date	Oct. 01, 2016
Senior unsecured notes, redemption percentage on principal amount	35.00%
Senior unsecured notes, repurchase price percentage on principal amount plus accrued and unpaid interest	101.00%

Debt - 2012 Senior Unsecured Notes - Additional Information (Detail) - 2012 Senior Unsecured Notes [Member] - USD ($) $ in Millions			12 Months Ended
	Aug. 20, 2013	Feb. 17, 2012	Dec. 31, 2014	Dec. 31, 2013
Debt Instrument [Line Items]
Senior unsecured notes, value of offering	$ 150.0	$ 200.0
Senior unsecured notes, interest rate			6.375%	6.375%
Debt instrument, maturity date			Feb. 15, 2022
Senior notes frequency of periodic payment			Semi-annually
Net proceeds, after underwriting discount	$ 150.4	$ 196.5
Senior notes, earliest redemption date			Feb. 15, 2017
Senior notes, repurchase price percentage on principal amount plus accrued and unpaid interest			101.00%
Debt instrument redemption price			102.00%
Debt instrument effective rate			5.998%

Debt - 2011 Senior Unsecured Notes - Additional Information (Detail) - 2011 Senior Unsecured Notes [Member] - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Apr. 26, 2011
Debt Instrument [Line Items]
Debt instrument face amount			$ 450
Senior unsecured notes, interest rate	6.875%	6.875%
Debt instrument, maturity date	May 01, 2021
Senior notes frequency of periodic payment	Semi-annually
Senior notes, earliest redemption date	May 01, 2016
Senior notes, repurchase price percentage on principal amount plus accrued and unpaid interest	101.00%

Debt - 2006 Senior Unsecured Notes - Additional Information (Detail) - 2006 Senior Unsecured Notes [Member] - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2006
Debt Instrument [Line Items]
Senior unsecured notes, value of offering		$ 125.0
Credit facilities, periodic payments of interest	$ 65.0
Senior notes frequency of periodic payment	Quarterly
Unsecured senior notes, year of maturity	2016-07
London Interbank Offered Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate	2.30%

Debt - Interest Rate Swap - Additional Information (Detail) - USD ($)	3 Months Ended	12 Months Ended
	Jun. 30, 2010	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012	Oct. 31, 2011
Interest Rate Contract [Member]
Debt Instrument [Line Items]
Fair value of the interest rate swaps		$ 6,000,000	$ 9,000,000
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					$ 60,000,000
Interest rate of derivative instrument		5.675%
Interest Rate Swap [Member]
Debt Instrument [Line Items]
Hedge ineffectiveness and income statement effect in period		$ 0	0	$ 0
Other assets, collateral		$ 3,300,000	$ 5,000,000
2006 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Portion of debt instrument face amount	$ 65,000,000

Debt - Term Loans - Additional Information (Detail) - USD ($) $ in Millions		3 Months Ended	12 Months Ended
	Feb. 14, 2011	Jun. 30, 2014	Dec. 31, 2014	Dec. 31, 2013
2014 Term Loan [Member]
Debt Instrument [Line Items]
Paid off term loan		$ 125.0
Debt instrument maturity date			Jun. 30, 2019
Interest rate at end of period			1.82%	2.43%
2014 Term Loan [Member] \| Minimum [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			0.60%
2014 Term Loan [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			1.20%
2014 Term Loan [Member] \| London Interbank Offered Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			1.65%
2014 Term Loan [Member] \| London Interbank Offered Rate [Member] \| Minimum [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			1.60%
2014 Term Loan [Member] \| London Interbank Offered Rate [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			2.20%
2014 Term Loan [Member] \| Federal Funds Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate		0.50%	0.50%
2014 Term Loan [Member] \| Eurodollar Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate		1.00%	1.00%
2014 Term Loan [Member] \| Initial Spread [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			0.65%
Mortgages [Member] \| Northland Ltach Hospital [Member]
Debt Instrument [Line Items]
Debt instrument maturity date			Jan. 01, 2018
Liabilities acquired	$ 14.6
Amortization period			30 years
Interest rate			6.20%
Debt instrument earliest prepayment date			Jan. 01, 2013
Collateralized real estate property			$ 17.5	$ 18.0
Term Loans [Member]
Debt Instrument [Line Items]
Debt instrument face amount			$ 13.7

Debt - Other Commitments - Additional Information (Detail) $ in Millions	12 Months Ended
	Dec. 31, 2014 USD ($)
Debt Disclosure [Abstract]
Unsecured interim bridge loan facility	$ 215.0
Fees incurred on available but unused facility	$ 1.4

Debt - Covenants - Additional Information (Detail)	12 Months Ended
Debt - Covenants - Additional Information (Detail)	Dec. 31, 2014
Debt Disclosure [Abstract]
Percentage of dividends which could be paid from adjusted operating funds	95.00%
Percentage of dividends which could be paid from operation funds	95.00%
Maximum percentage of total unencumbered assets	150.00%

Income Taxes - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Income Taxes [Line Items]
Percentage of ordinary taxable income to be distributed for real estate investment trust qualification	90.00%	90.00%	90.00%
Percentage of taxable income to be distributed for federal income tax assumption	100.00%
Amount of foreign loss before income taxes	$ 7.5	$ 12.9
Amount of domestic loss before income taxes	20.9	$ 7.6	$ 0.1
U.S federal NOLs	50.7
U.S. state NOLs	121.8
Foreign NOLs	$ 6.7
U.S. federal and state NOLs, expiration period	2021 through 2034
U.S federal alternative minimum tax credits carry forward	$ 0.1
Increased Valuation Allowances [Member]
Income Taxes [Line Items]
Acquisition-related costs on consummated deals	$ 8.9

Income Taxes - Schedule of Income Tax Expense (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Current income tax (benefit) expense:
Domestic	$ 114	$ 358	$ (44)
Foreign	225	158
Total income tax expense	339	516	(44)
Deferred income tax (benefit) expense
Domestic	(23)	210	63
Foreign	24
Total income tax expense	1	210	63
Income tax (benefit) expense	$ 340	$ 726	$ 19

Income Taxes - Schedule of Deferred Tax Assets and liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2014	Dec. 31, 2013
Deferred tax liabilities:
Property and equipment		$ (2,560)
Unbilled rent	$ (2,070)	(610)
Partnership investments	(3,468)
Other	(3,759)	(2,313)
Total deferred tax liabilities	(9,297)	(5,483)
Deferred tax assets:
Loan loss and other reserves		7,751
Operating loss and interest deduction carry forwards	19,546	2,283
Property and equipment	2,373
Partnership investments		805
Other	3,971	2,256
Total deferred tax assets	25,890	13,095
Valuation allowance	(16,831)	(7,843)
Total net deferred tax assets	9,059	5,252
Net deferred tax (liability)	$ (238)	$ (231)

Income Taxes - Summary of Reconciliation of the Income Tax Expense at the Statutory Income Tax Rate and the Effective Tax Rate for Income from Continuing Operations before Income Taxes (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Income Tax Disclosure [Abstract]
Income from continuing operations (before-tax)	$ 51,138,000	$ 90,027,000	$ 72,889,000
Income tax at the US statutory federal rate (35%)	17,898,000	31,509,000	25,511,000
Rate differential	1,145,000	2,380,000
State income taxes, net of federal benefit	(337,000)	271,000	(8,000)
Dividends paid deduction	(27,873,000)	(33,345,000)	(25,454,000)
Change in valuation allowance	8,988	(697,000)
Other items, net	519,000	608,000	(30,000)
Total income tax expense	$ 340,000	$ 726,000	$ 19,000

Income Taxes - Summary of Reconciliation of the Income Tax Expense at the Statutory Income Tax Rate and the Effective Tax Rate for Income from Continuing Operations before Income Taxes (Parenthetical) (Detail)	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Income Tax Disclosure [Abstract]
Income tax at the US statutory federal rate	35.00%	35.00%	35.00%

