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Document and Entity Information - shares	9 Months Ended
Document and Entity Information - shares	Sep. 30, 2016	Nov. 07, 2016
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2016
Document Fiscal Year Focus	2016
Document Fiscal Period Focus	Q3
Trading Symbol	MPW
Entity Registrant Name	MEDICAL PROPERTIES TRUST INC
Entity Central Index Key	0001287865
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		320,247,632
MPT Operating Partnership, L.P. [Member]
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2016
Document Fiscal Year Focus	2016
Document Fiscal Period Focus	Q3
Entity Registrant Name	MPT OPERATING PARTNERSHIP, L.P.
Entity Central Index Key	0001524607
Current Fiscal Year End Date	--12-31
Entity Filer Category	Non-accelerated Filer

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Real estate assets
Land, buildings and improvements, intangible lease assets, and other	$ 3,652,215	$ 3,297,705
Net investment in direct financing leases	533,491	626,996
Mortgage loans	550,118	757,581
Gross investment in real estate assets	4,735,824	4,682,282
Accumulated depreciation and amortization	(301,262)	(257,928)
Net investment in real estate assets	4,434,562	4,424,354
Cash and cash equivalents	1,094,917	195,541
Interest and rent receivables	54,554	46,939
Straight-line rent receivables	103,413	82,155
Other loans	165,784	664,822
Other assets	242,107	195,540
Total Assets	6,095,337	5,609,351
Liabilities
Debt, net	2,728,549	3,322,541
Accounts payable and accrued expenses	149,190	137,356
Deferred revenue	24,528	29,358
Lease deposits and other obligations to tenants	27,104	12,831
Total Liabilities	2,929,371	3,502,086
Equity / Capital
Preferred stock, $0.001 par value. Authorized 10,000 shares; no shares outstanding
Common stock, $0.001 par value. Authorized 500,000 shares; issued and outstanding - 309,792 shares at September 30, 2016 and 236,744 shares at December 31, 2015	310	237
Limited Partners:
Additional paid in capital	3,623,673	2,593,827
Distributions in excess of net income	(402,632)	(418,650)
Accumulated other comprehensive loss	(60,036)	(72,884)
Treasury shares, at cost	(262)	(262)
Total Medical Properties Trust, Inc. Stockholders' Equity	3,161,053	2,102,268
Non-controlling interests	4,913	4,997
Total Equity / Capital	3,165,966	2,107,265
Total Liabilities and Equity / Capital	6,095,337	5,609,351
MPT Operating Partnership, L.P. [Member]
Real estate assets
Land, buildings and improvements, intangible lease assets, and other	3,652,215	3,297,705
Net investment in direct financing leases	533,491	626,996
Mortgage loans	550,118	757,581
Gross investment in real estate assets	4,735,824	4,682,282
Accumulated depreciation and amortization	(301,262)	(257,928)
Net investment in real estate assets	4,434,562	4,424,354
Cash and cash equivalents	1,094,917	195,541
Interest and rent receivables	54,554	46,939
Straight-line rent receivables	103,413	82,155
Other loans	165,784	664,822
Other assets	242,107	195,540
Total Assets	6,095,337	5,609,351
Liabilities
Debt, net	2,728,549	3,322,541
Accounts payable and accrued expenses	90,430	84,628
Deferred revenue	24,528	29,358
Lease deposits and other obligations to tenants	27,104	12,831
Payable due to Medical Properties Trust, Inc.	58,370	52,338
Total Liabilities	2,928,981	3,501,696
Limited Partners:
Accumulated other comprehensive loss	(60,036)	(72,884)
Total Medical Properties Trust, Inc. Stockholders' Equity	3,161,443	2,102,658
Non-controlling interests	4,913	4,997
Total Equity / Capital	3,166,356	2,107,655
Total Liabilities and Equity / Capital	6,095,337	5,609,351
MPT Operating Partnership, L.P. [Member] \| General Partner [Member]
Equity / Capital
General Partner - issued and outstanding - 3,095 units at September 30, 2016 and 2,363 units at December 31, 2015	32,235	21,773
MPT Operating Partnership, L.P. [Member] \| Common Units [Member]
Limited Partners:
Limited Partners Capital	$ 3,189,244	$ 2,153,769

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 2016	Dec. 31, 2015
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	500,000,000	500,000,000
Common stock, shares issued	309,792,000	236,744,000
Common stock, shares outstanding	309,792,000	236,744,000
MPT Operating Partnership, L.P. [Member] \| Common Units [Member]
Limited Partners, units issued	306,697,000	234,381,000
Limited Partners, units outstanding	306,697,000	234,381,000
General Partner [Member] \| MPT Operating Partnership, L.P. [Member]
General partner, units issued	3,095,000	2,363,000
General partner, units outstanding	3,095,000	2,363,000
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

Condensed Consolidated Statements of Net Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Revenues
Rent billed	$ 82,387	$ 70,358	$ 234,408	$ 177,351
Straight-line rent	9,741	5,023	26,509	15,003
Income from direct financing leases	14,678	14,692	47,181	40,055
Interest and fee income	19,749	24,497	79,756	77,924
Total revenues	126,555	114,570	387,854	310,333
Expenses
Real estate depreciation and amortization	23,876	20,016	67,850	49,728
Impairment charges	(80)		7,295
Property-related	(93)	1,727	1,592	2,608
Acquisition expenses	2,677	24,949	6,379	56,997
General and administrative	12,305	10,778	35,821	32,325
Total operating expenses	38,685	57,470	118,937	141,658
Operating income	87,870	57,100	268,917	168,675
Other income (expense)
Interest expense	(40,262)	(31,643)	(121,132)	(84,961)
Gain on sale of real estate and other asset dispositions, net	44,616	3,268	61,294	3,268
Unutilized financing fees / debt refinancing costs	(22,535)	(4,080)	(22,539)	(4,319)
Earnings (loss) from equity and other interests	1,245	476	(2,556)	2,432
Other income (expense)	99	(1,918)	(118)	(2,488)
Income tax expense	(490)	(80)	(1,173)	(1,018)
Net other expense	(17,327)	(33,977)	(86,224)	(87,086)
Income from continuing operations	70,543	23,123	182,693	81,589
Loss from discontinued operations			(1)
Net income	70,543	23,123	182,692	81,589
Net income attributable to non-controlling interests	(185)	(66)	(683)	(228)
Net income attributable to MPT common stockholders	$ 70,358	$ 23,057	$ 182,009	$ 81,361
Earnings per common share - basic
Income from continuing operations attributable to MPT common stockholders	$ 0.29	$ 0.10	$ 0.75	$ 0.38
Loss from discontinued operations attributable to MPT common stockholders	0	0	0	0
Net income attributable to MPT common stockholders	$ 0.29	$ 0.10	$ 0.75	$ 0.38
Weighted average shares outstanding - basic	246,230	223,948	240,607	211,659
Earnings per common share - diluted
Income from continuing operations attributable to MPT common stockholders	$ 0.28	$ 0.10	$ 0.75	$ 0.38
Loss from discontinued operations attributable to MPT common stockholders	0	0	0	0
Net income attributable to MPT common stockholders	$ 0.28	$ 0.10	$ 0.75	$ 0.38
Weighted average shares outstanding - diluted	247,468	223,948	241,432	212,068
Dividends declared per common share	$ 0.23	$ 0.22	$ 0.68	$ 0.66
MPT Operating Partnership, L.P. [Member]
Revenues
Rent billed	$ 82,387	$ 70,358	$ 234,408	$ 177,351
Straight-line rent	9,741	5,023	26,509	15,003
Income from direct financing leases	14,678	14,692	47,181	40,055
Interest and fee income	19,749	24,497	79,756	77,924
Total revenues	126,555	114,570	387,854	310,333
Expenses
Real estate depreciation and amortization	23,876	20,016	67,850	49,728
Impairment charges	(80)		7,295
Property-related	(93)	1,727	1,592	2,608
Acquisition expenses	2,677	24,949	6,379	56,997
General and administrative	12,305	10,778	35,821	32,325
Total operating expenses	38,685	57,470	118,937	141,658
Operating income	87,870	57,100	268,917	168,675
Other income (expense)
Interest expense	(40,262)	(31,643)	(121,132)	(84,961)
Gain on sale of real estate and other asset dispositions, net	44,616	3,268	61,294	3,268
Unutilized financing fees / debt refinancing costs	(22,535)	(4,080)	(22,539)	(4,319)
Earnings (loss) from equity and other interests	1,245	476	(2,556)	2,432
Other income (expense)	99	(1,918)	(118)	(2,488)
Income tax expense	(490)	(80)	(1,173)	(1,018)
Net other expense	(17,327)	(33,977)	(86,224)	(87,086)
Income from continuing operations	70,543	23,123	182,693	81,589
Loss from discontinued operations			(1)
Net income	70,543	23,123	182,692	81,589
Net income attributable to non-controlling interests	(185)	(66)	(683)	(228)
Net income attributable to MPT common stockholders	$ 70,358	$ 23,057	$ 182,009	$ 81,361
Earnings per common share - basic
Income from continuing operations attributable to MPT common stockholders	$ 0.29	$ 0.10	$ 0.75	$ 0.38
Loss from discontinued operations attributable to MPT common stockholders	0	0	0	0
Net income attributable to MPT common stockholders	$ 0.29	$ 0.10	$ 0.75	$ 0.38
Weighted average shares outstanding - basic	246,230	223,948	240,607	211,659
Earnings per common share - diluted
Income from continuing operations attributable to MPT common stockholders	$ 0.28	$ 0.10	$ 0.75	$ 0.38
Loss from discontinued operations attributable to MPT common stockholders	0	0	0	0
Net income attributable to MPT common stockholders	$ 0.28	$ 0.10	$ 0.75	$ 0.38
Weighted average shares outstanding - diluted	247,468	223,948	241,432	212,068
Dividends declared per common share	$ 0.23	$ 0.22	$ 0.68	$ 0.66

Condensed Consolidated Statements of Comprehensive Income (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Net income	$ 70,543	$ 23,123	$ 182,692	$ 81,589
Other comprehensive income:
Unrealized gain on interest rate swap	854	727	2,494	2,042
Foreign currency translation gain (loss)	4,450	(573)	10,354	(39,859)
Total comprehensive income	75,847	23,277	195,540	43,772
Comprehensive income attributable to non-controlling interests	(185)	(66)	(683)	(228)
Comprehensive income attributable to MPT common stockholders	75,662	23,211	194,857	43,544
MPT Operating Partnership, L.P. [Member]
Net income	70,543	23,123	182,692	81,589
Other comprehensive income:
Unrealized gain on interest rate swap	854	727	2,494	2,042
Foreign currency translation gain (loss)	4,450	(573)	10,354	(39,859)
Total comprehensive income	75,847	23,277	195,540	43,772
Comprehensive income attributable to non-controlling interests	(185)	(66)	(683)	(228)
Comprehensive income attributable to MPT common stockholders	$ 75,662	$ 23,211	$ 194,857	$ 43,544

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015
Operating activities
Net income	$ 182,692	$ 81,589
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	69,720	51,149
Straight-line rent revenue	(27,009)	(17,815)
Straight-line rent and other write-off	3,063	2,812
Impairment charges	7,295
Direct financing lease interest accretion	(6,757)	(5,286)
Share / (Unit)-based compensation expense	5,832	8,383
Gain from sale of real estate and other asset dispositions, net	(61,294)	(3,268)
Amortization and write-off of deferred financing costs and debt discount	5,799	4,293
Unutilized financing fees / debt refinancing costs	22,539	4,319
Other adjustments	(8,398)	(265)
Changes in:
Interest and rent receivable	(12,790)	(5,471)
Accounts payable and accrued expenses	(12,403)	11,744
Net cash provided by operating activities	168,289	132,184
Investing activities
Cash paid for acquisitions and other related investments	(213,100)	(2,020,198)
Net proceeds from sale of real estate	198,767	19,175
Principal received on loans receivable	804,809	698,040
Investment in loans receivable	(102,909)	(354,002)
Construction in progress and other	(139,336)	(115,700)
Investment in unsecured senior notes	(50,000)
Proceeds from sale of unsecured senior notes	50,000
Other investments, net	(52,701)	(9,803)
Net cash provided by (used for) investing activities	495,530	(1,782,488)
Financing activities
Revolving credit facilities, net	(1,100,000)	500,415
Proceeds from term debt	1,000,000	676,877
Payments of term debt	(515,221)	(210)
Distributions paid	(160,060)	(130,841)
Proceeds from sale of common shares / units, net of offering costs	1,024,088	817,533
Lease deposits and other obligations to tenants	13,784	(12,669)
Debt issuance costs paid and other financing activities	(31,317)	(7,950)
Net cash provided by financing activities	231,274	1,843,155
Increase in cash and cash equivalents for period	895,093	192,851
Effect of exchange rate changes	4,283	(5,157)
Cash and cash equivalents at beginning of period	195,541	144,541
Cash and cash equivalents at end of period	1,094,917	332,235
Interest paid	120,374	74,911
Supplemental schedule of non-cash investing activities:
Increase in development projects construction costs incurred, unpaid	17,458	83
Supplemental schedule of non-cash financing activities:
Distributions declared, unpaid	58,333	52,388
MPT Operating Partnership, L.P. [Member]
Operating activities
Net income	182,692	81,589
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	69,720	51,149
Straight-line rent revenue	(27,009)	(17,815)
Straight-line rent and other write-off	3,063	2,812
Impairment charges	7,295
Direct financing lease interest accretion	(6,757)	(5,286)
Share / (Unit)-based compensation expense	5,832	8,383
Gain from sale of real estate and other asset dispositions, net	(61,294)	(3,268)
Amortization and write-off of deferred financing costs and debt discount	5,799	4,293
Unutilized financing fees / debt refinancing costs	22,539	4,319
Other adjustments	(8,398)	(265)
Changes in:
Interest and rent receivable	(12,790)	(5,471)
Accounts payable and accrued expenses	(12,403)	11,744
Net cash provided by operating activities	168,289	132,184
Investing activities
Cash paid for acquisitions and other related investments	(213,100)	(2,020,198)
Net proceeds from sale of real estate	198,767	19,175
Principal received on loans receivable	804,809	698,040
Investment in loans receivable	(102,909)	(354,002)
Construction in progress and other	(139,336)	(115,700)
Investment in unsecured senior notes	(50,000)
Proceeds from sale of unsecured senior notes	50,000
Other investments, net	(52,701)	(9,803)
Net cash provided by (used for) investing activities	495,530	(1,782,488)
Financing activities
Revolving credit facilities, net	(1,100,000)	500,415
Proceeds from term debt	1,000,000	676,877
Payments of term debt	(515,221)	(210)
Distributions paid	(160,060)	(130,841)
Proceeds from sale of common shares / units, net of offering costs	1,024,088	817,533
Lease deposits and other obligations to tenants	13,784	(12,669)
Debt issuance costs paid and other financing activities	(31,317)	(7,950)
Net cash provided by financing activities	231,274	1,843,155
Increase in cash and cash equivalents for period	895,093	192,851
Effect of exchange rate changes	4,283	(5,157)
Cash and cash equivalents at beginning of period	195,541	144,541
Cash and cash equivalents at end of period	1,094,917	332,235
Interest paid	120,374	74,911
Supplemental schedule of non-cash investing activities:
Increase in development projects construction costs incurred, unpaid	17,458	83
Supplemental schedule of non-cash financing activities:
Distributions declared, unpaid	$ 58,333	$ 52,388

