MEDICAL PROPERTIES TRUST INC, 10-Q filed on 5/8/2026
Quarterly Report
v3.26.1
Document and Entity Information - shares
shares in Millions
3 Months Ended
Mar. 31, 2026
May 06, 2026
Document Information [Line Items]    
Document Type 10-Q  
Amendment Flag false  
Document Period End Date Mar. 31, 2026  
Document Fiscal Year Focus 2026  
Document Fiscal Period Focus Q1  
Trading Symbol MPT  
Entity Registrant Name MEDICAL PROPERTIES TRUST, INC.  
Entity Central Index Key 0001287865  
Current Fiscal Year End Date --12-31  
Entity Current Reporting Status Yes  
Entity Interactive Data Current Yes  
Entity Filer Category Large Accelerated Filer  
Entity Small Business false  
Entity Emerging Growth Company false  
Entity Common Stock, Shares Outstanding   598.1
Title of 12(b) Security Common stock, par value $0.001 per share, of Medical Properties Trust, Inc.  
Security Exchange Name NYSE  
Entity Shell Company false  
Entity File Number 001-32559  
Entity Tax Identification Number 20-0191742  
Entity Address, Address Line One 10500 LIBERTY PARKWAY  
Entity Address, City or Town BIRMINGHAM  
Entity Address, State or Province AL  
Entity Address, Postal Zip Code 35242  
City Area Code 205  
Local Phone Number 969-3755  
Entity Incorporation, State or Country Code MD  
Document Quarterly Report true  
Document Transition Report false  
MPT Operating Partnership, L.P. [Member]    
Document Information [Line Items]    
Document Type 10-Q  
Amendment Flag false  
Document Period End Date Mar. 31, 2026  
Document Fiscal Year Focus 2026  
Document Fiscal Period Focus Q1  
Entity Registrant Name MPT OPERATING PARTNERSHIP, L.P.  
Entity Central Index Key 0001524607  
Current Fiscal Year End Date --12-31  
Entity Current Reporting Status Yes  
Entity Interactive Data Current Yes  
Entity Filer Category Non-accelerated Filer  
Entity Small Business false  
Entity Emerging Growth Company false  
Entity Shell Company false  
Entity File Number 333-177186  
Entity Tax Identification Number 20-0242069  
Entity Address, Address Line One 10500 LIBERTY PARKWAY  
Entity Address, City or Town BIRMINGHAM  
Entity Address, State or Province AL  
Entity Address, Postal Zip Code 35242  
City Area Code 205  
Local Phone Number 969-3755  
Entity Incorporation, State or Country Code DE  
v3.26.1
Condensed Consolidated Balance Sheets - USD ($)
$ in Thousands
Mar. 31, 2026
Dec. 31, 2025
Real estate assets    
Land, buildings and improvements, intangible lease assets, and other $ 12,109,743 $ 12,205,687
Investment in financing leases 381,589 421,684
Mortgage loans 124,479 123,651
Gross investment in real estate assets 12,615,811 12,751,022
Accumulated depreciation and amortization (1,713,282) (1,663,056)
Net investment in real estate assets 10,902,529 11,087,966
Cash and cash equivalents 425,001 540,859
Interest and rent receivables 17,981 19,210
Straight-line rent receivables 904,075 881,452
Investments in unconsolidated real estate joint ventures 1,390,385 1,399,777
Investments in unconsolidated operating entities 320,928 322,179
Other loans 237,957 186,292
Other assets 563,821 564,040
Total Assets 14,762,677 15,001,775
Liabilities    
Debt, net 9,662,659 9,697,835
Accounts payable and accrued expenses 433,165 549,105
Deferred revenue 18,580 19,289
Obligations to tenants and other lease liabilities 102,514 128,297
Total Liabilities 10,216,918 10,394,526
Equity / Capital    
Preferred stock, $0.001 par value. Authorized 10,000 shares; no shares outstanding
Common stock, $0.001 par value. Authorized 750,000 shares; issued and outstanding - 597,715 shares at March 31, 2026 and 597,008 shares at December 31, 2025 598 597
Additional paid-in capital 8,577,846 8,573,396
Retained deficit (4,157,439) (4,136,011)
Accumulated other comprehensive income 123,700 168,213
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital) 4,544,705 4,606,195
Non-controlling interests 1,054 1,054
Total Equity / Capital 4,545,759 4,607,249
Total Liabilities and Equity / Capital 14,762,677 15,001,775
MPT Operating Partnership, L.P. [Member]    
Real estate assets    
Land, buildings and improvements, intangible lease assets, and other 12,109,743 12,205,687
Investment in financing leases 381,589 421,684
Mortgage loans 124,479 123,651
Gross investment in real estate assets 12,615,811 12,751,022
Accumulated depreciation and amortization (1,713,282) (1,663,056)
Net investment in real estate assets 10,902,529 11,087,966
Cash and cash equivalents 425,001 540,859
Interest and rent receivables 17,981 19,210
Straight-line rent receivables 904,075 881,452
Investments in unconsolidated real estate joint ventures 1,390,385 1,399,777
Investments in unconsolidated operating entities 320,928 322,179
Other loans 237,957 186,292
Other assets 563,821 564,040
Total Assets 14,762,677 15,001,775
Liabilities    
Debt, net 9,662,659 9,697,835
Accounts payable and accrued expenses 378,520 493,364
Deferred revenue 18,580 19,289
Obligations to tenants and other lease liabilities 102,514 128,297
Payable due to Medical Properties Trust, Inc. 54,255 55,351
Total Liabilities 10,216,528 10,394,136
Equity / Capital    
General Partner - issued and outstanding - 5,979 units at March 31, 2026 and 5,972 units at December 31, 2025 44,287 44,457
Limited Partners - issued and outstanding - 591,736 units at March 31, 2026 and 591,036 units at December 31, 2025 4,377,108 4,393,915
Accumulated other comprehensive income 123,700 168,213
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital) 4,545,095 4,606,585
Non-controlling interests 1,054 1,054
Total Equity / Capital 4,546,149 4,607,639
Total Liabilities and Equity / Capital $ 14,762,677 $ 15,001,775
v3.26.1
Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares
Mar. 31, 2026
Dec. 31, 2025
Preferred stock, par value $ 0.001 $ 0.001
Preferred stock, shares authorized 10,000,000 10,000,000
Preferred stock, shares outstanding 0 0
Common stock, par value $ 0.001 $ 0.001
Common stock, shares authorized 750,000,000 750,000,000
Common stock, shares issued 597,715,000 597,008,000
Common stock, shares outstanding 597,715,000 597,008,000
General Partner [Member] | MPT Operating Partnership, L.P. [Member]    
General partner, units issued 5,979,000 5,972,000
General partner, units outstanding 5,979,000 5,972,000
Common Units | MPT Operating Partnership, L.P. [Member]    
Limited Partners, units issued 591,736,000 591,036,000
Limited Partners, units outstanding 591,736,000 591,036,000
v3.26.1
Condensed Consolidated Statements of Net Income (Unaudited) - USD ($)
shares in Thousands, $ in Thousands
3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Revenues    
Rent billed $ 197,520 $ 165,190
Straight-line rent 34,196 40,127
Income from financing leases 10,064 9,905
Interest and other income 10,285 8,577
Total revenues 252,065 223,799
Expenses    
Interest 133,330 115,801
Real estate depreciation and amortization 69,717 64,572
Property-related 9,940 7,035
General and administrative 32,205 41,911
Total expenses 245,192 229,319
Other (expense) income    
(Loss) gain on sale of real estate (790) 8,059
Real estate and other impairment charges, net (19,032) (76,102)
Earnings from equity interests 15,739 13,986
Debt refinancing and unutilized financing costs 0 (3,796)
Other (including fair value adjustments on securities) (2,505) (45,206)
Total other expense (6,588) (103,059)
Income (loss) before income tax 285 (108,579)
Income tax benefit (expense) 32,822 (9,437)
Net income (loss) 33,107 (118,016)
Net income attributable to non-controlling interests (280) (259)
Net income (loss) attributable to MPT common stockholders $ 32,827 $ (118,275)
Earnings per common share (units) basic    
Net income (loss) attributable to MPT common stockholders (Operating Partnership partners), basic $ 0.05 $ (0.2)
Earnings per common share (units) diluted    
Net income (loss) attributable to MPT common stockholders (Operating Partnership partners), diluted $ 0.05 $ (0.2)
Weighted average shares (units) outstanding basic 597,715 600,594
Weighted average shares (units) outstanding diluted 597,715 600,594
Dividends declared per common share (unit) $ 0.09 $ 0.08
MPT Operating Partnership, L.P. [Member]    
Revenues    
Rent billed $ 197,520 $ 165,190
Straight-line rent 34,196 40,127
Income from financing leases 10,064 9,905
Interest and other income 10,285 8,577
Total revenues 252,065 223,799
Expenses    
Interest 133,330 115,801
Real estate depreciation and amortization 69,717 64,572
Property-related 9,940 7,035
General and administrative 32,205 41,911
Total expenses 245,192 229,319
Other (expense) income    
(Loss) gain on sale of real estate (790) 8,059
Real estate and other impairment charges, net (19,032) (76,102)
Earnings from equity interests 15,739 13,986
Debt refinancing and unutilized financing costs 0 (3,796)
Other (including fair value adjustments on securities) (2,505) (45,206)
Total other expense (6,588) (103,059)
Income (loss) before income tax 285 (108,579)
Income tax benefit (expense) 32,822 (9,437)
Net income (loss) 33,107 (118,016)
Net income attributable to non-controlling interests (280) (259)
Net income (loss) attributable to MPT common stockholders $ 32,827 $ (118,275)
Earnings per common share (units) basic    
Net income (loss) attributable to MPT common stockholders (Operating Partnership partners), basic $ 0.05 $ (0.2)
Earnings per common share (units) diluted    
Net income (loss) attributable to MPT common stockholders (Operating Partnership partners), diluted $ 0.05 $ (0.2)
Weighted average shares (units) outstanding basic 597,715 600,594
Weighted average shares (units) outstanding diluted 597,715 600,594
Dividends declared per common share (unit) $ 0.09 $ 0.08
v3.26.1
Condensed Consolidated Statements of Comprehensive Loss (Unaudited) - USD ($)
$ in Thousands
3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Net income (loss) $ 33,107 $ (118,016)
Other comprehensive (loss) gain:    
Unrealized loss on interest rate hedges, net of tax 0 (4,015)
Foreign currency translation (loss) gain (44,513) 93,467
Total comprehensive loss (11,406) (28,564)
Comprehensive income attributable to non-controlling interests (280) (259)
Comprehensive loss attributable to MPT Operating Partnership partners (11,686) (28,823)
MPT Operating Partnership, L.P. [Member]    
Net income (loss) 33,107 (118,016)
Other comprehensive (loss) gain:    
Unrealized loss on interest rate hedges, net of tax 0 (4,015)
Foreign currency translation (loss) gain (44,513) 93,467
Total comprehensive loss (11,406) (28,564)
Comprehensive income attributable to non-controlling interests (280) (259)
Comprehensive loss attributable to MPT Operating Partnership partners $ (11,686) $ (28,823)
v3.26.1
Condensed Consolidated Statements of Equity / Capital - USD ($)
shares in Thousands, $ in Thousands
Total
MPT Operating Partnership, L.P. [Member]
MPT Operating Partnership, L.P. [Member]
General Partner [Member]
MPT Operating Partnership, L.P. [Member]
Limited Partner [Member]
Common Par Value [Member]
Additional Paid-in Capital [Member]
Retained Deficit [Member]
Accumulated Other Comprehensive Income (Loss) [Member]
Accumulated Other Comprehensive Income (Loss) [Member]
MPT Operating Partnership, L.P. [Member]
Non-Controlling Interests [Member]
Non-Controlling Interests [Member]
MPT Operating Partnership, L.P. [Member]
Beginning balance at Dec. 31, 2024 $ 4,833,783 $ 4,834,173 $ 49,348 $ 4,878,043 $ 600 $ 8,584,917 $ (3,658,516) $ (94,272) $ (94,272) $ 1,054 $ 1,054
Beginning balance (in shares) at Dec. 31, 2024     6,006 594,397 600,403            
Net (loss) income (118,016) (118,016) $ (1,183) $ (117,092)     (118,275)     259 259
Unrealized (loss) gain on interest rate hedges, net of tax (4,015) (4,015)           (4,015) (4,015)    
Foreign currency translation (loss) gain 93,467 93,467           93,467 93,467    
Stock (Unit) vesting and amortization of stock (unit)-based compensation 5,794 5,794 $ 58 $ 5,736   5,794          
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)     3 264 267            
Stock (Unit) vesting - satisfaction of tax withholding (289) (289) $ (3) $ (286)   (289)          
Stock (Unit) vesting - satisfaction of tax withholding (shares)     (1) (74) (75)            
Distributions to non-controlling interests (259) (259)               (259) (259)
Dividends (Distributions) declared (48,387) (48,387) $ (484) $ (47,903)     (48,387)        
Ending balance at Mar. 31, 2025 4,762,078 4,762,468 $ 47,736 $ 4,718,498 $ 600 8,590,422 (3,825,178) (4,820) (4,820) 1,054 1,054
Ending balance (in shares) at Mar. 31, 2025     6,008 594,587 600,595            
Beginning balance at Dec. 31, 2025 4,607,249 4,607,639 $ 44,457 $ 4,393,915 $ 597 8,573,396 (4,136,011) 168,213 168,213 1,054 1,054
Beginning balance (in shares) at Dec. 31, 2025     5,972 591,036 597,008            
Net (loss) income 33,107 33,107 $ 328 $ 32,499     32,827     280 280
Unrealized (loss) gain on interest rate hedges, net of tax 0 0                  
Foreign currency translation (loss) gain (44,513) (44,513)           (44,513) (44,513)    
Stock (Unit) vesting and amortization of stock (unit)-based compensation 6,282 6,282 $ 63 $ 6,219 $ 1 6,281          
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)     11 1,052 1,063            
Stock (Unit) vesting - satisfaction of tax withholding (1,792) (1,792) $ (18) $ (1,774)   (1,792)          
Stock (Unit) vesting - satisfaction of tax withholding (shares)     (4) (352) (356)            
Distributions to non-controlling interests (280) (280)               (280) (280)
Offering costs (39) (39)   $ (39)   (39)          
Dividends (Distributions) declared (54,255) (54,255) $ (543) (53,712)     (54,255)        
Ending balance at Mar. 31, 2026 $ 4,545,759 $ 4,546,149 $ 44,287 $ 4,377,108 $ 598 $ 8,577,846 $ (4,157,439) $ 123,700 $ 123,700 $ 1,054 $ 1,054
Ending balance (in shares) at Mar. 31, 2026     5,979 591,736 597,715            
v3.26.1
Condensed Consolidated Statements of Equity / Capital (Parenthetical) - $ / shares
3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Dividends (Distributions) declared per common share / unit $ 0.09 $ 0.08
MPT Operating Partnership, L.P. [Member]    
Dividends (Distributions) declared per common share / unit $ 0.09 $ 0.08
v3.26.1
Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Thousands
3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Operating activities    
Net income (loss) $ 33,107 $ (118,016)
Adjustments to reconcile net income (loss) to net cash (used for) provided by operating activities:    
Depreciation and amortization 73,348 65,431
Amortization of deferred financing costs and debt discount 6,983 5,796
Straight-line rent revenue from operating and finance leases (35,578) (41,601)
Stock / Unit-based compensation expense 573 17,665
(Loss) gain on sale of real estate 790 (8,059)
Real estate and other impairment charges, net 19,506 79,581
Debt refinancing and unutilized financing costs 0 3,796
Tax rate changes and other (45,155) 1,102
Non-cash fair value adjustments (5,568) 26,609
Other adjustments (1,596) 2,473
Changes in:    
Interest and rent receivables 905 6,626
Other assets 556 (1,792)
Accounts payable and accrued expenses (61,809) (35,400)
Deferred revenue (321) (3,827)
Net cash (used for) provided by operating activities (14,259) 384
Investing activities    
Cash paid for acquisitions and other related investments (29,322) (39,314)
Net proceeds from sale of real estate 18,500 19,837
Proceeds received from repayment of loans receivable 48,651 0
Investment in loans receivable (71,024) (21,800)
Construction in progress and other (12,717) (26,053)
Capital additions and other investments, net (30,864) (22,086)
Net cash used for investing activities (76,776) (89,416)
Financing activities    
Proceeds from term debt 0 2,512,970
Payments of term debt 0 (2,252,731)
Revolving credit facility, net 30,000 258,433
Dividends / Distribution paid (55,351) (48,164)
Lease deposits and other obligations to tenants 4,414 3,243
Offering costs (39) 0
Stock / Unit vesting - satisfaction of tax withholdings (1,792) (289)
Payment of debt refinancing and deferred financing costs and other financing activities (456) (47,142)
Net cash (used for) provided by financing activities (23,224) 426,320
(Decrease) increase in cash, cash equivalents, and restricted cash for period (114,259) 337,288
Effect of exchange rate changes (1,785) 4,024
Cash, cash equivalents, and restricted cash at beginning of period 543,995 335,173
Cash, cash equivalents, and restricted cash at end of period 427,951 676,485
Interest paid 174,061 118,005
Supplemental schedule of non-cash financing activities:    
Dividends / Distributions declared, unpaid 54,255 48,387
Cash, cash equivalents, and restricted cash are comprised of the following:    
Cash and cash equivalents at beginning of period 540,859 332,335
Restricted cash, included in Other assets at beginning of period $ 3,136 $ 2,838
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List] Other Assets Other Assets
Cash, cash equivalents, and restricted cash at beginning of period $ 543,995 $ 335,173
Cash and cash equivalents at end of period 425,001 673,482
Restricted cash, included in Other assets at end of period $ 2,950 $ 3,003
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List] Other Assets Other Assets
Cash, cash equivalents, and restricted cash at end of period $ 427,951 $ 676,485
MPT Operating Partnership, L.P. [Member]    
Operating activities    
Net income (loss) 33,107 (118,016)
Adjustments to reconcile net income (loss) to net cash (used for) provided by operating activities:    
Depreciation and amortization 73,348 65,431
Amortization of deferred financing costs and debt discount 6,983 5,796
Straight-line rent revenue and other (35,578) (41,601)
Stock / Unit-based compensation expense 573 17,665
(Loss) gain on sale of real estate 790 (8,059)
Real estate and other impairment charges, net 19,506 79,581
Debt refinancing and unutilized financing costs 0 3,796
Tax rate changes and other (45,155) 1,102
Non-cash fair value adjustments (5,568) 26,609
Other adjustments (1,596) 2,473
Changes in:    
Interest and rent receivables 905 6,626
Other assets 556 (1,792)
Accounts payable and accrued expenses (61,809) (35,400)
Deferred revenue (321) (3,827)
Net cash (used for) provided by operating activities (14,259) 384
Investing activities    
Cash paid for acquisitions and other related investments (29,322) (39,314)
Net proceeds from sale of real estate 18,500 19,837
Proceeds received from repayment of loans receivable 48,651 0
Investment in loans receivable (71,024) (21,800)
Construction in progress and other (12,717) (26,053)
Capital additions and other investments, net (30,864) (22,086)
Net cash used for investing activities (76,776) (89,416)
Financing activities    
Proceeds from term debt 0 2,512,970
Payments of term debt 0 (2,252,731)
Revolving credit facility, net 30,000 258,433
Dividends / Distribution paid (55,351) (48,164)
Lease deposits and other obligations to tenants 4,414 3,243
Offering costs (39) 0
Stock / Unit vesting - satisfaction of tax withholdings (1,792) (289)
Payment of debt refinancing and deferred financing costs and other financing activities (456) (47,142)
Net cash (used for) provided by financing activities (23,224) 426,320
(Decrease) increase in cash, cash equivalents, and restricted cash for period (114,259) 337,288
Effect of exchange rate changes (1,785) 4,024
Cash, cash equivalents, and restricted cash at beginning of period 543,995 335,173
Cash, cash equivalents, and restricted cash at end of period 427,951 676,485
Interest paid 174,061 118,005
Supplemental schedule of non-cash financing activities:    
Dividends / Distributions declared, unpaid 54,255 48,387
Cash, cash equivalents, and restricted cash are comprised of the following:    
Cash and cash equivalents at beginning of period 540,859 332,335
Restricted cash, included in Other assets at beginning of period $ 3,136 $ 2,838
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List] Other Assets Other Assets
Cash, cash equivalents, and restricted cash at beginning of period $ 543,995 $ 335,173
Cash and cash equivalents at end of period 425,001 673,482
Restricted cash, included in Other assets at end of period $ 2,950 $ 3,003
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List] Other Assets Other Assets
Cash, cash equivalents, and restricted cash at end of period $ 427,951 $ 676,485
v3.26.1
Pay vs Performance Disclosure - USD ($)
$ in Thousands
3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Pay vs Performance Disclosure    
Net Income (Loss) $ 32,827 $ (118,275)
v3.26.1
Insider Trading Arrangements
3 Months Ended
Mar. 31, 2026
Trading Arrangements, by Individual  
Rule 10b5-1 Arrangement Adopted false
Non-Rule 10b5-1 Arrangement Adopted false
Rule 10b5-1 Arrangement Terminated false
Non-Rule 10b5-1 Arrangement Terminated false
Rule 10b51 Arr Mofified Flag false
Non Rule 10b51 Arr Modified Flag false
v3.26.1
Organization
3 Months Ended
Mar. 31, 2026
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Organization