Income Taxes - Schedule of Per Share Distributions to Stockholders (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Income Tax Disclosure [Abstract]
Common share distribution	$ 0.840000	$ 0.800000	$ 0.800000
Ordinary income	0.520692	0.599384	0.601216
Capital gains	0.000276	0.046380	0.117584
Unrecaptured Sec. 1250 gain	0.000276	0.026512	0.086976
Return of capital	0.319032	0.154236	0.081200
Allocable to next year	$ 0	$ 0	$ 0

Earnings Per Share/Unit - Calculation of Earnings Per Share (Detail) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Income from continuing operations	$ 15,029	$ 28,663	$ (203)	$ 7,309	$ 13,309	$ 25,391	$ 25,031	$ 25,570	$ 50,798	$ 89,301	$ 72,870
Non-controlling interests' share in continuing operations									(274)	(224)	(177)
Participating securities' share in earnings									(894)	(729)	(887)
Income from continuing operations, less participating securities' share in earnings									49,630	88,348	71,806
Income (loss) from discontinued operations attributable to MPT common stockholders									(2)	7,914	17,207
Net income, less participating securities' share in earnings									$ 49,628	$ 96,262	$ 89,013
Basic weighted-average common shares	172,411	171,893	171,718	163,973	161,143	154,758	149,509	140,347	169,999	151,439	132,331
Dilutive potential common shares									541	1,159	2
Diluted weighted-average common shares	172,604	172,639	171,718	164,549	161,840	155,969	151,056	141,526	170,540	152,598	132,333
MPT Operating Partnership, L.P. [Member]
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Income from continuing operations	$ 15,029	$ 28,663	$ (203)	$ 7,309	$ 13,309	$ 25,391	$ 25,031	$ 25,570	$ 50,798	$ 89,301	$ 72,870
Non-controlling interests' share in continuing operations									(274)	(224)	(177)
Participating securities' share in earnings									(894)	(729)	(887)
Income from continuing operations, less participating securities' share in earnings									49,630	88,348	71,806
Income (loss) from discontinued operations attributable to MPT common stockholders									(2)	7,914	17,207
Net income, less participating securities' share in earnings									$ 49,628	$ 96,262	$ 89,013
Basic weighted-average common shares	172,411	171,893	171,718	163,973	161,143	154,758	149,509	140,347	169,999	151,439	132,331
Dilutive potential common shares									541	1,159	2
Diluted weighted-average common shares	172,604	172,639	171,718	164,549	161,840	155,969	151,056	141,526	170,540	152,598	132,333

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

Stock Awards - Additional Information (Detail) $ in Millions	12 Months Ended
	Dec. 31, 2014 USD ($) yr shares	Dec. 31, 2013 USD ($) yr shares	Dec. 31, 2012 USD ($) yr shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of stock options outstanding	0
Number of stock options exercisable	0
Stock options exercised	20,000
Stock options granted	0	0	0
Number of performance awards earned and vested	108,261
Number of performance awards to be earned	776,562
Stock-based compensation expense \| $	$ 9.2	$ 8.8	$ 7.6
Stock-based compensation expense, unrecognized cost \| $	$ 12.4
Stock-based compensation expense, unrecognized cost, reorganization period (in years)	2 years 4 months 24 days
Restricted equity awards, fair value \| $	$ 10.2	$ 9.2	$ 9.2
Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Performance award vesting period in years	10 years
Equity Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Reserved shares of common stock for awards under the Equity Incentive Plan	7,643,651
Common stock remaining for future stock awards transferred to the equity incentive plan	6,316,151
Maximum number of shares of common stock that may be awarded	5,000,000
Service-Based Awards [Member] \| Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock award required service period (in years)	5 years
Service-Based Awards [Member] \| Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock award required service period (in years)	3 years
40% of 2014 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based payment award, expected volatility rate	40.00%
Stock-based awards expiration date	Dec. 31, 2018
Share based payment award, weighted average risk-free rate of return	1.70%
Common stock options awarded, dividend yield	8.00%
Percentage of performance award grant in period	27.00%
Percentage of shareholder return annually	9.00%
Percentage of shareholder return annually achieving period (in years) \| yr	3
Share-based compensation arrangement by share based payment award, expected term (in years)	3 years
30% of 2014 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based payment award, expected volatility rate	27.00%
Share based payment award, weighted average risk-free rate of return	0.80%
Common stock options awarded, dividend yield	8.00%
Percentage of performance award grant in period	30.00%
Share-based compensation arrangement by share based payment award, expected term (in years)	5 years
Percentage of performance award to be earned of shareholder return reaches shareholder limit	100.00%
30% of 2014 Performance Awards [Member] \| If any shares are earned from this award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation award vesting rights	Vest in equal annual amounts on December 31, 2016, 2017
30% of 2014 Performance Awards [Member] \| Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned	35.00%
30% of 2014 Performance Awards [Member] \| Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned	27.00%
Remaining % of 2014 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based payment award, expected volatility rate	27.00%
Share based payment award, weighted average risk-free rate of return	0.80%
Common stock options awarded, dividend yield	8.00%
Share-based compensation arrangement by share based payment award, expected term (in years)	5 years
Percentage of performance award to be earned of shareholder return reaches shareholder limit	100.00%
Percentage of shareholder return to be earned	6.00%
Remaining % of 2014 Performance Awards [Member] \| If any shares are earned from this award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation award vesting rights	Vest in equal annual amounts on December 31, 2016, 2017 and 2018
27% of 2013 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Performance award vesting period in years		2 years
Share based payment award, expected volatility rate		27.00%
Stock-based awards expiration date		Dec. 31, 2017
Share based payment award, weighted average risk-free rate of return		0.72%
Common stock options awarded, dividend yield		8.00%
Percentage of performance award grant in period		27.00%
Percentage of shareholder return annually		8.50%
Percentage of shareholder return annually achieving period (in years) \| yr		3
Share-based compensation arrangement by share based payment award, expected term (in years)		3 years
Number of shares sold under performance awards		0
36% of 2013 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based payment award, expected volatility rate		28.00%
Share based payment award, weighted average risk-free rate of return		0.38%
Common stock options awarded, dividend yield		8.00%
Percentage of performance award grant in period		36.00%
Share-based compensation arrangement by share based payment award, expected term (in years)		5 years
Percentage of performance award to be earned of shareholder return reaches shareholder limit		100.00%
36% of 2013 Performance Awards [Member] \| If any shares are earned from this award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation award vesting rights		Vest in equal annual amounts on December 31, 2015, 2016 and 2017
36% of 2013 Performance Awards [Member] \| Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned		33.50%
36% of 2013 Performance Awards [Member] \| Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned		25.50%
Remaining % of 2013 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based payment award, expected volatility rate		28.00%
Share based payment award, weighted average risk-free rate of return		0.38%
Common stock options awarded, dividend yield		8.00%
Share-based compensation arrangement by share based payment award, expected term (in years)		5 years
Percentage of performance award to be earned of shareholder return reaches shareholder limit		100.00%
Percentage of shareholder return to be earned		6.00%
Remaining % of 2013 Performance Awards [Member] \| If any shares are earned from this award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation award vesting rights		Vest in equal annual amounts on December 31, 2015, 2016 and 2017
30% of 2012 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based payment award, expected volatility rate			34.00%
Stock-based awards expiration date			Dec. 31, 2016
Share based payment award, weighted average risk-free rate of return			0.93%
Common stock options awarded, dividend yield			8.60%
Percentage of performance award grant in period			30.00%
Percentage of shareholder return annually			9.00%
Percentage of shareholder return annually achieving period (in years) \| yr			3
Share-based compensation arrangement by share based payment award, expected term (in years)			4 years
35% of 2012 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based payment award, expected volatility rate			35.00%
Share based payment award, weighted average risk-free rate of return			0.43%
Common stock options awarded, dividend yield			8.60%
Percentage of performance award grant in period			35.00%
Share-based compensation arrangement by share based payment award, expected term (in years)			5 years
Percentage of performance award to be earned of shareholder return reaches shareholder limit			100.00%
35% of 2012 Performance Awards [Member] \| If any shares are earned from this award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation award vesting rights			Vest in equal annual amounts on January 1, 2015, 2016 and 2017
35% of 2012 Performance Awards [Member] \| Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned			35.00%
35% of 2012 Performance Awards [Member] \| Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned			27.00%
Remaining % of 2012 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based payment award, expected volatility rate			35.00%
Share based payment award, weighted average risk-free rate of return			0.43%
Common stock options awarded, dividend yield			8.60%
Share-based compensation arrangement by share based payment award, expected term (in years)			5 years
Percentage of performance award to be earned of shareholder return reaches shareholder limit			100.00%
Percentage of shareholder return to be earned			6.00%
Remaining % of 2012 Performance Awards [Member] \| If any shares are earned from this award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation award vesting rights			Vest in equal annual amounts on January 1, 2015, 2016 and 2017
2013 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of performance awards earned and vested	80,293	68,086
Number of performance awards to be earned	624,187
2012 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of performance awards earned and vested	84,190	84,188	84,188
Number of performance awards to be earned	641,476
Number of performance awards forfeited		2,599	5,718

