MEDICAL PROPERTIES TRUST INC, 10-K filed on 2/26/2026
Annual Report
v3.25.4
Document and Entity Information - USD ($)
shares in Millions, $ in Billions
 12 Months Ended
Dec. 31, 2025
Feb. 23, 2026
Jun. 30, 2025
Document Information [Line Items]      
Document Type 10-K    
Amendment Flag false    
Document Period End Date Dec. 31, 2025    
Document Fiscal Year Focus 2025    
Document Fiscal Period Focus FY    
Trading Symbol MPT    
Entity Registrant Name Medical Properties Trust, Inc    
Entity Central Index Key 0001287865    
Current Fiscal Year End Date --12-31    
Entity Well-known Seasoned Issuer Yes    
Entity Current Reporting Status Yes    
Entity Voluntary Filers No    
Entity Filer Category Large Accelerated Filer    
Document Financial Statement Error Correction [Flag] false    
Entity Shell Company false    
Entity Small Business false    
Entity Emerging Growth Company false    
ICFR Auditor Attestation Flag true    
Entity Common Stock, Shares Outstanding   597.7  
Entity Public Float     $ 2.6
Title of 12(b) Security Common stock, par value $0.001 per share, of Medical Properties Trust, Inc.    
Security Exchange Name NYSE    
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 Annual Report true    
Document Transition Report false    
Entity Interactive Data Current Yes    
Auditor Name PricewaterhouseCoopers LLP    
Auditor Location Birmingham, Alabama    
Auditor Firm ID 238    
Documents Incorporated by Reference

Portions of the definitive Proxy Statement of Medical Properties Trust, Inc. for the Annual Meeting of Stockholders to be held on May 28, 2026 are incorporated by reference into Items 10 through 14 of Part III, of this Annual Report on Form 10-K.

    
Auditor Opinion [Text Block]

Opinions on the Financial Statements and Internal Control over Financial Reporting

We have audited the accompanying consolidated balance sheets of Medical Properties Trust, Inc. and its subsidiaries (the "Company") as of December 31, 2025 and 2024, and the related consolidated statements of net income, of comprehensive loss, of equity and of cash flows for each of the three years in the period ended December 31, 2025, including the related notes and financial statement schedules listed in the index appearing under Item 15(a) (collectively referred to as the "consolidated financial statements"). We also have audited the Company's internal control over financial reporting as of December 31, 2025, based on criteria established in Internal Control - Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).

In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the financial position of the Company as of December 31, 2025 and 2024, and the results of its operations and its cash flows for each of the three years in the period ended December 31, 2025 in conformity with accounting principles generally accepted in the United States of America. Also in our opinion, the Company maintained, in all material respects, effective internal control over financial reporting as of December 31, 2025, based on criteria established in Internal Control - Integrated Framework (2013) issued by the COSO.

    
MPT Operating Partnership, L.P. [Member]      
Document Information [Line Items]      
Document Type 10-K    
Amendment Flag false    
Document Period End Date Dec. 31, 2025    
Document Fiscal Year Focus 2025    
Document Fiscal Period Focus FY    
Entity Registrant Name MPT Operating Partnership, L.P.    
Entity Central Index Key 0001524607    
Current Fiscal Year End Date --12-31    
Entity Well-known Seasoned Issuer Yes    
Entity Current Reporting Status Yes    
Entity Voluntary Filers No    
Entity Filer Category Non-accelerated Filer    
Document Financial Statement Error Correction [Flag] false    
Entity Shell Company false    
Entity Small Business false    
Entity Emerging Growth Company false    
ICFR Auditor Attestation Flag true    
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    
Entity Interactive Data Current Yes    
Auditor Name PricewaterhouseCoopers LLP    
Auditor Location Birmingham, Alabama    
Auditor Firm ID 238    
Auditor Opinion [Text Block]

Opinions on the Financial Statements and Internal Control over Financial Reporting

We have audited the accompanying consolidated balance sheets of MPT Operating Partnership, L.P. and its subsidiaries (the "Company") as of December 31, 2025 and 2024, and the related consolidated statements of net income, of comprehensive loss, of capital and of cash flows for each of the three years in the period ended December 31, 2025, including the related notes and financial statement schedules listed in the index appearing under Item 15(a) (collectively referred to as the "consolidated financial statements"). We also have audited the Company's internal control over financial reporting as of December 31, 2025, based on criteria established in Internal Control - Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).

In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the financial position of the Company as of December 31, 2025 and 2024, and the results of its operations and its cash flows for each of the three years in the period ended December 31, 2025 in conformity with accounting principles generally accepted in the United States of America. Also in our opinion, the Company maintained, in all material respects, effective internal control over financial reporting as of December 31, 2025, based on criteria established in Internal Control - Integrated Framework (2013) issued by the COSO.

    
v3.25.4
Consolidated Balance Sheets - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Real estate assets    
Land $ 1,790,154 $ 1,607,869
Buildings and improvements 9,543,162 8,847,892
Intangible lease assets 872,371 804,081
Investment in financing leases 421,684 1,057,770
Real estate held for sale 0 34,019
Mortgage loans 123,651 119,912
Gross investment in real estate assets 12,751,022 12,471,543
Accumulated depreciation (1,438,594) (1,221,644)
Accumulated amortization (224,462) (201,304)
Net investment in real estate assets 11,087,966 11,048,595
Cash and cash equivalents 540,859 332,335
Interest and rent receivables 19,210 36,327
Straight-line rent receivables 881,452 700,783
Investments in unconsolidated real estate joint ventures 1,399,777 1,156,397
Investments in unconsolidated operating entities 322,179 439,578
Other loans 186,292 109,175
Other assets 564,040 471,404
Total Assets 15,001,775 14,294,594
Liabilities    
Debt, net 9,697,835 8,848,112
Accounts payable and accrued expenses 549,105 454,209
Deferred revenue 19,289 29,445
Obligations to tenants and other lease liabilities 128,297 129,045
Total Liabilities 10,394,526 9,460,811
Commitments and Contingencies
Equity / Capital    
Preferred stock, $0.001 par value. Authorized 10,000 shares; no shares outstanding
Common stock, $0.001 par value. Authorized 750,000 shares; issued and outstanding - 597,008 shares at December 31, 2025 and 600,403 shares at December 31, 2024 597 600
Additional paid-in capital 8,573,396 8,584,917
Retained deficit (4,136,011) (3,658,516)
Accumulated other comprehensive income (loss) 168,213 (94,272)
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital) 4,606,195 4,832,729
Non-controlling interests 1,054 1,054
Total Equity / Capital 4,607,249 4,833,783
Total Liabilities and Equity / Capital 15,001,775 14,294,594
MPT Operating Partnership, L.P. [Member]    
Real estate assets    
Land 1,790,154 1,607,869
Buildings and improvements 9,543,162 8,847,892
Intangible lease assets 872,371 804,081
Investment in financing leases 421,684 1,057,770
Real estate held for sale 0 34,019
Mortgage loans 123,651 119,912
Gross investment in real estate assets 12,751,022 12,471,543
Accumulated depreciation (1,438,594) (1,221,644)
Accumulated amortization (224,462) (201,304)
Net investment in real estate assets 11,087,966 11,048,595
Cash and cash equivalents 540,859 332,335
Interest and rent receivables 19,210 36,327
Straight-line rent receivables 881,452 700,783
Investments in unconsolidated real estate joint ventures 1,399,777 1,156,397
Investments in unconsolidated operating entities 322,179 439,578
Other loans 186,292 109,175
Other assets 564,040 471,404
Total Assets 15,001,775 14,294,594
Liabilities    
Debt, net 9,697,835 8,848,112
Accounts payable and accrued expenses 493,364 405,655
Deferred revenue 19,289 29,445
Obligations to tenants and other lease liabilities 128,297 129,045
Payable due to Medical Properties Trust, Inc. 55,351 48,164
Total Liabilities 10,394,136 9,460,421
Commitments and Contingencies
Equity / Capital    
General Partner - issued and outstanding - 5,972 units at December 31, 2025 and 6,006 units at December 31, 2024 44,457 49,348
Limited Partners - issued and outstanding - 591,036 units at December 31, 2025 and 594,397 units at December 31, 2024 4,393,915 4,878,043
Accumulated other comprehensive income (loss) 168,213 (94,272)
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital) 4,606,585 4,833,119
Non-controlling interests 1,054 1,054
Total Equity / Capital 4,607,639 4,834,173
Total Liabilities and Equity / Capital $ 15,001,775 $ 14,294,594
v3.25.4
Consolidated Balance Sheets (Parenthetical) - $ / shares
Dec. 31, 2025
Dec. 31, 2024
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 597,008,000 600,403,000
Common stock, shares outstanding 597,008,000 600,403,000
General Partner [Member] | MPT Operating Partnership, L.P. [Member]    
General partner, units issued 5,972,000 6,006,000
General partner, units outstanding 5,972,000 6,006,000
Common Units | MPT Operating Partnership, L.P. [Member]    
Limited Partners, units issued 591,036,000 594,397,000
Limited Partners, units outstanding 591,036,000 594,397,000
v3.25.4
Consolidated Statements of Net Income - USD ($)
shares in Thousands, $ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Revenues      
Rent billed $ 736,543 $ 719,749 $ 803,375
Straight-line rent 152,163 163,414 (127,894)
Income from financing leases 39,735 63,651 127,141
Interest and other income 43,581 48,733 69,177
Total revenues 972,022 995,547 871,799
Expenses      
Interest 510,362 417,824 411,171
Real estate depreciation and amortization 265,405 447,657 603,360
Property-related 36,415 27,255 41,567
General and administrative 130,427 133,789 145,588
Total expenses 942,609 1,026,525 1,201,686
Other (expense) income      
Gain (loss) on sale of real estate 5,545 478,693 (1,815)
Real estate and other impairment charges, net (193,947) (1,825,402) (376,907)
Earnings (loss) from equity interests 97,851 (366,642) 13,967
Debt refinancing and unutilized financing (costs) benefit (3,629) (4,292) 285
Other (including fair value adjustments on securities) (172,552) (615,565) 7,586
Total other expense (266,732) (2,333,208) (356,884)
Loss before income tax (237,319) (2,364,186) (686,771)
Income tax (expense) benefit (38,618) (44,101) 130,679
Net (loss) income (275,937) (2,408,287) (556,092)
Net income attributable to non-controlling interests (1,112) (1,984) (384)
Net loss attributable to MPT common stockholders $ (277,049) $ (2,410,271) $ (556,476)
Earnings per common share (units) basic      
Net loss attributable to MPT common stockholders (Operating Partnership partners), basic $ (0.46) $ (4.02) $ (0.93)
Earnings per common share (units) diluted      
Net loss attributable to MPT common stockholders (Operating Partnership partners), diluted $ (0.46) $ (4.02) $ (0.93)
Weighted average shares (units) outstanding basic 600,892 600,248 598,518
Weighted average shares (units) outstanding diluted 600,892 600,248 598,518
MPT Operating Partnership, L.P. [Member]      
Revenues      
Rent billed $ 736,543 $ 719,749 $ 803,375
Straight-line rent 152,163 163,414 (127,894)
Income from financing leases 39,735 63,651 127,141
Interest and other income 43,581 48,733 69,177
Total revenues 972,022 995,547 871,799
Expenses      
Interest 510,362 417,824 411,171
Real estate depreciation and amortization 265,405 447,657 603,360
Property-related 36,415 27,255 41,567
General and administrative 130,427 133,789 145,588
Total expenses 942,609 1,026,525 1,201,686
Other (expense) income      
Gain (loss) on sale of real estate 5,545 478,693 (1,815)
Real estate and other impairment charges, net (193,947) (1,825,402) (376,907)
Earnings (loss) from equity interests 97,851 (366,642) 13,967
Debt refinancing and unutilized financing (costs) benefit (3,629) (4,292) 285
Other (including fair value adjustments on securities) (172,552) (615,565) 7,586
Total other expense (266,732) (2,333,208) (356,884)
Loss before income tax (237,319) (2,364,186) (686,771)
Income tax (expense) benefit (38,618) (44,101) 130,679
Net (loss) income (275,937) (2,408,287) (556,092)
Net income attributable to non-controlling interests (1,112) (1,984) (384)
Net loss attributable to MPT common stockholders $ (277,049) $ (2,410,271) $ (556,476)
Earnings per common share (units) basic      
Net loss attributable to MPT common stockholders (Operating Partnership partners), basic $ (0.46) $ (4.02) $ (0.93)
Earnings per common share (units) diluted      
Net loss attributable to MPT common stockholders (Operating Partnership partners), diluted $ (0.46) $ (4.02) $ (0.93)
Weighted average shares (units) outstanding basic 600,892 600,248 598,518
Weighted average shares (units) outstanding diluted 600,892 600,248 598,518
v3.25.4
Consolidated Statements of Comprehensive Loss - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Net loss $ (275,937) $ (2,408,287) $ (556,092)
Other comprehensive (loss) income:      
Unrealized loss on interest rate hedges, net of tax (4,208) (20,779) (34,932)
Reclassification of interest rate hedges gain from AOCI to earnings, net of tax 0 (18,926) (28,553)
Foreign currency translation gain (loss) 266,693 (97,068) 162,680
Reclassification of foreign currency translation loss from AOCI to earnings 0 0 2,490
Total comprehensive loss (13,452) (2,545,060) (454,407)
Comprehensive income attributable to non-controlling interests (1,112) (1,984) (384)
Comprehensive loss attributable to MPT Operating Partnership partners (14,564) (2,547,044) (454,791)
MPT Operating Partnership, L.P. [Member]      
Net loss (275,937) (2,408,287) (556,092)
Other comprehensive (loss) income:      
Unrealized loss on interest rate hedges, net of tax (4,208) (20,779) (34,932)
Reclassification of interest rate hedges gain from AOCI to earnings, net of tax   (18,926) (28,553)
Foreign currency translation gain (loss) 266,693 (97,068) 162,680
Reclassification of foreign currency translation loss from AOCI to earnings     2,490
Total comprehensive loss (13,452) (2,545,060) (454,407)
Comprehensive income attributable to non-controlling interests (1,112) (1,984) (384)
Comprehensive loss attributable to MPT Operating Partnership partners $ (14,564) $ (2,547,044) $ (454,791)
v3.25.4
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 Earnings (Deficit) [Member]
Accumulated Other Comprehensive (Loss) Income [Member]
Accumulated Other Comprehensive (Loss) Income [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, 2022 $ 8,594,407 $ 8,594,797 $ 86,599 $ 8,565,813 $ 597 $ 8,535,140 $ 116,285 $ (59,184) $ (59,184) $ 1,569 $ 1,569
Beginning balance (in shares) at Dec. 31, 2022     5,976 591,500 597,476            
Net (loss) income (556,092) (556,092) $ (5,564) $ (550,912)     (556,476)     384 384
Unrealized gain (loss) on interest rate hedges, net of tax (34,932) (34,932)           (34,932) (34,932)    
Reclassification of interest rate hedge gain to earnings, net of tax (28,553) (28,553)           (28,553) (28,553)    
Foreign currency translation gain (loss) 162,680 162,680           162,680 162,680    
Reclassification of foreign currency translation loss from AOCI to earnings 2,490 2,490           2,490 2,490    
Stock (Unit) vesting and amortization of stock-based compensation 33,250 33,250 $ 332 $ 32,918 $ 2 33,248          
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)     25 2,432 2,457            
Stock (Unit) vesting - satisfaction of tax withholding (8,079) (8,079) $ (81) $ (7,998)   (8,079)          
Stock (Unit) vesting - satisfaction of tax withholding (shares)     (10) (932) (942)            
Issuance of non-controlling interest 1,375 1,375               1,375 1,375
Distributions to non-controlling interests, net (1,063) (1,063)               (1,063) (1,063)
Dividends (Distributions) declared (531,618) (531,618) $ (5,317) $ (526,301)     (531,618)        
Ending balance at Dec. 31, 2023 7,633,865 7,634,255 $ 75,969 $ 7,513,520 $ 599 8,560,309 (971,809) 42,501 42,501 2,265 2,265
Ending balance (in shares) at Dec. 31, 2023     5,991 593,000 598,991            
Net (loss) income (2,408,287) (2,408,287) $ (24,102) $ (2,386,169)     (2,410,271)     1,984 1,984
Unrealized gain (loss) on interest rate hedges, net of tax (20,779) (20,779)           (20,779) (20,779)    
Reclassification of interest rate hedge gain to earnings, net of tax (18,926) (18,926)           (18,926) (18,926)    
Foreign currency translation gain (loss) (97,068) (97,068)           (97,068) (97,068)    
Reclassification of foreign currency translation loss from AOCI to earnings 0                    
Stock (Unit) vesting and amortization of stock-based compensation 28,414 28,414 $ 285 $ 28,129 $ 2 28,412          
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)     23 2,150 2,173            
Stock (Unit) vesting - satisfaction of tax withholding (3,805) (3,805) $ (39) $ (3,766) $ (1) (3,804)          
Stock (Unit) vesting - satisfaction of tax withholding (shares)     (8) (753) (761)            
Acquisitions of non-controlling interest (1,500) (1,500)               (1,500) (1,500)
Distributions to non-controlling interests, net (1,695) (1,695)               (1,695) (1,695)
Dividends (Distributions) declared (276,436) (276,436) $ (2,765) $ (273,671)     (276,436)        
Ending 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
Ending balance (in shares) at Dec. 31, 2024     6,006 594,397 600,403            
Net (loss) income (275,937) (275,937) $ (2,771) $ (274,278)     (277,049)     1,112 1,112
Unrealized gain (loss) on interest rate hedges, net of tax (4,208) (4,208)           (4,208) (4,208)    
Foreign currency translation gain (loss) 266,693 266,693           266,693 266,693    
Reclassification of foreign currency translation loss from AOCI to earnings 0                    
Stock (Unit) vesting and amortization of stock-based compensation 15,118 15,118 $ 151 $ 14,967 $ 2 15,116          
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)     17 1,622 1,639            
Stock (Unit) vesting - satisfaction of tax withholding (2,474) (2,474) $ (25) $ (2,449)   (2,474)          
Stock (Unit) vesting - satisfaction of tax withholding (shares)     (6) (523) (529)            
Repurchase of units (23,441) (23,441) $ (234) $ (23,207) $ (5) (23,436)          
Repurchase of units (shares)     (45) (4,460) (4,505)            
Distributions to non-controlling interests, net (1,112) (1,112)               (1,112) (1,112)
Offering costs (727) (727) $ (7) $ (720)   (727)          
Dividends (Distributions) declared (200,446) (200,446) (2,005) (198,441)     (200,446)        
Ending 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
Ending balance (in shares) at Dec. 31, 2025     5,972 591,036 597,008            
v3.25.4
Consolidated Statements of Equity / Capital (Parenthetical) - $ / shares
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Dividends (Distributions) declared per common share / unit $ 0.33 $ 0.46 $ 0.88
MPT Operating Partnership, L.P. [Member]      
Dividends (Distributions) declared per common share / unit $ 0.33 $ 0.46 $ 0.88
v3.25.4
Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Operating activities      
Net loss $ (275,937) $ (2,408,287) $ (556,092)
Adjustments to reconcile net loss to net cash provided by operating activities:      
Depreciation and amortization 272,817 453,749 616,127
Amortization of deferred financing costs and debt discount 26,283 17,348 15,775
Straight-line rent revenue and other (158,172) (172,765) (233,703)
Stock / (Unit)-based compensation expense 25,746 32,976 33,250
(Gain) loss on sale of real estate (5,545) (478,693) 1,815
Real estate and other impairment charges, net 193,947 1,825,402 376,907
Equity interest real estate impairment   410,790  
Straight-line rent and other write-off 11,054 2,514 649,911
Debt refinancing and unutilized financing (benefit) costs 3,629 4,292 (285)
Tax rate changes and other (11,231) 5,119 (167,332)
Non-cash fair value adjustments 106,442 563,666 (34,157)
Non-cash revenue from debt and equity securities received     (81,706)
Other adjustments 7,580 4,975 10,287
Changes in:      
Interest and rent receivables 7,111 2,778 (141,729)
Other assets 14,971 (36,109) 13,750
Accounts payable and accrued expenses 21,680 23,481 (4,599)
Deferred revenue (9,608) (5,753) 7,567
Net cash provided by operating activities 230,767 245,483 505,786
Investing activities      
Cash paid for acquisitions and other related investments (142,089) (105,618) (235,187)
Net proceeds from sale of real estate 120,550 1,854,077 897,500
Principal received from sale and repayment of loans receivable 116,309 214,416 501,630
Investment in loans receivable (205,752) (420,324) (250,223)
Construction in progress and other (80,003) (79,788) (114,425)
Proceeds from sale and return of equity investments   11,656 12,430
Capital additions and other investments, net (73,753) (156,078) (294,167)
Net cash (used for) provided by investing activities (264,738) 1,318,341 517,558
Financing activities      
Proceeds from term debt 2,512,970 804,188  
Payments of term debt (2,252,731) (701,809) (988,162)
Revolving credit facilities, net 241,530 (1,131,312) 567,910
Dividends / Distribution paid (193,259) (321,080) (615,390)
Lease deposits and other obligations to tenants (3,202) 2,237 10,139
Offering costs (727)    
Repurchase of common stock / unit (23,441)    
Stock / Unit vesting - satisfaction of tax withholdings (2,474) (3,805) (8,079)
Payment of debt refinancing and deferred financing costs and other financing activities (50,585) (127,798) 13,255
Net cash provided by (used for) financing activities 228,081 (1,479,379) (1,020,327)
Increase in cash, cash equivalents, and restricted cash for the year 194,110 84,445 3,017
Effect of exchange rate changes 14,712 (5,224) 11,397
Cash, cash equivalents, and restricted cash at beginning of year 335,173 255,952 241,538
Cash, cash equivalents, and restricted cash at end of year 543,995 335,173 255,952
Interest paid, including capitalized interest of $12,920 in 2025, $7,642 in 2024, and $14,178 in 2023 458,225 420,315 406,141
Supplemental schedule of non-cash investing activities:      
Debt and equity securities received for certain obligations, real estate, and revenue     804,520
Certain obligations and receivable satisfied and real estate sold 50,000   722,814
Lease incentive provided 50,000    
Supplemental schedule of non-cash financing activities:      
Dividends declared, unpaid 55,351 48,164 92,808
Cash, cash equivalents, and restricted cash are comprised of the following:      
Cash and cash equivalents at beginning of period 332,335 250,016 235,668
Restricted cash, included in Other assets at beginning of period $ 2,838 $ 5,936 $ 5,870
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List] Other Assets Other Assets Other Assets
Cash, cash equivalents, and restricted cash at beginning of year $ 543,995 $ 335,173 $ 255,952
Cash and cash equivalents at end of period 540,859 332,335 250,016
Restricted cash, included in Other assets at end of period $ 3,136 $ 2,838 $ 5,936
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List] Other Assets Other Assets Other Assets
Cash, cash equivalents, and restricted cash at end of year $ 543,995 $ 335,173 $ 255,952
MPT Operating Partnership, L.P. [Member]      
Operating activities      
Net loss (275,937) (2,408,287) (556,092)
Adjustments to reconcile net loss to net cash provided by operating activities:      
Depreciation and amortization 272,817 453,749 616,127
Amortization of deferred financing costs and debt discount 26,283 17,348 15,775
Straight-line rent revenue and other (158,172) (172,765) (233,703)
Stock / (Unit)-based compensation expense 25,746 32,976 33,250
(Gain) loss on sale of real estate (5,545) (478,693) 1,815
Real estate and other impairment charges, net 193,947 1,825,402 376,907
Equity interest real estate impairment   410,790  
Straight-line rent and other write-off 11,054 2,514 649,911
Debt refinancing and unutilized financing (benefit) costs 3,629 4,292 (285)
Tax rate changes and other (11,231) 5,119 (167,332)
Non-cash fair value adjustments 106,442 563,666 (34,157)
Non-cash revenue from debt and equity securities received     (81,706)
Other adjustments 7,580 4,975 10,287
Changes in:      
Interest and rent receivables 7,111 2,778 (141,729)
Other assets 14,971 (36,109) 13,750
Accounts payable and accrued expenses 21,680 23,481 (4,599)
Deferred revenue (9,608) (5,753) 7,567
Net cash provided by operating activities 230,767 245,483 505,786
Investing activities      
Cash paid for acquisitions and other related investments (142,089) (105,618) (235,187)
Net proceeds from sale of real estate 120,550 1,854,077 897,500
Principal received from sale and repayment of loans receivable 116,309 214,416 501,630
Investment in loans receivable (205,752) (420,324) (250,223)
Construction in progress and other (80,003) (79,788) (114,425)
Proceeds from sale and return of equity investments   11,656 12,430
Capital additions and other investments, net (73,753) (156,078) (294,167)
Net cash (used for) provided by investing activities (264,738) 1,318,341 517,558
Financing activities      
Proceeds from term debt 2,512,970 804,188  
Payments of term debt (2,252,731) (701,809) (988,162)
Revolving credit facilities, net 241,530 (1,131,312) 567,910
Dividends / Distribution paid (193,259) (321,080) (615,390)
Lease deposits and other obligations to tenants (3,202) 2,237 10,139
Offering costs (727)    
Repurchase of common stock / unit (23,441)    
Stock / Unit vesting - satisfaction of tax withholdings (2,474) (3,805) (8,079)
Payment of debt refinancing and deferred financing costs and other financing activities (50,585) (127,798) 13,255
Net cash provided by (used for) financing activities 228,081 (1,479,379) (1,020,327)
Increase in cash, cash equivalents, and restricted cash for the year 194,110 84,445 3,017
Effect of exchange rate changes 14,712 (5,224) 11,397
Cash, cash equivalents, and restricted cash at beginning of year 335,173 255,952 241,538
Cash, cash equivalents, and restricted cash at end of year 543,995 335,173 255,952
Interest paid, including capitalized interest of $12,920 in 2025, $7,642 in 2024, and $14,178 in 2023 458,225 420,315 406,141
Supplemental schedule of non-cash investing activities:      
Debt and equity securities received for certain obligations, real estate, and revenue     804,520
Certain obligations and receivable satisfied and real estate sold 50,000   722,814
Lease incentive provided 50,000    
Supplemental schedule of non-cash financing activities:      
Dividends declared, unpaid 55,351 48,164 92,808
Cash, cash equivalents, and restricted cash are comprised of the following:      
Cash and cash equivalents at beginning of period 332,335 250,016 235,668
Restricted cash, included in Other assets at beginning of period $ 2,838 $ 5,936 $ 5,870
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List] Other Assets Other Assets Other Assets
Cash, cash equivalents, and restricted cash at beginning of year $ 543,995 $ 335,173 $ 255,952
Cash and cash equivalents at end of period 540,859 332,335 250,016
Restricted cash, included in Other assets at end of period $ 3,136 $ 2,838 $ 5,936
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List] Other Assets Other Assets Other Assets
Cash, cash equivalents, and restricted cash at end of year $ 543,995 $ 335,173 $ 255,952
v3.25.4
Consolidated Statements of Cash Flows (Parenthetical) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Interest paid, capitalized $ 12,920 $ 7,642 $ 14,178
MPT Operating Partnership, L.P. [Member]      
Interest paid, capitalized $ 12,920 $ 7,642 $ 14,178
v3.25.4
Pay vs Performance Disclosure - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Pay vs Performance Disclosure      
Net Income (Loss) $ (277,049) $ (2,410,271) $ (556,476)
v3.25.4
Insider Trading Arrangements
 3 Months Ended
Dec. 31, 2025
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
v3.25.4
Insider Trading Policies and Procedures
 12 Months Ended
Dec. 31, 2025
Insider Trading Policies and Procedures [Line Items]  
Insider Trading Policies and Procedures Adopted true
v3.25.4
Cybersecurity Risk Management Strategy and Governance
 12 Months Ended
Dec. 31, 2025
Cybersecurity Risk Management, Strategy, and Governance [Line Items]  
Cybersecurity Risk Management Processes for Assessing, Identifying, and Managing Threats [Text Block]

ITEM 1C. Cybersecurity

Cyber Risk Management and Strategy

We have developed, implemented, and continue to maintain processes and procedures to identify and mitigate cybersecurity risks across our company (including our offices in Europe). Because we rely on various information technology systems and software programs to operate our business, we have an extensive cybersecurity program designed to protect our properties and confidential data. Our cybersecurity risk management and strategy program includes the following:

•
implementing the latest software releases and tools (including multi-factor authentication) in a timely manner;
•
seek to minimize the amount of personal information collected and stored about our employees and seek to avoid any collection and storage of non-financial or contact information from our tenants/borrowers (and given we are a commercial real estate landlord, we do not maintain credit card or patient information in our systems);
•
seek to restrict information system access to appropriate levels while allowing users to fulfill their business responsibilities;
•
constant security monitoring of computers, networks, and cloud-based information assets to detect and respond to cybersecurity risks and threats;
•
third party internal and external vulnerability assessments and penetration testing;
•
annual review and audit of cyber controls and procedures;
•
periodic review of cybersecurity procedures and implementation of new procedures as necessary to adhere to cybersecurity standards set forth by the National Institute of Standards and Technology;
•
periodic evaluation and review of cybersecurity risks associated with our use of key third-party business partners, vendors, and service providers. Because we do not control the systems or cybersecurity plans put in place by such third parties, and we may have limited contractual protections with such parties, we may be negatively impacted as a result of threats or incidents experienced by such third parties;
•
security awareness training provided during employee onboarding process and successful completion required at least annually for all employees with passing requirements;
•
employee anti-phishing campaigns performed at least quarterly;
•
a cybersecurity incident response plan, which is reviewed annually, but generally consists of a coordinated approach to investigating, containing, documenting, and reporting findings and keeping management and others informed and involved as appropriate; and
•
a cybersecurity risk insurance policy.

 

We have not identified any known cybersecurity threats or incidents within the prior year that have materially affected or are reasonably likely to materially affect us, including our overall business strategy, results of operations, or financial condition. Although we have taken steps to protect the security of our information systems and the data maintained in those systems, there is no guarantee the measures and security we have implemented will be successful in detecting and preventing a cybersecurity incident. Please refer to Item 1A of this Annual Report on Form 10-K for more information regarding additional risks related to cybersecurity and information technology.

Cyber Governance

Cybersecurity holds a pivotal role in our comprehensive risk management processes and is a key focus for both our Board of Directors and management. Our management has primary responsibility for identifying, assessing, and managing our exposure to cybersecurity threats and incidents. However, the Board of Directors, led by members of the Risk Committee, oversees the enterprise risk management process, specifically addressing material risks stemming from cybersecurity threats.

The Board of Directors receives regular updates from the Computer Security Incident Response Team (“CSIRT”) to provide insight into significant cybersecurity risks, potential impacts on business operations, and management's strategies for identifying, monitoring, and mitigating these risks. This includes sharing results from assessments or audits of relevant processes.

Led by our Head of Technology with years of experience in Information Technology, our CSIRT, comprising cross-functional professionals, collaborates to execute our cybersecurity risk assessment and management processes by reviewing and assessing cybersecurity initiatives, including the incident response plan, cybersecurity compliance, training, and overall risk management efforts. The collaborative efforts of the Board of Directors and our skilled CSIRT team underscore our commitment to effectively addressing and mitigating cybersecurity risks within the organization.
Cybersecurity Risk Third Party Oversight and Identification Processes [Flag] true
Cybersecurity Risk Materially Affected or Reasonably Likely to Materially Affect Registrant [Flag] false
Cybersecurity Risk Board of Directors Oversight [Text Block]

Cybersecurity holds a pivotal role in our comprehensive risk management processes and is a key focus for both our Board of Directors and management. Our management has primary responsibility for identifying, assessing, and managing our exposure to cybersecurity threats and incidents. However, the Board of Directors, led by members of the Risk Committee, oversees the enterprise risk management process, specifically addressing material risks stemming from cybersecurity threats.

Cybersecurity Risk Board Committee or Subcommittee Responsible for Oversight [Text Block] the Board of Directors, led by members of the Risk Committee, oversees the enterprise risk management process, specifically addressing material risks stemming from cybersecurity threats.
Cybersecurity Risk Process for Informing Board Committee or Subcommittee Responsible for Oversight [Text Block]

The Board of Directors receives regular updates from the Computer Security Incident Response Team (“CSIRT”) to provide insight into significant cybersecurity risks, potential impacts on business operations, and management's strategies for identifying, monitoring, and mitigating these risks. This includes sharing results from assessments or audits of relevant processes.

Cybersecurity Risk Role of Management [Text Block]

Cybersecurity holds a pivotal role in our comprehensive risk management processes and is a key focus for both our Board of Directors and management. Our management has primary responsibility for identifying, assessing, and managing our exposure to cybersecurity threats and incidents. However, the Board of Directors, led by members of the Risk Committee, oversees the enterprise risk management process, specifically addressing material risks stemming from cybersecurity threats.

The Board of Directors receives regular updates from the Computer Security Incident Response Team (“CSIRT”) to provide insight into significant cybersecurity risks, potential impacts on business operations, and management's strategies for identifying, monitoring, and mitigating these risks. This includes sharing results from assessments or audits of relevant processes.

Cybersecurity Risk Management Positions or Committees Responsible [Flag] true
Cybersecurity Risk Management Positions or Committees Responsible [Text Block]

The Board of Directors receives regular updates from the Computer Security Incident Response Team (“CSIRT”) to provide insight into significant cybersecurity risks, potential impacts on business operations, and management's strategies for identifying, monitoring, and mitigating these risks. This includes sharing results from assessments or audits of relevant processes.

Led by our Head of Technology with years of experience in Information Technology, our CSIRT, comprising cross-functional professionals, collaborates to execute our cybersecurity risk assessment and management processes by reviewing and assessing cybersecurity initiatives, including the incident response plan, cybersecurity compliance, training, and overall risk management efforts. The collaborative efforts of the Board of Directors and our skilled CSIRT team underscore our commitment to effectively addressing and mitigating cybersecurity risks within the organization.
Cybersecurity Risk Management Expertise of Management Responsible [Text Block] Head of Technology with years of experience in Information Technology, our CSIRT, comprising cross-functional professionals, collaborates to execute our cybersecurity risk assessment and management processes by reviewing and assessing cybersecurity initiatives, including the incident response plan, cybersecurity compliance, training, and overall risk management efforts.
Cybersecurity Risk Process for Informing Management or Committees Responsible [Text Block]

The Board of Directors receives regular updates from the Computer Security Incident Response Team (“CSIRT”) to provide insight into significant cybersecurity risks, potential impacts on business operations, and management's strategies for identifying, monitoring, and mitigating these risks. This includes sharing results from assessments or audits of relevant processes.

our CSIRT, comprising cross-functional professionals, collaborates to execute our cybersecurity risk assessment and management processes by reviewing and assessing cybersecurity initiatives, including the incident response plan, cybersecurity compliance, training, and overall risk management efforts. The collaborative efforts of the Board of Directors and our skilled CSIRT team underscore our commitment to effectively addressing and mitigating cybersecurity risks within the organization.
Cybersecurity Risk Management Positions or Committees Responsible Report to Board [Flag] true
v3.25.4
Organization
 12 Months Ended
Dec. 31, 2025
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 December 31, 2025, we have investments in 384 facilities in 31 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.

v3.25.4
Summary of Significant Accounting Policies
 12 Months Ended
Dec. 31, 2025
Accounting Policies [Abstract]  
Summary of Significant Accounting Policies

2. Summary of Significant Accounting Policies

Use of Estimates: The preparation of our consolidated financial statements in conformity with accounting principles generally accepted in the U.S. requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. We believe the estimates and assumptions underlying our consolidated financial statements at December 31, 2025 are reasonable and supportable based on the information available (particularly as it relates to our assessments of the recoverability of our real estate and the adequacy of our credit loss reserves on loans and financing receivables). Actual results could differ from those estimates.

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

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

At December 31, 2025, we had loans and/or equity investments in certain VIEs, which may also be tenants of our facilities. 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 December 31, 2025 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

 

 

120,398

 

 

Mortgage and other loans

 

 

120,398

 

 

(1)
Carrying amount only reflects the net book value (which has been reduced by any impairments or negative fair value adjustments) of our loan or equity investment in the VIE.
(2)
Our maximum loss exposure related to loans with VIEs represents our current aggregate net book 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 net book 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 December 31, 2025, 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 short falls).

Investments in Unconsolidated Entities: Investments in entities in which we have the ability to significantly influence (but not control) are accounted for by the equity method. This includes the five investments in unconsolidated real estate joint ventures at December 31, 2025. Under the equity method of accounting, our share of the investee’s earnings or losses are included in the “Earnings (loss) from equity interests” line of our consolidated statements of net income. Except for our joint venture with Primotop Holdings S.à.r.l. (“Primotop”) (for which we handle the accounting of), we have elected to record our share of such investee’s earnings or losses on a lag basis (not to exceed three months). The initial carrying value of investments in unconsolidated entities is based on the amount paid to purchase the interest in the investee entity. Subsequently, our investments are increased/decreased by our share in the investees’ earnings/losses and decreased by cash distributions from our investees. To the extent that our cost basis is different from the basis reflected at the investee entity level, the basis difference is generally amortized over the lives of the related assets and liabilities, and such amortization is included in our share of equity in earnings of the investee.

We evaluate our equity method investments for impairment based upon a comparison of the fair value of the equity method investment to its carrying value, when impairment indicators exist. If we determine a decline in the fair value of an investment in an unconsolidated investee entity below its carrying value is other-than-temporary, an impairment is recorded.

Investments in entities in which we do not control nor do we have the ability to significantly influence and for which there is no readily determinable fair value are accounted for at cost, less any impairment, plus or minus changes resulting from observable price changes in orderly transactions involving the investee. Cash distributions on these types of investments are recorded to either income upon receipt (if a return on investment) or as a reduction of our investment (if the distributions received are in excess of our share of the investee’s earnings). For similar investments but for which there are readily determinable fair values, such investments are measured at fair value, with unrealized gains and losses recorded in income.

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

Revenue Recognition: Our revenues are primarily from leases and loans. For leases, we follow Accounting Standards Codification (“ASC”) 842, “Leases”, (“ASC 842”). ASC 842 sets out the principles for the recognition, measurement, presentation, and disclosure of leases for both parties to a contract (i.e. lessees and lessors). For lessors, we apply this standard as follows:

Operating Lease Revenue

We receive income from operating leases based on the fixed required rents (base rents) per the lease agreements. Rent revenue from base rents is recorded on the straight-line method, when collectibility of the lease payments is deemed probable, over the terms of the related lease agreements for new leases and the remaining terms of existing leases for those acquired as part of a property

acquisition. The straight-line method records the periodic average amount of base rents earned over the term of a lease, taking into account contractual rent increases over the lease term. The straight-line method typically has the effect of recording more rent revenue from a lease than a tenant is required to pay early in the term of the lease. During the later parts of a lease term, this effect reverses with less rent revenue recorded than a tenant is required to pay. Rent revenue, as recorded on the straight-line method, in our consolidated statements of net income is presented as two amounts: rent billed and straight-line rent. Rent billed revenue is the amount of base rent actually billed to our tenants each period as required by the lease. Straight-line rent revenue is the difference between rent revenue earned based on the straight-line method and the amount recorded as rent billed revenue. We record the difference between rent revenues earned and amounts due per the respective lease agreements, as applicable, as an increase or decrease to straight-line rent receivables.

In instances where collectibility of the lease payments is not deemed probable, rent revenue is constrained to the lower of 1) the revenue that would have been recognized if collection were probable (i.e., straight-line method) and 2) the amount of lease payments received in cash.

Rental payments received prior to their recognition as income are classified as deferred revenue.

Financing Lease Revenue

Under ASC 842, if an acquisition and subsequent lease of a property back to the seller does not meet the definition of a sale, we must account for the transaction as a financing lease with income recognized using the imputed interest method.

Another type of financing lease is a direct financing lease (“DFL”). For leases accounted for as DFLs, the future minimum lease payments are recorded as a receivable at lease inception, while, the difference between the future minimum lease payments and the estimated residual values less the cost of the properties is recorded as unearned income. Unearned income is deferred and amortized to income over the lease term to provide a constant yield when collectability of the lease payments is reasonably assured. Investments in DFLs are presented net of unearned income.

Other Leasing Revenue

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

We also receive additional rent (contingent rent) under some leases based on increases in the consumer price index (“CPI”) (or similar index outside the U.S.) or when CPI exceeds the annual minimum percentage increase as stipulated in the lease. Contingent rents are recorded as rent billed revenue in the period earned.

Tenant payments for ground leases along with other operating expenses, such as property taxes and insurance, that are paid directly by us and reimbursed by our tenants are presented on a gross basis with the related revenues recorded in “Interest and other income” and the related expenses in “Property-related” in our consolidated statements of net income. All payments of other operating expenses made directly by the tenant to the applicable government or appropriate third-party vendor are recorded on a net basis.

Interest Revenue

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

Other Revenue

Commitment fees received on operating leases for development and leasing services are initially recorded as deferred revenue and recognized as income over the initial term of a lease on the straight-line method. Commitment and origination fees from lending services are also recorded as deferred revenue initially and recognized as income over the life of the loan using the interest method.

Acquired Real Estate Purchase Price Allocation: We account for acquisitions of real estate under asset acquisition accounting rules. Under this accounting standard, we allocate the purchase price (including any third-party transaction costs directly related to the acquisition) of acquired properties to tangible and identified intangible assets acquired and liabilities assumed (if any) based on their

relative fair values. In making estimates of fair values for purposes of allocating purchase prices of acquired real estate, we may utilize a number of sources, from time-to-time, including available real estate broker data, independent appraisals that may be obtained in connection with the acquisition, internal data from previous acquisitions or developments, and other market data, including market comparables for significant assumptions such as market rents, capitalization, and discount rates. We also consider information obtained about each property as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the tangible and intangible assets acquired.

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

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

We amortize the value of our lease intangible assets to expense over the term of the respective leases. If a lease is terminated early, the unamortized portion of the lease intangibles are charged to expense. This amortization expense is included in the "Real estate depreciation and amortization" line of our consolidated statements of net income.

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

Real Estate and Depreciation: Real estate, consisting of land, buildings and improvements, is maintained at cost. Although typically paid by our tenants, any expenditure for ordinary maintenance and repairs that we pay are expensed to operations as incurred. Significant renovations and improvements, which improve and/or extend the useful life of the asset, are capitalized and depreciated over their estimated useful lives. We review real estate investments for impairment when events and circumstances indicate that the assets may not be recoverable. We analyze recoverability by comparing the carrying value of the real estate assets to a probability-weighted set of estimated undiscounted cash flows to be generated by those assets, including an estimated liquidation amount, during the expected holding periods. Assumptions used in determining undiscounted cash flows may include, but are not limited to, market rental rates, capitalization rates, and holding periods. If the recoverability analysis indicates that the carrying value of the real estate asset is greater than the expected future undiscounted cash flows, impairment losses are measured as the difference between carrying value and fair value of the assets. Future cash flows are discounted when determining fair value of an asset. Estimated future cash flows used in such analysis are based on our plans for the real estate asset and our view of market economic conditions. Assumptions used in determining fair value may include, but are not limited to, market rental rates, discount rates, and capitalization rates.

When a real estate investment is designated as held for sale, we cease recording depreciation expense and adjust the assets’ value to the lower of its carrying value or fair value, less cost of disposal. Fair value is typically based on estimated cash flows discounted at a risk-adjusted rate of interest. We classify real estate assets as held for sale when we have commenced an active program to sell the assets, and in the opinion of management, it is probable the asset will be sold within the next 12 months.

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

underlying property ready for its intended use have been initiated. We stop the capitalization of costs when the property is substantially complete and ready for its intended use.

Depreciation is calculated on the straight-line method over the estimated useful lives of the related real estate and other assets. Our weighted-average useful lives at December 31, 2025 are as follows:

 

Buildings and improvements

 

38.6 years

Lease intangibles

 

28.2 years

Leasehold improvements

 

14.3 years

Furniture, equipment, and other

 

5.0 years

 

Credit Losses:

Losses from Rent Receivables: For our leases, we review tenant provided financial data and monitor the performance of our tenants in areas generally consisting of: admission levels and surgery/procedure volumes by type; current operating margins; ratio of our tenant's operating margins both to facility rent and to facility rent plus other fixed costs; trends in revenue, cash collections, patient mix; and the effect of evolving healthcare regulations, adverse economic and political conditions, such as inflation and interest rates, and other events ongoing on a tenant's profitability and liquidity.

Operating Lease Receivables: We utilize the information above along with the tenant’s payment and default history in evaluating (on a lease-by-lease basis) whether or not lease payments are deemed probable of collection. As noted earlier, if not deemed probable of collection, rent revenue, under lease accounting rules, is constrained to the lesser of 1) the revenue that would have been recognized if collection were probable (i.e., straight-line method) and 2) the amount of lease payments received in cash.

Financing Lease Receivables: We apply a forward-looking “expected credit loss” model to all of our financing receivables, including financing leases and loans. To do this, we group our financial instruments into two primary pools of similar credit risk: secured and unsecured. The secured instruments include our investments in financing receivables as all are secured by the underlying real estate, among other collateral. Within the two primary pools, we further group our instruments into sub-pools based on several tenant/borrower characteristics, including years of experience in the healthcare industry and in a particular market or region and overall capitalization. We then determine a credit loss percentage per pool based on our history over a period of time that closely matches the remaining terms of the financial instruments being analyzed and adjust as needed for current trends or unusual circumstances. We apply these credit loss percentages to the book value of the related instruments to establish a credit loss reserve on our financing lease receivables and such credit loss reserve (including the underlying assumptions) is reviewed and adjusted quarterly. If a financing receivable is under performing and is deemed uncollectible based on the lessee’s overall financial condition, we will adjust the credit loss reserve based on the fair value of the underlying collateral.

We made the accounting policy election to exclude interest receivables from the credit loss reserve model. Instead, such receivables are impaired and an allowance recorded when it is deemed probable that we will be unable to collect all amounts due. The need for an allowance is based upon our assessment of the lessee’s overall financial condition, economic resources and payment record, the prospects for support from any financially responsible guarantors, and, if appropriate, the realizable value of any collateral. Financing leases are placed on non-accrual status when we determine that the collectability of contractual amounts is not reasonably assured. If on non-accrual status, we generally account for the financing lease on a cash basis, in which income is recognized only upon receipt of cash.

Loans: Loans consist of mortgage loans, working capital loans, and other loans. Mortgage loans are collateralized by interests in real property. Working capital and other loans are typically collateralized by interests in receivables, personal property, and corporate and individual guarantees. We record loans at cost. Like our financing lease receivables, we establish credit loss reserves on all outstanding loans based on historical credit losses of similar instruments. Such credit loss reserves, including the underlying assumptions, are reviewed and adjusted quarterly. If a loan’s performance worsens and foreclosure is deemed probable for our collateral-based loans (after considering the borrower’s overall financial condition as described above for leases), we will adjust the allowance for expected credit losses based on the current fair value of such collateral at the time the loan is deemed uncollectible. If the loan is not collateralized, the loan will be reserved for/written-off once it is determined that such loan is no longer collectible.

Interest receivables on loans are excluded from the forward looking credit loss reserve model; however, an allowance is recorded when it is deemed probable that we will be unable to collect all amounts due. Loans are placed on non-accrual status when we determined that the collectibility of contractual amounts is not reasonably assured. If on non-accrual status, we generally account for the loan on the cash basis, in which income is recognized only upon receipt of cash.

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

 

 

 

December 31, 2025

 

 

December 31, 2024

 

Balance at beginning of the year

 

$

511,473

 

 

$

96,001

 

Provision for credit loss, net

 

 

168,186

 

 

 

1,241,020

 

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

 

 

(126,362

)

 

 

(825,548

)

Balance at end of year

 

$

553,297

 

 

$

511,473

 

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

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

Income Taxes: We conduct our business as a REIT under Sections 856 through 860 of the Internal Revenue Code of 1986, as amended (“the Code”). To qualify as a REIT, we must meet certain organizational and operational requirements, including a requirement to distribute to stockholders at least 90% of our REIT’s ordinary taxable income. As a REIT, we generally pay little U.S. federal and state income tax because of the dividends paid deduction that we are allowed to take. If we fail to qualify as a REIT in any taxable year, we will then be subject to U.S. federal income taxes on our taxable income at regular corporate rates and will not be permitted to qualify for treatment as a REIT for U.S. federal income tax purposes for four years following the year during which qualification is lost, unless the Internal Revenue Service grants us relief under certain statutory provisions. Such an event could materially adversely affect our net income and net cash available for distribution to stockholders. However, we intend to operate in such a manner so that we will remain qualified as a REIT for U.S. federal income tax purposes.

Our financial statements include the operations of TRS entities. None of our TRS entities are entitled to a dividends paid deduction and are subject to U.S. federal, state, and local income taxes. Our TRS entities are authorized to provide property development, leasing, and management services for third-party owned properties, and we will make non-mortgage loans to and/or investments in our lessees through these entities.

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

The calculation of our income taxes involves dealing with uncertainties in the application of complex tax laws and regulations in a multitude of jurisdictions across our global operations. An income tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, on the basis of technical merits. However, if a more likely than not position cannot be reached, we record a liability as an offset to the tax benefit and adjust the liabilities when our judgment changes as a result of the evaluation of new information not previously available. Because of the complexity of some of these uncertainties, the ultimate resolution may result in a payment that is materially different from our current estimate of the uncertain tax position liabilities. These differences will be reflected as increases or decreases to income tax expense in the period in which new information is available.

Stock-Based Compensation: We adopted the 2019 Equity Incentive Plan (the “Equity Incentive Plan”) during the second quarter of 2019, which was amended during the second quarter of 2022. Equity awards of restricted stock with service conditions are valued at the average stock price per share on the date of grant and are amortized to compensation expense over the service periods (typically three years), using the straight-line method. Equity awards that contain market conditions are valued on the grant date using a Monte Carlo valuation model and are amortized to compensation expense over the derived service periods, which correspond to the periods over which we estimate the awards will be earned, which generally range from three to five years, using the straight-line method.

Equity awards with performance conditions are valued at the average stock price per share on the date of grant and are amortized using the straight-line method over the service period, adjusted for the probability of achieving the performance conditions. In 2024 and 2025, certain market-based restricted stock units ("RSUs") were issued with cash-settlement features. These liability-type awards are adjusted to fair value (using a Monte Carlo valuation model) on a quarterly basis and amortized over the derived service period, which is also adjusted on a quarterly basis. Forfeitures of stock-based awards are recognized as they occur.

Deferred Costs: Costs incurred that directly relate to the offerings of stock are deferred and netted against proceeds received from the offering. Leasing commissions and other third-party leasing costs that would not have been incurred if the lease was not obtained are capitalized as deferred leasing costs and amortized on the straight-line method over the terms of the related lease agreements. Costs identifiable with loans made to borrowers are capitalized and recognized as a reduction in interest income over the life of the loan.

Deferred Financing Costs: We generally capitalize financing costs incurred in connection with new financings and refinancings of debt. These costs are amortized over the lives of the related debt as an addition to interest expense. For debt with defined principal re-payment terms, the deferred costs are amortized to produce a constant effective yield on the debt (interest method) and are included within “Debt, net” on our consolidated balance sheets. For debt without defined principal repayment terms, such as our revolving credit facility, the deferred costs are amortized on the straight-line method over the term of the debt and are included as a component of “Other assets” on our consolidated balance sheets.

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

Certain of our U.S. subsidiaries will enter into short-term and long-term transactions denominated in a foreign currency from time-to-time. Gains or losses resulting from these foreign currency transactions are revalued into U.S. dollars at the rates of exchange prevailing at the dates of the transactions. The effects of revaluation gains or losses on our short-term transactions are included in other income (expense) in the consolidated statements of income, while the revaluation effects on our long-term investments are recorded in accumulated other comprehensive income (loss) on our consolidated balance sheets.

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

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

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

reflect our market assumptions. This hierarchy requires the use of observable market data when available. These inputs have created the following fair value hierarchy:

•
Level 1 — quoted prices for identical instruments in active markets;
•
Level 2 — quoted prices for similar instruments in active markets; quoted prices for identical or similar instruments in markets that are not active; and model-derived valuations in which significant inputs and significant value drivers are observable in active markets; and
•
Level 3 — fair value measurements derived from valuation techniques in which one or more significant inputs or significant value drivers are unobservable.

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

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

Fair Value Option Election: For our equity investment in the international joint venture and PHP Holdings (which we sold on July 1, 2025), along with any related investments such as loans (see Note 10 for more details), 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. We have not made a similar election for other investments that exist at December 31, 2025.

Leases (Lessee)

Pursuant to ASC 842, we are required to apply a dual approach, classifying leases (in which we are the lessee) as either financing or operating leases based on the principle of whether or not the lease is effectively a financed purchase. This classification determines whether lease expense is recognized based on an effective interest method (for finance leases) or on a straight-line basis (for operating leases) over the term of the lease. We record a right-of-use asset and a lease liability for all material leases with a term greater than 12 months regardless of their classification. Leases with a term of 12 months or less are off balance sheet with lease expense recognized on a straight-line basis over the lease term.

Segment Reporting

In November 2023, the Financial Accounting Standards Board ("FASB") issued ASU 2023-07, "Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures" ("ASU 2023-07") to improve reportable segment disclosure requirements. We adopted this guidance in the fourth quarter of 2024 and have included the required disclosures within Note 13 - Segment Disclosures.

Reclassifications: Certain amounts in the consolidated financial statements for prior periods have been reclassified to conform to the current period presentation.

Recent Accounting Developments

Disaggregation of Income Statement Expenses

In November 2024, the 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. ASU 2024-03 is effective for annual periods beginning after December 15, 2026. We are currently evaluating the potential impact of the adoption of this standard on our consolidated financial statements.
v3.25.4
Real Estate and Other Activities
 12 Months Ended
Dec. 31, 2025
Real Estate [Abstract]  
Real Estate and Other Activities

3. Real Estate and Other Activities

New Investments

For the years ended December 31, 2025, 2024, and 2023, we acquired or invested in the following net assets (in thousands):

 

 

2025

 

 

2024

 

 

2023

 

Land and land improvements

 

$

25,231

 

 

$

—

 

 

$

28,916

 

Buildings

 

 

48,742

 

 

 

—

 

 

 

114,966

 

Intangible lease assets — subject to amortization
   (weighted-average useful life of 19.9 years in 2025 and 24.8 years in 2023)

 

 

5,101

 

 

 

—

 

 

 

16,305

 

Investments in unconsolidated real estate joint ventures

 

 

63,015

 

 

 

107,908

 

 

 

—

 

Investments in unconsolidated operating entities

 

 

—

 

 

 

—

 

 

 

50,000

 

Other loans

 

 

—

 

 

 

—

 

 

 

25,000

 

Liabilities assumed

 

 

—

 

 

 

(2,290

)

 

 

—

 

 

$

142,089

 

 

$

105,618

 

 

$

235,187

 

Loans repaid(1)

 

 

—

 

 

 

—

 

 

 

(22,900

)

Total net assets acquired

 

$

142,089

 

 

$

105,618

 

 

$

212,287

 

 

(1)
The 2023 column includes a $23 million mortgage loan that was converted to fee simple ownership of one property as described under the Lifepoint Transaction below.

2025 Activity

In 2025, our real estate and other investments totaling approximately $142 million included:

a)
the acquisition of one post-acute property for $32 million in November 2025 to be leased to Vibra Healthcare (“Vibra”);
b)
a new investment in April 2025 of CHF 52 million (or approximately $63 million), inclusive of a CHF 25 million (or approximately $30 million) short-term loan, in the Swiss Medical Network real estate joint venture, proceeds of which, along with fundings from our joint venture partner, were used to facilitate the acquisition and leasing of one general acute care facility in Switzerland and repayment of debt; and
c)
the funding of approximately $47 million to the secured lender in the Steward bankruptcy in March 2025 in order to obtain control over certain real estate assets for use by our new tenants.