1. Organization

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

We operate as a real estate investment trust (“REIT”). Accordingly, we are generally not subject to United States (“U.S.”) federal income tax on our REIT taxable income, provided that we continue to qualify as a REIT and our distributions to our stockholders equal or exceed such taxable income. Similarly, the majority of our real estate operations in the United Kingdom ("U.K.") operate as a REIT and generally are subject only to a withholding tax on earnings upon distribution out of the U.K. REIT. Certain non-real estate activities we undertake in the U.S. are conducted by entities which we elected to be treated as taxable REIT subsidiaries (“TRS”). Our TRS entities are subject to both U.S. federal and state income taxes. For our properties located outside the U.S. (excluding those assets that are in the U.K. REIT), we are subject to the local income taxes of the jurisdictions where our properties reside and/or legal entities are domiciled; however, we do not expect to incur additional taxes, of a significant nature, in the U.S. from foreign-based income as the majority of such income flows through our REIT.

Our primary business strategy is to acquire and develop healthcare facilities and lease the facilities to healthcare operating companies under long-term net leases, which require the tenant to bear most of the costs associated with the property. The majority of our leased assets are owned 100%; however, we do own some leased assets through joint ventures with other partners that share our view that healthcare facilities are part of the infrastructure of any community, which we refer to as investments in unconsolidated real estate joint ventures. We also may make mortgage loans to healthcare operators collateralized by their real estate. In addition, we may make noncontrolling investments in our tenants (which we refer to as investments in unconsolidated operating entities), from time-to-time, typically in conjunction with larger real estate transactions with the tenant, which may enhance our overall return and provide for certain minority rights and protections.

Our business model facilitates acquisitions and recapitalizations, and allows operators of healthcare facilities to unlock the value of their real estate to fund facility improvements, technology upgrades, and other investments in operations. At March 31, 2026, we have investments in 378 facilities in 30 states in the U.S., in seven countries in Europe, and one country in South America. Our properties consist of general acute care hospitals, behavioral health facilities, post acute care facilities (including inpatient physical rehabilitation facilities and long-term acute care hospitals), and freestanding ER/urgent care facilities.

v3.26.1
Summary of Significant Accounting Policies
3 Months Ended
Mar. 31, 2026
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 (“SEC”). 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 statement have been included. Operating results for the three months ended March 31, 2026, are not necessarily indicative of the results that may be expected for the year ending December 31, 2026. The condensed consolidated balance sheet at December 31, 2025 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.

The preparation of our condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. We believe the estimates and assumptions underlying our condensed consolidated financial statements are reasonable and supportable based on the information available as of March 31, 2026 (particularly as it relates to our assessments of the recoverability of our real estate, the ability of our tenants/borrowers to make lease/loan payments in accordance with their respective agreements, the fair value of our equity and loan investments, and the adequacy of our credit loss reserves on loans and financing receivables).

For information about significant accounting policies, and how actual results could differ from estimates, refer to the consolidated financial statements and footnotes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2025 ("2025 Annual Report"). There have been no material changes to these significant accounting policies.

Variable Interest Entities

At March 31, 2026, we had loans and/or equity investments in certain variable interest entities ("VIEs"), including our international joint venture, Healthcare Systems of America ("HSA"), and NOR Healthcare Systems ("NOR"). We have determined that we were not the primary beneficiary of these VIEs. The carrying value and classification of the related assets and maximum exposure to loss as a result of our involvement with these VIEs at March 31, 2026 are presented below (in thousands):

 

VIE Type

 

Carrying
    Amount(1)

 

 

Asset Type
Classification

 

Maximum Loss
Exposure(2)

 

Loans, net and equity investments

 

$

 

 

Investments in Unconsolidated
Operating Entities

 

$

 

Loans, net

 

 

238,805

 

 

Mortgage and other loans

 

 

246,410

 

(1)
Carrying amount only reflects the net book value of our loan or equity investment in the VIE.
(2)
Our maximum loss exposure related to loans with VIEs represents our current aggregate gross carrying value of the loan plus accrued interest and any other related assets (such as rent receivables), less any liabilities. Our maximum loss exposure related to our equity investments in VIEs represents the current carrying values of such investments plus any other related assets (such as rent receivables), less any liabilities.

For the VIE types above, we do not consolidate the VIEs because we do not have the ability to control the activities (such as the day-to-day healthcare operations of our borrowers or investees) that most significantly impact the VIE's economic performance. As of March 31, 2026, we had a remaining funding commitment of $7.6 million related to HSA's electronic health records system. Otherwise, we were not required to provide financial support through a liquidity arrangement or otherwise to our unconsolidated VIEs, including circumstances in which they could be exposed to further losses (e.g. cash shortfalls).

Recent Accounting Developments

Disaggregation of Income Statement Expenses

In November 2024, FASB issued ASU 2024-03, "Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses" ("ASU 2024-03") to improve the disclosures about a public company's expenses and address requests from investors for more detailed information about the types of expenses in commonly presented expense captions. FASB further clarified the effective date in January 2025 with the issuance of ASU 2025-01, Income Statement – Reporting Comprehensive Income – Expense Disaggregation Disclosures (Subtopic 220-40): Clarifying the Effective Date. The ASU is effective for annual periods beginning after December 15, 2026, and interim periods beginning after December 15, 2027. We are currently evaluating the potential impact of the adoption of this standard on our consolidated financial statements.

v3.26.1
Real Estate and Other Activities
3 Months Ended
Mar. 31, 2026
Real Estate [Abstract]  
Real Estate and Other Activities

3. Real Estate and Other Activities

New Investments

We acquired or invested in the following net assets (in thousands):

 

 

 

For the Three Months
Ended March 31,

 

 

 

2026

 

 

2025

 

Land and land improvements

 

$

2,163

 

 

$

19,905

 

Buildings and other

 

 

24,340

 

 

 

19,409

 

Intangible lease assets — subject to amortization
   (weighted-average useful life of
25.1 years in 2026)

 

 

2,819

 

 

 

 

Total net assets acquired

 

$

29,322

 

 

$

39,314

 

 

2026 Activity

During the first quarter of 2026, we closed on the acquisition of one property in Germany for approximately €23 million (along with real estate transfer tax) leased to Median Kliniken S.à r.l ("MEDIAN") pursuant to a long-term lease with annual inflation-based escalators.

2025 Activity

In the first quarter of 2025, we funded approximately $39 million to Steward Health Care System's ("Steward") secured lender in order to obtain control over certain real estate assets for use by our new tenants.

Development and Capital Addition Activities

 

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

 

Property

 

Commitment

 

 

Costs
Paid as of
March 31, 2026

 

 

Cost Remaining

 

IMED Hospitales ("IMED") (Spain)

 

$

65,952

 

 

$

49,820

 

 

$

16,132

 

IMED (Spain)

 

 

42,780

 

 

 

42,594

 

 

 

186

 

HSA (Florida)

 

 

43,500

 

 

 

4,421

 

 

 

39,079

 

NOR (California)

 

 

24,333

 

 

 

289

 

 

 

24,044

 

Other (Various)

 

 

554

 

 

 

210

 

 

 

344

 

 

 

$

177,119

 

 

$

97,334

 

 

$

79,785

 

We have two other development projects ongoing in Texas (Texarkana development) and Massachusetts (Norwood redevelopment). These are not highlighted above; however, we have completed construction to the stage where the building is "weathered in" and environmentally secure so as to physically protect our investment while we actively market the hospitals for sale or lease. As of March 31, 2026, we estimate that the cost of additional construction that we believe will be more efficient if completed in the near-term (such as electing to accelerate completion of a parking structure at one hospital), approximates between $5 million and $10 million.

2026 Activity

During the first quarter of 2026, we completed construction and began recording rental income on a $10.7 million capital addition project at an Avondale, Arizona facility leased to Lifepoint Behavioral.

2025 Activity

During the first quarter of 2025, we completed construction and began recording rental income on a $10.5 million capital addition project at a Gilbert, Arizona facility leased to Lifepoint Behavioral.

Disposals

2026 Activity

During the first three months of 2026, we completed the sale of two facilities for total proceeds of approximately $31 million, of which $12 million was received in advance of the sale in the first quarter of 2025, resulting in a loss on real estate of $0.8 million.

2025 Activity

During the first three months of 2025, we completed the sale of two facilities and an ancillary facility for approximately $20 million, resulting in a gain on real estate of $8.1 million.

Leasing Operations (Lessor)

We acquire and develop healthcare facilities and lease the facilities to healthcare operating companies. The initial fixed lease terms of these infrastructure-type assets are typically at least 15 years, and most include renewal options at the election of our tenants, generally in five-year increments. Over 99% of our leases provide annual rent escalations based on increases in the Consumer Price Index ("CPI") (or similar indices outside the U.S.) and/or fixed minimum annual rent escalations. Many of our domestic leases contain purchase options with pricing set at various terms but in no case less than our total initial investment. Our leases typically require the tenant to handle and bear most of the costs associated with our properties including repair/maintenance, property taxes, and insurance.

For all of our properties subject to lease, we are the legal owner of the property and the tenant's right to use and possess such property is guided by the terms of a lease. At March 31, 2026, we account for all of these leases as operating leases, except where GAAP requires alternative classification, including leases on certain Ernest Health, Inc. ("Ernest") facilities that are accounted for as either direct financing or other financing type leases. The components of our total investment in financing leases consisted of the following (in thousands):

 

 

 

As of March 31,
   2026

 

 

As of December 31,
   2025

 

Minimum lease payments receivable

 

$

564,783

 

 

$

570,150

 

Estimated unguaranteed residual values

 

 

203,818

 

 

 

203,818

 

Less: Unearned income and allowance for credit loss

 

 

(517,683

)

 

 

(523,746

)

Net investment in direct financing leases

 

 

250,918

 

 

 

250,222

 

Other financing leases (net of allowance for credit loss)

 

 

130,671

 

 

 

171,462

 

Total investment in financing leases

 

$

381,589

 

 

$

421,684

 

Other Leasing Activities

At March 31, 2026, our vacant properties represented less than 1% of total assets. We are in various stages of either re-leasing or selling these vacant properties.

Our tenants’ financial performance and resulting ability to satisfy their lease and loan obligations to us are material to our financial results and our ability to service our debt and make distributions to our stockholders. Our tenants operate in the healthcare industry, which is highly regulated, and changes in regulation (or delays in enacting regulation) may temporarily impact our tenants’ operations until they are able to make the appropriate adjustments to their business. In addition, our tenants may experience operational challenges from time-to-time as a result of many factors, including those external to them, such as cybersecurity attacks, public health crises, economic issues resulting in high inflation and spikes in labor costs, extreme or severe weather and climate-related events, and adverse market and political conditions. We monitor our tenants' operating results and the potential impact from these challenges. We may elect to provide support to our tenants from time-to-time in the form of short-term rent abatements or rent deferrals to be paid back in full, or in the form of temporary loans. See below for an update on some of our current and former tenants.

Prospect

In August 2019, we invested in a portfolio of 14 acute care hospitals in three states (California, Pennsylvania, and Connecticut) operated by and master leased to or mortgaged by Prospect Medical Holdings, Inc. ("Prospect") for a combined investment of approximately $1.6 billion.

On May 23, 2023, Prospect completed a recapitalization plan, which included receiving $375 million in new financing from several lenders. Along with this new capital from third-party lenders, we agreed to the following restructuring of our then $1.7 billion investment including: a) maintaining the master lease covering six California hospitals without any changes in rental rates or escalator provisions, b) transitioning the Pennsylvania properties back to Prospect in return for a $150 million first lien mortgage, c) providing up to $75 million in a loan secured by a first lien on Prospect's accounts receivable and certain other assets, and d) obtaining a non-controlling ownership interest in PHP Holdings in exchange for unpaid rent and interest, among other things.

Prospect filed for Chapter 11 bankruptcy on January 11, 2025 with the United States Bankruptcy Court for the Northern District of Texas. On March 20, 2025, the bankruptcy court approved a global settlement (including a recovery waterfall) between us, Prospect, and other stakeholders. Due to the bankruptcy, we recorded more than $400 million of impairment charges and negative fair value adjustments associated with our investments in Prospect in the 2024 fourth quarter, resulting in a full reserve of the asset-backed loan and our Pennsylvania mortgage loan, along with a decrease in the value in our Connecticut properties. No charge was recorded on our California properties.