Organization	9 Months Ended
Organization	Sep. 30, 2016
Accounting Policies [Abstract]
Organization	1. Organization Medical Properties Trust, Inc., a Maryland corporation, was formed on August 27, 2003, under the Maryland General Corporation Law for the purpose of engaging in the business of investing in, owning, and leasing commercial real estate. Our operating partnership subsidiary, MPT Operating Partnership, L.P., (the “Operating Partnership”) through which we conduct all of our operations, was formed in September 2003. Through another wholly-owned subsidiary, Medical Properties Trust, LLC, we are the sole general partner of the Operating Partnership. At present, we directly own substantially all of the limited partnership interests in the Operating Partnership and have elected to report our required disclosures and that of the Operating Partnership on a combined basis except where material differences exist. We have operated as a real estate investment trust (“REIT”) since April 6, 2004, and accordingly, elected REIT status upon the filing in September 2005 of the calendar year 2004 federal income tax return. Accordingly, we will generally not be subject to federal income tax in the United States (“U.S.”), provided that we continue to qualify as a REIT and our distributions to our stockholders equal or exceed our taxable income. Certain activities we undertake must be conducted by entities which we elected to be treated as taxable REIT subsidiaries (“TRSs”). Our TRSs are subject to both U.S. federal and state income taxes. For our properties located outside the U.S., we are subject to local taxes; however, we do not expect to incur additional taxes in the U.S. as such income will flow through our REIT. 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 U.S. and Europe.

Summary of Significant Accounting Policies

9 Months Ended

Sep. 30, 2016

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

2. Summary of Significant Accounting Policies

Unaudited Interim Condensed Consolidated Financial Statements: The accompanying unaudited interim condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the U.S. for interim financial information, including rules and regulations of the Securities and Exchange Commission. Accordingly, they do not include all of the information and footnotes required by generally accepted accounting principles (“GAAP”) for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair presentation have been included. Operating results for the three and nine month periods ended September 30, 2016, are not necessarily indicative of the results that may be expected for the year ending December 31, 2016. The condensed consolidated balance sheet at December 31, 2015 has been derived from the audited financial statements at that date but does not include all of the information and footnotes required by accounting principles generally accepted in the U.S. for complete financial statements.

For information about significant accounting policies, refer to the consolidated financial statements and footnotes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2015. During the nine months ended September 30, 2016, there were no material changes to these policies.

Recent Accounting Developments:

Revenue from Contracts with Customers

In May 2014, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2014-09, Revenue from Contracts with Customers. Under the new standard, revenue is recognized at the time a good or service is transferred to a customer for the amount of consideration received for that specific good or service. Entities may use a full retrospective approach or report the cumulative effect as of the date of adoption. On April 1, 2015, the FASB proposed deferring the effective date of this standard by one year to December 15, 2017, for annual reporting periods beginning after that date. The FASB also proposed permitting early adoption of the standard, but not before the original effective date of December 15, 2016. We are continuing to evaluate this standard; however, we do not expect it to have a significant impact on our financial results, as a substantial portion of our revenue consists of rental income from leasing arrangements, which are specifically excluded from ASU No. 2014-09.

Leases

In February 2016, the FASB issued ASU 2016-02 - Leases, which sets out the principles for the recognition, measurement, presentation and disclosure of leases for both parties to a contract (i.e. lessees and lessors). The new standard requires lessees to apply a dual approach, classifying leases as either financing or operating leases based on the principle of whether or not the lease is effectively a financed purchase by the lessee. This classification will determine whether lease expense is recognized based on an effective interest method or on a straight line basis over the term of the lease. A lessee is also required to record a right-of-use asset and a lease liability for all leases with a term of greater than 12 months regardless of their classification. Leases with a term of 12 months or less will be accounted for similar to existing guidance for operating leases today. The new standard requires lessors to account for leases using an approach that is substantially equivalent to existing guidance for sales-type leases, direct financing leases and operating leases. The ASU is not effective for us until January 1, 2019 with early adoption permitted. We are continuing to evaluate this standard and the impact to us from both a lessor and a lessee perspective.

Measurement of Credit Losses on Financial Instruments

In June 2016, the FASB issued ASU 2016-13, Measurement of Credit Losses on Financial Instruments, which is intended to improve financial reporting by requiring timely recording of credit losses on loans and other financial instruments held by financial institutions and other organizations. The ASU requires the measurement of all expected credit losses for financial assets not recorded at fair value based on historical experience, current conditions, and reasonable and supportable forecasts. The ASU will be required to be implemented through a cumulative-effect adjustment to retained earnings as of the beginning of the first reporting period in which the amendments are effective. The ASU is not effective for us until January 1, 2019. We do not expect the adoption of this ASU to have a significant impact on our consolidated financial statements.

Classification of Certain Cash Receipts and Cash Payments

In August 2016, the FASB issued ASU No. 2016-15, Classification of Certain Cash Receipts and Cash Payments, which clarifies the classification within the statement of cash flows for certain transactions, including debt extinguishment costs, zero-coupon debt, contingent consideration related to business combinations, insurance proceeds, equity method distributions and beneficial interests in securitizations. The standard also clarifies that cash flows with aspects of multiple classes of cash flows or that cannot be separated by source or use should be classified based on the activity that is likely to be the predominant source or use of cash flows for the item. This guidance is effective for us starting January 1, 2018.

Variable Interest Entities

At September 30, 2016, we had loans to and/or equity investments in certain variable interest entities (“VIEs”), which are also tenants of our facilities, including Ernest Health, Inc. (“Ernest”). 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 September 30, 2016 (in thousands):


VIE Type	Maximum Loss Exposure(1)		Asset Type Classification	Carrying Amount(2)
Loans, net	$	306,928	Mortgage and other loans	$	226,117
Equity investments	$	32,325	Other assets	$	207

(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 rent receivables), less any liabilities. Our maximum loss exposure related to our equity investment in VIEs represents the current carrying values of such investment plus any other related assets (such as rent receivables) less any liabilities.

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

For the VIE types above, we do not consolidate the VIE because we do not have the ability to control the activities (such as the day-to-day healthcare operations of our borrower or investees) that most significantly impact the VIE’s economic performance. As of September 30, 2016, we were not required to provide any material 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 and 7 for additional description of the nature, purpose and activities of our more significant VIEs and interests therein.

Real Estate and Lending Activities

9 Months Ended

Sep. 30, 2016

Text Block [Abstract]

Real Estate and Lending Activities

3. Real Estate and Lending Activities

Acquisitions

We acquired the following assets (in thousands):


	Nine Months Ended September 30,
	2016			2015
Assets Acquired
Land and land improvements	$	13,874		$	113,309
Building		125,472			711,805
Intangible lease assets — subject to amortization (weighted average useful life of 19.4 years in 2016 and 28.4 years in 2015)		10,754			144,900
Mortgage loans		—			365,000
Net investments in direct financing leases		63,000			170,700
Other loans		—			514,484

Total assets acquired	$	213,100		$	2,020,198
Loans repaid (1)		(93,262	)		(385,851	)

Total net assets acquired	$	119,838		$	1,634,347

(1)

$93.3 million loans advanced to Capella in 2015 and repaid in 2016 as a part of the Capella transaction. $385.9 million loans advanced to MEDIAN in 2014 and repaid in 2015 as a part of the MEDIAN transaction.

The purchase price allocations attributable to certain 2016 acquisitions and acquisitions completed in the fourth quarter of 2015 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.

2016 Activity

On July 22, 2016, we acquired an acute care facility in Olympia, Washington in exchange for a $93.3 million loan and an additional $7 million in cash, as contemplated in the August 2015 Capella Healthcare, Inc. (“Capella”) acquisition transaction. The terms of the Olympia lease are substantially similar to those of the master lease with Capella. See “2015 Activity” for a description of the August 2015 Capella Acquisition. Also, see the Capella Disposal Transaction under the subheading “Disposals” below for further details.

On June 22, 2016, we closed on the final Median Kliniken S.à r.l., (“MEDIAN”) property for a purchase price of €41.6 million. See “2015 Activity” for a description of the initial MEDIAN Transaction.

On May 2, 2016, we acquired an acute care hospital in Newark, New Jersey for an aggregate purchase price of $63 million leased to Prime Healthcare Services, Inc. (“Prime”) pursuant to a fifth master lease, which has a 15-year term with three five-year extension options, plus consumer-price indexed increases. Furthermore, we committed to advance an additional $30 million to Prime over a three-year period to be used solely for capital additions to the real estate; any such addition will be added to the basis upon which the lessee will pay us rents.

From the respective acquisition dates, the properties acquired during the nine months ended September 30, 2016, contributed $4.6 million and $3.8 million of revenue and income (excluding related acquisition expenses), respectively, for the three months ended September 30, 2016. From the respective acquisition dates, the properties acquired during the nine months ended September 30, 2016 contributed $5.7 million and $4.9 million of revenue and income (excluding related acquisition expenses), respectively, for the nine months ended September 30, 2016. In addition, we incurred $2.4 million of acquisition-related costs on the 2016 acquisitions for the nine months ended September 30, 2016.

On October 3, 2016, we closed on a portfolio of nine acute care hospitals in Massachusetts operated by Steward Health Care System LLC (“Steward”). Our investment in the portfolio includes the acquisition of five hospitals for $600 million, the making of $600 million in mortgage loans on four facilities and a $50 million minority equity contribution in Steward, for a combined investment of $1.25 billion. The five facilities acquired are being leased to Steward under a master lease agreement that has a 15-year term with three 5-year extension options, plus annual inflation-based escalators. The terms of the mortgage loan are substantially similar to the master lease.

2015 Activity

Capella Acquisition

On August 31, 2015, we closed on our acquisition of assets of and interests in Capella. Our investment in the Capella portfolio originally included seven acute care hospitals (two properties of which our investment was in the form of mortgage loans), an acquisition loan, and an equity interest in the operator for a combined purchase price and investment of approximately $900 million plus Capella’s cash on hand at the acquisition date. We closed on six of the seven Capella properties on August 31, 2015, two of which were in the form of mortgage loans, and we closed on the last property in the third quarter of 2016 (see discussion of the acquisition of the Olympia, Washington facility above). The remaining investment in the operations of Capella were in the form of an acquisition loan to Capella, which had a fixed interest rate of 8% and 49% interest in the equity of the operator, with management owning the remaining 51%. See subheading “Disposals” below for details of the disposal of our investment in Capella operations and further transactions.

MEDIAN Transaction

On April 29, 2015, we entered into a series of definitive agreements with MEDIAN, a German provider of post-acute and acute rehabilitation services, to acquire the real estate assets of 32 hospitals owned by MEDIAN for an aggregate purchase price of approximately €688 million. Upon acquisition, each property became subject to a master lease between us and MEDIAN providing for the leaseback of the property to MEDIAN. The master lease had an initial term of 27 years and provided for an initial GAAP lease rate of 9.3%, with annual escalators at the greater of one percent or 70% of the German consumer price index.

MEDIAN is owned by an affiliate of Waterland Private Equity Fund V C.V. (“Waterland”), which acquired 94.9% of the outstanding equity interests in MEDIAN, and by a subsidiary of our operating partnership, which acquired the remaining 5.1% of the outstanding equity interests in MEDIAN, each in December 2014. In December 2014, we provided interim acquisition loans to affiliates of Waterland and MEDIAN in connection with Waterland’s acquisition of its stake in MEDIAN in an aggregate amount of approximately €425 million. In addition, we made further loans to MEDIAN during the first half of 2015 in an aggregate amount of approximately €240 million, which were used by MEDIAN to repay existing debt on properties we acquired.