2024 Activity

Utah Transaction

On April 12, 2024, we sold our interests in five Utah hospitals for an aggregate agreed valuation of approximately $1.2 billion to a newly formed joint venture (the "Utah partnership") with an institutional asset manager (the "Fund"), which we call the Utah Transaction, and we recognized a gain on real estate of approximately $380 million, partially offset by a $20 million write-off of unbilled straight-line rent receivables. We retained an approximately 25% interest in the Utah partnership valued initially at approximately $108 million, which is being accounted for on the equity method on a quarterly lag basis and included in the "Investments in unconsolidated real estate joint ventures" line of the consolidated balance sheets. The Fund purchased an approximate 75% interest for $886 million. In conjunction with this transaction closing, the Utah partnership placed new non-recourse secured financing, providing $190 million of additional cash to us. In total, the Utah Transaction generated $1.1 billion of cash to us. The Utah lessee (an affiliate of CommonSpirit Health ("CommonSpirit")) may acquire the leased real estate at a price equal to the greater of fair market value and the approximate $1.2 billion lease base at the fifth or tenth anniversary of the 2023 master lease commencement. We granted the Fund certain limited and conditional preferences based on the possible execution of the purchase option, which we accounted for as a derivative liability with an initial value of approximately $2.3 million.

2023 Activity

Lifepoint Transaction

On February 7, 2023, a subsidiary of Lifepoint Health, Inc. ("Lifepoint") acquired a majority interest in Springstone (now Lifepoint Behavioral Health, "Lifepoint Behavioral") (the "Lifepoint Transaction") based on an enterprise value of $250 million. As part of the transaction, we received approximately $205 million in full satisfaction of our initial acquisition loan, including accrued interest, and we retained (at that time) our minority equity investment in the operations of Lifepoint Behavioral. Separately, we

converted an approximate $23 million mortgage loan (made as part of our initial acquisition in 2021) into the fee simple ownership of a property in Washington, which is leased, along with other behavioral health hospitals, to Lifepoint Behavioral, under a master lease agreement. In connection with the Lifepoint Transaction, Lifepoint extended its lease on eight existing general acute care hospitals by five years to 2041.

In the first quarter of 2024, we sold our minority equity investment in Lifepoint Behavioral for approximately $12 million.

Other Transactions

In the second quarter of 2023, we acquired three inpatient rehabilitation facilities for a total of approximately €70 million (approximately $77 million). These hospitals are leased to Median Kliniken S.á.r.l ("MEDIAN") pursuant to a long-term master lease with annual inflation-based escalators.

On April 14, 2023, we acquired five behavioral health hospitals located in the U.K. for approximately £44 million (approximately $58 million). These hospitals are leased to Priory pursuant to five separate lease agreements with annual inflation-based escalators.

In the first quarter of 2023, we originated a $50 million convertible loan to PHP Holdings, the managed care business of Prospect at that time. See subheading "Leasing Operations (Lessor)" in this Note 3 for further updates on Prospect.

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
December 31, 2025

 

 

Cost Remaining

 

IMED Hospitales ("IMED") (Spain)

 

$

67,054

 

 

$

39,954

 

 

$

27,100

 

Healthcare Systems of America (Florida)

 

 

43,500

 

 

 

2,064

 

 

 

41,436

 

IMED (Spain)

 

 

43,495

 

 

 

39,797

 

 

 

3,698

 

Lifepoint Behavioral (Arizona)

 

 

10,659

 

 

 

8,281

 

 

 

2,378

 

Other (Various)

 

 

554

 

 

 

210

 

 

 

344

 

 

$

165,262

 

 

$

90,306

 

 

$

74,956

 

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 December 31, 2025, 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 $10 million and $15 million.

Separately, on the Norwood redevelopment, we recovered from our casualty insurers cash in November 2024 that was in excess of our recovery receivable related to the 2020 storm losses (included in "Other assets" in the consolidated balance sheets), resulting in a $24 million additional recovery in the 2024 third quarter.

2025 Activity

During 2025, we completed construction, and began recording rental income, on three projects totaling approximately $46.5 million, two of which are leased to Lifepoint Behavioral and the other to Surgery Partners.

2024 Activity

During the fourth quarter of 2024, we completed construction and began recording rental income on an existing general acute care facility located in Idaho Falls, Idaho for a total amount of approximately $50 million.

During the first quarter of 2024, we completed construction, and began recording rental income, on a $35.4 million behavioral health facility located in McKinney, Texas, that is leased to Lifepoint Behavioral. We also completed construction and began recording rental income on a €46 million (approximately $49.0 million) general acute care facility located in Spain that is leased to IMED.

2023 Activity

During 2023, we completed construction and began recording rental income on one inpatient rehabilitation facility located in Lexington, South Carolina, which commenced rent on July 1, 2023, and another inpatient rehabilitation facility located in Stockton, California, which commenced rent on May 1, 2023. Both of these facilities are leased to Ernest Health, Inc. ("Ernest") pursuant to an existing long-term master lease.

Disposals

2025 Activity

During 2025, we completed the sale of nine facilities (including two former Steward-operated facilities that were being leased to College Health for nominal rent) along with certain ancillary land and facilities for aggregate cash proceeds of approximately $121 million, resulting in a gain on real estate of approximately $5.5 million. For one of the properties sold, we agreed for the tenant to retain the cash proceeds of approximately $50 million as an incentive to close on a substitute property and keep cash rents the same. The $50 million lease incentive will be amortized over the remaining 16-year master lease term as a reduction of revenue.

2024 Activity

During 2024, we had the following disposal activities:

•
See Utah Transaction above for a discussion of the five Utah hospitals sold on April 12, 2024.
•
On April 9, 2024, we sold five properties to Prime Healthcare Services, Inc. ("Prime") for total proceeds of approximately $250 million along with a $100 million interest-bearing mortgage loan (which was fully repaid on August 29, 2024). This transaction resulted in a gain on real estate of approximately $53 million, partially offset by a non-cash straight-line rent write-off of approximately $30 million. As part of this sale transaction, we extended the lease maturity of four other facilities with Prime to 2044. This amended lease has inflation-based escalators, collared between 2% and 4%, and a purchase option on or prior to August 26, 2028 for a value of $238 million, which is greater than our net book value for these properties. After August 26, 2028, this option price reverts to $260 million (subject to annual escalations).
•
On July 23, 2024, we sold the 50-bed Arizona General Hospital in Mesa, Arizona and seven freestanding emergency departments to Dignity Health ("Dignity") for $160 million. This sale resulted in a gain on real estate of approximately $85 million, partially offset by a non-cash straight-line rent write-off of approximately $20 million.
•
On August 14, 2024, we sold 11 freestanding emergency departments to UCHealth for $86 million. This sale resulted in a gain on real estate of approximately $40 million, partially offset by a non-cash straight-line rent write-off of approximately $16 million.
•
As a result of our global settlement with Steward Health Care System ("Steward") as discussed further under "Leasing Operations (Lessor)" under this same Note 3, we consented to the sale of three facilities located in Florida ("Space Coast" properties) to Orlando Health, which closed on October 23, 2024. In accordance with the terms of the global settlement, the Steward bankruptcy estate retained $395 million of the approximately $440 million total proceeds, and we retained the remaining proceeds and recognized an approximate $2 million gain in the fourth quarter of 2024.
•
In the fourth quarter of 2024, we sold the Watsonville facility resulting in cash proceeds of approximately $40 million and an approximate $4 million gain.
•
During 2024, we also completed the sale of six other facilities and two ancillary facilities for approximately $14 million.

2023 Activity

On March 30, 2023, we entered into a definitive agreement to sell our 11 general acute care facilities located in Australia and operated by Healthscope Ltd. ("Healthscope") (the "Australia Transaction") to affiliates of HMC Capital for cash proceeds of approximately A$1.2 billion. As a result, we designated the Australian portfolio as held for sale in the first quarter of 2023 and recorded approximately $79 million of net impairment charges at that time, which included $37.4 million of straight-line rent receivable write-offs and approximately $8 million in fees to sell the hospitals, partially offset by approximately $16 million of gains from our interest rate swap and foreign currency translation amounts in accumulated other comprehensive income that were reclassified to earnings in 2023 as part of the transaction. This transaction closed in two phases. The first phase closed on May 18, 2023, in which we sold seven of the 11 facilities for A$730 million, and the final phase closed on October 10, 2023, in which we sold the remaining four facilities for approximately A$470 million.

On March 8, 2023, we received notice that Prime planned to exercise its right to repurchase from us the real estate associated with one master lease for approximately $100 million. As such, we recorded an approximate $11 million impairment charge in the first quarter of 2023 related to non-cash rent receivables on the three facilities that were sold on July 11, 2023.

Intangible Assets

At December 31, 2025 and 2024, our intangible lease assets were $0.9 billion ($0.6 billion, net of accumulated amortization) and $0.8 billion ($0.6 billion, net of accumulated amortization), respectively.

We recorded amortization expense related to intangible lease assets of $30.4 million, $205.6 million (including $170 million for accelerating the amortization of the in-place lease intangibles associated with two master leases, including the Steward master lease that was terminated effective September 18, 2024), and $332.5 million (including $286 million for accelerating the amortization of the in-place lease intangibles related to re-leasing the Utah properties to CommonSpirit as described in this same Note 3), in 2025, 2024, and 2023, respectively, and expect to recognize amortization expense from existing lease intangible assets as follows (amounts in thousands):

 

For the Year Ended December 31:

 

 

 

2026

 

$

32,165

 

2027

 

 

31,847

 

2028

 

 

31,684

 

2029

 

 

29,840

 

2030

 

 

29,173

 

 

As of December 31, 2025, capitalized lease intangibles have a weighted-average remaining life of 22.7 years.

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 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.

The following table summarizes total future contractual minimum lease payments, excluding operating expense reimbursements, tenant recoveries, and other lease-related adjustments to revenue (i.e., straight-line rents, deferred revenues, or reserves/write-offs), from tenants under noncancelable leases as of December 31, 2025 (amounts in thousands):

 

 

 

Total Under
Operating Leases

 

 

Total Under
Financing Leases

 

 

Total

 

2026

 

$

842,559

 

 

$

34,726

 

 

$

877,285

 

2027

 

 

933,571

 

 

 

35,477

 

 

 

969,048

 

2028

 

 

942,705

 

 

 

36,243

 

 

 

978,948

 

2029

 

 

946,839

 

 

 

37,025

 

 

 

983,864

 

2030

 

 

952,310

 

 

 

37,822

 

 

 

990,132

 

Thereafter

 

 

20,829,144

 

 

 

840,542

 

 

 

21,669,686

 

 

$

25,447,128

 

 

$

1,021,835

 

 

$

26,468,963

 

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 December 31, 2025, we account for all of these leases as operating leases, except where generally accepted accounting principles (“GAAP”) requires alternative classification, including leases on certain Ernest Health, Inc. ("Ernest") and Prospect 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 December 31, 2025

 

 

As of December 31, 2024

 

Minimum lease payments receivable

 

$

570,150

 

 

$

591,142

 

Estimated unguaranteed residual values

 

 

203,818

 

 

 

203,818

 

Less: Unearned income and allowance for credit loss

 

 

(523,746

)

 

 

(547,770

)

Net investment in direct financing leases

 

 

250,222

 

 

 

247,190

 

Other financing leases (net of allowance for credit loss)

 

 

171,462

 

 

 

810,580

 

Total investment in financing leases

 

$

421,684

 

 

$

1,057,770

 

The decrease in our investment in financing leases is primarily due to the re-leasing of six California properties formerly operated by Prospect, with a net book value of approximately $510 million, to NOR Healthcare Systems Corporation ("NOR") as a result of their successful bid to acquire the hospital operations. These six properties are now accounted for as operating leases as further discussed in this same Note 3.

Other Leasing Activities

At December 31, 2025, our vacant properties (excluding developments) represent 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 deferrals to be paid back in full, or in the form of temporary loans. See below for an update on some of our tenants.

Steward Health Care System

Steward filed for Chapter 11 bankruptcy on May 6, 2024 with the United States Bankruptcy Court for the Southern District of Texas. On September 18, 2024, the bankruptcy court approved a global settlement between Steward, its lenders, the unsecured creditors committee, and the Company. The order provided for the following: a) termination of our master lease with Steward; b) the release of claims against 23 of our properties allowing us to begin the process of re-tenanting these properties; and c) a full release of claims against us from all parties. In return, we consented to the sale of the operations and our real estate in three facilities in the Space Coast region of Florida (as discussed earlier), along with a full release of our claims in Steward including claims to past due rent and interest, outstanding loans, and our equity investment.

In regard to our real estate partnership with Macquarie that owned and leased eight properties in Massachusetts to Steward, the bankruptcy court approved the termination of the master lease with Steward during the 2024 third quarter. We and Macquarie entered into an agreement with the mortgage lender of the joint venture to transition the eight properties to them along with cash proceeds of approximately $40 million (representing our share), in return for full payment of the underlying mortgage debt and a release of claims against each party.

With this global settlement and termination of the joint venture master lease, our relationship with Steward effectively ended.

Impairment Charges

Due to the events discussed above, we recorded various impairment charges during 2024 and 2023, which included the following (in millions):

 

 

For the Years Ended December 31,

 

 

 

Description

 

2024

 

 

2023

 

 

Income Statement
Classification

Reserve for unpaid rent and interest and straight-line
   rent receivables

 

$

—

 

 

$

413

 

 

Total revenues

Working capital and other loans(1)

 

 

787

 

 

 

—

 

 

Real estate and other
impairment charges, net

Investment in Massachusetts partnership(2)

 

 

445

 

 

 

30

 

 

Earnings (loss) from
equity interests

Real estate(2)

 

 

277

 

 

 

100

 

 

Real estate and other
impairment charges, net

Equity investment and other(1)

 

 

54

 

 

 

171

 

 

Real estate and other
impairment charges, net

Total

 

$

1,563

 

 

$

714

 

 

 
(1)
For our non-real estate investments in Steward, we compared our carrying value of all such investments to the fair value of the underlying collateral, which had no value after the global settlement and our release of claims against Steward as discussed above.
(2)
The three Space Coast properties and certain excess properties previously leased to Steward were deemed held for sale in the 2024 third quarter. We recognized a real estate impairment charge of approximately $180 million to adjust our net book value to align with fair value less cost to sell based on expected proceeds, including from a binding agreement for the Space Coast properties. For the other real estate held for use, we made a comparison of the projected undiscounted future cash flows with the net book value of each asset. For those properties where the carrying value was deemed not recoverable, we recorded an impairment charge to reduce the carrying value to its estimated fair value. For the real estate in the Massachusetts partnership, there was no fair value as we transitioned those properties to the mortgage lender to satisfy the mortgage debt. For the remaining properties (less than 10 in total in 2024 and 2023), we, along with assistance from a third-party, independent valuation firm, estimated fair value using 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 sale prices of similar properties. For the income approach, we divided the expected operating income (rent revenue less expenses, if any) from the property by a market capitalization rate (range from 8% to 10%).

In addition with the lease termination discussed above, we fully amortized the related in-place lease intangibles resulting in $149 million of amortization expense in 2024 as reflected in the real estate depreciation and amortization line of our consolidated statements of net income.

Re-tenanting Activity

Subsequent to the release of claims on the 23 properties as part of the global settlement, we reached definitive agreements with six operators (Healthcare Systems of America, Honor Health, Insight Health ("Insight"), Quorum, College Health, and Tenor Health ("Tenor")) to lease 18 of these facilities. 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, and $26.1 million in the 2025 fourth quarter. Based on these lease contracts (adjusted for the sale of the two properties to College Health in 2025), rent payments are to increase to approximately 79% of contractual rent by second quarter 2026, and 100% of contractual rent starting October 2026. As of December 31, 2025, 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 December 31, 2025, we have provided approximately $140 million in working capital related loans 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). Our maximum loss exposure to these tenants at December 31, 2025 is the loan carrying value along with up to $30 million, which reflects the remaining amount available under the loans.

The remaining five former Steward 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.

Other Activity

During 2024, we received and recorded rent and interest revenue from Steward of $40 million for the year ended December 31, 2024. In addition, we were benefited from rent paid by Steward to the Massachusetts joint venture of $76 million ($38 million representing our share) for the year ended December 31, 2024.

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 determining the impairment charges needed for these investments, we compared the carrying value of each investment to the fair value of the underlying collateral less costs to sell and factored in the priority of claims associated with the bankruptcy. In estimating the fair value of 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 in accordance with the global settlement and the estimated recovery waterfall, we recorded approximately $140 million of additional impairment charges. In determining the 2025 impairment charges, we compared the carrying value of our investments to our current 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 applied the same approach as discussed above for the 2024 impairment charges, except we used bids received for valuing the Pennsylvania and Connecticut properties in the third and fourth quarters of 2025.

At December 31, 2025, our investment in Prospect is approximately $61 million with recoveries limited to collection of Connecticut accounts receivable and minor proceeds from remaining asset sales. Prospect's bankruptcy proceedings are continuing, and the ultimate outcome of such proceedings is uncertain. At this time, we cannot assure you that we will be able to recover our remaining investment in full as of December 31, 2025.

Possible Additional Funding

In 2025, the bankruptcy court approved an order for up to $70 million in additional advances which we may be required to fund. This possible loan advance is conditioned on other events occurring including the sale of the last Connecticut facility and the bankruptcy plan becoming effective. Any funds advanced are expected to be secured by recoveries, if any, from causes of action owned by the debtor. At this time, we cannot predict with full certainty as to the amount or timing of such recoveries from these causes of action.

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, 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 have committed to fund up to $60 million in seismic improvements that may be required by California regulators over the next four years, 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. Each quarter, we marked such investment to fair value as more fully described in Note 10 to the consolidated financial statements. In 2025, we recorded an approximate $147 million negative fair value adjustment, whereas this adjustment was approximately $550 million in 2024. 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.

International Joint Venture

We placed our loan to the international joint venture on the cash basis of accounting in 2023, as we determined that it was no longer probable that the borrower would pay its future interest in full. This loan, accounted for under the fair value option method, was collateralized by the equity of Steward held by an investor in both Steward and the international joint venture. Consistent with the discussion above on non-real estate investments in Steward, we recorded a $225 million unfavorable fair value adjustment in the 2024 first quarter to fully reserve for the loan and related equity investment. These investments, which are included in “Investments in unconsolidated operating entities” on our consolidated balance sheets, were adjusted for after comparing our carrying value to an updated fair value analysis of the underlying collateral, with assistance from a third-party, independent valuation firm.

CommonSpirit

On May 1, 2023, Catholic Health Initiatives Colorado ("CHIC"), a wholly owned subsidiary of CommonSpirit, acquired the Utah hospital operations of five general acute care facilities previously operated by Steward. The new lease, at the time, for these Utah assets had an initial fixed term of 15 years with annual escalation provisions. As part of this transaction, we severed these facilities from the master lease with Steward, and accordingly accelerated the amortization of the associated in-place lease intangibles (approximately $286 million) and wrote-off approximately $95 million of straight-line rent receivables related to the former lease. As described earlier, these five properties make up the Utah Transaction.

Vibra

In the 2023 third quarter, we moved to cash basis of accounting for Vibra due to declines in operating results. As a result, we recorded a $49 million charge to reserve billed and straight-line rent receivables. During the 2024 third quarter, we terminated the lease with this tenant, resulting in the acceleration of lease intangible amortization of $22 million. On December 31, 2024, we entered into a forbearance and restructuring agreement with the former tenant, which was later amended. The substantive terms of the forbearance and restructuring agreement included, among other things, the repayment of $10 million of unpaid rent in cash, which we received on December 31, 2024 and recognized as revenue; Vibra's acquisition of certain of our facilities, one of which closed in early January 2025 for approximately $3 million (and we received payment in full); and entering into a new lease agreement.

In the 2025 fourth quarter, we completed the restructuring of our relationship with Vibra including entering into a new 20-year master lease agreement with annual inflation escalators covering several properties; the acquisition by us of one post-acute property for $32 million that was joined to the master lease with Vibra; the transition of one post-acute property with a net book value of approximately $53 million to a new tenant (joint venture with Select Medical) that is subject to a 20-year master lease agreement with annual inflation escalators; the cash receipt of approximately $18 million for past rent obligations that we recognized as revenue; and the sale of one post-acute property to Vibra for $12 million at a small gain in February 2026, proceeds of which we had previously received in advance of such sale. We are continuing to account for revenue associated from Vibra on a cash basis at this time.

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 December 31, 2025

 

 

As of December 31, 2024

 

Swiss Medical Network

 

70%

 

$

611,347

 

 

$

483,770

 

MEDIAN

 

50%

 

 

486,695

 

 

 

431,964

 

CommonSpirit (Utah partnership)

 

25%

 

 

162,278

 

 

 

113,202

 

Policlinico di Monza

 

50%

 

 

86,091

 

 

 

77,592

 

HM Hospitales

 

45%

 

 

53,366

 

 

 

49,869

 

Total

 

 

 

$

1,399,777

 

 

$

1,156,397

 

 

The increase in the Swiss Medical Network real estate joint venture is due to the new investment made in 2025 as described earlier in this same Note 3 along with the impact from foreign currency changes.

For our unconsolidated real estate joint venture that leases more than 70 healthcare facilities to MEDIAN, we, along with our joint venture partner, finalized a refinancing of the €655 million secured debt on June 17, 2025, that was due on June 30, 2025. The new €702.5 million non-recourse, 10-year non-amortizing secured debt has an approximately 5.1% fixed rate, and the majority of the proceeds were used to fund the repayment of the prior €655 million secured loan that carried a lower rate. In the 2025 third quarter, Germany enacted legislation that will reduce future income tax rates by 5%, which resulted in a $13 million (our share) deferred income tax benefit in the period.

The Utah partnership applies specialized accounting and reporting for investment companies under Topic 946, which measures the underlying investments at fair value. For the year ended December 31, 2025, our share of the Utah partnership's income included a favorable fair value adjustment of approximately $49 million, primarily related to an unrealized gain on investments in real estate.

 

For 2025 and 2024, we received $62 million and $45 million, respectively, in dividends from these real estate joint ventures.

The following tables present summary financial information on a combined basis for our investments in unconsolidated real estate joint ventures (amounts in thousands):

 

 

 

For the Year Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

Revenue

 

$

357,823

 

 

$

348,404

 

 

$

315,108

 

Net income (loss)

 

$

313,593

 

 

$

(739,393

)

 

$

14,701

 

 

 

 

As of December 31,

 

 

 

2025

 

 

2024

 

Assets

 

$

5,614,938

 

 

$

4,872,918

 

Liabilities

 

$

2,831,599

 

 

$

2,599,078

 

The summary above by year reflects the financial information of all five of our current investments, except for the Utah Partnership that was formed in April 2024 with reporting starting in the 2024 third quarter. In addition, we have included financial information for the Macquarie partnership in 2023 and through the 2024 second quarter - see discussion under "Leasing Operations (Lessor)" in this same Note 3 for more details on this investment and its conclusion.

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 December 31,
2025

 

 

As of December 31,
2024

 

Swiss Medical Network

 

$

197,497

 

 

$

172,453

 

Aevis Victoria SA ("Aevis")

 

 

64,859

 

 

 

63,409

 

Priory

 

 

43,913

 

 

 

38,739

 

Aspris Children's Services ("Aspris")

 

 

15,910

 

 

 

15,950

 

PHP Holdings

 

 

—

 

 

 

149,027

 

Total

 

$

322,179

 

 

$

439,578

 

 

For our investments marked to fair value (including our investments in PHP Holdings (through the 2025 third quarter), Aevis, and the international joint venture), we recorded approximately $154 million of unfavorable non-cash fair value adjustments during 2025; whereas, this was an approximately $794 million of unfavorable non-cash fair value adjustments during 2024. The amount recorded in 2025 and included in "Other (including fair value adjustments on securities)" line of our consolidated statements of net income was primarily related to our investment in PHP Holdings, which was sold on July 1, 2025. The amount recorded in 2024 includes an approximate $550 million unfavorable fair market value adjustment to our investment in PHP Holdings - see "Prospect" subheading of this Note 3 for more information. In addition, we recorded a $225 million unfavorable fair value adjustment in the 2024 first quarter related to our international joint venture investments as described in Note 3 and included in the "Real estate and other impairment charges, net" line of the consolidated statements of net income.

In the first quarter of 2024, we sold our interest in the Priory syndicated term loan for £90 million (approximately $115 million), resulting in an approximate £6 million ($7.8 million) economic loss.

Other Investment Activities

In the third quarter of 2023, we invested approximately $105 million for a participation in Steward's syndicated asset-backed credit facility, and we loaned an additional $40 million. On August 17, 2023, we sold the $105 million interest to a global asset manager for approximately $100 million, and Steward paid approximately $2 million on November 3, 2023. The remainder was written off as part of the loan impairment charge in 2024 as discussed in the "Leasing Operations (Lessor)" section of this same Note 3.

In the second quarter of 2023, we received repayment of the CHF 60 million mortgage loan from Infracore that was originally made in the fourth quarter of 2022.

Concentrations of Credit Risks

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 December 31, 2025

 

 

As of December 31, 2024

 

Operators

 

Total Assets (1)

 

 

Percentage of
Total Assets

 

 

Total Assets (1)

 

 

Percentage of
Total Assets

 

Circle

 

$

2,121,848

 

 

 

14.1

%

 

$

2,026,778

 

 

 

14.2

%

Priory

 

 

1,301,888

 

 

 

8.7

%

 

 

1,233,462

 

 

 

8.6

%

Healthcare Systems of America

 

 

1,200,996

 

 

 

8.0

%

 

 

1,187,006

 

 

 

8.3

%

Swiss Medical Network

 

 

873,703

 

 

 

5.8

%

 

 

719,632

 

 

 

5.1

%

Lifepoint Behavioral

 

 

809,492

 

 

 

5.4

%

 

 

813,584

 

 

 

5.7

%

Other operators

 

 

6,688,287

 

 

 

44.6

%

 

 

6,624,256

 

 

 

46.3

%

Other assets

 

 

2,005,561

 

 

 

13.4

%

 

 

1,689,876

 

 

 

11.8

%

Total

 

$

15,001,775

 

 

 

100.0

%

 

$

14,294,594

 

 

 

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 December 31, 2025

 

 

As of December 31, 2024

 

U.S. States and Other Countries

 

Total Assets

 

 

Percentage of
Total Assets

 

 

Total Assets

 

 

Percentage of
Total Assets

 

Texas

 

$

1,427,391

 

 

 

9.5

%

 

$

1,394,296

 

 

 

9.8

%

California

 

 

977,890

 

 

 

6.5

%

 

 

935,470

 

 

 

6.4

%

Florida

 

 

834,940

 

 

 

5.6

%

 

 

840,876

 

 

 

5.9

%

Ohio

 

 

330,189

 

 

 

2.2

%

 

 

327,577

 

 

 

2.3

%

Arizona

 

 

328,873

 

 

 

2.2

%

 

 

379,801

 

 

 

2.7

%

All other states

 

 

2,480,182

 

 

 

16.5

%

 

 

2,636,587

 

 

 

18.5

%

Other domestic assets

 

 

1,072,900

 

 

 

7.2

%

 

 

951,486

 

 

 

6.6

%

Total U.S.

 

$

7,452,365

 

 

 

49.7

%

 

$

7,466,093

 

 

 

52.2

%

United Kingdom

 

$

4,184,188

 

 

 

27.9

%

 

$

3,985,672

 

 

 

27.9

%

Switzerland

 

 

873,703

 

 

 

5.8

%

 

 

719,632

 

 

 

5.0

%

Germany

 

 

751,806

 

 

 

5.0

%

 

 

672,343

 

 

 

4.7

%

Spain

 

 

302,323

 

 

 

2.0

%

 

 

247,996

 

 

 

1.7

%

Finland

 

 

220,813

 

 

 

1.5

%

 

 

199,721

 

 

 

1.4

%

All other countries

 

 

283,916

 

 

 

1.9

%

 

 

264,747

 

 

 

1.9

%

Other international assets

 

 

932,661

 

 

 

6.2

%

 

 

738,390

 

 

 

5.2

%

Total international

 

$

7,549,410

 

 

 

50.3

%

 

$

6,828,501

 

 

 

47.8

%

Grand total

 

$

15,001,775

 

 

 

100.0

%

 

$

14,294,594

 

 

 

100.0

%

 

Total Assets by Facility Type (1)

 

 

 

As of December 31, 2025

 

 

As of December 31, 2024

 

Facility Types

 

Total Assets

 

 

Percentage of
Total Assets

 

 

Total Assets

 

 

Percentage of
Total Assets

 

General acute care hospitals

 

$

8,769,909

 

 

 

58.5

%

 

$

8,493,331

 

 

 

59.4

%

Behavioral health facilities

 

 

2,445,418

 

 

 

16.3

%

 

 

2,376,460

 

 

 

16.7

%

Post acute care facilities

 

 

1,671,616

 

 

 

11.1

%

 

 

1,617,596

 

 

 

11.3

%

Freestanding ER/urgent care facilities

 

 

109,271

 

 

 

0.7

%

 

 

117,331

 

 

 

0.8

%

Other assets

 

 

2,005,561

 

 

 

13.4

%

 

 

1,689,876

 

 

 

11.8

%

Total

 

$

15,001,775

 

 

 

100.0

%

 

$

14,294,594

 

 

 

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 December 31, 2025.

On a revenue basis, concentration for the year ended December 31, 2025 as compared to the two prior years is as follows:

The following shows those tenants that represented 10% or more of our total revenues by year (in thousands):

 

2025

 

Operator

 

Total Revenues

 

 

Percentage of
Total Revenues

 

Circle

 

$

212,719

 

 

 

21.9

%

Priory

 

 

105,986

 

 

 

10.9

%

 

2024

 

Operator

 

Total Revenues

 

 

Percentage of
Total Revenues

 

Circle

 

$

205,582

 

 

 

20.7

%

Priory

 

 

101,675

 

 

 

10.2

%

 

2023

 

Operator

 

Total Revenues

 

 

Percentage of
Total Revenues

 

Circle

 

$

194,390

 

 

 

22.3

%

Priory

 

 

107,557

 

 

 

12.3

%

Total Revenues by Geographic Location

 

 

 

For the Years Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

Geographic Location

 

Total Revenues

 

 

Percentage of
Total Revenues

 

 

Total Revenues

 

 

Percentage of
Total Revenues

 

 

Total Revenues

 

 

Percentage of
Total Revenues

 

Total U.S.

 

$

517,878

 

 

 

53.3

%

 

$

561,673

 

 

 

56.4

%

 

$

407,329

 

 

 

46.7

%

United Kingdom

 

 

373,279

 

 

 

38.4

%

 

 

359,991

 

 

 

36.2

%

 

 

352,594

 

 

 

40.4

%

All other countries

 

 

80,865

 

 

 

8.3

%

 

 

73,883

 

 

 

7.4

%

 

 

111,876

 

 

 

12.9

%

Grand total

 

$

972,022

 

 

 

100.0

%

 

$

995,547

 

 

 

100.0

%

 

$

871,799

 

 

 

100.0

%

 

 

Total Revenues by Facility Type

 

 

 

For the Years Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

Facility Types

 

Total Revenues

 

 

Percentage of
Total Revenues

 

 

Total Revenues

 

 

Percentage of
Total Revenues

 

 

Total Revenues

 

 

Percentage of
Total Revenues

 

General acute care hospitals

 

$

586,648

 

 

 

60.3

%

 

$

628,622

 

 

 

63.1

%

 

$

541,888

 

 

 

62.2

%

Behavioral health facilities

 

 

214,437

 

 

 

22.1

%

 

 

209,668

 

 

 

21.1

%

 

 

213,292

 

 

 

24.5

%

Post acute care facilities

 

 

162,954

 

 

 

16.8

%

 

 

139,859

 

 

 

14.0

%

 

 

92,787

 

 

 

10.6

%

Freestanding ER/urgent care
   facilities

 

 

7,983

 

 

 

0.8

%

 

 

17,398

 

 

 

1.8

%

 

 

23,832

 

 

 

2.7

%

Total

 

$

972,022

 

 

 

100.0

%

 

$

995,547

 

 

 

100.0

%

 

$

871,799

 

 

 

100.0

%

Related Party Transactions

Revenues earned from tenants and real estate joint ventures in which we had an equity interest (accounted for under either the equity or fair value option methods) during the year were $23.7 million, $33.9 million, and $83.0 million for 2025, 2024, and 2023, respectively.
v3.25.4
Debt
 12 Months Ended
Dec. 31, 2025
Debt Disclosure [Abstract]  
Debt

4. Debt

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

 

 

 

As of December 31,
2025

 

 

As of December 31,
2024

 

Secured revolving credit facility(A)

 

$

638,063

 

 

$

361,726

 

Secured term loan

 

 

200,000

 

 

 

200,000

 

British pound sterling term loan due 2025(B)

 

 

—

 

 

 

617,039

 

British pound sterling secured term loan due 2034(B)

 

 

850,784

 

 

 

790,234

 

3.325% Senior Unsecured Notes due 2025(B)

 

 

—

 

 

 

517,700

 

0.993% Senior Unsecured Notes due 2026(B)

 

 

587,300

 

 

 

517,700

 

2.500% Senior Unsecured Notes due 2026(B)

 

 

—

 

 

 

625,800

 

5.250% Senior Unsecured Notes due 2026

 

 

—

 

 

 

500,000

 

5.000% Senior Unsecured Notes due 2027

 

 

1,400,000

 

 

 

1,400,000

 

3.692% Senior Unsecured Notes due 2028(B)

 

 

808,500

 

 

 

750,960

 

4.625% Senior Unsecured Notes due 2029

 

 

900,000

 

 

 

900,000

 

3.375% Senior Unsecured Notes due 2030(B)

 

 

471,625

 

 

 

438,060

 

3.500% Senior Unsecured Notes due 2031

 

 

1,300,000

 

 

 

1,300,000

 

7.000% Senior Secured Notes due 2032(B)

 

 

1,174,600

 

 

 

—

 

8.500% Senior Secured Notes due 2032

 

 

1,500,000

 

 

 

—

 

 

$

9,830,872

 

 

$

8,919,219

 

Debt issue costs and discount, net

 

 

(133,037

)

 

 

(71,107

)

 

 

$

9,697,835

 

 

$

8,848,112

 

 

(A)
Includes €100 million and €303 million of Euro-denominated borrowings and CHF 52 million and CHF - million of Swiss franc-denominated borrowings that reflect the applicable exchange rates at December 31, 2025 and December 31, 2024, respectively.
(B)
Non-U.S. dollar denominated debt that reflects the exchange rates at period-end.

As of December 31, 2025, 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

 

$

1,225,363

 

(1)

2027

 

 

1,600,000

 

 

2028

 

 

808,500

 

 

2029

 

 

900,000

 

 

2030

 

 

471,625

 

 

Thereafter

 

 

4,825,384

 

 

Total

 

$

9,830,872

 

 
(1)
$638 million (of which approximately $200 million was repaid in January 2026) represents the outstanding balance of the revolving portion of our credit facility for which we have provided notice of our intent to extend to 2027 - see "Credit Facility" subheading for further details.

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 (the "USD Notes") and €1.0 billion aggregate principal amount of senior secured notes due 2032 (the "Euro Notes"). See section titled "Senior Notes" for a description of interest rates and maturity for both notes. We may redeem some or all of the notes at any time prior to February 15, 2028, at a redemption price equal to 100% of the principal amount, plus an applicable “make whole” premium and accrued and unpaid interest. On or after February 15, 2028, we may redeem some or all of the notes at a premium that will decrease over time. In addition, at any time prior to February 15, 2028, we may redeem up to 40% of the notes at a redemption price equal to 108.500% and 107.000% for the USD Notes and Euro Notes, respectively, of the aggregate principal amount thereof, plus accrued and unpaid interest thereon, using proceeds from one or more equity offerings.

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.

2024 Activity

During 2024, we closed on a term loan with an aggregate principal amount of approximately £631 million (approximately $800 million) secured by a portfolio of properties in the U.K. We used the majority of the net proceeds of the facility to pay down our revolving credit facility by $375 million and British pound sterling term loan due 2025 by £105 million, and to pay off our British pound sterling secured term loan due 2024 (approximately £105 million). During the year, we also paid down an additional $756 million on our revolving credit facility and £102 million on our British pound sterling term loan due 2025 with cash proceeds from asset sales. In addition, on April 18, 2024, we paid off and terminated the remainder of the A$470 million (approximately $306 million) Australian term loan facility with proceeds from the Utah Transaction described in Note 3.

2023 Activity

During 2023, we paid down, prior to maturity, A$730 million (approximately $475 million) of the A$1.2 billion Australian term loan with proceeds from the Australia Transaction as discussed in Note 3. In addition, we purchased approximately £50 million of our 2.550% Senior Unsecured Notes due 2023 at a discounted price and yield averaging approximately 13%. As a result of this prepayment, we realized an approximate $1.1 million gain. On December 5, 2023, we fully paid off the remaining £350 million balance of our 2.550% Senior Unsecured Notes due 2023 with cash on-hand and proceeds from the revolving portion of our credit facility.

 

Credit Facility

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

2025 Activity

At December 31, 2025 and 2024, we had $0.6 billion and $0.4 billion outstanding on the revolving portion of our Credit Facility, respectively. At December 31, 2025 and 2024, our availability under our revolver was $0.7 billion and $0.9 billion, respectively. The weighted-average interest rate on the revolver was 5.5% and 6.6% during 2025 and 2024, respectively.

At December 31, 2025 and 2024, the interest rate in effect on our term loan was 6.1% and 7.5%, respectively.

On February 13, 2025 and concurrent with the closing of the Senior Secured Notes due 2032 discussed above, we amended the Credit Facility to among other things: (i) provide for the facility to be secured and guaranteed ratably with the senior notes issued concurrently, (ii) provide notice that we plan to exercise both of our maturity extension options such that the maturity of the revolving portion would move from June 30, 2026 to June 30, 2027, the same maturity date as our term loan facility (subject to the satisfaction of other conditions), (iii) reset the interest rate to the Secured Overnight Financing Rate ("SOFR") plus 225 basis points (which had previously been moved to SOFR plus 300 basis points in August 2024), and (iv) amend certain covenants as described under "Covenants and Restrictions" in this same Note 4.

In regard to the maturity of the revolving portion of our Credit Facility, we have two 6-month extension options available to move the maturity from June 30, 2026 to June 30, 2027. Although the extension options are at our election (and as noted above, we have given notice of our intention to exercise both extension options), there are certain conditions that must be satisfied, 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).

2024 Activity

Prior to the 2024 amendments described below and at our election, loans were made as either alternate base rate loans ("ABR Loans") or loans for an interest period of either one, three, or six months ("Term Benchmark Loans"). The applicable margin for term

loans that were ABR Loans was adjustable on a sliding scale from 0.00% to 0.70% based on current credit rating. The applicable margin for term loans that were Term Benchmark Loans was adjustable on a sliding scale from 0.875% to 1.70% based on current credit rating. The applicable margin for revolving loans that were ABR Loans was adjustable on a sliding scale from 0.00% to 0.50% based on current credit rating. The applicable margin for revolving loans that were Term Benchmark Loans or risk-free rate loans ("RFR Loans"), as defined in the Credit Facility agreement, was adjustable on a sliding scale from 0.80% to 1.50% based on current credit rating. The facility fee was adjustable on a sliding scale from 0.125% to 0.30% based on current credit rating and was payable on the revolving loan facility. During 2023, our credit rating negatively changed, resulting in adjustments to the applicable margin by 0.375% and an increase to the facility fee from 0.25% to 0.30%.

On April 12, 2024, we amended our Credit Facility and certain other agreements to (i) reduce revolving commitments from $1.8 billion to $1.4 billion, (ii) apply certain proceeds from asset sales and debt transactions to repay the Australian term loan facility and certain other outstanding obligations, including revolving loans under the Credit Facility to the extent necessary to reduce the outstanding borrowings to no more than the amended $1.4 billion commitment, and (iii) amend or waive certain covenants to our Credit Facility and British pound sterling term loan due 2025 as described under "Covenants and Restrictions" in this same Note 4.

On August 6, 2024, we amended the Credit Facility and the British pound sterling term loan due 2025 to (i) further reduce revolving commitments in the Credit Facility from $1.4 billion to $1.28 billion, (ii) increase borrowing spreads to 300 basis points during the Modified Covenant Period (defined in "Covenants" section in this same Note 4) and then to 225 basis points after the Modified Covenant Period, (iii) require that proceeds of certain future asset sales and debt transactions (during the Modified Covenant Period) be applied to repay certain outstanding obligations, including our revolving loans (by 15% of such proceeds but for which the revolving loans can be reborrowed) and our British pound sterling term loan due 2025 (by 50% of such proceeds), and (iv) amend or waive certain covenants as described under "Covenants and Restrictions" in this same Note 4.

Non-U.S. Term Loans

British Pound Sterling Secured Term Loan due 2034

On May 24, 2024, we completed a secured loan facility with a consortium of institutional investors that provides for a term loan in aggregate principal amount of approximately £631 million (approximately $800 million) secured by a portfolio of 27 properties located in the U.K. currently leased to affiliates of Circle. The facility carries a fixed rate of 6.877% over its 10-year term, excluding fees and expenses, and is interest-only (payable quarterly in advance) through the maturity date. The facility is secured by first priority mortgages or similar security instruments on the relevant properties, including assignments of rents and security over accounts, and is non-recourse to us.

British Pound Sterling Term Loan due 2025

On January 6, 2020, we entered into a £700 million unsecured sterling-denominated term loan with Bank of America, N.A., as administrative agent, and several lenders from time-to-time are parties thereto. The applicable margin under the term loan was adjustable based on a pricing grid from 0.85% to 1.65% dependent on our credit rating. On March 4, 2020, we entered into an interest rate swap transaction (effective March 6, 2020) to fix the interest rate to approximately 0.70% for the duration of the loan. The applicable margin for the pricing grid (which varied based on our credit rating) increased from 1.25% to 1.65% on March 10, 2023 with the change in our credit rating, for an all-in fixed rate at December 31, 2023 of 2.349%. With the August 6, 2024 amendment discussed above, our all-in fixed rate increased to 3.70%.

As noted earlier, we paid down the British pound sterling secured term loan due 2025 by £207 million in 2024 with proceeds from the British pound sterling secured term due 2034 and asset sales. The balance of this loan of £493 million was paid in full on January 15, 2025.

Senior Notes

The following are the basic terms of our senior notes at December 31, 2025 (par value amounts in thousands):

 

 

 

Offering
Completion Date

 

Maturity Date

 

Par Value

 

 

% of Par
Value

 

 

Interest Payment Frequency

0.993% Senior Unsecured Notes due 2026

 

October 6, 2021

 

October 15, 2026

 

€

500,000

 

 

 

100.000

%

 

Annually

5.000% Senior Unsecured Notes due 2027

 

September 21, 2017

 

October 15, 2027

 

$

1,400,000

 

 

 

100.000

%

 

Semi-annually

3.692% Senior Unsecured Notes due 2028

 

December 5, 2019

 

June 5, 2028

 

£

600,000

 

 

 

99.998

%

 

Annually

4.625% Senior Unsecured Notes due 2029

 

July 26, 2019

 

August 1, 2029

 

$

900,000

 

 

 

99.500

%

 

Semi-annually

3.375% Senior Unsecured Notes due 2030

 

March 24, 2021

 

April 24, 2030

 

£

350,000

 

 

 

99.448

%

 

Annually

3.500% Senior Unsecured Notes due 2031

 

December 4, 2020

 

March 15, 2031

 

$

1,300,000

 

 

 

100.000

%

 

Semi-annually

7.000% Senior Secured Notes due 2032

 

February 13, 2025

 

February 15, 2032

 

€

1,000,000

 

 

 

98.645

%

 

Semi-annually

8.500% Senior Secured Notes due 2032

 

February 13, 2025

 

February 15, 2032

 

$

1,500,000

 

 

 

98.710

%

 

Semi-annually

We may repurchase, redeem, or refinance senior notes from time-to-time. We may purchase senior notes for cash through open market purchases, privately negotiated transactions, or a tender offer. In some cases, we may redeem some or all of the notes at any time, but may require a redemption premium that will decrease over time. In the event of a change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase. Redemptions and repurchases of debt, if any, will depend on prevailing market conditions, our liquidity requirements, contractual restrictions, and other factors.

In regard to the 0.993% Senior Unsecured Notes due 2026, management plans to repay these notes in full closer to the maturity date using a combination of available cash and borrowings under the revolving portion of our Credit Facility.

Debt Refinancing and Unutilized Financing Costs (Benefit)

2025 Activity

In 2025, we incurred $3.6 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.

2024 Activity

In 2024, we incurred $4.3 million of debt refinancing and unutilized financing costs. These costs were incurred primarily as a result of the reduction in revolving commitments under our Credit Facility and partial paydowns of our British pound sterling term loan due 2025.

2023 Activity

As a result of the early redemption of a portion of the Australian term loan, we incurred approximately $0.8 million to accelerate the amortization of related debt issue costs in 2023. This charge was more than offset by the $1.1 million gain realized on the purchase of approximately £50 million of our 2.550% Senior Unsecured Notes due 2023 at a discount in 2023.

Covenants and Restrictions

Our debt facilities impose certain restrictions on us, including, but not limited to, 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 agreement governing our Credit Facility limits 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 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, consolidated adjusted net worth, unsecured leverage ratio, and unsecured interest coverage ratio. On April 12, 2024, the Credit Facility was amended to waive the 10% cap on

unencumbered asset value attributable to tenants subject to a bankruptcy event for purposes of determining compliance with the unsecured leverage ratio for the trailing four fiscal quarter period ended June 30, 2024.

On August 6, 2024, we entered into an amendment to the Credit Facility to increase the maximum total leverage ratio covenant from 60% to 65% and the maximum unsecured leverage ratio covenant from 65% to 70% and to decrease the minimum unsecured interest coverage ratio from 1.75:1.00 to 1.45:1.00. The amendment was effective as of June 30, 2024 and was to continue in effect through and including September 30, 2025 (the “Modified Covenant Period”) at which point the credit agreement provided that covenants would automatically reset to their prior levels. In addition, the amendment permanently reduced the minimum consolidated adjusted net worth covenant from approximately $6.7 billion to $5 billion, in each case plus the sum of certain equity proceeds. The amendment also limited the payment of dividends in cash during the Modified Covenant Period to $0.08 per share in any fiscal quarter, but the amendment did not provide any additional restrictions on the payment of dividends outside of the Modified Covenant Period.

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) set the maximum secured leverage ratio at 40%, and 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 1.15:1.00 (which increases to 1.30:1.00 starting in March 2026).

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 December 31, 2025, we were in compliance with all financial and operating covenants.
v3.25.4
Income Taxes
 12 Months Ended
Dec. 31, 2025
Income Tax Disclosure [Abstract]  
Income Taxes

5. Income Taxes

Medical Properties Trust, Inc.

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

Income Tax (Expense) Benefit

From our TRS entities and our foreign operations, income tax (expense) benefit were as follows (in thousands):

 

 

 

For the Years Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

Current income tax (expense) benefit:

 

 

 

 

 

 

 

 

 

Domestic

 

$

—

 

 

$

477

 

 

$

(7,756

)

Foreign

 

 

(27,987

)

 

 

(31,589

)

 

 

(24,257

)

 

 

 

(27,987

)

 

 

(31,112

)

 

 

(32,013

)

Deferred income tax (expense) benefit:

 

 

 

 

 

 

 

 

 

Domestic

 

 

—

 

 

 

(465

)

 

 

8,926

 

Foreign

 

 

(10,631

)

 

 

(12,524

)

 

 

153,766

 

 

 

 

(10,631

)

 

 

(12,989

)

 

 

162,692

 

Income tax (expense) benefit

 

$

(38,618

)

 

$

(44,101

)

 

$

130,679

 

 

A reconciliation of income tax (expense) benefit from the statutory income tax rate to the effective tax rate based on our loss before income taxes for the years ended December 31, 2025, 2024, and 2023 is as follows (in thousands):

 

 

 

For the Years Ended December 31,

 

 

 

2025*

 

 

2024

 

 

2023

 

 

 

Amount

 

Percent

 

 

Amount

 

 

Amount

 

Loss before income tax

 

$

(237,319

)

 

100.0

%

 

$

(2,364,186

)

 

$

(686,771

)

Income tax benefit at the U.S. statutory federal rate

 

 

49,837

 

 

21.0

%

 

 

496,479

 

 

 

144,222

 

State and local income tax, net of federal income tax effect

 

 

—

 

 

—

 

 

 

—

 

 

 

1,275

 

Foreign tax effects:

 

 

 

 

 

 

 

 

 

 

 

U.K.:

 

 

 

 

 

 

 

 

 

 

 

Statutory tax rate difference between U.K. and U.S.

 

 

4,193

 

 

1.8

%

 

 

—

 

 

 

—

 

Changes in valuation allowances

 

 

(10,222

)

 

(4.3

)%

 

 

—

 

 

 

—

 

Tax impact of U.K. REIT conversion

 

 

—

 

 

—

 

 

 

—

 

 

 

160,641

 

Other

 

 

1,227

 

 

0.5

%

 

 

—

 

 

 

—

 

Colombia:

 

 

 

 

 

 

 

 

 

 

 

Statutory tax rate difference between Colombia and U.S.

 

 

3,826

 

 

1.6

%

 

 

—

 

 

 

—

 

Changes in valuation allowances

 

 

(9,954

)

 

(4.2

)%

 

 

—

 

 

 

—

 

Other

 

 

(1,713

)

 

(0.7

)%

 

 

—

 

 

 

—

 

Other foreign jurisdictions

 

 

(3,210

)

 

(1.4

)%

 

 

—

 

 

 

—

 

Foreign rate differential

 

 

—

 

 

—

 

 

 

4,888

 

 

 

(4,122

)

Interest disallowance

 

 

—

 

 

—

 

 

 

(2,965

)

 

 

(3,421

)

Changes in valuation allowances

 

 

(46,033

)

 

(19.4

)%

 

 

(301,468

)

 

 

(45,692

)

Nontaxable or nondeductible items:

 

 

 

 

 

 

 

 

 

 

 

U.S. earnings not subject to federal income tax

 

 

(26,569

)

 

(11.2

)%

 

 

(227,080

)

 

 

(115,189

)

Other adjustments

 

 

—

 

 

—

 

 

 

(13,955

)

 

 

(7,035

)

Total income tax (expense) benefit/effective tax rate

 

$

(38,618

)

 

(16.3

)%

 

$

(44,101

)

 

$

130,679

 

*Above is a reconciliation of the U.S. federal statutory income tax rate to our effective tax rate pursuant to the disclosure requirements of ASU 2023-09, "Income Taxes (Topic 740): Improvements to Income Tax Disclosures" ("ASU 2023-09"), for the year ended December 31, 2025. As allowed by ASU 2023-09, the 2024 and 2023 columns have not been restated to conform to the 2025 presentation.

The foreign provision for income taxes is based on foreign profit before income taxes of $108.4 million, $127.9 million, and $6.3 million in 2025, 2024, and 2023, respectively.

The domestic provision for income taxes is based on loss before income taxes of $(219.2) million in 2025, $(1.4) billion in 2024, and $(144.5) million in 2023 from our TRS entities.

Income Taxes Paid

The amounts of cash taxes we paid (net of refunds) are as follows (in thousands):

 

 

Year Ended December 31,

 

 

 

 

2025

 

 

Federal

 

$

(426

)

 

State

 

 

63

 

 

Foreign

 

 

20,884

 

(1)

Total

 

$

20,521

 

 
(1)
Income taxes paid (net of refunds) in the U.K. and Spain were $18.2 million and $1.5 million, respectively, and exceeded 5% of total income taxes paid (net of refunds).

Deferred Income Taxes

At December 31, 2025 and 2024, components of our deferred tax assets and liabilities were as follows (in thousands):

 

 

 

2025

 

 

2024

 

Deferred tax assets:

 

 

 

 

 

 

Operating loss and interest deduction carryforwards

 

$

334,501

 

 

$

263,523

 

Depreciation

 

 

70,051

 

 

 

56,089

 

Partnership investments

 

 

143,695

 

 

 

112,892

 

Impairment and other loss reserves

 

 

66,969

 

 

 

101,834

 

Other

 

 

10,263

 

 

 

8,500

 

Total deferred tax assets

 

 

625,479

 

 

 

542,838

 

Valuation allowance

 

 

(489,604

)

 

 

(418,659

)

Total net deferred tax assets

 

$

135,875

 

 

$

124,179

 

Deferred tax liabilities:

 

 

 

 

 

 

Property and equipment

 

$

(149,602

)

 

$

(145,835

)

Net unbilled revenue

 

 

(106,088

)

 

 

(82,170

)

Partnership investments

 

 

(26,885

)

 

 

(21,445

)

Other

 

 

(4,102

)

 

 

(3,450

)

Total deferred tax liabilities

 

 

(286,677

)

 

 

(252,900

)

Net deferred tax asset (liability)

 

$

(150,802

)

 

$

(128,721

)

 

At December 31, 2025, we had net operating losses ("NOL") and other tax attribute carryforwards as follows (in thousands):

 

 

U.S.

 

 

Foreign

 

Gross NOL carryforwards

$

929,887

 

 

$

569,760

 

 

 

 

 

 

 

Tax-effected carryforwards and other attributes

$

197,555

 

 

$

129,821

 

Valuation allowance

 

(197,555

)

 

 

(17,462

)

Net deferred tax asset - carryforwards and other attributes

$

—

 

 

$

112,359

 

Expiration periods

2034-indefinite

 

 

indefinite

 

 

Valuation Allowance

A valuation allowance has been recorded on certain foreign and domestic net operating loss carryforwards and other net deferred tax assets that may not be realized. As of each reporting date, we consider all new evidence that could impact the future realization of our deferred tax assets. In the evaluation of the need for a valuation allowance on our deferred income tax assets, we consider all available positive and negative evidence, including scheduled reversals of deferred income tax liabilities, carryback of future period losses to prior periods, projected future taxable income, tax planning strategies, and recent financial performance.

During 2025, an additional valuation allowance of $70.9 million has been recorded against a portion of our deferred tax assets to recognize only the components of the deferred tax assets that is more likely than not to be realized. The valuation allowance was primarily recorded against deferred tax assets for NOLs, non-depreciable basis of real property, and other tax attributes that we believe will not be realized. Valuation allowance activity recorded generally follows the activity of the associated deferred tax asset that is not expected to be recognized. From time-to-time, we may acquire deferred tax assets as part of real estate transactions and will assess the need for a valuation allowance as part of the opening balance sheet. Additionally, valuation allowances will be remeasured for foreign currency translation fluctuations through other comprehensive income.

Given the global nature of our business, we are currently and have in the past been subject to tax audits as part of normal course. However, at December 31, 2025, we have no material uncertain tax position liabilities and/or related interest or penalties.

REIT Status

We have met the annual U.S. REIT distribution requirements by payment of at least 90% of our REIT taxable income in 2025, 2024, and 2023. Earnings and profits, which determine the taxability of such distributions, will differ from net income reported for financial reporting purposes due primarily to differences in cost basis, differences in the estimated useful lives used to compute depreciation, and differences between the allocation of our net income and loss for financial reporting purposes and for tax reporting purposes.

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

 

 

 

For the Years Ended December 31,

 

Per share:

 

2025

 

 

2024

 

 

2023

 

Ordinary dividend (1)

 

$

—

 

 

$

—

 

 

$

1.0639

 

Long-term capital gain (2)

 

 

—

 

 

 

—

 

 

 

0.1061

 

Return of capital

 

 

0.3200

 

 

 

0.3800

 

 

 

—

 

Total

 

$

0.3200

 

(3)

$

0.3800

 

 

$

1.1700

 

 

(1)
For the year ended December 31, 2023, includes Section 199A dividends of 1.0639.
(2)
For the year ended December 31, 2023, includes Unrecaptured Section 1250 gains of 0.1061.
(3)
The dividend declared on November 17, 2025 and paid January 8, 2026 will be applicable to the 2026 tax year and thus is not reflected in the table above.

Similar to our U.S. REIT, we have met all requirements of our U.K. REIT as of December 31, 2025.

MPT Operating Partnership, L.P.

As a partnership, the allocated share of income of the Operating Partnership is included in the income tax returns of the general and limited partners. Accordingly, no accounting for income taxes is generally required for such income of the Operating Partnership. However, the Operating Partnership has formed TRS entities on behalf of Medical Properties Trust, Inc., which are subject to U.S. federal, state, and local income taxes at regular corporate rates, and its international subsidiaries are subject to income taxes in the jurisdictions in which they operate. See discussion above under Medical Properties Trust, Inc. for more details of income taxes associated with our TRS entities and international operations.
v3.25.4
Earnings Per Share/Unit
 12 Months Ended
Dec. 31, 2025
Earnings Per Share [Abstract]  
Earnings Per Share/Unit

6. Earnings Per Share/Unit

Medical Properties Trust, Inc.