In 2025 and in accordance with the global settlement and the estimated recovery waterfall, we recorded approximately $140 million of additional impairment charges (including $55 million of impairment charges in the 2025 first quarter that further reduced our investment in the Connecticut properties). In determining the 2025 first quarter impairment charges, we compared the carrying value of our investments to our estimate of expected proceeds (net of any possible future cash outlays) to be received under the bankruptcy court approved recovery waterfall, factoring in an estimated recovery of Prospect assets (including our real estate assets as applicable) and applying the priority of claims associated with the bankruptcy. In estimating the fair value of the California, Pennsylvania, and Connecticut real estate, we, along with assistance from a third-party independent valuation firm, used a combination of cost, market, and income approaches using Level 3 inputs. The cost approach used comparable sales to value the land and cost manuals to value the improvements. The value derived from the market approach was based on sales prices of similar properties. For the income approach, we divided the expected operating income from the property by an estimated market capitalization rate (ranging from 8.25% to 8.5%).

In 2025 and through the first quarter of 2026, all the Connecticut and Pennsylvania properties (along with our investment in PHP Holdings discussed below) have been sold, and Prospect's bankruptcy plan has been deemed effective.

During the 2026 first quarter, we received approximately $45 million from these asset sales and collection of Connecticut accounts receivable that serve as collateral for our remaining investment, while funding $45 million of the $70 million bankruptcy court approved funding commitment, as disclosed in our 2025 Annual Report. At March 31, 2026, our remaining investment in Prospect is approximately $61 million. In addition, we expect to fund the remaining $25 million of the $70 million commitment in the 2026 second quarter. We believe this total investment is fully recoverable from the collection of Connecticut accounts receivable (of which we received $9 million in April 2026) and proceeds from litigation and other causes of action, the ultimate outcome and timing of which are uncertain.

Re-tenanting Activity

In December 2025, we re-leased the six California properties to NOR as a result of their successful bid to acquire the hospital operations. Terms of the lease include an initial annualized rent almost identical to the previous rent amount due from Prospect in 2025, annual inflation-based escalators starting in the 2027 first quarter, and an initial fixed term of 15 years. All rent is to be deferred for six months (until mid-June 2026), and 50% of rent is to be deferred for an additional six months, after which the aggregate deferred rent will be paid over the remaining lease term. We are accounting for rent revenue associated with the NOR lease on the cash basis. We have committed to fund approximately $24 million for a new emergency department at one facility and up to $60 million in seismic improvements that may be required by California regulators over the next four years, both of which will increase the lease base and result in additional rent.

PHP Investment

In regard to our investment in PHP Holdings, we accounted for this investment using the fair value option method. In 2025, we recorded an approximate $147 million negative fair value adjustment, including $18 million in the 2025 first quarter. The adjustment in 2025 was made based on changes to the purchase agreement between PHP Holdings and Astrana Health and updates to PHP Holdings' working capital position. On July 1, 2025, we received $2.3 million from the sale of PHP Holdings to Astrana Health.

Other Re-tenanting Activity

As discussed in previous filings, we entered into agreements in September 2024 with six operators (HSA, Honor Health, Insight Health ("Insight"), Quorum, College Health, and Tenor Health ("Tenor")) to lease 18 of the 23 former Steward-operated facilities. Since then, we have sold three of the facilities (including one in the 2026 first quarter) at a net gain. These leases included a rent ramp up period. In the 2025 first quarter, cash rents received from these operators were approximately $3.4 million, ramping up to $11 million in the 2025 second quarter, approximately $12 million in the 2025 third quarter, $26.1 million in the 2025 fourth quarter (including approximately $4 million of September 2025 rent from a cash-basis tenant that was received on October 1, 2025), and $24.5 million in the first quarter of 2026. Based on these lease contracts (adjusted for the sales noted above), rent payments are to increase to approximately 79% of contractual rent by the second quarter 2026, and 100% of contractual rent starting with October 2026. As of March 31, 2026, all of these new operators have paid the rent due under their respective leases, except for cash-basis tenants Insight/Tenor who represent less than 1% of our annual revenues.

As of March 31, 2026, we have approximately $130 million in working capital and other loans related to these operators to assist in the takeover of these operations and the transition of certain services (such as revenue cycle management). These loans are generally secured by accounts receivables and/or other assets (like personal property). Approximately $3 million of working capital loans have been repaid to-date, and we impaired a portion of the loans associated with Insight/Tenor in the 2026 first quarter.

The remaining five former Steward-operated properties (with a net book value of approximately 4% of our total assets), including two developments (see "Development and Capital Addition Activities" above), are in various stages of being re-tenanted or sold.

Investments in Unconsolidated Entities

Investments in Unconsolidated Real Estate Joint Ventures

Our primary business strategy is to acquire real estate and lease to providers of healthcare services. Typically, we directly own 100% of such investments. However, from time-to-time, we will co-invest with other investors that share a similar view that hospital real estate is a necessary infrastructure-type asset in communities. In these types of investments, we will own undivided interests of less than 100% of the real estate through unconsolidated real estate joint ventures. The underlying real estate and leases in these unconsolidated real estate joint ventures are generally structured similarly and carry a similar risk profile to the rest of our real estate portfolio.

 

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

 

Operator

 

Ownership Percentage

As of March 31,
   2026

 

 

As of December 31,
   2025

 

Swiss Medical Network

 

70%

$

609,795

 

 

$

611,347

 

MEDIAN

 

50%

 

474,120

 

 

 

486,695

 

CommonSpirit (Utah partnership)

 

25%

 

169,269

 

 

 

162,278

 

Policlinico di Monza

 

50%

 

85,503

 

 

 

86,091

 

HM Hospitales

 

45%

 

51,698

 

 

 

53,366

 

Total

 

 

$

1,390,385

 

 

$

1,399,777

 

 

The Utah partnership applies specialized accounting and reporting for investment companies under Topic 946, which measures the underlying investments at fair value. For the quarters ended March 31, 2026 and 2025, our share of the Utah partnership's income included a favorable fair value adjustment of approximately $7.2 million (primarily related to an unrealized gain on investments in real estate) and $6.0 million (primarily related to its interest rate swap), respectively.

Investments in Unconsolidated Operating Entities

Our investments in unconsolidated operating entities are noncontrolling investments that are typically made in conjunction with larger real estate transactions in which the operators are vetted as part of our overall underwriting process. In many cases, we would not be able to acquire the larger real estate portfolio without such investments in operators. These investments also offer the opportunity to enhance our overall return and provide for certain minority rights and protections.

 

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

 

Operator

 

As of March 31,
   2026

 

 

As of December 31,
   2025

 

Swiss Medical Network

 

$

195,838

 

 

$

197,497

 

Aevis Victoria SA ("Aevis")

 

 

63,346

 

 

 

64,859

 

Priory Group ("Priory")

 

 

45,844

 

 

 

43,913

 

Aspris Children's Services ("Aspris")

 

 

15,900

 

 

 

15,910

 

Total

 

$

320,928

 

 

$

322,179

 

 

For our investments marked to fair value (including our investments in Aevis, the international joint venture, and PHP Holdings through the first half of 2025), we recorded approximately $2 million in unfavorable non-cash fair value adjustments during the first three months of 2026; whereas, this was a $30 million unfavorable non-cash fair value adjustment for the same period of 2025.

Credit Loss Reserves

We apply a forward-looking "expected loss" model to our financing receivables, including financing leases and loans, based on historical credit losses of similar instruments.

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

 

 

 

For the Three Months
Ended March 31,

 

 

 

 

2026

 

 

2025

 

 

Balance at beginning of the year

 

$

553,297

 

 

$

511,473

 

 

Provision for credit loss, net (1)

 

 

14,554

 

 

 

65,982

 

 

Expected credit loss reserve written off or related to financial
     instruments sold, repaid, or satisfied (2)

 

 

(525,079

)

 

 

 

 

Balance at end of the period

 

$

42,772

 

 

$

577,455

 

 

(1)
The amount in 2025 is primarily related to Prospect. See "Leasing Operations (Lessor)" in this Note 3 for further discussion.
(2)
The amount in 2026 is primarily related to write-offs of previously reserved Prospect mortgages and other financing leases. See "Leasing Operations (Lessor)" in this Note 3 for further discussion.

Concentrations of Credit Risk

We monitor concentration risk in several ways due to the nature of our real estate assets that are vital to the communities in which they are located and given our history of being able to replace inefficient operators of our facilities, if needed, with more effective operators. See below for our concentration details (dollars in thousands):

Total Assets by Operator

 

 

 

As of March 31, 2026

 

 

As of December 31, 2025

 

Operators

 

Total Assets (1)

 

 

Percentage of
Total Assets

 

 

Total Assets (1)

 

 

Percentage of
Total Assets

 

Circle Health Ltd ("Circle")

 

$

2,069,009

 

 

 

14.0

%

 

$

2,121,848

 

 

 

14.1

%

Priory

 

 

1,273,725

 

 

 

8.6

%

 

 

1,301,888

 

 

 

8.7

%

HSA

 

 

1,209,459

 

 

 

8.2

%

 

 

1,200,996

 

 

 

8.0

%

Swiss Medical Network

 

 

868,978

 

 

 

5.9

%

 

 

873,703

 

 

 

5.8

%

Lifepoint Behavioral

 

 

806,344

 

 

 

5.5

%

 

 

809,492

 

 

 

5.4

%

Other operators

 

 

6,624,284

 

 

 

44.9

%

 

 

6,688,287

 

 

 

44.6

%

Other assets

 

 

1,910,878

 

 

 

12.9

%

 

 

2,005,561

 

 

 

13.4

%

Total

 

$

14,762,677

 

 

 

100.0

%

 

$

15,001,775

 

 

 

100.0

%

(1)
Total assets by operator are generally comprised of real estate assets, mortgage loans, investments in unconsolidated real estate joint ventures, investments in unconsolidated operating entities, and other loans.

 

Total Assets by U.S. State and Country (1)

 

 

As of March 31, 2026

 

 

As of December 31, 2025

 

U.S. States and Other Countries

 

Total Assets

 

 

Percentage of
Total Assets

 

 

Total Assets

 

 

Percentage of
Total Assets

 

Texas

 

$

1,403,311

 

 

 

9.5

%

 

$

1,427,391

 

 

 

9.5

%

California

 

 

1,024,998

 

 

 

7.0

%

 

 

977,890

 

 

 

6.5

%

Florida

 

 

832,712

 

 

 

5.6

%

 

 

834,940

 

 

 

5.6

%

Arizona

 

 

329,471

 

 

 

2.2

%

 

 

328,873

 

 

 

2.2

%

Ohio

 

 

317,842

 

 

 

2.2

%

 

 

330,189

 

 

 

2.2

%

All other states

 

 

2,422,158

 

 

 

16.4

%

 

 

2,480,182

 

 

 

16.5

%

Other domestic assets

 

 

1,046,367

 

 

 

7.1

%

 

 

1,072,900

 

 

 

7.2

%

Total U.S.

 

$

7,376,859

 

 

 

50.0

%

 

$

7,452,365

 

 

 

49.7

%

United Kingdom

 

$

4,084,982

 

 

 

27.7

%

 

$

4,184,188

 

 

 

27.9

%

Switzerland

 

 

868,978

 

 

 

5.9

%

 

 

873,703

 

 

 

5.8

%

Germany

 

 

761,421

 

 

 

5.1

%

 

 

751,806

 

 

 

5.0

%

Spain

 

 

306,718

 

 

 

2.1

%

 

 

302,323

 

 

 

2.0

%

All other countries

 

 

499,208

 

 

 

3.4

%

 

 

504,729

 

 

 

3.4

%

Other international assets

 

 

864,511

 

 

 

5.8

%

 

 

932,661

 

 

 

6.2

%

Total international

 

$

7,385,818

 

 

 

50.0

%

 

$

7,549,410

 

 

 

50.3

%

Grand total

 

$

14,762,677

 

 

 

100.0

%

 

$

15,001,775

 

 

 

100.0

%

 

Total Assets by Facility Type (1)

 

 

As of March 31, 2026

 

 

As of December 31, 2025

 

Facility Types

 

Total Assets

 

 

Percentage of
Total Assets

 

 

Total Assets

 

 

Percentage of
Total Assets

 

General acute care hospitals

 

$

8,673,783

 

 

 

58.8

%

 

$

8,769,909

 

 

 

58.5

%

Behavioral health facilities

 

 

2,407,964

 

 

 

16.3

%

 

 

2,445,418

 

 

 

16.3

%

Post acute care facilities

 

 

1,668,629

 

 

 

11.3

%

 

 

1,671,616

 

 

 

11.1

%

Freestanding ER/urgent care facilities

 

 

101,423

 

 

 

0.7

%

 

 

109,271

 

 

 

0.7

%

Other assets

 

 

1,910,878

 

 

 

12.9

%

 

 

2,005,561

 

 

 

13.4

%

Total

 

$

14,762,677

 

 

 

100.0

%

 

$

15,001,775

 

 

 

100.0

%

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

On an individual property basis, our largest investment in any single property was less than 2% of our total assets as of March 31, 2026.

On a revenue basis, concentration in 2026 compared to the same periods of 2025 is as follows:

Total Revenues by Geographic Location

 

 

 

For the Three Months Ended March 31,

 

 

 

2026

 

 

2025

 

Geographic Location

 

Total Revenues

 

 

Percentage of
Total Revenues

 

 

Total Revenues

 

 

Percentage of
Total Revenues

 

Total U.S.

 

$

134,861

 

 

 

53.5

%

 

$

116,840

 

 

 

52.2

%

United Kingdom

 

 

96,396

 

 

 

38.2

%

 

 

88,653

 

 

 

39.6

%

All other countries

 

 

20,808

 

 

 

8.3

%

 

 

18,306

 

 

 

8.2

%

Grand total

 

$

252,065

 

 

 

100.0

%

 

$

223,799

 

 

 

100.0

%

Total Revenues by Facility Type

 

 

 

For the Three Months Ended March 31,

 

 

 

2026

 

 

2025

 

Facility Types

 

Total Revenues

 

 

Percentage of
Total Revenues

 

 

Total Revenues

 

 

Percentage of
Total Revenues

 

General acute care hospitals

 

$

156,194

 

 

 

62.0

%

 

$

135,019

 

 

 

60.3

%

Behavioral health facilities

 

 

55,575

 

 

 

22.0

%

 

 

51,520

 

 

 

23.0

%

Post acute care facilities

 

 

38,370

 

 

 

15.2

%

 

 

35,256

 

 

 

15.8

%

Freestanding ER/urgent care facilities

 

 

1,926

 

 

 

0.8

%

 

 

2,004

 

 

 

0.9

%

Total

 

$

252,065

 

 

 

100.0

%

 

$

223,799

 

 

 

100.0

%

The following shows those tenants that represented 10% or more of our total revenues for the three months ended March 31, 2026 and 2025:

 

 

 

For the Three Months Ended March 31,

 

 

 

2026

 

 

2025

 

Operators

 

Total Revenues

 

 

Percentage of
Total Revenues

 

 

Total Revenues

 

 

Percentage of
Total Revenues

 

Circle

 

$

54,961

 

 

 

21.8

%

 

$

50,711

 

 

 

22.7

%

Priory

 

 

27,496

 

 

 

10.9

%

 

 

24,941

 

 

 

11.1

%

Other operators

 

 

169,608

 

 

 

67.3

%

 

 

148,147

 

 

 

66.2

%

Total

 

$

252,065

 

 

 

100.0

%

 

$

223,799

 

 

 

100.0

%

v3.26.1
Debt
3 Months Ended
Mar. 31, 2026
Debt Disclosure [Abstract]  
Debt

4. Debt

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

 

 

 

As of March 31,
2026

 

 

As of December 31,
2025

 

Secured revolving credit facility(A)

 

$

665,577

 

 

$

638,063

 

Secured term loan

 

 

200,000

 

 

 

200,000

 

British pound sterling secured term loan due 2034(B)

 

 

835,126

 

 

 

850,784

 

0.993% Senior Unsecured Notes due 2026(B)

 

 

577,650

 

 

 

587,300

 

5.000% Senior Unsecured Notes due 2027

 

 

1,400,000

 

 

 

1,400,000

 

3.692% Senior Unsecured Notes due 2028(B)

 

 

793,620

 

 

 

808,500

 

4.625% Senior Unsecured Notes due 2029

 

 

900,000

 

 

 

900,000

 

3.375% Senior Unsecured Notes due 2030(B)

 

 

462,945

 

 

 

471,625

 

3.500% Senior Unsecured Notes due 2031

 

 

1,300,000

 

 

 

1,300,000

 

7.000% Senior Secured Notes due 2032(B)

 

 

1,155,300

 

 

 

1,174,600

 

8.500% Senior Secured Notes due 2032

 

 

1,500,000

 

 

 

1,500,000

 

 

 

$

9,790,218

 

 

$

9,830,872

 

Debt issue costs and discount, net

 

 

(127,559

)

 

 

(133,037

)

 

 

$

9,662,659

 

 

$

9,697,835

 

 

(A)
Includes 100 million and €100 million of Euro-denominated borrowings and CHF 52 million and CHF 52 million of Swiss franc-denominated borrowings that reflect the applicable exchange rates at March 31, 2026 and December 31, 2025, respectively.
(B)
Non-U.S. dollar denominated debt reflects the exchange rates at March 31, 2026 and December 31, 2025.