Closing of the sale-leaseback transactions began in the second quarter of 2015. At each closing, the purchase price for each facility was reduced and offset against the interim loans made to affiliates of Waterland and MEDIAN as described above and against the amount of any debt assumed or repaid by us in connection with the closing. As of September 30, 2015, we had closed on 30 properties for an aggregate amount of €627 million.

Other Acquisitions

On September 30, 2015, we provided a $100 million mortgage financing (of which $85 million had been funded through September 30, 2015 with an additional $15 million funded in the 2015 fourth quarter) to Prime for three general acute care hospitals and one free-standing emergency department and health center in New Jersey. The loan had a five-year term and provided for consumer-price indexed interest increases, subject to a floor. On October 21, 2016, we acquired these facilities (as originally contemplated in the agreements) by reducing the $100 million mortgage loan and advancing an additional $15 million. We are leasing these properties to Prime pursuant to a fifth master lease.

On August 31, 2015, we closed on a $30 million mortgage loan transaction with Prime for the acquisition of Lake Huron Medical Center, a 144-bed general acute care hospital located in Port Huron, Michigan. The loan provided for consumer-price indexed interest increases, subject to a floor. The mortgage loan had a 5-year term with conversion rights to our standard sale leaseback agreement, which we exercised for $20 million on December 31, 2015, and reduced the mortgage loan accordingly. This facility is now leased to Prime pursuant to a fourth master lease.

On June 16, 2015, we acquired the real estate of two facilities in Lubbock, Texas, a 60-bed inpatient rehabilitation hospital and a 37-bed long-term acute care hospital, for an aggregate purchase price of $31.5 million. We entered into a 20-year lease with Ernest for the rehabilitation hospital, which provided for three five-year extension options, and separately entered into a lease with Ernest for the long-term acute care hospital that had a final term ending December 31, 2034. In connection with the transaction, we funded an acquisition loan to Ernest of approximately $12.0 million. Ernest is operating the rehabilitation hospital in a joint venture with Covenant Health System. Effective July 18, 2016, we amended the lease of the rehabilitation hospital to include the long-term acute care hospital. Ernest’s plans are to convert the long-term acute care facility into a rehabilitation facility by the second quarter of 2017.

On February 27, 2015, we acquired an inpatient rehabilitation hospital in Weslaco, Texas for $10.7 million leased to Ernest pursuant to the 2012 master lease which had an original 20-year fixed term and three five-year extension options. This lease provided for consumer-price indexed annual rent increases, subject to a floor and a cap. In addition, we agreed to fund an acquisition loan in the amount of $5 million.

On February 13, 2015, we acquired two general acute care hospitals in the Kansas City area for $110 million. Prime is the tenant and operator pursuant to a master lease that has similar terms and security enhancements as the other master lease agreements entered into in 2013. This master lease had a 10-year initial fixed term with two extension options of five years each. The lease provided for consumer-price indexed annual rent increases, subject to a specified floor. In addition, we agreed to fund a mortgage loan in the amount of $40 million, which had a 10-year term.

From the respective acquisition dates, the properties and mortgage loans acquired in 2015 contributed $30.0 million and $13.9 million of revenue and income (excluding related acquisition expenses), respectively, for the three months ended September 30, 2015. From the respective acquisition dates, the properties and mortgage loans acquired in 2015 contributed $59.2 million and $34.3 million of revenue and income (excluding related acquisition expenses), respectively, for the nine months ended September 30, 2015. In addition, we incurred $23.7 million and $52.9 million of acquisition related costs on the 2015 acquisitions for the three and nine months ended September 30, 2015, respectively.

Pro Forma Information

The following unaudited supplemental pro forma operating data is presented for the three and nine months ended September 30, 2016 and 2015, as if each acquisition (including the Steward investments completed subsequent to September 30, 2016) was completed on January 1, 2015. Supplemental pro forma earnings were adjusted to exclude acquisition-related costs on consummated deals incurred. 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/unit amounts).


	For the Three Months Ended September 30,				For the Nine Months Ended September 30,
	2016		2015		2016		2015
Total revenues	$	162.4	$	156.5	$	479.8	$	480.1
Net income	$	73.3	$	63.0	$	206.3	$	227.0
Net income per share/unit — diluted	$	0.23	$	0.20	$	0.64	$	0.71

Development Activities

During the first nine months of 2016, we completed construction and began recording rental income on the following facilities:

•

Adeptus Health, Inc. (“Adeptus Health”) – We completed 13 acute care facilities for this tenant during 2016. These facilities are leased pursuant to the master leases entered into in both 2014 and 2015 and are cross-defaulted with each other and with the original master lease executed in 2013.

•

Ernest Toledo – This inpatient rehabilitation facility located in Toledo, Ohio opened on April 1, 2016 and is being leased to Ernest pursuant to the original 2012 master lease.

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


Operator	Commitment		Costs Incurred as of 09/30/16		Estimated Completion Date
Adeptus Health	$	32,684	$	18,472		4Q 2016
Adeptus Health		11,578		2,860		1Q 2017
Adeptus Health		69,801		29,616		2Q 2017
Ernest Health		28,067		3,206		3Q 2017
Adeptus Health		59,054		—		Various

	$	201,184	$	54,154

On September 9, 2015, we acquired the real estate of a general acute care hospital under development located in Spain, for an aggregate purchase and development price to us of approximately €21.4 million. The acquisition was effected through a joint venture between us and clients of AXA Real Estate, in which we own a 50% interest. Upon completion, the facility will be leased to a Spanish operator of acute care hospitals, pursuant to a long-term lease. We expect construction to complete on this facility in the second quarter of 2017.

Disposals

2016 Activity

Capella Disposal Transaction

On March 21, 2016, we entered into definitive agreements with RegionalCare Hospital Partners, Inc. (“RegionalCare”), an affiliate of certain funds managed by affiliates of Apollo Global Management, LLC (together with its consolidated subsidiaries, “Apollo”), under which our investment in the operations of Capella would be merged with RegionalCare, forming RCCH Healthcare Partners (“RCCH”).

On April 29, 2016, this transaction closed and funded, effective April 30, 2016. As part of the transaction, we received net proceeds of approximately $550 million including approximately $492 million for our equity investment and loans made as part of the original Capella acquisition that closed on August 31, 2015. In addition, we received $210 million in prepayment of two mortgage loans for hospitals in Russellville, Arkansas, and Lawton, Oklahoma, that we made to subsidiaries of Capella in connection with the Capella transaction on August 31, 2015. We made a new $93.3 million loan for a hospital property in Olympia, Washington (which was subsequently converted to real estate on July 22, 2016 as disclosed above). Additionally, we and an Apollo affiliate invested $50 million each in unsecured senior notes issued by RegionalCare, which we sold to a large institution on June 20, 2016 at par. The proceeds from this transaction represented the recoverability of our investment in full, except for transaction costs incurred of $6.3 million.

We maintained our ownership of five Capella hospitals in Hot Springs, Arkansas; Camden, South Carolina; Hartsville, South Carolina; Muskogee, Oklahoma; and McMinnville, Oregon. Pursuant to the transaction described above, the underlying leases, one of which is a master lease covering all but one property, was amended to shorten the initial fixed lease term, increase the security deposit, and eliminate the lessees’ purchase option provisions. Due to this lease amendment, we reclassified the lease of the properties under the master lease from a direct financing lease (“DFL”) to an operating lease. This reclassification resulted in a write-off of $2.6 million in unbilled DFL rent in the 2016 second quarter.

Post Acute Transaction

On May 23, 2016, we sold five properties (three of which were in Texas and two in Louisiana) that were leased and operated by Post Acute Medical (“Post Acute”). As part of this transaction, our outstanding loans of $4 million were paid in full, and we recovered our investment in the operations. Total proceeds from this transaction were $71 million, resulting in a net gain of approximately $15 million.

Corinth Transaction

On June 17, 2016, we sold the Atrium Medical Center real estate located in Corinth, Texas, which was leased and operated by Corinth Investor Holdings. Total proceeds from the transaction were $28 million, resulting in a gain on the sale of real estate of approximately $8 million. This gain on real estate was offset by approximately $9 million of non-cash charges that included the write-off of our investment in the operations of the facility, straight-line rent receivables, and a lease intangible.

HealthSouth Transaction

On July 20, 2016, we sold three inpatient rehabilitation hospitals located in Texas and operated by HealthSouth Corporation (“HealthSouth”) for $111.5 million, resulting in a net gain of approximately $45 million.

Summary of Operations for Disposed Assets in 2016

The properties sold during the year do not meet the definition of discontinued operations. However, the following represents the operating results (excluding gain on sale, transaction costs, and impairment or other non-cash charges) from these properties (excluding loans repaid in the Capella Disposal Transaction) for the periods presented (in thousands):


	For the Three Months						For the Nine Months
	Ended September 30,						Ended September 30,
	2016			2015			2016			2015
Revenues	$	244		$	4,523		$	7,851		$	13,598
Real estate depreciation and amortization		—			(949	)		(1,754	)		(2,846	)
Property-related expenses		—			(10	)		(114	)		(82	)
Other income (expense)		(24	)		521			(92	)		1,078

Income from real estate dispositions, net	$	220		$	4,085		$	5,891		$	11,748

2015 Activity

On July 30, 2015, we sold a long-term acute care facility in Luling, Texas for approximately $9.7 million, resulting in a gain of $1.5 million. Due to this sale, we wrote off $0.9 million of straight-line receivables. On August 5, 2015, we sold six wellness centers in the United States for total proceeds of approximately $9.5 million (of which $1.5 million is in the form of a note), resulting in a gain of $1.7 million. Due to this sale, we wrote off $0.9 million of billed rent receivables. With these disposals, we accelerated the amortization of the related lease intangible assets resulting in approximately $0.7 million of additional expense in the 2015 third quarter.

Leasing Operations

All of our leases are currently accounted for as operating leases except for the master lease of 15 Ernest facilities and six Prime facilities which are accounted for as DFLs. The components of our net investment in DFLs (which includes the Capella properties for 2015 only) consisted of the following (in thousands):


	As of September 30, 2016			As of December 31, 2015
Minimum lease payments receivable	$	1,884,144		$	2,587,912
Estimated residual values		292,647			393,097
Less: Unearned income		(1,643,300	)		(2,354,013	)

Net investment in direct financing leases	$	533,491		$	626,996

Twelve Oaks Facility

In the third quarter of 2015, we sent notice of termination of the lease to the tenant at our Twelve Oaks facility due to payment default. As a result of terminating the lease, we recorded a charge of $1.9 million to write-off the straight-line rent receivables in the 2015 third quarter. In addition, we accelerated the amortization of the related lease intangible asset resulting in $0.5 million of additional expense in the 2015 third quarter. This former tenant has continued to occupy the facility. During the third quarter of 2016, the tenant paid us approximately $2.5 million representing substantially all of amounts owed to us and agreed to general terms of a new lease, which we expect to execute during the 2016 fourth quarter. The tenant is now current on all of its obligations to us through November 30, 2016. Although no assurances can be made that we will not have any impairment charges in the future, we believe our real estate investment in Twelve Oaks at September 30, 2016 is fully recoverable.

Loans

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


	As of September 30, 2016		As of December 31, 2015
Mortgage loans	$	550,118	$	757,581
Acquisition loans		122,161		610,469
Working capital and other loans		43,623		54,353

	$	715,902	$	1,422,403

The decrease in our mortgage and acquisition loans are related to the Capella Disposal Transaction as discussed previously.

Our non-mortgage loans typically consist of loans to our tenants for acquisitions and working capital purposes. At September 30, 2016, acquisition loans include our original $93.2 million loan to Ernest.

On March 1, 2012, pursuant to our convertible note agreement, we converted $1.7 million of our $5.0 million convertible note into a 9.9% equity interest in the operator of our Hoboken University Medical Center facility. At September 30, 2016, $3.3 million remains outstanding on the convertible note, and we retain the option, subject to regulatory approvals, to convert this remainder into 15.1% of equity interest in the operator.