Stock Awards - Restricted Equity Awards Activity (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013
Vesting Based on Service [Member]
Employee Restricted Equity Awards Vesting Activity [Line Items]
Nonvested awards at beginning of the year, Shares	325,999	466,883
Awarded, Shares	424,366	240,425
Vested, Shares	(298,102)	(381,309)
Nonvested awards at end of year, Shares	452,263	325,999
Nonvested awards at beginning of the year, Weighted Average Value at Award Date	$ 11.36	$ 10.72
Awarded, Weighted Average Value at Award Date	12.21	12.26
Vested, Weighted Average Value at Award Date	11.43	11.15
Nonvested awards at end of year, Weighted Average Value at Award Date	$ 12.11	$ 11.36
Vesting Based on Market/Performance Conditions [Member]
Employee Restricted Equity Awards Vesting Activity [Line Items]
Nonvested awards at beginning of the year, Shares	1,999,179	1,879,889
Awarded, Shares	903,134	754,255
Vested, Shares	(473,795)	(386,446)
Forfeited, Shares		(248,519)
Nonvested awards at end of year, Shares	2,428,518	1,999,179
Nonvested awards at beginning of the year, Weighted Average Value at Award Date	$ 5.44	$ 6.48
Awarded, Weighted Average Value at Award Date	7.57	6.13
Vested, Weighted Average Value at Award Date	7.60	8.27
Forfeited, Weighted Average Value at Award Date		11.03
Nonvested awards at end of year, Weighted Average Value at Award Date	$ 5.81	$ 5.44

Commitments and Contingencies - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Commitments and Contingencies Disclosure [Abstract]
Term of lease period	50 years or more
Lease and Rental Expenses	$ 2,321,790	$ 2,304,461	$ 2,195,835
Sublease rental income	192,098	$ 512,503	$ 492,095
Total amount to be received in the future from non-cancellable subleases	$ 86,500,000

Commitments and Contingencies - Fixed Minimum Rental Payments Due under Operating Leases with Non-Cancelable Terms (Detail) $ in Thousands	Dec. 31, 2014 USD ($)
Commitments and Contingencies Disclosure [Abstract]
2015	$ 3,415
2016	3,434
2017	3,443
2018	3,436
2019	3,055
Thereafter	84,759
Minimum rental payments, total	$ 101,542

Common Stock/Partner's Capital - Additional Information (Detail)				1 Months Ended	12 Months Ended
	Mar. 11, 2014 USD ($) shares	Aug. 20, 2013 USD ($) $ / shares shares	Feb. 28, 2013 USD ($) $ / shares shares	Jan. 31, 2014 USD ($)	Dec. 31, 2014 USD ($) Director Employee Partner $ / shares shares	Dec. 31, 2013 USD ($) shares	Dec. 31, 2012 USD ($)
Class of Stock [Line Items]
Common stock, issued \| shares					172,743,000	161,310,000
Net proceed from issuance of common stock					$ 138,173,000	$ 313,330,000	$ 233,048,000
Ownership interest in equity					100.00%
MPT Operating Partnership, L.P. [Member]
Class of Stock [Line Items]
Net proceed from issuance of common stock					$ 138,173,000	$ 313,330,000	$ 233,048,000
Percentage of ownership of general partner					100.00%
Ownership interest in equity					99.80%
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]
Common stock, issued \| shares	7,700,000	11,500,000	12,700,000
Net proceed from issuance of common stock	$ 100,200,000	$ 140,400,000	$ 172,900,000
Time granted to underwriters to purchase shares					30 days
Additional shares purchased by underwritters \| shares	1,200,000	1,500,000	1,700,000
Net proceeds from additional issuance of shares	$ 16,000,000
Public offering price for common stock per share \| $ / shares		$ 12.75	$ 14.25
Market Equity Offering Program [Member]
Class of Stock [Line Items]
Common stock, issued \| shares					1,700,000
Net proceed from issuance of common stock					$ 22,600,000
Sales commission percentage				1.25%
Market Equity Offering Program [Member] \| IPO [Member]
Class of Stock [Line Items]
Public offering price for common stock per share \| $ / shares					$ 13.56
Market Equity Offering Program [Member] \| Maximum [Member]
Class of Stock [Line Items]
Number of shares can be sold out				$ 250,000,000

Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Detail) - USD ($) $ in Thousands	Dec. 31, 2014	Dec. 31, 2013
Fair Value Disclosures [Abstract]
Interest and rent receivables, Book value	$ 41,137	$ 58,565
Loans, Book value	773,311	351,713
Debt, net Book value	(2,201,654)	(1,421,681)
Interest and rent receivables, Fair value	41,005	44,415
Loans, Fair value	803,824	358,383
Debt, net Fair value	$ (2,285,727)	$ (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	Dec. 31, 2014 USD ($)
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	$ 200,750
Cost	200,750
Fair Value Measurements, Recurring [Member] \| Acquisition loans [Member] \| Other loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	97,450
Cost	97,450
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 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 of Financial Instruments - Additional information (Detail)	12 Months Ended
	Dec. 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	12 Months Ended
	Dec. 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	$ (451)
- 100 basis points [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated Increase (Decrease) In Fair Value of Financial Instruments	$ 451

Discontinued Operations - Discontinued Operations (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended					12 Months Ended
	Mar. 31, 2014	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Discontinued Operations and Disposal Groups [Abstract]
Revenues							$ 988	$ 3,470
Gain on sale							7,659	16,369
Income (loss) from discontinued operations	$ (2)	$ 4,588	$ 312	$ 2,374	$ 640	$ (2)	$ 7,914	$ 17,207
Income from discontinued operations - diluted per share/unit							$ 0.05	$ 0.13

Other Assets - Summary of Other Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2014	Dec. 31, 2013
Other Assets [Abstract]
Debt issue costs, net	$ 35,324	$ 27,180
Other corporate assets	28,197	20,337
Prepaids and other assets	58,584	20,356
Total other assets	$ 122,105	$ 67,873

Other Assets - Additional Information (Detail) $ in Millions	Dec. 31, 2014 USD ($)
Monroe Properties [Member]
Other Assets [Line Items]
Lease inducements to tenants	$ 5