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

 

 

 

For the Years Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

Numerator:

 

 

 

 

 

 

 

 

 

Net loss

 

$

(275,937

)

 

$

(2,408,287

)

 

$

(556,092

)

Non-controlling interests’ share in earnings

 

 

(1,112

)

 

 

(1,984

)

 

 

(384

)

Participating securities’ share in earnings

 

 

(889

)

 

 

(946

)

 

 

(1,644

)

Net loss, less participating securities’ share in
   earnings

 

$

(277,938

)

 

$

(2,411,217

)

 

$

(558,120

)

Denominator:

 

 

 

 

 

 

 

 

 

Basic weighted-average common shares

 

 

600,892

 

 

 

600,248

 

 

 

598,518

 

Dilutive potential common shares(1)

 

 

—

 

 

 

—

 

 

 

—

 

Diluted weighted-average common shares

 

 

600,892

 

 

 

600,248

 

 

 

598,518

 

 

MPT Operating Partnership, L.P.

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

 

 

 

For the Years Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

Numerator:

 

 

 

 

 

 

 

 

 

Net loss

 

$

(275,937

)

 

$

(2,408,287

)

 

$

(556,092

)

Non-controlling interests’ share in earnings

 

 

(1,112

)

 

 

(1,984

)

 

 

(384

)

Participating securities’ share in earnings

 

 

(889

)

 

 

(946

)

 

 

(1,644

)

Net loss, less participating securities’ share in
   earnings

 

$

(277,938

)

 

$

(2,411,217

)

 

$

(558,120

)

Denominator:

 

 

 

 

 

 

 

 

 

Basic weighted-average units

 

 

600,892

 

 

 

600,248

 

 

 

598,518

 

Dilutive potential units(1)

 

 

—

 

 

 

—

 

 

 

—

 

Diluted weighted-average units

 

 

600,892

 

 

 

600,248

 

 

 

598,518

 

 

(1)
The above computation of diluted earnings per share does not include 112,452, 17,162, and 32,382 potential common shares/units for the years ended December 31, 2025, 2024, and 2023, respectively.
v3.25.4
Stock Awards
 12 Months Ended
Dec. 31, 2025
Share-Based Payment Arrangement [Abstract]  
Stock Awards

7. Stock Awards

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, RSUs, 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 8.0 million shares remain available for future stock awards as of December 31, 2025. The Equity Incentive Plan contains a limit of 5 million shares as the maximum number of shares of common stock that may be awarded to an individual in any fiscal year. Awards under the Equity Incentive Plan are subject to forfeiture due to termination of employment prior to vesting and/or from not achieving the respective performance/market conditions. In the event of a change in control, outstanding and unvested options will immediately vest, unless otherwise provided in the participant’s award or employment agreement, and restricted stock, restricted stock units, deferred stock units, and other stock-based awards will vest if so provided in the participant’s award agreement. The term of the awards is set by the Compensation Committee, though Incentive Stock Options may not have terms of more than ten years. Forfeited awards (along with shares withheld for payroll tax withholding purposes) are returned to the Equity Incentive Plan and are then available to be re-issued as future awards. For each share of common stock issued by Medical Properties Trust, Inc. pursuant to its Equity Incentive Plan, the Operating Partnership issues a corresponding number of Operating Partnership units.

For the past three years, we have only granted restricted stock and RSUs pursuant to our Equity Incentive Plan. These awards have been granted in the form of service-based awards, performance awards based on company-specific performance hurdles, and market-based awards. See below for further details on each of these awards:

Service-Based Awards

In 2025, 2024, and 2023, the Compensation Committee granted service-based awards to employees and non-employee directors. Service-based awards vest as the employee/director provides the required service (typically over three years). Dividends are generally paid on these awards prior to vesting.

Performance-Based Awards

In 2023, the Compensation Committee granted performance-based awards to employees. Generally, dividends are not paid on performance awards until the award is earned. See below for details of our 2023 performance-based award grants.

In 2023, a target number of stock awards were granted to employees that could be earned based on the achievement of specific performance thresholds as set by our Compensation Committee. The performance thresholds were based on a three-year period with the opportunity to earn a portion of the award earlier. More or less shares than the target number of shares were available to be earned based on our performance compared to the set thresholds. At the end of each of the performance periods, any earned shares during such period vested on January 1 of the following calendar year. The performance thresholds were based on strategic transactions

(including new investments and proceeds from individual property disposals and larger asset disposals through joint venture transactions) and EBITDA.

Certain performance awards granted were subject to a modifier which increases or decreases the actual shares earned in each performance period. The modifier for the 2023 awards was based on two components: 1) how our total shareholder return (“TSR”) compared to the Dow Jones U.S. Real Estate Health Care Index and 2) how our TSR compared to a threshold set by the Compensation Committee.

The three-year performance period for these awards ended in 2025 and resulted in a $10.9 million reduction of expense as less shares were earned than our previous estimate.

Market-Based Awards

In 2025, 2024, and 2023, the Compensation Committee granted market-based awards to employees. Generally, dividends are not paid on market-based awards until the award is earned. See details below of such market-based award grants.

On September 24, 2025, a target number of market-based restricted stock awards were granted to employees other than the Company’s Chief Executive Officer and Chief Financial Officer. These shares will be earned at the target level only if the Company’s total shareholder return reaches 20%, with the opportunity to earn up to three times target if the Company’s total shareholder return reaches higher hurdles during the three-year period ending April 14, 2028. The actual number of shares to be earned pursuant to these awards will be determined based on a total shareholder return achieved by a trailing 20-trading day average closing price of the Company’s common stock, assuming contemporaneous reinvestment in such common stock of all dividends and other distributions. The baseline price of common stock used in determining total shareholder return is $5.44. Earned shares will vest in equal quarterly installments over one year following the date that the Compensation Committee makes a determination of achievement of the performance metrics, subject to the grantee’s continued employment through such date, provided that all unvested earned shares will vest in full following the end of the performance period.

On April 15, 2025, the Compensation Committee granted 621,061 market-based RSUs to the Company’s Chief Executive Officer and Chief Financial Officer at the target level of achievement. The RSUs may be settled only in cash, and the cash payment will be calculated based on the average closing price of the Company’s common stock on the five trading days ending on the vesting date. The RSUs are earned at the target level if the Company’s total shareholder return reaches 20%, with the opportunity to earn up to three times target if the Company’s total shareholder return reaches higher hurdles during the three-year period ending on April 14, 2028. The actual number of RSUs to be earned pursuant to these awards will be determined based on a total shareholder return achieved by a trailing 20-trading day average closing price of the Company’s common stock, assuming contemporaneous reinvestment in such common stock of all dividends and other distributions. The baseline price of common stock used in determining total shareholder return is the closing price of the common stock on April 15, 2025, of $5.44. Earned RSUs will become vested on the earlier of equal quarterly installments over the first year from the date the RSUs are earned or the date that the Committee makes a determination of achievement of the performance metrics following the end of the three-year performance period, subject to the grantee’s continued employment through such date, provided that all unvested earned RSUs will vest in full following the end of the performance period.

On March 8, 2024, the Compensation Committee granted 2,700,000 market-based RSUs to the Company's Chief Executive Officer and Chief Financial Officer at the target level of achievement, which would represent a 67% increase in the market price of our common stock at time of grant. The RSUs may be settled only in cash, and the cash payment will be calculated based on the average closing price of the Company's common stock on the five trading days ending on the vesting date. The RSUs will be earned at the target level only if the Company's share price increases to $7.00 per share, with the opportunity to earn up to three times target if the Company's share price reaches higher stock price hurdles. The actual number of shares to be earned pursuant to these awards will be determined based on a trailing 20-trading day average closing price of the Company's common stock during the four-year period ending December 31, 2027. Earned RSUs will become vested on the earlier of equal quarterly installments over the first year from the date the RSUs are earned or the date that the Committee makes a determination of achievement of the performance metrics following the end of the four-year performance period, subject to the grantee’s continued employment through such date, provided that all unvested earned RSUs will vest in full following the end of the performance period.

On December 8, 2023, the Compensation Committee approved market-based restricted stock awards to employees other than the Company's Chief Executive Officer and Chief Financial Officer of 2,500,000 shares of common stock at the target level of achievement. These shares will be earned at the target level only if the Company's share price increases to $7.00 per share, with the opportunity to earn more shares (up to three times target), based on higher stock price hurdles. The actual number of shares to be earned pursuant to these awards will be determined based on a trailing 20-trading day average closing price of the Company's common stock during the four-year period following the December 8, 2023 grant date or December 31, 2027, for certain awards granted after December 8, 2023. Earned shares will vest in equal quarterly installments over two years following the date that the Compensation Committee makes a determination of achievement of the performance metrics, subject to the grantee’s continued employment through such date, provided that all unvested earned shares will vest in full following the end of the performance period.

The following summarizes award activity in 2025 and 2024 (which includes awards granted in 2025, 2024, and any applicable prior years), respectively:

For the Year Ended December 31, 2025:

 

 

Vesting Based
on Service

 

 

Vesting Based on
Market/Performance
Conditions

 

 

 

Shares

 

 

Weighted-Average
Value at Award Date

 

 

Shares

 

 

Weighted-Average
Value at Award Date

 

Nonvested awards at beginning of the year

 

 

1,641,500

 

 

$

6.50

 

 

 

10,313,221

 

 

$

9.33

 

Awarded

 

 

2,538,451

 

 

$

5.24

 

 

 

1,347,895

 

 

$

11.00

 

Vested

 

 

(1,550,294

)

 

$

6.63

 

 

 

(89,065

)

 

$

22.11

 

Forfeited

 

 

(21,493

)

 

$

5.77

 

 

 

(3,689,223

)

 

$

11.89

 

Nonvested awards at end of year

 

 

2,608,164

 

 

$

5.20

 

 

 

7,882,828

 

(1)

$

8.97

 
(1)
Reflects the maximum share payout of certain market-based awards granted in 2023, 2024, and 2025. However, share payout at target level for these market-based awards would result in nonvested awards at December 31, 2025 of 3.1 million shares.

For the Year Ended December 31, 2024:

 

 

Vesting Based
on Service

 

 

Vesting Based on
Market/Performance
Conditions

 

 

 

Shares

 

 

Weighted-Average
Value at Award Date

 

 

Shares

 

 

Weighted-Average
Value at Award Date

 

Nonvested awards at beginning of the year

 

 

1,144,796

 

 

$

13.01

 

 

 

12,576,792

 

 

$

10.20

 

Awarded

 

 

1,519,207

 

 

$

4.36

 

 

 

345,000

 

 

$

7.78

 

Vested

 

 

(993,312

)

 

$

10.62

 

 

 

(1,179,631

)

 

$

16.81

 

Forfeited

 

 

(29,191

)

 

$

9.58

 

 

 

(1,428,940

)

 

$

10.40

 

Nonvested awards at end of year

 

 

1,641,500

 

 

$

6.50

 

 

 

10,313,221

 

 

$

9.33

 

 

Additionally, the market-based RSUs granted in 2025 and 2024 (not included in the tables above) with cash-settlement features are nonvested as of December 31, 2025. These liability-type awards are adjusted to fair value on a quarterly basis using a Monte Carlo valuation model, which used the following assumptions for grant date and quarterly valuations for the year ended December 31, 2025: (i) common stock price at measurement date, (ii) annual equity volatility ranging from 59.0% to 62.0%, (iii) risk-free rate ranging from 3.47% to 3.89%, and (iv) dividend yield ranging from 5.31% to 7.42%. The grant date fair value of the RSUs awarded April 15, 2025 was $8.1 million, and the fair value of the RSUs awarded March 8, 2024 was $13.3 million, and none of these RSUs were earned, vested, or forfeited as of December 31, 2025.

 

The value of stock-based awards is charged to compensation expense over the service periods. For the years ended December 31, 2025, 2024, and 2023, we recorded $15.1 million, $28.4 million, and $33.3 million, respectively, of non-cash compensation expense. For the years ended December 31, 2025 and 2024, we also recorded $10.6 million and $4.6 million, respectively, of compensation expense for the RSUs with cash-settlement features, and we had a corresponding $15.2 million and $4.6 million liability as of December 31, 2025 and 2024, respectively.

The remaining unrecognized cost from equity-settled awards at December 31, 2025, is $17.9 million, which will be recognized over a weighted-average period of 0.93 years. The remaining unrecognized cost from cash-settled awards at December 31, 2025, is $14.3 million, which will be recognized over a derived service period of 1.38 years as of December 31, 2025. Stock-based awards that vested in 2025, 2024, and 2023, had a value of $7.7 million, $10.9 million, and $22.5 million, respectively.
v3.25.4
Contingencies
 12 Months Ended
Dec. 31, 2025
Loss Contingency [Abstract]  
Contingencies

8. Contingencies

As part of the global settlement with Steward discussed in Note 3, upon completion of the transfers to the new operators and satisfaction of certain other conditions, in addition to approval by relevant state and local regulators, 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 have established an approximate $16 million reserve at December 31, 2025, for certain obligations due to third parties associated with properties formerly leased to Steward.

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.
v3.25.4
Common Stock/Partner's Capital
 12 Months Ended
Dec. 31, 2025
Equity [Abstract]  
Common Stock/Partner's Capital

9. Common Stock/Partner’s Capital

Medical Properties Trust, Inc.

On October 28, 2025, the Board of Directors of the Company authorized a stock repurchase program (the "Stock Repurchase Program") for up to $150 million of common stock, par value $0.001 per share. Under the Stock Repurchase Program, we may repurchase shares of our common stock from time to time in the open market or in privately negotiated transactions. In 2025, we repurchased 4.5 million shares for a total of $23.4 million.

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 December 31, 2025, we had not sold any shares under the ATM Program.

MPT Operating Partnership, L.P.

At December 31, 2025, the Operating Partnership is made up of a general partner, Medical Properties Trust, LLC (“General Partner”) and limited partners, including the Company (which owns 100% of the General Partner) and MPT TRS, Inc. (which is 100% owned by the General Partner). By virtue of its ownership of the General Partner, the Company has a 100% ownership interest in the Operating Partnership.

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

The Operating Partnership’s net income will generally be allocated first to the General Partner to the extent of any cumulative losses and then to the partners in accordance with their respective percentage interests in the common units issued by the Operating Partnership. Any losses of the Operating Partnership will be allocated pro-rata to the partners in accordance with their respective percentage interests in the common units issued by the Operating Partnership until their adjusted capital balances are reduced to zero, then to the General Partner. In accordance with the Operating Partnership Agreement, LTIP units are treated as common units for purposes of income and loss allocations. Limited partners have the right to require the Operating Partnership to redeem part or all of their common units. It is at the Operating Partnership’s discretion to redeem such common units for cash based on the fair market value of an equivalent number of shares of the Company’s common stock at the time of redemption or, alternatively, redeem the common units for shares of the Company’s common stock on a one-for-one basis, subject to adjustment in the event of stock splits, stock dividends, or similar events. LTIP units must wait two years from the issuance of the LTIP units to be redeemed, and then converted to common units. No LTIP units exist at December 31, 2025.

For each share of common stock issued/repurchased by Medical Properties Trust, Inc., the Operating Partnership issues/repurchases a corresponding number of operating partnership units.
v3.25.4
Fair Value of Financial Instruments
 12 Months Ended
Dec. 31, 2025
Fair Value Disclosures [Abstract]  
Fair Value of Financial Instruments

10. Fair Value of Financial Instruments

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

 

 

 

December 31, 2025

 

 

December 31, 2024

 

Asset (Liability)

 

Book
Value

 

 

Fair
Value

 

 

Book
Value

 

 

Fair
Value

 

Interest and rent receivables

 

$

19,210

 

 

$

19,907

 

 

$

36,327

 

 

$

36,432

 

Loans(1)

 

 

624,243

 

(2)

 

624,369

 

 

 

467,120

 

(2)

 

470,380

 

Debt, net

 

 

(9,697,835

)

 

 

(8,980,547

)

 

 

(8,848,112

)

 

 

(7,301,395

)

 

(1)
Includes all loan investments other than those accounted for under the fair value option method, as noted below.
(2)
Includes $7.5 million and $7.9 million of mortgage loans, a $388.9 million and $315.5 million shareholder loans included in investments in unconsolidated real estate joint ventures, $45.4 million and $39.7 million of loans that are part of our investments in unconsolidated operating entities, and $182.4 million and $104.0 million of other loans at December 31, 2025 and December 31, 2024, respectively.

Items Measured at Fair Value on a Recurring Basis

Our equity investment and related loan to the international joint venture, our loan investment in the real estate of three hospitals operated by subsidiaries of the international joint venture in Colombia, and our investment in PHP Holdings (which was sold in July 2025) 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 December 31, 2025 and 2024, the amounts recorded under the fair value option method were as follows (in thousands):

 

 

 

December 31, 2025

 

 

December 31, 2024

 

 

 

Asset (Liability)

 

Fair Value

 

 

Original
Cost

 

 

Fair Value

 

 

Original
Cost

 

 

Asset Type Classification

Mortgage loans

 

$

116,113

 

 

$

151,692

 

 

$

111,985

 

 

$

129,968

 

 

Mortgage loans

Equity investment and other loans

 

 

4,285

 

 

 

264,160

 

 

 

154,229

 

 

 

910,594

 

 

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 and our investment in PHP Holdings (as of December 31, 2024 only) are recorded at fair value by using a market approach (for our equity investment in the international joint venture) and a market approach based on the agreed upon price in the transaction (for our investment in PHP Holdings), 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 these investments 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. For the market approach model used for our investment in PHP Holdings (as of December 31, 2024 only), our unobservable inputs include purchase price adjustments related to expected balance sheet values at the time of the transaction close, and an adjustment for a marketability discount ("DLOM") of 14.2%. In regard to the underlying projections used in the discounted cash flow model for our investment in the international joint venture, such projections are provided by the investees. However, we may modify such projections as needed based on our review and analysis of historical results, meetings with key members of management, and our understanding of trends and developments within the healthcare industry.

In 2025, we recorded a net unfavorable adjustment to the investments accounted for under the fair value option method of approximately $169 million, primarily related to our investment in three hospitals in Colombia and our investment in PHP Holdings. In 2024, we recorded a net unfavorable adjustment to the investments accounted for under the fair value option method of approximately $790 million, primarily related to the loan to the international joint venture and our investment in PHP Holdings.

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 and Fair Value Adjustments of Non-Real Estate Investments

2024

Prior to the global settlement in September 2024 (as described in Note 3 to the consolidated financial statements) in which our claims were released, our non-real estate investments in Steward and related affiliates included our 9.9% equity investment, working capital and other secured loans, and a loan made to a Steward affiliate in 2021, proceeds of which were used to redeem a similarly sized convertible loan held by Steward’s former private equity sponsor. In addition, the loan to the international joint venture was collateralized by the equity of Steward held by an investor in both Steward and the international joint venture. To assess recovery of these investments, we performed a valuation of Steward’s business at March 31, 2024, with assistance from a third-party, independent valuation firm. The valuation approaches utilized included the cost, market, and income approaches. The fair value analysis was performed under a non-going concern, orderly liquidation premise of value and assuming normal exposure to market participants. We utilized this premise of value due to Steward’s ongoing financial distress and subsequent filing of bankruptcy. Accordingly, the valuation approaches used, including the Level 3 inputs, were based on the financial performance of the Steward assets. For profitable hospitals, Level 3 inputs included a weighted average EBITDA multiple of 6.48x from a selected range of 5x to 7x in reference to comparable transactions. We also used a weighted average discount rate of 15.03% from a selected range of 15% to 16%. For unprofitable hospitals, Level 3 inputs included a weighted average net revenue multiple of 0.275x from a selected range of 0.25x to 0.30x in reference to comparable transactions. We also considered the reported book values inclusive of various adjustments for unprofitable hospitals. After reducing the derived fair value of Steward's business for Steward's secured debt (including our working capital and other secured loans) and their working capital deficit, we arrived at only a nominal remaining value that could not support the carrying value of the loan to a Steward affiliate from 2021 or our remaining 9.9% equity investment. In addition, the value of the investor's share of the remaining 90.1% of Steward's equity that collateralized the loan to the international joint venture was deemed insufficient to support recovery of this investment. As a result, we recorded impairment charges and negative fair value adjustments in the 2024 first quarter of approximately $625 million, as discussed further in Note 3 to the consolidated financial statements.

In the third quarter of 2024, as a result of the Company’s global settlement with Steward (as discussed further in Note 3 to the consolidated financial statements), the Company recorded impairment charges of approximately $425 million for the working capital loans and other secured loans previously advanced to Steward.

2023

To assess recovery of our non-real estate investments in Steward in 2023, along with the $219 million loan to the international joint venture that was collateralized by the equity of Steward held by an investor in both Steward and the international joint venture, we performed a valuation of Steward's business at December 31, 2023, with assistance from a third-party, independent valuation firm, using a market valuation approach, with Level 3 inputs including the selected revenue multiple range of 0.50x to 0.60x in reference to comparable transactions. After reducing the derived fair value for the loans to Steward discussed above, we arrived at a fair value for Steward's equity. We then compared our equity investment's carrying value to our 9.9% share of the fair value of Steward's equity, which resulted in the need for an impairment charge of approximately $90 million. The value of the investor's share of the remaining 90.1% of Steward's equity that collateralized the loan to the international joint venture was deemed sufficient to support recovery of this investment at that time.

Impairment of Real Estate Investments

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

Equity Investments Without a Readily Determinable Fair Value

For our equity investment in Swiss Medical (which does not have a readily determinable fair value), we marked our investment to fair value in the 2023 third quarter based on the price paid by a new investor in the same security, resulting in a CHF 20 million favorable adjustment.
v3.25.4
Leases (Lessee)
 12 Months Ended
Dec. 31, 2025
Leases [Abstract]  
Leases (Lessee)

11. Leases (Lessee)

We lease the land underlying certain of our facilities (for which we typically sublease to our tenants), along with certain corporate offices and equipment. Our leases have remaining lease terms that vary in years, and some of the leases have initial fixed terms (or renewal options available) that extend the leases up to, or just beyond, the depreciable life of the properties that occupy the leased land. Renewal options that we are reasonably certain to exercise are recognized in our right-of-use assets and lease liabilities. As most of our leases do not provide an implicit rate, we use our incremental borrowing rate based on the information available at lease commencement date in determining the present value of future payments.

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

 

 

 

Income Statement

 

For the Years Ended December 31,

 

 

 

Classification

 

2025

 

 

2024

 

 

2023

 

Operating lease cost (1)

 

(2)

 

$

9,254

 

 

$

10,725

 

 

$

11,653

 

Finance lease cost:

 

 

 

 

 

 

 

 

 

 

 

Amortization of right-of-use assets

 

Real estate depreciation and amortization

 

 

51

 

 

 

51

 

 

 

51

 

Interest on lease liabilities

 

Interest

 

 

128

 

 

 

128

 

 

 

128

 

Sublease income

 

Other

 

 

(2,425

)

 

 

(3,259

)

 

 

(4,178

)

Total lease cost

 

 

 

$

7,008

 

 

$

7,645

 

 

$

7,654

 

 

(1)
Includes short-term leases.
(2)
$4.1 million, $5.1 million, and $6.0 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2025, 2024, and 2023, respectively.

Fixed minimum payments due over the remaining lease term under non-cancelable leases of more than one year and amounts to be received in the future from non-cancelable subleases over their remaining lease term at December 31, 2025 are as follows (amounts in thousands):

 

 

 

Operating Leases

 

 

Finance Leases

 

 

Amounts To
Be Received
From
Subleases

 

 

Net
Payments

 

 

2026

 

$

7,109

 

 

$

133

 

 

$

(2,877

)

 

$

4,365

 

2027

 

 

6,567

 

 

 

134

 

 

 

(2,515

)

 

 

4,186

 

2028

 

 

6,648

 

 

 

135

 

 

 

(2,516

)

 

 

4,267

 

2029

 

 

6,706

 

 

 

137

 

 

 

(2,518

)

 

 

4,325

 

2030

 

 

6,733

 

 

 

138

 

 

 

(2,525

)

 

 

4,346

 

Thereafter

 

 

160,583

 

 

 

4,106

 

 

 

(38,522

)

 

 

126,167

 

(1)

Total undiscounted minimum lease payments

 

$

194,346

 

 

$

4,783

 

 

$

(51,473

)

 

$

147,656

 

Less: interest

 

 

(122,351

)

 

 

(2,850

)

 

 

 

 

 

 

 

Present value of lease liabilities

 

$

71,995

 

 

$

1,933

 

 

 

 

 

 

 

 

 

(1)
Reflects certain ground leases, in which we are the lessee, that have longer initial fixed terms than our existing sublease to our tenants. However, we would expect to either renew the related sublease, enter into a lease with a new tenant, or attempt to early terminate the ground lease to reduce or avoid any significant impact from such ground leases.

 

Supplemental balance sheet information is as follows (in thousands, except lease terms and discount rate):

 

 

 

Balance Sheet
Classification

 

December 31,
2025

 

 

December 31,
2024

 

Right of use assets:

 

 

 

 

 

 

 

 

Operating leases - real estate

 

Land

 

$

43,801

 

 

$

46,881

 

Finance leases - real estate

 

Land

 

 

1,581

 

 

 

1,632

 

Total real estate right of use assets

 

 

 

$

45,382

 

 

$

48,513

 

Operating leases - corporate

 

Other assets

 

 

17,641

 

 

 

20,701

 

Total right of use assets

 

 

 

$

63,023

 

 

$

69,214

 

 

 

 

 

 

 

 

 

 

Lease liabilities:

 

 

 

 

 

 

 

 

Operating leases

 

Obligations to tenants and
other lease liabilities

 

$

71,995

 

 

$

78,585

 

Financing leases

 

Obligations to tenants and
other lease liabilities

 

 

1,933

 

 

 

1,936

 

Total lease liabilities

 

 

 

$

73,928

 

 

$

80,521

 

 

 

 

 

 

 

 

 

 

Weighted-average remaining lease term:

 

 

 

 

 

 

 

 

Operating leases

 

 

 

 

33.4

 

 

 

32.6

 

Finance leases

 

 

 

 

30.9

 

 

 

31.9

 

Weighted-average discount rate:

 

 

 

 

 

 

 

 

Operating leases

 

 

 

 

6.1

%

 

 

6.1

%

Finance leases

 

 

 

 

6.6

%

 

 

6.6

%

 

The following is supplemental cash flow information (in thousands):

 

 

 

For the Years Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

Cash paid for amounts included in the measurement of lease liabilities:

 

 

 

 

 

 

 

 

 

Operating cash flows used for operating leases

 

$

8,013

 

 

$

8,447

 

 

$

8,210

 

Operating cash flows used for finance leases

 

 

131

 

 

 

130

 

 

 

129

 
v3.25.4
Other Assets
 12 Months Ended
Dec. 31, 2025
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]  
Other Assets

12. Other Assets

The following is a summary of our other assets on our consolidated balance sheets (in thousands):

 

 

 

December 31,

 

 

 

2025

 

 

2024

 

Debt issue costs, net(1)

 

$

3,265

 

 

$

5,675

 

Other corporate assets

 

 

372,751

 

 

 

330,638

 

Prepaids and other assets

 

 

188,024

 

 

 

135,091

 

Total other assets

 

$

564,040

 

 

$

471,404

 
(1)
Relates to our revolving credit facility

Other corporate assets include building, land and land improvements associated with our corporate headquarters, furniture and fixtures, equipment, corporate vehicles, aircraft, enterprise and other software, deposits, and right-of-use assets associated with corporate leases. Included in prepaids and other assets is prepaid insurance, prepaid taxes, deferred income tax assets (net of valuation allowances, if any), non-tenant receivables, derivative assets, and lease incentives provided to tenants, among other items.

Other corporate assets increased in 2025 primarily due to additional funding of our new corporate headquarters, which we have recently completed. Remaining funding costs are estimated to be between $10 million and $15 million. Prepaids and other assets increased in 2025 primarily due to lease incentives provided to tenants as previously described in Note 3 to the consolidated financial statements.

v3.25.4
Segment Disclosures
 12 Months Ended
Dec. 31, 2025
Segment Reporting [Abstract]  
Segment Disclosures

13. 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 (loss) income (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 consolidated financial statements for entity-wide disclosures around major customers, geographic areas, and property types.
v3.25.4
Subsequent Events
 12 Months Ended
Dec. 31, 2025
Subsequent Events [Abstract]  
Subsequent Events

14. Subsequent Events

Subsequent to December 31, 2025, 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 plan to adjust the deferred tax liabilities associated with these entities, which we expect will result in an approximate $40 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.

On February 12, 2026, we announced that our Board of Directors declared a regular quarterly cash dividend of $0.09 per share of common stock to be paid on April 9, 2026, to shareholders of record on March 12, 2026.

On February 13, 2026, we closed on the acquisition of one property in Germany for approximately €23 million to be leased to MEDIAN.

 

 
v3.25.4
Schedule II: Valuation and Qualifying Accounts
 12 Months Ended
Dec. 31, 2025
SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]  
Schedule II: Valuation and Qualifying Accounts

Schedule II: Valuation and Qualifying Accounts

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

December 31, 2025

 

 

 

 

 

 

Additions

 

 

 

Deductions

 

 

 

 

 

Year Ended December 31,

 

Balance at
Beginning of
Year(1)

 

 

Charged
Against
Operations(1)

 

 

 

Charged to
Other Accounts

 

 

 

Net
Recoveries/
Write-offs(1)

 

 

 

Balance at
End of Year(1)

 

 

 

(In thousands)

 

2025

 

$

2,165,754

 

 

$

602,464

 

(2)

 

$

—

 

 

 

$

(426,550

)

(3)

 

$

2,341,668

 

2024

 

$

878,318

 

 

$

2,783,001

 

(4)

 

$

—

 

 

 

$

(1,495,565

)

(5)

 

$

2,165,754

 

2023

 

$

393,057

 

 

$

755,627

 

(6)

 

$

—

 

 

 

$

(270,366

)

(7)

 

$

878,318

 

 

(1)
Includes real estate impairment reserves, allowances for doubtful accounts, straight-line rent reserves, credit loss reserves, tax valuation allowances, and other reserves.
(2)
Represents approximately $170 million of increase in credit loss reserves on loans and financing-type investments (primarily related to Prospect as further described in Note 3 to Item 8 of this Annual Report on Form 10-K), an approximate $350 million increase in accounts receivable reserves, and an approximate $10 million increase to real estate impairment reserves. Also includes approximately $70 million of increase in valuation allowances to reserve against our net deferred tax assets in 2025.
(3)
Includes a $191 million decrease in accounts receivable reserves and an approximate $130 million decrease in credit loss reserves on loans (primarily related to Prospect as further described in Note 3 to Item 8 of this Annual Report on Form 10-K, as well as the Vibra restructuring transaction), and an approximate $100 million decrease in real estate impairment reserves related to disposals in 2025.
(4)
Represents $1.5 billion increase in credit loss reserves on loans and financing-type investments (primarily related to Steward and Prospect as further described in Note 3 to Item 8 of this Annual Report on Form 10-K) and negative fair value adjustment on our investment in the international joint venture, $86 million increase to real estate impairment reserves, approximately $500 million increase to equity investment impairment reserves, and a $384 million increase in accounts receivable reserves. Also includes an approximately $302 million increase in valuation allowances to reserve against our net deferred tax assets in 2024.
(5)
Includes a $520 million decrease in accounts receivable reserves and $826 million decrease in credit loss reserves on loans (primarily related to the full release of our claims in Steward as a result of the global settlement), along with a $138 million decrease to our equity investment reserves (primarily related to the write-off of our Steward equity investment), and a $12 million decrease in real estate impairment reserves related to disposals in 2024.
(6)
Represents $261 million increase in accounts receivable reserves, $259 million increase in straight-line rent receivable reserves, $90 million increase to equity investment impairment reserves, and $89 million increase to real estate impairment reserves, as further described in Note 3 to Item 8 of this Annual Report on Form 10-K. Also includes an increase of $10 million in credit loss reserves and an approximately $47 million increase in valuation allowances to reserve against our net deferred tax assets in 2023.
(7)
Includes a $170 million decrease in real estate impairment reserves, an approximately $35 million decrease in credit loss reserves related to transitioning properties back to a tenant in exchange for a first-lien mortgage, and a $50 million recovery of previously reserved interest satisfied as part of the “Prospect Transaction” as disclosed in Note 3 to Item 8 of this Annual Report on Form 10-K. Also includes an approximately $11 million write-off of previously reserved accounts receivable.
v3.25.4
SCHEDULE III - REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION
 12 Months Ended
Dec. 31, 2025
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]  
SCHEDULE III - REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION

SCHEDULE III — REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION

December 31, 2025

 

 

 

 

 

Initial Costs

 

 

Additions Subsequent
to Acquisition

 

 

Cost at December 31, 2025(1)

 

 

Accumulated

 

 

 

 

 

 

 

 

 

Life on
which
depreciation
in latest
income
statements is

 

Location

 

Type of Property

 

Land

 

 

Buildings

 

 

Improve-
ments

 

 

Carrying
Costs

 

 

Land

 

 

Buildings

 

 

Total

 

 

Depreciation

 

 

Encum-
brances

 

 

Date of
Construction

 

Date
Acquired

 

computed
(Years)

 

 

 

(Dollar amounts in thousands)

 

Aberdeen, UK

 

Acute care general hospital

 

$

4,501

 

 

$

106,607

 

 

$

—

 

 

$

—

 

 

$

4,501

 

 

$

106,607

 

 

$

111,108

 

 

$

16,045

 

 

$

47,809

 

 

1985

 

January 9, 2020

 

 

40

 

Algeciras, Spain

 

Acute care general hospital

 

 

554

 

 

 

8,749

 

 

 

—

 

 

 

—

 

 

 

554

 

 

 

8,749

 

 

 

9,303

 

 

 

882

 

 

 

—

 

 

1997

 

April 29, 2022

 

 

40

 

Altoona, WI

 

Acute care general hospital

 

 

—

 

 

 

35,500

 

 

 

—

 

 

 

—

 

 

 

—

 

 

 

35,500

 

 

 

35,500

 

 

 

8,234

 

 

 

—

 

(3)

2014

 

August 31, 2014

 

 

40

 

Altrincham, UK

 

Behavioral health facility

 

 

15,499

 

 

 

26,606

 

 

 

—

 

 

 

—

 

 

 

15,499

 

 

 

26,606

 

 

 

42,105

 

 

 

2,494

 

 

 

—

 

(3)

1890, 2014

 

December 9, 2022

 

 

40

 

Alvin, TX

 

Freestanding ER

 

 

105

 

 

 

4,087

 

 

 

—

 

 

 

—

 

 

 

105

 

 

 

4,087

 

 

 

4,192

 

 

 

1,177

 

 

 

—

 

(3)

2014

 

March 19, 2014

 

 

40

 

Arnold, UK

 

Behavioral health facility

 

 

505

 

 

 

10,496

 

 

 

—

 

 

 

—

 

 

 

505

 

 

 

10,496

 

 

 

11,001

 

 

 

1,296

 

 

 

—

 

(3)

2008

 

June 25, 2021

 

 

40

 

Ashtead, UK

 

Acute care general hospital

 

 

39,969

 

 

 

74,936

 

 

 

—

 

 

 

—

 

 

 

39,969

 

 

 

74,936

 

 

 

114,905

 

 

 

12,400

 

 

 

—

 

(3)

1981

 

August 16, 2019

 

 

40

 

Austin, TX

 

Freestanding ER

 

 

3,507

 

 

 

4,200

 

 

 

—

 

 

 

—

 

 

 

3,507

 

 

 

4,200

 

 

 

7,707

 

 

 

955

 

 

 

—

 

 

2017

 

March 2, 2017

 

 

40

 

Avondale, AZ

 

Behavioral health facility

 

 

5,383

 

 

 

64,650

 

 

 

8,281

 

 

 

—

 

 

 

5,383

 

 

 

72,931

 

 

 

78,314

 

 

 

7,320

 

 

 

—

 

(3)

2016

 

October 19, 2021

 

 

40

 

Ayr, UK

 

Behavioral health facility

 

 

17,982

 

 

 

51,498

 

 

 

—

 

 

 

—

 

 

 

17,982

 

 

 

51,498

 

 

 

69,480

 

 

 

5,917

 

 

 

—

 

(3)

2004

 

June 25, 2021

 

 

40

 

Bad Salzuflen, Germany

 

Rehabilitation hospital

 

 

11,176

 

 

 

28,283

 

 

 

—

 

 

 

—

 

 

 

11,176

 

 

 

28,283

 

 

 

39,459

 

 

 

6,233

 

 

 

—

 

(3)

1974, 2016

 

November 30, 2017

 

 

40

 

Bad Salzuflen, Germany

 

Rehabilitation hospital

 

 

7,595

 

 

 

24,873

 

 

 

—

 

 

 

—

 

 

 

7,595

 

 

 

24,873

 

 

 

32,468

 

 

 

5,221

 

 

 

—

 

(3)

1989, 2016

 

November 30, 2017

 

 

40

 

Bad Oeynhausen, Germany

 

Rehabilitation hospital

 

 

1,198

 

 

 

2,928

 

 

 

—

 

 

 

—

 

 

 

1,198

 

 

 

2,928

 

 

 

4,126

 

 

 

662

 

 

 

—

 

(3)

1973, 2010

 

November 30, 2017

 

 

40

 

Bakersfield, CA

 

Rehabilitation hospital

 

 

2,178

 

 

 

45,253

 

 

 

—

 

 

 

—

 

 

 

2,178

 

 

 

45,253

 

 

 

47,431

 

 

 

4,337

 

 

 

—

 

(3)

2022

 

May 15, 2020

 

 

40

 

Barby, Germany

 

Rehabilitation hospital

 

 

1,938

 

 

 

21,619

 

 

 

—

 

 

 

—

 

 

 

1,938

 

 

 

21,619

 

 

 

23,557

 

 

 

1,681

 

 

 

—

 

(3)

1995

 

April 19, 2023

 

 

40

 

Basingstoke, UK

 

Acute care general hospital

 

 

13,677

 

 

 

53,123

 

 

 

—

 

 

 

—

 

 

 

13,677

 

 

 

53,123

 

 

 

66,800

 

 

 

8,049

 

 

 

34,016

 

 

1984

 

January 9, 2020

 

 

40

 

Bassenheim, Germany

 

Rehabilitation hospital

 

 

1,179

 

 

 

5,628

 

 

 

—

 

 

 

—

 

 

 

1,179

 

 

 

5,628

 

 

 

6,807

 

 

 

1,079

 

 

 

—

 

(3)

1887, 1983

 

February 9, 2019

 

 

39

 

Bath, UK

 

Acute care general hospital

 

 

1,597

 

 

 

33,105

 

 

 

—

 

 

 

—

 

 

 

1,597

 

 

 

33,105

 

 

 

34,702

 

 

 

9,518

 

 

 

—

 

(3)

2008, 2009

 

July 1, 2014

 

 

40

 

Bath, UK

 

Acute care general hospital

 

 

7,613

 

 

 

13,816

 

 

 

—

 

 

 

—

 

 

 

7,613

 

 

 

13,816

 

 

 

21,429

 

 

 

2,153

 

 

 

16,326

 

 

1992

 

January 9, 2020

 

 

40

 

Beckenham, UK

 

Acute care general hospital

 

 

5,781

 

 

 

22,172

 

 

 

—

 

 

 

—

 

 

 

5,781

 

 

 

22,172

 

 

 

27,953

 

 

 

3,347

 

 

 

15,750

 

 

1981

 

January 9, 2020

 

 

40

 

Bedford, UK

 

Acute care general hospital

 

 

1,630

 

 

 

7,942

 

 

 

42

 

 

 

—

 

 

 

1,630

 

 

 

7,984

 

 

 

9,614

 

 

 

1,213

 

 

 

8,489

 

 

1982

 

January 9, 2020

 

 

40

 

Bellflower, CA

 

Behavioral health facility

 

 

10,155

 

 

 

21,296

 

 

 

—

 

 

 

—

 

 

 

10,155

 

 

 

21,296

 

 

 

31,451

 

 

 

88

 

 

 

—

 

 

1972

 

August 23, 2019

 

 

21

 

Big Spring, TX

 

Acute care general hospital

 

 

1,655

 

 

 

21,254

 

 

 

815

 

 

 

—

 

 

 

1,655

 

 

 

22,069

 

 

 

23,724

 

 

 

4,028

 

 

 

—

 

 

1973

 

April 12, 2019

 

 

41

 

Birmingham, UK

 

Behavioral health facility

 

 

981

 

 

 

10,753

 

 

 

—

 

 

 

—

 

 

 

981

 

 

 

10,753

 

 

 

11,734

 

 

 

760

 

 

 

—

 

(3)

1864, 2009

 

April 14, 2023

 

 

40

 

Birmingham, UK

 

Acute care general hospital

 

 

8,276

 

 

 

44,683

 

 

 

—

 

 

 

—

 

 

 

8,276

 

 

 

44,683

 

 

 

52,959

 

 

 

6,144

 

 

 

—

 

(3)

2017

 

April 3, 2017

 

 

40

 

Birmingham, UK

 

Acute care general hospital

 

 

10,437

 

 

 

99,353

 

 

 

—

 

 

 

—

 

 

 

10,437

 

 

 

99,353

 

 

 

109,790

 

 

 

15,057

 

 

 

—

 

(3)

1982

 

January 9, 2020

 

 

40

 

Birmingham, UK

 

Rehabilitation hospital

 

 

—

 

 

 

18,375

 

 

 

—

 

 

 

—

 

 

 

—

 

 

 

18,375

 

 

 

18,375

 

 

 

2,527

 

 

 

—

 

(3)

2018

 

June 29, 2020

 

 

40

 

Birmingham, UK

 

Behavioral health facility

 

 

436

 

 

 

20,284

 

 

 

—

 

 

 

—

 

 

 

436

 

 

 

20,284

 

 

 

20,720

 

 

 

2,445

 

 

 

—

 

(3)

1900, 1984, 2016

 

June 25, 2021

 

 

40

 

Blackburn, UK

 

Acute care general hospital

 

 

2,816

 

 

 

53,982

 

 

 

—

 

 

 

—

 

 

 

2,816

 

 

 

53,982

 

 

 

56,798

 

 

 

8,146

 

 

 

25,085

 

 

1957

 

January 9, 2020

 

 

40

 

Blackburn, UK

 

Behavioral health facility

 

 

21,201

 

 

 

57,514

 

 

 

—

 

 

 

—

 

 

 

21,201

 

 

 

57,514

 

 

 

78,715

 

 

 

7,094

 

 

 

—

 

(3)

1930

 

June 25, 2021

 

 

40

 

Blue Springs, MO

 

Acute care general hospital

 

 

4,347

 

 

 

23,494

 

 

 

—

 

 

 

—

 

 

 

4,347

 

 

 

23,494

 

 

 

27,841

 

 

 

6,737

 

 

 

—

 

 

1980

 

February 13, 2015

 

 

40

 

Boardman, OH

 

Long term acute care hospital

 

 

79

 

 

 

275

 

 

 

—

 

 

 

—

 

 

 

79

 

 

 

275

 

 

 

354

 

 

 

49

 

 

 

—

 

 

2008

 

August 30, 2019

 

 

40

 

Boise, ID

 

Long term acute care hospital

 

 

1,558

 

 

 

11,027

 

 

 

—

 

 

 

—

 

 

 

1,558

 

 

 

11,027

 

 

 

12,585

 

 

 

1,786

 

 

 

—

 

 

2008

 

February 29, 2012

 

 

50

 

Bolton, UK

 

Acute care general hospital

 

 

1,678

 

 

 

47,136

 

 

 

—

 

 

 

—

 

 

 

1,678

 

 

 

47,136

 

 

 

48,814

 

 

 

7,095

 

 

 

22,412

 

 

1989

 

January 9, 2020

 

 

40

 

 

 

 

 

 

Initial Costs

 

 

Additions Subsequent
to Acquisition

 

 

Cost at December 31, 2025(1)

 

 

Accumulated

 

 

 

 

 

 

 

 

 

Life on
which
depreciation
in latest
income statements is

 

Location

 

Type of Property

 

Land

 

 

Buildings

 

 

Improve-
ments

 

 

Carrying
Costs

 

 

Land

 

 

Buildings

 

 

Total

 

 

Depreciation

 

 

Encum-
brances

 

 

Date of
Construction

 

Date
Acquired

 

computed
(Years)

 

 

 

(Dollar amounts in thousands)

 

Bossier City, LA

 

Long term acute care hospital

 

 

900

 

 

 

17,818

 

 

 

944

 

 

 

—

 

 

 

900

 

 

 

18,762

 

 

 

19,662

 

 

 

8,126

 

 

 

—

 

(3)

1982

 

April 1, 2008

 

 

40

 

Bowling Green, KY

 

Rehabilitation hospital

 

 

3,486

 

 

 

56,296

 

 

 

3,550

 

 

 

—

 

 

 

3,486

 

 

 

59,846

 

 

 

63,332

 

 

 

10,251

 

 

 

—

 

 

1992

 

August 30, 2019

 

 

40

 

Brandis, Germany

 

Rehabilitation hospital

 

 

2,358

 

 

 

25,958

 

 

 

—

 

 

 

—

 

 

 

2,358

 

 

 

25,958

 

 

 

28,316

 

 

 

2,074

 

 

 

—

 

(3)

1995

 

April 19, 2023

 

 

40

 

Braunfels, Germany

 

Acute care general hospital

 

 

2,314

 

 

 

14,415

 

 

 

8

 

 

 

—

 

 

 

2,314

 

 

 

14,423

 

 

 

16,737

 

 

 

3,825

 

 

 

—

 

(3)

1977

 

June 30, 2015

 

 

40

 

Bristol, UK

 

Behavioral health facility

 

 

4,980

 

 

 

39,538

 

 

 

—

 

 

 

—

 

 

 

4,980

 

 

 

39,538

 

 

 

44,518

 

 

 

3,270

 

 

 

—

 

(3)

1790, 2014

 

December 9, 2022

 

 

40

 

Bromley, UK

 

Behavioral health facility

 

 

7,646

 

 

 

16,428

 

 

 

—

 

 

 

—

 

 

 

7,646

 

 

 

16,428

 

 

 

24,074

 

 

 

2,053

 

 

 

—

 

(3)

1714, 1830, 2021

 

June 25, 2021

 

 

40

 

Bury, UK

 

Behavioral health facility

 

 

9,007

 

 

 

20,524

 

 

 

—

 

 

 

—

 

 

 

9,007

 

 

 

20,524

 

 

 

29,531

 

 

 

2,664

 

 

 

—

 

(3)

2003

 

June 25, 2021

 

 

40

 

Bussage, UK

 

Behavioral health facility

 

 

8,986

 

 

 

3,972

 

 

 

—

 

 

 

—

 

 

 

8,986

 

 

 

3,972

 

 

 

12,958

 

 

 

500

 

 

 

—

 

(3)

1970

 

June 25, 2021

 

 

40

 

Cadiz, Spain

 

Acute care general hospital

 

 

319

 

 

 

7,234

 

 

 

—

 

 

 

—

 

 

 

319

 

 

 

7,234

 

 

 

7,553

 

 

 

711

 

 

 

—

 

 

2000

 

April 29, 2022

 

 

40

 

Canterbury, UK

 

Acute care general hospital

 

 

9,722

 

 

 

29,202

 

 

 

—

 

 

 

—

 

 

 

9,722

 

 

 

29,202

 

 

 

38,924

 

 

 

4,415

 

 

 

20,342

 

 

1982

 

January 9, 2020

 

 

40

 

Carmarthen, UK

 

Acute care general hospital

 

 

963

 

 

 

27,071

 

 

 

—

 

 

 

—

 

 

 

963

 

 

 

27,071

 

 

 

28,034

 

 

 

4,101

 

 

 

16,025

 

 

1990

 

January 9, 2020

 

 

40

 

Carrollton, TX

 

Behavioral health facility

 

 

4,941

 

 

 

52,227

 

 

 

—

 

 

 

—

 

 

 

4,941

 

 

 

52,227

 

 

 

57,168

 

 

 

5,940

 

 

 

—

 

(3)

2012

 

October 19, 2021

 

 

40

 

Casper, WY

 

Rehabilitation hospital

 

 

1,581

 

 

 

—

 

 

 

—

 

 

 

—

 

 

 

1,581

 

 

 

—

 

 

 

1,581

 

 

 

—

 

 

 

—

 

(3)

2012

 

February 29, 2012

 

 

—

 

Caterham, UK

 

Acute care general hospital

 

 

11,169

 

 

 

22,065

 

 

 

—

 

 

 

—

 

 

 

11,169

 

 

 

22,065

 

 

 

33,234

 

 

 

3,704

 

 

 

—

 

(3)

1982

 

August 16, 2019

 

 

40

 

Cayce, SC

 

Rehabilitation hospital

 

 

1,022

 

 

 

20,419

 

 

 

—

 

 

 

—

 

 

 

1,022

 

 

 

20,419

 

 

 

21,441

 

 

 

1,276

 

 

 

—

 

(3)

2023

 

October 21, 2022

 

 

40

 

Cheadle, UK

 

Acute care general hospital

 

 

32,744

 

 

 

172,486

 

 

 

25

 

 

 

—

 

 

 

32,744

 

 

 

172,511

 

 

 

205,255

 

 

 

26,035

 

 

 

113,319

 

 

1981

 

January 9, 2020

 

 

40

 

Cheadle, UK

 

Behavioral health facility

 

 

31,557

 

 

 

100,349

 

 

 

—

 

 

 

—

 

 

 

31,557

 

 

 

100,349

 

 

 

131,906

 

 

 

12,217

 

 

 

—

 

(3)

1849, 2018

 

June 25, 2021

 

 

40

 

Clarksville, TX

 

Rehabilitation hospital

 

 

2,460

 

 

 

25,540

 

 

 

—

 

 

 

—

 

 

 

2,460

 

 

 

25,540

 

 

 

28,000

 

 

 

3,550

 

 

 

—

 

(3)

2019

 

December 17, 2020

 

 

39

 

Cologne, Germany

 

Acute care general hospital

 

 

4,710

 

 

 

15,923

 

 

 

—

 

 

 

—

 

 

 

4,710

 

 

 

15,923

 

 

 

20,633

 

 

 

3,444

 

 

 

—

 

(3)

2011

 

June 23, 2017

 

 

40

 

Columbus, OH

 

Behavioral health facility

 

 

2,101

 

 

 

44,218

 

 

 

—

 

 

 

—

 

 

 

2,101

 

 

 

44,218

 

 

 

46,319

 

 

 

5,077

 

 

 

—

 

(3)

2017

 

October 19, 2021

 

 

40

 

Conroe, TX

 

Behavioral health facility

 

 

3,855

 

 

 

38,892

 

 

 

—

 

 

 

—

 

 

 

3,855

 

 

 

38,892

 

 

 

42,747

 

 

 

4,563

 

 

 

—

 

(3)

2018

 

October 19, 2021

 

 

40

 

Converse, TX

 

Freestanding ER

 

 

750

 

 

 

4,423

 

 

 

—

 

 

 

—

 

 

 

750

 

 

 

4,423

 

 

 

5,173

 

 

 

1,189

 

 

 

—

 

(3)

2015

 

April 10, 2015

 

 

40

 

Coral Gables, FL

 

Acute care general hospital

 

 

26,215

 

 

 

84,584

 

 

 

2,624

 

 

 

—

 

 

 

26,215

 

 

 

87,208

 

 

 

113,423

 

 

 

9,771

 

 

 

—

 

 

1959

 

August 1, 2021

 

 

40

 

Croydon, UK

 

Acute care general hospital

 

 

10,524

 

 

 

44,143

 

 

 

—

 

 

 

—

 

 

 

10,524

 

 

 

44,143

 

 

 

54,667

 

 

 

6,708

 

 

 

27,085

 

 

1982

 

January 9, 2020

 

 

40

 

Culver City, CA

 

Acute care general hospital

 

 

37,885

 

 

 

178,101

 

 

 

—

 

 

 

—

 

 

 

37,885

 

 

 

178,101

 

 

 

215,986

 

 

 

517

 

 

 

—

 

 

1969

 

August 23, 2019

 

 

29

 

Dahlen, Germany

 

Rehabilitation hospital

 

 

1,428

 

 

 

12,065

 

 

 

—

 

 

 

—

 

 

 

1,428

 

 

 

12,065

 

 

 

13,493

 

 

 

1,796

 

 

 

—

 

(3)

1994

 

July 8, 2020

 

 

40

 

Darlington, UK

 

Acute care general hospital

 

 

2,210

 

 

 

37,911

 

 

 

—

 

 

 

—

 

 

 

2,210

 

 

 

37,911

 

 

 

40,121

 

 

 

5,265

 

 

 

36,188

 

 

2001

 

August 7, 2020

 

 

40

 

Darlington, UK

 

Behavioral health facility

 

 

22,488

 

 

 

51,083

 

 

 

—

 

 

 

—

 

 

 

22,488

 

 

 

51,083

 

 

 

73,571

 

 

 

6,731

 

 

 

—

 

(3)

1935, 2018, 2020

 

June 25, 2021

 

 

40

 

Darlington, UK

 

Behavioral health facility

 

 

5,534

 

 

 

27,888

 

 

 

—

 

 

 

—

 

 

 

5,534

 

 

 

27,888

 

 

 

33,422

 

 

 

3,305

 

 

 

—

 

(3)

1960, 1990

 

June 25, 2021

 

 

40

 

Dewsbury, UK

 

Behavioral health facility

 

 

1,185

 

 

 

10,795

 

 

 

—

 

 

 

—

 

 

 

1,185

 

 

 

10,795

 

 

 

11,980

 

 

 

802

 

 

 

—

 

(3)

2012

 

April 14, 2023

 

 

40

 

Diss, UK

 

Behavioral health facility

 

 

3,080

 

 

 

10,984

 

 

 

—

 

 

 

—

 

 

 

3,080

 

 

 

10,984

 

 

 

14,064

 

 

 

1,516

 

 

 

—

 

(3)

1840 (2)

 

June 25, 2021

 

 

40

 

Dorchester, UK

 

Acute care general hospital

 

 

571

 

 

 

33,173

 

 

 

—

 

 

 

—

 

 

 

571

 

 

 

33,173

 

 

 

33,744

 

 

 

5,000

 

 

 

—

 

(3)

1981

 

January 9, 2020

 

 

40

 

Dormagen, Germany

 

Rehabilitation hospital

 

 

2,032

 

 

 

6,010

 

 

 

—

 

 

 

—

 

 

 

2,032

 

 

 

6,010

 

 

 

8,042

 

 

 

1,172

 

 

 

—

 

(3)

1993, 2006

 

August 28, 2018

 

 

40

 

 

 

 

 

 

 

Initial Costs

 

 

Additions Subsequent
to Acquisition

 

 

Cost at December 31, 2025(1)

 

 

Accumulated

 

 

 

 

 

 

 

 

 

Life on
which
depreciation
in latest
income statements is

 

Location

 

Type of Property

 

Land

 

 

Buildings

 

 

Improve-
ments

 

 

Carrying
Costs

 

 

Land

 

 

Buildings

 

 

Total

 

 

Depreciation

 

 

Encum-
brances

 

 

Date of
Construction

 

Date
Acquired

 

computed
(Years)

 

 

 

(Dollar amounts in thousands)

 

Droitwich, UK

 

Acute care general hospital

 

 

81

 

 

 

16,192

 

 

 

—

 

 

 

—

 

 

 

81

 

 

 

16,192

 

 

 

16,273

 

 

 

2,461

 

 

 

—

 

(3)

1984

 

January 9, 2020

 

 

40

 

Dublin, OH

 

Behavioral health facility

 

 

5,118

 

 

 

69,346

 

 

 

—

 

 

 

—

 

 

 

5,118

 

 

 

69,346

 

 

 

74,464

 

 

 

7,804

 

 

 

—

 

(3)

2012

 

October 19, 2021

 

 

40

 

El Paso, TX

 

Rehabilitation hospital

 

 

4,268

 

 

 

21,345

 

 

 

—

 

 

 

—

 

 

 

4,268

 

 

 

21,345

 

 

 

25,613

 

 

 

3,099

 

 

 

—

 

(3)

2018

 

December 17, 2020

 

 

38

 

Englewood, CO

 