Concentrations of Credit Risk

Our revenue concentration for the nine months ended September 30, 2016 as compared to the prior year is as follows (dollars in thousands):

Revenue by Operator


	For the Nine Months Ended September 30, 2016					For the Nine Months Ended September 30, 2015
Operators	Total Revenue		Percentage of Total Revenue			Total Revenue		Percentage of Total Revenue
Prime	$	89,389		23.1	%	$	75,982		24.5	%
MEDIAN		70,242		18.1	%		56,609		18.2	%
Ernest		50,564		13.0	%		45,874		14.8	%
RCCH		42,776		11.0	%		7,155		2.3	%
Adeptus Health		25,873		6.7	%		12,982		4.2	%

Revenue by U.S. State and Country


	For the Nine Months Ended September 30, 2016					For the Nine Months Ended September 30, 2015
U.S. States and Other Countries	Total Revenue		Percentage of Total Revenue			Total Revenue		Percentage of Total Revenue
Texas	$	72,811		18.8	%	$	63,815		20.6	%
California		49,724		12.8	%		49,595		16.0	%
All other states		189,365		48.8	%		137,006		44.1	%

Total U.S.	$	311,900		80.4	%	$	250,416		80.7	%

Germany	$	72,718		18.8	%	$	56,609		18.2	%
United Kingdom, Italy, and Spain		3,236		0.8	%		3,308		1.1	%

Total International	$	75,954		19.6	%	$	59,917		19.3	%

Grand Total	$	387,854		100.0	%	$	310,333		100.0	%

From an asset basis, our concentration as of September 30, 2016 as compared to December 31, 2015 is as follows (dollars in thousands):

Gross Assets by Operator


	As of September 30, 2016					As of December 31, 2015
Operators	Total Gross Assets		Percentage of Total Gross Assets			Total Gross Assets		Percentage of Total Gross Assets
	(A)		(B)			(A)		(B)
Steward	$	1,250,000		17.3	%	$	—		—
Prime		1,142,760		15.9	%		1,032,353		17.1	%
MEDIAN		1,054,568		14.6	%		1,031,039		17.1	%
Ernest		622,416		8.6	%		579,182		9.6	%
RCCH		564,509		7.8	%		1,059,989		17.6	%

Gross Assets by U.S. State and Country


	As of September 30, 2016					As of December 31, 2015
U.S. States and Other Countries	Total Gross Assets		Percentage of Total Gross Assets			Total Gross Assets		Percentage of Total Gross Assets
	(A)		(B)			(A)		(B)
Massachusetts	$	1,250,000		17.3	%	$	—		—
Texas		944,028		13.1	%		1,060,990		17.6	%
California		542,892		7.5	%		547,085		9.1	%
All other states		2,669,401		37.0	%		3,047,204		50.5	%
Other domestic assets		251,587		3.5	%		177,317		2.9	%

Total U.S.	$	5,657,908		78.4	%	$	4,832,596		80.1	%

Germany	$	1,376,626		19.1	%	$	1,031,039		17.1	%
United Kingdom, Italy, and Spain		156,226		2.1	%		161,317		2.7	%
Other international assets		27,017		0.4	%		10,970		0.1	%

Total International	$	1,559,869		21.6	%	$	1,203,326		19.9	%

Grand Total	$	7,217,777		100.0	%	$	6,035,922		100.0	%

(A)	Gross Assets represents total assets plus accumulated depreciation/amortization assuming all real estate commitments (such as the Steward transaction and the commitments disclosed in Note 9) as of the period end are fully funded.

(B)	Includes both leased and loaned assets.

On an individual property basis, we had no investment of any single property greater than 3.3% of our total gross assets as of September 30, 2016.

Debt

9 Months Ended

Sep. 30, 2016

Debt Disclosure [Abstract]

Debt

4. Debt

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


	As of September 30, 2016						As of December 31, 2015
	Balance			Interest Rate			Balance			Interest Rate
Revolving credit facility	$	—			Variable		$	1,100,000			Variable
2006 Senior Unsecured Notes due 2016		60,000			5.675	%		125,000			Various
2011 Senior Unsecured Notes		—			—			450,000			6.875	%
2012 Senior Unsecured Notes due 2022:
Principal amount		350,000			6.375	%		350,000			6.375	%
Unamortized premium		1,902						2,168

		351,902						352,168
2013 Senior Unsecured Notes due 2020(A)		224,700			5.750	%		217,240			5.750	%
2014 Senior Unsecured Notes due 2024		300,000			5.500	%		300,000			5.500	%
2015 Senior Unsecured Notes due 2022(A)		561,750			4.000	%		543,100			4.000	%
2016 Senior Unsecured Notes due 2024		500,000			6.375	%		—			—
2016 Senior Unsecured Notes due 2026		500,000			5.250	%		—			—
Term loans		263,179			Various			263,400			Various

	$	2,761,531					$	3,350,908
Debt issue costs, net		(32,982	)					(28,367	)

	$	2,728,549					$	3,322,541

(A)	These notes are Euro-denominated and reflect the exchange rate at September 30, 2016 and December 31, 2015, respectively.

As of September 30, 2016, principal payments due on our debt (which exclude the effects of any discounts, premiums, or debt issue costs recorded) are as follows (in thousands):


2016	$	60,078	(A)
2017		320
2018		12,781
2019		250,000
2020		224,700
Thereafter		2,211,750

Total	$	2,759,629

(A)	The remaining $60 million of our 2006 Senior Unsecured Notes were paid in full on October 31, 2016.

2016 Activity

On July 22, 2016, we completed a $500 million senior unsecured notes offering (“2026 Senior Unsecured Notes”). Interest on the notes is payable on February 1 and August 1 of each year, commencing on February 1, 2017. Interest on the notes is to be paid in cash at a rate of 5.25% per year. The notes mature on August 1, 2026. We may redeem some or all of the notes at any time prior to August 1, 2021 at a “make whole” redemption price. On or after August 1, 2021, we may redeem some or all of the notes at a premium that will decrease over time. In addition, at any time prior to August 1, 2019, we may redeem up to 35% of the notes at a redemption price equal to 105.25% of the aggregate principal amount thereof, plus accrued and unpaid interest thereon, using proceeds from one or more equity offerings. In the event of a change in control, each holder of the notes may require us to repurchase some or all of the notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase.

We used the net proceeds from the 2026 Senior Unsecured Notes offering to redeem our $450 million 2011 Senior Unsecured Notes. This redemption resulted in a $22.5 million debt refinancing charge during the 2016 third quarter, consisting of a $15.5 million redemption premium along with the write-off of deferred debt issuance costs associated with the redeemed notes.

On February 22, 2016, we completed a $500 million senior unsecured notes offering (“2016 Senior Unsecured Notes”), proceeds of which were used to repay borrowings under our revolving credit facility. Interest on the notes is payable on March 1 and September 1 of each year, commencing on September 1, 2016. Interest on the notes is to be paid in cash at a rate of 6.375% per year. The notes mature on March 1, 2024. We may redeem some or all of the notes at any time prior to March 1, 2019 at a “make whole” redemption price. On or after March 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 March 1, 2019, we may redeem up to 35% of the notes at a redemption price equal to 106.375% of the aggregate principal amount thereof, plus accrued and unpaid interest thereon, using proceeds from one or more equity offerings. In the event of a change in control, each holder of the notes may require us to repurchase some or all of the notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase.

2015 Activity

On July 27, 2015, we received a commitment to provide a senior unsecured bridge loan facility in the original principal amount of $1.0 billion to fund the acquisition of Capella. Funding under the bridge facility was not necessary as we funded the acquisition through a combination of an equity issuance and other borrowings. However, we incurred and expensed certain customary structuring and underwriting fees of $3.9 million in the third quarter related to the bridge commitment.

On August 19, 2015, we completed a €500 million senior unsecured notes offering (“2015 Senior Unsecured Notes”), proceeds of which were used to repay Euro-denominated borrowings under our credit facility and to fund our European investments.

On September 30, 2015, we amended our credit facility to, among other things, increase the aggregate commitment under our revolver to its current level of $1.3 billion and increase the term loan portion to $250 million. In addition, this amendment included a new accordion feature that allows us to expand our credit facility by another $400 million for a total commitment of $1.95 billion. This amendment resulted in a $0.1 million expense in the 2015 third quarter.

Other

During the 2010 second quarter, we entered into interest rate swaps to manage our exposure to variable interest rates by fixing the interest rate on the outstanding amount of our 2006 Senior Unsecured Notes. In July 2016, $65 million of the 2006 Senior Unsecured Notes was paid in full and the related swap expired. For the remaining $60 million, the interest rate swap, which started October 31, 2011 (date on which the related interest rate turned variable) and will continue through the maturity date (or October 2016) fixed the interest rate at 5.675%. The fair value of the interest rate swaps was $0.4 million and $2.9 million as of September 30, 2016 and December 31, 2015, respectively, which is reflected in accounts payable and accrued expenses on the consolidated balance sheets.

We account for interest rate swaps as cash flow hedges. Accordingly, the effective portion of changes in the fair value of our swaps is recorded as a component of accumulated other comprehensive income/loss on the balance sheet and reclassified into earnings in the same period, or periods, during which the hedged transactions effect earnings, while any ineffective portion is recorded through earnings immediately. We did not have any hedge ineffectiveness from inception of our interest rate swaps through September 30, 2016 and therefore, there was no income statement effect recorded during the three and nine month periods ended September 30, 2016 or 2015. We do expect current losses included in accumulated other comprehensive loss to be reclassified into earnings in October 2016. At September 30, 2016 and December 31, 2015, we have posted $0.4 million and $1.7 million, respectively, of collateral related to our interest rate swaps, which is reflected in other assets on our consolidated balance sheets.

Covenants

Our debt facilities impose certain restrictions on us, including restrictions on our ability to: incur debts; create or incur liens; provide guarantees in respect of obligations of any other entity; make redemptions and repurchases of our capital stock; prepay, redeem or repurchase debt; engage in mergers or consolidations; enter into affiliated transactions; dispose of real estate or other assets; and change our business. In addition, the credit agreements governing our revolving credit facility and term loan limit the amount of dividends we can pay as a percentage of normalized adjusted funds from operations (“FFO”), as defined in the agreements, on a rolling four quarter basis. At September 30, 2016, 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, secured leverage ratio, consolidated adjusted net worth, unsecured 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 September 30, 2016, we were in compliance with all such financial and operating covenants.

Common Stock/Partners' Capital	9 Months Ended
Common Stock/Partners' Capital	Sep. 30, 2016
Equity [Abstract]
Common Stock/Partners' Capital	5. Common Stock/Partners’ Capital Medical Properties Trust, Inc. On October 7, 2016, we sold 10.3 million shares of common stock in a private placement with an affiliate of Cerberus Capital Management (“Cerberus”), the controlling member of Steward. We sold these shares at a price per share of $14.50, equal to the public offering price of our September 2016 equity offering, generating total proceeds of approximately $150 million. On September 30, 2016, we completed an underwritten public offering of 57.5 million shares (including the exercise of the underwriters’ 30-day option to purchase an additional 7.5 million shares) of our common stock, resulting in net proceeds of $799.5 million, after deducting estimated offering expenses. On March 1, 2016, we updated our at-the-market equity offering program, which gave us the ability to sell up to $227 million of stock with a commission rate of 1.25%. During the nine months ended September 30, 2016, we sold approximately 15 million shares of our common stock under this program, resulting in net proceeds of approximately $224 million, after deducting approximately $2.8 million of commissions. We have no capacity to sell additional shares under this at-the-market equity offering program. On August 11, 2015, we completed an underwritten public offering of 28.75 million shares (including the exercise of the underwriters’ 30-day option to purchase an additional 3.75 million shares) of our common stock, resulting in net proceeds of $337 million, after deducting estimated offering expenses. 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. MPT Operating Partnership, L.P. At September 30, 2016, the Company has a 99.87% ownership interest in the Operating Partnership with the remainder owned by three other partners, two of whom are employees and one of whom is a director. During the nine months ended September 30, 2016 and 2015, the Operating Partnership issued 72.5 million units and 63.25 million units, respectively, in direct response to the common stock offerings by Medical Properties Trust, Inc.

Stock Awards	9 Months Ended
Stock Awards	Sep. 30, 2016
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Stock Awards	6. Stock Awards We adopted the 2013 Equity Incentive Plan (the “Equity Incentive Plan”) during the second quarter of 2013, which authorizes the issuance of common stock options, restricted stock, restricted stock units, deferred stock units, stock appreciation rights, performance units and awards of interests in our Operating Partnership. The Equity Incentive Plan is administered by the Compensation Committee of the Board of Directors. We have reserved 8,196,770 shares of common stock for awards under the Equity Incentive Plan for which 4,763,066 shares remain available for future stock awards as of September 30, 2016. We awarded the following stock awards during 2016 and 2015: Time-based awards —We granted 254,574 and 407,969 shares in 2016 and 2015, respectively, of time-based restricted stock. These awards generally vest quarterly based on service, over three years, in equal amounts. Performance-based awards —We awarded 366,838 shares of performance based awards in 2015. No such awards have been granted in 2016. These awards vest ratably over a three-year period based on the achievement of certain total shareholder return measures, with a carry-back and carry-forward provision through December 31, 2017. Dividends on these awards are paid only upon achievement of the performance measures. Multi-year Performance-based awards —We awarded 799,804 and 505,050 shares in 2016 and 2015, respectively, of multi-year performance-based awards. These shares are subject to three-year cumulative performance hurdles based on measures of total shareholder return. At the end of the three-year performance period, any earned shares will be subject to an additional two years of ratable time-based vesting on an annual basis. Dividends are paid on these shares only upon achievement of the performance measures.

- Definition

The entire disclosure for compensation-related costs for equity-based compensation, which may include disclosure of policies, compensation plan details, allocation of equity compensation, incentive distributions, equity-based arrangements to obtain goods and services, deferred compensation arrangements, employee stock ownership plan details and employee stock purchase plan details.

+ References + Details

Fair Value of Financial Instruments

9 Months Ended

Sep. 30, 2016

Fair Value Disclosures [Abstract]

Fair Value of Financial Instruments

7. Fair Value of Financial Instruments

We have various assets and liabilities that are considered financial instruments. We estimate that the carrying value of cash and cash equivalents, and accounts payable and accrued expenses approximate their fair values. Included in our accounts payable and accrued expenses are our interest rate swaps, which are recorded at fair value based on Level 2 observable market assumptions using standardized derivative pricing models. We estimate the fair value of our interest and rent receivables using Level 2 inputs such as discounting the estimated future cash flows using the current rates at which similar receivables would be made to others with similar credit ratings and for the same remaining maturities. The fair value of our mortgage loans and working capital loans are estimated by using Level 2 inputs 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 (excluding our 2006 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, our revolving credit facility, and term loans using Level 2 inputs based on the present value of future payments, discounted at a rate which we consider appropriate for such debt.