Quarterly Financial Data (Unaudited) - Unaudited Quarterly Financial Information (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Quarterly Financial Information [Line Items]
Revenues	$ 82,106	$ 80,777	$ 76,560	$ 73,089	$ 67,679	$ 60,106	$ 57,124	$ 57,614	$ 312,532	$ 242,523	$ 198,125
Income (loss) from continuing operations	15,029	28,663	(203)	7,309	13,309	25,391	25,031	25,570	50,798	89,301	72,870
Income (loss) from discontinued operations				(2)	4,588	312	2,374	640	(2)	7,914	17,207
Net income	15,029	28,663	(203)	7,307	17,897	25,703	27,405	26,210	50,796	97,215	90,077
Net income attributable to MPT common stockholders	$ 14,947	$ 28,537	$ (203)	$ 7,241	$ 17,839	$ 25,648	$ 27,348	$ 26,156	$ 50,522	$ 96,991	$ 89,900
Net income attributable to MPT common stockholders per share - basic	$ 0.08	$ 0.16		$ 0.04	$ 0.11	$ 0.16	$ 0.18	$ 0.19	$ 0.29	$ 0.64	$ 0.67
Weighted average shares outstanding - basic	172,411	171,893	171,718	163,973	161,143	154,758	149,509	140,347	169,999	151,439	132,331
Net income attributable to MPT common stockholders per share - diluted	$ 0.08	$ 0.16		$ 0.04	$ 0.11	$ 0.16	$ 0.18	$ 0.18	$ 0.29	$ 0.63	$ 0.67
Weighted average shares outstanding - diluted	172,604	172,639	171,718	164,549	161,840	155,969	151,056	141,526	170,540	152,598	132,333
MPT Operating Partnership, L.P. [Member]
Quarterly Financial Information [Line Items]
Revenues	$ 82,106	$ 80,777	$ 76,560	$ 73,089	$ 67,679	$ 60,106	$ 57,124	$ 57,614	$ 312,532	$ 242,523	$ 198,125
Income (loss) from continuing operations	15,029	28,663	(203)	7,309	13,309	25,391	25,031	25,570	50,798	89,301	72,870
Income (loss) from discontinued operations				(2)	4,588	312	2,374	640	(2)	7,914	17,207
Net income	15,029	28,663	(203)	7,307	17,897	25,703	27,405	26,210	50,796	97,215	90,077
Net income attributable to MPT common stockholders	$ 14,948	$ 28,537	$ (203)	$ 7,241	$ 17,839	$ 25,648	$ 27,348	$ 26,156	$ 50,522	$ 96,991	$ 89,900
Net income attributable to MPT common stockholders per share - basic	$ 0.08	$ 0.16		$ 0.04	$ 0.11	$ 0.16	$ 0.18	$ 0.19	$ 0.29	$ 0.64	$ 0.67
Weighted average shares outstanding - basic	172,411	171,893	171,718	163,973	161,143	154,758	149,509	140,347	169,999	151,439	132,331
Net income attributable to MPT common stockholders per share - diluted	$ 0.08	$ 0.16		$ 0.04	$ 0.11	$ 0.16	$ 0.18	$ 0.18	$ 0.29	$ 0.63	$ 0.67
Weighted average shares outstanding - diluted	172,604	172,639	171,718	164,549	161,840	155,969	151,056	141,526	170,540	152,598	132,333

Subsequent Events - Additional Information (Detail) - Subsequent Event [Member] shares in Millions, $ in Millions	Jan. 14, 2015 USD ($) shares
Subsequent Event [Line Items]
Shares issued	34.5
Number of shares that can be called in by option exercises	4.5
Proceeds from issuance of shares \| $	$ 480

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

12 Months Ended

Dec. 31, 2014

Dec. 31, 2013

Dec. 31, 2012

Valuation and Qualifying Accounts [Abstract]

Balance at Beginning of Year

^[1]

$ 41,573

$ 34,769

$ 32,618

Additions charged against operations

^[1]

65,512

^[2]

9,397

^[3]

4,540

^[4]

Deductions,Net recoveries/write offs

^[1]

(86,956)

^[5]

(2,593)

(2,389)

Balance at end of year

^[1]

$ 20,129

$ 41,573

$ 34,769

[1]	Includes allowance for doubtful accounts, straight-line rent reserves, allowance for loan losses, tax valuation allowances and other reserves.
[2]	Includes the $47 million of impairment charges related to the Monroe property, $9.5 million of rent and interest reserves primarily related to the Monroe property (prior to change in operators - see note 3 to Item 8 of the Form 10-K for further details), and approximately $9 million increase in the valuation allowance to fully reserve our net deferred tax assets.
[3]	Includes $4.8 million and $2.7 million in rent and interest reserves, respectively, related to our Monroe properties along with $1.9 million to fully reserve for the net deferred tax asset of certain German subsidiaries.
[4]	Includes $1.6 million and $2.9 million in rent and interest reserves, respectively, related to our Monroe properties.
[5]	Writeoffs of loans and other receivables, related to the Monroe facility due to change in operators.

Schedule II - Schedule of Valuation and Qualifying Accounts (Parenthetical) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Impairment charges	$ 50,128
Monroe Properties [Member]
Rent & interest reserves		$ 4,800	$ 1,600
Interest reserves		2,700	$ 2,900
Germany [Member]
Full reserve for net deferred tax asset		$ 1,900
Monroe Properties [Member]
Impairment charges	47,000
Rent & interest reserves	9,500
Increase in valuation allowance	$ 9,000