Behavioral health facility

 

 

3,369

 

 

 

65,480

 

 

 

—

 

 

 

—

 

 

 

3,369

 

 

 

65,480

 

 

 

68,849

 

 

 

7,432

 

 

 

—

 

(3)

2017

 

October 19, 2021

 

 

40

 

Essex, UK

 

Behavioral health facility

 

 

4,913

 

 

 

45,715

 

 

 

—

 

 

 

—

 

 

 

4,913

 

 

 

45,715

 

 

 

50,628

 

 

 

3,769

 

 

 

—

 

(3)

1790, 1992, 2014

 

December 9, 2022

 

 

40

 

Euxton, UK

 

Acute care general hospital

 

 

4,887

 

 

 

37,638

 

 

 

—

 

 

 

—

 

 

 

4,887

 

 

 

37,638

 

 

 

42,525

 

 

 

6,412

 

 

 

—

 

(3)

1981

 

August 16, 2019

 

 

40

 

Flagstaff, AZ

 

Rehabilitation hospital

 

 

3,049

 

 

 

22,464

 

 

 

—

 

 

 

—

 

 

 

3,049

 

 

 

22,464

 

 

 

25,513

 

 

 

4,399

 

 

 

—

 

(3)

2016

 

August 23, 2016

 

 

40

 

Florence, AZ

 

Acute care general hospital

 

 

900

 

 

 

28,462

 

 

 

105

 

 

 

—

 

 

 

900

 

 

 

28,567

 

 

 

29,467

 

 

 

9,817

 

 

 

—

 

 

2012

 

February 7, 2012

 

 

40

 

Floridablanca, Colombia

 

Acute care general hospital

 

 

836

 

 

 

26,157

 

 

 

—

 

 

 

—

 

 

 

836

 

 

 

26,157

 

 

 

26,993

 

 

 

2,256

 

 

 

—

 

 

1997

 

July 29, 2022

 

 

40

 

Folsom, CA

 

Long term acute care hospital

 

 

3,291

 

 

 

21,293

 

 

 

—

 

 

 

—

 

 

 

3,291

 

 

 

21,293

 

 

 

24,584

 

 

 

4,002

 

 

 

—

 

 

2009

 

August 30, 2019

 

 

40

 

Fort Worth, TX

 

Behavioral health facility

 

 

3,406

 

 

 

34,627

 

 

 

—

 

 

 

—

 

 

 

3,406

 

 

 

34,627

 

 

 

38,033

 

 

 

4,039

 

 

 

—

 

(3)

2014

 

October 19, 2021

 

 

40

 

Fresno, CA

 

Rehabilitation hospital

 

 

5,507

 

 

 

70,473

 

 

 

—

 

 

 

—

 

 

 

5,507

 

 

 

70,473

 

 

 

75,980

 

 

 

12,025

 

 

 

—

 

 

1991

 

August 30, 2019

 

 

40

 

Frome, UK

 

Behavioral health facility

 

 

3,065

 

 

 

18,571

 

 

 

—

 

 

 

—

 

 

 

3,065

 

 

 

18,571

 

 

 

21,636

 

 

 

2,357

 

 

 

—

 

(3)

1980

 

June 25, 2021

 

 

40

 

Frome, UK

 

Behavioral health facility

 

 

11,531

 

 

 

11,337

 

 

 

—

 

 

 

—

 

 

 

11,531

 

 

 

11,337

 

 

 

22,868

 

 

 

1,895

 

 

 

—

 

(3)

1700, 2015, 2017

 

June 25, 2021

 

 

40

 

Gainesborough, UK

 

Behavioral health facility

 

 

1,618

 

 

 

10,592

 

 

 

—

 

 

 

—

 

 

 

1,618

 

 

 

10,592

 

 

 

12,210

 

 

 

981

 

 

 

—

 

(3)

2008

 

April 14, 2023

 

 

40

 

Gardena, CA

 

Acute care general hospital

 

 

14,010

 

 

 

65,282

 

 

 

211

 

 

 

—

 

 

 

14,010

 

 

 

65,493

 

 

 

79,503

 

 

 

7,938

 

 

 

—

 

(3)

1966

 

July 6, 2021

 

 

40

 

Georgetown, TX

 

Behavioral health facility

 

 

4,569

 

 

 

22,858

 

 

 

10,561

 

 

 

—

 

 

 

4,569

 

 

 

33,419

 

 

 

37,988

 

 

 

3,208

 

 

 

—

 

(3)

2014

 

October 19, 2021

 

 

40

 

Gilbert, AZ

 

Behavioral health facility

 

 

4,790

 

 

 

45,933

 

 

 

9,647

 

 

 

—

 

 

 

4,790

 

 

 

55,580

 

 

 

60,370

 

 

 

5,272

 

 

 

—

 

(3)

2020

 

October 19, 2021

 

 

40

 

Glasgow, UK

 

Acute care general hospital

 

 

6,818

 

 

 

139,259

 

 

 

—

 

 

 

—

 

 

 

6,818

 

 

 

139,259

 

 

 

146,077

 

 

 

20,948

 

 

 

72,792

 

 

1983

 

January 9, 2020

 

 

40

 

Glasgow, UK

 

Behavioral health facility

 

 

1,512

 

 

 

16,531

 

 

 

—

 

 

 

—

 

 

 

1,512

 

 

 

16,531

 

 

 

18,043

 

 

 

2,016

 

 

 

—

 

(3)

1900, 1980

 

June 25, 2021

 

 

40

 

Gloucester, UK

 

Acute care general hospital

 

 

5,906

 

 

 

64,960

 

 

 

—

 

 

 

—

 

 

 

5,906

 

 

 

64,960

 

 

 

70,866

 

 

 

10,894

 

 

 

—

 

(3)

1990

 

August 16, 2019

 

 

40

 

Godalming, UK

 

Behavioral health facility

 

 

9,903

 

 

 

20,090

 

 

 

—

 

 

 

—

 

 

 

9,903

 

 

 

20,090

 

 

 

29,993

 

 

 

2,621

 

 

 

—

 

(3)

1796, 2007

 

June 25, 2021

 

 

40

 

Great Missenden, UK

 

Acute care general hospital

 

 

12,458

 

 

 

111,313

 

 

 

—

 

 

 

—

 

 

 

12,458

 

 

 

111,313

 

 

 

123,771

 

 

 

16,829

 

 

 

58,207

 

 

1981

 

January 9, 2020

 

 

40

 

Grefath, Germany

 

Rehabilitation hospital

 

 

1,277

 

 

 

3,222

 

 

 

—

 

 

 

—

 

 

 

1,277

 

 

 

3,222

 

 

 

4,499

 

 

 

642

 

 

 

—

 

(3)

1886, 1983

 

August 28, 2018

 

 

40

 

Guildford, UK

 

Acute care general hospital

 

 

7,283

 

 

 

38,556

 

 

 

—

 

 

 

—

 

 

 

7,283

 

 

 

38,556

 

 

 

45,839

 

 

 

5,835

 

 

 

23,155

 

 

1989

 

January 9, 2020

 

 

40

 

Halsall, UK

 

Acute care general hospital

 

 

2,132

 

 

 

32,980

 

 

 

—

 

 

 

—

 

 

 

2,132

 

 

 

32,980

 

 

 

35,112

 

 

 

5,546

 

 

 

—

 

(3)

1986

 

August 16, 2019

 

 

40

 

Harrow, UK

 

Acute care general hospital

 

 

40,647

 

 

 

42,777

 

 

 

—

 

 

 

—

 

 

 

40,647

 

 

 

42,777

 

 

 

83,424

 

 

 

6,505

 

 

 

—

 

(3)

1980

 

January 9, 2020

 

 

40

 

Hartsville, SC

 

Acute care general hospital

 

 

2,050

 

 

 

43,970

 

 

 

—

 

 

 

—

 

 

 

2,050

 

 

 

43,970

 

 

 

46,020

 

 

 

13,211

 

 

 

—

 

(3)

1999

 

August 31, 2015

 

 

34

 

Hassocks, UK

 

Behavioral health facility

 

 

5,805

 

 

 

30,350

 

 

 

—

 

 

 

—

 

 

 

5,805

 

 

 

30,350

 

 

 

36,155

 

 

 

4,198

 

 

 

—

 

(3)

1998

 

June 25, 2021

 

 

40

 

Hastings, PA

 

Acute care general hospital

 

 

603

 

 

 

8,834

 

 

 

—

 

 

 

—

 

 

 

603

 

 

 

8,834

 

 

 

9,437

 

 

 

2,179

 

 

 

—

 

(3)

1924

 

December 17, 2019

 

 

30

 

Hausman, TX

 

Acute care general hospital

 

 

1,500

 

 

 

8,957

 

 

 

—

 

 

 

—

 

 

 

1,500

 

 

 

8,957

 

 

 

10,457

 

 

 

2,856

 

 

 

—

 

(3)

2013

 

March 1, 2013

 

 

40

 

Heidelberg, Germany

 

Rehabilitation hospital

 

 

6,636

 

 

 

37,907

 

 

 

—

 

 

 

—

 

 

 

6,636

 

 

 

37,907

 

 

 

44,543

 

 

 

9,051

 

 

 

—

 

(3)

1885, 1991

 

June 22, 2016

 

 

40

 

Helotes, TX

 

Freestanding ER

 

 

1,900

 

 

 

5,115

 

 

 

—

 

 

 

—

 

 

 

1,900

 

 

 

5,115

 

 

 

7,015

 

 

 

1,258

 

 

 

—

 

(3)

2016

 

March 10, 2016

 

 

40

 

Helsinki, Finland

 

Acute care general hospital

 

 

4,347

 

 

 

71,714

 

 

 

1,164

 

 

 

—

 

 

 

4,347

 

 

 

72,878

 

 

 

77,225

 

 

 

6,896

 

 

 

—

 

 

1992, 2013

 

March 11, 2022

 

 

40

 

Hemel Hempstead, UK

 

Behavioral health facility

 

 

13,220

 

 

 

6,672

 

 

 

—

 

 

 

—

 

 

 

13,220

 

 

 

6,672

 

 

 

19,892

 

 

 

1,048

 

 

 

—

 

(3)

1901, 1990

 

June 25, 2021

 

 

40

 

Hialeah, FL

 

Acute care general hospital

 

 

18,802

 

 

 

105,316

 

 

 

4,784

 

 

 

—

 

 

 

18,802

 

 

 

110,100

 

 

 

128,902

 

 

 

12,422

 

 

 

—

 

 

1950

 

August 1, 2021

 

 

40

 

 

 

 

 

 

 

Initial Costs

 

 

Additions Subsequent
to Acquisition

 

 

Cost at December 31, 2025(1)

 

 

Accumulated

 

 

 

 

 

 

 

 

 

Life on
which
depreciation
in latest
income
statements is

 

Location

 

Type of Property

 

Land

 

 

Buildings

 

 

Improve-
ments

 

 

Carrying
Costs

 

 

Land

 

 

Buildings

 

 

Total

 

 

Depreciation

 

 

Encum-
brances

 

 

Date of
Construction

 

Date
Acquired

 

computed
(Years)

 

 

 

(Dollar amounts in thousands)

 

Hialeah, FL

 

Acute care general hospital

 

 

75,339

 

 

 

222,271

 

 

 

2,564

 

 

 

—

 

 

 

75,339

 

 

 

224,835

 

 

 

300,174

 

 

 

28,114

 

 

 

—

 

 

1969

 

August 1, 2021

 

 

40

 

Highland Hills, OH

 

Behavioral health facility

 

 

3,148

 

 

 

43,891

 

 

 

—

 

 

 

—

 

 

 

3,148

 

 

 

43,891

 

 

 

47,039

 

 

 

5,042

 

 

 

—

 

(3)

2015

 

October 19, 2021

 

 

40

 

Hinckley, UK

 

Behavioral health facility

 

 

2,610

 

 

 

17,786

 

 

 

—

 

 

 

—

 

 

 

2,610

 

 

 

17,786

 

 

 

20,396

 

 

 

2,167

 

 

 

—

 

(3)

1892, 2007

 

June 25, 2021

 

 

40

 

Hollywood, CA

 

Acute care general hospital

 

 

62,916

 

 

 

37,051

 

 

 

—

 

 

 

—

 

 

 

62,916

 

 

 

37,051

 

 

 

99,967

 

 

 

95

 

 

 

—

 

 

1962

 

August 23, 2019

 

 

34

 

Hook, UK

 

Behavioral health facility

 

 

5,732

 

 

 

10,918

 

 

 

—

 

 

 

—

 

 

 

5,732

 

 

 

10,918

 

 

 

16,650

 

 

 

1,447

 

 

 

—

 

(3)

1980

 

June 25, 2021

 

 

40

 

Hoover, AL

 

Freestanding ER

 

 

—

 

 

 

7,581

 

 

 

—

 

 

 

—

 

 

 

—

 

 

 

7,581

 

 

 

7,581

 

 

 

2,361

 

 

 

—

 

(3)

2015

 

May 1, 2015

 

 

34

 

Hoover, AL

 

Freestanding ER

 

 

—

 

 

 

1,034

 

 

 

296

 

 

 

—

 

 

 

—

 

 

 

1,330

 

 

 

1,330

 

 

 

388

 

 

 

—

 

(3)

2015

 

May 1, 2015

 

 

34

 

Hot Springs, AR

 

Acute care general hospital

 

 

5,622

 

 

 

59,432

 

 

 

21,221

 

 

 

—

 

 

 

5,622

 

 

 

80,653

 

 

 

86,275

 

 

 

21,530

 

 

 

—

 

(3)

1985

 

August 31, 2015

 

 

40

 

Houston, TX

 

Acute care general hospital

 

 

3,274

 

 

 

27,324

 

 

 

32,499

 

 

 

—

 

 

 

3,274

 

 

 

59,823

 

 

 

63,097

 

 

 

24,422

 

 

 

—

 

 

1960

 

August 10, 2007

 

 

40

 

Houston, TX

 

Behavioral health facility

 

 

6,063

 

 

 

19,881

 

 

 

2,565

 

 

 

—

 

 

 

6,063

 

 

 

22,446

 

 

 

28,509

 

 

 

2,806

 

 

 

—

 

 

2020

 

October 25, 2019

 

 

40

 

Houston, TX

 

Acute care general hospital

 

 

29,706

 

 

 

101,846

 

 

 

90,935

 

 

 

—

 

 

 

29,706

 

 

 

192,781

 

 

 

222,487

 

 

 

24,195

 

 

 

—

 

 

1940-1950

 

September 29, 2017

 

 

41

 

Houston, TX

 

Freestanding ER

 

 

950

 

 

 

3,996

 

 

 

—

 

 

 

—

 

 

 

950

 

 

 

3,996

 

 

 

4,946

 

 

 

924

 

 

 

—

 

(3)

2016

 

September 26, 2016

 

 

40

 

Huntington Park, CA

 

Acute care general hospital

 

 

3,935

 

 

 

6,103

 

 

 

—

 

 

 

—

 

 

 

3,935

 

 

 

6,103

 

 

 

10,038

 

 

 

829

 

 

 

—

 

(3)

1960-1969

 

July 6, 2021

 

 

40

 

Idaho Falls, ID

 

Acute care general hospital

 

 

1,822

 

 

 

37,467

 

 

 

72,789

 

 

 

—

 

 

 

1,822

 

 

 

110,256

 

 

 

112,078

 

 

 

23,598

 

 

 

—

 

 

2002

 

April 1, 2008

 

 

40

 

Idaho Falls, ID

 

Acute care general hospital

 

 

1,880

 

 

 

108,498

 

 

 

15,146

 

 

 

—

 

 

 

1,880

 

 

 

123,644

 

 

 

125,524

 

 

 

16,083

 

 

 

—

 

(3)

2020

 

December 19, 2017

 

 

40

 

Johnstown, PA

 

Acute care general hospital

 

 

8,877

 

 

 

247,158

 

 

 

—

 

 

 

—

 

 

 

8,877

 

 

 

247,158

 

 

 

256,035

 

 

 

50,152

 

 

 

—

 

(3)

1924

 

December 17, 2019

 

 

30

 

Kansas City, KS

 

Acute care general hospital

 

 

2,351

 

 

 

13,665

 

 

 

—

 

 

 

—

 

 

 

2,351

 

 

 

13,665

 

 

 

16,016

 

 

 

1,946

 

 

 

—

 

(3)

2017

 

June 10, 2019

 

 

50

 

Kansas City, MO

 

Acute care general hospital

 

 

10,497

 

 

 

64,419

 

 

 

—

 

 

 

—

 

 

 

10,497

 

 

 

64,419

 

 

 

74,916

 

 

 

17,920

 

 

 

—

 

 

1978

 

February 13, 2015

 

 

40

 

Katy, TX

 

Freestanding ER

 

 

1,491

 

 

 

2,870

 

 

 

—

 

 

 

—

 

 

 

1,491

 

 

 

2,870

 

 

 

4,361

 

 

 

904

 

 

 

—

 

 

2016

 

October 10, 2016

 

 

40

 

Kuhlungsborn, Germany

 

Rehabilitation hospital

 

 

7,138

 

 

 

18,355

 

 

 

—

 

 

 

—

 

 

 

7,138

 

 

 

18,355

 

 

 

25,493

 

 

 

1,354

 

 

 

—

 

(3)

1998

 

June 1, 2023

 

 

40

 

Kuopio, Finland

 

Acute care general hospital

 

 

1,364

 

 

 

46,129

 

 

 

—

 

 

 

—

 

 

 

1,364

 

 

 

46,129

 

 

 

47,493

 

 

 

4,622

 

 

 

—

 

 

2017

 

March 11, 2022

 

 

29

 

Lafayette, IN

 

Rehabilitation hospital

 

 

800

 

 

 

14,968

 

 

 

(25

)

 

 

—

 

 

 

800

 

 

 

14,943

 

 

 

15,743

 

 

 

4,816

 

 

 

—

 

(3)

2013

 

February 1, 2013

 

 

40

 

Lafayette, IN

 

Behavioral health facility

 

 

2,829

 

 

 

10,795

 

 

 

—

 

 

 

—

 

 

 

2,829

 

 

 

10,795

 

 

 

13,624

 

 

 

1,504

 

 

 

—

 

(3)

2012

 

October 19, 2021

 

 

40

 

Lander, WY

 

Acute care general hospital

 

 

757

 

 

 

42,849

 

 

 

—

 

 

 

—

 

 

 

757

 

 

 

42,849

 

 

 

43,606

 

 

 

6,869

 

 

 

—

 

(3)

1983

 

December 17, 2019

 

 

40

 

Lauderdale Lakes, FL

 

Acute care general hospital

 

 

10,657

 

 

 

150,313

 

 

 

2,168

 

 

 

—

 

 

 

10,657

 

 

 

152,481

 

 

 

163,138

 

 

 

18,902

 

 

 

—

 

 

1975

 

August 1, 2021

 

 

40

 

League City, TX

 

Freestanding ER

 

 

1,244

 

 

 

3,901

 

 

 

—

 

 

 

—

 

 

 

1,244

 

 

 

3,901

 

 

 

5,145

 

 

 

1,024

 

 

 

—

 

 

2015

 

June 19, 2015

 

 

40

 

Leawood, KS

 

Acute care general hospital

 

 

2,513

 

 

 

13,938

 

 

 

—

 

 

 

—

 

 

 

2,513

 

 

 

13,938

 

 

 

16,451

 

 

 

1,972

 

 

 

—

 

(3)

2017

 

June 10, 2019

 

 

50

 

Leeds, UK

 

Behavioral health facility

 

 

2,413

 

 

 

10,078

 

 

 

—

 

 

 

—

 

 

 

2,413

 

 

 

10,078

 

 

 

12,491

 

 

 

1,267

 

 

 

—

 

(3)

1990

 

June 25, 2021

 

 

40

 

Lewiston, ID

 

Acute care general hospital

 

 

5,389

 

 

 

75,435

 

 

 

—

 

 

 

—

 

 

 

5,389

 

 

 

75,435

 

 

 

80,824

 

 

 

22,108

 

 

 

—

 

(3)

1922

 

May 1, 2017

 

 

40

 

London, UK

 

Acute care general hospital

 

 

9,252

 

 

 

60,527

 

 

 

—

 

 

 

—

 

 

 

9,252

 

 

 

60,527

 

 

 

69,779

 

 

 

9,111

 

 

 

40,474

 

 

1984

 

January 9, 2020

 

 

40

 

London, UK

 

Behavioral health facility

 

 

38,386

 

 

 

54,940

 

 

 

—

 

 

 

—

 

 

 

38,386

 

 

 

54,940

 

 

 

93,326

 

 

 

4,554

 

 

 

—

 

(3)

1811, 2014

 

December 9, 2022

 

 

40

 

London, UK

 

Acute care general hospital

 

 

3,477

 

 

 

4,390

 

 

 

—

 

 

 

—

 

 

 

3,477

 

 

 

4,390

 

 

 

7,867

 

 

 

669

 

 

 

—

 

(3)

1987

 

January 9, 2020

 

 

40

 

London, UK

 

Behavioral health facility

 

 

30,627

 

 

 

15,847

 

 

 

—

 

 

 

—

 

 

 

30,627

 

 

 

15,847

 

 

 

46,474

 

 

 

1,497

 

 

 

—

 

(3)

1790, 1992, 2014

 

December 9, 2022

 

 

40

 

London, UK

 

Acute care general hospital

 

 

13,179

 

 

 

86,016

 

 

 

—

 

 

 

—

 

 

 

13,179

 

 

 

86,016

 

 

 

99,195

 

 

 

12,913

 

 

 

44,446

 

 

1977

 

January 9, 2020

 

 

40

 

London, UK

 

Behavioral health facility

 

 

6,521

 

 

 

16,570

 

 

 

—

 

 

 

—

 

 

 

6,521

 

 

 

16,570

 

 

 

23,091

 

 

 

2,051

 

 

 

—

 

(3)

1900, 1960

 

June 25, 2021

 

 

40

 

 

 

 

 

 

 

Initial Costs

 

 

Additions Subsequent
to Acquisition

 

 

Cost at December 31, 2025(1)

 

 

Accumulated

 

 

 

 

 

 

 

 

 

Life on
which
depreciation
in latest
income
statements is

 

Location

 

Type of Property

 

Land

 

 

Buildings

 

 

Improve-
ments

 

 

Carrying
Costs

 

 

Land

 

 

Buildings

 

 

Total

 

 

Depreciation

 

 

Encum-
brances

 

 

Date of
Construction

 

Date
Acquired

 

computed
(Years)

 

 

 

(Dollar amounts in thousands)

 

London, UK

 

Behavioral health facility

 

 

14,617

 

 

 

7,208

 

 

 

—

 

 

 

—

 

 

 

14,617

 

 

 

7,208

 

 

 

21,825

 

 

 

928

 

 

 

—

 

(3)

1992

 

June 25, 2021

 

 

40

 

Los Angeles, CA

 

Acute care general hospital

 

 

12,562

 

 

 

40,164

 

 

 

394

 

 

 

—

 

 

 

12,562

 

 

 

40,558

 

 

 

53,120

 

 

 

4,680

 

 

 

—

 

(3)

1972

 

July 6, 2021

 

 

40

 

Los Angeles, CA

 

Acute care general hospital

 

 

10,579

 

 

 

62,948

 

 

 

—

 

 

 

—

 

 

 

10,579

 

 

 

62,948

 

 

 

73,527

 

 

 

144

 

 

 

—

 

 

1955

 

August 23, 2019

 

 

37

 

Lubbock, TX

 

Rehabilitation hospital

 

 

1,376

 

 

 

28,292

 

 

 

3,648

 

 

 

—

 

 

 

1,376

 

 

 

31,940

 

 

 

33,316

 

 

 

8,342

 

 

 

—

 

(3)

2008

 

June 16, 2015

 

 

40

 

Malaga, SP

 

Acute care general hospital

 

 

796

 

 

 

12,469

 

 

 

—

 

 

 

—

 

 

 

796

 

 

 

12,469

 

 

 

13,265

 

 

 

1,167

 

 

 

—

 

 

2018

 

April 29, 2022

 

 

40

 

Mandeville, LA

 

Freestanding ER

 

 

2,800

 

 

 

5,370

 

 

 

—

 

 

 

—

 

 

 

2,800

 

 

 

5,370

 

 

 

8,170

 

 

 

1,231

 

 

 

—

 

(3)

2016

 

October 28, 2016

 

 

40

 

Marrero, LA

 

Freestanding ER

 

 

1,517

 

 

 

5,801

 

 

 

—

 

 

 

—

 

 

 

1,517

 

 

 

5,801

 

 

 

7,318

 

 

 

1,378

 

 

 

—

 

(3)

2016

 

July 15, 2016

 

 

40

 

McKinney, TX

 

Freestanding ER

 

 

2,441

 

 

 

4,060

 

 

 

—

 

 

 

—

 

 

 

2,441

 

 

 

4,060

 

 

 

6,501

 

 

 

1,421

 

 

 

—

 

 

2015

 

July 31, 2015

 

 

30

 

McKinney, TX

 

Behavioral health facility

 

 

2,934

 

 

 

31,068

 

 

 

—

 

 

 

—

 

 

 

2,934

 

 

 

31,068

 

 

 

34,002

 

 

 

1,399

 

 

 

—

 

(3)

2024

 

October 19, 2021

 

 

40

 

McMinnville, OR

 

Acute care general hospital

 

 

5,000

 

 

 

97,900

 

 

 

—

 

 

 

—

 

 

 

5,000

 

 

 

97,900

 

 

 

102,900

 

 

 

24,113

 

 

 

—

 

(3)

1996

 

August 31, 2015

 

 

41

 

Melton Mowbray, UK

 

Behavioral health facility

 

 

6,035

 

 

 

16,916

 

 

 

—

 

 

 

—

 

 

 

6,035

 

 

 

16,916

 

 

 

22,951

 

 

 

2,177

 

 

 

—

 

(3)

1990

 

June 25, 2021

 

 

40

 

Mesa, AZ

 

Acute care general hospital

 

 

6,140

 

 

 

99,275

 

 

 

4,152

 

 

 

—

 

 

 

6,140

 

 

 

103,427

 

 

 

109,567

 

 

 

32,867

 

 

 

—

 

 

2007

 

September 26, 2013

 

 

40

 

Mesa, AZ

 

Acute care general hospital

 

 

2,604

 

 

 

16,400

 

 

 

—

 

 

 

—

 

 

 

2,604

 

 

 

16,400

 

 

 

19,004

 

 

 

1,556

 

 

 

—

 

 

2019

 

April 18, 2022

 

 

40

 

Meyersdale, PA

 

Acute care general hospital

 

 

390

 

 

 

4,280

 

 

 

—

 

 

 

—

 

 

 

390

 

 

 

4,280

 

 

 

4,670

 

 

 

1,096

 

 

 

—

 

(3)

1960

 

December 17, 2019

 

 

30

 

Miami, FL

 

Acute care general hospital

 

 

44,400

 

 

 

107,203

 

 

 

3,444

 

 

 

—

 

 

 

44,400

 

 

 

110,647

 

 

 

155,047

 

 

 

14,913

 

 

 

—

 

 

1955

 

August 1, 2021

 

 

40

 

Miami, FL

 

Acute care general hospital

 

 

20,430

 

 

 

30,276

 

 

 

10,947

 

 

 

—

 

 

 

20,430

 

 

 

41,223

 

 

 

61,653

 

 

 

3,276

 

 

 

—

 

 

1958, 1962, 1988, 2016

 

April 25, 2022

 

 

40

 

Milton Keynes, UK

 

Acute care general hospital

 

 

5,552

 

 

 

37,956

 

 

 

—

 

 

 

—

 

 

 

5,552

 

 

 

37,956

 

 

 

43,508

 

 

 

5,731

 

 

 

—

 

(3)

1983

 

January 9, 2020

 

 

40

 

Monmouth, UK

 

Behavioral health facility

 

 

16,413

 

 

 

12,227

 

 

 

—

 

 

 

—

 

 

 

16,413

 

 

 

12,227

 

 

 

28,640

 

 

 

1,859

 

 

 

—

 

(3)

2017

 

June 25, 2021

 

 

40

 

Montclair, NJ

 

Acute care general hospital

 

 

7,900

 

 

 

99,640

 

 

 

577

 

 

 

—

 

 

 

8,477

 

 

 

99,640

 

 

 

108,117

 

 

 

29,917

 

 

 

—

 

(3)

1920-2000

 

April 1, 2014

 

 

40

 

New Braunfels, TX

 

Rehabilitation hospital

 

 

1,853

 

 

 

10,622

 

 

 

—

 

 

 

—

 

 

 

1,853

 

 

 

10,622

 

 

 

12,475

 

 

 

1,402

 

 

 

—

 

(3)

2011

 

February 29, 2012

 

 

40

 

New Orleans, LA

 

Freestanding ER

 

 

2,850

 

 

 

6,125

 

 

 

—

 

 

 

—

 

 

 

2,850

 

 

 

6,125

 

 

 

8,975

 

 

 

1,416

 

 

 

—

 

(3)

2016

 

September 23, 2016

 

 

40

 

Newark, NJ

 

Acute care general hospital

 

 

32,957

 

 

 

24,553

 

 

 

—

 

 

 

—

 

 

 

32,957

 

 

 

24,553

 

 

 

57,510

 

 

 

3,294

 

 

 

—

 

 

1919, 1920-2003

 

May 2, 2016

 

 

40

 

Newburgh, IN

 

Behavioral health facility

 

 

1,215

 

 

 

7,212

 

 

 

—

 

 

 

—

 

 

 

1,215

 

 

 

7,212

 

 

 

8,427

 

 

 

908

 

 

 

—

 

(3)

2010

 

October 19, 2021

 

 

40

 

Northland, MO

 

Long term acute care hospital

 

 

834

 

 

 

17,182

 

 

 

—

 

 

 

—

 

 

 

834

 

 

 

17,182

 

 

 

18,016

 

 

 

6,408

 

 

 

—

 

(3)

2007

 

February 14, 2011

 

 

40

 

Norwalk, CA

 

Acute care general hospital

 

 

2,811

 

 

 

5,940

 

 

 

—

 

 

 

—

 

 

 

2,811

 

 

 

5,940

 

 

 

8,751

 

 

 

835

 

 

 

—

 

(3)

1959, 1995

 

July 6, 2021

 

 

40

 

Norwalk, CA

 

Acute care general hospital

 

 

7,946

 

 

 

30,465

 

 

 

7,104

 

 

 

—

 

 

 

7,946

 

 

 

37,569

 

 

 

45,515

 

 

 

4,158

 

 

 

—

 

(3)

1958-1978

 

July 6, 2021

 

 

40

 

Norwalk, CA

 

Acute care general hospital

 

 

6,982

 

 

 

14,308

 

 

 

—

 

 

 

—

 

 

 

6,982

 

 

 

14,308

 

 

 

21,290

 

 

 

36

 

 

 

—

 

 

1954

 

August 23, 2019

 

 

37

 

Norwood, MA

 

Acute care general hospital

 

 

6,860

 

 

 

—

 

 

 

—

 

 

 

—

 

 

 

6,860

 

 

 

—

 

 

 

6,860

 

 

 

—

 

 

 

—

 

 

N/A

 

June 27, 2018

 

 

46

 

Nottingham, UK

 

Acute care general hospital

 

 

5,242

 

 

 

48,637

 

 

 

—

 

 

 

—

 

 

 

5,242

 

 

 

48,637

 

 

 

53,879

 

 

 

7,398

 

 

 

34,690

 

 

1983

 

January 9, 2020

 

 

40

 

Nottingham, UK

 

Behavioral health facility

 

 

10,596

 

 

 

9,483

 

 

 

—

 

 

 

—

 

 

 

10,596

 

 

 

9,483

 

 

 

20,079

 

 

 

1,401

 

 

 

—

 

(3)

2000

 

June 25, 2021

 

 

40

 

Nottingham, UK

 

Behavioral health facility

 

 

10,754

 

 

 

3,436

 

 

 

—

 

 

 

—

 

 

 

10,754

 

 

 

3,436

 

 

 

14,190

 

 

 

432

 

 

 

—

 

(3)

1980

 

June 25, 2021

 

 

40

 

Odessa, TX

 

Acute care general hospital

 

 

6,217

 

 

 

123,518

 

 

 

16,600

 

 

 

—

 

 

 

6,217

 

 

 

140,118

 

 

 

146,335

 

 

 

27,772

 

 

 

—

 

 

1973-2004

 

September 29, 2017

 

 

41

 

Ogden, UT

 

Rehabilitation hospital

 

 

1,759

 

 

 

16,414

 

 

 

—

 

 

 

—

 

 

 

1,759

 

 

 

16,414

 

 

 

18,173

 

 

 

4,846

 

 

 

—

 

(3)

2014

 

March 1, 2014

 

 

40

 

Oklahoma City, OK

 

Behavioral health facility

 

 

3,641

 

 

 

3,047

 

 

 

—

 

 

 

—

 

 

 

3,641

 

 

 

3,047

 

 

 

6,688

 

 

 

647

 

 

 

—

 

(3)

2017

 

October 19, 2021

 

 

40

 

Olathe, KS

 

Behavioral health facility

 

 

6,882

 

 

 

57,056

 

 

 

18,873

 

 

 

—

 

 

 

6,882

 

 

 

75,929

 

 

 

82,811

 

 

 

6,778

 

 

 

—

 

(3)

2015

 

October 19, 2021

 

 

40

 

Olathe, KS

 

Acute care general hospital

 

 

3,485

 

 

 

14,484

 

 

 

—

 

 

 

—

 

 

 

3,485

 

 

 

14,484

 

 

 

17,969

 

 

 

2,071

 

 

 

—

 

 

2018

 

June 10, 2019

 

 

50

 

Orpington, UK

 

Acute care general hospital

 

 

10,942

 

 

 

45,210

 

 

 

—

 

 

 

—

 

 

 

10,942

 

 

 

45,210

 

 

 

56,152

 

 

 

6,846

 

 

 

26,061

 

 

1987

 

January 9, 2020

 

 

40

 

Ottumwa, IA

 

Acute care general hospital

 

 

2,377

 

 

 

48,697

 

 

 

—

 

 

 

—

 

 

 

2,377

 

 

 

48,697

 

 

 

51,074

 

 

 

10,869

 

 

 

—

 

(3)

1950

 

December 17, 2019

 

 

30

 

Oulu, Finland

 

Acute care general hospital

 

 

3,376

 

 

 

47,789

 

 

 

—

 

 

 

—

 

 

 

3,376

 

 

 

47,789

 

 

 

51,165

 

 

 

4,848

 

 

 

—

 

 

2017

 

March 11, 2022

 

 

40

 

Overland Park, KS

 

Acute care general hospital

 

 

2,974

 

 

 

14,405

 

 

 

—

 

 

 

—

 

 

 

2,974

 

 

 

14,405

 

 

 

17,379

 

 

 

2,070

 

 

 

—

 

 

2017

 

June 10, 2019

 

 

50

 

 

 

 

 

 

Initial Costs

 

 

Additions Subsequent
to Acquisition

 

 

Cost at December 31, 2025(1)

 

 

Accumulated

 

 

 

 

 

 

 

 

 

Life on
which
depreciation
in latest
income
statements is

 

Location

 

Type of Property

 

Land

 

 

Buildings

 

 

Improve-
ments

 

 

Carrying
Costs

 

 

Land

 

 

Buildings

 

 

Total

 

 

Depreciation

 

 

Encum-
brances

 

 

Date of
Construction

 

Date
Acquired

 

computed
(Years)

 

 

 

(Dollar amounts in thousands)

 

Overland Park, KS

 

Acute care general hospital

 

 

3,191

 

 

 

14,263

 

 

 

—

 

 

 

—

 

 

 

3,191

 

 

 

14,263

 

 

 

17,454

 

 

 

2,152

 

 

 

—

 

(3)

2019

 

June 10, 2019

 

 

50

 

Overlook, TX

 

Acute care general hospital

 

 

2,452

 

 

 

9,666

 

 

 

7

 

 

 

—

 

 

 

2,452

 

 

 

9,673

 

 

 

12,125

 

 

 

3,112

 

 

 

—

 

(3)

2012

 

February 1, 2013

 

 

40

 

Palestine, TX

 

Acute care general hospital

 

 

1,848

 

 

 

95,257

 

 

 

—

 

 

 

—

 

 

 

1,848

 

 

 

95,257

 

 

 

97,105

 

 

 

14,978

 

 

 

—

 

(3)

1988

 

December 17, 2019

 

 

40

 

Pasco, WA

 

Acute care general hospital

 

 

2,594

 

 

 

13,195

 

 

 

—

 

 

 

—

 

 

 

2,594

 

 

 

13,195

 

 

 

15,789

 

 

 

3,306

 

 

 

—

 

(3)

1920

 

August 31, 2018

 

 

30

 

Pearland, TX

 

Freestanding ER

 

 

1,075

 

 

 

3,577

 

 

 

—

 

 

 

—

 

 

 

1,075

 

 

 

3,577

 

 

 

4,652

 

 

 

1,013

 

 

 

—

 

(3)

2014

 

September 8, 2014

 

 

40

 

Petersburg, VA

 

Rehabilitation hospital

 

 

1,302

 

 

 

9,121

 

 

 

—

 

 

 

—

 

 

 

1,302

 

 

 

9,121

 

 

 

10,423

 

 

 

3,990

 

 

 

—

 

 

2006

 

July 1, 2008

 

 

40

 

Phoenix, AZ

 

Acute care general hospital

 

 

5,773

 

 

 

—

 

 

 

—

 

 

 

—

 

 

 

5,773

 

 

 

—

 

 

 

5,773

 

 

 

—

 

 

 

—

 

 

N/A

 

September 29, 2017

 

 

—

 

Poole, UK

 

Acute care general hospital

 

 

2,461

 

 

 

40,625

 

 

 

—

 

 

 

—

 

 

 

2,461

 

 

 

40,625

 

 

 

43,086

 

 

 

7,102

 

 

 

13,804

 

 

1996

 

April 3, 2019

 

 

40

 

Poplar Bluff, MO

 

Acute care general hospital

 

 

2,659

 

 

 

38,694

 

 

 

—

 

 

 

—

 

 

 

2,659

 

 

 

38,694

 

 

 

41,353

 

 

 

17,125

 

 

 

—

 

(3)

1980

 

April 22, 2008

 

 

40

 

Port Arthur, TX

 

Acute care general hospital

 

 

11,432

 

 

 

76,746

 

 

 

6,877

 

 

 

—

 

 

 

11,432

 

 

 

83,623

 

 

 

95,055

 

 

 

25,305

 

 

 

—

 

 

2005

 

September 26, 2013

 

 

40

 

Port Huron, MI

 

Acute care general hospital

 

 

2,531

 

 

 

14,252

 

 

 

—

 

 

 

—

 

 

 

2,531

 

 

 

14,252

 

 

 

16,783

 

 

 

4,869

 

 

 

—

 

 

1953, 1973-1983

 

December 31, 2015

 

 

30

 

Post Falls, ID

 

Rehabilitation hospital

 

 

417

 

 

 

12,175

 

 

 

1,905

 

 

 

—

 

 

 

767

 

 

 

13,730

 

 

 

14,497

 

 

 

4,128

 

 

 

—

 

(3)

2013

 

December 31, 2013

 

 

40

 

Preston, UK

 

Behavioral health facility

 

 

9,251

 

 

 

33,685

 

 

 

—

 

 

 

—

 

 

 

9,251

 

 

 

33,685

 

 

 

42,936

 

 

 

3,583

 

 

 

—

 

(3)

1850, 2018, 2021

 

June 25, 2021

 

 

40

 

Princes Risborough, UK

 

Acute care general hospital

 

 

2,601

 

 

 

—

 

 

 

—

 

 

 

—

 

 

 

2,601

 

 

 

—

 

 

 

2,601

 

 

 

—

 

 

 

—

 

 

N/A

 

January 9, 2020

 

 

40

 

Raleigh, NC

 

Behavioral health facility

 

 

3,469

 

 

 

27,514

 

 

 

—

 

 

 

—

 

 

 

3,469

 

 

 

27,514

 

 

 

30,983

 

 

 

3,402

 

 

 

—

 

(3)

2018

 

October 19, 2021

 

 

40

 

Reading, UK

 

Acute care general hospital

 

 

36,829

 

 

 

48,872

 

 

 

—

 

 

 

—

 

 

 

36,829

 

 

 

48,872

 

 

 

85,701

 

 

 

8,085

 

 

 

—

 

(3)

1990

 

August 16, 2019

 

 

40

 

Reading, UK

 

Acute care general hospital

 

 

27,515

 

 

 

88,165

 

 

 

—

 

 

 

—

 

 

 

27,515

 

 

 

88,165

 

 

 

115,680

 

 

 

11,241

 

 

 

23,813

 

 

2012

 

December 18, 2020

 

 

40

 

Redding, CA

 

Long term acute care hospital

 

 

1,856

 

 

 

25,586

 

 

 

—

 

 

 

—

 

 

 

1,856

 

 

 

25,586

 

 

 

27,442

 

 

 

77

 

 

 

—

 

 

1991

 

November 17, 2025

 

 

30

 

Remscheid, Germany

 

Rehabilitation hospital

 

 

1,116

 

 

 

2,689

 

 

 

—

 

 

 

—

 

 

 

1,116

 

 

 

2,689

 

 

 

3,805

 

 

 

523

 

 

 

—

 

(3)

1951, 1983

 

August 28, 2018

 

 

40

 

Richmond, TX

 

Behavioral health facility

 

 

5,380

 

 

 

6,155

 

 

 

10,815

 

 

 

—

 

 

 

5,380

 

 

 

16,970

 

 

 

22,350

 

 

 

1,382

 

 

 

—

 

(3)

2014

 

October 19, 2021

 

 

40

 

Richmond, VA

 

Long term acute care hospital

 

 

1,289

 

 

 

10,071

 

 

 

—

 

 

 

—

 

 

 

1,289

 

 

 

10,071

 

 

 

11,360

 

 

 

2,065

 

 

 

—

 

 

1989

 

August 30, 2019

 

 

40

 

Riverton, WY

 

Acute care general hospital

 

 

1,163

 

 

 

29,647

 

 

 

—

 

 

 

—

 

 

 

1,163

 

 

 

29,647

 

 

 

30,810

 

 

 

5,513

 

 

 

—

 

(3)

1983

 

December 17, 2019

 

 

36

 

Roaring Springs, PA

 

Acute care general hospital

 

 

1,446

 

 

 

9,549

 

 

 

—

 

 

 

—

 

 

 

1,446

 

 

 

9,549

 

 

 

10,995

 

 

 

2,432

 

 

 

—

 

(3)

1924

 

December 17, 2019

 

 

30

 

Rochdale, MA

 

Long term acute care hospital

 

 

654

 

 

 

3,368

 

 

 

—

 

 

 

—

 

 

 

654

 

 

 

3,368

 

 

 

4,022

 

 

 

625

 

 

 

—

 

 

1989

 

August 30, 2019

 

 

40

 

Rochdale, MA

 

Acute care general hospital

 

 

67

 

 

 

344

 

 

 

—

 

 

 

—

 

 

 

67

 

 

 

344

 

 

 

411

 

 

 

64

 

 

 

—

 

 

1989

 

August 30, 2019

 

 

40

 

Rochdale, UK

 

Acute care general hospital

 

 

3,786

 

 

 

43,135

 

 

 

—

 

 

 

—

 

 

 

3,786

 

 

 

43,135

 

 

 

46,921

 

 

 

6,530

 

 

 

23,581

 

 

1965

 

January 9, 2020

 

 

40

 

Roeland Park, KS

 

Acute care general hospital

 

 

1,569

 

 

 

15,103

 

 

 

—

 

 

 

—

 

 

 

1,569

 

 

 

15,103

 

 

 

16,672

 

 

 

2,116

 

 

 

—

 

(3)

2018

 

June 10, 2019

 

 

50

 

Romford, UK

 

Behavioral health facility

 

 

5,667

 

 

 

9,278

 

 

 

—

 

 

 

—

 

 

 

5,667

 

 

 

9,278

 

 

 

14,945

 

 

 

1,317

 

 

 

—

 

(3)

1980

 

June 25, 2021

 

 

40

 

Rosenberg, TX

 

Freestanding ER

 

 

1,217

 

 

 

4,505

 

 

 

—

 

 

 

—

 

 

 

1,217

 

 

 

4,505

 

 

 

5,722

 

 

 

1,126

 

 

 

—

 

 

2016

 

January 15, 2016

 

 

40

 

Rowley, UK

 

Acute care general hospital

 

 

3,078

 

 

 

19,371

 

 

 

—

 

 

 

—

 

 

 

3,078

 

 

 

19,371

 

 

 

22,449

 

 

 

3,359

 

 

 

—

 

(3)

1986

 

August 16, 2019

 

 

40

 

Royston, UK

 

Behavioral health facility

 

 

7,127

 

 

 

21,220

 

 

 

—

 

 

 

—

 

 

 

7,127

 

 

 

21,220

 

 

 

28,347

 

 

 

3,007

 

 

 

—

 

(3)

1906, 1970

 

June 25, 2021

 

 

40

 

San Antonio, TX

 

Acute care general hospital

 

 

7,061

 

 

 

10,851

 

 

 

7,982

 

 

 

—

 

 

 

7,061

 

 

 

18,833

 

 

 

25,894

 

 

 

6,730

 

 

 

—

 

 

1978-2002

 

September 29, 2017

 

 

41

 

San Antonio, TX

 

Freestanding ER

 

 

2,988

 

 

 

4,801

 

 

 

—

 

 

 

—

 

 

 

2,988

 

 

 

4,801

 

 

 

7,789

 

 

 

1,090

 

 

 

—

 

(3)

2016

 

December 9, 2016

 

 

40

 

San Antonio, TX

 

Freestanding ER

 

 

351

 

 

 

3,952

 

 

 

—

 

 

 

—

 

 

 

351

 

 

 

3,952

 

 

 

4,303

 

 

 

1,160

 

 

 

—

 

(3)

2014

 

January 1, 2014

 

 

40

 

San Antonio, TX

 

Acute care general hospital

 

 

2,248

 

 

 

5,880

 

 

 

—

 

 

 

—

 

 

 

2,248

 

 

 

5,880

 

 

 

8,128

 

 

 

1,936

 

 

 

—

 

(3)

2012

 

October 2, 2012

 

 

40

 

San Antonio, TX

 

Freestanding ER

 

 

2,310

 

 

 

4,253

 

 

 

—

 

 

 

—

 

 

 

2,310

 

 

 

4,253

 

 

 

6,563

 

 

 

975

 

 

 

—

 

(3)

2016

 

October 27, 2016

 

 

40

 

San Bernardino, CA

 

Acute care general hospital

 

 

2,209

 

 

 

37,498

 

 

 

—

 

 

 

—

 

 

 

2,209

 

 

 

37,498

 

 

 

39,707

 

 

 

6,488

 

 

 

—

 

 

1993

 

August 30, 2019

 

 

40

 

 

 

 

 

 

 

 

 

—

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Initial Costs

 

 

Additions Subsequent
to Acquisition

 

 

Cost at December 31, 2025(1)

 

 

Accumulated

 

 

 

 

 

 

 

 

 

Life on which
depreciation
in latest
income
statements is

 

Location

 

Type of Property

 

Land

 

 

Buildings

 

 

Improve-
ments

 

 

Carrying
Costs

 

 

Land

 

 

Buildings

 

 

Total

 

 

Depreciation

 

 

Encum-
brances

 

 

Date of
Construction

 

Date Acquired

 

computed
(Years)

 

 

 

(Dollar amounts in thousands)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Santa Maria de Feira, PT

 

Acute care general hospital

 

 

1,979

 

 

 

18,981

 

 

 

—

 

 

 

—

 

 

 

1,979

 

 

 

18,981

 

 

 

20,960

 

 

 

2,083

 

 

 

—

 

 

2015

 

October 21, 2021

 

 

40

 

Sharon, PA

 

Acute care general hospital

 

 

6,179

 

 

 

9,066

 

 

 

8,513

 

 

 

—

 

 

 

6,179

 

 

 

17,579

 

 

 

23,758

 

 

 

4,430

 

 

 

—

 

 

1950-1980

 

May 1, 2017

 

 

41

 

Shawnee, KS

 

Acute care general hospital

 

 

3,076

 

 

 

14,945

 

 

 

—

 

 

 

—

 

 

 

3,076

 

 

 

14,945

 

 

 

18,021

 

 

 

2,440

 

 

 

—

 

 

2018

 

June 10, 2019

 

 

50

 

Sheffield, UK

 

Acute care general hospital

 

 

7,000

 

 

 

47,222

 

 

 

—

 

 

 

—

 

 

 

7,000

 

 

 

47,222

 

 

 

54,222

 

 

 

7,188

 

 

 

34,458

 

 

2008

 

January 9, 2020

 

 

40

 

Sherman, TX

 

Acute care general hospital

 

 

3,363

 

 

 

10,931

 

 

 

—

 

 

 

—

 

 

 

3,363

 

 

 

10,931

 

 

 

14,294

 

 

 

4,962

 

 

 

—

 

 

1913, 1960-2010

 

October 31, 2014

 

 

40

 

Southampton, UK

 

Behavioral health facility

 

 

6,821

 

 

 

20,030

 

 

 

—

 

 

 

—

 

 

 

6,821

 

 

 

20,030

 

 

 

26,851

 

 

 

2,792

 

 

 

—

 

(3)

1820, 1985

 

June 25, 2021

 

 

40

 

Spartanburg, SC

 

Rehabilitation hospital

 

 

1,135

 

 

 

15,717

 

 

 

—

 

 

 

—

 

 

 

1,135

 

 

 

15,717

 

 

 

16,852

 

 

 

4,866

 

 

 

—

 

(3)

2013

 

August 1, 2013

 

 

40

 

Stirling, UK

 

Acute care general hospital

 

 

1,116

 

 

 

20,651

 

 

 

—

 

 

 

—

 

 

 

1,116

 

 

 

20,651

 

 

 

21,767

 

 

 

2,428

 

 

 

9,691

 

 

1992

 

July 6, 2021

 

 

40

 

Stockton, CA

 

Rehabilitation hospital

 

 

2,717

 

 

 

50,681

 

 

 

—

 

 

 

—

 

 

 

2,717

 

 

 

50,681

 

 

 

53,398

 

 

 

3,379

 

 

 

—

 

(3)

2021

 

November 23, 2020

 

 

40

 

Surrey, UK

 

Behavioral health facility

 

 

15,926

 

 

 

9,663

 

 

 

—

 

 

 

—

 

 

 

15,926

 

 

 

9,663

 

 

 

25,589

 

 

 

1,007

 

 

 

—

 

(3)

1950, 2014

 

December 9, 2022

 

 

40

 

Swindon, UK

 

Acute care general hospital

 

 

5,639

 

 

 

63,265

 

 

 

—

 

 

 

—

 

 

 

5,639

 

 

 

63,265

 

 

 

68,904

 

 

 

9,546

 

 

 

33,219

 

 

1984

 

January 9, 2020

 

 

40

 

Tadley, UK

 

Behavioral health facility

 

 

22,140

 

 

 

20,174

 

 

 

—

 

 

 

—

 

 

 

22,140

 

 

 

20,174

 

 

 

42,314

 

 

 

2,982

 

 

 

—

 

(3)

2020

 

June 25, 2021

 

 

40

 

Tempe, AZ

 

Acute care general hospital

 

 

6,050

 

 

 

10,986

 

 

 

5,239

 

 

 

—

 

 

 

6,050

 

 

 

16,225

 

 

 

22,275

 

 

 

3,843

 

 

 

—

 

 

1940

 

September 29, 2017

 

 

41

 

Texarkana, TX

 

Acute care general hospital

 

 

14,562

 

 

 

—

 

 

 

—

 

 

 

—

 

 

 

14,562

 

 

 

—

 

 

 

14,562

 

 

 

—

 

 

 

—

 

 

N/A

 

September 29, 2017

 

-

 

The Woodlands, TX

 

Freestanding ER

 

 

1,922

 

 

 

4,524

 

 

 

—

 

 

 

—

 

 

 

1,922

 

 

 

4,524

 

 

 

6,446

 

 

 

1,103

 

 

 

—

 

(3)

2016

 

March 28, 2016

 

 

40

 

Toledo, OH

 

Rehabilitation hospital

 

 

1,103

 

 

 

17,740

 

 

 

—

 

 

 

—

 

 

 

1,103

 

 

 

17,740

 

 

 

18,843

 

 

 

4,324

 

 

 

—

 

(3)

2016

 

April 1, 2016

 

 

40

 

Tomball, TX

 

Long term acute care hospital

 

 

1,299

 

 

 

16,185

 

 

 

—

 

 

 

—

 

 

 

1,299

 

 

 

16,185

 

 

 

17,484

 

 

 

8,684

 

 

 

—

 

 

2005

 

December 21, 2010

 

 

40

 

Torquay, UK

 

Acute care general hospital

 

 

3,155

 

 

 

37,831

 

 

 

—

 

 

 

—

 

 

 

3,155

 

 

 

37,831

 

 

 

40,986

 

 

 

6,177

 

 

 

—

 

(3)

1981

 

August 16, 2019

 

 

40

 

Turku, Finland

 

Acute care general hospital

 

 

1,285

 

 

 

61,920

 

 

 

—

 

 

 

—

 

 

 

1,285

 

 

 

61,920

 

 

 

63,205

 

 

 

6,046

 

 

 

—

 

 

2018

 

March 11, 2022

 

 

40

 

Usk, UK

 

Behavioral health facility

 

 

1,831

 

 

 

32,837

 

 

 

—

 

 

 

—

 

 

 

1,831

 

 

 

32,837

 

 

 

34,668

 

 

 

3,207

 

 

 

—

 

(3)

1770, 1850, 1980

 

June 25, 2021

 

 

40

 

Valencia, SP

 

Acute care general hospital

 

 

11,841

 

 

 

74,006

 

 

 

—

 

 

 

—

 

 

 

11,841

 

 

 

74,006

 

 

 

85,847

 

 

 

8,710

 

 

 

—

 

 

2017

 

December 2, 2021

 

 

40

 

Valencia, SP

 

Acute care general hospital

 

 

27,603

 

 

 

25,848

 

 

 

—

 

 

 

—

 

 

 

27,603

 

 

 

25,848

 

 

 

53,451

 

 

 

1,240

 

 

 

—

 

 

1960, 2024

 

May 6, 2022

 

 

40

 

Vancouver, WA

 

Behavioral health facility

 

 

9,313

 

 

 

12,505

 

 

 

—

 

 

 

—

 

 

 

9,313

 

 

 

12,505

 

 

 

21,818

 

 

 

1,222

 

 

 

—

 

(3)

2018

 

October 19, 2021

 

 

40

 

Van Nuys, CA

 

Behavioral health facility

 

 

8,041

 

 

 

18,436

 

 

 

—

 

 

 

—

 

 

 

8,041

 

 

 

18,436

 

 

 

26,477

 

 

 

48

 

 

 

—

 

 

1958

 

August 23, 2019

 

 

35

 

Viseu, Portugal

 

Acute care general hospital

 

 

2,697

 

 

 

30,733

 

 

 

—

 

 

 

—

 

 

 

2,697

 

 

 

30,733

 

 

 

33,430

 

 

 

5,243

 

 

 

—

 

 

2016

 

November 28, 2019

 

 

37

 

Warren, OH

 

Acute care general hospital

 

 

5,385

 

 

 

47,466

 

 

 

10,492

 

 

 

—

 

 

 

5,385

 

 

 

57,958

 

 

 

63,343

 

 

 

14,060

 

 

 

—

 

 

1982

 

May 1, 2017

 

 

41

 

Warren, OH

 

Rehabilitation hospital

 

 

2,417

 

 

 

15,857

 

 

 

1,737

 

 

 

—

 

 

 

2,417

 

 

 

17,594

 

 

 

20,011

 

 

 

4,367

 

 

 

—

 

 

1922-2000

 

May 1, 2017

 

 

46

 

West Chester, OH

 

Behavioral health facility

 

 

3,670

 

 

 

61,338

 

 

 

—

 

 

 

—

 

 

 

3,670

 

 

 

61,338

 

 

 

65,008

 

 

 

7,058

 

 

 

—

 

(3)

2013

 

October 19, 2021

 

 

40

 

West Midlands, UK

 

Behavioral health facility

 

 

2,035

 

 

 

7,581

 

 

 

—

 

 

 

—

 

 

 

2,035

 

 

 

7,581

 

 

 

9,616

 

 

 

579

 

 

 

—

 

(3)

2013

 

April 14, 2023

 

 

40

 

West Monroe, LA

 

Acute care general hospital

 

 

11,702

 

 

 

69,433

 

 

 

19,116

 

 

 

—

 

 

 

12,254

 

 

 

87,997

 

 

 

100,251

 

 

 

25,540

 

 

 

—

 

 

1962

 

September 26, 2013

 

 

40

 

Wichita, KS

 

Rehabilitation hospital

 

 

1,019

 

 

 

16,881

 

 

 

—

 

 

 

—

 

 

 

1,019

 

 

 

16,881

 

 

 

17,900

 

 

 

8,131

 

 

 

—

 

 

1992

 

April 4, 2008

 

 

40

 

Willenhall, UK

 

Behavioral health facility

 

 

7,715

 

 

 

17,212

 

 

 

—

 

 

 

—

 

 

 

7,715

 

 

 

17,212

 

 

 

24,927

 

 

 

2,094

 

 

 

—

 

(3)

2000

 

June 25, 2021

 

 

40

 

Winchester, UK

 

Acute care general hospital

 

 

6,865

 

 

 

10,877

 

 

 

—

 

 

 

—

 

 

 

6,865

 

 

 

10,877

 

 

 

17,742

 

 

 

1,683

 

 

 

11,033

 

 

1911

 

January 9, 2020

 

 

40

 

Windsor, UK

 

Acute care general hospital

 

 

12,896

 

 

 

110,846

 

 

 

—

 

 

 

—

 

 

 

12,896

 

 

 

110,846

 

 

 

123,742

 

 

 

16,670

 

 

 

—

 

(3)

1955

 

January 9, 2020

 

 

40

 

Woking, UK

 

Behavioral health facility

 

 

7,663

 

 

 

4,954

 

 

 

—

 

 

 

—

 

 

 

7,663

 

 

 

4,954

 

 

 

12,617

 

 

 

683

 

 

 

—

 

(3)

1800, 2020

 

June 25, 2021

 

 

40

 

Worthing, UK

 

Acute care general hospital

 

 

7,108

 

 

 

31,908

 

 

 

—

 

 

 

—

 

 

 

7,108

 

 

 

31,908

 

 

 

39,016

 

 

 

4,827

 

 

 

18,509

 

 

1994

 

January 9, 2020

 

 

40

 

York, UK

 

Behavioral health facility

 

 

3,924

 

 

 

7,137

 

 

 

—

 

 

 

—

 

 

 

3,924

 

 

 

7,137

 

 

 

11,061

 

 

 

549

 

 

 

—

 

(3)

2008

 

April 14, 2023

 

 

40

 

York, UK

 

Behavioral health facility

 

 

22,899

 

 

 

75,966

 

 

 

—

 

 

 

—

 

 

 

22,899

 

 

 

75,966

 

 

 

98,865

 

 

 

9,030

 

 

 

—

 

(3)

1900, 1980

 

June 25, 2021

 

 

40

 

Youngstown, OH

 

Acute care general hospital

 

 

3,555

 

 

 

3,565

 

 

 

488

 

 

 

—

 

 

 

3,555

 

 

 

4,053

 

 

 

7,608

 

 

 

2,823

 

 

 

—

 

 

1929-2003

 

May 1, 2017

 

 

41

 

 

 

 

 

$

1,786,342

 

 

$

8,594,759

 

 

$

421,829

 

 

$

—

 

 

$

1,787,821

 

 

$

9,015,109

 

 

$

10,802,930

 

 

$

1,438,594

 

 

$

850,779

 

 

 

 

 

 

 

 
(1)
The aggregate cost for federal income tax purposes is $12.0 billion.
(2)
Date of construction is based off of best available information, but note that this facility has had multiple updates since initial construction.
(3)
Equity in the legal entity holding this property is pledged as collateral for the 7.000% Senior Secured Notes due 2032 and the 8.500% Senior Secured Notes due 2032.