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


	September 30, 2016						December 31, 2015
Asset (Liability)	Book Value			Fair Value			Book Value			Fair Value
Interest and rent receivables	$	54,554		$	54,522		$	46,939		$	46,858
Loans (1)		496,767			529,053			508,851			543,859
Debt, net		(2,728,549	)		(2,875,619	)		(3,322,541	)		(3,372,773	)

(1)	Excludes loans related to Ernest and Capella (2015 only) since they are recorded at fair value and discussed below.

Items Measured at Fair Value on a Recurring Basis

Our equity interest in Ernest and related loans, which were acquired in 2012, are being measured at fair value on a recurring basis as we elected to account for these investments using the fair value option method. We have elected to account for these investments at fair value due to the size of the investments and because we believe this method is more reflective of current values. We have not made a similar election for other equity interests or loans made in or prior to 2016, except for our investments in Capella that were disposed of in the 2016 second quarter.

At September 30, 2016, these amounts were as follows (in thousands):


Asset Type	Fair Value		Cost		Asset Type Classification
Mortgage loans	$	102,550	$	102,550		Mortgage loans
Acquisition and other loans		116,585		116,585		Other loans
Equity investments		3,300		3,300		Other assets

	$	222,435	$	222,435

Our mortgage loans with Ernest are recorded at fair value based on Level 2 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 September 30, 2016.

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	$	(61	)
- 100 basis points		61

Because the fair value of Ernest investments noted above approximate their original cost, we did not recognize any unrealized gains/losses during the first nine months of 2016 or 2015.

- 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

Earnings Per Share/Common Unit

9 Months Ended

Sep. 30, 2016

Earnings Per Share [Abstract]

Earnings Per Share/Common Unit

8. Earnings Per Share/Common Unit

Medical Properties Trust, Inc.

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


	For the Three Months Ended September 30,
	2016			2015
Numerator:
Income from continuing operations	$	70,543		$	23,123
Non-controlling interests’ share in continuing operations		(185	)		(66	)
Participating securities’ share in earnings		(154	)		(265	)

Income from continuing operations, less participating securities’ share in earnings		70,204			22,792
Income from discontinued operations attributable to MPT common stockholders		—			—

Net income, less participating securities’ share in earnings	$	70,204		$	22,792

Denominator:
Basic weighted-average common shares		246,230			223,948
Dilutive potential common shares		1,238			—

Dilutive weighted-average common shares		247,468			223,948


	For the Nine Months Ended September 30,
	2016			2015
Numerator:
Income from continuing operations	$	182,693		$	81,589
Non-controlling interests’ share in continuing operations		(683	)		(228	)
Participating securities’ share in earnings		(430	)		(781	)

Income from continuing operations, less participating securities’ share in earnings		181,580			80,580
Loss from discontinued operations attributable to MPT common stockholders		(1	)		—

Net income, less participating securities’ share in earnings	$	181,579		$	80,580

Denominator:
Basic weighted-average common shares		240,607			211,659
Dilutive potential common shares		825			409

Dilutive weighted-average common shares		241,432			212,068

MPT Operating Partnership, L.P.

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


	For the Three Months Ended September 30,
	2016			2015
Numerator:
Income from continuing operations	$	70,543		$	23,123
Non-controlling interests’ share in continuing operations		(185	)		(66	)
Participating securities’ share in earnings		(154	)		(265	)

Income from continuing operations, less participating securities’ share in earnings		70,204			22,792
Income from discontinued operations attributable to MPT Operating Partnership partners		—			—

Net income, less participating securities’ share in earnings	$	70,204		$	22,792

Denominator:
Basic weighted-average units		246,230			223,948
Dilutive potential units		1,238			—

Dilutive weighted-average units		247,468			223,948


	For the Nine Months Ended September 30,
	2016			2015
Numerator:
Income from continuing operations	$	182,693		$	81,589
Non-controlling interests’ share in continuing operations		(683	)		(228	)
Participating securities’ share in earnings		(430	)		(781	)

Income from continuing operations, less participating securities’ share in earnings		181,580			80,580
Loss from discontinued operations attributable to MPT Operating Partnership partners		(1	)		—

Net income, less participating securities’ share in earnings	$	181,579		$	80,580

Denominator:
Basic weighted-average units		240,607			211,659
Dilutive potential units		825			409

Dilutive weighted-average units		241,432			212,068

Commitments and Contingencies	9 Months Ended
Commitments and Contingencies	Sep. 30, 2016
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	9. Commitments and Contingencies Commitments On July 20, 2016, we entered into definitive agreements to acquire 23 rehabilitation hospitals in Germany for an aggregate purchase price to us of approximately €215.7 million. Upon closing, the facilities will be leased to affiliates of MEDIAN, pursuant to a long-term master lease. Closing of the transaction, which is expected to begin during the fourth quarter of 2016, is subject to customary real estate, regulatory and other closing conditions. On September 9, 2016, we entered into definitive agreements to acquire six rehabilitation hospitals in Germany for an aggregate purchase price to us of approximately €46.3 million. Upon closing, the facilities will be leased to affiliates of MEDIAN, pursuant to a long-term master lease. Closing of the transaction, which is expected during the fourth quarter of 2016, is subject to customary real estate, regulatory and other closing conditions. Subsequent to September 30, 2016, we closed on three of the six facilities in the amount of €22.9 million. On September 28, 2016, we entered into definitive agreements to acquire two acute care hospitals in Washington and Idaho for an aggregate purchase price to us of approximately $105 million. Upon closing, the facilities will be leased to RCCH, pursuant to the current master lease. Closing of the transaction, which is expected to be completed by the first quarter of 2017, is subject to customary real estate, regulatory and other closing conditions. 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.

Summary of Significant Accounting Policies (Policies)

9 Months Ended

Sep. 30, 2016

Accounting Policies [Abstract]

Unaudited Interim Condensed Consolidated Financial Statements

Recent Accounting Developments

Recent Accounting Developments:

Revenue from Contracts with Customers

Leases

Measurement of Credit Losses on Financial Instruments

Classification of Certain Cash Receipts and Cash Payments

Variable Interest Entities

Variable Interest Entities


VIE Type	Maximum Loss Exposure(1)		Asset Type Classification	Carrying Amount(2)
Loans, net	$	306,928	Mortgage and other loans	$	226,117
Equity investments	$	32,325	Other assets	$	207

(1)

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

See Note 3 and 7 for additional description of the nature, purpose and activities of our more significant VIEs and interests therein.

Summary of Significant Accounting Policies (Tables)

9 Months Ended

Sep. 30, 2016

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 September 30, 2016 (in thousands):


VIE Type	Maximum Loss Exposure(1)		Asset Type Classification	Carrying Amount(2)
Loans, net	$	306,928	Mortgage and other loans	$	226,117
Equity investments	$	32,325	Other assets	$	207

(1)

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

- Definition

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

+ References + Details

Real Estate and Lending Activities (Tables)

9 Months Ended

Sep. 30, 2016

Text Block [Abstract]

Assets Acquired

We acquired the following assets (in thousands):


	Nine Months Ended September 30,
	2016			2015
Assets Acquired
Land and land improvements	$	13,874		$	113,309
Building		125,472			711,805
Intangible lease assets — subject to amortization (weighted average useful life of 19.4 years in 2016 and 28.4 years in 2015)		10,754			144,900
Mortgage loans		—			365,000
Net investments in direct financing leases		63,000			170,700
Other loans		—			514,484

Total assets acquired	$	213,100		$	2,020,198
Loans repaid (1)		(93,262	)		(385,851	)

Total net assets acquired	$	119,838		$	1,634,347

(1)

Schedule of Unaudited Supplemental Pro Forma Operating Data


	For the Three Months Ended September 30,				For the Nine Months Ended September 30,
	2016		2015		2016		2015
Total revenues	$	162.4	$	156.5	$	479.8	$	480.1
Net income	$	73.3	$	63.0	$	206.3	$	227.0
Net income per share/unit — diluted	$	0.23	$	0.20	$	0.64	$	0.71

Summary of Status Update on Current Development Projects

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


Operator	Commitment		Costs Incurred as of 09/30/16		Estimated Completion Date
Adeptus Health	$	32,684	$	18,472		4Q 2016
Adeptus Health		11,578		2,860		1Q 2017
Adeptus Health		69,801		29,616		2Q 2017
Ernest Health		28,067		3,206		3Q 2017
Adeptus Health		59,054		—		Various

	$	201,184	$	54,154

Summary of Operations for Disposed Assets in 2016


	For the Three Months						For the Nine Months
	Ended September 30,						Ended September 30,
	2016			2015			2016			2015
Revenues	$	244		$	4,523		$	7,851		$	13,598
Real estate depreciation and amortization		—			(949	)		(1,754	)		(2,846	)
Property-related expenses		—			(10	)		(114	)		(82	)
Other income (expense)		(24	)		521			(92	)		1,078

Income from real estate dispositions, net	$	220		$	4,085		$	5,891		$	11,748

Components of Net Investment in Direct Financing Leases

The components of our net investment in DFLs (which includes the Capella properties for 2015 only) consisted of the following (in thousands):


	As of September 30, 2016			As of December 31, 2015
Minimum lease payments receivable	$	1,884,144		$	2,587,912
Estimated residual values		292,647			393,097
Less: Unearned income		(1,643,300	)		(2,354,013	)

Net investment in direct financing leases	$	533,491		$	626,996

Summary of Loans

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


	As of September 30, 2016		As of December 31, 2015
Mortgage loans	$	550,118	$	757,581
Acquisition loans		122,161		610,469
Working capital and other loans		43,623		54,353

	$	715,902	$	1,422,403

Schedule of Revenue by Operator

Revenue by Operator


	For the Nine Months Ended September 30, 2016					For the Nine Months Ended September 30, 2015
Operators	Total Revenue		Percentage of Total Revenue			Total Revenue		Percentage of Total Revenue
Prime	$	89,389		23.1	%	$	75,982		24.5	%
MEDIAN		70,242		18.1	%		56,609		18.2	%
Ernest		50,564		13.0	%		45,874		14.8	%
RCCH		42,776		11.0	%		7,155		2.3	%
Adeptus Health		25,873		6.7	%		12,982		4.2	%

Schedule of Revenue from External Customers by Geographic Areas

Revenue by U.S. State and Country


	For the Nine Months Ended September 30, 2016					For the Nine Months Ended September 30, 2015
U.S. States and Other Countries	Total Revenue		Percentage of Total Revenue			Total Revenue		Percentage of Total Revenue
Texas	$	72,811		18.8	%	$	63,815		20.6	%
California		49,724		12.8	%		49,595		16.0	%
All other states		189,365		48.8	%		137,006		44.1	%

Total U.S.	$	311,900		80.4	%	$	250,416		80.7	%
Germany	$	72,718		18.8	%	$	56,609		18.2	%
United Kingdom, Italy, and Spain		3,236		0.8	%		3,308		1.1	%

Total International	$	75,954		19.6	%	$	59,917		19.3	%

Grand Total	$	387,854		100.0	%	$	310,333		100.0	%

Schedule of Gross Assets by Operator

Gross Assets by Operator


	As of September 30, 2016					As of December 31, 2015
Operators	Total Gross Assets		Percentage of Total Gross Assets			Total Gross Assets		Percentage of Total Gross Assets
	(A)		(B)			(A)		(B)
Steward	$	1,250,000		17.3	%	$	—		—
Prime		1,142,760		15.9	%		1,032,353		17.1	%
MEDIAN		1,054,568		14.6	%		1,031,039		17.1	%
Ernest		622,416		8.6	%		579,182		9.6	%
RCCH		564,509		7.8	%		1,059,989		17.6	%

Schedule of Gross Assets by Geographic Areas

Gross Assets by U.S. State and Country


	As of September 30, 2016					As of December 31, 2015
U.S. States and Other Countries	Total Gross Assets		Percentage of Total Gross Assets			Total Gross Assets		Percentage of Total Gross Assets
	(A)		(B)			(A)		(B)
Massachusetts	$	1,250,000		17.3	%	$	—		—
Texas		944,028		13.1	%		1,060,990		17.6	%
California		542,892		7.5	%		547,085		9.1	%
All other states		2,669,401		37.0	%		3,047,204		50.5	%
Other domestic assets		251,587		3.5	%		177,317		2.9	%

Total U.S.	$	5,657,908		78.4	%	$	4,832,596		80.1	%
Germany	$	1,376,626		19.1	%	$	1,031,039		17.1	%
United Kingdom, Italy, and Spain		156,226		2.1	%		161,317		2.7	%
Other international assets		27,017		0.4	%		10,970		0.1	%

Total International	$	1,559,869		21.6	%	$	1,203,326		19.9	%

Grand Total	$	7,217,777		100.0	%	$	6,035,922		100.0	%

(A)	Gross Assets represents total assets plus accumulated depreciation/amortization assuming all real estate commitments (such as the Steward transaction and the commitments disclosed in Note 9) as of the period end are fully funded.

(B)	Includes both leased and loaned assets.