Schedule III - Real Estate Investments and Accumulated Depreciation (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 49,878
Initial costs, land	184,596
Initial costs, buildings	1,809,242
Additions subsequent to acquisition, Improvements	20,910
Additions subsequent to acquisition, carrying costs	25,979
Land at cost	192,551
Buildings at cost	1,848,176
Total at cost	2,040,727	$ 1,733,194	$ 1,189,552	$ 1,191,096
Accumulated Depreciation	$ 181,441	$ 144,235	$ 114,399	$ 93,430
Baden-Wurttemburg, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 382
Initial costs, buildings	13,806
Additions subsequent to acquisition, Improvements	250
Land at cost	382
Buildings at cost	14,056
Total at cost	14,438
Accumulated Depreciation	$ 29
Date of Construction	1988
Date Acquired	Dec. 11, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Saxony, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 600
Initial costs, buildings	16,644
Land at cost	600
Buildings at cost	16,644
Total at cost	17,244
Accumulated Depreciation	$ 451
Date of Construction	1995
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Rhineland-Pflaz, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 6,498
Initial costs, buildings	17,942
Land at cost	6,498
Buildings at cost	17,942
Total at cost	24,440
Accumulated Depreciation	$ 486
Date of Construction	1930
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Brandenburg, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 386
Initial costs, buildings	19,908
Land at cost	386
Buildings at cost	19,908
Total at cost	20,294
Accumulated Depreciation	$ 539
Date of Construction	1994
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Hesse, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,428
Initial costs, buildings	16,488
Land at cost	3,428
Buildings at cost	16,488
Total at cost	19,916
Accumulated Depreciation	$ 447
Date of Construction	1977
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Bavaria Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,455
Initial costs, buildings	10,352
Additions subsequent to acquisition, Improvements	216
Land at cost	2,455
Buildings at cost	10,568
Total at cost	13,023
Accumulated Depreciation	$ 22
Date of Construction	1974
Date Acquired	Nov. 19, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Thuringia Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,788
Initial costs, buildings	37,772
Land at cost	1,788
Buildings at cost	37,772
Total at cost	39,560
Accumulated Depreciation	$ 157
Date of Construction	1954
Date Acquired	Nov. 05, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Bath, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,232
Initial costs, buildings	36,614
Land at cost	3,232
Buildings at cost	36,614
Total at cost	39,846
Accumulated Depreciation	$ 458
Date of Construction	2008
Date Acquired	Jul. 01, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,757
Initial costs, buildings	56,238
Additions subsequent to acquisition, Improvements	(37)
Additions subsequent to acquisition, carrying costs	1,259
Land at cost	5,427
Buildings at cost	56,790
Total at cost	62,217
Accumulated Depreciation	$ 11,427
Date of Construction	2006
Date Acquired	Dec. 01, 2006
Life on which depreciation in latest income statements is computed (Years)	40 years
Allen TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,550
Initial costs, buildings	3,847
Land at cost	1,550
Buildings at cost	3,847
Total at cost	5,397
Accumulated Depreciation	$ 47
Date of Construction	2014
Date Acquired	Jul. 14, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
San Diego, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,550
Initial costs, buildings	15,653
Additions subsequent to acquisition, carrying costs	77
Land at cost	6,550
Buildings at cost	15,730
Total at cost	22,280
Accumulated Depreciation	$ 3,013
Date of Construction	1964
Date Acquired	May 09, 2007
Life on which depreciation in latest income statements is computed (Years)	40 years
Alvin TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 105
Initial costs, buildings	4,087
Land at cost	105
Buildings at cost	4,087
Total at cost	4,192
Accumulated Depreciation	$ 53
Date of Construction	2014
Date Acquired	Mar. 19, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Bayonne, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,003
Initial costs, buildings	51,495
Land at cost	2,003
Buildings at cost	51,495
Total at cost	53,498
Accumulated Depreciation	$ 10,084
Date of Construction	1918
Date Acquired	Feb. 04, 2011
Life on which depreciation in latest income statements is computed (Years)	20 years
Bennettsville, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 794
Initial costs, buildings	15,772
Land at cost	794
Buildings at cost	15,772
Total at cost	16,566
Accumulated Depreciation	$ 2,662
Date of Construction	1984
Date Acquired	Apr. 01, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
Bossier City, LA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 900
Initial costs, buildings	17,818
Land at cost	900
Buildings at cost	17,818
Total at cost	18,718
Accumulated Depreciation	$ 3,004
Date of Construction	1982
Date Acquired	Apr. 01, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
Bristol, CT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Wellness Center
Initial costs, land	$ 485
Initial costs, buildings	2,267
Land at cost	485
Buildings at cost	2,267
Total at cost	2,752
Accumulated Depreciation	$ 1,253
Date of Construction	1975
Date Acquired	Apr. 22, 2008
Life on which depreciation in latest income statements is computed (Years)	10 years
Austin TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,140
Initial costs, buildings	3,909
Land at cost	1,140
Buildings at cost	3,909
Total at cost	5,049
Accumulated Depreciation	$ 64
Date of Construction	2014
Date Acquired	May 29, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Broomfield, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 825
Initial costs, buildings	3,116
Land at cost	825
Buildings at cost	3,116
Total at cost	3,941
Accumulated Depreciation	$ 39
Date of Construction	2014
Date Acquired	Jul. 03, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Cedar Hill TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,122
Initial costs, buildings	3,583
Land at cost	1,122
Buildings at cost	3,583
Total at cost	4,705
Accumulated Depreciation	$ 50
Date of Construction	2014
Date Acquired	Jun. 23, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Spring, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,310
Initial costs, buildings	3,513
Land at cost	1,310
Buildings at cost	3,513
Total at cost	4,823
Accumulated Depreciation	$ 40
Date of Construction	2014
Date Acquired	Jul. 15, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Cheraw, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 657
Initial costs, buildings	19,576
Land at cost	657
Buildings at cost	19,576
Total at cost	20,233
Accumulated Depreciation	$ 3,303
Date of Construction	1982
Date Acquired	Apr. 01, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
Webster, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 663
Initial costs, buildings	33,751
Land at cost	663
Buildings at cost	33,751
Total at cost	34,414
Accumulated Depreciation	$ 3,375
Date of Construction	2004
Date Acquired	Dec. 21, 2010
Life on which depreciation in latest income statements is computed (Years)	40 years
Commerce City TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 707
Initial costs, buildings	3,518
Land at cost	707
Buildings at cost	3,518
Total at cost	4,225
Accumulated Depreciation	$ 6
Date of Construction	2014
Date Acquired	Dec. 11, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Corinth, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,288
Initial costs, buildings	21,175
Additions subsequent to acquisition, Improvements	313
Land at cost	1,601
Buildings at cost	21,175
Total at cost	22,776
Accumulated Depreciation	$ 2,120
Date of Construction	2008
Date Acquired	Jan. 31, 2011
Life on which depreciation in latest income statements is computed (Years)	40 years
Covington, LA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 821
Initial costs, buildings	10,238
Additions subsequent to acquisition, carrying costs	14
Land at cost	821
Buildings at cost	10,252
Total at cost	11,073
Accumulated Depreciation	$ 2,456
Date of Construction	1984
Date Acquired	Jun. 09, 2005
Life on which depreciation in latest income statements is computed (Years)	40 years
Dallas, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,000
Initial costs, buildings	13,589
Additions subsequent to acquisition, carrying costs	368
Land at cost	1,421
Buildings at cost	13,536
Total at cost	14,957
Accumulated Depreciation	$ 2,820
Date of Construction	2006
Date Acquired	Sep. 05, 2006
Life on which depreciation in latest income statements is computed (Years)	40 years
DeSoto, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,067
Initial costs, buildings	10,701
Additions subsequent to acquisition, Improvements	86
Additions subsequent to acquisition, carrying costs	8
Land at cost	1,161
Buildings at cost	10,701
Total at cost	11,862
Accumulated Depreciation	$ 929
Date of Construction	2008
Date Acquired	Jul. 18, 2011
Life on which depreciation in latest income statements is computed (Years)	40 years
Detroit, MI [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,220
Initial costs, buildings	8,687
Additions subsequent to acquisition, carrying costs	(365)
Land at cost	1,220
Buildings at cost	8,322
Total at cost	9,542
Accumulated Depreciation	$ 1,449
Date of Construction	1956
Date Acquired	May 22, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
Dulles TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,076
Initial costs, buildings	3,384
Land at cost	1,076
Buildings at cost	3,384
Total at cost	4,460
Accumulated Depreciation	$ 28
Date of Construction	2014
Date Acquired	Sep. 12, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Enfield, CT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Wellness Center
Initial costs, land	$ 384
Initial costs, buildings	2,257
Land at cost	384
Buildings at cost	2,257
Total at cost	2,641
Accumulated Depreciation	$ 1,248
Date of Construction	1974
Date Acquired	Apr. 22, 2008
Life on which depreciation in latest income statements is computed (Years)	10 years
East Providence, RI [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Wellness Center
Initial costs, land	$ 209
Initial costs, buildings	1,265
Land at cost	209
Buildings at cost	1,265
Total at cost	1,474
Accumulated Depreciation	$ 701
Date of Construction	1979
Date Acquired	Apr. 22, 2008
Life on which depreciation in latest income statements is computed (Years)	10 years
Fairmont CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,000
Initial costs, buildings	12,301
Additions subsequent to acquisition, Improvements	277
Land at cost	1,277
Buildings at cost	12,301
Total at cost	13,578
Accumulated Depreciation	$ 95
Date of Construction	1939
Date Acquired	Sep. 19, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Firestone TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 495
Initial costs, buildings	3,951
Land at cost	495
Buildings at cost	3,951
Total at cost	4,446
Accumulated Depreciation	$ 58
Date of Construction	2014
Date Acquired	Jun. 06, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Florence, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 900
Initial costs, buildings	28,462
Land at cost	900
Buildings at cost	28,462
Total at cost	29,362
Accumulated Depreciation	$ 1,947
Date of Construction	2012
Date Acquired	Nov. 04, 2010
Life on which depreciation in latest income statements is computed (Years)	40 years
Fort Lauderdale, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,499
Initial costs, buildings	21,939
Additions subsequent to acquisition, carrying costs	1