As of March 31, 2026, principal payments due on our debt (which exclude the effects of any discounts, premiums, or debt issue costs recorded) are as follows (amounts in thousands):

2026

 

$

1,243,227

 

(1)

2027

 

 

1,600,000

 

 

2028

 

 

793,620

 

 

2029

 

 

900,000

 

 

2030

 

 

462,945

 

 

Thereafter

 

 

4,790,426

 

 

Total

 

$

9,790,218

 

 

 

(1)
$666 million (of which we have had an approximate $145 million net reduction since March 31, 2026) represents the outstanding balance of our revolving credit facility for which we have provided notice of our intent to extend to 2027 - see "Credit Facility" subheading for further details.

Credit Facility

We have a multi-currency denominated revolver and a $200 million term loan that make up our Credit Facility (the "Credit Facility"). The maximum borrowings under the revolving portion of the Credit Facility is $1.28 billion.

On February 13, 2025 and concurrent with the closing of our private notes offering discussed previously, we further amended the Credit Facility and (i) removed the Modified Covenant Period and any restrictions related thereto from the existing Credit Facility, (ii) permanently removed financial covenants regarding minimum consolidated tangible net worth, maximum unsecured indebtedness to unencumbered asset value and minimum unsecured net operating income to unsecured interest expense, (iii) amended certain definitions used in the financial covenant regarding maximum total indebtedness to total asset value to conform to corresponding definitions in our existing unsecured indentures and the secured notes issued concurrently and set the covenant level at 60%, (iv) provided notice that we plan to exercise both of our 6-month extension options such that the maturity of the revolving portion of our Credit Facility would move to June 30, 2027 (subject to the satisfaction of certain conditions with the primary condition of not being in default at the time of each extension option date - and believe we will meet all conditions to do so), (v) reset the interest rate to SOFR plus 225 basis points, (vi) provided for the loans thereunder to be secured and guaranteed ratably with the secured notes issued in February 2025, (vii) set the maximum secured leverage ratio at 40%, and (viii) added mandatory prepayments of senior debt or addition of additional collateral in connection with any failure to (x) maintain a 65% maximum ratio of secured first lien debt to the

undepreciated real estate value of the secured pool properties or (y) maintain a minimum senior secured debt service coverage ratio of 1.30:1.00.

2025 Activity

British Pound Sterling Term Loan due 2025

On January 15, 2025, we paid off the remaining £493 million balance of our British pound sterling term loan due 2025. With this payoff, we also terminated the sterling-denominated term loan interest rate swap.

Senior Secured Notes due 2032

On February 13, 2025, we closed on a private offering that consisted of $1.5 billion aggregate principal amount of senior secured notes due 2032 and €1.0 billion aggregate principal amount of senior secured notes due 2032.

We used the net proceeds from the notes to fund the early redemption of our 3.325% Senior Unsecured Notes due 2025, 2.500% Senior Unsecured Notes due 2026, and 5.250% Senior Unsecured Notes due 2026. We used the remaining net proceeds to pay down the revolving portion of our Credit Facility.

Debt Refinancing and Unutilized Financing Costs

In the first quarter of 2025, we incurred $3.8 million of debt refinancing and unutilized financing costs. These costs were incurred primarily as a result of the early redemption of our 3.325% Senior Unsecured Notes due 2025, 2.500% Senior Unsecured Notes due 2026, and 5.250% Senior Unsecured Notes due 2026.

Covenants and Restrictions

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 the Credit Facility limit the amount of dividends we can pay as a percentage of normalized adjusted funds from operations (“NAFFO”), as defined in the agreements, on a rolling four quarter basis to 95% of NAFFO. The indentures governing our senior unsecured notes also limit the amount of dividends we can pay based on the sum of 95% of NAFFO, proceeds of equity issuances, and certain other net cash proceeds. Finally, our senior notes require us to maintain total unencumbered assets (as defined in the related indenture) of not less than 150% of our unsecured indebtedness.

In addition to these restrictions, the Credit Facility contains customary financial and operating covenants, including covenants relating to our total leverage ratio, fixed charge coverage ratio, secured leverage ratio, unsecured leverage ratio, and unsecured interest coverage ratio.

In addition to the covenants and restrictions discussed above, our Credit Facility contains customary events of default, including among others, nonpayment of principal or interest, material inaccuracy of representations, and failure to comply with our covenants. If an event of default occurs and is continuing under the Credit Facility, the entire outstanding balance may become immediately due and payable. At March 31, 2026, we were in compliance with all financial and operating covenants.

v3.26.1
Income Taxes
3 Months Ended
Mar. 31, 2026
Income Tax Disclosure [Abstract]  
Income Taxes

5. Income Taxes

In the 2026 first quarter, we moved seven additional U.K. property holding legal entities into our U.K. REIT that was formed on July 1, 2023. With this move, we adjusted the deferred tax liabilities associated with these entities, resulting in an approximately $43 million one-time tax benefit in the first quarter of 2026. Going forward, these U.K. entities (like the others in the U.K. REIT) will be subject only to a withholding tax on earnings upon distribution out of the U.K. REIT.

v3.26.1
Common Stock
3 Months Ended
Mar. 31, 2026
Equity [Abstract]  
Common Stock

6. Common Stock

On August 11, 2025, we entered into an at-the-market equity offering program (the "ATM Program"), which provides for the sale, from time to time, of up to $500 million of our common stock with a commission rate up to 2%. As of March 31, 2026, we had not sold any shares under the ATM Program.

v3.26.1
Stock Awards
3 Months Ended
Mar. 31, 2026
Share-Based Payment Arrangement [Abstract]  
Stock Awards

7. Stock Awards

During the second quarter of 2022, we amended the 2019 Equity Incentive Plan (the “Equity Incentive Plan”), which authorizes the issuance of common stock options, restricted stock, restricted stock units, deferred stock units, stock appreciation rights,

performance units, and awards of interests in our Operating Partnership. Our Equity Incentive Plan is administered by the Compensation Committee of the Board of Directors, and we have reserved 28.9 million shares of common stock for awards, of which 1.8 million shares remain available for future stock awards as of March 31, 2026. Share-based compensation expense totaled $0.6 million and $17.7 million for the three months ended March 31, 2026 and 2025, respectively. Of this expense, a benefit of ($8.5) million and an expense of $9.5 million for the three months ended March 31, 2026 and 2025, respectively, are from performance award grants that contain cash-settlement features and are marked to fair value quarterly. None of the cash-settled performance awards have been earned or vested at March 31, 2026, and will not begin to earn/vest until, for 20 consecutive days, our stock price reaches $7.00 for the 2024 performance award and our total shareholder return reaches 20% (based on the April 15, 2025 grant date) for our 2025 performance award.

v3.26.1
Fair Value of Financial Instruments
3 Months Ended
Mar. 31, 2026
Fair Value Disclosures [Abstract]  
Fair Value of Financial Instruments

8. Fair Value of Financial Instruments

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

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

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

 

 

 

 

As of March 31, 2026

 

 

As of December 31, 2025

 

Asset (Liability)

 

Book
Value

 

 

Fair
Value

 

 

Book
Value

 

 

Fair
Value

 

Interest and rent receivables

 

$

17,981

 

 

$

18,659

 

 

$

19,210

 

 

$

19,907

 

Loans(1)

 

 

669,499

 

(2)

 

668,217

 

 

 

624,243

 

(2)

 

624,369

 

Debt, net

 

 

(9,662,659

)

 

 

(8,656,491

)

 

 

(9,697,835

)

 

 

(8,980,547

)

 

(1)
Excludes the acquisition loan made in May 2020 related to our investment in the international joint venture, along with the related subsequent investment in the real estate of three hospitals in Colombia, as these assets are accounted for under the fair value option method, as noted below.
(2)
Includes $7.5 million and $7.5 million of mortgage loans, $383.0 million and $388.9 million of loans (including a shareholder loan) included in investments in unconsolidated real estate joint ventures, $45.1 million and $45.4 million of loans that are part of our investments in unconsolidated operating entities, and $233.9 million and $182.4 million of other loans at March 31, 2026 and December 31, 2025, respectively.

Items Measured at Fair Value on a Recurring Basis

Our equity investment and related loan to the international joint venture and our loan investment in the real estate of three hospitals operated by subsidiaries of the international joint venture in Colombia are measured at fair value on a recurring basis as we elected to account for these investments using the fair value option at the point of initial investment. We elected to account for these investments at fair value due to the size of the investments and because we believed this method was more reflective of current values.

At March 31, 2026 and December 31, 2025, the amounts recorded under the fair value option method were as follows (in thousands):

 

 

 

As of March 31, 2026

 

 

As of December 31, 2025

 

 

 

Asset (Liability)

 

Fair Value

 

 

Original
Cost

 

 

Fair Value

 

 

Original
Cost

 

 

Asset Type Classification

Mortgage loans

 

$

116,942

 

 

$

155,884

 

 

$

116,113

 

 

$

151,692

 

 

Mortgage loans

Equity investment and other loans

 

 

4,387

 

 

 

265,091

 

 

 

4,285

 

 

 

264,160

 

 

Investments in unconsolidated operating entities/Other loans

Our loans to the international joint venture and its subsidiaries are recorded at fair value by discounting the estimated future contractual cash flows using a credit-adjusted rate of return, which is derived from market rates of return on similar loans with similar credit quality and remaining maturity. Our equity investment in the international joint venture is recorded at fair value by using a market approach, which requires significant estimates of our investee, such as projected revenue, expenses, and working capital, and appropriate consideration of the underlying risk profile of the forecasted assumptions associated with the investee. We classify our valuations of this investment as Level 3, as we use certain unobservable inputs to the valuation methodology that are significant to the fair value measurement, and the valuations require management judgment due to the absence of quoted market prices.

In the first three months of 2026, we recorded an unfavorable adjustment to the investments accounted for under the fair value option method of approximately $3 million, primarily related to our investment in three hospitals in Colombia. In the first three months of 2025, we recorded a net unfavorable adjustment to the investments accounted for under the fair value option method of approximately $30 million, primarily related to our investment in three hospitals in Colombia and our investment in PHP Holdings as further discussed in Note 3 to the condensed consolidated financial statements.

Items Measured at Fair Value on a Nonrecurring Basis

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

Impairment of Real Estate Investments

See the Prospect subheading under "Leasing Operations (Lessor)" in Note 3 to the condensed consolidated financial statements for a discussion around the use of fair value and related assumptions in the impairment of our real estate investments.

v3.26.1
Earnings Per Share/Unit
3 Months Ended
Mar. 31, 2026
Earnings Per Share [Abstract]  
Earnings Per Share/Unit

9. Earnings Per Share/Unit

Medical Properties Trust, Inc.

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

 

 

 

For the Three Months
Ended March 31,

 

 

 

2026

 

 

2025

 

Numerator:

 

 

 

 

 

 

Net income (loss)

 

$

33,107

 

 

$

(118,016

)

Non-controlling interests’ share in net income

 

 

(280

)

 

 

(259

)

Participating securities’ share in earnings

 

 

(461

)

 

 

(117

)

Net income (loss), less participating securities’ share in earnings

 

$

32,366

 

 

$

(118,392

)

Denominator:

 

 

 

 

 

 

Basic weighted-average common shares

 

 

597,715

 

 

 

600,594

 

Dilutive potential common shares(1)

 

 

 

 

 

 

Diluted weighted-average common shares

 

 

597,715

 

 

 

600,594

 

 

MPT Operating Partnership, L.P.

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

 

 

 

For the Three Months
Ended March 31,

 

 

 

2026

 

 

2025

 

Numerator:

 

 

 

 

 

 

Net income (loss)

 

$

33,107

 

 

$

(118,016

)

Non-controlling interests’ share in net income

 

 

(280

)

 

 

(259

)

Participating securities’ share in earnings

 

 

(461

)

 

 

(117

)

Net income (loss), less participating securities’ share in earnings

 

$

32,366

 

 

$

(118,392

)

Denominator:

 

 

 

 

 

 

Basic weighted-average units

 

 

597,715

 

 

 

600,594

 

Dilutive potential units(1)

 

 

 

 

 

 

Diluted weighted-average units

 

 

597,715

 

 

 

600,594

 

 

(1)
The above computation of diluted earnings per share/unit does not include 66,244 shares/units for the three months ended March 31, 2025, as inclusion of these shares when a loss exists would be antidilutive. There were no dilutive potential common shares/units for the three months ended March 31, 2026.
v3.26.1
Contingencies
3 Months Ended
Mar. 31, 2026
Loss Contingency [Abstract]  
Contingencies

10. Contingencies

As part of the global settlement with Steward discussed in previous filings, we and Steward agreed, subject to specified exceptions, to the mutual release of claims against each other. In connection with the global settlement and reciprocal release of claims, we established a reserve for certain obligations due to third parties associated with properties formerly leased to Steward, which is approximately $16 million at March 31, 2026.

We are, or were, party to various lawsuits as described below:

Securities and Derivative Litigation

On April 13, 2023, we and certain of our executives were named as defendants in a putative federal securities class action lawsuit filed by a purported stockholder in the United States District Court for the Northern District of Alabama (Case No. 2:23-cv-00486). This class action complaint was amended on September 22, 2023 and alleged that we made material misstatements or omissions relating to the financial health of certain of our tenants. On September 26, 2024, the Court dismissed the amended complaint with prejudice, and the plaintiff thereafter moved the Court to alter its judgment. On August 14, 2025, the Court denied the plaintiff’s motion and dismissed the amended complaint with prejudice.

Members of our Board of Directors were also named as defendants in two related shareholder derivative lawsuits filed by purported stockholders in the United States District Court for the Northern District of Alabama on October 19, 2023 (Case No. 2:23- cv-01415) and December 7, 2023 (Case No. 2:23-cv-01667). The Company was named as a nominal defendant in both complaints. These shareholder derivative complaints both made allegations similar to those made in the now-dismissed Alabama securities lawsuit described above relating to purported material misstatements or omissions relating to the financial health of certain of our tenants. After the related securities case was dismissed, the plaintiffs in these derivative actions each filed a notice of voluntary dismissal and these cases have now been dismissed without prejudice.

Members of our Board of Directors were also named as defendants in three related shareholder derivative lawsuits filed by purported stockholders in the United States District Court for the District of Maryland on February 16, 2024 (Case No. 1:24-cv-00471), June 28, 2024 (Case No. 1:24-cv-01899), and July 26, 2024 (Case No. 1:24-cv-02173). The Company was named as a nominal defendant. These shareholder derivative complaints made allegations similar to those made in the now-dismissed Alabama securities and derivative lawsuits described above relating to purported material misstatements or omissions relating to the financial health of certain of our tenants. After the related securities case was dismissed, the plaintiffs in these derivative actions each filed a notice of voluntary dismissal and each of these cases has now been dismissed without prejudice.

On September 29, 2023, we and certain of our executives were named as defendants in a putative federal securities class action lawsuit filed by a purported stockholder in the United States District Court for the Southern District of New York (Case No. 1:23-cv- 08597). The complaint seeks class certification on behalf of purchasers of our common stock between May 23, 2023 and August 17, 2023 and alleges false and/or misleading statements and/or omissions in connection with certain transactions involving Prospect. This class action complaint was amended on October 30, 2024 and alleges that we made material misstatements or omissions in connection with certain transactions involving Prospect. Defendants filed a motion to dismiss the amended complaint on January 14, 2025. That motion has been fully briefed and is currently pending before the Court.

Members of our Board of Directors were also named as defendants in two related shareholder derivative lawsuits filed by purported stockholders in the United States District Court for the Southern District of New York on December 18, 2023 (Case No. 1:23-cv- 10934) and March 1, 2024 (Case No. 1:24-cv-01589). The Company was named as a nominal defendant in both complaints. These shareholder derivative complaints both make allegations similar to those made in the New York securities lawsuit described above relating to purported false and/or misleading statements and/or omissions in connection with certain transactions involving Prospect. The two cases have been consolidated and stayed pending further developments in the New York securities lawsuit described above. On February 21, 2024, members of our Board of Directors were named as defendants in a shareholder derivative lawsuit filed by a purported stockholder in the United States District Court for the District of Maryland (Case No. 1:24-cv-00527). The Company was named as a nominal defendant. This shareholder derivative complaint makes allegations similar to those made in the New York securities and derivative lawsuits described above relating to purported false and/or misleading statements and/or omissions in connection with certain transactions involving Prospect. This action has been stayed pending further developments in the New York securities action described above.

We believe these claims are without merit and intend to defend the remaining open cases vigorously. We have not recorded a liability related to the lawsuits above because, at this time, we are unable to determine whether an unfavorable outcome is probable or to estimate reasonably possible losses.