 

 

 

The changes in total real estate assets (excluding construction in progress, intangible lease assets, investment in financing leases, and mortgage loans) are as follows for the years ended (in thousands):

 

 

 

December 31, 2025

 

 

December 31, 2024

 

 

December 31, 2023

 

 

COST

 

 

 

 

 

 

 

 

 

 

Balance at beginning of period

 

$

10,086,493

 

 

$

11,813,175

 

 

$

12,300,524

 

 

Acquisitions

 

 

73,973

 

 

 

—

 

 

 

143,882

 

 

Transfers from construction in progress

 

 

—

 

 

 

79,385

 

 

 

72,791

 

 

Additions

 

 

42,326

 

 

 

73,523

 

 

 

87,873

 

 

Dispositions

 

 

(249,587

)

 

 

(1,492,320

)

 

 

(874,519

)

 

Impairments

 

 

29,906

 

 

 

(276,572

)

 

 

(67,671

)

 

Other

 

 

819,819

 

(4)

 

(110,698

)

(4)

 

150,295

 

(4)

Balance at end of period

 

$

10,802,930

 

(5)

$

10,086,493

 

(5)

$

11,813,175

 

(5)

 

The changes in accumulated depreciation are as follows for the years ended (in thousands):

 

 

 

December 31, 2025

 

 

December 31, 2024

 

 

December 31, 2023

 

 

ACCUMULATED DEPRECIATION

 

 

 

 

 

 

 

 

 

 

Balance at beginning of period

 

$

1,239,897

 

 

$

1,227,619

 

 

$

1,008,340

 

 

Depreciation

 

 

235,053

 

 

 

242,802

 

 

 

270,816

 

 

Depreciation on disposed property

 

 

(74,103

)

 

 

(220,435

)

 

 

(73,765

)

 

Other

 

 

37,747

 

 

 

(10,089

)

 

 

22,228

 

 

Balance at end of period

 

$

1,438,594

 

 

$

1,239,897

 

(6)

$

1,227,619

 

 

 

(4)
Includes foreign currency fluctuations for all years. In addition, the 2025 column includes approximately $500 million of real estate related to the six California facilities previously operated by Prospect and classified as financing leases.
(5)
Excludes approximately $530 million, $420 million, and $400 million of construction and building improvements in progress reflected in buildings and improvements at December 31, 2025, 2024 and 2023, respectively. Includes $52.2 million of land and building cost reflected in real estate held for sale at December 31, 2024.
(6)
Includes $18.2 million of accumulated depreciation reflected in real estate held for sale at December 31, 2024.
v3.25.4
SCHEDULE IV - MORTGAGE LOANS ON REAL ESTATE
 12 Months Ended
Dec. 31, 2025
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Abstract]  
SCHEDULE IV - MORTGAGE LOANS ON REAL ESTATE

SCHEDULE IV — MORTGAGE LOANS ON REAL ESTATE

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

December 31, 2025

 

Column A

 

Column B

 

 

Column C

 

Column D

 

 

Column E

 

 

Column F

 

 

Column G(1)

 

 

 

Column H

 

Description

 

Interest
Rate

 

 

Final
Maturity
Date

 

Periodic Payment
Terms

 

 

Prior
Liens

 

 

Face
Amount of
Mortgages

 

 

Carrying
Amount of
Mortgages

 

 

 

Principal
Amount of
Loans
Subject to
Delinquent
Principal or
Interest

 

 

 

(Dollar amounts in thousands)

 

Long-term first mortgage loan: (2)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Colombia(3)

 

 

12.23

%

 

2035

 

 

(4

)

 

 

(5

)

 

$

151,692

 

 

$

116,113

 

 

 

 

(7

)

Hill County, TX

 

 

10.00

%

 

2030

 

 

(4

)

 

 

(5

)

 

 

7,598

 

 

 

7,538

 

 

 

 

(7

)

 

 

 

 

 

 

 

 

 

 

 

 

 

$

159,290

 

 

$

123,651

 

 

(6

)

 

 

 

(1)
The aggregate cost for federal income tax purposes is $159.3 million.
(2)
The remaining mortgage loans of the Prospect facilities (with a face value of $99.5 million) are not included as they are part of the ongoing bankruptcy proceedings, carrying amount has been fully reserved, and no remaining payments are expected from these loans.
(3)
Mortgage loans covering three properties.
(4)
Payable in monthly installments of interest plus principal payable in full at maturity.
(5)
There were no prior liens on loans as of December 31, 2025.
(6)
Includes reserves/writedowns of approximately $18 million for Colombia in 2025.
(7)
Mortgage loans were not delinquent with respect to principal or interest, except for interest payments on the Colombia loan.

Changes in mortgage loans (net of allowance for credit loss) for the years ended December 31, 2025, 2024, and 2023 are summarized as follows:

 

 

 

Year Ended December 31,

 

 

 

 

2025

 

 

2024

 

 

2023

 

 

 

 

(Dollar amounts in thousands)

 

 

Balance at beginning of year

 

$

119,912

 

 

$

310,101

 

 

$

364,420

 

 

Additions during year:

 

 

 

 

 

 

 

 

 

 

New mortgage loans and additional advances
   on existing loans

 

 

16,498

 

 

 

100,824

 

 

 

155,223

 

 

Exchange rate fluctuations

 

 

21,722

 

 

 

(17,748

)

 

 

31,530

 

 

 

 

 

158,132

 

 

 

393,177

 

 

 

551,173

 

 

Deductions during year:

 

 

 

 

 

 

 

 

 

 

Collection of principal

 

 

(16,886

)

 

 

(100,000

)

 

 

(241,072

)

(9)

Other

 

 

(17,595

)

(6)

 

(173,265

)

(8)

 

—

 

 

 

 

 

(34,481

)

 

 

(273,265

)

 

 

(241,072

)

 

Balance at end of year

 

$

123,651

 

 

$

119,912

 

 

$

310,101

 

 
(8)
Includes reserves/writedowns of approximately $18 million for Colombia and $155 million for Prospect in 2024.
(9)
Includes a $151 million mortgage loan satisfied in exchange for non-controlling ownership interest in PHP Holdings.
v3.25.4
Summary of Significant Accounting Policies (Policies)
 12 Months Ended
Dec. 31, 2025
Accounting Policies [Abstract]  
Use of Estimates

Use of Estimates: The preparation of our consolidated financial statements in conformity with accounting principles generally accepted in the U.S. requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. We believe the estimates and assumptions underlying our consolidated financial statements at December 31, 2025 are reasonable and supportable based on the information available (particularly as it relates to our assessments of the recoverability of our real estate and the adequacy of our credit loss reserves on loans and financing receivables). Actual results could differ from those estimates.
Principles of Consolidation

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

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

At December 31, 2025, we had loans and/or equity investments in certain VIEs, which may also be tenants of our facilities. 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 December 31, 2025 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

 

 

120,398

 

 

Mortgage and other loans

 

 

120,398

 

 

(1)
Carrying amount only reflects the net book value (which has been reduced by any impairments or negative fair value adjustments) of our loan or equity investment in the VIE.
(2)
Our maximum loss exposure related to loans with VIEs represents our current aggregate net book 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 net book 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 December 31, 2025, 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 short falls).
Investments in Unconsolidated Entities

Investments in Unconsolidated Entities: Investments in entities in which we have the ability to significantly influence (but not control) are accounted for by the equity method. This includes the five investments in unconsolidated real estate joint ventures at December 31, 2025. Under the equity method of accounting, our share of the investee’s earnings or losses are included in the “Earnings (loss) from equity interests” line of our consolidated statements of net income. Except for our joint venture with Primotop Holdings S.à.r.l. (“Primotop”) (for which we handle the accounting of), we have elected to record our share of such investee’s earnings or losses on a lag basis (not to exceed three months). The initial carrying value of investments in unconsolidated entities is based on the amount paid to purchase the interest in the investee entity. Subsequently, our investments are increased/decreased by our share in the investees’ earnings/losses and decreased by cash distributions from our investees. To the extent that our cost basis is different from the basis reflected at the investee entity level, the basis difference is generally amortized over the lives of the related assets and liabilities, and such amortization is included in our share of equity in earnings of the investee.

We evaluate our equity method investments for impairment based upon a comparison of the fair value of the equity method investment to its carrying value, when impairment indicators exist. If we determine a decline in the fair value of an investment in an unconsolidated investee entity below its carrying value is other-than-temporary, an impairment is recorded.

Investments in entities in which we do not control nor do we have the ability to significantly influence and for which there is no readily determinable fair value are accounted for at cost, less any impairment, plus or minus changes resulting from observable price changes in orderly transactions involving the investee. Cash distributions on these types of investments are recorded to either income upon receipt (if a return on investment) or as a reduction of our investment (if the distributions received are in excess of our share of the investee’s earnings). For similar investments but for which there are readily determinable fair values, such investments are measured at fair value, with unrealized gains and losses recorded in income.
Cash and Cash Equivalents

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

Revenue Recognition: Our revenues are primarily from leases and loans. For leases, we follow Accounting Standards Codification (“ASC”) 842, “Leases”, (“ASC 842”). ASC 842 sets out the principles for the recognition, measurement, presentation, and disclosure of leases for both parties to a contract (i.e. lessees and lessors). For lessors, we apply this standard as follows:

Operating Lease Revenue

We receive income from operating leases based on the fixed required rents (base rents) per the lease agreements. Rent revenue from base rents is recorded on the straight-line method, when collectibility of the lease payments is deemed probable, over the terms of the related lease agreements for new leases and the remaining terms of existing leases for those acquired as part of a property

acquisition. The straight-line method records the periodic average amount of base rents earned over the term of a lease, taking into account contractual rent increases over the lease term. The straight-line method typically has the effect of recording more rent revenue from a lease than a tenant is required to pay early in the term of the lease. During the later parts of a lease term, this effect reverses with less rent revenue recorded than a tenant is required to pay. Rent revenue, as recorded on the straight-line method, in our consolidated statements of net income is presented as two amounts: rent billed and straight-line rent. Rent billed revenue is the amount of base rent actually billed to our tenants each period as required by the lease. Straight-line rent revenue is the difference between rent revenue earned based on the straight-line method and the amount recorded as rent billed revenue. We record the difference between rent revenues earned and amounts due per the respective lease agreements, as applicable, as an increase or decrease to straight-line rent receivables.

In instances where collectibility of the lease payments is not deemed probable, rent revenue is constrained to the lower of 1) the revenue that would have been recognized if collection were probable (i.e., straight-line method) and 2) the amount of lease payments received in cash.

Rental payments received prior to their recognition as income are classified as deferred revenue.

Financing Lease Revenue

Under ASC 842, if an acquisition and subsequent lease of a property back to the seller does not meet the definition of a sale, we must account for the transaction as a financing lease with income recognized using the imputed interest method.

Another type of financing lease is a direct financing lease (“DFL”). For leases accounted for as DFLs, the future minimum lease payments are recorded as a receivable at lease inception, while, the difference between the future minimum lease payments and the estimated residual values less the cost of the properties is recorded as unearned income. Unearned income is deferred and amortized to income over the lease term to provide a constant yield when collectability of the lease payments is reasonably assured. Investments in DFLs are presented net of unearned income.

Other Leasing Revenue

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

We also receive additional rent (contingent rent) under some leases based on increases in the consumer price index (“CPI”) (or similar index outside the U.S.) or when CPI exceeds the annual minimum percentage increase as stipulated in the lease. Contingent rents are recorded as rent billed revenue in the period earned.

Tenant payments for ground leases along with other operating expenses, such as property taxes and insurance, that are paid directly by us and reimbursed by our tenants are presented on a gross basis with the related revenues recorded in “Interest and other income” and the related expenses in “Property-related” in our consolidated statements of net income. All payments of other operating expenses made directly by the tenant to the applicable government or appropriate third-party vendor are recorded on a net basis.

Interest Revenue

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

Other Revenue

Commitment fees received on operating leases for development and leasing services are initially recorded as deferred revenue and recognized as income over the initial term of a lease on the straight-line method. Commitment and origination fees from lending services are also recorded as deferred revenue initially and recognized as income over the life of the loan using the interest method.
Acquired Real Estate Purchase Price Allocation

Acquired Real Estate Purchase Price Allocation: We account for acquisitions of real estate under asset acquisition accounting rules. Under this accounting standard, we allocate the purchase price (including any third-party transaction costs directly related to the acquisition) of acquired properties to tangible and identified intangible assets acquired and liabilities assumed (if any) based on their

relative fair values. In making estimates of fair values for purposes of allocating purchase prices of acquired real estate, we may utilize a number of sources, from time-to-time, including available real estate broker data, independent appraisals that may be obtained in connection with the acquisition, internal data from previous acquisitions or developments, and other market data, including market comparables for significant assumptions such as market rents, capitalization, and discount rates. We also consider information obtained about each property as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the tangible and intangible assets acquired.

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

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

We amortize the value of our lease intangible assets to expense over the term of the respective leases. If a lease is terminated early, the unamortized portion of the lease intangibles are charged to expense. This amortization expense is included in the "Real estate depreciation and amortization" line of our consolidated statements of net income.

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

Real Estate and Depreciation: Real estate, consisting of land, buildings and improvements, is maintained at cost. Although typically paid by our tenants, any expenditure for ordinary maintenance and repairs that we pay are expensed to operations as incurred. Significant renovations and improvements, which improve and/or extend the useful life of the asset, are capitalized and depreciated over their estimated useful lives. We review real estate investments for impairment when events and circumstances indicate that the assets may not be recoverable. We analyze recoverability by comparing the carrying value of the real estate assets to a probability-weighted set of estimated undiscounted cash flows to be generated by those assets, including an estimated liquidation amount, during the expected holding periods. Assumptions used in determining undiscounted cash flows may include, but are not limited to, market rental rates, capitalization rates, and holding periods. If the recoverability analysis indicates that the carrying value of the real estate asset is greater than the expected future undiscounted cash flows, impairment losses are measured as the difference between carrying value and fair value of the assets. Future cash flows are discounted when determining fair value of an asset. Estimated future cash flows used in such analysis are based on our plans for the real estate asset and our view of market economic conditions. Assumptions used in determining fair value may include, but are not limited to, market rental rates, discount rates, and capitalization rates.

When a real estate investment is designated as held for sale, we cease recording depreciation expense and adjust the assets’ value to the lower of its carrying value or fair value, less cost of disposal. Fair value is typically based on estimated cash flows discounted at a risk-adjusted rate of interest. We classify real estate assets as held for sale when we have commenced an active program to sell the assets, and in the opinion of management, it is probable the asset will be sold within the next 12 months.

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

underlying property ready for its intended use have been initiated. We stop the capitalization of costs when the property is substantially complete and ready for its intended use.

Depreciation is calculated on the straight-line method over the estimated useful lives of the related real estate and other assets. Our weighted-average useful lives at December 31, 2025 are as follows:

 

Buildings and improvements

 

38.6 years

Lease intangibles

 

28.2 years

Leasehold improvements

 

14.3 years

Furniture, equipment, and other

 

5.0 years
Losses from Rent Receivables

Credit Losses:

Losses from Rent Receivables: For our leases, we review tenant provided financial data and monitor the performance of our tenants in areas generally consisting of: admission levels and surgery/procedure volumes by type; current operating margins; ratio of our tenant's operating margins both to facility rent and to facility rent plus other fixed costs; trends in revenue, cash collections, patient mix; and the effect of evolving healthcare regulations, adverse economic and political conditions, such as inflation and interest rates, and other events ongoing on a tenant's profitability and liquidity.

Operating Lease Receivables: We utilize the information above along with the tenant’s payment and default history in evaluating (on a lease-by-lease basis) whether or not lease payments are deemed probable of collection. As noted earlier, if not deemed probable of collection, rent revenue, under lease accounting rules, is constrained to the lesser of 1) the revenue that would have been recognized if collection were probable (i.e., straight-line method) and 2) the amount of lease payments received in cash.

Financing Lease Receivables: We apply a forward-looking “expected credit loss” model to all of our financing receivables, including financing leases and loans. To do this, we group our financial instruments into two primary pools of similar credit risk: secured and unsecured. The secured instruments include our investments in financing receivables as all are secured by the underlying real estate, among other collateral. Within the two primary pools, we further group our instruments into sub-pools based on several tenant/borrower characteristics, including years of experience in the healthcare industry and in a particular market or region and overall capitalization. We then determine a credit loss percentage per pool based on our history over a period of time that closely matches the remaining terms of the financial instruments being analyzed and adjust as needed for current trends or unusual circumstances. We apply these credit loss percentages to the book value of the related instruments to establish a credit loss reserve on our financing lease receivables and such credit loss reserve (including the underlying assumptions) is reviewed and adjusted quarterly. If a financing receivable is under performing and is deemed uncollectible based on the lessee’s overall financial condition, we will adjust the credit loss reserve based on the fair value of the underlying collateral.

We made the accounting policy election to exclude interest receivables from the credit loss reserve model. Instead, such receivables are impaired and an allowance recorded when it is deemed probable that we will be unable to collect all amounts due. The need for an allowance is based upon our assessment of the lessee’s overall financial condition, economic resources and payment record, the prospects for support from any financially responsible guarantors, and, if appropriate, the realizable value of any collateral. Financing leases are placed on non-accrual status when we determine that the collectability of contractual amounts is not reasonably assured. If on non-accrual status, we generally account for the financing lease on a cash basis, in which income is recognized only upon receipt of cash.
Loans

Loans: Loans consist of mortgage loans, working capital loans, and other loans. Mortgage loans are collateralized by interests in real property. Working capital and other loans are typically collateralized by interests in receivables, personal property, and corporate and individual guarantees. We record loans at cost. Like our financing lease receivables, we establish credit loss reserves on all outstanding loans based on historical credit losses of similar instruments. Such credit loss reserves, including the underlying assumptions, are reviewed and adjusted quarterly. If a loan’s performance worsens and foreclosure is deemed probable for our collateral-based loans (after considering the borrower’s overall financial condition as described above for leases), we will adjust the allowance for expected credit losses based on the current fair value of such collateral at the time the loan is deemed uncollectible. If the loan is not collateralized, the loan will be reserved for/written-off once it is determined that such loan is no longer collectible.

Interest receivables on loans are excluded from the forward looking credit loss reserve model; however, an allowance is recorded when it is deemed probable that we will be unable to collect all amounts due. Loans are placed on non-accrual status when we determined that the collectibility of contractual amounts is not reasonably assured. If on non-accrual status, we generally account for the loan on the cash basis, in which income is recognized only upon receipt of cash.

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

 

 

 

December 31, 2025

 

 

December 31, 2024

 

Balance at beginning of the year

 

$

511,473

 

 

$

96,001

 

Provision for credit loss, net

 

 

168,186

 

 

 

1,241,020

 

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

 

 

(126,362

)

 

 

(825,548

)

Balance at end of year

 

$

553,297

 

 

$

511,473

 
Earnings Per Share/Units

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

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

Income Taxes: We conduct our business as a REIT under Sections 856 through 860 of the Internal Revenue Code of 1986, as amended (“the Code”). To qualify as a REIT, we must meet certain organizational and operational requirements, including a requirement to distribute to stockholders at least 90% of our REIT’s ordinary taxable income. As a REIT, we generally pay little U.S. federal and state income tax because of the dividends paid deduction that we are allowed to take. If we fail to qualify as a REIT in any taxable year, we will then be subject to U.S. federal income taxes on our taxable income at regular corporate rates and will not be permitted to qualify for treatment as a REIT for U.S. federal income tax purposes for four years following the year during which qualification is lost, unless the Internal Revenue Service grants us relief under certain statutory provisions. Such an event could materially adversely affect our net income and net cash available for distribution to stockholders. However, we intend to operate in such a manner so that we will remain qualified as a REIT for U.S. federal income tax purposes.

Our financial statements include the operations of TRS entities. None of our TRS entities are entitled to a dividends paid deduction and are subject to U.S. federal, state, and local income taxes. Our TRS entities are authorized to provide property development, leasing, and management services for third-party owned properties, and we will make non-mortgage loans to and/or investments in our lessees through these entities.

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

The calculation of our income taxes involves dealing with uncertainties in the application of complex tax laws and regulations in a multitude of jurisdictions across our global operations. An income tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, on the basis of technical merits. However, if a more likely than not position cannot be reached, we record a liability as an offset to the tax benefit and adjust the liabilities when our judgment changes as a result of the evaluation of new information not previously available. Because of the complexity of some of these uncertainties, the ultimate resolution may result in a payment that is materially different from our current estimate of the uncertain tax position liabilities. These differences will be reflected as increases or decreases to income tax expense in the period in which new information is available.
Stock-Based Compensation

Stock-Based Compensation: We adopted the 2019 Equity Incentive Plan (the “Equity Incentive Plan”) during the second quarter of 2019, which was amended during the second quarter of 2022. Equity awards of restricted stock with service conditions are valued at the average stock price per share on the date of grant and are amortized to compensation expense over the service periods (typically three years), using the straight-line method. Equity awards that contain market conditions are valued on the grant date using a Monte Carlo valuation model and are amortized to compensation expense over the derived service periods, which correspond to the periods over which we estimate the awards will be earned, which generally range from three to five years, using the straight-line method.

Equity awards with performance conditions are valued at the average stock price per share on the date of grant and are amortized using the straight-line method over the service period, adjusted for the probability of achieving the performance conditions. In 2024 and 2025, certain market-based restricted stock units ("RSUs") were issued with cash-settlement features. These liability-type awards are adjusted to fair value (using a Monte Carlo valuation model) on a quarterly basis and amortized over the derived service period, which is also adjusted on a quarterly basis. Forfeitures of stock-based awards are recognized as they occur.
Deferred Costs

Deferred Costs: Costs incurred that directly relate to the offerings of stock are deferred and netted against proceeds received from the offering. Leasing commissions and other third-party leasing costs that would not have been incurred if the lease was not obtained are capitalized as deferred leasing costs and amortized on the straight-line method over the terms of the related lease agreements. Costs identifiable with loans made to borrowers are capitalized and recognized as a reduction in interest income over the life of the loan.
Deferred Financing Costs

Deferred Financing Costs: We generally capitalize financing costs incurred in connection with new financings and refinancings of debt. These costs are amortized over the lives of the related debt as an addition to interest expense. For debt with defined principal re-payment terms, the deferred costs are amortized to produce a constant effective yield on the debt (interest method) and are included within “Debt, net” on our consolidated balance sheets. For debt without defined principal repayment terms, such as our revolving credit facility, the deferred costs are amortized on the straight-line method over the term of the debt and are included as a component of “Other assets” on our consolidated balance sheets.
Foreign Currency Translation and Transactions

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

Certain of our U.S. subsidiaries will enter into short-term and long-term transactions denominated in a foreign currency from time-to-time. Gains or losses resulting from these foreign currency transactions are revalued into U.S. dollars at the rates of exchange prevailing at the dates of the transactions. The effects of revaluation gains or losses on our short-term transactions are included in other income (expense) in the consolidated statements of income, while the revaluation effects on our long-term investments are recorded in accumulated other comprehensive income (loss) on our consolidated balance sheets.
Derivative Financial Investments and Hedging Activities

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

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

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

reflect our market assumptions. This hierarchy requires the use of observable market data when available. These inputs have created the following fair value hierarchy:

•
Level 1 — quoted prices for identical instruments in active markets;
•
Level 2 — quoted prices for similar instruments in active markets; quoted prices for identical or similar instruments in markets that are not active; and model-derived valuations in which significant inputs and significant value drivers are observable in active markets; and
•
Level 3 — fair value measurements derived from valuation techniques in which one or more significant inputs or significant value drivers are unobservable.

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

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

Fair Value Option Election: For our equity investment in the international joint venture and PHP Holdings (which we sold on July 1, 2025), along with any related investments such as loans (see Note 10 for more details), 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. We have not made a similar election for other investments that exist at December 31, 2025.
Leases (Lessee)

Leases (Lessee)

Pursuant to ASC 842, we are required to apply a dual approach, classifying leases (in which we are the lessee) as either financing or operating leases based on the principle of whether or not the lease is effectively a financed purchase. This classification determines whether lease expense is recognized based on an effective interest method (for finance leases) or on a straight-line basis (for operating leases) over the term of the lease. We record a right-of-use asset and a lease liability for all material leases with a term greater than 12 months regardless of their classification. Leases with a term of 12 months or less are off balance sheet with lease expense recognized on a straight-line basis over the lease term.
Segment Reporting

Segment Reporting

In November 2023, the Financial Accounting Standards Board ("FASB") issued ASU 2023-07, "Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures" ("ASU 2023-07") to improve reportable segment disclosure requirements. We adopted this guidance in the fourth quarter of 2024 and have included the required disclosures within Note 13 - Segment Disclosures.
Reclassification

Reclassifications: Certain amounts in the consolidated financial statements for prior periods have been reclassified to conform to the current period presentation.

Recent Accounting Developments

Recent Accounting Developments

Disaggregation of Income Statement Expenses

In November 2024, the 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. ASU 2024-03 is effective for annual periods beginning after December 15, 2026. We are currently evaluating the potential impact of the adoption of this standard on our consolidated financial statements.
v3.25.4
Summary of Significant Accounting Policies (Tables)
 12 Months Ended
Dec. 31, 2025
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 December 31, 2025 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

 

 

120,398

 

 

Mortgage and other loans

 

 

120,398

 

 

(1)
Carrying amount only reflects the net book value (which has been reduced by any impairments or negative fair value adjustments) of our loan or equity investment in the VIE.
(2)
Our maximum loss exposure related to loans with VIEs represents our current aggregate net book 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 net book values of such investments plus any other related assets (such as rent receivables), less any liabilities.
Estimated Useful Lives of Related Real Estate and Other Assets

Depreciation is calculated on the straight-line method over the estimated useful lives of the related real estate and other assets. Our weighted-average useful lives at December 31, 2025 are as follows:

 

Buildings and improvements

 

38.6 years

Lease intangibles

 

28.2 years

Leasehold improvements

 

14.3 years

Furniture, equipment, and other

 

5.0 years
Summary of Credit Loss Reserves

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

 

 

 

December 31, 2025

 

 

December 31, 2024

 

Balance at beginning of the year

 

$

511,473

 

 

$

96,001

 

Provision for credit loss, net

 

 

168,186

 

 

 

1,241,020

 

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

 

 

(126,362

)

 

 

(825,548

)

Balance at end of year

 

$

553,297

 

 

$

511,473

 
v3.25.4
Real Estate and Other Activities (Tables)
 12 Months Ended
Dec. 31, 2025
Real Estate [Abstract]  
Net Assets Acquired

For the years ended December 31, 2025, 2024, and 2023, we acquired or invested in the following net assets (in thousands):

 

 

2025

 

 

2024

 

 

2023

 

Land and land improvements

 

$

25,231

 

 

$

—

 

 

$

28,916

 

Buildings

 

 

48,742

 

 

 

—

 

 

 

114,966

 

Intangible lease assets — subject to amortization
   (weighted-average useful life of 19.9 years in 2025 and 24.8 years in 2023)

 

 

5,101

 

 

 

—

 

 

 

16,305

 

Investments in unconsolidated real estate joint ventures

 

 

63,015

 

 

 

107,908

 

 

 

—

 

Investments in unconsolidated operating entities

 

 

—

 

 

 

—

 

 

 

50,000

 

Other loans

 

 

—

 

 

 

—

 

 

 

25,000

 

Liabilities assumed

 

 

—

 

 

 

(2,290

)

 

 

—

 

 

$

142,089

 

 

$

105,618

 

 

$

235,187

 

Loans repaid(1)

 

 

—

 

 

 

—

 

 

 

(22,900

)

Total net assets acquired

 

$

142,089

 

 

$

105,618

 

 

$

212,287

 

 

(1)
The 2023 column includes a $23 million mortgage loan that was converted to fee simple ownership of one property as described under the Lifepoint Transaction below.
Summary of Status on Current Development and Capital Addition Projects

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

 

Property

 

Commitment

 

 

Costs
Paid as of
December 31, 2025

 

 

Cost Remaining

 

IMED Hospitales ("IMED") (Spain)

 

$

67,054

 

 

$

39,954

 

 

$

27,100

 

Healthcare Systems of America (Florida)

 

 

43,500

 

 

 

2,064

 

 

 

41,436

 

IMED (Spain)

 

 

43,495

 

 

 

39,797

 

 

 

3,698

 

Lifepoint Behavioral (Arizona)

 

 

10,659

 

 

 

8,281

 

 

 

2,378

 

Other (Various)

 

 

554

 

 

 

210

 

 

 

344

 

 

$

165,262

 

 

$

90,306

 

 

$

74,956

 
Amortization Expense from Existing Lease Intangible Assets

We recorded amortization expense related to intangible lease assets of $30.4 million, $205.6 million (including $170 million for accelerating the amortization of the in-place lease intangibles associated with two master leases, including the Steward master lease that was terminated effective September 18, 2024), and $332.5 million (including $286 million for accelerating the amortization of the in-place lease intangibles related to re-leasing the Utah properties to CommonSpirit as described in this same Note 3), in 2025, 2024, and 2023, respectively, and expect to recognize amortization expense from existing lease intangible assets as follows (amounts in thousands):

 

For the Year Ended December 31:

 

 

 

2026

 

$

32,165

 

2027

 

 

31,847

 

2028

 

 

31,684

 

2029

 

 

29,840

 

2030

 

 

29,173

 
Summary of Total Future Contractual Minimum Lease Payments to be Received

The following table summarizes total future contractual minimum lease payments, excluding operating expense reimbursements, tenant recoveries, and other lease-related adjustments to revenue (i.e., straight-line rents, deferred revenues, or reserves/write-offs), from tenants under noncancelable leases as of December 31, 2025 (amounts in thousands):

 

 

 

Total Under
Operating Leases

 

 

Total Under
Financing Leases

 

 

Total

 

2026

 

$

842,559

 

 

$

34,726

 

 

$

877,285

 

2027

 

 

933,571

 

 

 

35,477

 

 

 

969,048

 

2028

 

 

942,705

 

 

 

36,243

 

 

 

978,948

 

2029

 

 

946,839

 

 

 

37,025

 

 

 

983,864

 

2030

 

 

952,310

 

 

 

37,822

 

 

 

990,132

 

Thereafter

 

 

20,829,144

 

 

 

840,542

 

 

 

21,669,686

 

 

$

25,447,128

 

 

$

1,021,835

 

 

$

26,468,963

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

 

 

 

As of December 31, 2025

 

 

As of December 31, 2024

 

Minimum lease payments receivable

 

$

570,150

 

 

$

591,142

 

Estimated unguaranteed residual values

 

 

203,818

 

 

 

203,818

 

Less: Unearned income and allowance for credit loss

 

 

(523,746

)

 

 

(547,770

)

Net investment in direct financing leases

 

 

250,222

 

 

 

247,190

 

Other financing leases (net of allowance for credit loss)

 

 

171,462

 

 

 

810,580

 

Total investment in financing leases

 

$

421,684

 

 

$

1,057,770

 
Schedule of Real Estate and Other Impairment Charges, Net

Due to the events discussed above, we recorded various impairment charges during 2024 and 2023, which included the following (in millions):

 

 

For the Years Ended December 31,

 

 

 

Description

 

2024

 

 

2023

 

 

Income Statement
Classification

Reserve for unpaid rent and interest and straight-line
   rent receivables

 

$

—

 

 

$

413

 

 

Total revenues

Working capital and other loans(1)

 

 

787

 

 

 

—

 

 

Real estate and other
impairment charges, net

Investment in Massachusetts partnership(2)

 

 

445

 

 

 

30

 

 

Earnings (loss) from
equity interests

Real estate(2)

 

 

277

 

 

 

100

 

 

Real estate and other
impairment charges, net

Equity investment and other(1)

 

 

54

 

 

 

171

 

 

Real estate and other
impairment charges, net

Total

 

$

1,563

 

 

$

714

 

 

 
(1)
For our non-real estate investments in Steward, we compared our carrying value of all such investments to the fair value of the underlying collateral, which had no value after the global settlement and our release of claims against Steward as discussed above.
(2)
The three Space Coast properties and certain excess properties previously leased to Steward were deemed held for sale in the 2024 third quarter. We recognized a real estate impairment charge of approximately $180 million to adjust our net book value to align with fair value less cost to sell based on expected proceeds, including from a binding agreement for the Space Coast properties. For the other real estate held for use, we made a comparison of the projected undiscounted future cash flows with the net book value of each asset. For those properties where the carrying value was deemed not recoverable, we recorded an impairment charge to reduce the carrying value to its estimated fair value. For the real estate in the Massachusetts partnership, there was no fair value as we transitioned those properties to the mortgage lender to satisfy the mortgage debt. For the remaining properties (less than 10 in total in 2024 and 2023), we, along with assistance from a third-party, independent valuation firm, estimated fair value using 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 sale prices of similar properties. For the income approach, we divided the expected operating income (rent revenue less expenses, if any) from the property by a market capitalization rate (range from 8% to 10%).
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 December 31, 2025

 

 

As of December 31, 2024

 

Swiss Medical Network

 

70%

 

$

611,347

 

 

$

483,770

 

MEDIAN

 

50%

 

 

486,695

 

 

 

431,964

 

CommonSpirit (Utah partnership)

 

25%

 

 

162,278

 

 

 

113,202

 

Policlinico di Monza

 

50%

 

 

86,091

 

 

 

77,592

 

HM Hospitales

 

45%

 

 

53,366

 

 

 

49,869

 

Total

 

 

 

$

1,399,777

 

 

$

1,156,397

 

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

 

Operator

 

As of December 31,
2025

 

 

As of December 31,
2024

 

Swiss Medical Network

 

$

197,497

 

 

$

172,453

 

Aevis Victoria SA ("Aevis")

 

 

64,859

 

 

 

63,409

 

Priory

 

 

43,913

 

 

 

38,739

 

Aspris Children's Services ("Aspris")

 

 

15,910

 

 

 

15,950

 

PHP Holdings

 

 

—

 

 

 

149,027

 

Total

 

$

322,179

 

 

$

439,578

 
Summary of Financial Information on Combined Basis for Our Investments in Unconsolidated Real Estate Joint Ventures

The following tables present summary financial information on a combined basis for our investments in unconsolidated real estate joint ventures (amounts in thousands):

 

 

 

For the Year Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

Revenue

 

$

357,823

 

 

$

348,404

 

 

$

315,108

 

Net income (loss)

 

$

313,593

 

 

$

(739,393

)

 

$

14,701

 

 

 

 

As of December 31,

 

 

 

2025

 

 

2024

 

Assets

 

$

5,614,938

 

 

$

4,872,918

 

Liabilities

 

$

2,831,599

 

 

$

2,599,078

 

The summary above by year reflects the financial information of all five of our current investments, except for the Utah Partnership that was formed in April 2024 with reporting starting in the 2024 third quarter. In addition, we have included financial information for the Macquarie partnership in 2023 and through the 2024 second quarter - see discussion under "Leasing Operations (Lessor)" in this same Note 3 for more details on this investment and its conclusion.
Schedule of Concentrations of Credit Risk See below for our concentration details (dollars in thousands):

Total Assets by Operator

 

 

 

As of December 31, 2025

 

 

As of December 31, 2024

 

Operators

 

Total Assets (1)

 

 

Percentage of
Total Assets

 

 

Total Assets (1)

 

 

Percentage of
Total Assets

 

Circle

 

$

2,121,848

 

 

 

14.1

%

 

$

2,026,778

 

 

 

14.2

%

Priory

 

 

1,301,888

 

 

 

8.7

%

 

 

1,233,462

 

 

 

8.6

%

Healthcare Systems of America

 

 

1,200,996

 

 

 

8.0

%

 

 

1,187,006

 

 

 

8.3

%

Swiss Medical Network

 

 

873,703

 

 

 

5.8

%

 

 

719,632

 

 

 

5.1

%

Lifepoint Behavioral

 

 

809,492

 

 

 

5.4

%

 

 

813,584

 

 

 

5.7

%

Other operators

 

 

6,688,287

 

 

 

44.6

%

 

 

6,624,256

 

 

 

46.3

%

Other assets

 

 

2,005,561

 

 

 

13.4

%

 

 

1,689,876

 

 

 

11.8

%

Total

 

$

15,001,775

 

 

 

100.0

%

 

$

14,294,594

 

 

 

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 December 31, 2025

 

 

As of December 31, 2024

 

U.S. States and Other Countries

 

Total Assets

 

 

Percentage of
Total Assets

 

 

Total Assets

 

 

Percentage of
Total Assets

 

Texas

 

$

1,427,391

 

 

 

9.5

%

 

$

1,394,296

 

 

 

9.8

%

California

 

 

977,890

 

 

 

6.5

%

 

 

935,470

 

 

 

6.4

%

Florida

 

 

834,940

 

 

 

5.6

%

 

 

840,876

 

 

 

5.9

%

Ohio

 

 

330,189

 

 

 

2.2

%

 

 

327,577

 

 

 

2.3

%

Arizona

 

 

328,873

 

 

 

2.2

%

 

 

379,801

 

 

 

2.7

%

All other states

 

 

2,480,182

 

 

 

16.5

%

 

 

2,636,587

 

 

 

18.5

%

Other domestic assets

 

 

1,072,900

 

 

 

7.2

%

 

 

951,486

 

 

 

6.6

%

Total U.S.

 

$

7,452,365

 

 

 

49.7

%

 

$

7,466,093

 

 

 

52.2

%

United Kingdom

 

$

4,184,188

 

 

 

27.9

%

 

$

3,985,672

 

 

 

27.9

%

Switzerland

 

 

873,703

 

 

 

5.8

%

 

 

719,632

 

 

 

5.0

%

Germany

 

 

751,806

 

 

 

5.0

%

 

 

672,343

 

 

 

4.7

%

Spain

 

 

302,323

 

 

 

2.0

%

 

 

247,996

 

 

 

1.7

%

Finland

 

 

220,813

 

 

 

1.5

%

 

 

199,721

 

 

 

1.4

%

All other countries

 

 

283,916

 

 

 

1.9

%

 

 

264,747

 

 

 

1.9

%

Other international assets

 

 

932,661

 

 

 

6.2

%

 

 

738,390

 

 

 

5.2

%

Total international

 

$

7,549,410

 

 

 

50.3

%

 

$

6,828,501

 

 

 

47.8

%

Grand total

 

$

15,001,775

 

 

 

100.0

%

 

$

14,294,594

 

 

 

100.0

%

Total Assets by Facility Type (1)

 

 

 

As of December 31, 2025

 

 

As of December 31, 2024

 

Facility Types

 

Total Assets

 

 

Percentage of
Total Assets

 

 

Total Assets

 

 

Percentage of
Total Assets

 

General acute care hospitals

 

$

8,769,909

 

 

 

58.5

%

 

$

8,493,331

 

 

 

59.4

%

Behavioral health facilities

 

 

2,445,418

 

 

 

16.3

%

 

 

2,376,460

 

 

 

16.7

%

Post acute care facilities

 

 

1,671,616

 

 

 

11.1

%

 

 

1,617,596

 

 

 

11.3

%

Freestanding ER/urgent care facilities

 

 

109,271

 

 

 

0.7

%

 

 

117,331

 

 

 

0.8

%

Other assets

 

 

2,005,561

 

 

 

13.4

%

 

 

1,689,876

 

 

 

11.8

%

Total

 

$

15,001,775

 

 

 

100.0

%

 

$

14,294,594

 

 

 

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 a revenue basis, concentration for the year ended December 31, 2025 as compared to the two prior years is as follows:

The following shows those tenants that represented 10% or more of our total revenues by year (in thousands):

 

2025

 

Operator

 

Total Revenues

 

 

Percentage of
Total Revenues

 

Circle

 

$

212,719

 

 

 

21.9

%

Priory

 

 

105,986

 

 

 

10.9

%

 

2024

 

Operator

 

Total Revenues

 

 

Percentage of
Total Revenues

 

Circle

 

$

205,582

 

 

 

20.7

%

Priory

 

 

101,675

 

 

 

10.2

%

 

2023

 

Operator

 

Total Revenues

 

 

Percentage of
Total Revenues

 

Circle

 

$

194,390

 

 

 

22.3

%

Priory

 

 

107,557

 

 

 

12.3

%
Total Revenues by Geographic Location

 

 

 

For the Years Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

Geographic Location

 

Total Revenues

 

 

Percentage of
Total Revenues

 

 

Total Revenues

 

 

Percentage of
Total Revenues

 

 

Total Revenues

 

 

Percentage of
Total Revenues

 

Total U.S.

 

$

517,878

 

 

 

53.3

%

 

$

561,673

 

 

 

56.4

%

 

$

407,329

 

 

 

46.7

%

United Kingdom

 

 

373,279

 

 

 

38.4

%

 

 

359,991

 

 

 

36.2

%

 

 

352,594

 

 

 

40.4

%

All other countries

 

 

80,865

 

 

 

8.3

%

 

 

73,883

 

 

 

7.4

%

 

 

111,876

 

 

 

12.9

%

Grand total

 

$

972,022

 

 

 

100.0

%

 

$

995,547

 

 

 

100.0

%

 

$

871,799

 

 

 

100.0

%

 

 

Total Revenues by Facility Type

 

 

 

For the Years Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

Facility Types

 

Total Revenues

 

 

Percentage of
Total Revenues

 

 

Total Revenues

 

 

Percentage of
Total Revenues

 

 

Total Revenues

 

 

Percentage of
Total Revenues

 

General acute care hospitals

 

$

586,648

 

 

 

60.3

%

 

$

628,622

 

 

 

63.1

%

 

$

541,888

 

 

 

62.2

%

Behavioral health facilities

 

 

214,437

 

 

 

22.1

%

 

 

209,668

 

 

 

21.1

%

 

 

213,292

 

 

 

24.5

%

Post acute care facilities

 

 

162,954

 

 

 

16.8

%

 

 

139,859

 

 

 

14.0

%

 

 

92,787

 

 

 

10.6

%

Freestanding ER/urgent care
   facilities

 

 

7,983

 

 

 

0.8

%

 

 

17,398

 

 

 

1.8

%

 

 

23,832

 

 

 

2.7

%

Total

 

$

972,022

 

 

 

100.0

%

 

$

995,547

 

 

 

100.0

%

 

$

871,799

 

 

 

100.0

%
v3.25.4
Debt (Tables)
 12 Months Ended
Dec. 31, 2025
Debt Disclosure [Abstract]  
Summary of Debt

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

 

 

 

As of December 31,
2025

 

 

As of December 31,
2024

 

Secured revolving credit facility(A)

 

$

638,063

 

 

$

361,726

 

Secured term loan

 

 

200,000

 

 

 

200,000

 

British pound sterling term loan due 2025(B)

 

 

—

 

 

 

617,039

 

British pound sterling secured term loan due 2034(B)

 

 

850,784

 

 

 

790,234

 

3.325% Senior Unsecured Notes due 2025(B)

 

 

—

 

 

 

517,700

 

0.993% Senior Unsecured Notes due 2026(B)

 

 

587,300

 

 

 

517,700

 

2.500% Senior Unsecured Notes due 2026(B)

 

 

—

 

 

 

625,800

 

5.250% Senior Unsecured Notes due 2026

 

 

—

 

 

 

500,000

 

5.000% Senior Unsecured Notes due 2027

 

 

1,400,000

 

 

 

1,400,000

 

3.692% Senior Unsecured Notes due 2028(B)

 

 

808,500

 

 

 

750,960

 

4.625% Senior Unsecured Notes due 2029

 

 

900,000

 

 

 

900,000

 

3.375% Senior Unsecured Notes due 2030(B)

 

 

471,625

 

 

 

438,060

 

3.500% Senior Unsecured Notes due 2031

 

 

1,300,000

 

 

 

1,300,000

 

7.000% Senior Secured Notes due 2032(B)

 

 

1,174,600

 

 

 

—

 

8.500% Senior Secured Notes due 2032

 

 

1,500,000

 

 

 

—

 

 

$

9,830,872

 

 

$

8,919,219

 

Debt issue costs and discount, net

 

 

(133,037

)

 

 

(71,107

)

 

 

$

9,697,835

 

 

$

8,848,112

 

 

(A)
Includes €100 million and €303 million of Euro-denominated borrowings and CHF 52 million and CHF - million of Swiss franc-denominated borrowings that reflect the applicable exchange rates at December 31, 2025 and December 31, 2024, respectively.
(B)
Non-U.S. dollar denominated debt that reflects the exchange rates at period-end.
Principal Payments Due on Debt

As of December 31, 2025, 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

 

$

1,225,363

 

(1)

2027

 

 

1,600,000

 

 

2028

 

 

808,500

 

 

2029

 

 

900,000

 

 

2030

 

 

471,625

 

 

Thereafter

 

 

4,825,384

 

 

Total

 

$

9,830,872

 

 
(1)
$638 million (of which approximately $200 million was repaid in January 2026) represents the outstanding balance of the revolving portion of our credit facility for which we have provided notice of our intent to extend to 2027 - see "Credit Facility" subheading for further details.
Basic Terms of Senior Notes

The following are the basic terms of our senior notes at December 31, 2025 (par value amounts in thousands):

 

 

 

Offering
Completion Date

 

Maturity Date

 

Par Value

 

 

% of Par
Value

 

 

Interest Payment Frequency

0.993% Senior Unsecured Notes due 2026

 

October 6, 2021

 

October 15, 2026

 

€

500,000

 

 

 

100.000

%

 

Annually

5.000% Senior Unsecured Notes due 2027

 

September 21, 2017

 

October 15, 2027

 

$

1,400,000

 

 

 

100.000

%

 

Semi-annually

3.692% Senior Unsecured Notes due 2028

 

December 5, 2019

 

June 5, 2028

 

£

600,000

 

 

 

99.998

%

 

Annually

4.625% Senior Unsecured Notes due 2029

 

July 26, 2019

 

August 1, 2029

 

$

900,000

 

 

 

99.500

%

 

Semi-annually

3.375% Senior Unsecured Notes due 2030

 

March 24, 2021

 

April 24, 2030

 

£

350,000

 

 

 

99.448

%

 

Annually

3.500% Senior Unsecured Notes due 2031

 

December 4, 2020

 

March 15, 2031

 

$

1,300,000

 

 

 

100.000

%

 

Semi-annually

7.000% Senior Secured Notes due 2032

 

February 13, 2025

 

February 15, 2032

 

€

1,000,000

 

 

 

98.645

%

 

Semi-annually

8.500% Senior Secured Notes due 2032

 

February 13, 2025

 

February 15, 2032

 

$

1,500,000

 

 

 

98.710

%

 

Semi-annually
v3.25.4
Income Taxes (Tables)
 12 Months Ended
Dec. 31, 2025
Income Tax Disclosure [Abstract]  
Schedule of Income Tax (Expense) Benefit

Income Tax (Expense) Benefit

From our TRS entities and our foreign operations, income tax (expense) benefit were as follows (in thousands):

 

 

 

For the Years Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

Current income tax (expense) benefit:

 

 

 

 

 

 

 

 

 

Domestic

 

$

—

 

 

$

477

 

 

$

(7,756

)

Foreign

 

 

(27,987

)

 

 

(31,589

)

 

 

(24,257

)

 

 

 

(27,987

)

 

 

(31,112

)

 

 

(32,013

)

Deferred income tax (expense) benefit:

 

 

 

 

 

 

 

 

 

Domestic

 

 

—

 

 

 

(465

)

 

 

8,926

 

Foreign

 

 

(10,631

)

 

 

(12,524

)

 

 

153,766

 

 

 

 

(10,631

)

 

 

(12,989

)

 

 

162,692

 

Income tax (expense) benefit

 

$

(38,618

)

 

$

(44,101

)

 

$

130,679

 

 
Summary of Reconciliation of Income Tax Benefit (Expense) from the Statutory Income Tax Rate to the Effective Tax Rate Based on Income before Income Taxes

A reconciliation of income tax (expense) benefit from the statutory income tax rate to the effective tax rate based on our loss before income taxes for the years ended December 31, 2025, 2024, and 2023 is as follows (in thousands):

 

 

 

For the Years Ended December 31,

 

 

 

2025*

 

 

2024

 

 

2023

 

 

 

Amount

 

Percent

 

 

Amount

 

 

Amount

 

Loss before income tax

 

$

(237,319

)

 

100.0

%

 

$

(2,364,186

)

 

$

(686,771

)

Income tax benefit at the U.S. statutory federal rate

 

 

49,837

 

 

21.0

%

 

 

496,479

 

 

 

144,222

 

State and local income tax, net of federal income tax effect

 

 

—

 

 

—

 

 

 

—

 

 

 

1,275

 

Foreign tax effects:

 

 

 

 

 

 

 

 

 

 

 

U.K.:

 

 

 

 

 

 

 

 

 

 

 

Statutory tax rate difference between U.K. and U.S.

 

 

4,193

 

 

1.8

%

 

 

—

 

 

 

—

 

Changes in valuation allowances

 

 

(10,222

)

 

(4.3

)%

 

 

—

 

 

 

—

 

Tax impact of U.K. REIT conversion

 

 

—

 

 

—

 

 

 

—

 

 

 

160,641

 

Other

 

 

1,227

 

 

0.5

%

 

 

—

 

 

 

—

 

Colombia:

 

 

 

 

 

 

 

 

 

 

 

Statutory tax rate difference between Colombia and U.S.

 

 

3,826

 

 

1.6

%

 

 

—

 

 

 

—

 

Changes in valuation allowances

 

 

(9,954

)

 

(4.2

)%

 

 

—

 

 

 

—

 

Other

 

 

(1,713

)

 

(0.7

)%

 

 

—

 

 

 

—

 

Other foreign jurisdictions

 

 

(3,210

)

 

(1.4

)%

 

 

—

 

 

 

—

 

Foreign rate differential

 

 

—

 

 

—

 

 

 

4,888

 

 

 

(4,122

)

Interest disallowance

 

 

—

 

 

—

 

 

 

(2,965

)

 

 

(3,421

)

Changes in valuation allowances

 

 

(46,033

)

 

(19.4

)%

 

 

(301,468

)

 

 

(45,692

)

Nontaxable or nondeductible items:

 

 

 

 

 

 

 

 

 

 

 

U.S. earnings not subject to federal income tax

 

 

(26,569

)

 

(11.2

)%

 

 

(227,080

)

 

 

(115,189

)

Other adjustments

 

 

—

 

 

—

 

 

 

(13,955

)

 

 

(7,035

)

Total income tax (expense) benefit/effective tax rate

 

$

(38,618

)

 

(16.3

)%

 

$

(44,101

)

 

$

130,679

 

*Above is a reconciliation of the U.S. federal statutory income tax rate to our effective tax rate pursuant to the disclosure requirements of ASU 2023-09, "Income Taxes (Topic 740): Improvements to Income Tax Disclosures" ("ASU 2023-09"), for the year ended December 31, 2025. As allowed by ASU 2023-09, the 2024 and 2023 columns have not been restated to conform to the 2025 presentation.
Summary of Amounts of Cash and Income Taxes Paid (Net of Refunds)

Income Taxes Paid

The amounts of cash taxes we paid (net of refunds) are as follows (in thousands):

 

 

Year Ended December 31,

 

 

 

 

2025

 

 

Federal

 

$

(426

)

 

State

 

 

63

 

 

Foreign

 

 

20,884

 

(1)

Total

 

$

20,521

 

 
(1)
Income taxes paid (net of refunds) in the U.K. and Spain were $18.2 million and $1.5 million, respectively, and exceeded 5% of total income taxes paid (net of refunds).
Schedule of Deferred Tax Assets and Liabilities

Deferred Income Taxes

At December 31, 2025 and 2024, components of our deferred tax assets and liabilities were as follows (in thousands):

 

 

 

2025

 

 

2024

 

Deferred tax assets:

 

 

 

 

 

 

Operating loss and interest deduction carryforwards

 

$

334,501

 

 

$

263,523

 

Depreciation

 

 

70,051

 

 

 

56,089

 

Partnership investments

 

 

143,695

 

 

 

112,892

 

Impairment and other loss reserves

 

 

66,969

 

 

 

101,834

 

Other

 

 

10,263

 

 

 

8,500

 

Total deferred tax assets

 

 

625,479

 

 

 

542,838

 

Valuation allowance

 

 

(489,604

)

 

 

(418,659

)

Total net deferred tax assets

 

$

135,875

 

 

$

124,179

 

Deferred tax liabilities:

 

 

 

 

 

 

Property and equipment

 

$

(149,602

)

 

$

(145,835

)

Net unbilled revenue

 

 

(106,088

)

 

 

(82,170

)

Partnership investments

 

 

(26,885

)

 

 

(21,445

)

Other

 

 

(4,102

)

 

 

(3,450

)

Total deferred tax liabilities

 

 

(286,677

)

 

 

(252,900

)

Net deferred tax asset (liability)

 

$

(150,802

)

 

$

(128,721

)
Schedule of Net Operating Losses ("NOL") and Other Tax Attribute Carryforwards

At December 31, 2025, we had net operating losses ("NOL") and other tax attribute carryforwards as follows (in thousands):

 

 

U.S.