Land at cost	3,499
Buildings at cost	21,940
Total at cost	25,439
Accumulated Depreciation	$ 3,664
Date of Construction	1985
Date Acquired	Apr. 22, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
Fountain, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,508
Initial costs, buildings	4,020
Land at cost	1,508
Buildings at cost	4,020
Total at cost	5,528
Accumulated Depreciation	$ 42
Date of Construction	2014
Date Acquired	Jul. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Frisco TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,500
Initial costs, buildings	3,863
Land at cost	1,500
Buildings at cost	3,863
Total at cost	5,363
Accumulated Depreciation	$ 52
Date of Construction	2014
Date Acquired	Jun. 13, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Garden Grove, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,502
Initial costs, buildings	10,748
Additions subsequent to acquisition, carrying costs	51
Land at cost	5,502
Buildings at cost	10,799
Total at cost	16,301
Accumulated Depreciation	$ 1,655
Date of Construction	1982
Date Acquired	Nov. 25, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
Garden Grove, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Medical Office Building
Initial costs, land	$ 862
Initial costs, buildings	7,888
Additions subsequent to acquisition, carrying costs	28
Land at cost	862
Buildings at cost	7,916
Total at cost	8,778
Accumulated Depreciation	$ 1,206
Date of Construction	1982
Date Acquired	Nov. 25, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
Gilbert, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 150
Initial costs, buildings	15,553
Land at cost	150
Buildings at cost	15,553
Total at cost	15,703
Accumulated Depreciation	$ 1,555
Date of Construction	2005
Date Acquired	Jan. 04, 2011
Life on which depreciation in latest income statements is computed (Years)	40 years
Hammond LA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 519
Initial costs, buildings	8,941
Land at cost	519
Buildings at cost	8,941
Total at cost	9,460
Accumulated Depreciation	$ 466
Date of Construction	2003
Date Acquired	Dec. 14, 2012
Life on which depreciation in latest income statements is computed (Years)	40 years
Hausman, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,500
Initial costs, buildings	8,958
Land at cost	1,500
Buildings at cost	8,958
Total at cost	10,458
Accumulated Depreciation	$ 386
Date of Construction	2013
Date Acquired	Mar. 01, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Hill County, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,120
Initial costs, buildings	17,882
Land at cost	1,120
Buildings at cost	17,882
Total at cost	19,002
Accumulated Depreciation	$ 5,095
Date of Construction	1980
Date Acquired	Sep. 17, 2010
Life on which depreciation in latest income statements is computed (Years)	40 years
Hoboken, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,387
Initial costs, buildings	44,351
Land at cost	1,387
Buildings at cost	44,351
Total at cost	45,738
Accumulated Depreciation	$ 6,951
Date of Construction	1863
Date Acquired	Nov. 04, 2011
Life on which depreciation in latest income statements is computed (Years)	20 years
Idaho Falls, ID [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,822
Initial costs, buildings	37,467
Additions subsequent to acquisition, carrying costs	4,665
Land at cost	1,822
Buildings at cost	42,132
Total at cost	43,954
Accumulated Depreciation	$ 6,971
Date of Construction	2002
Date Acquired	Apr. 01, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
Lafayette, IN [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 800
Initial costs, buildings	14,968
Additions subsequent to acquisition, Improvements	(25)
Land at cost	800
Buildings at cost	14,943
Total at cost	15,743
Accumulated Depreciation	$ 702
Date of Construction	2013
Date Acquired	Feb. 01, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Little Elm, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,241
Initial costs, buildings	3,491
Land at cost	1,241
Buildings at cost	3,491
Total at cost	4,732
Accumulated Depreciation	$ 91
Date of Construction	2013
Date Acquired	Dec. 01, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Luling, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 811
Initial costs, buildings	9,345
Land at cost	811
Buildings at cost	9,345
Total at cost	10,156
Accumulated Depreciation	$ 1,889
Date of Construction	2002
Date Acquired	Dec. 01, 2006
Life on which depreciation in latest income statements is computed (Years)	40 years
Mesa - AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,900
Initial costs, buildings	97,980
Additions subsequent to acquisition, Improvements	2,242
Land at cost	7,142
Buildings at cost	97,980
Total at cost	105,122
Accumulated Depreciation	$ 3,249
Date of Construction	2007
Date Acquired	Sep. 26, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Bloomington, IN
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,392
Initial costs, buildings	28,212
Additions subsequent to acquisition, Improvements	5,000
Additions subsequent to acquisition, carrying costs	408
Land at cost	2,392
Buildings at cost	33,620
Total at cost	36,012
Accumulated Depreciation	$ 6,599
Date of Construction	2006
Date Acquired	Aug. 08, 2006
Life on which depreciation in latest income statements is computed (Years)	40 years
Montclair NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,900
Initial costs, buildings	99,632
Additions subsequent to acquisition, Improvements	585
Land at cost	8,485
Buildings at cost	99,632
Total at cost	108,117
Accumulated Depreciation	$ 1,897
Date of Construction	1920
Date Acquired	Apr. 01, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 351
Initial costs, buildings	3,952
Land at cost	351
Buildings at cost	3,952
Total at cost	4,303
Accumulated Depreciation	$ 73
Date of Construction	2014
Date Acquired	Jan. 01, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
New Braunfels, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,100
Initial costs, buildings	7,883
Land at cost	1,100
Buildings at cost	7,883
Total at cost	8,983
Accumulated Depreciation	$ 640
Date of Construction	2007
Date Acquired	Sep. 30, 2011
Life on which depreciation in latest income statements is computed (Years)	40 years
Newington, CT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Wellness Center
Initial costs, land	$ 270
Initial costs, buildings	1,615
Land at cost	270
Buildings at cost	1,615
Total at cost	1,885
Accumulated Depreciation	$ 894
Date of Construction	1979
Date Acquired	Apr. 22, 2008
Life on which depreciation in latest income statements is computed (Years)	10 years
Shenandoah, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,033
Initial costs, buildings	21,943
Land at cost	2,033
Buildings at cost	21,943
Total at cost	23,976
Accumulated Depreciation	$ 2,469
Date of Construction	2008
Date Acquired	Jun. 17, 2010
Life on which depreciation in latest income statements is computed (Years)	40 years
Colorado Springs CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 600
Initial costs, buildings	4,222
Land at cost	600
Buildings at cost	4,222
Total at cost	4,822
Accumulated Depreciation	$ 62
Date of Construction	2014
Date Acquired	Jun. 05, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Northland, MO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 834
Initial costs, buildings	17,182
Land at cost	834
Buildings at cost	17,182
Total at cost	18,016
Accumulated Depreciation	$ 1,683
Date of Construction	2007
Date Acquired	Feb. 14, 2011
Life on which depreciation in latest income statements is computed (Years)	40 years
Altoona, WI [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, buildings	$ 27,650
Buildings at cost	27,650
Total at cost	27,650
Accumulated Depreciation	$ 241
Date of Construction	2014
Date Acquired	Aug. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Ogden UT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,759
Initial costs, buildings	16,414
Land at cost	1,759
Buildings at cost	16,414
Total at cost	18,173
Accumulated Depreciation	$ 328
Date of Construction	2014
Date Acquired	Mar. 01, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Overlook, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,452
Initial costs, buildings	9,666
Additions subsequent to acquisition, Improvements	7
Land at cost	2,452
Buildings at cost	9,673
Total at cost	12,125
Accumulated Depreciation	$ 440
Date of Construction	2012
Date Acquired	Feb. 01, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Pearland, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,075
Initial costs, buildings	3,272
Land at cost	1,075
Buildings at cost	3,272
Total at cost	4,347
Accumulated Depreciation	$ 27
Date of Construction	2014
Date Acquired	Sep. 08, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Petersburg, VA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,302
Initial costs, buildings	9,121
Land at cost	1,302
Buildings at cost	9,121
Total at cost	10,423
Accumulated Depreciation	$ 1,482
Date of Construction	2006
Date Acquired	Jul. 01, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
Poplar Bluff, MO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,659
Initial costs, buildings	38,694
Additions subsequent to acquisition, carrying costs	1
Land at cost	2,660
Buildings at cost	38,694
Total at cost	41,354
Accumulated Depreciation	$ 6,462
Date of Construction	1980
Date Acquired	Apr. 22, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
Port Arthur, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,000
Initial costs, buildings	72,341
Additions subsequent to acquisition, Improvements	1,062
Land at cost	4,062
Buildings at cost	72,341
Total at cost	76,403
Accumulated Depreciation	$ 2,349
Date of Construction	2005
Date Acquired	Sep. 26, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Portland, OR [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 3,085
Initial costs, buildings	17,859
Additions subsequent to acquisition, carrying costs	2,559
Land at cost	3,071
Buildings at cost	20,432
Total at cost	23,503
Accumulated Depreciation	$ 3,869
Date of Construction	1964
Date Acquired	Apr. 18, 2007
Life on which depreciation in latest income statements is computed (Years)	40 years
Post Falls, ID [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 417
Initial costs, buildings	12,175
Additions subsequent to acquisition, Improvements	1,905
Land at cost	767
Buildings at cost	13,730
Total at cost	14,497
Accumulated Depreciation	$ 352
Date of Construction	2013
Date Acquired	Dec. 31, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Redding, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, buildings	$ 19,952
Additions subsequent to acquisition, carrying costs	4,361
Land at cost	1,629
Buildings at cost	22,684
Total at cost	24,313
Accumulated Depreciation	$ 5,189
Date of Construction	1991
Date Acquired	Jun. 30, 2005
Life on which depreciation in latest income statements is computed (Years)	40 years
Richardson, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,219
Initial costs, buildings	17,419
Land at cost	2,219
Buildings at cost	17,419
Total at cost	19,638
Accumulated Depreciation	$ 1,960
Date of Construction	2008
Date Acquired	Jun. 17, 2010
Life on which depreciation in latest income statements is computed (Years)	40 years
Addison, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,013
Initial costs, buildings	22,531
Land at cost	2,013
Buildings at cost	22,531
Total at cost	24,544
Accumulated Depreciation	$ 2,535
Date of Construction	2008
Date Acquired	Jun. 17, 2010
Life on which depreciation in latest income statements is computed (Years)	40 years
San Dimas, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Medical Office Building
Initial costs, land	$ 1,915
Initial costs, buildings	5,085