Debt (Tables)

9 Months Ended

Sep. 30, 2016

Debt Disclosure [Abstract]

Summary of Debt

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


	As of September 30, 2016						As of December 31, 2015
	Balance			Interest Rate			Balance			Interest Rate
Revolving credit facility	$	—			Variable		$	1,100,000			Variable
2006 Senior Unsecured Notes due 2016		60,000			5.675	%		125,000			Various
2011 Senior Unsecured Notes		—			—			450,000			6.875	%
2012 Senior Unsecured Notes due 2022:
Principal amount		350,000			6.375	%		350,000			6.375	%
Unamortized premium		1,902						2,168

		351,902						352,168
2013 Senior Unsecured Notes due 2020(A)		224,700			5.750	%		217,240			5.750	%
2014 Senior Unsecured Notes due 2024		300,000			5.500	%		300,000			5.500	%
2015 Senior Unsecured Notes due 2022(A)		561,750			4.000	%		543,100			4.000	%
2016 Senior Unsecured Notes due 2024		500,000			6.375	%		—			—
2016 Senior Unsecured Notes due 2026		500,000			5.250	%		—			—
Term loans		263,179			Various			263,400			Various

	$	2,761,531					$	3,350,908
Debt issue costs, net		(32,982	)					(28,367	)

	$	2,728,549					$	3,322,541

(A)	These notes are Euro-denominated and reflect the exchange rate at September 30, 2016 and December 31, 2015, respectively.

Principal Payments Due on Debt

As of September 30, 2016, principal payments due on our debt (which exclude the effects of any discounts, premiums, or debt issue costs recorded) are as follows (in thousands):


2016	$	60,078	(A)
2017		320
2018		12,781
2019		250,000
2020		224,700
Thereafter		2,211,750

Total	$	2,759,629

(A)	The remaining $60 million of our 2006 Senior Unsecured Notes were paid in full on October 31, 2016.

Fair Value of Financial Instruments (Tables)

9 Months Ended

Sep. 30, 2016

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):


	September 30, 2016						December 31, 2015
Asset (Liability)	Book Value			Fair Value			Book Value			Fair Value
Interest and rent receivables	$	54,554		$	54,522		$	46,939		$	46,858
Loans (1)		496,767			529,053			508,851			543,859
Debt, net		(2,728,549	)		(2,875,619	)		(3,322,541	)		(3,372,773	)

(1)	Excludes loans related to Ernest and Capella (2015 only) since they are recorded at fair value and discussed below.

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

At September 30, 2016, these amounts were as follows (in thousands):


Asset Type	Fair Value		Cost		Asset Type Classification
Mortgage loans	$	102,550	$	102,550		Mortgage loans
Acquisition and other loans		116,585		116,585		Other loans
Equity investments		3,300		3,300		Other assets

	$	222,435	$	222,435

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	$	(61	)
- 100 basis points		61

Earnings Per Share/Common Unit (Tables)

9 Months Ended

Sep. 30, 2016

Earnings Per Share [Abstract]

Calculation of Earnings Per Share

Medical Properties Trust, Inc.

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


	For the Three Months Ended September 30,
	2016			2015
Numerator:
Income from continuing operations	$	70,543		$	23,123
Non-controlling interests’ share in continuing operations		(185	)		(66	)
Participating securities’ share in earnings		(154	)		(265	)

Income from continuing operations, less participating securities’ share in earnings		70,204			22,792
Income from discontinued operations attributable to MPT common stockholders		—			—

Net income, less participating securities’ share in earnings	$	70,204		$	22,792

Denominator:
Basic weighted-average common shares		246,230			223,948
Dilutive potential common shares		1,238			—

Dilutive weighted-average common shares		247,468			223,948


	For the Nine Months Ended September 30,
	2016			2015
Numerator:
Income from continuing operations	$	182,693		$	81,589
Non-controlling interests’ share in continuing operations		(683	)		(228	)
Participating securities’ share in earnings		(430	)		(781	)

Income from continuing operations, less participating securities’ share in earnings		181,580			80,580
Loss from discontinued operations attributable to MPT common stockholders		(1	)		—

Net income, less participating securities’ share in earnings	$	181,579		$	80,580

Denominator:
Basic weighted-average common shares		240,607			211,659
Dilutive potential common shares		825			409

Dilutive weighted-average common shares		241,432			212,068

MPT Operating Partnership, L.P.

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


	For the Three Months Ended September 30,
	2016			2015
Numerator:
Income from continuing operations	$	70,543		$	23,123
Non-controlling interests’ share in continuing operations		(185	)		(66	)
Participating securities’ share in earnings		(154	)		(265	)

Income from continuing operations, less participating securities’ share in earnings		70,204			22,792
Income from discontinued operations attributable to MPT Operating Partnership partners		—			—

Net income, less participating securities’ share in earnings	$	70,204		$	22,792

Denominator:
Basic weighted-average units		246,230			223,948
Dilutive potential units		1,238			—

Dilutive weighted-average units		247,468			223,948


	For the Nine Months Ended September 30,
	2016			2015
Numerator:
Income from continuing operations	$	182,693		$	81,589
Non-controlling interests’ share in continuing operations		(683	)		(228	)
Participating securities’ share in earnings		(430	)		(781	)

Income from continuing operations, less participating securities’ share in earnings		181,580			80,580
Loss from discontinued operations attributable to MPT Operating Partnership partners		(1	)		—

Net income, less participating securities’ share in earnings	$	181,579		$	80,580

Denominator:
Basic weighted-average units		240,607			211,659
Dilutive potential units		825			409

Dilutive weighted-average units		241,432			212,068

Summary of Significant Accounting Policies - Carrying Value and Classification of Related Assets and Maximum Exposure to Loss (Detail)	Sep. 30, 2016 USD ($)
Mortgage and other loans [Member]
Variable Interest Entity [Line Items]
Carrying Amount	$ 226,117,000
Loans, net [Member]
Variable Interest Entity [Line Items]
Maximum Loss Exposure	306,928,000
Other Assets [Member]
Variable Interest Entity [Line Items]
Carrying Amount	207,000
Equity investments [Member]
Variable Interest Entity [Line Items]
Maximum Loss Exposure	$ 32,325,000

Real Estate and Lending Activities - Assets Acquired (Detail) - USD ($) $ in Thousands	Sep. 30, 2016	Sep. 30, 2015
Business Acquisition [Line Items]
Total assets acquired	$ 213,100	$ 2,020,198
Loans repaid	(93,262)	(385,851)
Total net assets acquired	119,838	1,634,347
Land and Land Improvements [Member]
Business Acquisition [Line Items]
Total assets acquired	13,874	113,309
Building [Member]
Business Acquisition [Line Items]
Total assets acquired	125,472	711,805
Intangible Lease Assets - Subject to Amortization [Member]
Business Acquisition [Line Items]
Total assets acquired	10,754	144,900
Net Investments in Direct Financing Leases [Member]
Business Acquisition [Line Items]
Total assets acquired	$ 63,000	170,700
Other Loans [Member]
Business Acquisition [Line Items]
Total assets acquired		514,484
Mortgage Loans [Member]
Business Acquisition [Line Items]
Total assets acquired		$ 365,000

Real Estate and Lending Activities - Assets Acquired (Parenthetical) (Detail) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015
Business Acquisition [Line Items]
Loans repaid	$ 93,262	$ 385,851
Intangible Lease Assets - Subject to Amortization [Member]
Business Acquisition [Line Items]
Weighted average useful life of acquired intangible lease assets (in years)	19 years 4 months 24 days	28 years 4 months 24 days
Capella [Member]
Business Acquisition [Line Items]
Loans repaid	$ 93,262
Median [Member]
Business Acquisition [Line Items]
Loans repaid		$ 385,851

Real Estate and Lending Activities - 2016 Activity - Additional Information (Detail) € in Thousands, $ in Thousands				3 Months Ended		9 Months Ended
	Oct. 03, 2016 USD ($) Facility RenewalOptions Hospital	Jun. 22, 2016 EUR (€)	May 02, 2016 USD ($) RenewalOptions	Sep. 30, 2016 USD ($)	Sep. 30, 2015 USD ($)	Sep. 30, 2016 USD ($)	Sep. 30, 2015 USD ($)
Business Acquisition [Line Items]
Loans repaid				$ 93,262	$ 385,851	$ 93,262	$ 385,851
Acquisition related costs				2,677	24,949	6,379	56,997
Median [Member]
Business Acquisition [Line Items]
Loans repaid					$ 385,851		$ 385,851
2016 [Member] \| Median [Member]
Business Acquisition [Line Items]
Value of properties closed \| €		€ 41,600
2016 [Member] \| Steward [Member] \| Subsequent Event [Member]
Business Acquisition [Line Items]
Loans repaid	$ 600,000
Cash paid for acquisition transaction	$ 600,000
Term of lease, years	15 years
Number of lease extension options \| RenewalOptions	3
Number of hospitals closed \| Hospital	9
Combined purchase price and investment amount	$ 1,250,000
Number of licensed hospitals \| Hospital	5
Equity interest acquired	$ 50,000
Number of facilities for making mortgage loans \| Facility	4
Acute Care Hospital [Member] \| 2016 [Member] \| New Jersey [Member]
Business Acquisition [Line Items]
Term of lease, years			15 years
Number of lease extension options \| RenewalOptions			3
Commitment to advance an additional amount for capital additions			$ 30,000
Commitment period to advance an additional amount for capital additions			3 years
Acquisition costs			$ 63,000
Business Acquisitions [Member] \| 2016 [Member]
Business Acquisition [Line Items]
Revenue contributed by the acquired entity				4,600		5,700
Acquisition related costs						2,400
Income contributed by the acquired entity				3,800		4,900
Capella [Member]
Business Acquisition [Line Items]
Loans repaid				$ 93,262		$ 93,262
Capella [Member] \| 2016 [Member] \| Olympia, Washington [Member]
Business Acquisition [Line Items]
Loans repaid \| €		93,262
Cash paid for acquisition transaction \| €		€ 7,000

Real Estate and Lending Activities - 2015 Activity - Additional Information (Detail) $ in Thousands, € in Millions							3 Months Ended			9 Months Ended		12 Months Ended
	Sep. 30, 2015 USD ($) Property Hospital	Aug. 31, 2015 USD ($) Investment Bed	Jun. 16, 2015 USD ($) RenewalOptions Property Bed	Apr. 29, 2015 EUR (€) Hospital	Feb. 27, 2015 USD ($) RenewalOptions	Feb. 13, 2015 USD ($) Facility RenewalOptions	Sep. 30, 2016 USD ($)	Dec. 31, 2015 USD ($) Property	Sep. 30, 2015 USD ($)	Sep. 30, 2016 USD ($)	Sep. 30, 2015 USD ($)	Dec. 31, 2015 USD ($)	Sep. 30, 2015 EUR (€)	Dec. 31, 2014 EUR (€)
Business Acquisition [Line Items]
Acquisition related costs							$ 2,677		$ 24,949	$ 6,379	$ 56,997
2015 [Member] \| Ernest [Member]
Business Acquisition [Line Items]
Acquisition costs			$ 31,500
Term of lease, years			20 years
Loans provided for acquisition			$ 12,000
Number of properties acquired \| Property			2
Number of lease extension options \| RenewalOptions			3
Term of lease extension, years			5 years
2015 [Member] \| Lake Huron Medical Center [Member]
Business Acquisition [Line Items]
Acquisition costs												$ 20,000
Mortgage financing		$ 30,000
Mortgage financing term		5 years
2015 [Member] \| Rehabilitation Hospital with Covenant Health System [Member] \| Ernest [Member]
Business Acquisition [Line Items]
Number of beds acquired \| Bed			60
2015 [Member] \| Acute Care Hospital [Member] \| Kansas [Member]
Business Acquisition [Line Items]
Term of lease, years						10 years
Mortgage financing						$ 40,000
Mortgage financing term						10 years
Number of lease extension options \| RenewalOptions						2
Term of lease extension, years						5 years
Number of facilities acquired \| Facility						2
Purchase price of acquisition						$ 110,000
2015 [Member] \| Acute Care Hospital [Member] \| Ernest [Member]
Business Acquisition [Line Items]
Number of beds acquired \| Bed			37
2015 [Member] \| Inpatient Rehabilitation Hospital [Member] \| Ernest [Member] \| Weslaco Texas [Member]
Business Acquisition [Line Items]
Acquisition costs					$ 10,700
Term of lease, years					20 years
Number of lease extension options \| RenewalOptions					3
Term of lease extension, years					5 years
Payments to fund long-term loans to related parties					$ 5,000
2015 [Member] \| General Acute Care Hospital and Healthcare System [Member]
Business Acquisition [Line Items]
Mortgage financing	$ 100,000
Number of licensed hospitals \| Hospital	3
Number of free-standing emergency department and health center \| Hospital	1
Mortgage financing term	5 years
Mortgage financing funded	$ 85,000							$ 15,000
2015 [Member] \| General Acute Care Hospital [Member] \| Lake Huron Medical Center [Member]
Business Acquisition [Line Items]
Number of beds acquired \| Bed		144
2015 [Member] \| Median [Member]
Business Acquisition [Line Items]
Number of properties closed \| Property	30
Number of hospitals acquired \| Hospital				32
Acquisition costs \| €				€ 688
Term of lease, years				27 years
Lease rent increase percentage				70.00%
Lease rate				9.30%
Ownership percentage														5.10%
Loans provided for acquisition \| €													€ 240	€ 425
Value of properties closed \| €													€ 627
2015 [Member] \| Waterland Private Equity Fund [Member] \| Median [Member]
Business Acquisition [Line Items]
Ownership percentage														94.90%
2015 [Member] \| Capella [Member]
Business Acquisition [Line Items]
Combined purchase price and investment amount		$ 900,000
Number of properties closed \| Property								6
Ownership interest in joint venture under the equity method		49.00%
Ownership interests owned by management		51.00%
2015 [Member] \| Capella [Member] \| Acute Care Hospital [Member]
Business Acquisition [Line Items]
Number of portfolio investments \| Investment		7
Number of investment in form of mortgage loan \| Investment		2
2015 [Member] \| Capella [Member] \| Joint Venture Partner [Member]
Business Acquisition [Line Items]
Fixed interest rate		8.00%
2015 [Member] \| Business Acquisitions [Member]
Business Acquisition [Line Items]
Revenue contributed by the acquired entity									30,000		59,200
Income contributed by the acquired entity									13,900		34,300
Acquisition related costs									$ 23,700		$ 52,900