 

 

Foreign

 

Gross NOL carryforwards

$

929,887

 

 

$

569,760

 

 

 

 

 

 

 

Tax-effected carryforwards and other attributes

$

197,555

 

 

$

129,821

 

Valuation allowance

 

(197,555

)

 

 

(17,462

)

Net deferred tax asset - carryforwards and other attributes

$

—

 

 

$

112,359

 

Expiration periods

2034-indefinite

 

 

indefinite

 
Schedule of Per Share Distributions to Stockholders

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

 

 

 

For the Years Ended December 31,

 

Per share:

 

2025

 

 

2024

 

 

2023

 

Ordinary dividend (1)

 

$

—

 

 

$

—

 

 

$

1.0639

 

Long-term capital gain (2)

 

 

—

 

 

 

—

 

 

 

0.1061

 

Return of capital

 

 

0.3200

 

 

 

0.3800

 

 

 

—

 

Total

 

$

0.3200

 

(3)

$

0.3800

 

 

$

1.1700

 

 

(1)
For the year ended December 31, 2023, includes Section 199A dividends of 1.0639.
(2)
For the year ended December 31, 2023, includes Unrecaptured Section 1250 gains of 0.1061.
(3)
The dividend declared on November 17, 2025 and paid January 8, 2026 will be applicable to the 2026 tax year and thus is not reflected in the table above.
v3.25.4
Earnings Per Share/Unit (Tables)
 12 Months Ended
Dec. 31, 2025
Earnings Per Share [Abstract]  
Calculation of Earnings Per Share

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

 

 

 

For the Years Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

Numerator:

 

 

 

 

 

 

 

 

 

Net loss

 

$

(275,937

)

 

$

(2,408,287

)

 

$

(556,092

)

Non-controlling interests’ share in earnings

 

 

(1,112

)

 

 

(1,984

)

 

 

(384

)

Participating securities’ share in earnings

 

 

(889

)

 

 

(946

)

 

 

(1,644

)

Net loss, less participating securities’ share in
   earnings

 

$

(277,938

)

 

$

(2,411,217

)

 

$

(558,120

)

Denominator:

 

 

 

 

 

 

 

 

 

Basic weighted-average common shares

 

 

600,892

 

 

 

600,248

 

 

 

598,518

 

Dilutive potential common shares(1)

 

 

—

 

 

 

—

 

 

 

—

 

Diluted weighted-average common shares

 

 

600,892

 

 

 

600,248

 

 

 

598,518

 

 

MPT Operating Partnership, L.P.

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

 

 

 

For the Years Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

Numerator:

 

 

 

 

 

 

 

 

 

Net loss

 

$

(275,937

)

 

$

(2,408,287

)

 

$

(556,092

)

Non-controlling interests’ share in earnings

 

 

(1,112

)

 

 

(1,984

)

 

 

(384

)

Participating securities’ share in earnings

 

 

(889

)

 

 

(946

)

 

 

(1,644

)

Net loss, less participating securities’ share in
   earnings

 

$

(277,938

)

 

$

(2,411,217

)

 

$

(558,120

)

Denominator:

 

 

 

 

 

 

 

 

 

Basic weighted-average units

 

 

600,892

 

 

 

600,248

 

 

 

598,518

 

Dilutive potential units(1)

 

 

—

 

 

 

—

 

 

 

—

 

Diluted weighted-average units

 

 

600,892

 

 

 

600,248

 

 

 

598,518

 

 

(1)
The above computation of diluted earnings per share does not include 112,452, 17,162, and 32,382 potential common shares/units for the years ended December 31, 2025, 2024, and 2023, respectively.
v3.25.4
Stock Awards (Tables)
 12 Months Ended
Dec. 31, 2025
Share-Based Payment Arrangement [Abstract]  
Stock-based Award Activity

The following summarizes award activity in 2025 and 2024 (which includes awards granted in 2025, 2024, and any applicable prior years), respectively:

For the Year Ended December 31, 2025:

 

 

Vesting Based
on Service

 

 

Vesting Based on
Market/Performance
Conditions

 

 

 

Shares

 

 

Weighted-Average
Value at Award Date

 

 

Shares

 

 

Weighted-Average
Value at Award Date

 

Nonvested awards at beginning of the year

 

 

1,641,500

 

 

$

6.50

 

 

 

10,313,221

 

 

$

9.33

 

Awarded

 

 

2,538,451

 

 

$

5.24

 

 

 

1,347,895

 

 

$

11.00

 

Vested

 

 

(1,550,294

)

 

$

6.63

 

 

 

(89,065

)

 

$

22.11

 

Forfeited

 

 

(21,493

)

 

$

5.77

 

 

 

(3,689,223

)

 

$

11.89

 

Nonvested awards at end of year

 

 

2,608,164

 

 

$

5.20

 

 

 

7,882,828

 

(1)

$

8.97

 
(1)
Reflects the maximum share payout of certain market-based awards granted in 2023, 2024, and 2025. However, share payout at target level for these market-based awards would result in nonvested awards at December 31, 2025 of 3.1 million shares.

For the Year Ended December 31, 2024:

 

 

Vesting Based
on Service

 

 

Vesting Based on
Market/Performance
Conditions

 

 

 

Shares

 

 

Weighted-Average
Value at Award Date

 

 

Shares

 

 

Weighted-Average
Value at Award Date

 

Nonvested awards at beginning of the year

 

 

1,144,796

 

 

$

13.01

 

 

 

12,576,792

 

 

$

10.20

 

Awarded

 

 

1,519,207

 

 

$

4.36

 

 

 

345,000

 

 

$

7.78

 

Vested

 

 

(993,312

)

 

$

10.62

 

 

 

(1,179,631

)

 

$

16.81

 

Forfeited

 

 

(29,191

)

 

$

9.58

 

 

 

(1,428,940

)

 

$

10.40

 

Nonvested awards at end of year

 

 

1,641,500

 

 

$

6.50

 

 

 

10,313,221

 

 

$

9.33

 
v3.25.4
Fair Value of Financial Instruments (Tables)
 12 Months Ended
Dec. 31, 2025
Fair Value Disclosures [Abstract]  
Summary of Fair Value Information of Financial Instruments

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

 

 

 

December 31, 2025

 

 

December 31, 2024

 

Asset (Liability)

 

Book
Value

 

 

Fair
Value

 

 

Book
Value

 

 

Fair
Value

 

Interest and rent receivables

 

$

19,210

 

 

$

19,907

 

 

$

36,327

 

 

$

36,432

 

Loans(1)

 

 

624,243

 

(2)

 

624,369

 

 

 

467,120

 

(2)

 

470,380

 

Debt, net

 

 

(9,697,835

)

 

 

(8,980,547

)

 

 

(8,848,112

)

 

 

(7,301,395

)

 

(1)
Includes all loan investments other than those accounted for under the fair value option method, as noted below.
(2)
Includes $7.5 million and $7.9 million of mortgage loans, a $388.9 million and $315.5 million shareholder loans included in investments in unconsolidated real estate joint ventures, $45.4 million and $39.7 million of loans that are part of our investments in unconsolidated operating entities, and $182.4 million and $104.0 million of other loans at December 31, 2025 and December 31, 2024, respectively.
Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis

At December 31, 2025 and 2024, the amounts recorded under the fair value option method were as follows (in thousands):

 

 

 

December 31, 2025

 

 

December 31, 2024

 

 

 

Asset (Liability)

 

Fair Value

 

 

Original
Cost

 

 

Fair Value

 

 

Original
Cost

 

 

Asset Type Classification

Mortgage loans

 

$

116,113

 

 

$

151,692

 

 

$

111,985

 

 

$

129,968

 

 

Mortgage loans

Equity investment and other loans

 

 

4,285

 

 

 

264,160

 

 

 

154,229

 

 

 

910,594

 

 

Investments in unconsolidated
operating entities/Other loans
v3.25.4
Leases (Lessee) (Tables)
 12 Months Ended
Dec. 31, 2025
Leases [Abstract]  
Summary of Lease Expense

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

 

 

 

Income Statement

 

For the Years Ended December 31,

 

 

 

Classification

 

2025

 

 

2024

 

 

2023

 

Operating lease cost (1)

 

(2)

 

$

9,254

 

 

$

10,725

 

 

$

11,653

 

Finance lease cost:

 

 

 

 

 

 

 

 

 

 

 

Amortization of right-of-use assets

 

Real estate depreciation and amortization

 

 

51

 

 

 

51

 

 

 

51

 

Interest on lease liabilities

 

Interest

 

 

128

 

 

 

128

 

 

 

128

 

Sublease income

 

Other

 

 

(2,425

)

 

 

(3,259

)

 

 

(4,178

)

Total lease cost

 

 

 

$

7,008

 

 

$

7,645

 

 

$

7,654

 

 

(1)
Includes short-term leases.
(2)
$4.1 million, $5.1 million, and $6.0 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2025, 2024, and 2023, respectively.
Schedule Of Future Minimum Rental Payments For Leases Sublease Receivable And Net Payments

Fixed minimum payments due over the remaining lease term under non-cancelable leases of more than one year and amounts to be received in the future from non-cancelable subleases over their remaining lease term at December 31, 2025 are as follows (amounts in thousands):

 

 

 

Operating Leases

 

 

Finance Leases

 

 

Amounts To
Be Received
From
Subleases

 

 

Net
Payments

 

 

2026

 

$

7,109

 

 

$

133

 

 

$

(2,877

)

 

$

4,365

 

2027

 

 

6,567

 

 

 

134

 

 

 

(2,515

)

 

 

4,186

 

2028

 

 

6,648

 

 

 

135

 

 

 

(2,516

)

 

 

4,267

 

2029

 

 

6,706

 

 

 

137

 

 

 

(2,518

)

 

 

4,325

 

2030

 

 

6,733

 

 

 

138

 

 

 

(2,525

)

 

 

4,346

 

Thereafter

 

 

160,583

 

 

 

4,106

 

 

 

(38,522

)

 

 

126,167

 

(1)

Total undiscounted minimum lease payments

 

$

194,346

 

 

$

4,783

 

 

$

(51,473

)

 

$

147,656

 

Less: interest

 

 

(122,351

)

 

 

(2,850

)

 

 

 

 

 

 

 

Present value of lease liabilities

 

$

71,995

 

 

$

1,933

 

 

 

 

 

 

 

 

 

(1)
Reflects certain ground leases, in which we are the lessee, that have longer initial fixed terms than our existing sublease to our tenants. However, we would expect to either renew the related sublease, enter into a lease with a new tenant, or attempt to early terminate the ground lease to reduce or avoid any significant impact from such ground leases.
Summary of Supplemental Balance Sheet Information

Supplemental balance sheet information is as follows (in thousands, except lease terms and discount rate):

 

 

 

Balance Sheet
Classification

 

December 31,
2025

 

 

December 31,
2024

 

Right of use assets:

 

 

 

 

 

 

 

 

Operating leases - real estate

 

Land

 

$

43,801

 

 

$

46,881

 

Finance leases - real estate

 

Land

 

 

1,581

 

 

 

1,632

 

Total real estate right of use assets

 

 

 

$

45,382

 

 

$

48,513

 

Operating leases - corporate

 

Other assets

 

 

17,641

 

 

 

20,701

 

Total right of use assets

 

 

 

$

63,023

 

 

$

69,214

 

 

 

 

 

 

 

 

 

 

Lease liabilities:

 

 

 

 

 

 

 

 

Operating leases

 

Obligations to tenants and
other lease liabilities

 

$

71,995

 

 

$

78,585

 

Financing leases

 

Obligations to tenants and
other lease liabilities

 

 

1,933

 

 

 

1,936

 

Total lease liabilities

 

 

 

$

73,928

 

 

$

80,521

 

 

 

 

 

 

 

 

 

 

Weighted-average remaining lease term:

 

 

 

 

 

 

 

 

Operating leases

 

 

 

 

33.4

 

 

 

32.6

 

Finance leases

 

 

 

 

30.9

 

 

 

31.9

 

Weighted-average discount rate:

 

 

 

 

 

 

 

 

Operating leases

 

 

 

 

6.1

%

 

 

6.1

%

Finance leases

 

 

 

 

6.6

%

 

 

6.6

%
Summary of Supplemental Cash Flow Information

The following is supplemental cash flow information (in thousands):

 

 

 

For the Years Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

Cash paid for amounts included in the measurement of lease liabilities:

 

 

 

 

 

 

 

 

 

Operating cash flows used for operating leases

 

$

8,013

 

 

$

8,447

 

 

$

8,210

 

Operating cash flows used for finance leases

 

 

131

 

 

 

130

 

 

 

129

 
v3.25.4
Other Assets (Tables)
 12 Months Ended
Dec. 31, 2025
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]  
Summary of Other Assets

The following is a summary of our other assets on our consolidated balance sheets (in thousands):

 

 

 

December 31,

 

 

 

2025

 

 

2024

 

Debt issue costs, net(1)

 

$

3,265

 

 

$

5,675

 

Other corporate assets

 

 

372,751

 

 

 

330,638

 

Prepaids and other assets

 

 

188,024

 

 

 

135,091

 

Total other assets

 

$

564,040

 

 