Additions subsequent to acquisition, carrying costs	18
Land at cost	1,915
Buildings at cost	5,103
Total at cost	7,018
Accumulated Depreciation	$ 778
Date of Construction	1979
Date Acquired	Nov. 25, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
Sherman TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,491
Initial costs, buildings	24,802
Land at cost	4,491
Buildings at cost	24,802
Total at cost	29,293
Accumulated Depreciation	$ 109
Date of Construction	1913
Date Acquired	Oct. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Sienna, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 999
Initial costs, buildings	3,562
Land at cost	999
Buildings at cost	3,562
Total at cost	4,561
Accumulated Depreciation	$ 37
Date of Construction	2014
Date Acquired	Aug. 20, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Spartanburg, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,135
Initial costs, buildings	15,717
Land at cost	1,135
Buildings at cost	15,717
Total at cost	16,852
Accumulated Depreciation	$ 538
Date of Construction	2013
Date Acquired	Aug. 01, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Thornton CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,350
Initial costs, buildings	3,793
Land at cost	1,350
Buildings at cost	3,793
Total at cost	5,143
Accumulated Depreciation	$ 32
Date of Construction	2014
Date Acquired	Aug. 29, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Tomball, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,299
Initial costs, buildings	23,982
Land at cost	1,299
Buildings at cost	23,982
Total at cost	25,281
Accumulated Depreciation	$ 2,398
Date of Construction	2005
Date Acquired	Dec. 21, 2010
Life on which depreciation in latest income statements is computed (Years)	40 years
Victoria, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 625
Initial costs, buildings	7,197
Land at cost	625
Buildings at cost	7,197
Total at cost	7,822
Accumulated Depreciation	$ 1,454
Date of Construction	1998
Date Acquired	Dec. 01, 2006
Life on which depreciation in latest income statements is computed (Years)	40 years
Anaheim, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,875
Initial costs, buildings	21,814
Additions subsequent to acquisition, carrying costs	10
Land at cost	1,875
Buildings at cost	21,824
Total at cost	23,699
Accumulated Depreciation	$ 4,455
Date of Construction	1964
Date Acquired	Nov. 08, 2006
Life on which depreciation in latest income statements is computed (Years)	40 years
Warwick, RI [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Wellness Center
Initial costs, land	$ 1,265
Initial costs, buildings	759
Land at cost	1,265
Buildings at cost	759
Total at cost	2,024
Accumulated Depreciation	$ 420
Date of Construction	1979
Date Acquired	Apr. 22, 2008
Life on which depreciation in latest income statements is computed (Years)	10 years
West Monroe, LA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,000
Initial costs, buildings	69,433
Additions subsequent to acquisition, Improvements	552
Land at cost	12,552
Buildings at cost	69,433
Total at cost	81,985
Accumulated Depreciation	$ 2,216
Date of Construction	1962
Date Acquired	Sep. 26, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,248
Initial costs, buildings	5,880
Land at cost	2,248
Buildings at cost	5,880
Total at cost	8,128
Accumulated Depreciation	$ 314
Date of Construction	2012
Date Acquired	Oct. 14, 2011
Life on which depreciation in latest income statements is computed (Years)	40 years
West Valley City, UT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,516
Initial costs, buildings	58,314
Land at cost	5,516
Buildings at cost	58,314
Total at cost	63,830
Accumulated Depreciation	$ 9,738
Date of Construction	1980
Date Acquired	Apr. 22, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
Wichita, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 8,678
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,019
Initial costs, buildings	18,373
Additions subsequent to acquisition, carrying costs	1
Land at cost	1,019
Buildings at cost	18,374
Total at cost	19,393
Accumulated Depreciation	$ 3,100
Date of Construction	1992
Date Acquired	Apr. 04, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
West Springfield, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Wellness Center
Initial costs, land	$ 583
Initial costs, buildings	3,185
Land at cost	583
Buildings at cost	3,185
Total at cost	3,768
Accumulated Depreciation	$ 1,765
Date of Construction	1976
Date Acquired	Apr. 22, 2008
Life on which depreciation in latest income statements is computed (Years)	10 years
1994 [Member] \| Baden-Wurttemburg, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, buildings	$ 10,536
Buildings at cost	10,536
Total at cost	10,536
Accumulated Depreciation	$ 285
Date of Construction	1994
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1996 [Member] \| Saxony, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 415
Initial costs, buildings	22,849
Land at cost	415
Buildings at cost	22,849
Total at cost	23,264
Accumulated Depreciation	$ 619
Date of Construction	1996
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1960 [Member] \| Rhineland-Pflaz, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,536
Initial costs, buildings	16,716
Land at cost	3,536
Buildings at cost	16,716
Total at cost	20,252
Accumulated Depreciation	$ 453
Date of Construction	1960
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1960 [Member] \| Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,501
Initial costs, buildings	34,530
Additions subsequent to acquisition, Improvements	8,477
Additions subsequent to acquisition, carrying costs	12,468
Land at cost	3,274
Buildings at cost	55,702
Total at cost	58,976
Accumulated Depreciation	$ 6,432
Date of Construction	1960
Date Acquired	Aug. 10, 2007
Life on which depreciation in latest income statements is computed (Years)	40 years
1960 [Member] \| Sherman TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,491
Initial costs, buildings	24,802
Land at cost	4,491
Buildings at cost	24,802
Total at cost	29,293
Accumulated Depreciation	$ 109
Date of Construction	1960
Date Acquired	Oct. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] \| Hesse, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 102
Initial costs, buildings	5,832
Land at cost	102
Buildings at cost	5,832
Total at cost	5,934
Accumulated Depreciation	$ 158
Date of Construction	1981
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1992 [Member] \| Rhineland-Pflaz, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, buildings	$ 33,081
Buildings at cost	33,081
Total at cost	33,081
Accumulated Depreciation	$ 896
Date of Construction	1992
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1992 [Member] \| Thuringia Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,788
Initial costs, buildings	37,772
Land at cost	1,788
Buildings at cost	37,772
Total at cost	39,560
Accumulated Depreciation	$ 157
Date of Construction	1992
Date Acquired	Nov. 05, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1904 [Member] \| Saxony, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 600
Initial costs, buildings	16,644
Land at cost	600
Buildings at cost	16,644
Total at cost	17,244
Accumulated Depreciation	$ 451
Date of Construction	1904
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] \| Rhineland-Pflaz, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 811
Initial costs, buildings	7,290
Land at cost	811
Buildings at cost	7,290
Total at cost	8,101
Accumulated Depreciation	$ 197
Date of Construction	1980
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Nineteen Eighty Six [Member] \| Baden-Wurttemburg, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,809
Initial costs, buildings	6,490
Land at cost	3,809
Buildings at cost	6,490
Total at cost	10,299
Accumulated Depreciation	$ 176
Date of Construction	1986
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1995 [Member] \| Baden-Wurttemburg, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 382
Initial costs, buildings	13,806
Additions subsequent to acquisition, Improvements	250
Land at cost	382
Buildings at cost	14,056
Total at cost	14,438
Accumulated Depreciation	$ 29
Date of Construction	1995
Date Acquired	Dec. 11, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2009 [Member] \| Bath, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,232
Initial costs, buildings	36,614
Land at cost	3,232
Buildings at cost	36,614
Total at cost	39,846
Accumulated Depreciation	$ 458
Date of Construction	2009
Date Acquired	Jul. 01, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1973 [Member] \| San Diego, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,663
Initial costs, buildings	52,432
Land at cost	12,663
Buildings at cost	52,432
Total at cost	65,095
Accumulated Depreciation	$ 5,134
Date of Construction	1973
Date Acquired	Feb. 09, 2011
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] \| Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,345
Initial costs, buildings	3,668
Land at cost	1,345
Buildings at cost	3,668
Total at cost	5,013
Accumulated Depreciation	$ 53
Date of Construction	2014
Date Acquired	Jun. 20, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1972 [Member] \| Fairmont CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,000
Initial costs, buildings	12,301
Additions subsequent to acquisition, Improvements	277
Land at cost	1,277
Buildings at cost	12,301
Total at cost	13,578
Accumulated Depreciation	$ 95
Date of Construction	1972
Date Acquired	Sep. 19, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1972 [Member] \| San Dimas, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,160
Initial costs, buildings	6,839
Additions subsequent to acquisition, carrying costs	34
Land at cost	6,160
Buildings at cost	6,873
Total at cost	13,033
Accumulated Depreciation	$ 1,046
Date of Construction	1972
Date Acquired	Nov. 25, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1985 [Member] \| Fairmont CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,000
Initial costs, buildings	12,301
Additions subsequent to acquisition, Improvements	277
Land at cost	1,277
Buildings at cost	12,301
Total at cost	13,578
Accumulated Depreciation	$ 95
Date of Construction	1985
Date Acquired	Sep. 19, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2000 [Member] \| Montclair NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,900
Initial costs, buildings	99,632
Additions subsequent to acquisition, Improvements	585
Land at cost	8,485
Buildings at cost	99,632
Total at cost	108,117
Accumulated Depreciation	$ 1,897
Date of Construction	2000
Date Acquired	Apr. 01, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1974 [Member] \| Redding, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,555
Initial costs, buildings	53,863
Additions subsequent to acquisition, carrying costs	13
Land at cost	1,555
Buildings at cost	53,876
Total at cost	55,431
Accumulated Depreciation	$ 9,999
Date of Construction	1974
Date Acquired	Aug. 10, 2007
Life on which depreciation in latest income statements is computed (Years)	40 years
2010 [Member] \| Sherman TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,491
Initial costs, buildings	24,802
Land at cost	4,491
Buildings at cost	24,802
Total at cost	29,293
Accumulated Depreciation	$ 109
Date of Construction	2010
Date Acquired	Oct. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2013 [Member] \| Victoria, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, buildings	$ 10,412
Buildings at cost	10,412
Total at cost	10,412
Accumulated Depreciation	$ 254
Date of Construction	2013
Date Acquired	Dec. 31, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Two Thousand And Six [Member] \| Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 41,200