From time-to-time, we are a party to other legal proceedings, claims, or regulatory inquiries and investigations arising out of, or incidental to, our business. While we are unable to predict with certainty the outcome of any particular matter, in the opinion of management, after consultation with legal counsel, the ultimate liability, if any, with respect to those proceedings is not presently expected to materially affect our financial position, results of operations, or cash flows.

v3.26.1
Segment Disclosures
3 Months Ended
Mar. 31, 2026
Segment Reporting [Abstract]  
Segment Disclosures

11. Segment Disclosures

We manage our business and report financial results as one business segment. This is consistent with the manner in which our chief operating decision maker ("CODM"), our executive team made up of our Chief Executive Officer and Chief Financial Officer, evaluates performance and makes resource and operating decisions for the business.

Our primary business strategy and source of revenue is from the acquisition and development of healthcare facilities that are leased to healthcare operating companies under long-term net leases, which require the tenant to bear most of the costs associated with the property. The majority of our leased assets are owned 100%; however, we do own some leased assets through joint ventures with other partners. We also may make mortgage loans to healthcare operators collateralized by their real estate. In addition, we may make noncontrolling investments in our tenants, from time-to-time, typically in conjunction with larger real estate transactions with the tenant, which may enhance our overall return and provide for certain minority rights and protections. Although we generate our revenues from these investments in the U.S. and eight other countries across multiple property types, we centrally manage these business activities on a consolidated basis. The accounting policies of our business segment are the same as those described in the summary of significant accounting policies.

The CODM evaluates performance and makes resource and operating decisions for the business on a consolidated basis using consolidated net income from our consolidated statements of net income as our primary GAAP profit measure supplemented by consolidated funds from operations ("FFO"). We use net income and FFO to monitor expected versus actual results to assess performance. The measure of segment assets is total assets as reported on our consolidated balance sheets. We compute FFO in accordance with the definition provided by the National Association of Real Estate Investment Trusts, which represents consolidated net income (loss) (computed in accordance with GAAP), excluding gains (losses) on sales of real estate and impairment charges on real estate assets, plus real estate depreciation and amortization, including amortization related to in-place lease intangibles, and after adjustments for unconsolidated partnerships and joint ventures.

Given FFO excludes real estate related depreciation and amortization expense by definition and due to our typical net lease structure which requires our tenants to bear most of the costs associated with our properties (including property taxes, insurance, etc.), the primary expenses reviewed by the CODM include general and administrative and interest expenses from our consolidated statements of net income. See "Concentration of Credit Risks" in Note 3 to our condensed consolidated financial statements for entity-wide disclosures around major customers, geographic areas, and property types.

v3.26.1
Summary of Significant Accounting Policies (Policies)
3 Months Ended
Mar. 31, 2026
Accounting Policies [Abstract]  
Unaudited Interim Condensed Consolidated Financial Statements

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 (“SEC”). 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 statement have been included. Operating results for the three months ended March 31, 2026, are not necessarily indicative of the results that may be expected for the year ending December 31, 2026. The condensed consolidated balance sheet at December 31, 2025 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.

The preparation of our condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. We believe the estimates and assumptions underlying our condensed consolidated financial statements are reasonable and supportable based on the information available as of March 31, 2026 (particularly as it relates to our assessments of the recoverability of our real estate, the ability of our tenants/borrowers to make lease/loan payments in accordance with their respective agreements, the fair value of our equity and loan investments, and the adequacy of our credit loss reserves on loans and financing receivables).

For information about significant accounting policies, and how actual results could differ from estimates, refer to the consolidated financial statements and footnotes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2025 ("2025 Annual Report"). There have been no material changes to these significant accounting policies.

Variable Interest Entities

Variable Interest Entities

At March 31, 2026, we had loans and/or equity investments in certain variable interest entities ("VIEs"), including our international joint venture, Healthcare Systems of America ("HSA"), and NOR Healthcare Systems ("NOR"). We have determined that we were not the primary beneficiary of these VIEs. The carrying value and classification of the related assets and maximum exposure to loss as a result of our involvement with these VIEs at March 31, 2026 are presented below (in thousands):

 

VIE Type

 

Carrying
    Amount(1)

 

 

Asset Type
Classification

 

Maximum Loss
Exposure(2)

 

Loans, net and equity investments

 

$

 

 

Investments in Unconsolidated
Operating Entities

 

$

 

Loans, net

 

 

238,805

 

 

Mortgage and other loans

 

 

246,410

 

(1)
Carrying amount only reflects the net book value of our loan or equity investment in the VIE.
(2)
Our maximum loss exposure related to loans with VIEs represents our current aggregate gross carrying value of the loan plus accrued interest and any other related assets (such as rent receivables), less any liabilities. Our maximum loss exposure related to our equity investments in VIEs represents the current carrying values of such investments plus any other related assets (such as rent receivables), less any liabilities.

For the VIE types above, we do not consolidate the VIEs because we do not have the ability to control the activities (such as the day-to-day healthcare operations of our borrowers or investees) that most significantly impact the VIE's economic performance. As of March 31, 2026, we had a remaining funding commitment of $7.6 million related to HSA's electronic health records system. Otherwise, we were not required to provide financial support through a liquidity arrangement or otherwise to our unconsolidated VIEs, including circumstances in which they could be exposed to further losses (e.g. cash shortfalls).

Recent Accounting Developments

Recent Accounting Developments

Disaggregation of Income Statement Expenses

In November 2024, FASB issued ASU 2024-03, "Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses" ("ASU 2024-03") to improve the disclosures about a public company's expenses and address requests from investors for more detailed information about the types of expenses in commonly presented expense captions. FASB further clarified the effective date in January 2025 with the issuance of ASU 2025-01, Income Statement – Reporting Comprehensive Income – Expense Disaggregation Disclosures (Subtopic 220-40): Clarifying the Effective Date. The ASU is effective for annual periods beginning after December 15, 2026, and interim periods beginning after December 15, 2027. We are currently evaluating the potential impact of the adoption of this standard on our consolidated financial statements.

v3.26.1
Summary of Significant Accounting Policies (Tables)
3 Months Ended
Mar. 31, 2026
Accounting Policies [Abstract]  
Summary of Carrying Value and Classification of the Assets and Maximum Exposure The carrying value and classification of the related assets and maximum exposure to loss as a result of our involvement with these VIEs at March 31, 2026 are presented below (in thousands):

 

VIE Type

 

Carrying
    Amount(1)

 

 

Asset Type
Classification

 

Maximum Loss
Exposure(2)

 

Loans, net and equity investments

 

$

 

 

Investments in Unconsolidated
Operating Entities

 

$

 

Loans, net

 

 

238,805

 

 

Mortgage and other loans

 

 

246,410

 

(1)
Carrying amount only reflects the net book value of our loan or equity investment in the VIE.
(2)
Our maximum loss exposure related to loans with VIEs represents our current aggregate gross carrying value of the loan plus accrued interest and any other related assets (such as rent receivables), less any liabilities. Our maximum loss exposure related to our equity investments in VIEs represents the current carrying values of such investments plus any other related assets (such as rent receivables), less any liabilities.
v3.26.1
Real Estate and Other Activities (Tables)
3 Months Ended
Mar. 31, 2026
Real Estate [Abstract]  
Net Assets Acquired

We acquired or invested in the following net assets (in thousands):

 

 

 

For the Three Months
Ended March 31,

 

 

 

2026

 

 

2025

 

Land and land improvements

 

$

2,163

 

 

$

19,905

 

Buildings and other

 

 

24,340

 

 

 

19,409

 

Intangible lease assets — subject to amortization
   (weighted-average useful life of
25.1 years in 2026)

 

 

2,819

 

 

 

 

Total net assets acquired

 

$

29,322

 

 

$

39,314

 

 

Summary of Status on Current Development and Capital Additions Projects

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

 

Property

 

Commitment

 

 

Costs
Paid as of
March 31, 2026

 

 

Cost Remaining

 

IMED Hospitales ("IMED") (Spain)

 

$

65,952

 

 

$

49,820

 

 

$

16,132

 

IMED (Spain)

 

 

42,780

 

 

 

42,594

 

 

 

186

 

HSA (Florida)

 

 

43,500

 

 

 

4,421

 

 

 

39,079

 

NOR (California)

 

 

24,333

 

 

 

289

 

 

 

24,044

 

Other (Various)

 

 

554

 

 

 

210

 

 

 

344

 

 

 

$

177,119

 

 

$

97,334

 

 

$

79,785

 

Components of Total Investment in Financing Leases The components of our total investment in financing leases consisted of the following (in thousands):

 

 

 

As of March 31,
   2026

 

 

As of December 31,
   2025

 

Minimum lease payments receivable

 

$

564,783

 

 

$

570,150

 

Estimated unguaranteed residual values

 

 

203,818

 

 

 

203,818

 

Less: Unearned income and allowance for credit loss

 

 

(517,683

)

 

 

(523,746

)

Net investment in direct financing leases

 

 

250,918

 

 

 

250,222

 

Other financing leases (net of allowance for credit loss)

 

 

130,671

 

 

 

171,462

 

Total investment in financing leases

 

$

381,589

 

 

$

421,684

 

Summary of Investments in Unconsolidated Operating Entities

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

 

Operator

 

Ownership Percentage

As of March 31,
   2026

 

 

As of December 31,
   2025

 

Swiss Medical Network

 

70%

$

609,795

 

 

$

611,347

 

MEDIAN

 

50%

 

474,120

 

 

 

486,695

 

CommonSpirit (Utah partnership)

 

25%

 

169,269

 

 

 

162,278

 

Policlinico di Monza

 

50%

 

85,503

 

 

 

86,091

 

HM Hospitales

 

45%

 

51,698

 

 

 

53,366

 

Total

 

 

$

1,390,385

 

 

$

1,399,777

 

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

 

Operator

 

As of March 31,
   2026

 

 

As of December 31,
   2025

 

Swiss Medical Network

 

$

195,838

 

 

$

197,497

 

Aevis Victoria SA ("Aevis")

 

 

63,346

 

 

 

64,859

 

Priory Group ("Priory")

 

 

45,844

 

 

 

43,913

 

Aspris Children's Services ("Aspris")

 

 

15,900

 

 

 

15,910

 

Total

 

$

320,928

 

 

$

322,179

 

Summary of Activity in Credit Loss reserves

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

 

 

 

For the Three Months
Ended March 31,

 

 

 

 

2026

 

 

2025

 

 

Balance at beginning of the year

 

$

553,297

 

 

$

511,473

 

 

Provision for credit loss, net (1)

 

 

14,554

 

 

 

65,982

 

 

Expected credit loss reserve written off or related to financial
     instruments sold, repaid, or satisfied (2)

 

 

(525,079

)

 

 

 

 

Balance at end of the period

 

$

42,772

 

 

$

577,455

 

 

(1)
The amount in 2025 is primarily related to Prospect. See "Leasing Operations (Lessor)" in this Note 3 for further discussion.
(2)
The amount in 2026 is primarily related to write-offs of previously reserved Prospect mortgages and other financing leases. See "Leasing Operations (Lessor)" in this Note 3 for further discussion.
Schedule of Concentrations of Credit Risk See below for our concentration details (dollars in thousands):

Total Assets by Operator

 

 

 

As of March 31, 2026

 

 

As of December 31, 2025

 

Operators

 

Total Assets (1)

 

 

Percentage of
Total Assets

 

 

Total Assets (1)

 

 

Percentage of
Total Assets

 

Circle Health Ltd ("Circle")

 

$

2,069,009

 

 

 

14.0

%

 

$

2,121,848

 

 

 

14.1

%

Priory

 

 

1,273,725

 

 

 

8.6

%

 

 

1,301,888

 

 

 

8.7

%

HSA

 

 

1,209,459

 

 

 

8.2

%

 

 

1,200,996

 

 

 

8.0

%

Swiss Medical Network

 

 

868,978

 

 

 

5.9

%

 

 

873,703

 

 

 

5.8

%

Lifepoint Behavioral

 

 

806,344

 

 

 

5.5

%

 

 

809,492

 

 

 

5.4

%

Other operators

 

 

6,624,284

 

 

 

44.9

%

 

 

6,688,287

 

 

 

44.6

%

Other assets

 

 

1,910,878

 

 

 

12.9

%

 

 

2,005,561

 

 

 

13.4

%

Total

 

$

14,762,677

 

 

 

100.0

%

 

$

15,001,775

 

 

 

100.0

%

(1)
Total assets by operator are generally comprised of real estate assets, mortgage loans, investments in unconsolidated real estate joint ventures, investments in unconsolidated operating entities, and other loans.

 

Total Assets by U.S. State and Country (1)

 

 

As of March 31, 2026

 

 

As of December 31, 2025

 

U.S. States and Other Countries

 

Total Assets

 

 

Percentage of
Total Assets

 

 

Total Assets

 

 

Percentage of
Total Assets

 

Texas

 

$

1,403,311

 

 

 

9.5

%

 

$

1,427,391

 

 

 

9.5

%

California

 

 

1,024,998

 

 

 

7.0

%

 

 

977,890

 

 

 

6.5

%

Florida

 

 

832,712

 

 

 

5.6

%

 

 

834,940

 

 

 

5.6

%

Arizona

 

 

329,471

 

 

 

2.2

%

 

 

328,873

 

 

 

2.2

%

Ohio

 

 

317,842

 

 

 

2.2

%

 

 

330,189

 

 

 

2.2

%

All other states

 

 

2,422,158

 

 

 

16.4

%

 

 

2,480,182

 

 

 

16.5

%

Other domestic assets

 

 

1,046,367

 

 

 

7.1

%

 

 

1,072,900

 

 

 

7.2

%

Total U.S.

 

$

7,376,859

 

 

 

50.0

%

 

$

7,452,365

 

 

 

49.7

%

United Kingdom

 

$

4,084,982

 

 

 

27.7

%

 

$

4,184,188

 

 

 

27.9

%

Switzerland

 

 

868,978

 

 

 

5.9

%

 

 

873,703

 

 

 

5.8

%

Germany

 

 

761,421

 

 

 

5.1

%

 

 

751,806

 

 

 

5.0

%

Spain

 

 

306,718

 

 

 

2.1

%

 

 

302,323

 

 

 

2.0

%

All other countries

 

 

499,208

 

 

 

3.4

%

 

 

504,729

 

 

 

3.4

%

Other international assets

 

 

864,511

 

 

 

5.8

%

 

 

932,661

 

 

 

6.2

%

Total international

 

$

7,385,818

 

 

 

50.0

%

 

$

7,549,410

 

 

 

50.3

%

Grand total

 

$

14,762,677

 

 

 

100.0

%

 

$

15,001,775

 

 

 

100.0

%

 

Total Assets by Facility Type (1)

 

 

As of March 31, 2026

 

 

As of December 31, 2025

 

Facility Types

 

Total Assets

 

 

Percentage of
Total Assets

 

 

Total Assets

 

 

Percentage of
Total Assets

 

General acute care hospitals

 

$

8,673,783

 

 

 

58.8

%

 

$

8,769,909

 

 

 

58.5

%

Behavioral health facilities

 

 

2,407,964

 

 

 

16.3

%

 

 

2,445,418

 

 

 

16.3

%

Post acute care facilities

 

 

1,668,629

 

 

 

11.3

%

 

 

1,671,616

 

 

 

11.1

%

Freestanding ER/urgent care facilities

 

 

101,423

 

 

 

0.7

%

 

 

109,271

 

 

 

0.7

%

Other assets

 

 

1,910,878

 

 

 

12.9

%

 

 

2,005,561

 

 

 

13.4

%

Total

 

$

14,762,677

 

 

 

100.0

%

 

$

15,001,775

 

 

 

100.0

%

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

On an individual property basis, our largest investment in any single property was less than 2% of our total assets as of March 31, 2026.

On a revenue basis, concentration in 2026 compared to the same periods of 2025 is as follows:

Total Revenues by Geographic Location

 

 

 

For the Three Months Ended March 31,

 

 

 

2026

 

 

2025

 

Geographic Location

 

Total Revenues

 

 

Percentage of
Total Revenues

 

 

Total Revenues

 

 

Percentage of
Total Revenues

 

Total U.S.