$

471,404

 
(1)
Relates to our revolving credit facility
v3.25.4
Organization - Additional Information (Detail)
 12 Months Ended
Dec. 31, 2025
State
Facility
Country
Business Acquisition [Line Items]  
Percentage of leased assets owned 100.00%
Number of facilities | Facility 384
Number of states | State 31
Europe [Member]  
Business Acquisition [Line Items]  
Number of countries 7
South America [Member]  
Business Acquisition [Line Items]  
Number of countries 1
v3.25.4
Summary of Significant Accounting Policies - Additional Information (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Significant Accounting Policies [Line Items]      
Threshold ownership percentage for inter company balances and transactions elimination 100.00%    
Expected lease-up periods for estimating lost rentals, in months 6 months    
Percentage of ordinary taxable income to be distributed for real estate investment trust qualification 90.00% 90.00% 90.00%
Number of years of federal income tax at corporate rates on failure to qualify as REIT 4 years    
Real estate and other impairment charges, net $ 193,947 $ 1,825,402 $ 376,907
Time-Based Awards [Member]      
Significant Accounting Policies [Line Items]      
Stock award service period in years 3 years    
Market Conditions Based Awards [Member] | Minimum [Member]      
Significant Accounting Policies [Line Items]      
Stock award service period in years 3 years    
Market Conditions Based Awards [Member] | Maximum [Member]      
Significant Accounting Policies [Line Items]      
Stock award service period in years 5 years    
v3.25.4
Summary of Significant Accounting Policies - Summary of Carrying Value and Classification of the Assets and Maximum Exposure (Detail) - Variable Interest Entity, Not Primary Beneficiary [Member]
$ in Thousands
Dec. 31, 2025
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 120,398
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 $ 120,398
v3.25.4
Summary of Significant Accounting Policies - Estimated Useful Lives of Related Real Estate and Other Assets (Detail)
Dec. 31, 2025
Buildings and improvements [Member]  
Property, Plant and Equipment [Line Items]  
Weighted average useful lives of related real estate and other assets 38 years 7 months 6 days
Lease Intangibles [Member]  
Property, Plant and Equipment [Line Items]  
Weighted average useful lives of related real estate and other assets 28 years 2 months 12 days
Leasehold improvements [Member]  
Property, Plant and Equipment [Line Items]  
Weighted average useful lives of related real estate and other assets 14 years 3 months 18 days
Furniture, equipment and other [Member]  
Property, Plant and Equipment [Line Items]  
Weighted average useful lives of related real estate and other assets 5 years
v3.25.4
Summary of Significant Accounting Policies - Summary of Credit Loss Reserves (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Accounting Policies [Abstract]    
Balance at beginning of the year $ 511,473 $ 96,001
Provision for credit loss, net 168,186 1,241,020
Expected credit loss reserve written off or related to financial instruments sold, repaid, or satisfied (126,362) (825,548)
Balance at end of year $ 553,297 $ 511,473
v3.25.4
Real Estate and Other Activities - Net Assets Acquired (Detail) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Business Acquisition [Line Items]      
Total assets acquired $ 142,089 $ 105,618 $ 235,187
Liabilities assumed 0 (2,290) 0
Loans repaid [1] 0 0 (22,900)
Total net assets acquired 142,089 105,618 212,287
Land and Land Improvements [Member]      
Business Acquisition [Line Items]      
Total assets acquired 25,231 0 28,916
Building [Member]      
Business Acquisition [Line Items]      
Total assets acquired 48,742 0 114,966
Intangible Lease Assets [Member]      
Business Acquisition [Line Items]      
Total assets acquired 5,101 0 16,305
Other Loans [Member]      
Business Acquisition [Line Items]      
Total assets acquired 0 0 25,000
Investments in Unconsolidated Real Estate Joint Ventures [Member]      
Business Acquisition [Line Items]      
Total assets acquired 63,015 107,908 0
Investments In Unconsolidated Operating Entities [Member]      
Business Acquisition [Line Items]      
Total assets acquired $ 0 $ 0 $ 50,000
[1] The 2023 column includes a $23 million mortgage loan that was converted to fee simple ownership of one property as described under the Lifepoint Transaction below.
v3.25.4
Real Estate and Other Activities - Net Assets Acquired (Parenthetical) (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2023
Dec. 31, 2024
Feb. 07, 2023
Business Acquisition [Line Items]        
Weighted-average useful life of acquired intangible lease assets (in years) 22 years 8 months 12 days      
Advanced to the mortgage loan [1] $ 0 $ 22,900 $ 0  
Mortgage Loans [Member] | Springstone Health Opco, LLC [Member]        
Business Acquisition [Line Items]        
Advanced to the mortgage loan   $ 23,000   $ 23,000
Intangible Lease Assets [Member]        
Business Acquisition [Line Items]        
Weighted-average useful life of acquired intangible lease assets (in years) 19 years 10 months 24 days 24 years 9 months 18 days    
[1] The 2023 column includes a $23 million mortgage loan that was converted to fee simple ownership of one property as described under the Lifepoint Transaction below.
v3.25.4
Real Estate and Other Activities - 2025 Activity - Additional Information (Detail)
$ in Thousands, £ in Millions, SFr in Millions
 1 Months Ended 3 Months Ended 12 Months Ended
Apr. 14, 2023
USD ($)
Apr. 14, 2023
GBP (£)
Nov. 30, 2025
USD ($)
Property
Apr. 30, 2025
USD ($)
Apr. 30, 2025
CHF (SFr)
Dec. 31, 2025
USD ($)
Mar. 31, 2024
USD ($)
Jun. 30, 2023
USD ($)
Jun. 30, 2023
GBP (£)
Dec. 31, 2025
USD ($)
Dec. 31, 2024
USD ($)
Dec. 31, 2023
USD ($)
Mar. 31, 2025
USD ($)
Debt Instrument [Line Items]                          
Cash paid for acquisitions of real estate assets                   $ 142,089 $ 105,618 $ 235,187  
Total assets acquired           $ 142,089       $ 142,089 $ 105,618 $ 235,187  
Lifepoint Behavioral Health and Surgery Partners                          
Debt Instrument [Line Items]                          
Profit (loss) from real estate operations           $ 46,500              
Behavioral Health Hospitals [Member]                          
Debt Instrument [Line Items]                          
Payment for acquisition $ 58,000 £ 44           $ 77,000 £ 70        
Profit (loss) from real estate operations             $ 35,400            
Vibra [Member]                          
Debt Instrument [Line Items]                          
Number of property acquired | Property     1                    
Payment for acquisition     $ 32,000                    
Steward [Member]                          
Debt Instrument [Line Items]                          
Total assets acquired                         $ 47,000
Swiss Medical Network [Member]                          
Debt Instrument [Line Items]                          
Cash paid for acquisitions of real estate assets       $ 63,000 SFr 52                
Proceeds from short-term loan       $ 30,000 SFr 25                
v3.25.4
Real Estate and Other Activities - 2024 Activity - Additional Information (Detail)
$ in Thousands
 12 Months Ended
Apr. 12, 2024
USD ($)
Hospital
Dec. 31, 2025
USD ($)
Dec. 31, 2024
USD ($)
Dec. 31, 2023
USD ($)
Business Combination [Line Items]        
Gain (loss) on real estate dispositions   $ 5,500    
Investments in unconsolidated real estate joint ventures   1,399,777 $ 1,156,397  
Payments of term debt   $ (2,252,731) $ (701,809) $ (988,162)
Derivative Liability Statement of Financial Position Extensible Enumeration Not Disclosed Flag   true    
CommonSpirit Health [Member]        
Business Combination [Line Items]        
Leased real estate acquire lease base $ 1,200,000      
Derivative liability $ 2,300      
Institutional Asset Manager [Member]        
Business Combination [Line Items]        
Number Of Utah Hospitals Sold | Hospital 5      
Agreegate agreed valuation $ 1,200,000      
Gain (loss) on real estate dispositions 380,000      
Write-off of unbilled straight-line rent receivables $ 20,000      
Percentage of interest retained in venture 25.00%      
Investments in unconsolidated real estate joint ventures $ 108,000      
Percentage of interest sold in venture 75.00%      
Proceeds from divestiture of interest in joint venture $ 886,000      
Additional cash proceeds of non-recourse secured finance 190,000      
Payments of term debt $ (1,100,000)      
v3.25.4
Real Estate and Other Activities - 2023 Activity - Additional Information (Detail)
$ in Thousands, £ in Millions
 3 Months Ended 12 Months Ended
Apr. 14, 2023
USD ($)
Facility
Apr. 14, 2023
GBP (£)
Facility
Feb. 07, 2023
USD ($)
Facility
Mar. 31, 2024
USD ($)
Jun. 30, 2023
USD ($)
Facility
Jun. 30, 2023
GBP (£)
Facility
Mar. 31, 2023
USD ($)
Dec. 31, 2024
USD ($)
Dec. 31, 2025
USD ($)
Dec. 31, 2023
USD ($)
Business Acquisition [Line Items]                    
Net impairment charge       $ 225,000     $ 79,000 $ 180,000    
Additional mortgage loan               105,618 $ 142,089 $ 235,187
Loans repaid [1]               $ 0 $ 0 22,900
PHP Holdings [Member]                    
Business Acquisition [Line Items]                    
Convertible loan             $ 50,000      
General Acute Care Hospitals [Member]                    
Business Acquisition [Line Items]                    
Number of facilities acquired | Facility     8              
Lease extension expiration term     5 years              
Lease extension expiration year     2041              
Behavioral Health Hospitals [Member]                    
Business Acquisition [Line Items]                    
Number of facilities acquired | Facility 5 5     3 3        
Payment for acquisition $ 58,000 £ 44     $ 77,000 £ 70        
Number of leased facilities | Facility 5 5                
Springstone Health Opco, LLC [Member]                    
Business Acquisition [Line Items]                    
Purchase price of acquisition     $ 250,000              
Additional mortgage loan     205,000              
Business Combination, Consideration Transferred, Equity Interest       $ 12,000            
Springstone Health Opco, LLC [Member] | Mortgage Loans [Member]                    
Business Acquisition [Line Items]                    
Loans repaid     $ 23,000             $ 23,000
[1] The 2023 column includes a $23 million mortgage loan that was converted to fee simple ownership of one property as described under the Lifepoint Transaction below.
v3.25.4
Real Estate and Other Activities - Development and Capital Addition Activities - Summary of Status on Current Development Projects (Detail)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
USD ($)
Business Acquisition [Line Items]  
Commitment $ 165,262
Costs Paid as of December 31, 2025 90,306
Cost remaining 74,956
Lifepoint Behavioral [Member] | ARIZONA  
Business Acquisition [Line Items]  
Commitment 10,659
Costs Paid as of December 31, 2025 8,281
Cost remaining 2,378
IMED [Member] | Spain [Member]  
Business Acquisition [Line Items]  
Commitment 67,054
Costs Paid as of December 31, 2025 39,954
Cost remaining 27,100
Healthcare Systems of America [Member] | Florida [Member]  
Business Acquisition [Line Items]  
Commitment 43,500
Costs Paid as of December 31, 2025 2,064
Cost remaining 41,436
IMED [Member] | Spain [Member]  
Business Acquisition [Line Items]  
Commitment 43,495
Costs Paid as of December 31, 2025 39,797
Cost remaining 3,698
Other [Member] | Various [Member]  
Business Acquisition [Line Items]  
Commitment 554
Costs Paid as of December 31, 2025 210
Cost remaining $ 344
v3.25.4
Real Estate and Other Activities - Development and Capital Addition Activities - Additional Information (Detail)
€ in Millions, $ in Millions
 3 Months Ended
Dec. 31, 2024
USD ($)
Mar. 31, 2024
USD ($)
Mar. 31, 2024
EUR (€)
Dec. 31, 2025
USD ($)
Projects
Behavioral Health Hospitals [Member]        
Business Combination [Line Items]        
Profit (loss) from real estate operations   $ 35.4    
General Acute Care Facility [Member]        
Business Combination [Line Items]        
Profit (loss) from real estate operations   $ 49.0 € 46  
Massachusetts [Member]        
Business Combination [Line Items]        
Redevelopment of recovery received from settlement excess of damage to property       $ 24.0
TEXAS And MASSACHUSETTS [Member]        
Business Combination [Line Items]        
Number of other development projects | Projects       2
Idaho [Member]        
Business Combination [Line Items]        
Profit (loss) from real estate operations $ 50.0      
Minimum [Member] | TEXAS And MASSACHUSETTS [Member]        
Business Combination [Line Items]        
Construction amount       $ 10.0
Maximum [Member] | TEXAS And MASSACHUSETTS [Member]        
Business Combination [Line Items]        
Construction amount       $ 15.0
v3.25.4
Real Estate and Other Activities - Disposals - 2025 Activity - Additional Information (Detail)
$ in Millions
 3 Months Ended 12 Months Ended
Mar. 31, 2023
Facility
Dec. 31, 2025
USD ($)
Facility
Business Combination [Line Items]    
Number of facilities sold | Facility 3 9
Gain (loss) on real estate dispositions   $ 5.5
Proceeds from sale of investments   121.0
ScionHealth Master Lease [Member]    
Business Combination [Line Items]    
Proceeds from sale of investments   50.0
Lease incentive   $ 50.0
Lease incentive amortized over remaining period   16 years
v3.25.4
Real Estate and Other Activities - Disposals - 2024 Activity Additional Information (Detail)
$ in Thousands
 3 Months Ended 12 Months Ended
Sep. 18, 2024
Facility
Aug. 14, 2024
USD ($)
Freestanding
Jul. 23, 2024
USD ($)
Freestanding
Bed
Apr. 12, 2024
USD ($)
Hospital
Apr. 09, 2024
USD ($)
Property
May 01, 2023
USD ($)
Dec. 31, 2024
USD ($)
Mar. 31, 2023
Facility
Dec. 31, 2025
USD ($)
Facility
Dec. 31, 2024
USD ($)
Facility
Dec. 31, 2023
USD ($)
Debt Instrument [Line Items]                      
Number of facilities sold | Facility               3 9    
Proceeds from sale of investments                 $ 121,000    
Gain (loss) on sale of real estate                 5,545 $ 478,693 $ (1,815)
Gain (loss) on real estate dispositions                 $ 5,500    
Space Coast Properties                      
Debt Instrument [Line Items]                      
Proceeds from sale of investments             $ 440,000        
Space Coast Properties | Orlando Health [Member]                      
Debt Instrument [Line Items]                      
Gain (loss) on sale of real estate             2,000        
Space Coast Properties | Florida | Orlando Health [Member]                      
Debt Instrument [Line Items]                      
Number of facilities sold | Facility 3                    
Watsonville Facility | Pajaro Valley Healthcare District Corporation [Member]                      
Debt Instrument [Line Items]                      
Proceeds from sale of investments             40,000        
Gain (loss) on sale of real estate             4,000        
Institutional Asset Manager [Member]                      
Debt Instrument [Line Items]                      
Number of Utah hospitals sold | Hospital       5              
Gain (loss) on real estate dispositions       $ 380,000              
Prime Healthcare Services, Inc. Facilities [Member]                      
Debt Instrument [Line Items]                      
Number of properties sold | Property         5            
Profit (loss) from real estate operations                   $ 14,000  
Number of facilities sold | Facility                   6  
Number of ancillary facilities sold | Facility                   2  
Proceeds from sale of investments         $ 250,000            
Gain (loss) on real estate dispositions         53,000            
Proceeds from interest-bearing mortgage loan         100,000            
Non-cash straight-line rent write-offs         30,000            
Lease purchase option value         238,000            
Lease purchase option price reverts         $ 260,000            
Prime Healthcare Services, Inc. Facilities [Member] | Minimum [Member]                      
Debt Instrument [Line Items]                      
Inflation-based Percentage for Amended Lease         2.00%            
Prime Healthcare Services, Inc. Facilities [Member] | Maximum [Member]                      
Debt Instrument [Line Items]                      
Inflation-based Percentage for Amended Lease         4.00%            
Arizona General Hospital [Member] | Dignity Health [Member]                      
Debt Instrument [Line Items]                      
Number of bed sold | Bed     50                
Freestanding Emergency Departments [Member] | Dignity Health [Member]                      
Debt Instrument [Line Items]                      
Number of facilities sold | Freestanding     7                
Freestanding Emergency Departments [Member] | UCHealth [Member]                      
Debt Instrument [Line Items]                      
Number of facilities sold | Freestanding   11                  
General Hospital and Freestanding Emergency Departments [Member]                      
Debt Instrument [Line Items]                      
Gain (loss) on sale of real estate   $ 40,000 $ 85,000                
Non-cash straight-line rent receivables   16,000 20,000                
General Hospital and Freestanding Emergency Departments [Member] | Dignity Health [Member]                      
Debt Instrument [Line Items]                      
Proceeds from sale of investments     $ 160,000                
General Hospital and Freestanding Emergency Departments [Member] | UCHealth [Member]                      
Debt Instrument [Line Items]                      
Proceeds from sale of investments   $ 86,000                  
CommonSpirit Health [Member]                      
Debt Instrument [Line Items]                      
Straight-line rent write-offs           $ 95,000          
Steward Health Care System LLC [Member]                      
Debt Instrument [Line Items]                      
Bankruptcy claims amount settled             $ 395,000     $ 395,000  
v3.25.4
Real Estate and Other Activities - Disposals - 2023 Activity Additional Information (Detail)
$ in Millions, $ in Millions
 3 Months Ended 12 Months Ended
Apr. 09, 2024
USD ($)
Oct. 10, 2023
AUD ($)
Facility
May 18, 2023
AUD ($)
Facility
Mar. 29, 2023
Facility
Mar. 08, 2023
USD ($)
Mar. 31, 2024
USD ($)
Mar. 31, 2023
USD ($)
Facility
Mar. 31, 2023
AUD ($)
Facility
Dec. 31, 2025
USD ($)
Facility
Dec. 31, 2024
USD ($)
Facility
Debt Instrument [Line Items]                    
Number of facilities sold | Facility             3 3 9  
Proceeds from sale of facilities                 $ 121.0  
Net impairment charge           $ 225.0 $ 79.0     $ 180.0
Straight-line rent receivables             37.4      
Estimated fees to sell the hospitals             8.0      
General Acute Care Facility [Member] | Australia [Member]                    
Debt Instrument [Line Items]                    
Number of facilities sold | Facility       11            
Australia Transaction [Member]                    
Debt Instrument [Line Items]                    
Number of facilities sold | Facility     7              
Proceeds from sale of facilities   $ 470 $ 730         $ 1,200    
Number of remaining facilities sold | Facility   4                
Prime Healthcare Services, Inc. Facilities [Member]                    
Debt Instrument [Line Items]                    
Number of facilities sold | Facility                   6
Proceeds from sale of facilities $ 250.0                  
Prime [Member]                    
Debt Instrument [Line Items]                    
Proceeds from sale of facilities         $ 100.0          
Non-cash impairment charge             $ 11.0      
v3.25.4
Real Estate and Other Activities - Intangible Assets - Additional Information (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Sep. 18, 2024
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Business Combination [Line Items]        
Intangible lease assets   $ 872,371 $ 804,081  
Accumulated amortization, net   600,000 600,000  
Amortization expense related to intangible lease assets $ 205,600 $ 30,400   $ 332,500
Capitalized lease intangibles, weighted average life (in years)   22 years 8 months 12 days    
In-place lease intangibles [Member]        
Business Combination [Line Items]        
Amortization of Intangible Assets $ 170,000   $ 149,000 $ 286,000
v3.25.4
Real Estate and Other Activities - Amortization Expense from Existing Lease Intangible Assets (Detail)
$ in Thousands
Dec. 31, 2025
USD ($)
Business Combination [Abstract]  
2026 $ 32,165
2027 31,847
2028 31,684
2029 29,840
2030 $ 29,173
v3.25.4
Real Estate and Other Activities - Leasing Operations (Lessor) - Additional Information (Detail)
$ in Millions
 12 Months Ended
Dec. 31, 2025
USD ($)
Lease
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
NOR Healthcare Systems Corporation [Member]  
Lessor Lease Description [Line Items]  
Net book value of property | $ $ 510
Number of operating leases | Lease 6
v3.25.4
Real Estate and Other Activities - Summary of Total Future Contractual Minimum Lease Payments to be Received (Detail)
$ in Thousands
Dec. 31, 2025
USD ($)
Lessor Lease Description [Line Items]  
2026 $ 877,285
2027 969,048
2028 990,132
2029 978,948
2030 983,864
Thereafter 21,669,686
Future minimum lease payments to be received 26,468,963
Operating Leases [Member]  
Lessor Lease Description [Line Items]  
2026 842,559
2027 933,571
2028 952,310
2029 942,705
2030 946,839
Thereafter 20,829,144
Future minimum lease payments to be received 25,447,128
Financing Leases [Member]  
Lessor Lease Description [Line Items]  
2026 34,726
2027 35,477
2028 37,822
2029 36,243
2030 37,025
Thereafter 840,542
Future minimum lease payments to be received $ 1,021,835
v3.25.4
Real Estate and Other Activities - Components of Total Investment in Financing Leases (Detail) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Direct Financing Lease Net Investment In Leases [Abstract]    
Minimum lease payments receivable $ 570,150 $ 591,142
Estimated unguaranteed residual values 203,818 203,818
Less: Unearned income and allowance for credit loss (523,746) (547,770)
Net investment in direct financing leases 250,222 247,190
Other financing leases (net of allowance for credit loss) 171,462 810,580
Total investment in financing leases $ 421,684 $ 1,057,770
v3.25.4
Real Estate and Other Activities - Other Leasing Activities - Additional Information (Detail)
Dec. 31, 2025
Business Combination [Abstract]  
Percentage of vacant on leased property 1.00%
v3.25.4
Real Estate and Other Activities - Steward Health Care System - Additional Information (Detail)
$ in Millions
 12 Months Ended
Sep. 18, 2024
USD ($)
Property
Dec. 31, 2025
USD ($)
Dec. 31, 2024
USD ($)
Dec. 31, 2023
USD ($)
Business Combination [Line Items]        
Proceeds from sale of facilities   $ 121    
In-place lease intangibles [Member]        
Business Combination [Line Items]        
Amortization of Intangible Assets $ 170   $ 149 $ 286
Steward Health Care System LLC [Member]        
Business Combination [Line Items]        
Number of properties | Property 23      
Proceeds from sale of facilities $ 40      
v3.25.4
Real Estate and Other Activities - Schedule of Impairment Charges, Net (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Business Combination [Line Items]      
Total revenues $ 972,022 $ 995,547 $ 871,799
Real estate and other impairment charges, net (193,947) (1,825,402) (376,907)
Earnings (loss) from equity interests $ 97,851 (366,642) 13,967
Steward Health Care System L L C [Member]      
Business Combination [Line Items]      
Total   1,563 714
Steward Health Care System L L C [Member] | Reserve for unpaid rent and interest and straight-line rent receivables [Member]      
Business Combination [Line Items]      
Total revenues   0 413
Steward Health Care System L L C [Member] | Working capital and other loans [Member]      
Business Combination [Line Items]      
Real estate and other impairment charges, net [1]   787 0
Steward Health Care System L L C [Member] | Investment in Massachusetts partnership [Member]      
Business Combination [Line Items]      
Earnings (loss) from equity interests [2]   445 30
Steward Health Care System L L C [Member] | Real estate [Member]      
Business Combination [Line Items]      
Real estate and other impairment charges, net [2]   277 100
Steward Health Care System L L C [Member] | Equity investment and other [Member]      
Business Combination [Line Items]      
Real estate and other impairment charges, net [1]   $ 54 $ 171
[1] For our non-real estate investments in Steward, we compared our carrying value of all such investments to the fair value of the underlying collateral, which had no value after the global settlement and our release of claims against Steward as discussed above.
[2] The three Space Coast properties and certain excess properties previously leased to Steward were deemed held for sale in the 2024 third quarter. We recognized a real estate impairment charge of approximately $180 million to adjust our net book value to align with fair value less cost to sell based on expected proceeds, including from a binding agreement for the Space Coast properties. For the other real estate held for use, we made a comparison of the projected undiscounted future cash flows with the net book value of each asset. For those properties where the carrying value was deemed not recoverable, we recorded an impairment charge to reduce the carrying value to its estimated fair value. For the real estate in the Massachusetts partnership, there was no fair value as we transitioned those properties to the mortgage lender to satisfy the mortgage debt. For the remaining properties (less than 10 in total in 2024 and 2023), we, along with assistance from a third-party, independent valuation firm, estimated fair value using a combination of cost, market, and income approaches using Level 3 inputs. The cost approach used comparable sales to value the land and cost manuals to value the improvements. The value derived from the market approach was based on sale prices of similar properties. For the income approach, we divided the expected operating income (rent revenue less expenses, if any) from the property by a market capitalization rate (range from 8% to 10%).
v3.25.4
Real Estate and Other Activities - Schedule of Impairment Charges Net (Parenthetical) (Detail) - USD ($)
$ in Millions
 3 Months Ended 12 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Dec. 31, 2024
Business Combination [Line Items]      
Real estate impairment charges $ 225 $ 79 $ 180
Steward Health Care System LLC [Member] | Income Valuation Approach [Member] | Level 3 Inputs [Member] | Minimum [Member]      
Business Combination [Line Items]      
Market capitalization rate     8.00%
Steward Health Care System LLC [Member] | Income Valuation Approach [Member] | Level 3 Inputs [Member] | Maximum [Member]      
Business Combination [Line Items]      
Market capitalization rate     10.00%
v3.25.4
Real Estate and Other Activities - Re-tenanting Activity - Additional Information (Detail)
$ in Millions
 1 Months Ended 3 Months Ended 12 Months Ended
Oct. 31, 2026
Jun. 30, 2026
Dec. 31, 2025
USD ($)
Property
Sep. 30, 2025
USD ($)
Jun. 30, 2025
USD ($)
Mar. 31, 2025
USD ($)
Dec. 31, 2025
USD ($)
Property
Sep. 18, 2024
Property
Business Combination [Line Items]                
Maximum loss exposure to tenants loan carrying value | $     $ 30.0       $ 30.0  
Retenanting Activity [Member]                
Business Combination [Line Items]                
Number of properties     23       23  
Number of operators     6       6  
Number of leased facilities             18  
Working capital loans | $     $ 140.0       $ 140.0  
Percentage of annual revenues     1.00%       1.00%  
Cash rent received from operators | $     $ 26.1 $ 12.0 $ 11.0 $ 3.4    
Percentage of net book value of total assets re-tenanted or sold             4.00%  
Forecast [Member] | Retenanting Activity [Member]                
Business Combination [Line Items]                
Percentage of contractual rent 100.00% 79.00%            
Steward [Member]                
Business Combination [Line Items]                
Number of properties               23
Steward [Member] | Retenanting Activity [Member]                
Business Combination [Line Items]                
Number of controled properties     5       5  
v3.25.4
Real Estate and Other Activities - Other Activity - Additional Information (Detail)
$ in Millions
 12 Months Ended
Dec. 31, 2024
USD ($)
Business Combination [Line Items]  
Received rent $ 38
Steward [Member]  
Business Combination [Line Items]  
Rent and interest revenue 40
Massachusetts-Based Steward [Member]  
Business Combination [Line Items]  
Received rent $ 76
v3.25.4
Real Estate and Other Activities - Prospect - Additional Information (Detail)
$ in Millions
 1 Months Ended 3 Months Ended 12 Months Ended
May 23, 2023
USD ($)
Aug. 31, 2019
USD ($)
Hospital
Dec. 31, 2024
USD ($)
Dec. 31, 2025
USD ($)
Prospect [Member]        
Business Combination [Line Items]        
Recover of investments in Prospect       $ 61
Prospect [Member] | PHP Holdings [Member]        
Business Combination [Line Items]        
Asset impairment charges       $ 140
Loan impairment charges     $ 400  
Prospect [Member] | Minimum [Member] | Level 3 Inputs [Member] | Income Valuation Approach [Member]        
Business Combination [Line Items]        
Market capitalization rate       8.25%
Prospect [Member] | Maximum [Member]        
Business Combination [Line Items]        
Backstop facility claims       $ 70
Prospect [Member] | Maximum [Member] | Level 3 Inputs [Member] | Income Valuation Approach [Member]        
Business Combination [Line Items]        
Market capitalization rate       8.50%
Prospect [Member]        
Business Combination [Line Items]        
Purchase price of acquisition   $ 1,600    
Pay down of debt instruments $ 375      
Reconstitution of asset 1,700      
Prospect [Member] | Mortgage Loans [Member]        
Business Combination [Line Items]        
First lien secured loan 150      
Prospect [Member] | Maximum [Member]        
Business Combination [Line Items]        
First lien secured loan $ 75      
Acute Care Campus [Member] | Prospect [Member]        
Business Combination [Line Items]        
Number of facilities acquired | Hospital   14    
v3.25.4
Real Estate and Other Activities - Prospect - Re-tenanting Activity - (Details) - Prospect California Facilities [Member]
$ in Millions
 12 Months Ended
Dec. 31, 2025
USD ($)
Business Combination [Line Items]  
Initial lease term 15 years
Rent deferred, period 6 months
Percentage of rent deferred for additional six months 50.00%
Maximum fund committed to seismic improvements $ 60
Number of years required to committed fund 4 years
v3.25.4
Real Estate and Other Activities - PHP Investment - Additional Information (Details) - USD ($)
$ in Millions
 12 Months Ended
Jul. 01, 2025
Dec. 31, 2025
Dec. 31, 2024
Business Combination [Line Items]      
Proceeds from sale of investments   $ 121.0  
PHP Investment [Member]      
Business Combination [Line Items]      
Change in fair value adjustments   $ 147.0 $ 550.0
Proceeds from sale of investments $ 2.3    
v3.25.4
Real Estate and Other Activities - International Joint Venture - Additional Information (Detail) - USD ($)
$ in Millions
 3 Months Ended 12 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Dec. 31, 2024
Business Combination [Abstract]      
Real estate $ 225 $ 79 $ 180
v3.25.4
Real Estate and Other Activities - Common Spirit Additional Information (Detail)
$ in Millions
 12 Months Ended
Sep. 18, 2024
USD ($)
May 01, 2023
USD ($)
Facility
Dec. 31, 2024
USD ($)
Dec. 31, 2023
USD ($)
Common Spirit [Member]        
Business Combination [Line Items]        
Number of facilities acquired | Facility   5    
Straight-line rent write-offs   $ 95    
Catholic Health Initiatives Colorado [Member] | Common Spirit [Member]        
Business Combination [Line Items]        
Initial lease term   15 years    
In-place lease intangibles [Member]        
Business Combination [Line Items]        
Amortization of Intangible Assets $ 170   $ 149 $ 286
In-place lease intangibles [Member] | Common Spirit [Member]        
Business Combination [Line Items]        
Amortization of Intangible Assets   $ 286    
v3.25.4
Real Estate and Other Activities - Vibra - Additional Information (Detail)
$ in Millions
 1 Months Ended 3 Months Ended 12 Months Ended
Feb. 28, 2026
USD ($)
Dec. 31, 2025
USD ($)
Property
Sep. 30, 2024
USD ($)
Sep. 30, 2023
USD ($)
Dec. 31, 2025
USD ($)
Dec. 31, 2024
USD ($)
Business Combination [Line Items]            
Gain (loss) on real estate dispositions         $ 5.5  
Select Medical [Member]            
Business Combination [Line Items]            
Lease Agreement Term   20 years     20 years  
Number of property acquired | Property   1        
Net book value of property   $ 53.0        
Cash receipt of past due obligations   $ 18.0        
Select Medical [Member] | Subsequent Event [Member]            
Business Combination [Line Items]            
Gain (loss) on real estate dispositions $ 12.0          
Vibra [Member]            
Business Combination [Line Items]            
Reserve billed and straight line rent receivables       $ 49.0    
Repayment Of Unpaid Rent           $ 10.0
Amortization of Intangible Assets     $ 22.0      
Lease Agreement Term   20 years     20 years  
Repayment of mortgage loan           $ 3.0
Number of property acquired | Property   1        
Payment for acquisition   $ 32.0        
v3.25.4
Real Estate and Other Activities - Investments in Unconsolidated Real Estate Joint Ventures - Additional Information (Detail)
$ in Thousands, € in Millions
 3 Months Ended 12 Months Ended
Sep. 30, 2025
USD ($)
Dec. 31, 2025
USD ($)
Dec. 31, 2024
USD ($)
Dec. 31, 2023
USD ($)
Dec. 31, 2025
EUR (€)
HealthcareFacilities
Jun. 17, 2025
EUR (€)
Business Combination [Line Items]            
Deferred income tax benefit   $ 10,631 $ 12,989 $ (162,692)    
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   49,000        
Number of healthcare facilities under leases | HealthcareFacilities         70  
Debt instrument final refinancing amount | €         € 655.0 € 655.0
Debt, face amount | €         € 702.5  
Non amortizing period         10 years  
Fixed rate         5.10%  
Reduce future income tax rates 5.00%          
Deferred income tax benefit $ 13,000          
Dividend income   $ 62,000 $ 45,000      
Investments in Unconsolidated Real Estate Joint Ventures [Member] | Maximum [Member]            
Business Combination [Line Items]            
Percentage of equity investment         100.00%  
Common Spirit [Member]            
Business Combination [Line Items]            
Percentage of equity investment         25.00%  
v3.25.4
Real Estate and Other Activities - Summary of Financial Information on Combined Basis for Our Investments in Unconsolidated Real Estate Joint Ventures (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Schedule of Equity Method Investments [Line Items]      
Revenue $ 972,022 $ 995,547 $ 871,799
Net Income (Loss) (277,049) (2,410,271) (556,476)
Assets 15,001,775 14,294,594  
Liabilities 10,394,526 9,460,811  
Investments in Unconsolidated Real Estate Joint Ventures [Member]      
Schedule of Equity Method Investments [Line Items]      
Revenue 357,823 348,404 315,108
Net Income (Loss) 313,593 (739,393) $ 14,701
Assets 5,614,938 4,872,918  
Liabilities $ 2,831,599 $ 2,599,078  
v3.25.4
Real Estate and Other Activities - Summary of Investments in Unconsolidated Real Estate Joint Ventures by Operator (Detail) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Schedule of Equity Method Investments [Line Items]    
Investments in unconsolidated real estate joint ventures $ 1,399,777 $ 1,156,397
Swiss Medical Network [Member]    
Schedule of Equity Method Investments [Line Items]    
Ownership interest 70.00%  
Investments in unconsolidated real estate joint ventures $ 611,347 483,770
MEDIAN [Member]    
Schedule of Equity Method Investments [Line Items]    
Ownership interest 50.00%  
Investments in unconsolidated real estate joint ventures $ 486,695 431,964
Common Spirit [Member]    
Schedule of Equity Method Investments [Line Items]    
Ownership interest 25.00%  
Investments in unconsolidated real estate joint ventures $ 162,278 113,202
Policlinico di Monza [Member]    
Schedule of Equity Method Investments [Line Items]    
Ownership interest 50.00%  
Investments in unconsolidated real estate joint ventures $ 86,091 77,592
HM Hospital [Member]    
Schedule of Equity Method Investments [Line Items]    
Ownership interest 45.00%  
Investments in unconsolidated real estate joint ventures $ 53,366 $ 49,869
v3.25.4
Real Estate and Other Activities - Summary of Investments in Unconsolidated Operating Entities (Detail) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Schedule of Equity Method Investments [Line Items]    
Investments in unconsolidated operating entities $ 322,179 $ 439,578
Swiss Medical Network [Member]    
Schedule of Equity Method Investments [Line Items]    
Investments in unconsolidated operating entities 197,497 172,453
PHP Holdings [Member]    
Schedule of Equity Method Investments [Line Items]    
Investments in unconsolidated operating entities 0 149,027
Priory [Member]    
Schedule of Equity Method Investments [Line Items]    
Investments in unconsolidated operating entities 43,913 38,739
Aevis Victoria SA [Member]    
Schedule of Equity Method Investments [Line Items]    
Investments in unconsolidated operating entities 64,859 63,409
Aspris Children's Services [Member]    
Schedule of Equity Method Investments [Line Items]    
Investments in unconsolidated operating entities $ 15,910 $ 15,950
v3.25.4
Real Estate and Other Activities - Investments in Unconsolidated Operating Entities - Additional Information (Detail)
£ in Millions, $ in Millions
 3 Months Ended 12 Months Ended
Mar. 31, 2024
USD ($)
Mar. 31, 2024
GBP (£)
Dec. 31, 2025
USD ($)
Dec. 31, 2024
USD ($)
Syndicated Term Loan [Member]        
Business Combination [Line Items]        
Proceed from sale of interest in syndicated term loan $ 115.0 £ 90    
Gain (loss) on sale of interest in syndicated term loan (7.8) £ (6)    
Other [Member]        
Business Combination [Line Items]        
Unfavorable fair market value adjustment on investment $ 225.0   $ 154.0 $ 794.0
Other [Member] | PHP Holdings Equity Investment [Member]        
Business Combination [Line Items]        
Unfavorable fair market value adjustment on investment       $ 550.0
v3.25.4
Real Estate and Other Activities - Other Investment Activities - Additional Information (Detail)
SFr in Millions, $ in Millions
 3 Months Ended
Nov. 03, 2023
USD ($)
Aug. 17, 2023
USD ($)
Jun. 30, 2023
CHF (SFr)
Sep. 30, 2023
USD ($)
Steward Health Care System L L C [Member]        
Business Acquisition [Line Items]        
Other investment on secured loan with credit facility collateral       $ 40
Repayment received on credit facility availed $ 2      
Repayments of mortgage loan | SFr     SFr 60  
Steward Health Care System L L C [Member] | Asset-Backed Securities [Member]        
Business Acquisition [Line Items]        
Investments       $ 105
Sale of investment   $ 105    
Global Asset Manager [Member]        
Business Acquisition [Line Items]        
Sale of investment   $ 100    
v3.25.4
Real Estate and Other Activities - Schedule of Concentrations of Credit Risk - (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Business Combination [Line Items]      
Total Assets $ 15,001,775 $ 14,294,594  
Total revenues 972,022 995,547 $ 871,799
Operator Concentration Risk [Member] | Total Gross Assets [Member]      
Business Combination [Line Items]      
Total Assets [1] $ 15,001,775 $ 14,294,594  
Percentage of concentration risk 100.00% 100.00%  
Operator Concentration Risk [Member] | Total Gross Assets [Member] | Other Assets [Member]      
Business Combination [Line Items]      
Percentage of concentration risk 13.40% 11.80%  
Operator Concentration Risk [Member] | Total Gross Assets [Member] | Circle [Member]      
Business Combination [Line Items]      
Total Assets [1] $ 2,121,848 $ 2,026,778  
Percentage of concentration risk 14.10% 14.20%  
Operator Concentration Risk [Member] | Total Gross Assets [Member] | Priory [Member]      
Business Combination [Line Items]      
Total Assets [1] $ 1,301,888 $ 1,233,462  
Percentage of concentration risk 8.70% 8.60%  
Operator Concentration Risk [Member] | Total Gross Assets [Member] | Healthcare Systems of America [Member]      
Business Combination [Line Items]      
Total Assets [1] $ 1,200,996 $ 1,187,006  
Percentage of concentration risk 8.00% 8.30%  
Operator Concentration Risk [Member] | Total Gross Assets [Member] | Lifepoint Behavioral [Member]      
Business Combination [Line Items]      
Total Assets [1] $ 809,492 $ 813,584  
Percentage of concentration risk 5.40% 5.70%  
Operator Concentration Risk [Member] | Total Gross Assets [Member] | Swiss Medical Network [Member]      
Business Combination [Line Items]      
Total Assets [1] $ 873,703 $ 719,632  
Percentage of concentration risk 5.80% 5.10%  
Operator Concentration Risk [Member] | Total Gross Assets [Member] | Other Operators [Member]      
Business Combination [Line Items]      
Total Assets [1] $ 6,688,287 $ 6,624,256  
Percentage of concentration risk 44.60% 46.30%  
Operator Concentration Risk [Member] | Total Gross Assets [Member] | Other Assets by Operator [Member]      
Business Combination [Line Items]      
Total Assets [1] $ 2,005,561 $ 1,689,876  
Operator Concentration Risk [Member] | Revenue [Member] | Prospect [Member]      
Business Combination [Line Items]      
Percentage of concentration risk     12.30%
Total revenues     $ 107,557
Operator Concentration Risk [Member] | Revenue [Member] | Circle [Member]      
Business Combination [Line Items]      
Percentage of concentration risk 21.90% 20.70% 22.30%
Total revenues $ 212,719 $ 205,582 $ 194,390
Operator Concentration Risk [Member] | Revenue [Member] | Priory [Member]      
Business Combination [Line Items]      
Percentage of concentration risk 10.90% 10.20%  
Total revenues $ 105,986 $ 101,675  
Geographic Concentration Risk [Member] | Total Gross Assets [Member]      
Business Combination [Line Items]      
Total Assets [2] $ 15,001,775 $ 14,294,594  
Percentage of concentration risk [2] 100.00% 100.00%  
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Texas [Member]      
Business Combination [Line Items]      
Total Assets [2] $ 1,427,391 $ 1,394,296  
Percentage of concentration risk [2] 9.50% 9.80%  
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | California [Member]      
Business Combination [Line Items]      
Total Assets [2] $ 977,890 $ 935,470  
Percentage of concentration risk [2] 6.50% 6.40%  
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Florida [Member]      
Business Combination [Line Items]      
Total Assets [2] $ 834,940 $ 840,876  
Percentage of concentration risk [2] 5.60% 5.90%  
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Arizona [Member]      
Business Combination [Line Items]      
Total Assets [2] $ 328,873 $ 379,801  
Percentage of concentration risk [2] 2.20% 2.70%  
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Ohio [Member]      
Business Combination [Line Items]      
Total Assets [2] $ 330,189 $ 327,577  
Percentage of concentration risk [2] 2.20% 2.30%  
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | All Other States [Member]      
Business Combination [Line Items]      
Total Assets [2] $ 2,480,182 $ 2,636,587  
Percentage of concentration risk [2] 16.50% 18.50%  
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Other Domestic Assets [Member]      
Business Combination [Line Items]      
Total Assets [2] $ 1,072,900 $ 951,486  
Percentage of concentration risk [2] 7.20% 6.60%  
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Total U.S. [Member]      
Business Combination [Line Items]      
Total Assets [2] $ 7,452,365 $ 7,466,093  
Percentage of concentration risk [2] 49.70% 52.20%  
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | U.K. [Member]      
Business Combination [Line Items]      
Total Assets [2] $ 4,184,188 $ 3,985,672  
Percentage of concentration risk [2] 27.90% 27.90%  
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Switzerland [Member]      
Business Combination [Line Items]      
Total Assets [2] $ 873,703 $ 719,632  
Percentage of concentration risk [2] 5.80% 5.00%  
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Germany [Member]      
Business Combination [Line Items]      
Total Assets [2] $ 751,806 $ 672,343  
Percentage of concentration risk [2] 5.00% 4.70%  
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Spain [Member]      
Business Combination [Line Items]      
Total Assets [2] $ 302,323 $ 247,996  
Percentage of concentration risk [2] 2.00% 1.70%  
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Finland [Member]      
Business Combination [Line Items]      
Total Assets [2] $ 220,813 $ 199,721  
Percentage of concentration risk [2] 1.50% 1.40%  
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | All Other Countries [Member]      
Business Combination [Line Items]      
Total Assets [2] $ 283,916 $ 264,747  
Percentage of concentration risk [2] 1.90% 1.90%  
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Other International Assets [Member]      
Business Combination [Line Items]      
Total Assets [2] $ 932,661 $ 738,390  
Percentage of concentration risk [2] 6.20% 5.20%  
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Total International [Member]      
Business Combination [Line Items]      
Total Assets [2] $ 7,549,410 $ 6,828,501  
Percentage of concentration risk [2] 50.30% 47.80%  
Geographic Concentration Risk [Member] | Revenue [Member]      
Business Combination [Line Items]      
Percentage of concentration risk 100.00% 100.00% 100.00%
Total revenues $ 972,022 $ 995,547 $ 871,799
Geographic Concentration Risk [Member] | Revenue [Member] | Total U.S. [Member]      
Business Combination [Line Items]      
Percentage of concentration risk 53.30% 56.40% 46.70%
Total revenues $ 517,878 $ 561,673 $ 407,329
Geographic Concentration Risk [Member] | Revenue [Member] | U.K. [Member]      
Business Combination [Line Items]      
Percentage of concentration risk 38.40% 36.20% 40.40%
Total revenues $ 373,279 $ 359,991 $ 352,594
Geographic Concentration Risk [Member] | Revenue [Member] | All Other Countries [Member]      
Business Combination [Line Items]      
Percentage of concentration risk 8.30% 7.40% 12.90%
Total revenues $ 80,865 $ 73,883 $ 111,876
Customer Concentration Risk [Member] | Total Gross Assets [Member]      
Business Combination [Line Items]      
Total Assets $ 15,001,775 $ 14,294,594 [2]  
Percentage of concentration risk [2] 100.00% 100.00%  
Customer Concentration Risk [Member] | Total Gross Assets [Member] | Other Assets [Member]      
Business Combination [Line Items]      
Percentage of concentration risk [2] 13.40% 11.80%  
Customer Concentration Risk [Member] | Total Gross Assets [Member] | General Acute Care Hospitals [Member]      
Business Combination [Line Items]      
Total Assets $ 8,769,909 $ 8,493,331 [2]  
Percentage of concentration risk [2] 58.50% 59.40%  
Customer Concentration Risk [Member] | Total Gross Assets [Member] | Behavioral Health Facilities [Member]      
Business Combination [Line Items]      
Total Assets $ 2,445,418 $ 2,376,460 [2]  
Percentage of concentration risk [2] 16.30% 16.70%  
Customer Concentration Risk [Member] | Total Gross Assets [Member] | Post acute care facilities [Member]      
Business Combination [Line Items]      
Total Assets $ 1,671,616 $ 1,617,596 [2]  
Percentage of concentration risk [2] 11.10% 11.30%  
Customer Concentration Risk [Member] | Total Gross Assets [Member] | Freestanding E R Urgent Care Facilities [Member]      
Business Combination [Line Items]      
Total Assets $ 109,271 $ 117,331 [2]  
Percentage of concentration risk [2] 0.70% 0.80%  
Customer Concentration Risk [Member] | Total Gross Assets [Member] | Other Assets By Facility [Member]      
Business Combination [Line Items]      
Total Assets $ 2,005,561 $ 1,689,876 [2]  
Customer Concentration Risk [Member] | Revenue [Member]      
Business Combination [Line Items]      
Percentage of concentration risk 100.00% 100.00% 100.00%
Total revenues $ 972,022 $ 995,547 $ 871,799
Customer Concentration Risk [Member] | Revenue [Member] | General Acute Care Hospitals [Member]      
Business Combination [Line Items]      
Percentage of concentration risk 60.30% 63.10% 62.20%
Total revenues $ 586,648 $ 628,622 $ 541,888
Customer Concentration Risk [Member] | Revenue [Member] | Behavioral Health Facilities [Member]      
Business Combination [Line Items]      
Percentage of concentration risk 22.10% 21.10% 24.50%
Total revenues $ 214,437 $ 209,668 $ 213,292
Customer Concentration Risk [Member] | Revenue [Member] | Post acute care facilities [Member]      
Business Combination [Line Items]      
Percentage of concentration risk 16.80% 14.00% 10.60%
Total revenues $ 162,954 $ 139,859 $ 92,787
Customer Concentration Risk [Member] | Revenue [Member] | Freestanding E R Urgent Care Facilities [Member]      
Business Combination [Line Items]      
Percentage of concentration risk 0.80% 1.80% 2.70%
Total revenues $ 7,983 $ 17,398 $ 23,832
[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.
[2] 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.
v3.25.4
Real Estate and Other Activities - Concentration of Credit Risks and Related Party Transactions - Additional Information (Detail) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Related Party Transactions [Member]      
Business Acquisition [Line Items]      
Revenues earned from tenants $ 23.7 $ 33.9 $ 83.0
Total Gross Assets [Member] | Customer Concentration Risk [Member] | Maximum [Member] | Behavioral health facilities      
Business Acquisition [Line Items]      
Maximum percentage of entity's assets invested on single property 2.00%    
v3.25.4
Debt - Summary of Debt (Detail)
$ in Thousands, € in Billions
Dec. 31, 2025
USD ($)
Feb. 13, 2025
USD ($)
Feb. 13, 2025
EUR (€)
Dec. 31, 2024
USD ($)
Debt Instrument [Line Items]        
Debt $ 9,830,872     $ 8,919,219
Debt issue costs and discount, net (133,037)     (71,107)
Debt, net 9,697,835     8,848,112
Secured Revolving Credit Facility [Member]        
Debt Instrument [Line Items]        
Debt [1] 638,063     361,726
Secured Term Loan [Member]        
Debt Instrument [Line Items]        
Debt 200,000     200,000
Term loan due 2025 | British Pound Sterling [Member]        
Debt Instrument [Line Items]        
Debt [2] 0     617,039
Secured term loan due 2034 | British Pound Sterling [Member]        
Debt Instrument [Line Items]        
Debt [2] 850,784     790,234
3.325% Senior Unsecured Notes due 2025 [Member]        
Debt Instrument [Line Items]        
Debt [2] 0     517,700
0.993% Senior Unsecured Notes due 2026 [Member]        
Debt Instrument [Line Items]        
Debt [2] 587,300     517,700
2.500% Senior Unsecured Notes due 2026 [Member]        
Debt Instrument [Line Items]        
Debt [2] 0     625,800
5.250% Senior Unsecured Notes due 2026 [Member]        
Debt Instrument [Line Items]        
Debt 0     500,000
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] 808,500     750,960
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] 471,625     438,060
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 | €     € 1.0  
7.000% Senior Secured Notes due 2032 [Member]        
Debt Instrument [Line Items]        
Debt [2] 1,174,600     0
8.500% Senior Secured Notes due 2032 [Member]        
Debt Instrument [Line Items]        
Debt $ 1,500,000 $ 1,500,000   $ 0
[1] Includes €100 million and €303 million of Euro-denominated borrowings and CHF 52 million and CHF - million of Swiss franc-denominated borrowings that reflect the applicable exchange rates at December 31, 2025 and December 31, 2024, respectively.
[2] Non-U.S. dollar denominated debt that reflects the exchange rates at period-end.
v3.25.4
Debt - Summary of Debt (Parenthetical) (Detail)
$ in Thousands, € in Millions, SFr in Millions
Dec. 31, 2025
USD ($)
Dec. 31, 2025
EUR (€)
Dec. 31, 2025
CHF (SFr)
Feb. 13, 2025
EUR (€)
Dec. 31, 2024
USD ($)
Dec. 31, 2024
EUR (€)
Debt Instrument [Line Items]            
Debt $ 9,830,872       $ 8,919,219  
EURO-denominated Borrowings [Member]            
Debt Instrument [Line Items]            
Debt | €   € 100       € 303
Swiss Franc-denominated Borrowings [Member]            
Debt Instrument [Line Items]            
Debt | SFr     SFr 52      
3.325% Senior Unsecured Notes due 2025 [Member]            
Debt Instrument [Line Items]            
Senior unsecured notes, interest rate 3.325% 3.325% 3.325%   3.325% 3.325%
Debt [1] $ 0       $ 517,700  
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%
Debt [1] $ 587,300       $ 517,700  
2.500% Senior Unsecured Notes due 2026 [Member]            
Debt Instrument [Line Items]            
Senior unsecured notes, interest rate 2.50% 2.50% 2.50%   2.50% 2.50%
Debt [1] $ 0       $ 625,800  
5.250% Senior Unsecured Notes due 2026 [Member]            
Debt Instrument [Line Items]            
Senior unsecured notes, interest rate 5.25% 5.25% 5.25%   5.25% 5.25%
Debt $ 0       $ 500,000  
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%
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%
Debt [1] $ 808,500       $ 750,960  
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%
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%
Debt [1] $ 471,625       $ 438,060  
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%
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%
Debt | €       € 1,000    
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%
[1] Non-U.S. dollar denominated debt that reflects the exchange rates at period-end.
v3.25.4
Debt - Principal Payments Due for Debt (Detail) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Debt Disclosure [Abstract]    
2026 [1] $ 1,225,363  
2027 1,600,000  
2028 808,500  
2029 900,000  
2030 471,625  
Thereafter 4,825,384  
Total $ 9,830,872 $ 8,919,219
[1] $638 million (of which approximately $200 million was repaid in January 2026) represents the outstanding balance of the revolving portion of our credit facility for which we have provided notice of our intent to extend to 2027 - see "Credit Facility" subheading for further details.
v3.25.4
Debt - Principal Payments Due for Debt (Parenthetical) (Details) - USD ($)
$ in Thousands
 1 Months Ended 12 Months Ended
Jan. 31, 2026
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Debt Instrument [Line Items]        
Outstanding balance   $ 9,830,872 $ 8,919,219  
Payments of term debt   2,252,731 $ 701,809 $ 988,162
Revolving Credit Facility [Member]        
Debt Instrument [Line Items]        
Outstanding balance   $ 638,000    
Revolving Credit Facility [Member] | Subsequent Event [Member]        
Debt Instrument [Line Items]        
Payments of term debt $ 200,000      
v3.25.4
Debt - 2025 Activity - Additional Information (Detail)
$ in Thousands, £ in Millions, € in Billions
 12 Months Ended
Feb. 13, 2025
USD ($)
Jan. 15, 2025
USD ($)
Dec. 31, 2025
USD ($)
Dec. 31, 2024
USD ($)
Dec. 31, 2024
GBP (£)
Dec. 31, 2023
USD ($)
Feb. 13, 2025
EUR (€)
Debt Instrument [Line Items]              
Amount of term loan paid     $ 2,252,731 $ 701,809   $ 988,162  
Outstanding balance     9,830,872 8,919,219      
Maximum [Member]              
Debt Instrument [Line Items]              
Debt instrument redemption price 100.00%           100.00%
Maximum [Member] | Prior to February 15, 2028              
Debt Instrument [Line Items]              
Debt instrument redemption price 40.00%           40.00%
8.500% Senior Secured Notes due 2032 [Member]              
Debt Instrument [Line Items]              
Outstanding balance $ 1,500,000   $ 1,500,000 $ 0      
Percentage of Par Value     98.71%        
Debt instrument maturity date     Feb. 15, 2032        
8.500% Senior Secured Notes due 2032 [Member] | Prior to February 15, 2028              
Debt Instrument [Line Items]              
Debt instrument redemption price 108.50%           108.50%
7.000% Senior Secured Notes due 2032 [Member]              
Debt Instrument [Line Items]              
Outstanding balance | €             € 1.0
Senior unsecured notes, interest rate     7.00% 7.00%      
7.000% Senior Secured Notes due 2032 [Member] | Prior to February 15, 2028              
Debt Instrument [Line Items]              
Debt instrument redemption price 107.00%           107.00%
3.325% of Senior Unsecured Notes Due 2025              
Debt Instrument [Line Items]              
Debt instrument maturity year 2025   2025        
Senior unsecured notes, interest rate 3.325%   3.325%       3.325%
2.500% of Senior Unsecured Notes Due 2026              
Debt Instrument [Line Items]              
Debt instrument maturity year 2026   2026        
Senior unsecured notes, interest rate 2.50%   2.50%       2.50%
5.250% of Senior Unsecured Notes Due 2026              
Debt Instrument [Line Items]              
Debt instrument maturity year 2026   2026        
Senior unsecured notes, interest rate 5.25%   5.25%       5.25%
UNITED KINGDOM | Term loan due 2025              
Debt Instrument [Line Items]              
Amount of term loan paid   $ 493,000     £ 105    
Debt instrument maturity year   2025   2025 2025    
Outstanding balance [1]     $ 0 $ 617,039      
[1] Non-U.S. dollar denominated debt that reflects the exchange rates at period-end.
v3.25.4
Debt - 2024 Activity - Additional Information (Detail)
$ in Thousands, £ in Millions, $ in Millions
 3 Months Ended 12 Months Ended
Jan. 15, 2025
USD ($)
Apr. 18, 2024
USD ($)
Apr. 18, 2024
AUD ($)
Oct. 10, 2023
Facility
May 18, 2023
Facility
Mar. 31, 2023
Facility
Dec. 31, 2025
USD ($)
Facility
Dec. 31, 2024
USD ($)
Dec. 31, 2024
GBP (£)
Dec. 31, 2023
USD ($)
Dec. 31, 2023
AUD ($)
Dec. 31, 2024
GBP (£)
May 24, 2024
USD ($)
May 24, 2024
GBP (£)
Debt Instrument [Line Items]                            
Amount of term loan paid             $ 2,252,731 $ 701,809   $ 988,162        
Number of facilities sold | Facility           3 9              
Australia Facility [Member]                            
Debt Instrument [Line Items]                            
Term loan paid off and terminated with proceeds from Utah transaction   $ 306,000 $ 470                      
Revolving Credit Facility [Member]                            
Debt Instrument [Line Items]                            
Line of credit facility, Borrowing capacity             $ 1,280,000              
Revolving credit facility amount paid               375,000            
Additional amount of revolving credit facility paid               756,000            
Australia Transaction [Member]                            
Debt Instrument [Line Items]                            
Number of facilities sold | Facility         7                  
Number of remaining facilities sold | Facility       4                    
Proceeds from the sale of first tranche prepay                   475,000 $ 730      
Term loan                   $ 1,200,000        
Secured term loan due 2034 | British Pound Sterling [Member]                            
Debt Instrument [Line Items]                            
Principal amount               $ 800,000       £ 631 $ 800,000 £ 631
Debt instrument maturity year             2034              
Term loan due 2025 | British Pound Sterling [Member]                            
Debt Instrument [Line Items]                            
Debt instrument maturity year 2025             2025 2025          
Amount of term loan paid $ 493,000               £ 105          
Additional amount of term loan paid | £                 £ 102          
Secured term loan due 2024 | British Pound Sterling [Member]                            
Debt Instrument [Line Items]                            
Debt instrument maturity year               2024 2024          
Amount of term loan paid               $ 105,000            
v3.25.4
Debt - 2023 Activity - Additional Information (Detail)
$ in Thousands, £ in Millions, $ in Millions
 12 Months Ended
Dec. 05, 2023
GBP (£)
Dec. 31, 2023
USD ($)
Dec. 31, 2023
AUD ($)
Dec. 31, 2023
GBP (£)
Dec. 31, 2025
USD ($)
Dec. 31, 2024
USD ($)
Debt Instrument [Line Items]            
Principal amount | $         $ 9,830,872 $ 8,919,219
Australia Transaction [Member]            
Debt Instrument [Line Items]            
Proceeds from the sale of first tranche prepay   $ 475,000 $ 730      
Term loan | $   1,200,000        
2.550% Senior Unsecured Notes due 2023 [Member]            
Debt Instrument [Line Items]            
Principal amount | £       £ 50.0    
Senior unsecured notes, interest rate 2.55%     2.55%    
Purchase yield average percentage       13.00%    
Gain on prepayment of Debt   $ 1,100   £ 1.1    
Debt instrument paid off | £ £ 350.0          
v3.25.4
Debt - Credit Facility - Additional Information (Detail)
$ in Millions
 12 Months Ended
Feb. 13, 2025
Jan. 15, 2025
Aug. 06, 2024
USD ($)
Apr. 12, 2024
USD ($)
Dec. 31, 2024
USD ($)
Dec. 31, 2023
Dec. 31, 2025
USD ($)
Aug. 31, 2024
Jun. 29, 2022
USD ($)
Debt Instrument [Line Items]                  
Adjustments to applicable margin           0.375%      
Commitment fee         0.30% 0.25%      
Line of credit facility, description           Prior to the 2024 amendments described below and at our election, loans were made as either alternate base rate loans ("ABR Loans") or loans for an interest period of either one, three, or six months ("Term Benchmark Loans").      
Debt Instrument, Variable Interest Rate, Type [Extensible Enumeration] Secured Overnight Financing Rate (SOFR) [Member]                
Minimum [Member]                  
Debt Instrument [Line Items]                  
Commitment fee           0.125%      
Maximum [Member]                  
Debt Instrument [Line Items]                  
Commitment fee           0.30%      
Alternate Base Rate [Member] | Minimum [Member]                  
Debt Instrument [Line Items]                  
Applicable margin for term loan           0.00%      
Applicable margin for revolving loans           0.00%      
Alternate Base Rate [Member] | Maximum [Member]                  
Debt Instrument [Line Items]                  
Applicable margin for term loan           0.70%      
Applicable margin for revolving loans           0.50%      
Term Benchmark Loans or RFR Loans [Member] | Minimum [Member]                  
Debt Instrument [Line Items]                  
Applicable margin for revolving loans           0.80%      
Term Benchmark Loans or RFR Loans [Member] | Maximum [Member]                  
Debt Instrument [Line Items]                  
Applicable margin for revolving loans           1.50%      
British Pound Sterling [Member] | Term loan due 2025                  
Debt Instrument [Line Items]                  
Debt instrument maturity year   2025     2025        
Modified Covenant During the Period [Member]                  
Debt Instrument [Line Items]                  
Basis Points     3.00%            
Percentage of proceeds of future asset sales and debt transactions     15.00%            
Modified Covenant During the Period [Member] | British Pound Sterling [Member] | Term loan due 2025                  
Debt Instrument [Line Items]                  
Percentage of proceeds of future asset sales and debt transactions     50.00%            
Debt instrument maturity year     2025 2025          
Modified Covenant After the Period [Member]                  
Debt Instrument [Line Items]                  
Basis Points     2.25%            
Credit Facility Amendment [Member]                  
Debt Instrument [Line Items]                  
Credit facility, current borrowing capacity     $ 1,280 $ 1,400         $ 1,800
Unsecured interest coverage ratio 225             300  
Maximum total leverage ratio 60.00%                
Secured leverage ratio 40.00%                
Maximum ratio of secured first lien debt 65.00%                
Credit Facility Amendment [Member] | Minimum [Member]                  
Debt Instrument [Line Items]                  
Unsecured interest coverage ratio 1.15   1.75            
Maximum total leverage ratio     60.00%            
Credit Facility Amendment [Member] | Maximum [Member]                  
Debt Instrument [Line Items]                  
Unsecured interest coverage ratio 1.3   1.45            
Maximum total leverage ratio     65.00%            
Revolving Credit Facility [Member]                  
Debt Instrument [Line Items]                  
Line of credit facility, Borrowing capacity             $ 1,280    
Revolver [Member]                  
Debt Instrument [Line Items]                  
Credit facilities, amount outstanding         $ 400   600    
Line of credit facility, Borrowing capacity         $ 900   $ 700    
Credit facilities, weighted average interest rate         6.60%   5.50%    
Term Loan [Member]                  
Debt Instrument [Line Items]                  
Debt, face amount             $ 200    
Interest rate at end of period           6.10% 7.50%    
Term Loan [Member] | Term Benchmark Loans [Member] | Minimum [Member]                  
Debt Instrument [Line Items]                  
Applicable margin for term loan           0.875%      
Term Loan [Member] | Term Benchmark Loans [Member] | Maximum [Member]                  
Debt Instrument [Line Items]                  
Applicable margin for term loan           1.70%      
v3.25.4
Debt - British Pound Sterling Term Loan - Additional Information (Detail)
$ in Thousands, € in Millions
 12 Months Ended
Jan. 15, 2025
USD ($)
Jan. 15, 2025
EUR (€)
May 24, 2024
USD ($)
Property
Mar. 04, 2020
Jan. 06, 2020
GBP (£)
Dec. 31, 2025
USD ($)
Dec. 31, 2025
EUR (€)
Dec. 31, 2024
USD ($)
Dec. 31, 2024
GBP (£)
Dec. 31, 2023
USD ($)
Dec. 31, 2024
GBP (£)
Aug. 06, 2024
May 24, 2024
GBP (£)
Property
Mar. 10, 2023
Mar. 09, 2023
Debt Instrument [Line Items]                              
Amount of term loan paid           $ 2,252,731   $ 701,809   $ 988,162          
Revolving Credit Facility [Member]                              
Debt Instrument [Line Items]                              
Line of Credit Facility, Maximum Borrowing Capacity           $ 1,280,000                  
Revolving credit facility amount paid               375,000              
Secured term loan due 2034 | British Pound Sterling [Member]                              
Debt Instrument [Line Items]                              
Principal amount     $ 800,000         $ 800,000     £ 631,000,000   £ 631,000,000    
Number of properties | Property     27                   27    
Senior unsecured notes, interest rate     6.877%                   6.877%    
Debt insrtument term     10 years                        
Debt instrument maturity year           2034 2034                
Term loan due 2025 | British Pound Sterling [Member]                              
Debt Instrument [Line Items]                              
Debt instrument maturity year 2025 2025           2025 2025            
Amount of term loan paid $ 493,000               £ 105,000,000            
Term loan due 2025 | Bank of America, N.A | British Pound Sterling [Member]                              
Debt Instrument [Line Items]                              
Line of Credit Facility, Maximum Borrowing Capacity | £         £ 700,000,000                    
Debt instrument effective date       Mar. 06, 2020                      
Effective interest rate       0.70%                      
Variable interest rate                           1.65% 1.25%
Senior unsecured notes, interest rate                   2.349%   3.70%      
Term loan due 2025 | Bank of America, N.A | British Pound Sterling [Member] | Minimum [Member]                              
Debt Instrument [Line Items]                              
Applicable margin adjustable based on pricing grid, percentage         0.85%                    
Term loan due 2025 | Bank of America, N.A | British Pound Sterling [Member] | Maximum [Member]                              
Debt Instrument [Line Items]                              
Applicable margin adjustable based on pricing grid, percentage         1.65%                    
Secured term loan due 2024 | British Pound Sterling [Member]                              
Debt Instrument [Line Items]                              
Debt instrument maturity year               2024 2024            
Amount of term loan paid               $ 105,000              
Secured term loan due 2025                              
Debt Instrument [Line Items]                              
Amount of term loan paid | €   € 493                          
Secured term loan due 2025 | British Pound Sterling [Member]                              
Debt Instrument [Line Items]                              
Debt instrument maturity year           2025 2025                
Amount of term loan paid | €             € 207                
v3.25.4
Debt - Basic Terms of Senior Notes (Detail) - 12 months ended Dec. 31, 2025
EUR (€)
GBP (£)
USD ($)
0.993% Senior Unsecured Notes due 2026 [Member]      
Debt Instrument [Line Items]      
Offering Completion Date Oct. 06, 2021    
Debt instrument maturity date Oct. 15, 2026    
Par Value | € € 500,000,000    
% of Par Value 100.00%    
Interest Payment Frequency Annually    
5.000% Senior Unsecured Notes due 2027 [Member]      
Debt Instrument [Line Items]      
Offering Completion Date Sep. 21, 2017    
Debt instrument maturity date Oct. 15, 2027    
Par Value     $ 1,400,000,000
% of Par Value 100.00%    
Interest Payment Frequency Semi-annually    
3.692% Senior Unsecured Notes due 2028 [Member]      
Debt Instrument [Line Items]      
Offering Completion Date Dec. 05, 2019    
Debt instrument maturity date Jun. 05, 2028    
Par Value | £   £ 600,000,000  
% of Par Value 99.998%    
Interest Payment Frequency Annually    
4.625% Senior Unsecured Notes due 2029 [Member]      
Debt Instrument [Line Items]      
Offering Completion Date Jul. 26, 2019    
Debt instrument maturity date Aug. 01, 2029    
Par Value     900,000,000
% of Par Value 99.50%    
Interest Payment Frequency Semi-annually    
3.375% Senior Unsecured Notes due 2030 [Member]      
Debt Instrument [Line Items]      
Offering Completion Date Mar. 24, 2021    
Debt instrument maturity date Apr. 24, 2030    
Par Value | £   £ 350,000,000  
% of Par Value 99.448%    
Interest Payment Frequency Annually    
3.500% Senior Unsecured Notes due 2031 [Member]      
Debt Instrument [Line Items]      
Offering Completion Date Dec. 04, 2020    
Debt instrument maturity date Mar. 15, 2031    
Par Value     1,300,000,000
% of Par Value 100.00%    
Interest Payment Frequency Semi-annually    
7.000% Senior Secured Notes due 2032 [Member]      
Debt Instrument [Line Items]      
Offering Completion Date Feb. 13, 2025    
Debt instrument maturity date Feb. 15, 2032    
Par Value | € € 1,000,000,000    
% of Par Value 98.645%    
Interest Payment Frequency Semi-annually    
8.500% Senior Secured Notes due 2032 [Member]      
Debt Instrument [Line Items]      
Offering Completion Date Feb. 13, 2025    
Debt instrument maturity date Feb. 15, 2032    
Par Value     $ 1,500,000,000
% of Par Value 98.71%    
Interest Payment Frequency Semi-annually    
v3.25.4
Debt - Senior Notes - Additional Information (Detail)
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
0.993% Senior Unsecured Notes due 2026 [Member]    
Debt Instrument [Line Items]    
Senior unsecured notes, maturity year 2026  
Senior unsecured notes, interest rate 0.993% 0.993%
Senior Unsecured Notes [Member]    
Debt Instrument [Line Items]    
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest 101.00%  
v3.25.4
Debt - Additional Information (Detail)
$ in Thousands, £ in Millions
 12 Months Ended
Feb. 13, 2025
Dec. 31, 2025
USD ($)
Dec. 31, 2024
USD ($)
Dec. 31, 2023
USD ($)
Dec. 31, 2023
GBP (£)
Dec. 31, 2023
GBP (£)
Dec. 05, 2023
Debt Instrument [Line Items]              
Debt refinancing and unutilized financing costs   $ 3,629 $ 4,292 $ (285)      
Principal amount   $ 9,830,872 $ 8,919,219        
Accelerated amortization debt issue costs       $ 800      
0.993% Senior Unsecured Notes due 2026 [Member]              
Debt Instrument [Line Items]              
Senior unsecured notes, interest rate   0.993% 0.993%        
Debt instrument maturity year   2026          
Principal amount [1]   $ 587,300 $ 517,700        
Senior unsecured notes, interest rate   0.993% 0.993%        
3.500% Senior Unsecured Notes due 2031 [Member]              
Debt Instrument [Line Items]              
Senior unsecured notes, interest rate   3.50% 3.50%        
Principal amount   $ 1,300,000 $ 1,300,000        
Senior unsecured notes, interest rate   3.50% 3.50%        
2.550% Senior Unsecured Notes due 2023 [Member]              
Debt Instrument [Line Items]              
Senior unsecured notes, interest rate       2.55%   2.55% 2.55%
Gain on prepayment of Debt       $ 1,100 £ 1.1    
Principal amount | £           £ 50.0  
Senior unsecured notes, interest rate       2.55%   2.55% 2.55%
3.692% Senior Unsecured Notes due 2028 [Member]              
Debt Instrument [Line Items]              
Senior unsecured notes, interest rate   3.692% 3.692%        
Principal amount [1]   $ 808,500 $ 750,960        
Senior unsecured notes, interest rate   3.692% 3.692%        
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          
Senior unsecured notes, interest rate 3.325% 3.325%          
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          
Senior unsecured notes, interest rate 2.50% 2.50%          
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          
Senior unsecured notes, interest rate 5.25% 5.25%          
[1] Non-U.S. dollar denominated debt that reflects the exchange rates at period-end.
v3.25.4
Debt - Covenants and Restrictions - Additional Information (Detail)
$ / shares in Units, $ in Billions
 12 Months Ended
Feb. 13, 2025
Dec. 31, 2025
Aug. 31, 2024
Aug. 06, 2024
USD ($)
$ / shares
Apr. 12, 2024
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%      
Debt Instrument, Variable Interest Rate, Type [Extensible Enumeration] Secured Overnight Financing Rate (SOFR) [Member]        
Credit Facility Amendment [Member]          
Debt Instrument [Line Items]          
Permitted ratio         10.00%
Maximum total leverage ratio 60.00%        
Secured leverage ratio 40.00%        
Unsecured interest coverage ratio 225   300    
Payment of dividends in cash during modified covenant period | $ / shares       $ 0.08  
Maximum ratio of secured first lien debt 65.00%        
Credit Facility Amendment [Member] | Maximum [Member]          
Debt Instrument [Line Items]          
Maximum total leverage ratio       65.00%  
Unsecured leverage ratio       70.00%  
Unsecured interest coverage ratio 1.3     1.45  
Net worth covenant       $ 6.7  
Credit Facility Amendment [Member] | Minimum [Member]          
Debt Instrument [Line Items]          
Maximum total leverage ratio       60.00%  
Unsecured leverage ratio       65.00%  
Unsecured interest coverage ratio 1.15     1.75  
Net worth covenant       $ 5.0  
v3.25.4
Income Taxes - Additional Information (Detail) - USD ($)
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Income Tax Disclosure [Abstract]      
Percentage of ordinary taxable income to be distributed for real estate investment trust qualification 90.00% 90.00% 90.00%
Percentage of taxable income to be distributed for federal income tax assumption 100.00%    
Amount of foreign income (loss) before income taxes $ 108,400,000 $ 127,900,000 $ 6,300,000
Amount of domestic loss before income taxes (219,200,000) $ (1,400,000,000) $ (144,500,000)
Additional valuation allowance not expected to be realized 70,900,000    
Uncertain tax position liabilities and related interest or penalties $ 0    
v3.25.4
Income Taxes - Schedule of Income Tax (Expense) Benefit (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Current income tax (expense) benefit:      
Domestic $ 0 $ 477 $ (7,756)
Foreign (27,987) (31,589) (24,257)
Total income tax expense (27,987) (31,112) (32,013)
Deferred income tax (expense) benefit:      
Domestic 0 (465) 8,926
Foreign (10,631) (12,524) 153,766
Total income tax expense (10,631) (12,989) 162,692
Total income tax (expense) benefit $ (38,618) $ (44,101) $ 130,679
v3.25.4
Income Taxes - Summary of Reconciliation of Income Tax Benefit (Expense) Benefit from the Statutory Income Tax Rate to the Effective Tax Rate Based on Income before Income Taxes (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Effective Income Tax Rate Reconciliation, Amount [Abstract]      
Loss before income tax $ (237,319) $ (2,364,186) $ (686,771)
Income tax benefit at the U.S. statutory federal rate 49,837 496,479 144,222
State and local income tax, net of federal income tax effect 0   1,275
Foreign rate differential 0 4,888 (4,122)
Change in valuation allowance (46,033) (301,468) (45,692)
Tax impact of U.K. REIT conversion     160,641
Interest disallowance 0 (2,965) (3,421)
U.S. earnings not subject to federal income tax (26,569) (227,080) (115,189)
Other adjustments 0 (13,955) (7,035)
Total income tax (expense) benefit $ (38,618) $ (44,101) $ 130,679
Effective Income Tax Rate Reconciliation, Percent [Abstract]      
Loss before income tax 100.00%    
Income tax benefit at the U.S. statutory federal rate 21.00%    
State and local income tax, net of federal income tax effect 0.00%    
Foreign rate differential 0.00%    
Interest disallowance 0.00%    
Changes in valuation allowances (19.40%)    
U.S. earnings not subject to federal income tax (11.20%)    
Other adjustments 0.00%    
Effective tax rate (16.30%)    
U.K. [Member]      
Effective Income Tax Rate Reconciliation, Amount [Abstract]      
Foreign rate differential $ 4,193    
Change in valuation allowance (10,222)    
Tax impact of U.K. REIT conversion 0    
Other adjustments $ 1,227    
Effective Income Tax Rate Reconciliation, Percent [Abstract]      
Foreign rate differential 1.80%    
Changes in valuation allowances (4.30%)    
Tax Impact of UK REIT conversion 0.00%    
Other adjustments 0.50%    
Colombia [Member]      
Effective Income Tax Rate Reconciliation, Amount [Abstract]      
Foreign rate differential $ 3,826    
Change in valuation allowance (9,954)    
Other adjustments $ (1,713)    
Effective Income Tax Rate Reconciliation, Percent [Abstract]      
Foreign rate differential 1.60%    
Changes in valuation allowances (4.20%)    
Other adjustments (0.70%)    
Other Foreign Jurisdictions [Member]      
Effective Income Tax Rate Reconciliation, Amount [Abstract]      
Foreign rate differential $ (3,210)    
Effective Income Tax Rate Reconciliation, Percent [Abstract]      
Foreign rate differential (1.40%)    
v3.25.4
Income Taxes - Summary of Amounts of Cash and Income Taxes Paid (Net of Refunds) (Detail)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
USD ($)
Income Tax Disclosure [Abstract]  
Federal $ (426)
State 63
Foreign 20,884 [1]
Total $ 20,521
[1] Income taxes paid (net of refunds) in the U.K. and Spain were $18.2 million and $1.5 million, respectively, and exceeded 5% of total income taxes paid (net of refunds).
v3.25.4
Income Taxes - Summary of Amounts of Cash and Income Taxes Paid (Net of Refunds) (Parenthetical) (Details)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
USD ($)
Income Tax Paid, by Individual Jurisdiction [Line Items]  
Foreign $ 20,884 [1]
U.K. [Member]  
Income Tax Paid, by Individual Jurisdiction [Line Items]  
Foreign 18,200
Spain [Member]  
Income Tax Paid, by Individual Jurisdiction [Line Items]  
Foreign $ 1,500
[1] Income taxes paid (net of refunds) in the U.K. and Spain were $18.2 million and $1.5 million, respectively, and exceeded 5% of total income taxes paid (net of refunds).
v3.25.4
Income Taxes - Schedule of Deferred Tax Assets and liabilities (Detail) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Income Tax Disclosure [Abstract]    
Operating loss and interest deduction carryforwards $ 334,501 $ 263,523
Depreciation 70,051 56,089
Partnership investments 143,695 112,892
Impairment and other loss reserves 66,969 101,834
Other 10,263 8,500
Total deferred tax assets 625,479 542,838
Valuation allowance (489,604) (418,659)
Total net deferred tax assets 135,875 124,179
Property and equipment (149,602) (145,835)
Net unbilled revenue (106,088) (82,170)
Partnership investments (26,885) (21,445)
Other (4,102) (3,450)
Total deferred tax liabilities (286,677) (252,900)
Net deferred tax asset (liability) $ (150,802) $ (128,721)
v3.25.4
Income Taxes - Schedule of Net Operating Losses ("NOL") and Other Tax Attribute Carryforwards (Detail)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
USD ($)
U.S. [Member]  
Income Taxes [Line Items]  
Gross NOL carryforwards $ 929,887
Tax-effected carryforwards and other attributes 197,555
Valuation allowance $ (197,555)
Expiration periods 2034
Expiration periods indefinite
Foreign [Member]  
Income Taxes [Line Items]  
Gross NOL carryforwards $ 569,760
Tax-effected carryforwards and other attributes 129,821
Valuation allowance (17,462)
Net deferred tax asset - carryforwards and other attributes $ 112,359
Expiration periods indefinite
v3.25.4
Income Taxes - Schedule of Per Share Distributions to Stockholders (Detail) - $ / shares
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Income Tax Disclosure [Abstract]      
Ordinary dividend $ 0   $ 1.0639
Long-term capital gain 0   0.1061
Return of capital 0.32 $ 0.38  
Total $ 0.32 $ 0.38 $ 1.17
v3.25.4
Income Taxes - Schedule of Per Share Distributions to Stockholders (Parenthetical) (Detail) - $ / shares
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2023
Income Taxes [Line Items]    
Section 199A Dividends   $ 1.0639
Unrecaptured Sec. 1250 gain   $ 0.1061
O2026 A Dividends [Member]    
Income Taxes [Line Items]    
Dividend declared date Nov. 17, 2025  
Dividend paid date Jan. 08, 2026  
v3.25.4
Earnings Per Share/Unit - Calculation of Earnings Per Share (Detail) - USD ($)
shares in Thousands, $ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]      
Net (loss) income $ (275,937) $ (2,408,287) $ (556,092)
Non-controlling interests’ share in earnings (1,112) (1,984) (384)
Participating securities’ share in earnings (889) (946) (1,644)
Net loss, less participating securities' share in earnings $ (277,938) $ (2,411,217) $ (558,120)
Basic weighted-average common shares 600,892 600,248 598,518
Dilutive potential common shares 0 0 0
Diluted weighted-average common shares 600,892 600,248 598,518
MPT Operating Partnership, L.P. [Member]      
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]      
Net (loss) income $ (275,937) $ (2,408,287) $ (556,092)
Non-controlling interests’ share in earnings (1,112) (1,984) (384)
Participating securities’ share in earnings (889) (946) (1,644)
Net loss, less participating securities' share in earnings $ (277,938) $ (2,411,217) $ (558,120)
Basic weighted-average common shares 600,892 600,248 598,518
Dilutive potential common shares 0 0 0
Diluted weighted-average common shares 600,892 600,248 598,518
v3.25.4
Earnings Per Share/Unit - Calculation of Earnings Per Share (Parenthetical) (Detail) - shares
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]      
Potential common shares/units inclusion of shares 112,452 17,162 32,382
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 112,452 17,162 32,382
v3.25.4
Stock Awards - Additional Information (Detail) - USD ($)
$ / shares in Units, $ in Thousands
 1 Months Ended 12 Months Ended
Sep. 24, 2025
Mar. 08, 2024
Apr. 30, 2025
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Apr. 15, 2025
Dec. 08, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Stock / (Unit)-based compensation expense       $ 25,746 $ 32,976 $ 33,250    
Stock-based awards, fair value       $ 7,700 10,900 22,500    
RSUs vested       0        
RSUs forfeited       0        
Maximum [Member]                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Stock awards vesting period in years       10 years        
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       8,000,000        
Maximum number of shares of common stock that may be awarded       5,000,000        
Service-Based Awards [Member]                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Share-based compensation arrangement by share based payment award, expected service period (in years)       3 years        
Stock / (Unit)-based compensation expense       $ 15,100 28,400 $ 33,300    
Performance-Based Awards [Member]                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Share-based compensation arrangement by share based payment award, expected service period (in years)       3 years        
Reduction of share-based compensation       $ 10,900        
Market-Based Awards [Member]                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Percentage of increase in share price   67.00%            
Share Price $ 5.44 $ 7         $ 5.44 $ 7
Common stock remaining for future stock awards transferred to the equity incentive plan   2,700,000         621,061 2,500,000
Performance Awards Earned Or Vested Threshold Benchmark Percentage Of Total Shareholder Return     20.00%          
Stock awards vesting period in years   4 years            
Market awards earned or vested threshold benchmark percentage of total shareholder return 20.00%              
Cash Settled Awards [Member]                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Stock-based compensation expense, unrecognized cost       $ 14,300        
Stock-based compensation expense, unrecognized cost, reorganization period (in years)       1 year 4 months 17 days        
Equity Settled Awards [Member]                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Stock-based compensation expense, unrecognized cost       $ 17,900        
Stock-based compensation expense, unrecognized cost, reorganization period (in years)       11 months 4 days        
RSUs [Member]                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Stock / (Unit)-based compensation expense       $ 10,600 4,600      
Corresponding liability       15,200 $ 4,600      
Grant date fair value       $ 13,300     $ 8,100  
RSUs [Member] | Maximum [Member]                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Annual equity volatility       62.00%        
Risk-free rate       3.89%        
Dividend yield       7.42%        
RSUs [Member] | Minimum [Member]                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Annual equity volatility       59.00%        
Risk-free rate       3.47%        
Dividend yield       5.31%        
v3.25.4
Stock Awards - Stock-based Award Activity (Detail) - $ / shares
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Vesting Based on Service [Member]    