Schedule III - Changes in Total Real Estate Assets Including Real Estate Held for Sale (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
SEC Schedule III, Real Estate and Accumulated Depreciation Disclosure [Abstract]
Balance at beginning of period	$ 1,733,194	$ 1,189,552	$ 1,191,096
Acquisitions	263,811	480,503	9,460
Transfers from construction in progress	41,772	81,347	37,174
Additions	84,831	7,749	19,971
Dispositions	(56,590)	(28,616)	(68,149)
Other	(26,291)	2,659
Balance at end of period	$ 2,040,727	$ 1,733,194	$ 1,189,552

Schedule III - Changes in Accumulated Depreciation Including Real Estate Assets Held for Sale (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
SEC Schedule III, Real Estate and Accumulated Depreciation Disclosure [Abstract]
Balance at beginning of period	$ 144,235	$ 114,399	$ 93,430
Depreciation	46,935	33,349	31,026
Depreciation on disposed property	(9,213)	(3,513)	(10,057)
Other	(516)
Balance at end of period	$ 181,441	$ 144,235	$ 114,399

Schedule IV - Schedule of Mortgage Loan on Real Estate (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2014 USD ($)
Mortgage Loans on Real Estate [Line Items]
Prior Liens	$ 0
Face Amount of Mortgages	397,500
Carrying Amount of Mortgages	397,500
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member]
Mortgage Loans on Real Estate [Line Items]
Periodic Payment Terms	Payable in monthly installments of interest plus principal payable in full at maturity
Long-Term First Mortgage Loan [Member] \| Ernest Mortgage Loan [Member]
Mortgage Loans on Real Estate [Line Items]
Interest rate	9.40%
Final Maturity Date	2032
Prior Liens	$ 0
Face Amount of Mortgages	100,000
Carrying Amount of Mortgages	100,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] \| Desert Valley Hospital [Member]
Mortgage Loans on Real Estate [Line Items]
Interest rate	10.90%
Final Maturity Date	2022
Prior Liens	$ 0
Face Amount of Mortgages	70,000
Carrying Amount of Mortgages	70,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] \| Desert Valley Hospital [Member]
Mortgage Loans on Real Estate [Line Items]
Interest rate	11.50%
Final Maturity Date	2022
Prior Liens	$ 0
Face Amount of Mortgages	20,000
Carrying Amount of Mortgages	20,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] \| Desert Valley Hospital [Member]
Mortgage Loans on Real Estate [Line Items]
Interest rate	11.50%
Final Maturity Date	2015
Prior Liens	$ 0
Face Amount of Mortgages	12,500
Carrying Amount of Mortgages	12,500
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] \| Chino Valley Medical Center [Member]
Mortgage Loans on Real Estate [Line Items]
Interest rate	10.90%
Final Maturity Date	2022
Prior Liens	$ 0
Face Amount of Mortgages	50,000
Carrying Amount of Mortgages	50,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] \| Paradise Valley Hospital [Member]
Mortgage Loans on Real Estate [Line Items]
Interest rate	10.40%
Final Maturity Date	2022
Prior Liens	$ 0
Face Amount of Mortgages	25,000
Carrying Amount of Mortgages	25,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] \| Centinela Hospital Medical Center [Member]
Mortgage Loans on Real Estate [Line Items]
Interest rate	10.80%
Final Maturity Date	2022
Prior Liens	$ 0
Face Amount of Mortgages	100,000
Carrying Amount of Mortgages	100,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] \| Olympia Medical Center [Member]
Mortgage Loans on Real Estate [Line Items]
Interest rate	11.00%
Final Maturity Date	2024
Prior Liens	$ 0
Face Amount of Mortgages	20,000
Carrying Amount of Mortgages	20,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0

Schedule IV - Schedule of Mortgage Loan on Real Estate (Parenthetical) (Detail) $ in Thousands	Dec. 31, 2014 USD ($) Property
Mortgage Loans on Real Estate [Line Items]
Carrying amount of mortgages, federal income tax purposes	$ 397,500
Unamortized loan issue costs	$ 100
Long-Term First Mortgage Loan [Member] \| Ernest Mortgage Loan [Member]
Mortgage Loans on Real Estate [Line Items]
Number of properties \| Property	4

Schedule IV - Changes in Mortgage Loans Excluding Unamortized Loan Issue Costs (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Mortgage Loans on Real Estate [Abstract]
Balance at beginning of year	$ 388,650	$ 368,650	$ 165,000
New mortgage loans and additional advances on existing loans	12,500	20,000	203,650
Mortgage loans on real estate including additions during year	401,150	388,650	368,650
Collection of principal	(3,650)
Deductions during year	(3,650)
Balance at end of year	$ 397,500	$ 388,650	$ 368,650