Real Estate and Lending Activities - Schedule of Unaudited Supplemental Pro Forma Operating Data (Detail) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Business Acquisition, Pro Forma Information [Abstract]
Total revenues	$ 162,400	$ 156,500	$ 479,800	$ 480,100
Net income	$ 73,300	$ 63,000	$ 206,300	$ 227,000
Net income per share/unit - diluted	$ 0.23	$ 0.20	$ 0.64	$ 0.71

Real Estate and Lending Activities - Development Activities - Additional Information (Detail) € in Millions	Sep. 09, 2015 EUR (€)	Sep. 30, 2016 Facility
2015 [Member] \| AXA Real Estate [Member]
Business Acquisition [Line Items]
Ownership interest in joint venture under the equity method	50.00%
Acute Care Facilities in Altoona [Member] \| Development Activities [Member]
Business Acquisition [Line Items]
Number of facilities constructed \| Facility		13
Acute Care Hospital [Member] \| 2015 [Member] \| Spain [Member] \| AXA Real Estate [Member]
Business Acquisition [Line Items]
Estimated total development cost \| €	€ 21.4

Real Estate and Lending Activities - Summary of Status Update on Current Development Projects (Detail) $ in Thousands	9 Months Ended
	Sep. 30, 2016 USD ($)
Business Acquisition [Line Items]
Commitment	$ 201,184
Costs Incurred as of 09/30/16	54,154
Adeptus Health Two [Member]
Business Acquisition [Line Items]
Commitment	32,684
Costs Incurred as of 09/30/16	$ 18,472
Estimated Completion Date	4Q 2016
Adeptus Health Three [Member]
Business Acquisition [Line Items]
Commitment	$ 11,578
Costs Incurred as of 09/30/16	$ 2,860
Estimated Completion Date	1Q 2017
Adeptus Health Four [Member]
Business Acquisition [Line Items]
Commitment	$ 69,801
Costs Incurred as of 09/30/16	$ 29,616
Estimated Completion Date	2Q 2017
Ernest [Member]
Business Acquisition [Line Items]
Commitment	$ 28,067
Costs Incurred as of 09/30/16	$ 3,206
Estimated Completion Date	3Q 2017
Adeptus Health Five [Member]
Business Acquisition [Line Items]
Commitment	$ 59,054
Estimated Completion Date	Various

Real Estate and Lending Activities - Disposals - Additional Information (Detail) $ in Thousands							3 Months Ended		6 Months Ended	9 Months Ended
	Jul. 20, 2016 USD ($) Hospital	Jun. 17, 2016 USD ($)	May 23, 2016 USD ($) Property	Apr. 30, 2016 USD ($)	Aug. 05, 2015 USD ($)	Jul. 30, 2015 USD ($)	Jun. 30, 2016 USD ($)	Sep. 30, 2015 USD ($)	Jun. 30, 2016 Hospital	Sep. 30, 2016 USD ($)	Sep. 30, 2015 USD ($)
Debt Instrument [Line Items]
Proceeds from sale of real estate										$ 198,767	$ 19,175
Texas [Member]
Debt Instrument [Line Items]
Gain (loss) on sale of real estate						$ 1,500
Proceeds from sale of real estate						9,700
Straight line rent receivables write-off						$ 900
United States [Member]
Debt Instrument [Line Items]
Gain (loss) on sale of real estate					$ 1,700
Number of hospitals sold					6
Proceeds from sale of real estate					$ 9,500
Consideration received as note receivable					1,500
Billed rent receivables write-off					$ 900
Amortization of the related lease intangible asset								$ 700
Post Acute [Member]
Debt Instrument [Line Items]
Number of properties sold \| Property			5
Outstanding loans paid in full			$ 4,000
Proceeds from sale of facilities		$ 28,000	71,000
Gain on real estate dispositions			$ 15,000
Gain (loss) on sale of real estate		8,000
Post Acute [Member] \| Texas [Member]
Debt Instrument [Line Items]
Number of properties sold \| Property			3
Gain offset by non-cash charges		$ 9,000
Post Acute [Member] \| Louisiana [Member]
Debt Instrument [Line Items]
Number of properties sold \| Property			2
Capella [Member]
Debt Instrument [Line Items]
Net proceeds from transaction				$ 550,000
Net proceeds from equity investment and loans				492,000
Proceeds from prepayment of mortgage loans				210,000
New loan for hospital property				93,300
Investment on unsecured senior notes				50,000
Transaction costs incurred				$ 6,300
Number of hospital owned \| Hospital									5
Write off of unbilled direct finance lease rent							$ 2,600
HealthSouth [Member]
Debt Instrument [Line Items]
Proceeds from sale of facilities	$ 111,500
Gain on real estate dispositions	$ 45,000
HealthSouth [Member] \| Texas [Member]
Debt Instrument [Line Items]
Number of hospitals sold \| Hospital	3

Real Estate and Lending Activities - Summary of Operations for Disposed Assets in 2016 (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Disposal Group, Including Discontinued Operation, Income Statement Disclosures [Abstract]
Revenues	$ 244	$ 4,523	$ 7,851	$ 13,598
Real estate depreciation and amortization		(949)	(1,754)	(2,846)
Property-related expenses		(10)	(114)	(82)
Other income (expense)	(24)	521	(92)	1,078
Income from real estate dispositions, net	$ 220	$ 4,085	$ 5,891	$ 11,748

Real Estate and Lending Activities - Leasing Operations - Additional Information (Detail) - Leasing Operations [Member]	9 Months Ended
	Sep. 30, 2016 Leases
Ernest [Member]
Business Acquisition [Line Items]
Number of direct financing leases	15
Prime Facilities [Member]
Business Acquisition [Line Items]
Number of direct financing leases	6

Real Estate and Lending Activities - Components of Net Investment in Direct Financing Leases (Detail) - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Business Combinations [Abstract]
Minimum lease payments receivable	$ 1,884,144	$ 2,587,912
Estimated residual values	292,647	393,097
Less: Unearned income	(1,643,300)	(2,354,013)
Net investment in direct financing leases	$ 533,491	$ 626,996

Real Estate and Lending Activities - Twelve Oaks Facility - Additional Information (Detail) - Twelve Oaks Facility [Member] - USD ($) $ in Millions	3 Months Ended
	Sep. 30, 2015	Sep. 30, 2016
Business Acquisition [Line Items]
Outstanding amount receivable from tenant past due including interest		$ 2.5
Gain offset by non-cash charges	$ 1.9
Amortization of leased intangible assets	$ 0.5

Real Estate and Lending Activities - Summary of Loans (Detail) - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Loans [Line Items]
Loans, Balance	$ 715,902	$ 1,422,403
Mortgage Loans [Member]
Loans [Line Items]
Loans, Balance	550,118	757,581
Acquisition Loans [Member]
Loans [Line Items]
Loans, Balance	122,161	610,469
Working Capital and Other Loans [Member]
Loans [Line Items]
Loans, Balance	$ 43,623	$ 54,353

Real Estate and Loans Receivable - Loans - Additional Information (Detail) - USD ($) $ in Millions		9 Months Ended
	Mar. 01, 2012	Sep. 30, 2016
Business Acquisition [Line Items]
Amount of convertible note converted into equity interest	$ 1.7
Convertible note	$ 5.0
Percentage of equity shares from convertible debt	9.90%	15.10%
Remaining convertible debt after conversion of part of debt		$ 3.3
Ernest Transaction and Other Acquisitions [Member]
Business Acquisition [Line Items]
Existing mortgage loans		$ 93.2

Real Estate and Lending Activities - Schedule of Revenue by Operator (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Investment And Revenue From External Customers [Line Items]
Total Revenue	$ 126,555	$ 114,570	$ 387,854	$ 310,333
Revenue [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue			$ 387,854	$ 310,333
Percentage of Total Revenue			100.00%	100.00%
Revenue [Member] \| Credit Concentration Risk [Member] \| Prime [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue			$ 89,389	$ 75,982
Percentage of Total Revenue			23.10%	24.50%
Revenue [Member] \| Credit Concentration Risk [Member] \| Median [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue			$ 70,242	$ 56,609
Percentage of Total Revenue			18.10%	18.20%
Revenue [Member] \| Credit Concentration Risk [Member] \| Ernest [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue			$ 50,564	$ 45,874
Percentage of Total Revenue			13.00%	14.80%
Revenue [Member] \| Credit Concentration Risk [Member] \| RCCH [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue			$ 42,776	$ 7,155
Percentage of Total Revenue			11.00%	2.30%
Revenue [Member] \| Credit Concentration Risk [Member] \| Adeptus Health [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue			$ 25,873	$ 12,982
Percentage of Total Revenue			6.70%	4.20%

Real Estate and Lending Activities - Schedule of Revenue from External Customers by Geographic Areas (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 126,555	$ 114,570	$ 387,854	$ 310,333
Revenue [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue			$ 387,854	$ 310,333
Percentage of Total Revenue			100.00%	100.00%
Revenue [Member] \| Texas [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue			$ 72,811	$ 63,815
Percentage of Total Revenue			18.80%	20.60%
Revenue [Member] \| California [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue			$ 49,724	$ 49,595
Percentage of Total Revenue			12.80%	16.00%
Revenue [Member] \| All Other States [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue			$ 189,365	$ 137,006
Percentage of Total Revenue			48.80%	44.10%
Revenue [Member] \| United States [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue			$ 311,900	$ 250,416
Percentage of Total Revenue			80.40%	80.70%
Revenue [Member] \| Germany [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue			$ 72,718	$ 56,609
Percentage of Total Revenue			18.80%	18.20%
Revenue [Member] \| United Kingdom, Italy, and Spain [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue			$ 3,236	$ 3,308
Percentage of Total Revenue			0.80%	1.10%
Revenue [Member] \| International [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue			$ 75,954	$ 59,917
Percentage of Total Revenue			19.60%	19.30%

Real Estate and Lending Activities - Schedule of Gross Assets by Operator (Detail) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2016	Dec. 31, 2015
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 6,095,337	$ 5,609,351
Total Gross Assets [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 7,217,777	$ 6,035,922
Percentage of Total Gross Assets	100.00%	100.00%
Total Gross Assets [Member] \| Credit Concentration Risk [Member] \| Steward [Member]
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 1,250,000
Percentage of Total Gross Assets	17.30%
Total Gross Assets [Member] \| Credit Concentration Risk [Member] \| Prime [Member]
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 1,142,760	$ 1,032,353
Percentage of Total Gross Assets	15.90%	17.10%
Total Gross Assets [Member] \| Credit Concentration Risk [Member] \| Median [Member]
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 1,054,568	$ 1,031,039
Percentage of Total Gross Assets	14.60%	17.10%
Total Gross Assets [Member] \| Credit Concentration Risk [Member] \| Ernest [Member]
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 622,416	$ 579,182
Percentage of Total Gross Assets	8.60%	9.60%
Total Gross Assets [Member] \| Credit Concentration Risk [Member] \| RCCH [Member]
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 564,509	$ 1,059,989
Percentage of Total Gross Assets	7.80%	17.60%

Real Estate and Lending Activities - Schedule of Gross Assets by Geographic Areas (Detail) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2016	Dec. 31, 2015
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 6,095,337	$ 5,609,351
Total Gross Assets [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 7,217,777	$ 6,035,922
Percentage of Total Gross Assets	100.00%	100.00%
Total Gross Assets [Member] \| Massachusetts [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 1,250,000
Percentage of Total Gross Assets	17.30%
Total Gross Assets [Member] \| Texas [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 944,028	$ 1,060,990
Percentage of Total Gross Assets	13.10%	17.60%
Total Gross Assets [Member] \| California [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 542,892	$ 547,085
Percentage of Total Gross Assets	7.50%	9.10%
Total Gross Assets [Member] \| All Other States [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 2,669,401	$ 3,047,204
Percentage of Total Gross Assets	37.00%	50.50%
Total Gross Assets [Member] \| Other Domestic Assets [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 251,587	$ 177,317
Percentage of Total Gross Assets	3.50%	2.90%
Total Gross Assets [Member] \| United States [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 5,657,908	$ 4,832,596
Percentage of Total Gross Assets	78.40%	80.10%
Total Gross Assets [Member] \| Germany [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 1,376,626	$ 1,031,039
Percentage of Total Gross Assets	19.10%	17.10%
Total Gross Assets [Member] \| United Kingdom, Italy, and Spain [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 156,226	$ 161,317
Percentage of Total Gross Assets	2.10%	2.70%
Total Gross Assets [Member] \| Other International Assets [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 27,017	$ 10,970
Percentage of Total Gross Assets	0.40%	0.10%
Total Gross Assets [Member] \| International [Member] \| Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 1,559,869	$ 1,203,326
Percentage of Total Gross Assets	21.60%	19.90%