 

$

134,861

 

 

 

53.5

%

 

$

116,840

 

 

 

52.2

%

United Kingdom

 

 

96,396

 

 

 

38.2

%

 

 

88,653

 

 

 

39.6

%

All other countries

 

 

20,808

 

 

 

8.3

%

 

 

18,306

 

 

 

8.2

%

Grand total

 

$

252,065

 

 

 

100.0

%

 

$

223,799

 

 

 

100.0

%

Total Revenues by Facility Type

 

 

 

For the Three Months Ended March 31,

 

 

 

2026

 

 

2025

 

Facility Types

 

Total Revenues

 

 

Percentage of
Total Revenues

 

 

Total Revenues

 

 

Percentage of
Total Revenues

 

General acute care hospitals

 

$

156,194

 

 

 

62.0

%

 

$

135,019

 

 

 

60.3

%

Behavioral health facilities

 

 

55,575

 

 

 

22.0

%

 

 

51,520

 

 

 

23.0

%

Post acute care facilities

 

 

38,370

 

 

 

15.2

%

 

 

35,256

 

 

 

15.8

%

Freestanding ER/urgent care facilities

 

 

1,926

 

 

 

0.8

%

 

 

2,004

 

 

 

0.9

%

Total

 

$

252,065

 

 

 

100.0

%

 

$

223,799

 

 

 

100.0

%

The following shows those tenants that represented 10% or more of our total revenues for the three months ended March 31, 2026 and 2025:

 

 

 

For the Three Months Ended March 31,

 

 

 

2026

 

 

2025

 

Operators

 

Total Revenues

 

 

Percentage of
Total Revenues

 

 

Total Revenues

 

 

Percentage of
Total Revenues

 

Circle

 

$

54,961

 

 

 

21.8

%

 

$

50,711

 

 

 

22.7

%

Priory

 

 

27,496

 

 

 

10.9

%

 

 

24,941

 

 

 

11.1

%

Other operators

 

 

169,608

 

 

 

67.3

%

 

 

148,147

 

 

 

66.2

%

Total

 

$

252,065

 

 

 

100.0

%

 

$

223,799

 

 

 

100.0

%

v3.26.1
Debt (Tables)
3 Months Ended
Mar. 31, 2026
Debt Disclosure [Abstract]  
Summary of Debt

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

 

 

 

As of March 31,
2026

 

 

As of December 31,
2025

 

Secured revolving credit facility(A)

 

$

665,577

 

 

$

638,063

 

Secured term loan

 

 

200,000

 

 

 

200,000

 

British pound sterling secured term loan due 2034(B)

 

 

835,126

 

 

 

850,784

 

0.993% Senior Unsecured Notes due 2026(B)

 

 

577,650

 

 

 

587,300

 

5.000% Senior Unsecured Notes due 2027

 

 

1,400,000

 

 

 

1,400,000

 

3.692% Senior Unsecured Notes due 2028(B)

 

 

793,620

 

 

 

808,500

 

4.625% Senior Unsecured Notes due 2029

 

 

900,000

 

 

 

900,000

 

3.375% Senior Unsecured Notes due 2030(B)

 

 

462,945

 

 

 

471,625

 

3.500% Senior Unsecured Notes due 2031

 

 

1,300,000

 

 

 

1,300,000

 

7.000% Senior Secured Notes due 2032(B)

 

 

1,155,300

 

 

 

1,174,600

 

8.500% Senior Secured Notes due 2032

 

 

1,500,000

 

 

 

1,500,000

 

 

 

$

9,790,218

 

 

$

9,830,872

 

Debt issue costs and discount, net

 

 

(127,559

)

 

 

(133,037

)

 

 

$

9,662,659

 

 

$

9,697,835

 

 

(A)
Includes 100 million and €100 million of Euro-denominated borrowings and CHF 52 million and CHF 52 million of Swiss franc-denominated borrowings that reflect the applicable exchange rates at March 31, 2026 and December 31, 2025, respectively.
(B)
Non-U.S. dollar denominated debt reflects the exchange rates at March 31, 2026 and December 31, 2025.
Principal Payments Due on Debt

As of March 31, 2026, principal payments due on our debt (which exclude the effects of any discounts, premiums, or debt issue costs recorded) are as follows (amounts in thousands):

2026

 

$

1,243,227

 

(1)

2027

 

 

1,600,000

 

 

2028

 

 

793,620

 

 

2029

 

 

900,000

 

 

2030

 

 

462,945

 

 

Thereafter

 

 

4,790,426

 

 

Total

 

$

9,790,218

 

 

 

(1)
$666 million (of which we have had an approximate $145 million net reduction since March 31, 2026) represents the outstanding balance of our revolving credit facility for which we have provided notice of our intent to extend to 2027 - see "Credit Facility" subheading for further details.
v3.26.1
Fair Value of Financial Instruments (Tables)
3 Months Ended
Mar. 31, 2026
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):

 

 

 

 

As of March 31, 2026

 

 

As of December 31, 2025

 

Asset (Liability)

 

Book
Value

 

 

Fair
Value

 

 

Book
Value

 

 

Fair
Value

 

Interest and rent receivables

 

$

17,981

 

 

$

18,659

 

 

$

19,210

 

 

$

19,907

 

Loans(1)

 

 

669,499

 

(2)

 

668,217

 

 

 

624,243

 

(2)

 

624,369

 

Debt, net

 

 

(9,662,659

)

 

 

(8,656,491

)

 

 

(9,697,835

)

 

 

(8,980,547

)

 

(1)
Excludes the acquisition loan made in May 2020 related to our investment in the international joint venture, along with the related subsequent investment in the real estate of three hospitals in Colombia, as these assets are accounted for under the fair value option method, as noted below.
(2)
Includes $7.5 million and $7.5 million of mortgage loans, $383.0 million and $388.9 million of loans (including a shareholder loan) included in investments in unconsolidated real estate joint ventures, $45.1 million and $45.4 million of loans that are part of our investments in unconsolidated operating entities, and $233.9 million and $182.4 million of other loans at March 31, 2026 and December 31, 2025, respectively.
Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis

At March 31, 2026 and December 31, 2025, the amounts recorded under the fair value option method were as follows (in thousands):

 

 

 

As of March 31, 2026

 

 

As of December 31, 2025

 

 

 

Asset (Liability)

 

Fair Value

 

 

Original
Cost

 

 

Fair Value

 

 

Original
Cost

 

 

Asset Type Classification

Mortgage loans

 

$

116,942

 

 

$

155,884

 

 

$

116,113

 

 

$

151,692

 

 

Mortgage loans

Equity investment and other loans

 

 

4,387

 

 

 

265,091

 

 

 

4,285

 

 

 

264,160

 

 

Investments in unconsolidated operating entities/Other loans

v3.26.1
Earnings Per Share/Unit (Tables)
3 Months Ended
Mar. 31, 2026
Earnings Per Share [Abstract]  
Calculation of Earnings Per Share

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

 

 

 

For the Three Months
Ended March 31,

 

 

 

2026

 

 

2025

 

Numerator:

 

 

 

 

 

 

Net income (loss)

 

$

33,107

 

 

$

(118,016

)

Non-controlling interests’ share in net income

 

 

(280

)

 

 

(259

)

Participating securities’ share in earnings

 

 

(461

)

 

 

(117

)

Net income (loss), less participating securities’ share in earnings

 

$

32,366

 

 

$

(118,392

)

Denominator:

 

 

 

 

 

 

Basic weighted-average common shares

 

 

597,715

 

 

 

600,594

 

Dilutive potential common shares(1)

 

 

 

 

 

 

Diluted weighted-average common shares

 

 

597,715

 

 

 

600,594

 

 

MPT Operating Partnership, L.P.

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

 

 

 

For the Three Months
Ended March 31,

 

 

 

2026

 

 

2025

 

Numerator:

 

 

 

 

 

 

Net income (loss)

 

$

33,107

 

 

$

(118,016

)

Non-controlling interests’ share in net income

 

 

(280

)

 

 

(259

)

Participating securities’ share in earnings

 

 

(461

)

 

 

(117

)

Net income (loss), less participating securities’ share in earnings

 

$

32,366

 

 

$

(118,392

)

Denominator:

 

 

 

 

 

 

Basic weighted-average units

 

 

597,715

 

 

 

600,594

 

Dilutive potential units(1)

 

 

 

 

 

 

Diluted weighted-average units

 

 

597,715

 

 

 

600,594

 

 