Real Estate and Lending Activities - Concentrations of Credit Risk - Additional Information (Detail) - Total Gross Assets [Member] - Customer Concentration Risk [Member]	Sep. 30, 2016 Investment
Business Acquisition [Line Items]
Number of investment in property	0
Maximum percentage of entity's gross assets invested on single property	3.30%

Debt - Summary of Debt (Detail) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
Debt - Summary of Debt (Detail) - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Debt Instrument [Line Items]
Principal amount	$ 2,759,629
Debt issue costs, net	(32,982)	$ (28,367)
Debt	$ 2,728,549	$ 3,322,541
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Interest rate	Variable	Variable
Debt		$ 1,100,000
2006 Senior Unsecured Notes Due 2016 [Member]
Debt Instrument [Line Items]
Interest rate		Various
Senior unsecured notes, interest rate	5.675%
Debt	$ 60,000	$ 125,000
2011 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		6.875%
Debt		$ 450,000
2012 Senior Unsecured Notes Due 2022 [Member]
Debt Instrument [Line Items]
Principal amount	$ 350,000	$ 350,000
Senior unsecured notes, interest rate	6.375%	6.375%
Unamortized premium	$ 1,902	$ 2,168
Debt	$ 351,902	$ 352,168
2013 Senior Unsecured Notes due 2020 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	5.75%	5.75%
Debt	$ 224,700	$ 217,240
2014 Senior Unsecured Notes due 2024 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	5.50%	5.50%
Debt	$ 300,000	$ 300,000
2015 Senior Unsecured Notes due 2022 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	4.00%	4.00%
Debt	$ 561,750	$ 543,100
2016 Senior Unsecured Notes Due 2024 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	6.375%
Debt	$ 500,000
2016 Senior Unsecured Notes Due 2026 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	5.25%
Debt	$ 500,000
Term Loans [Member]
Debt Instrument [Line Items]
Interest rate	Various	Various
Debt	$ 263,179	$ 263,400
Senior Unsecured Debt [Member]
Debt Instrument [Line Items]
Debt	$ 2,761,531	$ 3,350,908

Debt - Principal Payments Due for Debt (Detail) $ in Thousands	Sep. 30, 2016 USD ($)
Debt Disclosure [Abstract]
2016	$ 60,078
2017	320
2018	12,781
2019	250,000
2020	224,700
Thereafter	2,211,750
Total	$ 2,759,629

Debt - Principal Payments Due for Debt (Parenthetical) (Detail) $ in Millions	Oct. 31, 2016 USD ($)
2006 Senior Unsecured Notes [Member] \| Subsequent Event [Member]
Debt Instrument [Line Items]
Unsecured debt, current	$ 60

Debt - 2016 Activity - Additional Information (Detail) - USD ($)			3 Months Ended	9 Months Ended
	Jul. 22, 2016	Feb. 22, 2016	Sep. 30, 2016	Sep. 30, 2016	Dec. 31, 2015
2026 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes face amount	$ 500,000,000
Senior unsecured notes, payable term				Interest on the notes will be payable on February 1 and August 1 of each year
Senior unsecured notes commencing date of payment	Feb. 01, 2017
Senior unsecured notes, interest rate	5.25%
Senior unsecured notes, maturity date	Aug. 01, 2026
Senior notes, earliest redemption date	Aug. 01, 2021
Senior unsecured notes, redemption description				We may redeem some or all of the notes at any time prior to August 1, 2021 at a “make whole” redemption price. On or after August 1, 2021, we may redeem some or all of the notes at a premium that will decrease over time. In addition, at any time prior to August 1, 2019, we may redeem up to 35% of the notes at a redemption price equal to 105.25% of the aggregate principal amount thereof, plus accrued and unpaid interest thereon, using proceeds from one or more equity offerings. In the event of a change in control, each holder of the notes may require us to repurchase some or all of the notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase.
Debt instrument, redemption price percentage	105.25%
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest	101.00%
2026 Senior Unsecured Notes [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Senior unsecured notes, redemption percentage on principal amount	35.00%
2011 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate					6.875%
Notes redeemed			$ 450,000,000
Debt refinancing charge			22,500,000
Redemption premium			$ 15,500,000
Revolving Credit Facility [Member] \| 2016 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes face amount		$ 500,000,000
Senior unsecured notes, payable term				Interest on the notes is payable on March 1 and September 1 of each year
Senior unsecured notes commencing date of payment		Sep. 01, 2016
Senior unsecured notes, interest rate		6.375%
Senior unsecured notes, maturity date		Mar. 01, 2024
Senior notes, earliest redemption date		Mar. 01, 2019
Senior unsecured notes, redemption description				we may redeem some or all of the notes at a premium that will decrease over time. In addition, at any time prior to March 1, 2019, we may redeem up to 35% of the notes at a redemption price equal to 106.375% of the aggregate principal amount thereof, plus accrued and unpaid interest thereon, using proceeds from one or more equity offerings. In the event of a change in control, each holder of the notes may require us to repurchase some or all of the notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase.
Debt instrument, redemption price percentage		106.375%
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest		101.00%
Revolving Credit Facility [Member] \| 2016 Senior Unsecured Notes [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Senior unsecured notes, redemption percentage on principal amount		35.00%

Debt - 2015 Activity - Additional Information (Detail)	3 Months Ended
Debt - 2015 Activity - Additional Information (Detail)	Sep. 30, 2015 USD ($)	Aug. 19, 2015 EUR (€)	Jul. 27, 2015 USD ($)
Debt Instrument [Line Items]
Aggregate committed amount of credit facility	$ 1,950,000,000
Credit facility, amendment fees incurred	100,000
2015 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes face amount \| €		€ 500,000,000
Term Loans [Member]
Debt Instrument [Line Items]
Aggregate committed amount of credit facility	250,000,000
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Aggregate committed amount of credit facility	1,300,000,000
Accordion to credit facility	400,000,000
Capella [Member]
Debt Instrument [Line Items]
Underwriting fees	$ 3,900,000
Bridge Loan [Member] \| Capella [Member]
Debt Instrument [Line Items]
Aggregate committed amount of credit facility			$ 1,000,000,000

Debt - Other - Additional Information (Detail) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015	Jul. 31, 2016	Dec. 31, 2015	Oct. 31, 2011
Interest Rate Swap [Member]
Debt Instrument [Line Items]
Hedge ineffectiveness and income statement effect in period	$ 0	$ 0	$ 0	$ 0
Other assets, collateral	400,000		400,000			$ 1,700,000
Interest Rate Swap [Member] \| 2006 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Unsecured debt, current					$ 65,000,000		$ 60,000,000
Interest Rate Contract [Member] \| 2006 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Fair value of the interest rate swaps	$ 400,000		$ 400,000			$ 2,900,000
Interest Rate Contract Two [Member] \| 2006 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Maturity date of interest rate swap			2016-10
Fixed interest rate							5.675%

Debt - Covenants - Additional Information (Detail)	9 Months Ended
Debt - Covenants - Additional Information (Detail)	Sep. 30, 2016
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%

Common Stock/Partners' Capital - Additional Information (Detail) $ / shares in Units, shares in Thousands, $ in Thousands					9 Months Ended
	Oct. 07, 2016 USD ($) $ / shares shares	Mar. 01, 2016 USD ($)	Aug. 11, 2015 USD ($) shares	Jan. 14, 2015 USD ($) shares	Sep. 30, 2016 USD ($) Partner Director Employee shares	Sep. 30, 2015 USD ($) shares	Dec. 31, 2015 shares
Class of Stock [Line Items]
Proceeds from sale of common shares / units, net of offering costs					$ 1,024,088	$ 817,533
Common stock, shares issued \| shares					309,792		236,744
Common Units [Member] \| Private Placement [Member] \| Subsequent Event [Member] \| Cerberus Capital Management [Member]
Class of Stock [Line Items]
Number of share sold \| shares	10,300
Sale of Stock, price per share \| $ / shares	$ 14.50
Proceeds from sale of common shares / units, net of offering costs	$ 150,000
MPT Operating Partnership, L.P. [Member]
Class of Stock [Line Items]
Proceeds from sale of common shares / units, net of offering costs					$ 1,024,088	$ 817,533
Ownership interest in equity					99.87%
Number of other partners \| Partner					3
Number of units sold \| shares					72,500	63,250
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
Market Equity Offering Program [Member]
Class of Stock [Line Items]
Proceeds from sale of common shares / units, net of offering costs					$ 224,000
Common stock, shares issued \| shares					15,000
Sales commission percentage		1.25%
Sales commissions, amount					$ 2,800
Market Equity Offering Program [Member] \| Maximum [Member]
Class of Stock [Line Items]
Value of stock		$ 227,000
Public Offering [Member]
Class of Stock [Line Items]
Proceeds from sale of common shares / units, net of offering costs			$ 337,000	$ 480,000	$ 799,500
Common stock, shares issued \| shares			28,750	34,500	57,500
Additional shares purchased by underwriters \| shares			3,750	4,500	7,500

Stock Awards - Additional Information (Detail) - shares	9 Months Ended
Stock Awards - Additional Information (Detail) - shares	Sep. 30, 2016	Sep. 30, 2015
Time-Based Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation, multi-year performance-based awards	254,574	407,969
Stock awards vesting period in years	3 years
Performance Shares [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation, multi-year performance-based awards	0	366,838
Stock awards vesting period in years	3 years
Multi-year performance-based awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation, multi-year performance-based awards	799,804	505,050
Stock awards vesting period in years	3 years
Equity Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Reserved shares of common stock for awards under the Equity Incentive Plan	8,196,770
Common stock remaining for future stock awards transferred to the equity incentive plan	4,763,066

Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Detail) - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Fair Value Disclosures [Abstract]
Interest and rent receivables, Book value	$ 54,554	$ 46,939
Loans, Book value	496,767	508,851
Debt, net Book value	(2,728,549)	(3,322,541)
Interest and rent receivables, Fair value	54,522	46,858
Loans, Fair value	529,053	543,859
Debt, net Fair value	$ (2,875,619)	$ (3,372,773)

Fair Value of Financial Instruments - Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis (Detail) $ in Thousands	Sep. 30, 2016 USD ($)
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	$ 222,435
Cost	222,435
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] \| Acquisition and Other Loans [Member] \| Other Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	116,585
Cost	116,585
Fair Value Measurements, Recurring [Member] \| Mortgage Loans [Member] \| Mortgage Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	102,550
Cost	$ 102,550

Fair Value of Financial Instruments - Additional information (Detail)	9 Months Ended
	Sep. 30, 2016
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	9 Months Ended
	Sep. 30, 2016 USD ($)
+100 basis points [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated Increase (Decrease) In Fair Value of Financial Instruments	$ (61)
- 100 basis points [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated Increase (Decrease) In Fair Value of Financial Instruments	$ 61

Earnings Per Share/Common Unit - Calculation of Earnings Per Share (Detail) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Income from continuing operations	$ 70,543	$ 23,123	$ 182,693	$ 81,589
Non-controlling interests' share in continuing operations	(185)	(66)	(683)	(228)
Participating securities' share in earnings	(154)	(265)	(430)	(781)
Income from continuing operations, less participating securities' share in earnings	70,204	22,792	181,580	80,580
Income (loss) from discontinued operations attributable to MPT Operating Partnership partners			(1)
Net income, less participating securities' share in earnings	$ 70,204	$ 22,792	$ 181,579	$ 80,580
Basic weighted-average common shares	246,230	223,948	240,607	211,659
Dilutive potential common shares	1,238		825	409
Dilutive weighted-average common shares	247,468	223,948	241,432	212,068
MPT Operating Partnership, L.P. [Member]
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Income from continuing operations	$ 70,543	$ 23,123	$ 182,693	$ 81,589
Non-controlling interests' share in continuing operations	(185)	(66)	(683)	(228)
Participating securities' share in earnings	(154)	(265)	(430)	(781)
Income from continuing operations, less participating securities' share in earnings	70,204	22,792	181,580	80,580
Income (loss) from discontinued operations attributable to MPT Operating Partnership partners			(1)
Net income, less participating securities' share in earnings	$ 70,204	$ 22,792	$ 181,579	$ 80,580
Basic weighted-average common shares	246,230	223,948	240,607	211,659
Dilutive potential common shares	1,238		825	409
Dilutive weighted-average common shares	247,468	223,948	241,432	212,068

Commitments and Contingencies - Additional Information (Detail) € in Millions, $ in Millions	Oct. 01, 2016 EUR (€) Facility	Sep. 28, 2016 USD ($) Hospital	Sep. 09, 2016 EUR (€) Hospital	Jul. 20, 2016 EUR (€) Hospital
Washington and Idaho [Member]
Commitment And Contingencies [Line Items]
Number of rehabilitation hospitals \| Hospital		2
Purchase price of acquisition \| $		$ 105
Germany [Member]
Commitment And Contingencies [Line Items]
Number of rehabilitation hospitals \| Hospital			6	23
Purchase price of acquisition \| €			€ 46.3	€ 215.7
Germany [Member] \| Subsequent Event [Member]
Commitment And Contingencies [Line Items]
Number of facilities closed \| Facility	3
Consideration received on closing of facilities \| €	€ 22.9