(1)
The above computation of diluted earnings per share/unit does not include 66,244 shares/units for the three months ended March 31, 2025, as inclusion of these shares when a loss exists would be antidilutive. There were no dilutive potential common shares/units for the three months ended March 31, 2026.
v3.26.1
Organization - Additional Information (Detail)
3 Months Ended
Mar. 31, 2026
Facility
Country
State
Business Acquisition [Line Items]  
Percentage of leased assets owned 100.00%
Number of facilities | Facility 378
Number of states | State 30
Europe [Member]  
Business Acquisition [Line Items]  
Number of countries 7
South America [Member]  
Business Acquisition [Line Items]  
Number of countries 1
v3.26.1
Summary of Significant Accounting Policies - Summary of Carrying Value and Classification of the Assets and Maximum Exposure (Details) - Variable Interest Entity, Not Primary Beneficiary [Member]
$ in Thousands
Mar. 31, 2026
USD ($)
Investments in Unconsolidated Operating Entities [Member]  
Variable Interest Entity [Line Items]  
Carrying Amount $ 0
Mortgage and Other Loans [Member]  
Variable Interest Entity [Line Items]  
Carrying Amount 238,805
Loans, Net and Equity Investments [Member]  
Variable Interest Entity [Line Items]  
Maximum Loss Exposure 0
Loans, Net Two [Member]  
Variable Interest Entity [Line Items]  
Maximum Loss Exposure $ 246,410
v3.26.1
Summary of Significant Accounting Policies - Additional Information (Detail)
$ in Millions
Mar. 31, 2026
USD ($)
Healthcare Systems of America [Member] | Variable Interest Entity, Not Primary Beneficiary [Member]  
Significant Accounting Policies [Line Items]  
Remaining funding commitment $ 7.6
v3.26.1
Real Estate and Other Activities - Net Assets Acquired (Detail) - USD ($)
$ in Thousands
Mar. 31, 2026
Mar. 31, 2025
Business Combination [Line Items]    
Total net assets acquired $ 29,322 $ 39,314
Land and Land Improvements [Member]    
Business Combination [Line Items]    
Assets acquired 2,163 19,905
Buildings and Other [Member]    
Business Combination [Line Items]    
Assets acquired 24,340 19,409
Intangible Lease Assets [Member]    
Business Combination [Line Items]    
Assets acquired $ 2,819 $ 0
v3.26.1
Real Estate and Other Activities - Net Assets Acquired (Parenthetical) (Details)
3 Months Ended
Mar. 31, 2026
Intangible Lease Assets  
Business Combination [Line Items]  
Weighted-average useful life of acquired intangible lease assets (in years) 25 years 1 month 6 days
v3.26.1
Real Estate and Other Activities - 2026 Activity - Additional Information (Details)
€ in Millions, $ in Millions
3 Months Ended
Mar. 31, 2026
EUR (€)
Property
Mar. 31, 2026
USD ($)
Property
Mar. 31, 2025
USD ($)
Debt Instrument [Line Items]      
Profit (loss) from real estate operations     $ 20.0
Germany [Member]      
Debt Instrument [Line Items]      
Number of property acquired | Property 1 1  
Payment for acquisition | € € 23    
Behavioral Health Hospitals [Member]      
Debt Instrument [Line Items]      
Profit (loss) from real estate operations   $ 10.7 $ 10.5
v3.26.1
Real Estate and Other Activities - 2025 Activity - Additional Information (Detail) - USD ($)
$ in Thousands
3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Dec. 31, 2025
Debt Instrument [Line Items]      
Gain (loss) on real estate dispositions $ (800) $ 8,100  
Investments in unconsolidated real estate joint ventures 1,390,385   $ 1,399,777
Profit (loss) from real estate operations   20,000  
Steward Health Care System LLC [Member]      
Debt Instrument [Line Items]      
Total assets acquired   39,000  
Behavioral Health Hospitals [Member]      
Debt Instrument [Line Items]      
Profit (loss) from real estate operations $ 10,700 $ 10,500  
v3.26.1
Real Estate and Other Activities - Development Activities - Summary of Status on Current Development and Capital Additions Projects (Detail)
$ in Thousands
3 Months Ended
Mar. 31, 2026
USD ($)
Business Acquisition [Line Items]  
Commitment $ 177,119
Costs Paid as of September 30, 2025 97,334
Cost Remaining 79,785
IMED Hospitales ("IMED") [Member] | Spain [Member]  
Business Acquisition [Line Items]  
Commitment 65,952
Costs Paid as of September 30, 2025 49,820
Cost Remaining 16,132
IMED [Member] | Spain [Member]  
Business Acquisition [Line Items]  
Commitment 42,780
Costs Paid as of September 30, 2025 42,594
Cost Remaining 186
HSA [Member] | Florida [Member]  
Business Acquisition [Line Items]  
Commitment 43,500
Costs Paid as of September 30, 2025 4,421
Cost Remaining 39,079
NOR | California [Member]  
Business Acquisition [Line Items]  
Commitment 24,333
Costs Paid as of September 30, 2025 289
Cost Remaining 24,044
Other [Member] | Various [Member]  
Business Acquisition [Line Items]  
Commitment 554
Costs Paid as of September 30, 2025 210
Cost Remaining $ 344
v3.26.1
Real Estate and Other Activities - Development and Capital Addition Activities - Additional Information (Details) - TEXAS And MASSACHUSETTS [Member]
$ in Millions
Mar. 31, 2026
USD ($)
Projects
Business Combination [Line Items]  
Number of other development projects | Projects 2
Minimum [Member]  
Business Combination [Line Items]  
Construction amount $ 5
Maximum [Member]  
Business Combination [Line Items]  
Construction amount $ 10
v3.26.1
Real Estate and Other Activities - Disposals - 2026 Activity - Additional Information (Detail)
$ in Thousands
3 Months Ended
Mar. 31, 2026
USD ($)
Facility
Mar. 31, 2025
USD ($)
Facility
Debt Instrument [Line Items]    
Number of facilities sold | Facility 2 2
Proceeds from sale of property $ 31,000 $ 12,000
Profit (loss) from real estate operations   20,000
Gain (loss) on real estate sale (800) 8,100
Gain (loss) on sale of real estate $ (790) $ 8,059
v3.26.1
Real Estate and Other Activities - Disposals - 2025 Activity - Additional Information (Detail)
$ in Millions
3 Months Ended
Mar. 31, 2026
USD ($)
Facility
Mar. 31, 2025
USD ($)
Facility
Debt Instrument [Line Items]    
Number of facilities sold | Facility 2 2
Proceeds from sale of investments $ 31.0 $ 12.0
Rental income   20.0
Gain (loss) on real estate dispositions $ (0.8) $ 8.1
v3.26.1
Real Estate and Other Activities - Leasing Operations (Lessor) - Additional Information (Detail)
3 Months Ended
Mar. 31, 2026
Lessor Lease Description [Line Items]  
Lease renewal term 5 years
Annual rent escalations 99.00%
Minimum [Member]  
Lessor Lease Description [Line Items]  
Term of lease 15 years
v3.26.1
Real Estate and Other Activities - Components of Total Investment in Financing Leases (Detail) - USD ($)
$ in Thousands
Mar. 31, 2026
Dec. 31, 2025
Direct Financing Lease Net Investment In Leases [Abstract]    
Minimum lease payments receivable $ 564,783 $ 570,150
Estimated unguaranteed residual values 203,818 203,818
Less: Unearned income and allowance for credit loss (517,683) (523,746)
Net investment in direct financing leases 250,918 250,222
Other financing leases (net of allowance for credit loss) 130,671 171,462
Total investment in financing leases $ 381,589 $ 421,684
v3.26.1
Real Estate and Other Activities - Other Leasing Activities - Additional Information (Details)
Mar. 31, 2026
Business Combination [Abstract]  
Percentage of vacant on leased property 1.00%
v3.26.1
Real Estate and Other Activities - Prospect - Additional Information (Detail)
$ in Thousands
1 Months Ended 3 Months Ended 12 Months Ended
May 23, 2023
USD ($)
Apr. 30, 2026
USD ($)
Aug. 31, 2019
USD ($)
Hospital
Mar. 31, 2026
USD ($)
Mar. 31, 2025
USD ($)
Dec. 31, 2024
USD ($)
Dec. 31, 2025
USD ($)
Business Combination [Line Items]              
Proceeds from sale of investments       $ 31,000 $ 12,000    
Investment in loans receivable       71,024 21,800    
Prospect [Member]              
Business Combination [Line Items]              
Purchase price of acquisition     $ 1,600,000        
Pay down of debt instruments $ 375,000            
Reconstitution of asset 1,700,000            
Mortgage Loans [Member] | Prospect [Member]              
Business Combination [Line Items]              
First lien secured loan 150,000            
Maximum [Member] | Prospect [Member]              
Business Combination [Line Items]              
First lien secured loan $ 75,000            
Acute Care Campus [Member] | Prospect [Member]              
Business Combination [Line Items]              
Number of facilities acquired | Hospital     14        
Prospect [Member]              
Business Combination [Line Items]              
Asset sales and collection of Connecticut accounts receivable   $ 9,000   45,000      
Funded investment       45,000      
Remaining funded investment       25,000      
Recover of investments in Prospect       $ 61,000      
Prospect [Member] | PHP Holdings [Member]              
Business Combination [Line Items]              
Loan impairment charges           $ 400,000  
Asset impairment charges         $ 55,000   $ 140,000
Prospect [Member] | Minimum [Member] | Income Valuation Approach [Member] | Level 3 [Member]              
Business Combination [Line Items]              
Market capitalization rate       8.25%      
Prospect [Member] | Maximum [Member]              
Business Combination [Line Items]              
Funded investment       $ 70,000      
Prospect [Member] | Maximum [Member] | Income Valuation Approach [Member] | Level 3 [Member]              
Business Combination [Line Items]              
Market capitalization rate       8.50%      
v3.26.1
Real Estate and Other Activities - Prospect - Re-tenanting Activity - Additional Information (Detail) - Prospect California Facilities [Member]
$ in Millions
12 Months Ended
Dec. 31, 2025
USD ($)
Business Combination [Line Items]  
Rent deferred, period 6 months
Initial lease term 15 years
Percentage of rent deferred for additional six months 50.00%
Maximum fund committed to emergency department $ 24
Maximum fund committed to seismic improvements $ 60
Number of years required to committed fund 4 years
v3.26.1
Real Estate and Other Activities-PHP Investment - Additional Information (Details) - USD ($)
$ in Millions
3 Months Ended 12 Months Ended
Jul. 01, 2025
Mar. 31, 2026
Mar. 31, 2025
Dec. 31, 2025
Business Combination [Line Items]        
Proceeds from sale of investments   $ 31.0 $ 12.0  
PHP Investment [Member]        
Business Combination [Line Items]        
Change in fair value adjustments     $ 18.0 $ 147.0
Proceeds from sale of investments $ 2.3      
v3.26.1
Real Estate and Other Activities - Re-tenanting Activity - Additional Information (Detail) - Other Re-tenanting Activity [Member]
$ in Millions
1 Months Ended 3 Months Ended
Oct. 01, 2025
USD ($)
Oct. 31, 2026
Jun. 30, 2026
Mar. 31, 2026
USD ($)
Property
Dec. 31, 2025
USD ($)
Sep. 30, 2025
USD ($)
Jun. 30, 2025
USD ($)
Mar. 31, 2025
USD ($)
Business Combination [Line Items]                
Number of properties | Property       23        
Number of operators | Property       6        
Number of leased facilities | Property       18        
Cash rent received from operators | $       $ 24.5 $ 26.1 $ 12.0 $ 11.0 $ 3.4
Cash-basis tenant rent from operators | $ $ 4.0              
Percentage of annual revenues       1.00%        
Working capital loans | $       $ 130.0        
Working capital loan repaid | $       $ 3.0        
Percentage of net book value of total assets re-tenanted or sold       4.00%        
Steward [Member]                
Business Combination [Line Items]                
Number of controled properties | Property       5        
Forecast [Member]                
Business Combination [Line Items]                
Percentage of contractual rent   100.00% 79.00%          
v3.26.1
Real Estate and Other Activities - Summary of Investments in Unconsolidated Real Estate Joint Ventures by Operator (Detail) - USD ($)
$ in Thousands
Mar. 31, 2026
Dec. 31, 2025
Schedule of Equity Method Investments [Line Items]    
Investments in unconsolidated real estate joint ventures $ 1,390,385 $ 1,399,777
Swiss Medical Network [Member]    
Schedule of Equity Method Investments [Line Items]    
Ownership interest 70.00%  
Investments in unconsolidated real estate joint ventures $ 609,795 611,347
Median Kliniken S.a.r.l ("MEDIAN") [Member]    
Schedule of Equity Method Investments [Line Items]    
Ownership interest 50.00%  
Investments in unconsolidated real estate joint ventures $ 474,120 486,695
Common Spirit [Member]    
Schedule of Equity Method Investments [Line Items]    
Ownership interest 25.00%  
Investments in unconsolidated real estate joint ventures $ 169,269 162,278
Policlinico di Monza [Member]    
Schedule of Equity Method Investments [Line Items]    
Ownership interest 50.00%  
Investments in unconsolidated real estate joint ventures $ 85,503 86,091
HM Hospital [Member]    
Schedule of Equity Method Investments [Line Items]    
Ownership interest 45.00%  
Investments in unconsolidated real estate joint ventures $ 51,698 $ 53,366
v3.26.1
Real Estate and Other Activities - Investments in Unconsolidated Real Estate Joint Ventures - Additional Information (Detail) - USD ($)
$ in Millions
3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Interest Rate Swap    
Business Combination [Line Items]    
Favorable fair market value adjustment on investment   $ 6.0
Investments in Unconsolidated Real Estate Joint Ventures [Member]    
Business Combination [Line Items]    
Percentage of equity investment 100.00%  
Favorable fair market value adjustment on investment $ 7.2  
Investments in Unconsolidated Real Estate Joint Ventures [Member] | Maximum [Member]    
Business Combination [Line Items]    
Percentage of equity investment 100.00%  
Swiss Medical Network [Member]    
Business Combination [Line Items]    
Percentage of equity investment 70.00%  
Common Spirit [Member]    
Business Combination [Line Items]    
Percentage of equity investment 25.00%  
v3.26.1
Real Estate and Other Activities - Summary of Investments in Unconsolidated Operating Entities (Detail) - USD ($)
$ in Thousands
Mar. 31, 2026
Dec. 31, 2025
Schedule of Equity Method Investments [Line Items]    
Investments in unconsolidated operating entities $ 320,928 $ 322,179
Swiss Medical Network [Member]    
Schedule of Equity Method Investments [Line Items]    
Investments in unconsolidated operating entities 195,838 197,497
Aevis Victoria SA [Member]    
Schedule of Equity Method Investments [Line Items]    
Investments in unconsolidated operating entities 63,346 64,859
Priory Group [Member]    
Schedule of Equity Method Investments [Line Items]    
Investments in unconsolidated operating entities 45,844 43,913
Aspris Children's Services [Member]    
Schedule of Equity Method Investments [Line Items]    
Investments in unconsolidated operating entities $ 15,900 $ 15,910
v3.26.1
Real Estate and Other Activities - Investments in Unconsolidated Operating Entities - Additional Information (Detail) - USD ($)
$ in Millions
3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Other [Member]    
Business Combination [Line Items]    
Unfavorable fair market value adjustment on investment $ 2 $ 30
v3.26.1
Real Estate and Other Activities - Summary of Activity in Credit Loss Reserves (Detail) - USD ($)
$ in Thousands
3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Receivables [Abstract]    
Balance at beginning of the year $ 553,297 $ 511,473
Provision for credit loss, net [1] 14,554 65,982
Expected credit loss reserve written off or related to financial instruments sold, repaid, or satisfied [2] (525,079) 0
Balance at end of the period $ 42,772 $ 577,455
[1] The amount in 2025 is primarily related to Prospect. See "Leasing Operations (Lessor)" in this Note 3 for further discussion.
[2] The amount in 2026 is primarily related to write-offs of previously reserved Prospect mortgages and other financing leases. See "Leasing Operations (Lessor)" in this Note 3 for further discussion.
v3.26.1
Real Estate and Other Activities - Schedule of Concentrations of Credit Risk (Detail) - USD ($)
$ in Thousands
3 Months Ended 12 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Dec. 31, 2025
Business Acquisition [Line Items]      
Total Assets $ 14,762,677   $ 15,001,775
Total Revenues $ 252,065 $ 223,799  
Minimum [Member] | Customer Concentration Risk [Member]      
Business Acquisition [Line Items]      
Maximum percentage of entity's assets invested on single property 2.00%    
Total Gross Assets [Member] | Operator Concentration Risk [Member]      
Business Acquisition [Line Items]      
Total Assets $ 14,762,677   $ 15,001,775
Percentage of concentration risk 100.00%   100.00%
Total Gross Assets [Member] | Geographic Concentration [Member]      
Business Acquisition [Line Items]      
Total Assets $ 14,762,677   $ 15,001,775
Percentage of concentration risk 100.00%   100.00%
Total Gross Assets [Member] | Geographic Concentration [Member] | Texas [Member]      
Business Acquisition [Line Items]      
Total Assets $ 1,403,311   $ 1,427,391
Percentage of concentration risk 9.50%   9.50%
Total Gross Assets [Member] | Geographic Concentration [Member] | California [Member]      
Business Acquisition [Line Items]      
Total Assets $ 1,024,998   $ 977,890
Percentage of concentration risk 7.00%   6.50%
Total Gross Assets [Member] | Geographic Concentration [Member] | Florida [Member]      
Business Acquisition [Line Items]      
Total Assets $ 832,712   $ 834,940
Percentage of concentration risk 5.60%   5.60%
Total Gross Assets [Member] | Geographic Concentration [Member] | Ohio [Member]      
Business Acquisition [Line Items]      
Total Assets $ 317,842   $ 330,189
Percentage of concentration risk 2.20%   2.20%
Total Gross Assets [Member] | Geographic Concentration [Member] | Arizona [Member]      
Business Acquisition [Line Items]      
Total Assets $ 329,471   $ 328,873
Percentage of concentration risk 2.20%   2.20%
Total Gross Assets [Member] | Geographic Concentration [Member] | All Other States [Member]      
Business Acquisition [Line Items]      
Total Assets $ 2,422,158   $ 2,480,182
Percentage of concentration risk 16.40%   16.50%
Total Gross Assets [Member] | Geographic Concentration [Member] | Other Domestic Assets [Member]      
Business Acquisition [Line Items]      
Total Assets $ 1,046,367   $ 1,072,900
Percentage of concentration risk 7.10%   7.20%
Total Gross Assets [Member] | Geographic Concentration [Member] | Total U.S. [Member]      
Business Acquisition [Line Items]      
Total Assets $ 7,376,859   $ 7,452,365
Percentage of concentration risk 50.00%   49.70%
Total Gross Assets [Member] | Geographic Concentration [Member] | United Kingdom [Member]      
Business Acquisition [Line Items]      
Total Assets $ 4,084,982   $ 4,184,188
Percentage of concentration risk 27.70%   27.90%
Total Gross Assets [Member] | Geographic Concentration [Member] | Switzerland [Member]      
Business Acquisition [Line Items]      
Total Assets $ 868,978   $ 873,703
Percentage of concentration risk 5.90%   5.80%
Total Gross Assets [Member] | Geographic Concentration [Member] | Germany [Member]      
Business Acquisition [Line Items]      
Total Assets $ 761,421   $ 751,806
Percentage of concentration risk 5.10%   5.00%
Total Gross Assets [Member] | Geographic Concentration [Member] | Spain [Member]      
Business Acquisition [Line Items]      
Total Assets $ 306,718   $ 302,323
Percentage of concentration risk 2.10%   2.00%
Total Gross Assets [Member] | Geographic Concentration [Member] | All Other Countries [Member]      
Business Acquisition [Line Items]      
Total Assets $ 499,208   $ 504,729
Percentage of concentration risk 3.40%   3.40%
Total Gross Assets [Member] | Geographic Concentration [Member] | Other International Assets [Member]      
Business Acquisition [Line Items]      
Total Assets $ 864,511   $ 932,661
Percentage of concentration risk 5.80%   6.20%
Total Gross Assets [Member] | Geographic Concentration [Member] | Total International [Member]      
Business Acquisition [Line Items]      
Total Assets $ 7,385,818   $ 7,549,410
Percentage of concentration risk 50.00%   50.30%
Total Gross Assets [Member] | Customer Concentration Risk [Member]      
Business Acquisition [Line Items]      
Total Assets $ 14,762,677   $ 15,001,775
Percentage of concentration risk 100.00%   100.00%
Total Gross Assets [Member] | Customer Concentration Risk [Member] | General Acute Care Hospitals [Member]      
Business Acquisition [Line Items]      
Total Assets $ 8,673,783   $ 8,769,909
Percentage of concentration risk 58.80%   58.50%
Total Gross Assets [Member] | Customer Concentration Risk [Member] | Behavioral Health Facilities [Member]      
Business Acquisition [Line Items]      
Total Assets $ 2,407,964   $ 2,445,418
Percentage of concentration risk 16.30%   16.30%
Total Gross Assets [Member] | Customer Concentration Risk [Member] | Post Acute Care Facilities [Member]      
Business Acquisition [Line Items]      
Total Assets $ 1,668,629   $ 1,671,616
Percentage of concentration risk 11.30%   11.10%
Total Gross Assets [Member] | Customer Concentration Risk [Member] | Freestanding ER/Urgent Care Facilities [Member]      
Business Acquisition [Line Items]      
Total Assets $ 101,423   $ 109,271
Percentage of concentration risk 0.70%   0.70%
Total Gross Assets [Member] | Customer Concentration Risk [Member] | Other Assets By Facility [Member]      
Business Acquisition [Line Items]      
Total Assets $ 1,910,878   $ 2,005,561
Percentage of concentration risk 12.90%   13.40%
Total Gross Assets [Member] | Circle [Member] | Operator Concentration Risk [Member]      
Business Acquisition [Line Items]      
Total Assets $ 2,069,009   $ 2,121,848
Percentage of concentration risk 14.00%   14.10%
Total Gross Assets [Member] | Priory [Member] | Operator Concentration Risk [Member]      
Business Acquisition [Line Items]      
Total Assets $ 1,273,725   $ 1,301,888
Percentage of concentration risk 8.60%   8.70%
Total Gross Assets [Member] | HSA [Member] | Operator Concentration Risk [Member]      
Business Acquisition [Line Items]      
Total Assets $ 1,209,459   $ 1,200,996
Percentage of concentration risk 8.20%   8.00%
Total Gross Assets [Member] | Swiss Medical Network [Member] | Operator Concentration Risk [Member]      
Business Acquisition [Line Items]      
Total Assets $ 868,978   $ 873,703
Percentage of concentration risk 5.90%   5.80%
Total Gross Assets [Member] | Lifepoint Behavioral [Member] | Operator Concentration Risk [Member]      
Business Acquisition [Line Items]      
Total Assets $ 806,344   $ 809,492
Percentage of concentration risk 5.50%   5.40%
Total Gross Assets [Member] | Other Operators [Member] | Operator Concentration Risk [Member]      
Business Acquisition [Line Items]      
Total Assets $ 6,624,284   $ 6,688,287
Percentage of concentration risk 44.90%   44.60%
Total Gross Assets [Member] | Other Assets by Operator [Member] | Operator Concentration Risk [Member]      
Business Acquisition [Line Items]      
Total Assets $ 1,910,878   $ 2,005,561
Percentage of concentration risk 12.90%   13.40%
Revenue [Member] | Operator Concentration Risk [Member]      
Business Acquisition [Line Items]      
Percentage of concentration risk 100.00% 100.00%  
Total Revenues $ 252,065 $ 223,799  
Revenue [Member] | Geographic Concentration [Member]      
Business Acquisition [Line Items]      
Percentage of concentration risk 100.00% 100.00%  
Total Revenues $ 252,065 $ 223,799  
Revenue [Member] | Geographic Concentration [Member] | Total U.S. [Member]      
Business Acquisition [Line Items]      
Percentage of concentration risk 53.50% 52.20%  
Total Revenues $ 134,861 $ 116,840  
Revenue [Member] | Geographic Concentration [Member] | United Kingdom [Member]      
Business Acquisition [Line Items]      
Percentage of concentration risk 38.20% 39.60%  
Total Revenues $ 96,396 $ 88,653  
Revenue [Member] | Geographic Concentration [Member] | All Other Countries [Member]      
Business Acquisition [Line Items]      
Percentage of concentration risk 8.30% 8.20%  
Total Revenues $ 20,808 $ 18,306  
Revenue [Member] | Customer Concentration Risk [Member]      
Business Acquisition [Line Items]      
Percentage of concentration risk 100.00% 100.00%  
Total Revenues $ 252,065 $ 223,799  
Revenue [Member] | Customer Concentration Risk [Member] | General Acute Care Hospitals [Member]      
Business Acquisition [Line Items]      
Percentage of concentration risk 62.00% 60.30%  
Total Revenues $ 156,194 $ 135,019  
Revenue [Member] | Customer Concentration Risk [Member] | Behavioral Health Facilities [Member]      
Business Acquisition [Line Items]      
Percentage of concentration risk 22.00% 23.00%  
Total Revenues $ 55,575 $ 51,520  
Revenue [Member] | Customer Concentration Risk [Member] | Post Acute Care Facilities [Member]      
Business Acquisition [Line Items]      
Percentage of concentration risk 15.20% 15.80%  
Total Revenues $ 38,370 $ 35,256  
Revenue [Member] | Customer Concentration Risk [Member] | Freestanding ER/Urgent Care Facilities [Member]      
Business Acquisition [Line Items]      
Percentage of concentration risk 0.80% 0.90%  
Total Revenues $ 1,926 $ 2,004  
Revenue [Member] | Circle [Member] | Operator Concentration Risk [Member]      
Business Acquisition [Line Items]      
Percentage of concentration risk 21.80% 22.70%  
Total Revenues $ 54,961 $ 50,711  
Revenue [Member] | Priory [Member] | Operator Concentration Risk [Member]      
Business Acquisition [Line Items]      
Percentage of concentration risk 10.90% 11.10%  
Total Revenues $ 27,496 $ 24,941  
Revenue [Member] | Other Operators [Member] | Operator Concentration Risk [Member]      
Business Acquisition [Line Items]      
Percentage of concentration risk 67.30% 66.20%  
Total Revenues $ 169,608 $ 148,147  
v3.26.1
Debt - Summary of Debt (Detail) - USD ($)
$ in Thousands
Mar. 31, 2026
Dec. 31, 2025
Feb. 13, 2025
Debt Instrument [Line Items]      
Debt $ 9,790,218 $ 9,830,872  
Debt issue costs and discount, net (127,559) (133,037)  
Debt, net 9,662,659 9,697,835  
Secured Revolving Credit Facility [Member]      
Debt Instrument [Line Items]      
Debt [1] 665,577 638,063  
Secured Term Loan [Member]      
Debt Instrument [Line Items]      
Debt 200,000 200,000  
Secured term loan due 2034 | British Pound Sterling [Member]      
Debt Instrument [Line Items]      
Debt [2] 835,126 850,784  
0.993% Senior Unsecured Notes due 2026 [Member]      
Debt Instrument [Line Items]      
Debt [2] 577,650 587,300  
5.000% Senior Unsecured Notes due 2027 [Member]      
Debt Instrument [Line Items]      
Debt 1,400,000 1,400,000  
3.692% Senior Unsecured Notes due 2028 [Member]      
Debt Instrument [Line Items]      
Debt [2] 793,620 808,500  
4.625% Senior Unsecured Notes due 2029 [Member]      
Debt Instrument [Line Items]      
Debt 900,000 900,000  
3.375% Senior Unsecured Notes due 2030 [Member]      
Debt Instrument [Line Items]      
Debt [2] 462,945 471,625  
3.500% Senior Unsecured Notes due 2031 [Member]      
Debt Instrument [Line Items]      
Debt 1,300,000 1,300,000  
7.000% Senior Secured Notes due 2032 [Member]      
Debt Instrument [Line Items]      
Debt [2] 1,155,300 1,174,600  
8.500% Senior Secured Notes due 2032 [Member]      
Debt Instrument [Line Items]      
Debt $ 1,500,000 $ 1,500,000 $ 1,500,000
[1] Includes 100 million and €100 million of Euro-denominated borrowings and CHF 52 million and CHF 52 million of Swiss franc-denominated borrowings that reflect the applicable exchange rates at March 31, 2026 and December 31, 2025, respectively.
[2] Non-U.S. dollar denominated debt reflects the exchange rates at March 31, 2026 and December 31, 2025.
v3.26.1
Debt - Summary of Debt (Parenthetical) (Detail)
$ in Thousands, € in Millions, SFr in Millions
Mar. 31, 2026
USD ($)
Mar. 31, 2026
EUR (€)
Mar. 31, 2026
CHF (SFr)
Dec. 31, 2025
USD ($)
Dec. 31, 2025
EUR (€)
Dec. 31, 2025
CHF (SFr)
Feb. 13, 2025
USD ($)
Debt Instrument [Line Items]              
Debt $ 9,790,218     $ 9,830,872      
EURO-denominated Borrowings [Member]              
Debt Instrument [Line Items]              
Debt | €   € 100     € 100    
Swiss Franc-denominated Borrowings [Member]              
Debt Instrument [Line Items]              
Debt | SFr     SFr 52     SFr 52  
0.993% Senior Unsecured Notes due 2026 [Member]              
Debt Instrument [Line Items]              
Senior unsecured notes, interest rate 0.993% 0.993% 0.993% 0.993% 0.993% 0.993%  
Debt [1] $ 577,650     $ 587,300      
5.000% Senior Unsecured Notes due 2027 [Member]              
Debt Instrument [Line Items]              
Senior unsecured notes, interest rate 5.00% 5.00% 5.00% 5.00% 5.00% 5.00%  
Debt $ 1,400,000     $ 1,400,000      
3.692% Senior Unsecured Notes due 2028 [Member]              
Debt Instrument [Line Items]              
Senior unsecured notes, interest rate 3.692% 3.692% 3.692% 3.692% 3.692% 3.692%  
Debt [1] $ 793,620     $ 808,500      
4.625% Senior Unsecured Notes due 2029 [Member]              
Debt Instrument [Line Items]              
Senior unsecured notes, interest rate 4.625% 4.625% 4.625% 4.625% 4.625% 4.625%  
Debt $ 900,000     $ 900,000      
3.375% Senior Unsecured Notes due 2030 [Member]              
Debt Instrument [Line Items]              
Senior unsecured notes, interest rate 3.375% 3.375% 3.375% 3.375% 3.375% 3.375%  
Debt [1] $ 462,945     $ 471,625      
3.500% Senior Unsecured Notes due 2031 [Member]              
Debt Instrument [Line Items]              
Senior unsecured notes, interest rate 3.50% 3.50% 3.50% 3.50% 3.50% 3.50%  
Debt $ 1,300,000     $ 1,300,000      
7.000% Senior Secured Notes due 2032 [Member]              
Debt Instrument [Line Items]              
Senior unsecured notes, interest rate 7.00% 7.00% 7.00% 7.00% 7.00% 7.00%  
Debt [1] $ 1,155,300     $ 1,174,600      
8.500% Senior Secured Notes due 2032 [Member]              
Debt Instrument [Line Items]              
Senior unsecured notes, interest rate 8.50% 8.50% 8.50% 8.50% 8.50% 8.50%  
Debt $ 1,500,000     $ 1,500,000     $ 1,500,000
[1] Non-U.S. dollar denominated debt reflects the exchange rates at March 31, 2026 and December 31, 2025.
v3.26.1
Debt - Principal Payments Due for Debt (Detail) - USD ($)
$ in Thousands
Mar. 31, 2026
Dec. 31, 2025
Debt Disclosure [Abstract]    
2026 [1] $ 1,243,227  
2027 1,600,000  
2028 793,620  
2029 900,000  
2030 462,945  
Thereafter 4,790,426  
Total $ 9,790,218 $ 9,830,872
[1] $666 million (of which we have had an approximate $145 million net reduction since March 31, 2026) represents the outstanding balance of our revolving credit facility for which we have provided notice of our intent to extend to 2027 - see "Credit Facility" subheading for further details.
v3.26.1
Debt - Principal Payments Due for Debt (Parenthetical) (Details) - USD ($)
$ in Thousands
3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Dec. 31, 2025
Debt Instrument [Line Items]      
Outstanding balance $ 9,790,218   $ 9,830,872
Payments of term debt 0 $ 2,252,731  
Revolving Credit Facility [Member]      
Debt Instrument [Line Items]      
Outstanding balance 666,000    
Payments of term debt $ 145,000    
v3.26.1
Debt - Credit Facility - Additional Information (Detail) - USD ($)
$ in Millions
3 Months Ended
Feb. 13, 2025
Mar. 31, 2026
Debt Instrument [Line Items]    
Debt Instrument, Variable Interest Rate, Type [Extensible Enumeration] us-gaap:SecuredOvernightFinancingRateSofrMember  
Term Loan [Member]    
Debt Instrument [Line Items]    
Debt, face amount   $ 200
Credit Facility Amendment [Member]    
Debt Instrument [Line Items]    
Unsecured interest coverage ratio 225  
Maximum total leverage ratio 60.00%  
Secured leverage ratio 40.00%  
Maximum ratio of secured first lien debt 65.00%  
Debt instrument maturity date   Jun. 30, 2027
Credit Facility Amendment [Member] | Minimum [Member]    
Debt Instrument [Line Items]    
Unsecured interest coverage ratio 1.3  
Revolving Credit Facility [Member]    
Debt Instrument [Line Items]    
Line of credit facility, borrowing capacity   $ 1,280
v3.26.1
Debt - 2025 Activity - Additional Information (Details)
$ in Thousands, £ in Millions, € in Billions
3 Months Ended
Feb. 13, 2025
USD ($)
Jan. 15, 2025
GBP (£)
Mar. 31, 2026
USD ($)
Mar. 31, 2025
USD ($)
Dec. 31, 2025
USD ($)
Feb. 13, 2025
EUR (€)
Debt Instrument [Line Items]            
Amount of term loan paid     $ 0 $ 2,252,731    
Outstanding balance     $ 9,790,218   $ 9,830,872  
8.500% Senior Secured Notes due 2032 [Member]            
Debt Instrument [Line Items]            
Senior unsecured notes, interest rate     8.50%   8.50%  
Outstanding balance $ 1,500,000   $ 1,500,000   $ 1,500,000  
7.000% Senior Secured Notes due 2032 [Member]            
Debt Instrument [Line Items]            
Outstanding balance | €           € 1.0
3.325% of Senior Unsecured Notes Due 2025            
Debt Instrument [Line Items]            
Senior unsecured notes, interest rate 3.325%     3.325%   3.325%
Debt instrument maturity year 2025     2025    
2.500% of Senior Unsecured Notes Due 2026            
Debt Instrument [Line Items]            
Senior unsecured notes, interest rate 2.50%     2.50%   2.50%
Debt instrument maturity year 2026     2026    
5.250% of Senior Unsecured Notes Due 2026            
Debt Instrument [Line Items]            
Senior unsecured notes, interest rate 5.25%     5.25%   5.25%
Debt instrument maturity year 2026     2026    
UNITED KINGDOM | Term loan due 2025            
Debt Instrument [Line Items]            
Debt instrument maturity year   2025        
Amount of term loan paid | £   £ 493        
v3.26.1
Debt - Debt Refinancing and Unutilized Financing Costs (Additional Information) (Details) - USD ($)
$ in Thousands
3 Months Ended
Feb. 13, 2025
Mar. 31, 2026
Mar. 31, 2025
Debt Instrument [Line Items]      
Debt refinancing and unutilized financing costs   $ 0 $ 3,796
3.325% of Senior Unsecured Notes Due 2025      
Debt Instrument [Line Items]      
Senior unsecured notes, interest rate 3.325%   3.325%
Debt Instrument Maturity Year 2025   2025
2.500% of Senior Unsecured Notes Due 2026      
Debt Instrument [Line Items]      
Senior unsecured notes, interest rate 2.50%   2.50%
Debt Instrument Maturity Year 2026   2026
5.250% of Senior Unsecured Notes Due 2026      
Debt Instrument [Line Items]      
Senior unsecured notes, interest rate 5.25%   5.25%
Debt Instrument Maturity Year 2026   2026
v3.26.1
Debt - Covenants and Restrictions - Additional Information (Detail)
3 Months Ended
Mar. 31, 2026
Debt Instrument [Line Items]  
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%
v3.26.1
Income Taxes - Additional Information (Detail)
$ in Thousands
3 Months Ended
Mar. 31, 2026
USD ($)
Property
Mar. 31, 2025
USD ($)
Income Taxes [Line Items]    
Income tax expense $ (32,822) $ 9,437
United Kingdom [Member]    
Income Taxes [Line Items]    
Number of additional property moved into real estate investment trust qualification | Property 7  
Deferred tax liabilities amount of one-time tax benefit $ 43  
v3.26.1
Common Stock - Additional Information (Details) - At-the-market equity [Member] - USD ($)
$ in Millions
3 Months Ended
Aug. 11, 2025
Mar. 31, 2026
Class Of Stock [Line Items]    
Stock issued   0
Maximum [Member]    
Class Of Stock [Line Items]    
Stock issued during period, value $ 500  
Sales commission percentage 2.00%  
v3.26.1
Stock Awards - Additional Information (Detail) - USD ($)
$ in Thousands
3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]    
Stock / Unit-based compensation expense $ 573 $ 17,665
Value of common stock granted with cash settlement feature $ (8,500) $ 9,500
Equity Incentive Plan [Member]    
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]    
Reserved shares of new common stock for awards under the Equity Incentive Plan 28,900,000  
Common stock remaining for future stock awards transferred to the equity incentive plan 1,800,000  
2024 performance award    
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]    
Cash-settled performance award has been earned or vested 0  
Stock price earn/vest 7  
Number of consecutive days 20 days  
2025 performance award    
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]    
Performance awards earned or vested threshold benchmark percentage of total shareholder return 20.00%  
v3.26.1
Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Detail) - USD ($)
$ in Thousands
Mar. 31, 2026
Dec. 31, 2025
Fair Value Disclosures [Abstract]    
Interest and rent receivables, Book value $ 17,981 $ 19,210
Loans, Book value 669,499 624,243
Debt, net Book value (9,662,659) (9,697,835)
Interest and rent receivables, Fair value 18,659 19,907
Loans, Fair value 668,217 624,369
Debt, net Fair value $ (8,656,491) $ (8,980,547)
v3.26.1
Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Parenthetical) (Detail)
$ in Thousands
3 Months Ended
Mar. 31, 2026
USD ($)
Health_Center
Dec. 31, 2025
USD ($)
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]    
Mortgage loans $ 124,479 $ 123,651
Investments in unconsolidated real estate joint ventures 1,390,385 1,399,777
Investments in unconsolidated operating entities 320,928 322,179
Loans [Member]    
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]    
Investments in unconsolidated operating entities 45,100 45,400
Other loans 233,900 182,400
Shareholder Loan [Member]    
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]    
Mortgage loans 7,500 7,500
Investments in unconsolidated real estate joint ventures $ 383,000 $ 388,900
Fair Value, Recurring [Member] | Colombia [Member]    
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]    
Number of facilities acquired | Health_Center 3  
v3.26.1
Fair Value of Financial Instruments - Additional Information (Detail)
$ in Millions
3 Months Ended
Mar. 31, 2026
USD ($)
Health_Center
Springstone Inc and International Joint Venture [Member]  
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]  
Unfavorable fair market value adjustment on investment $ 30
Colombia [Member] | Springstone Inc and International Joint Venture [Member]  
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]  
Unfavorable fair market value adjustment on investment $ 3
Fair Value, Recurring [Member] | Colombia [Member]  
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]  
Number of facilities acquired | Health_Center 3
v3.26.1
Fair Value of Financial Instruments - Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis (Detail) - Fair Value, Recurring [Member] - USD ($)
$ in Thousands
Mar. 31, 2026
Dec. 31, 2025
Mortgage Loans [Member]    
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]    
Fair Value $ 116,942 $ 116,113
Original Cost 155,884 151,692
Equity Method Investment and Other Loans [Member]    
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]    
Fair Value 4,387 4,285
Original Cost $ 265,091 $ 264,160
v3.26.1
Earnings Per Share/Unit - Calculation of Earnings Per Share (Detail) - USD ($)
shares in Thousands, $ in Thousands
3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]    
Net income (loss) $ 33,107 $ (118,016)
Non-controlling interests' share in net income (280) (259)
Participating securities’ share in earnings (461) (117)
Net income (loss), less participating securities' share in earnings $ 32,366 $ (118,392)
Basic weighted-average common shares 597,715 600,594
Dilutive potential common shares 0 0
Diluted weighted-average common shares 597,715 600,594
MPT Operating Partnership, L.P. [Member]    
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]    
Net income (loss) $ 33,107 $ (118,016)
Non-controlling interests' share in net income (280) (259)
Participating securities’ share in earnings (461) (117)
Net income (loss), less participating securities' share in earnings $ 32,366 $ (118,392)
Basic weighted-average common shares 597,715 600,594
Dilutive potential common shares 0 0
Diluted weighted-average common shares 597,715 600,594
v3.26.1
Earnings Per Share/Unit - Calculation of Earnings Per Share (Parenthetical) (Detail) - shares
3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
MPT Operating Partnership, L.P. [Member]    
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]    
Potential common shares/units inclusion of shares 0 66,244
v3.26.1
Contingencies - Additional Information (Detail)
$ in Millions
Mar. 31, 2026
USD ($)
Steward Health Care System LLC [Member]  
Loss Contingencies [Line Items]  
Bridge financing to affiliate forfeited $ 16
v3.26.1
Segment Disclosures - Additional Information (Details)
3 Months Ended
Mar. 31, 2026
Segment
Segment Reporting [Abstract]  
Number of segment 1
Number of reportable segment 1
Segment Reporting, CODM, Individual Title and Position or Group Name [Extensible Enumeration] Chief Executive Officer And Chief Financial Officer [Member]
Leased assets 100.00%
Segment Reporting, CODM, Profit (Loss) Measure, How Used, Description We compute FFO in accordance with the definition provided by the National Association of Real Estate Investment Trusts, which represents consolidated net income (loss) (computed in accordance with GAAP), excluding gains (losses) on sales of real estate and impairment charges on real estate assets, plus real estate depreciation and amortization, including amortization related to in-place lease intangibles, and after adjustments for unconsolidated partnerships and joint ventures.Given FFO excludes real estate related depreciation and amortization expense by definition and due to our typical net lease structure which requires our tenants to bear most of the costs associated with our properties (including property taxes, insurance, etc.)
Segment Reporting, Expense Information Used by CODM, Description the primary expenses reviewed by the CODM include general and administrative and interest expenses from our consolidated statements of net income.
Segment Reporting, Expense Information Used by CODM, Type [Extensible Enumeration] General and Administrative Expense, Interest Expense, Operating and Nonoperating
v3.26.1
Subsequent Events - Additional Information (Details) - Germany [Member]
€ in Millions
3 Months Ended
Mar. 31, 2026
EUR (€)
Property
Subsequent Event [Line Items]  
Number of property acquired | Property 1
Payment for acquisition | € € 23