Employee Restricted Equity Awards Vesting Activity [Line Items]    
Nonvested awards at beginning of the year, Shares 1,641,500 1,144,796
Awarded, Shares 2,538,451 1,519,207
Vested, Shares (1,550,294) (993,312)
Forfeited, Shares (21,493) (29,191)
Nonvested awards at end of year, Shares 2,608,164 1,641,500
Nonvested awards at beginning of the year, Weighted Average Value at Award Date $ 6.50 $ 13.01
Awarded, Weighted Average Value at Award Date 5.24 4.36
Vested, Weighted Average Value at Award Date 6.63 10.62
Forfeited, Weighted Average Value at Award Date 5.77 9.58
Nonvested awards at end of year, Weighted Average Value at Award Date $ 5.20 $ 6.50
Vesting Based on Market/Performance Conditions [Member]    
Employee Restricted Equity Awards Vesting Activity [Line Items]    
Nonvested awards at beginning of the year, Shares 10,313,221 12,576,792
Awarded, Shares 1,347,895 345,000
Vested, Shares (89,065) (1,179,631)
Forfeited, Shares (3,689,223) (1,428,940)
Nonvested awards at end of year, Shares 7,882,828 [1] 10,313,221
Nonvested awards at beginning of the year, Weighted Average Value at Award Date $ 9.33 $ 10.20
Awarded, Weighted Average Value at Award Date 11.00 7.78
Vested, Weighted Average Value at Award Date 22.11 16.81
Forfeited, Weighted Average Value at Award Date 11.89 10.40
Nonvested awards at end of year, Weighted Average Value at Award Date $ 8.97 $ 9.33
[1] Reflects the maximum share payout of certain market-based awards granted in 2023, 2024, and 2025. However, share payout at target level for these market-based awards would result in nonvested awards at December 31, 2025 of 3.1 million shares.
v3.25.4
Stock Awards - Stock-based Award Activity (Parenthetical) (Details)
shares in Millions
Dec. 31, 2025
shares
Share-Based Payment Arrangement [Abstract]  
Share payout at target level for these market-based awards would result in nonvested awards 3.1
v3.25.4
Contingencies - Additional Information (Detail)
$ in Millions
Dec. 31, 2025
USD ($)
Steward Health Care System LLC [Member]  
Loss Contingencies [Line Items]  
Bridge financing to affiliate forfeited $ 16
v3.25.4
Common Stock/Partners' Capital - Additional Information (Detail) - USD ($)
 12 Months Ended
Aug. 11, 2025
Dec. 31, 2025
Oct. 28, 2025
Class Of Stock [Line Items]      
Shares issued price per share     $ 0.001
Stock repurchase, Value   $ 23,441,000  
Maximum [Member]      
Class Of Stock [Line Items]      
Stock repurchase program, authorized amount     $ 150,000,000
At-the-market equity [Member]      
Class Of Stock [Line Items]      
Stock issued   0  
At-the-market equity [Member] | Maximum [Member]      
Class Of Stock [Line Items]      
Stock issued during period, value $ 500,000,000    
Sales commission percentage 2.00%    
MPT Operating Partnership, L.P. [Member]      
Class Of Stock [Line Items]      
Stock repurchase, Value   $ 23,441,000  
Redemption of common units   $ 0  
MPT Operating Partnership, L.P. [Member] | Medical Properties Trust, LLC. [Member]      
Class Of Stock [Line Items]      
Percentage of ownership of general partner   100.00%  
MPT Operating Partnership, L.P. [Member] | MPT TRS, Inc [Member]      
Class Of Stock [Line Items]      
Percentage of ownership of general partner   100.00%  
MPT Operating Partnership, L.P. [Member] | Operating Partnership [Member]      
Class Of Stock [Line Items]      
Percentage of ownership limited partner   100.00%  
Common Units [Member]      
Class Of Stock [Line Items]      
Stock repurchase, Shares   4,505,000  
Stock repurchase, Value   $ 5,000  
v3.25.4
Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Detail) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Fair Value Disclosures [Abstract]    
Interest and rent receivables, Book value $ 19,210 $ 36,327
Loans, Book value 624,243 467,120
Debt, net Book value (9,697,835) (8,848,112)
Interest and rent receivables, Fair value 19,907 36,432
Loans, Fair value 624,369 470,380
Debt, net Fair value $ (8,980,547) $ (7,301,395)
v3.25.4
Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Parenthetical) (Detail)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
USD ($)
Health_Center
Dec. 31, 2024
USD ($)
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]    
Mortgage loans $ 123,651 $ 119,912
Investments in unconsolidated real estate joint ventures 1,399,777 1,156,397
Investments in unconsolidated operating entities 322,179 439,578
Shareholder Loan [Member]    
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]    
Mortgage loans 7,500 7,900
Investments in unconsolidated real estate joint ventures 388,900 315,500
Loans [Member]    
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]    
Investments in unconsolidated operating entities 45,400 39,700
Other loans $ 182,400 $ 104,000
Fair Value, Recurring | Colombia [Member]    
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]    
Number of facilities acquired | Health_Center 3  
v3.25.4
Fair Value of Financial Instruments - Additional Information (Detail)
SFr in Millions, $ in Millions
 3 Months Ended 12 Months Ended
Sep. 30, 2024
USD ($)
Mar. 31, 2024
USD ($)
Dec. 31, 2025
USD ($)
Health_Center
Dec. 31, 2024
USD ($)
Dec. 31, 2023
USD ($)
Dec. 31, 2023
CHF (SFr)
Steward's Equity [Member]            
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]            
Equity impairment charges         $ 90  
Equity investments percentage       9.90% 9.90% 9.90%
Impairment charge, working capital loans and other secured loans $ 425 $ 625        
Steward's Equity [Member] | Equity Securities [Member] | International Joint Venture [Member]            
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]            
Remaining equity investment percentage       90.10% 90.10% 90.10%
Steward and International Joint Venture [Member]            
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]            
Real estate investments, joint ventures         $ 219  
Fair Value, Inputs, Level 3 [Member] | Measurement Input, Discount Rate [Member] | Weighted Average [Member]            
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]            
Investments measurement input       0.1503    
Fair Value, Inputs, Level 3 [Member] | Measurement Input, Discount Rate [Member] | Minimum [Member]            
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]            
Investments measurement input       0.15    
Fair Value, Inputs, Level 3 [Member] | Steward's Equity [Member] | Measurement Input, Discount Rate [Member] | Maximum [Member]            
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]            
Investments measurement input       0.16    
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       $ 790    
PHP Holdings [Member]            
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]            
Discount for lack of marketability percentage on Springstone equity investment       14.20%    
Swiss Medical Network [Member]            
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]            
Favorable fair market value adjustment on investment | SFr           SFr 20
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     $ 169      
Fair Value, Recurring | Colombia [Member]            
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]            
Number of facilities acquired | Health_Center     3      
v3.25.4
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
Dec. 31, 2025
Dec. 31, 2024
Mortgage Loans [Member]    
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]    
Fair Value $ 116,113 $ 111,985
Original Cost 151,692 129,968
Equity Method Investment and Other Loans [Member]    
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]    
Fair Value 4,285 154,229
Original Cost $ 264,160 $ 910,594
v3.25.4
Leases (Lessee) - Summary of Lease Expense (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Lessee Lease Description [Line Items]      
Operating lease cost [1],[2] $ 9,254 $ 10,725 $ 11,653
Finance lease cost:      
Total lease cost 7,008 7,645 7,654
Real Estate Depreciation and Amortization [Member]      
Finance lease cost:      
Amortization of right-of-use assets 51 51 51
Interest [Member]      
Finance lease cost:      
Interest on lease liabilities 128 128 128
Other [Member]      
Finance lease cost:      
Sublease income $ (2,425) $ (3,259) $ (4,178)
[1] $4.1 million, $5.1 million, and $6.0 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2025, 2024, and 2023, respectively.
[2] Includes short-term leases.
v3.25.4
Leases (Lessee) - Summary of Lease Expense (Parenthetical) (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Lessee Lease Description [Line Items]      
Operating lease cost [1],[2] $ 9,254 $ 10,725 $ 11,653
Property-related [Member]      
Lessee Lease Description [Line Items]      
Operating lease cost $ 4,100 $ 5,100 $ 6,000
[1] $4.1 million, $5.1 million, and $6.0 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2025, 2024, and 2023, respectively.
[2] Includes short-term leases.
v3.25.4
Leases (Lessee) - Schedule of Fixed Minimum Rental Payments Due under Leases with Non-Cancelable Terms (Detail) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Leases [Abstract]    
Operating Leases, 2026 $ 7,109  
Operating Leases, 2027 6,567  
Operating Leases, 2028 6,648  
Operating Leases, 2029 6,706  
Operating Leases, 2030 6,733  
Operating Leases, Thereafter 160,583  
Operating Leases, Total undiscounted minimum lease payments 194,346  
Operating Leases, Less: interest (122,351)  
Operating Leases, Present value of lease liabilities 71,995 $ 78,585
Finance Leases, 2026 133  
Finance Leases, 2027 134  
Finance Leases, 2028 135  
Finance Leases, 2029 137  
Finance Leases, 2030 138  
Finance Leases, Thereafter 4,106  
Finance Leases, Total undiscounted minimum lease payments 4,783  
Finance Leases, Less: interest (2,850)  
Finance Leases, Present value of lease liabilities 1,933 $ 1,936
Amounts To Be Received From Subleases, 2026 (2,877)  
Amounts To Be Received From Subleases, 2027 (2,515)  
Amounts To Be Received From Subleases, 2028 (2,516)  
Amounts To Be Received From Subleases, 2029 (2,518)  
Amounts To Be Received From Subleases, 2030 (2,525)  
Amounts To Be Received From Subleases, Thereafter (38,522)  
Amounts To Be Received From Subleases, Total undiscounted minimum lease payments (51,473)  
Net Payments, 2026 4,365  
Net Payments, 2027 4,186  
Net Payments, 2028 4,267  
Net Payments, 2029 4,325  
Net Payments, 2030 4,346  
Net Payments, Thereafter [1] 126,167  
Net Payments, Total undiscounted minimum lease payments $ 147,656  
[1] Reflects certain ground leases, in which we are the lessee, that have longer initial fixed terms than our existing sublease to our tenants. However, we would expect to either renew the related sublease, enter into a lease with a new tenant, or attempt to early terminate the ground lease to reduce or avoid any significant impact from such ground leases
v3.25.4
Leases (Lessee) - Summary of Supplemental Balance Sheet Information (Detail) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Right of use assets:    
Total right of use assets $ 63,023 $ 69,214
Lease liabilities:    
Operating leases $ 71,995 $ 78,585
Operating Lease, Liability, Statement of Financial Position [Extensible Enumeration] Obligations to tenants and other lease liabilities Obligations to tenants and other lease liabilities
Financing leases $ 1,933 $ 1,936
Finance Lease, Liability, Statement of Financial Position [Extensible Enumeration] Obligations to tenants and other lease liabilities Obligations to tenants and other lease liabilities
Total lease liabilities $ 73,928 $ 80,521
Weighted-average remaining lease term:    
Operating leases 33 years 4 months 24 days 32 years 7 months 6 days
Finance leases 30 years 10 months 24 days 31 years 10 months 24 days
Weighted-average discount rate:    
Operating leases 6.10% 6.10%
Finance leases 6.60% 6.60%
Corporate [Member]    
Right of use assets:    
Operating leases $ 17,641 $ 20,701
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration] Other Assets Other Assets
Real Estate [Member]    
Right of use assets:    
Operating leases $ 43,801 $ 46,881
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration] Land Land
Finance leases $ 1,581 $ 1,632
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List] Land Land
Total real estate right of use assets $ 45,382 $ 48,513
v3.25.4
Leases (Lessee) - Summary of Supplemental Cash Flow Information (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Cash paid for amounts included in the measurement of lease liabilities:      
Operating cash flows used for operating leases $ 8,013 $ 8,447 $ 8,210
Operating cash flows used for finance leases $ 131 $ 130 $ 129
v3.25.4
Other Assets - Summary of Other Assets on our Condensed Consolidated Balance Sheets (Detail) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Other Assets [Abstract]    
Debt issue costs, net $ 3,265 $ 5,675
Other corporate assets 372,751 330,638
Prepaids and other assets 188,024 135,091
Total other assets $ 564,040 $ 471,404
v3.25.4
Other Assets - Additional Information (Details)
$ in Millions
Dec. 31, 2025
USD ($)
Maximum [Member]  
Other Assets [Line Items]  
Remaining funding costs $ 15
Minimum [Member]  
Other Assets [Line Items]  
Remaining funding costs $ 10
v3.25.4
Segment Disclosures - Additional Information (Detail)
 12 Months Ended
Dec. 31, 2025
Segment
Segment Reporting [Abstract]  
Leased assets 100.00%
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]
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 (loss) income (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
v3.25.4
Subsequent Events - Additional Information (Details)
$ / shares in Units, € in Millions, $ in Millions
 3 Months Ended
Feb. 13, 2026
EUR (€)
Property
Feb. 12, 2026
$ / shares
Mar. 31, 2026
USD ($)
Forecast [Member]      
Subsequent Event [Line Items]      
One-time tax benefit | $     $ 40
Subsequent Event [Member] | Germany [Member]      
Subsequent Event [Line Items]      
Number of property acquired | Property 1    
Payment for acquisition | € € 23    
Subsequent Event [Member] | O2026 Q1 Dividends [Member]      
Subsequent Event [Line Items]      
Cash dividend per share of common stock | $ / shares   $ 0.09  
Dividend declared date   Feb. 12, 2026  
Dividend paid date   Apr. 09, 2026  
Dividend record date   Mar. 12, 2026  
v3.25.4
Schedule II - Schedule of Valuation and Qualifying Accounts (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]      
Balance at Beginning of Year $ 2,165,754 $ 878,318 $ 393,057
Additions, Charged Against Operations 602,464 2,783,001 755,627
Deductions, Net Recoveries/Write-offs (426,550) (1,495,565) (270,366)
Balance at End of Year $ 2,341,668 $ 2,165,754 $ 878,318
v3.25.4
Schedule II - Schedule of Valuation and Qualifying Accounts (Parenthetical) (Detail) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
SEC Schedule, 12-09, Valuation and Qualifying Accounts Disclosure [Line Items]      
Increase in accounts receivable reserves $ 350 $ 384 $ 261
Decrease in accounts receivable reserves 191 520  
Increase in straight-line rent receivable reserves     259
Increase (decrease) in real estate impairment reserves 10 86 89
Write-off of previously reserved accounts receivable     11
Equity investment impairments reserves related to disposals   138  
Increase (decrease) in real estate impairment reserves related to disposals (100) (12) (170)
Increase in credit loss reserves on financing-type receivables 170 1,500 10
Decrease in credit loss reserves on financing-type receivables 130 826 35
Increase in equity investment impairments   500 90
Recovery of previously reserved interest     50
Valuation Allowance, Deferred Tax Asset [Member]      
SEC Schedule, 12-09, Valuation and Qualifying Accounts Disclosure [Line Items]      
Increase (decrease) in valuation allowances $ 70 $ 302 $ 47
v3.25.4
Schedule III - Real Estate Investments and Accumulated Depreciation (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
 [1]
Dec. 31, 2023
 [1]
Dec. 31, 2022
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Initial costs, land $ 1,786,342      
Initial costs, buildings 8,594,759      
Additions subsequent to acquisition, Improvements 421,829      
Land at cost 1,787,821      
Buildings at cost 9,015,109      
Total at cost 10,802,930 [1] $ 10,086,493 $ 11,813,175 $ 12,300,524
Accumulated Depreciation 1,438,594      
Encumbrances $ 850,779      
Phoenix, AZ [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 5,773      
Initial costs, buildings 0      
Additions subsequent to acquisition, Improvements 0      
Land at cost 5,773      
Buildings at cost 0      
Total at cost 5,773      
Accumulated Depreciation 0      
Encumbrances $ 0      
Date Acquired Sep. 29, 2017      
Princes Risborough, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,601      
Land at cost 2,601      
Total at cost 2,601      
Encumbrances $ 0      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1981 [Member] | Ashtead, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 39,969      
Initial costs, buildings 74,936      
Land at cost 39,969      
Buildings at cost 74,936      
Total at cost 114,905      
Accumulated Depreciation 12,400      
Encumbrances $ 0      
Date of Construction 1981      
Date Acquired Aug. 16, 2019      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1981 [Member] | Beckenham, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 5,781      
Initial costs, buildings 22,172      
Land at cost 5,781      
Buildings at cost 22,172      
Total at cost 27,953      
Accumulated Depreciation 3,347      
Encumbrances $ 15,750      
Date of Construction 1981      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1981 [Member] | Cheadle, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 32,744      
Initial costs, buildings 172,486      
Additions subsequent to acquisition, Improvements 25      
Land at cost 32,744      
Buildings at cost 172,511      
Total at cost 205,255      
Accumulated Depreciation 26,035      
Encumbrances $ 113,319      
Date of Construction 1981      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1981 [Member] | Dorchester, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 571      
Initial costs, buildings 33,173      
Land at cost 571      
Buildings at cost 33,173      
Total at cost 33,744      
Accumulated Depreciation 5,000      
Encumbrances $ 0      
Date of Construction 1981      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1981 [Member] | Euxton, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 4,887      
Initial costs, buildings 37,638      
Land at cost 4,887      
Buildings at cost 37,638      
Total at cost 42,525      
Accumulated Depreciation 6,412      
Encumbrances $ 0      
Date of Construction 1981      
Date Acquired Aug. 16, 2019      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1981 [Member] | Great Missenden, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 12,458      
Initial costs, buildings 111,313      
Land at cost 12,458      
Buildings at cost 111,313      
Total at cost 123,771      
Accumulated Depreciation 16,829      
Encumbrances $ 58,207      
Date of Construction 1981      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1981 [Member] | Torquay, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 3,155      
Initial costs, buildings 37,831      
Land at cost 3,155      
Buildings at cost 37,831      
Total at cost 40,986      
Accumulated Depreciation 6,177      
Encumbrances $ 0      
Date of Construction 1981      
Date Acquired Aug. 16, 2019      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2008 [Member] | Arnold, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 505      
Initial costs, buildings 10,496      
Land at cost 505      
Buildings at cost 10,496      
Total at cost 11,001      
Accumulated Depreciation 1,296      
Encumbrances $ 0      
Date of Construction 2008      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2008 [Member] | Bath, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 1,597      
Initial costs, buildings 33,105      
Land at cost 1,597      
Buildings at cost 33,105      
Total at cost 34,702      
Accumulated Depreciation 9,518      
Encumbrances $ 0      
Date of Construction 2008      
Date Acquired Jul. 01, 2014      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2008 [Member] | Boardman, OH [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Long term acute care hospital      
Initial costs, land $ 79      
Initial costs, buildings 275      
Land at cost 79      
Buildings at cost 275      
Total at cost 354      
Accumulated Depreciation 49      
Encumbrances $ 0      
Date of Construction 2008      
Date Acquired Aug. 30, 2019      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2008 [Member] | Boise, ID [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Long term acute care hospital      
Initial costs, land $ 1,558      
Initial costs, buildings 11,027      
Land at cost 1,558      
Buildings at cost 11,027      
Total at cost 12,585      
Accumulated Depreciation 1,786      
Encumbrances $ 0      
Date of Construction 2008      
Date Acquired Feb. 29, 2012      
Life on which depreciation in latest income statements is computed (Years) 50 years      
2008 [Member] | Gainesborough UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 1,618      
Initial costs, buildings 10,592      
Land at cost 1,618      
Buildings at cost 10,592      
Total at cost 12,210      
Accumulated Depreciation $ 981      
Date of Construction 2008      
Date Acquired Apr. 14, 2023      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2008 [Member] | Lubbock, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 1,376      
Initial costs, buildings 28,292      
Additions subsequent to acquisition, Improvements 3,648      
Land at cost 1,376      
Buildings at cost 31,940      
Total at cost 33,316      
Accumulated Depreciation 8,342      
Encumbrances $ 0      
Date of Construction 2008      
Date Acquired Jun. 16, 2015      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2008 [Member] | Sheffield, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 7,000      
Initial costs, buildings 47,222      
Land at cost 7,000      
Buildings at cost 47,222      
Total at cost 54,222      
Accumulated Depreciation 7,188      
Encumbrances $ 34,458      
Date of Construction 2008      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2008 [Member] | York, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 3,924      
Initial costs, buildings 7,137      
Land at cost 3,924      
Buildings at cost 7,137      
Total at cost 11,061      
Accumulated Depreciation $ 549      
Date of Construction 2008      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1811 [Member] | London, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 38,386      
Initial costs, buildings 54,940      
Land at cost 38,386      
Buildings at cost 54,940      
Total at cost 93,326      
Accumulated Depreciation 4,554      
Encumbrances $ 0      
Date of Construction 1811      
Date Acquired Dec. 09, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1890 [Member] | Altrincham, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 15,499      
Initial costs, buildings 26,606      
Land at cost 15,499      
Buildings at cost 26,606      
Total at cost 42,105      
Accumulated Depreciation 2,494      
Encumbrances $ 0      
Date of Construction 1890      
Date Acquired Dec. 09, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1790 [Member] | Bristol, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 4,980      
Initial costs, buildings 39,538      
Land at cost 4,980      
Buildings at cost 39,538      
Total at cost 44,518      
Accumulated Depreciation 3,270      
Encumbrances $ 0      
Date of Construction 1790      
Date Acquired Dec. 09, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1790 [Member] | Essex, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 4,913      
Initial costs, buildings 45,715      
Land at cost 4,913      
Buildings at cost 45,715      
Total at cost 50,628      
Accumulated Depreciation 3,769      
Encumbrances $ 0      
Date of Construction 1790      
Date Acquired Dec. 09, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1790 [Member] | London, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 30,627      
Initial costs, buildings 15,847      
Land at cost 30,627      
Buildings at cost 15,847      
Total at cost 46,474      
Accumulated Depreciation 1,497      
Encumbrances $ 0      
Date of Construction 1790      
Date Acquired Dec. 09, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2014 [Member] | Altoona, WI [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, buildings $ 35,500      
Buildings at cost 35,500      
Total at cost 35,500      
Accumulated Depreciation 8,234      
Encumbrances $ 0      
Date of Construction 2014      
Date Acquired Aug. 31, 2014      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2014 [Member] | Altrincham, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 15,499      
Initial costs, buildings 26,606      
Land at cost 15,499      
Buildings at cost 26,606      
Total at cost 42,105      
Accumulated Depreciation 2,494      
Encumbrances $ 0      
Date of Construction 2014      
Date Acquired Dec. 09, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2014 [Member] | Alvin, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Freestanding ER      
Initial costs, land $ 105      
Initial costs, buildings 4,087      
Land at cost 105      
Buildings at cost 4,087      
Total at cost 4,192      
Accumulated Depreciation 1,177      
Encumbrances $ 0      
Date of Construction 2014      
Date Acquired Mar. 19, 2014      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2014 [Member] | Bristol, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 4,980      
Initial costs, buildings 39,538      
Land at cost 4,980      
Buildings at cost 39,538      
Total at cost 44,518      
Accumulated Depreciation 3,270      
Encumbrances $ 0      
Date of Construction 2014      
Date Acquired Dec. 09, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2014 [Member] | Essex, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 4,913      
Initial costs, buildings 45,715      
Land at cost 4,913      
Buildings at cost 45,715      
Total at cost 50,628      
Accumulated Depreciation 3,769      
Encumbrances $ 0      
Date of Construction 2014      
Date Acquired Dec. 09, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2014 [Member] | Fort Worth, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 3,406      
Initial costs, buildings 34,627      
Land at cost 3,406      
Buildings at cost 34,627      
Total at cost 38,033      
Accumulated Depreciation 4,039      
Encumbrances $ 0      
Date of Construction 2014      
Date Acquired Oct. 19, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2014 [Member] | Georgetown, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 4,569      
Initial costs, buildings 22,858      
Additions subsequent to acquisition, Improvements 10,561      
Land at cost 4,569      
Buildings at cost 33,419      
Total at cost 37,988      
Accumulated Depreciation 3,208      
Encumbrances $ 0      
Date of Construction 2014      
Date Acquired Oct. 19, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2014 [Member] | London, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 38,386      
Initial costs, buildings 54,940      
Land at cost 38,386      
Buildings at cost 54,940      
Total at cost 93,326      
Accumulated Depreciation 4,554      
Encumbrances $ 0      
Date of Construction 2014      
Date Acquired Dec. 09, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2014 [Member] | Ogden, UT [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 1,759      
Initial costs, buildings 16,414      
Land at cost 1,759      
Buildings at cost 16,414      
Total at cost 18,173      
Accumulated Depreciation 4,846      
Encumbrances $ 0      
Date of Construction 2014      
Date Acquired Mar. 01, 2014      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2014 [Member] | Pearland, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Freestanding ER      
Initial costs, land $ 1,075      
Initial costs, buildings 3,577      
Land at cost 1,075      
Buildings at cost 3,577      
Total at cost 4,652      
Accumulated Depreciation 1,013      
Encumbrances $ 0      
Date of Construction 2014      
Date Acquired Sep. 08, 2014      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2014 [Member] | San Antonio, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Freestanding ER      
Initial costs, land $ 351      
Initial costs, buildings 3,952      
Land at cost 351      
Buildings at cost 3,952      
Total at cost 4,303      
Accumulated Depreciation 1,160      
Encumbrances $ 0      
Date of Construction 2014      
Date Acquired Jan. 01, 2014      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2014 [Member] | Richmond, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 5,380      
Initial costs, buildings 6,155      
Additions subsequent to acquisition, Improvements 10,815      
Land at cost 5,380      
Buildings at cost 16,970      
Total at cost 22,350      
Accumulated Depreciation 1,382      
Encumbrances $ 0      
Date of Construction 2014      
Date Acquired Oct. 19, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2014 [Member] | Surrey, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 15,926      
Initial costs, buildings 9,663      
Land at cost 15,926      
Buildings at cost 9,663      
Total at cost 25,589      
Accumulated Depreciation 1,007      
Encumbrances $ 0      
Date of Construction 2014      
Date Acquired Dec. 09, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2014-2 [Member] | London, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 30,627      
Initial costs, buildings 15,847      
Land at cost 30,627      
Buildings at cost 15,847      
Total at cost 46,474      
Accumulated Depreciation 1,497      
Encumbrances $ 0      
Date of Construction 2014      
Date Acquired Dec. 09, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1887 [Member] | Bassenheim, Germany [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 1,179      
Initial costs, buildings 5,628      
Land at cost 1,179      
Buildings at cost 5,628      
Total at cost 6,807      
Accumulated Depreciation 1,079      
Encumbrances $ 0      
Date of Construction 1887      
Date Acquired Feb. 09, 2019      
Life on which depreciation in latest income statements is computed (Years) 39 years      
1974 [Member] | Bad Salzuflen, Germany [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 11,176      
Initial costs, buildings 28,283      
Land at cost 11,176      
Buildings at cost 28,283      
Total at cost 39,459      
Accumulated Depreciation 6,233      
Encumbrances $ 0      
Date of Construction 1974      
Date Acquired Nov. 30, 2017      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2017 [Member] | Austin, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Freestanding ER      
Initial costs, land $ 3,507      
Initial costs, buildings 4,200      
Land at cost 3,507      
Buildings at cost 4,200      
Total at cost 7,707      
Accumulated Depreciation 955      
Encumbrances $ 0      
Date of Construction 2017      
Date Acquired Mar. 02, 2017      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2017 [Member] | Birmingham, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 8,276      
Initial costs, buildings 44,683      
Land at cost 8,276      
Buildings at cost 44,683      
Total at cost 52,959      
Accumulated Depreciation 6,144      
Encumbrances $ 0      
Date of Construction 2017      
Date Acquired Apr. 03, 2017      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2017 [Member] | Columbus OH [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 2,101      
Initial costs, buildings 44,218      
Land at cost 2,101      
Buildings at cost 44,218      
Total at cost 46,319      
Accumulated Depreciation 5,077      
Encumbrances $ 0      
Date of Construction 2017      
Date Acquired Oct. 19, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2017 [Member] | Englewood, CO [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 3,369      
Initial costs, buildings 65,480      
Land at cost 3,369      
Buildings at cost 65,480      
Total at cost 68,849      
Accumulated Depreciation 7,432      
Encumbrances $ 0      
Date of Construction 2017      
Date Acquired Oct. 19, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2017 [Member] | Frome, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 11,531      
Initial costs, buildings 11,337      
Land at cost 11,531      
Buildings at cost 11,337      
Total at cost 22,868      
Accumulated Depreciation 1,895      
Encumbrances $ 0      
Date of Construction 2017      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2017 [Member] | Kansas City, KS [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,351      
Initial costs, buildings 13,665      
Land at cost 2,351      
Buildings at cost 13,665      
Total at cost 16,016      
Accumulated Depreciation 1,946      
Encumbrances $ 0      
Date of Construction 2017      
Date Acquired Jun. 10, 2019      
Life on which depreciation in latest income statements is computed (Years) 50 years      
2017 [Member] | Kuopio, Finland [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 1,364      
Initial costs, buildings 46,129      
Land at cost 1,364      
Buildings at cost 46,129      
Total at cost 47,493      
Accumulated Depreciation 4,622      
Encumbrances $ 0      
Date of Construction 2017      
Date Acquired Mar. 11, 2022      
Life on which depreciation in latest income statements is computed (Years) 29 years      
2017 [Member] | Leawood, KS [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,513      
Initial costs, buildings 13,938      
Land at cost 2,513      
Buildings at cost 13,938      
Total at cost 16,451      
Accumulated Depreciation 1,972      
Encumbrances $ 0      
Date of Construction 2017      
Date Acquired Jun. 10, 2019      
Life on which depreciation in latest income statements is computed (Years) 50 years      
2017 [Member] | Oulu, Finland [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 3,376      
Initial costs, buildings 47,789      
Land at cost 3,376      
Buildings at cost 47,789      
Total at cost 51,165      
Accumulated Depreciation 4,848      
Encumbrances $ 0      
Date of Construction 2017      
Date Acquired Mar. 11, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2017 [Member] | Overland Park, KS [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,974      
Initial costs, buildings 14,405      
Land at cost 2,974      
Buildings at cost 14,405      
Total at cost 17,379      
Accumulated Depreciation 2,070      
Encumbrances $ 0      
Date of Construction 2017      
Date Acquired Jun. 10, 2019      
Life on which depreciation in latest income statements is computed (Years) 50 years      
2017 [Member] | Monmouth, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 16,413      
Initial costs, buildings 12,227      
Land at cost 16,413      
Buildings at cost 12,227      
Total at cost 28,640      
Accumulated Depreciation 1,859      
Encumbrances $ 0      
Date of Construction 2017      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2017 [Member] | Oklahoma City, OK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 3,641      
Initial costs, buildings 3,047      
Land at cost 3,641      
Buildings at cost 3,047      
Total at cost 6,688      
Accumulated Depreciation 647      
Encumbrances $ 0      
Date of Construction 2017      
Date Acquired Oct. 19, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2017 [Member] | Texarkana, Texas [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 14,562      
Land at cost 14,562      
Total at cost 14,562      
Accumulated Depreciation 0      
Encumbrances $ 0      
Date Acquired Sep. 29, 2017      
2017 [Member] | Valencia, Spain [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 11,841      
Initial costs, buildings 74,006      
Land at cost 11,841      
Buildings at cost 74,006      
Total at cost 85,847      
Accumulated Depreciation 8,710      
Encumbrances $ 0      
Date of Construction 2017      
Date Acquired Dec. 02, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2024 [Member] | McKinney, Texas [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 2,934      
Initial costs, buildings 31,068      
Land at cost 2,934      
Buildings at cost 31,068      
Total at cost 34,002      
Accumulated Depreciation 1,399      
Encumbrances $ 0      
Date of Construction 2024      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2024 [Member] | Valencia, Spain [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 27,603      
Initial costs, buildings 25,848      
Land at cost 27,603      
Buildings at cost 25,848      
Total at cost 53,451      
Accumulated Depreciation 1,240      
Encumbrances $ 0      
Date of Construction 2024      
Date Acquired May 06, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1864 [Member] | Birmingham, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 981      
Initial costs, buildings 10,753      
Land at cost 981      
Buildings at cost 10,753      
Total at cost 11,734      
Accumulated Depreciation 760      
Encumbrances      
Date of Construction 1864      
Date Acquired Apr. 14, 2023      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2016 [Member] | Avondale, AZ [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 5,383      
Initial costs, buildings 64,650      
Additions subsequent to acquisition, Improvements 8,281      
Land at cost 5,383      
Buildings at cost 72,931      
Total at cost 78,314      
Accumulated Depreciation 7,320      
Encumbrances $ 0      
Date of Construction 2016      
Date Acquired Oct. 19, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2016 [Member] | Bad Salzuflen, Germany [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 11,176      
Initial costs, buildings 28,283      
Land at cost 11,176      
Buildings at cost 28,283      
Total at cost 39,459      
Accumulated Depreciation 6,233      
Encumbrances $ 0      
Date of Construction 2016      
Date Acquired Nov. 30, 2017      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2016 [Member] | Birmingham, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 436      
Initial costs, buildings 20,284      
Land at cost 436      
Buildings at cost 20,284      
Total at cost 20,720      
Accumulated Depreciation 2,445      
Encumbrances $ 0      
Date of Construction 2016      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2016 [Member] | Flagstaff, AZ [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 3,049      
Initial costs, buildings 22,464      
Land at cost 3,049      
Buildings at cost 22,464      
Total at cost 25,513      
Accumulated Depreciation 4,399      
Encumbrances $ 0      
Date of Construction 2016      
Date Acquired Aug. 23, 2016      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2016 [Member] | Helotes, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Freestanding ER      
Initial costs, land $ 1,900      
Initial costs, buildings 5,115      
Land at cost 1,900      
Buildings at cost 5,115      
Total at cost 7,015      
Accumulated Depreciation 1,258      
Encumbrances $ 0      
Date of Construction 2016      
Date Acquired Mar. 10, 2016      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2016 [Member] | Houston, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Freestanding ER      
Initial costs, land $ 950      
Initial costs, buildings 3,996      
Land at cost 950      
Buildings at cost 3,996      
Total at cost 4,946      
Accumulated Depreciation 924      
Encumbrances $ 0      
Date of Construction 2016      
Date Acquired Sep. 26, 2016      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2016 [Member] | Katy, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Freestanding ER      
Initial costs, land $ 1,491      
Initial costs, buildings 2,870      
Land at cost 1,491      
Buildings at cost 2,870      
Total at cost 4,361      
Accumulated Depreciation 904      
Encumbrances $ 0      
Date of Construction 2016      
Date Acquired Oct. 10, 2016      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2016 [Member] | Mandeville, LA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Freestanding ER      
Initial costs, land $ 2,800      
Initial costs, buildings 5,370      
Land at cost 2,800      
Buildings at cost 5,370      
Total at cost 8,170      
Accumulated Depreciation 1,231      
Encumbrances $ 0      
Date of Construction 2016      
Date Acquired Oct. 28, 2016      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2016 [Member] | Marrero, LA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Freestanding ER      
Initial costs, land $ 1,517      
Initial costs, buildings 5,801      
Land at cost 1,517      
Buildings at cost 5,801      
Total at cost 7,318      
Accumulated Depreciation 1,378      
Encumbrances $ 0      
Date of Construction 2016      
Date Acquired Jul. 15, 2016      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2016 [Member] | Miami, FL [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 20,430      
Initial costs, buildings 30,276      
Additions subsequent to acquisition, Improvements 10,947      
Land at cost 20,430      
Buildings at cost 41,223      
Total at cost 61,653      
Accumulated Depreciation 3,276      
Encumbrances $ 0      
Date of Construction 2016      
Date Acquired Apr. 25, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2016 [Member] | New Orleans, LA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Freestanding ER      
Initial costs, land $ 2,850      
Initial costs, buildings 6,125      
Land at cost 2,850      
Buildings at cost 6,125      
Total at cost 8,975      
Accumulated Depreciation 1,416      
Encumbrances $ 0      
Date of Construction 2016      
Date Acquired Sep. 23, 2016      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2016 [Member] | San Antonio, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Freestanding ER      
Initial costs, land $ 2,988      
Initial costs, buildings 4,801      
Land at cost 2,988      
Buildings at cost 4,801      
Total at cost 7,789      
Accumulated Depreciation 1,090      
Encumbrances $ 0      
Date of Construction 2016      
Date Acquired Dec. 09, 2016      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2016 [Member] | Rosenberg, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Freestanding ER      
Initial costs, land $ 1,217      
Initial costs, buildings 4,505      
Land at cost 1,217      
Buildings at cost 4,505      
Total at cost 5,722      
Accumulated Depreciation 1,126      
Encumbrances $ 0      
Date of Construction 2016      
Date Acquired Jan. 15, 2016      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2016 [Member] | San Antonio, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Freestanding ER      
Initial costs, land $ 2,310      
Initial costs, buildings 4,253      
Land at cost 2,310      
Buildings at cost 4,253      
Total at cost 6,563      
Accumulated Depreciation 975      
Encumbrances $ 0      
Date of Construction 2016      
Date Acquired Oct. 27, 2016      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2016 [Member] | The Woodlands, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Freestanding ER      
Initial costs, land $ 1,922      
Initial costs, buildings 4,524      
Land at cost 1,922      
Buildings at cost 4,524      
Total at cost 6,446      
Accumulated Depreciation 1,103      
Encumbrances $ 0      
Date of Construction 2016      
Date Acquired Mar. 28, 2016      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2016 [Member] | Toledo, OH [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 1,103      
Initial costs, buildings 17,740      
Land at cost 1,103      
Buildings at cost 17,740      
Total at cost 18,843      
Accumulated Depreciation 4,324      
Encumbrances $ 0      
Date of Construction 2016      
Date Acquired Apr. 01, 2016      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2016 [Member] | Viseu, Portugal [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,697      
Initial costs, buildings 30,733      
Land at cost 2,697      
Buildings at cost 30,733      
Total at cost 33,430      
Accumulated Depreciation 5,243      
Encumbrances $ 0      
Date of Construction 2016      
Date Acquired Nov. 28, 2019      
Life on which depreciation in latest income statements is computed (Years) 37 years      
1989 [Member] | Bad Salzuflen, Germany [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 7,595      
Initial costs, buildings 24,873      
Land at cost 7,595      
Buildings at cost 24,873      
Total at cost 32,468      
Accumulated Depreciation 5,221      
Encumbrances $ 0      
Date of Construction 1989      
Date Acquired Nov. 30, 2017      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1989 [Member] | Bolton, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 1,678      
Initial costs, buildings 47,136      
Land at cost 1,678      
Buildings at cost 47,136      
Total at cost 48,814      
Accumulated Depreciation 7,095      
Encumbrances $ 22,412      
Date of Construction 1989      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1989 [Member] | Guildford, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 7,283      
Initial costs, buildings 38,556      
Land at cost 7,283      
Buildings at cost 38,556      
Total at cost 45,839      
Accumulated Depreciation 5,835      
Encumbrances $ 23,155      
Date of Construction 1989      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1989 [Member] | Richmond, VA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Long term acute care hospital      
Initial costs, land $ 1,289      
Initial costs, buildings 10,071      
Land at cost 1,289      
Buildings at cost 10,071      
Total at cost 11,360      
Accumulated Depreciation 2,065      
Encumbrances $ 0      
Date of Construction 1989      
Date Acquired Aug. 30, 2019      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1989 [Member] | Rochdale, MA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Long term acute care hospital      
Initial costs, land $ 654      
Initial costs, buildings 3,368      
Land at cost 654      
Buildings at cost 3,368      
Total at cost 4,022      
Accumulated Depreciation 625      
Encumbrances $ 0      
Date of Construction 1989      
Date Acquired Aug. 30, 2019      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1989 [Member] | Rochdale, MA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 67      
Initial costs, buildings 344      
Land at cost 67      
Buildings at cost 344      
Total at cost 411      
Accumulated Depreciation 64      
Encumbrances $ 0      
Date of Construction 1989      
Date Acquired Aug. 30, 2019      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2004 [Member] | Ayr, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 17,982      
Initial costs, buildings 51,498      
Land at cost 17,982      
Buildings at cost 51,498      
Total at cost 69,480      
Accumulated Depreciation 5,917      
Encumbrances $ 0      
Date of Construction 2004      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2004 [Member] | Odessa, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 6,217      
Initial costs, buildings 123,518      
Additions subsequent to acquisition, Improvements 16,600      
Land at cost 6,217      
Buildings at cost 140,118      
Total at cost 146,335      
Accumulated Depreciation 27,772      
Encumbrances $ 0      
Date of Construction 2004      
Date Acquired Sep. 29, 2017      
Life on which depreciation in latest income statements is computed (Years) 41 years      
1973 [Member] | Bad Oeynhausen, Germany [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 1,198      
Initial costs, buildings 2,928      
Land at cost 1,198      
Buildings at cost 2,928      
Total at cost 4,126      
Accumulated Depreciation 662      
Encumbrances $ 0      
Date of Construction 1973      
Date Acquired Nov. 30, 2017      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1973 [Member] | Big Spring, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 1,655      
Initial costs, buildings 21,254      
Additions subsequent to acquisition, Improvements 815      
Land at cost 1,655      
Buildings at cost 22,069      
Total at cost 23,724      
Accumulated Depreciation 4,028      
Encumbrances $ 0      
Date of Construction 1973      
Date Acquired Apr. 12, 2019      
Life on which depreciation in latest income statements is computed (Years) 41 years      
1973 [Member] | Odessa, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 6,217      
Initial costs, buildings 123,518      
Additions subsequent to acquisition, Improvements 16,600      
Land at cost 6,217      
Buildings at cost 140,118      
Total at cost 146,335      
Accumulated Depreciation 27,772      
Encumbrances $ 0      
Date of Construction 1973      
Date Acquired Sep. 29, 2017      
Life on which depreciation in latest income statements is computed (Years) 41 years      
1973 [Member] | Port Huron, MI        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,531      
Initial costs, buildings 14,252      
Land at cost 2,531      
Buildings at cost 14,252      
Total at cost 16,783      
Accumulated Depreciation 4,869      
Encumbrances $ 0      
Date of Construction 1973      
Date Acquired Dec. 31, 2015      
Life on which depreciation in latest income statements is computed (Years) 30 years      
2015 [Member] | Converse, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Freestanding ER      
Initial costs, land $ 750      
Initial costs, buildings 4,423      
Land at cost 750      
Buildings at cost 4,423      
Total at cost 5,173      
Accumulated Depreciation 1,189      
Encumbrances $ 0      
Date of Construction 2015      
Date Acquired Apr. 10, 2015      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2015 [Member] | Frome, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 11,531      
Initial costs, buildings 11,337      
Land at cost 11,531      
Buildings at cost 11,337      
Total at cost 22,868      
Accumulated Depreciation 1,895      
Encumbrances $ 0      
Date of Construction 2015      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2015 [Member] | Highland Hills, OH [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 3,148      
Initial costs, buildings 43,891      
Land at cost 3,148      
Buildings at cost 43,891      
Total at cost 47,039      
Accumulated Depreciation 5,042      
Encumbrances $ 0      
Date of Construction 2015      
Date Acquired Oct. 19, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2015 [Member] | Hoover, AL [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Freestanding ER      
Initial costs, land $ 0      
Initial costs, buildings 7,581      
Land at cost 0      
Buildings at cost 7,581      
Total at cost 7,581      
Accumulated Depreciation 2,361      
Encumbrances $ 0      
Date of Construction 2015      
Date Acquired May 01, 2015      
Life on which depreciation in latest income statements is computed (Years) 34 years      
2015 [Member] | League City, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Freestanding ER      
Initial costs, land $ 1,244      
Initial costs, buildings 3,901      
Land at cost 1,244      
Buildings at cost 3,901      
Total at cost 5,145      
Accumulated Depreciation 1,024      
Encumbrances $ 0      
Date of Construction 2015      
Date Acquired Jun. 19, 2015      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2015 [Member] | McKinney, Texas [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Freestanding ER      
Initial costs, land $ 2,441      
Initial costs, buildings 4,060      
Land at cost 2,441      
Buildings at cost 4,060      
Total at cost 6,501      
Accumulated Depreciation 1,421      
Encumbrances $ 0      
Date of Construction 2015      
Date Acquired Jul. 31, 2015      
Life on which depreciation in latest income statements is computed (Years) 30 years      
2015 [Member] | Olathe, KS [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 6,882      
Initial costs, buildings 57,056      
Additions subsequent to acquisition, Improvements 18,873      
Land at cost 6,882      
Buildings at cost 75,929      
Total at cost 82,811      
Accumulated Depreciation 6,778      
Encumbrances $ 0      
Date of Construction 2015      
Date Acquired Oct. 19, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2015 [Member] | Santa Maria de Feira, PT [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 1,979      
Initial costs, buildings 18,981      
Land at cost 1,979      
Buildings at cost 18,981      
Total at cost 20,960      
Accumulated Depreciation 2,083      
Encumbrances $ 0      
Date of Construction 2015      
Date Acquired Oct. 21, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1970 [Member] | Bussage, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 8,986      
Initial costs, buildings 3,972      
Land at cost 8,986      
Buildings at cost 3,972      
Total at cost 12,958      
Accumulated Depreciation 500      
Encumbrances $ 0      
Date of Construction 1970      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1970 [Member] | Royston, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 7,127      
Initial costs, buildings 21,220      
Land at cost 7,127      
Buildings at cost 21,220      
Total at cost 28,347      
Accumulated Depreciation 3,007      
Encumbrances $ 0      
Date of Construction 1970      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1992 [Member] | Bath, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 7,613      
Initial costs, buildings 13,816      
Land at cost 7,613      
Buildings at cost 13,816      
Total at cost 21,429      
Accumulated Depreciation 2,153      
Encumbrances $ 16,326      
Date of Construction 1992      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1992 [Member] | Bowling Green, KY [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 3,486      
Initial costs, buildings 56,296      
Additions subsequent to acquisition, Improvements 3,550      
Land at cost 3,486      
Buildings at cost 59,846      
Total at cost 63,332      
Accumulated Depreciation 10,251      
Encumbrances $ 0      
Date of Construction 1992      
Date Acquired Aug. 30, 2019      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1992 [Member] | Essex, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 4,913      
Initial costs, buildings 45,715      
Land at cost 4,913      
Buildings at cost 45,715      
Total at cost 50,628      
Accumulated Depreciation 3,769      
Encumbrances $ 0      
Date of Construction 1992      
Date Acquired Dec. 09, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1992 [Member] | Helsinki, Finland [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 4,347      
Initial costs, buildings 71,714      
Additions subsequent to acquisition, Improvements 1,164      
Land at cost 4,347      
Buildings at cost 72,878      
Total at cost 77,225      
Accumulated Depreciation 6,896      
Encumbrances $ 0      
Date of Construction 1992      
Date Acquired Mar. 11, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1992 [Member] | London, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 30,627      
Initial costs, buildings 15,847      
Land at cost 30,627      
Buildings at cost 15,847      
Total at cost 46,474      
Accumulated Depreciation 1,497      
Encumbrances $ 0      
Date of Construction 1992      
Date Acquired Dec. 09, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1992 [Member] | Stirling, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 1,116      
Initial costs, buildings 20,651      
Land at cost 1,116      
Buildings at cost 20,651      
Total at cost 21,767      
Accumulated Depreciation 2,428      
Encumbrances $ 9,691      
Date of Construction 1992      
Date Acquired Jul. 06, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1992 [Member] | Wichita, KS [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 1,019      
Initial costs, buildings 16,881      
Land at cost 1,019      
Buildings at cost 16,881      
Total at cost 17,900      
Accumulated Depreciation 8,131      
Encumbrances $ 0      
Date of Construction 1992      
Date Acquired Apr. 04, 2008      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1992 - 2 [Member] | London, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Initial costs, land $ 14,617      
Initial costs, buildings 7,208      
Land at cost 14,617      
Buildings at cost 7,208      
Total at cost 21,825      
Accumulated Depreciation 928      
Encumbrances $ 0      
Date of Construction 1992      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1984 [Member] | Basingstoke, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 13,677      
Initial costs, buildings 53,123      
Land at cost 13,677      
Buildings at cost 53,123      
Total at cost 66,800      
Accumulated Depreciation 8,049      
Encumbrances $ 34,016      
Date of Construction 1984      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1984 [Member] | Birmingham, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 436      
Initial costs, buildings 20,284      
Land at cost 436      
Buildings at cost 20,284      
Total at cost 20,720      
Accumulated Depreciation 2,445      
Encumbrances $ 0      
Date of Construction 1984      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1984 [Member] | Droitwich, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 81      
Initial costs, buildings 16,192      
Land at cost 81      
Buildings at cost 16,192      
Total at cost 16,273      
Accumulated Depreciation 2,461      
Encumbrances $ 0      
Date of Construction 1984      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1984 [Member] | London, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 3,477      
Initial costs, buildings 60,527      
Land at cost 3,477      
Buildings at cost 4,390      
Total at cost 7,867      
Accumulated Depreciation 669      
Encumbrances $ 0      
Date of Construction 1987      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1984 [Member] | Swindon, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 5,639      
Initial costs, buildings 63,265      
Land at cost 5,639      
Buildings at cost 63,265      
Total at cost 68,904      
Accumulated Depreciation 9,546      
Encumbrances $ 33,219      
Date of Construction 1984      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1980 [Member] | Blue Springs, MO [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 4,347      
Initial costs, buildings 23,494      
Land at cost 4,347      
Buildings at cost 23,494      
Total at cost 27,841      
Accumulated Depreciation 6,737      
Encumbrances $ 0      
Date of Construction 1980      
Date Acquired Feb. 13, 2015      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1980 [Member] | Frome, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 3,065      
Initial costs, buildings 18,571      
Land at cost 3,065      
Buildings at cost 18,571      
Total at cost 21,636      
Accumulated Depreciation 2,357      
Encumbrances $ 0      
Date of Construction 1980      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1980 [Member] | Glasgow, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 1,512      
Initial costs, buildings 16,531      
Land at cost 1,512      
Buildings at cost 16,531      
Total at cost 18,043      
Accumulated Depreciation 2,016      
Encumbrances $ 0      
Date of Construction 1980      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1980 [Member] | Harrow, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 40,647      
Initial costs, buildings 42,777      
Land at cost 40,647      
Buildings at cost 42,777      
Total at cost 83,424      
Accumulated Depreciation 6,505      
Encumbrances $ 0      
Date of Construction 1980      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1980 [Member] | Hook, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 5,732      
Initial costs, buildings 10,918      
Land at cost 5,732      
Buildings at cost 10,918      
Total at cost 16,650      
Accumulated Depreciation 1,447      
Encumbrances $ 0      
Date of Construction 1980      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1980 [Member] | Nottingham, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 10,596      
Initial costs, buildings 9,483      
Land at cost 10,596      
Buildings at cost 9,483      
Total at cost 20,079      
Accumulated Depreciation 1,401      
Encumbrances $ 0      
Date of Construction 2000      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1980 [Member] | Poplar Bluff, MO [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,659      
Initial costs, buildings 38,694      
Land at cost 2,659      
Buildings at cost 38,694      
Total at cost 41,353      
Accumulated Depreciation 17,125      
Encumbrances $ 0      
Date of Construction 1980      
Date Acquired Apr. 22, 2008      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1980 [Member] | Romford, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 5,667      
Initial costs, buildings 9,278      
Land at cost 5,667      
Buildings at cost 9,278      
Total at cost 14,945      
Accumulated Depreciation 1,317      
Encumbrances $ 0      
Date of Construction 1980      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1980 [Member] | Sharon, PA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 6,179      
Initial costs, buildings 9,066      
Additions subsequent to acquisition, Improvements 8,513      
Land at cost 6,179      
Buildings at cost 17,579      
Total at cost 23,758      
Accumulated Depreciation 4,430      
Encumbrances $ 0      
Date of Construction 1980      
Date Acquired May 01, 2017      
Life on which depreciation in latest income statements is computed (Years) 41 years      
1980 [Member] | Usk, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 1,831      
Initial costs, buildings 32,837      
Land at cost 1,831      
Buildings at cost 32,837      
Total at cost 34,668      
Accumulated Depreciation 3,207      
Encumbrances $ 0      
Date of Construction 1980      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1980 [Member] | York, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 22,899      
Initial costs, buildings 75,966      
Land at cost 22,899      
Buildings at cost 75,966      
Total at cost 98,865      
Accumulated Depreciation 9,030      
Encumbrances $ 0      
Date of Construction 1980      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1985 [Member] | Aberdeen, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 4,501      
Initial costs, buildings 106,607      
Land at cost 4,501      
Buildings at cost 106,607      
Total at cost 111,108      
Accumulated Depreciation 16,045      
Encumbrances $ 47,809      
Date of Construction 1985      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1985 [Member] | Hot Springs, AR [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 5,622      
Initial costs, buildings 59,432      
Additions subsequent to acquisition, Improvements 21,221      
Land at cost 5,622      
Buildings at cost 80,653      
Total at cost 86,275      
Accumulated Depreciation 21,530      
Encumbrances $ 0      
Date of Construction 1985      
Date Acquired Aug. 31, 2015      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1985 [Member] | Southampton, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 6,821      
Initial costs, buildings 20,030      
Land at cost 6,821      
Buildings at cost 20,030      
Total at cost 26,851      
Accumulated Depreciation 2,792      
Encumbrances $ 0      
Date of Construction 1985      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1997 [Member] | Algeciras, Spain [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 554      
Initial costs, buildings 8,749      
Land at cost 554      
Buildings at cost 8,749      
Total at cost 9,303      
Accumulated Depreciation 882      
Encumbrances $ 0      
Date of Construction 1997      
Date Acquired Apr. 29, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1997 [Member] | Floridablanca, Colombia [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 836      
Initial costs, buildings 26,157      
Land at cost 836      
Buildings at cost 26,157      
Total at cost 26,993      
Accumulated Depreciation 2,256      
Encumbrances $ 0      
Date of Construction 1997      
Date Acquired Jul. 29, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1982 [Member] | Bedford, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 1,630      
Initial costs, buildings 7,942      
Additions subsequent to acquisition, Improvements 42      
Land at cost 1,630      
Buildings at cost 7,984      
Total at cost 9,614      
Accumulated Depreciation 1,213      
Encumbrances $ 8,489      
Date of Construction 1982      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1982 [Member] | Birmingham, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 10,437      
Initial costs, buildings 99,353      
Land at cost 10,437      
Buildings at cost 99,353      
Total at cost 109,790      
Accumulated Depreciation 15,057      
Encumbrances $ 0      
Date of Construction 1982      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1982 [Member] | Bossier City, LA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Long term acute care hospital      
Initial costs, land $ 900      
Initial costs, buildings 17,818      
Additions subsequent to acquisition, Improvements 944      
Land at cost 900      
Buildings at cost 18,762      
Total at cost 19,662      
Accumulated Depreciation 8,126      
Encumbrances $ 0      
Date of Construction 1982      
Date Acquired Apr. 01, 2008      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1982 [Member] | Caterham, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 11,169      
Initial costs, buildings 22,065      
Land at cost 11,169      
Buildings at cost 22,065      
Total at cost 33,234      
Accumulated Depreciation 3,704      
Encumbrances $ 0      
Date of Construction 1982      
Date Acquired Aug. 16, 2019      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1982 [Member] | Canterbury, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 9,722      
Initial costs, buildings 29,202      
Land at cost 9,722      
Buildings at cost 29,202      
Total at cost 38,924      
Accumulated Depreciation 4,415      
Encumbrances $ 20,342      
Date of Construction 1982      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1982 [Member] | Croydon, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 10,524      
Initial costs, buildings 44,143      
Land at cost 10,524      
Buildings at cost 44,143      
Total at cost 54,667      
Accumulated Depreciation 6,708      
Encumbrances $ 27,085      
Date of Construction 1982      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1982 [Member] | Warren, OH [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 5,385      
Initial costs, buildings 47,466      
Additions subsequent to acquisition, Improvements 10,492      
Land at cost 5,385      
Buildings at cost 57,958      
Total at cost 63,343      
Accumulated Depreciation 14,060      
Encumbrances $ 0      
Date of Construction 1982      
Date Acquired May 01, 2017      
Life on which depreciation in latest income statements is computed (Years) 41 years      
2023 [Member] | Cayce, SC [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 1,022      
Initial costs, buildings 20,419      
Land at cost 1,022      
Buildings at cost 20,419      
Total at cost 21,441      
Accumulated Depreciation 1,276      
Encumbrances $ 0      
Date of Construction 2023      
Date Acquired Oct. 21, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2018 [Member] | Birmingham, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, buildings $ 18,375      
Buildings at cost 18,375      
Total at cost 18,375      
Accumulated Depreciation 2,527      
Encumbrances $ 0      
Date of Construction 2018      
Date Acquired Jun. 29, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2018 [Member] | Conroe, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 3,855      
Initial costs, buildings 38,892      
Land at cost 3,855      
Buildings at cost 38,892      
Total at cost 42,747      
Accumulated Depreciation 4,563      
Encumbrances $ 0      
Date of Construction 2018      
Date Acquired Oct. 19, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2018 [Member] | Cheadle, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 31,557      
Initial costs, buildings 100,349      
Land at cost 31,557      
Buildings at cost 100,349      
Total at cost 131,906      
Accumulated Depreciation 12,217      
Encumbrances $ 0      
Date of Construction 2018      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2018 [Member] | Darlington, United Kingdom [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 22,488      
Initial costs, buildings 51,083      
Land at cost 22,488      
Buildings at cost 51,083      
Total at cost 73,571      
Accumulated Depreciation 6,731      
Encumbrances $ 0      
Date of Construction 2018      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2018 [Member] | El Paso, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 4,268      
Initial costs, buildings 21,345      
Land at cost 4,268      
Buildings at cost 21,345      
Total at cost 25,613      
Accumulated Depreciation 3,099      
Encumbrances $ 0      
Date of Construction 2018      
Date Acquired Dec. 17, 2020      
Life on which depreciation in latest income statements is computed (Years) 38 years      
2018 [Member] | Malaga, SP [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 796      
Initial costs, buildings 12,469      
Land at cost 796      
Buildings at cost 12,469      
Total at cost 13,265      
Accumulated Depreciation 1,167      
Encumbrances $ 0      
Date of Construction 2018      
Date Acquired Apr. 29, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2018 [Member] | Olathe, KS [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 3,485      
Initial costs, buildings 14,484      
Land at cost 3,485      
Buildings at cost 14,484      
Total at cost 17,969      
Accumulated Depreciation 2,071      
Encumbrances $ 0      
Date of Construction 2018      
Date Acquired Jun. 10, 2019      
Life on which depreciation in latest income statements is computed (Years) 50 years      
2018 [Member] | Preston, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 9,251      
Initial costs, buildings 33,685      
Land at cost 9,251      
Buildings at cost 33,685      
Total at cost 42,936      
Accumulated Depreciation 3,583      
Encumbrances $ 0      
Date of Construction 2018      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2018 [Member] | Raleigh, NC [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 3,469      
Initial costs, buildings 27,514      
Land at cost 3,469      
Buildings at cost 27,514      
Total at cost 30,983      
Accumulated Depreciation 3,402      
Encumbrances $ 0      
Date of Construction 2018      
Date Acquired Oct. 19, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2018 [Member] | Roeland Park, KS [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 1,569      
Initial costs, buildings 15,103      
Land at cost 1,569      
Buildings at cost 15,103      
Total at cost 16,672      
Accumulated Depreciation 2,116      
Encumbrances $ 0      
Date of Construction 2018      
Date Acquired Jun. 10, 2019      
Life on which depreciation in latest income statements is computed (Years) 50 years      
2018 [Member] | Shawnee, KS [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 3,076      
Initial costs, buildings 14,945      
Land at cost 3,076      
Buildings at cost 14,945      
Total at cost 18,021      
Accumulated Depreciation 2,440      
Encumbrances $ 0      
Date of Construction 2018      
Date Acquired Jun. 10, 2019      
Life on which depreciation in latest income statements is computed (Years) 50 years      
2018 [Member] | Turku, Finland [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 1,285      
Initial costs, buildings 61,920      
Land at cost 1,285      
Buildings at cost 61,920      
Total at cost 63,205      
Accumulated Depreciation 6,046      
Encumbrances $ 0      
Date of Construction 2018      
Date Acquired Mar. 11, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2018 [Member] | Vancouver, WA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 9,313      
Initial costs, buildings 12,505      
Land at cost 9,313      
Buildings at cost 12,505      
Total at cost 21,818      
Accumulated Depreciation 1,222      
Encumbrances $ 0      
Date of Construction 2018      
Date Acquired Oct. 19, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1900 [Member] | Birmingham, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 436      
Initial costs, buildings 20,284      
Land at cost 436      
Buildings at cost 20,284      
Total at cost 20,720      
Accumulated Depreciation 2,445      
Encumbrances $ 0      
Date of Construction 1900      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1972 [Member] | Bellflower, CA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 10,155      
Initial costs, buildings 21,296      
Land at cost 10,155      
Buildings at cost 21,296      
Total at cost 31,451      
Accumulated Depreciation 88      
Encumbrances $ 0      
Date of Construction 1972      
Date Acquired Aug. 23, 2019      
Life on which depreciation in latest income statements is computed (Years) 21 years      
1972 [Member] | Los Angeles, CA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 12,562      
Initial costs, buildings 40,164      
Additions subsequent to acquisition, Improvements 394      
Land at cost 12,562      
Buildings at cost 40,558      
Total at cost 53,120      
Accumulated Depreciation 4,680      
Encumbrances $ 0      
Date of Construction 1972      
Date Acquired Jul. 06, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1957 [Member] | Blackburn, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,816      
Initial costs, buildings 53,982      
Land at cost 2,816      
Buildings at cost 53,982      
Total at cost 56,798      
Accumulated Depreciation 8,146      
Encumbrances $ 25,085      
Date of Construction 1957      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2006 [Member] | Dormagen Germany [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 2,032      
Initial costs, buildings 6,010      
Land at cost 2,032      
Buildings at cost 6,010      
Total at cost 8,042      
Accumulated Depreciation 1,172      
Encumbrances $ 0      
Date of Construction 2006      
Date Acquired Aug. 28, 2018      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2006 [Member] | Petersburg, VA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 1,302      
Initial costs, buildings 9,121      
Land at cost 1,302      
Buildings at cost 9,121      
Total at cost 10,423      
Accumulated Depreciation 3,990      
Encumbrances $ 0      
Date of Construction 2006      
Date Acquired Jul. 01, 2008      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1930 [Member] | Blackburn, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 21,201      
Initial costs, buildings 57,514      
Land at cost 21,201      
Buildings at cost 57,514      
Total at cost 78,715      
Accumulated Depreciation 7,094      
Encumbrances $ 0      
Date of Construction 1930      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2009 [Member] | Bath, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 1,597      
Initial costs, buildings 33,105      
Land at cost 1,597      
Buildings at cost 33,105      
Total at cost 34,702      
Accumulated Depreciation 9,518      
Encumbrances $ 0      
Date of Construction 2009      
Date Acquired Jul. 01, 2014      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2009 [Member] | Birmingham, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 981      
Initial costs, buildings 10,753      
Land at cost 981      
Buildings at cost 10,753      
Total at cost 11,734      
Accumulated Depreciation 760      
Encumbrances      
Date of Construction 2009      
Date Acquired Apr. 14, 2023      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2009 [Member] | Folsom, CA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Long term acute care hospital      
Initial costs, land $ 3,291      
Initial costs, buildings 21,293      
Land at cost 3,291      
Buildings at cost 21,293      
Total at cost 24,584      
Accumulated Depreciation 4,002      
Encumbrances $ 0      
Date of Construction 2009      
Date Acquired Aug. 30, 2019      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1983 [Member] | Bassenheim, Germany [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 1,179      
Initial costs, buildings 5,628      
Land at cost 1,179      
Buildings at cost 5,628      
Total at cost 6,807      
Accumulated Depreciation 1,079      
Encumbrances $ 0      
Date of Construction 1983      
Date Acquired Feb. 09, 2019      
Life on which depreciation in latest income statements is computed (Years) 39 years      
1983 [Member] | Glasgow, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 6,818      
Initial costs, buildings 139,259      
Land at cost 6,818      
Buildings at cost 139,259      
Total at cost 146,077      
Accumulated Depreciation 20,948      
Encumbrances $ 72,792      
Date of Construction 1983      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1983 [Member] | Grefath, Germany [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 1,277      
Initial costs, buildings 3,222      
Land at cost 1,277      
Buildings at cost 3,222      
Total at cost 4,499      
Accumulated Depreciation 642      
Encumbrances $ 0      
Date of Construction 1983      
Date Acquired Aug. 28, 2018      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1983 [Member] | Lander, WY [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 757      
Initial costs, buildings 42,849      
Land at cost 757      
Buildings at cost 42,849      
Total at cost 43,606      
Accumulated Depreciation 6,869      
Encumbrances $ 0      
Date of Construction 1983      
Date Acquired Dec. 17, 2019      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1983 [Member] | Nottingham, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 5,242      
Initial costs, buildings 48,637      
Land at cost 5,242      
Buildings at cost 48,637      
Total at cost 53,879      
Accumulated Depreciation 7,398      
Encumbrances $ 34,690      
Date of Construction 1983      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1983 [Member] | Milton Keynes, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 5,552      
Initial costs, buildings 37,956      
Land at cost 5,552      
Buildings at cost 37,956      
Total at cost 43,508      
Accumulated Depreciation 5,731      
Encumbrances $ 0      
Date of Construction 1983      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1983 [Member] | Port Huron, MI        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,531      
Initial costs, buildings 14,252      
Land at cost 2,531      
Buildings at cost 14,252      
Total at cost 16,783      
Accumulated Depreciation 4,869      
Encumbrances $ 0      
Date of Construction 1983      
Date Acquired Dec. 31, 2015      
Life on which depreciation in latest income statements is computed (Years) 30 years      
1983 [Member] | Remscheid, Germany [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 1,116      
Initial costs, buildings 2,689      
Land at cost 1,116      
Buildings at cost 2,689      
Total at cost 3,805      
Accumulated Depreciation 523      
Encumbrances $ 0      
Date of Construction 1983      
Date Acquired Aug. 28, 2018      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1983 [Member] | Riverton, WY [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 1,163      
Initial costs, buildings 29,647      
Land at cost 1,163      
Buildings at cost 29,647      
Total at cost 30,810      
Accumulated Depreciation 5,513      
Encumbrances $ 0      
Date of Construction 1983      
Date Acquired Dec. 17, 2019      
Life on which depreciation in latest income statements is computed (Years) 36 years      
2016 [Member] | Bad Salzuflen, Germany [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 7,595      
Initial costs, buildings 24,873      
Land at cost 7,595      
Buildings at cost 24,873      
Total at cost 32,468      
Accumulated Depreciation 5,221      
Encumbrances $ 0      
Date Acquired Nov. 30, 2017      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2010 [Member] | Bad Oeynhausen, Germany [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 1,198      
Initial costs, buildings 2,928      
Land at cost 1,198      
Buildings at cost 2,928      
Total at cost 4,126      
Accumulated Depreciation 662      
Encumbrances $ 0      
Date of Construction 2010      
Date Acquired Nov. 30, 2017      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2010 [Member] | Newburgh, IN [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 1,215      
Initial costs, buildings 7,212      
Land at cost 1,215      
Buildings at cost 7,212      
Total at cost 8,427      
Accumulated Depreciation 908      
Encumbrances $ 0      
Date of Construction 2010      
Date Acquired Oct. 19, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2010 [Member] | Sherman, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 3,363      
Initial costs, buildings 10,931      
Land at cost 3,363      
Buildings at cost 10,931      
Total at cost 14,294      
Accumulated Depreciation 4,962      
Encumbrances $ 0      
Date of Construction 2010      
Date Acquired Oct. 31, 2014      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2022 [Member] | Bakersfield, CA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 2,178      
Initial costs, buildings 45,253      
Land at cost 2,178      
Buildings at cost 45,253      
Total at cost 47,431      
Accumulated Depreciation 4,337      
Encumbrances $ 0      
Date of Construction 2022      
Date Acquired May 15, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1922 [Member] | Lewiston, ID [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 5,389      
Initial costs, buildings 75,435      
Land at cost 5,389      
Buildings at cost 75,435      
Total at cost 80,824      
Accumulated Depreciation 22,108      
Encumbrances $ 0      
Date of Construction 1922      
Date Acquired May 01, 2017      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1922 [Member] | Warren, OH [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 2,417      
Initial costs, buildings 15,857      
Additions subsequent to acquisition, Improvements 1,737      
Land at cost 2,417      
Buildings at cost 17,594      
Total at cost 20,011      
Accumulated Depreciation 4,367      
Encumbrances $ 0      
Date of Construction 1922      
Date Acquired May 01, 2017      
Life on which depreciation in latest income statements is computed (Years) 46 years      
2013 [Member] | Hausman, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 1,500      
Initial costs, buildings 8,957      
Land at cost 1,500      
Buildings at cost 8,957      
Total at cost 10,457      
Accumulated Depreciation 2,856      
Encumbrances $ 0      
Date of Construction 2013      
Date Acquired Mar. 01, 2013      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2013 [Member] | Helsinki, Finland [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 4,347      
Initial costs, buildings 71,714      
Additions subsequent to acquisition, Improvements 1,164      
Land at cost 4,347      
Buildings at cost 72,878      
Total at cost 77,225      
Accumulated Depreciation 6,896      
Encumbrances $ 0      
Date of Construction 2013      
Date Acquired Mar. 11, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2013 [Member] | Lafayette, IN [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 800      
Initial costs, buildings 14,968      
Additions subsequent to acquisition, Improvements (25)      
Land at cost 800      
Buildings at cost 14,943      
Total at cost 15,743      
Accumulated Depreciation 4,816      
Encumbrances $ 0      
Date of Construction 2013      
Date Acquired Feb. 01, 2013      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2013 [Member] | Post Falls Idaho        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 417      
Initial costs, buildings 12,175      
Additions subsequent to acquisition, Improvements 1,905      
Land at cost 767      
Buildings at cost 13,730      
Total at cost 14,497      
Accumulated Depreciation 4,128      
Encumbrances $ 0      
Date of Construction 2013      
Date Acquired Dec. 31, 2013      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2013 [Member] | Spartanburg, SC [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 1,135      
Initial costs, buildings 15,717      
Land at cost 1,135      
Buildings at cost 15,717      
Total at cost 16,852      
Accumulated Depreciation 4,866      
Encumbrances $ 0      
Date of Construction 2013      
Date Acquired Aug. 01, 2013      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2013 [Member] | West Chester, OH [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 3,670      
Initial costs, buildings 61,338      
Land at cost 3,670      
Buildings at cost 61,338      
Total at cost 65,008      
Accumulated Depreciation 7,058      
Encumbrances $ 0      
Date of Construction 2013      
Date Acquired Oct. 19, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2013 [Member] | West Midlands, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 2,035      
Initial costs, buildings 7,581      
Land at cost 2,035      
Buildings at cost 7,581      
Total at cost 9,616      
Accumulated Depreciation 579      
Encumbrances $ 0      
Date of Construction 2013      
Date Acquired Apr. 14, 2023      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2007 [Member] | Godalming, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 9,903      
Initial costs, buildings 20,090      
Land at cost 9,903      
Buildings at cost 20,090      
Total at cost 29,993      
Accumulated Depreciation 2,621      
Encumbrances $ 0      
Date of Construction 2007      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2007 [Member] | Hinckley, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 2,610      
Initial costs, buildings 17,786      
Land at cost 2,610      
Buildings at cost 17,786      
Total at cost 20,396      
Accumulated Depreciation 2,167      
Encumbrances $ 0      
Date of Construction 2007      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2007 [Member] | Northland, MO [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Long term acute care hospital      
Initial costs, land $ 834      
Initial costs, buildings 17,182      
Land at cost 834      
Buildings at cost 17,182      
Total at cost 18,016      
Accumulated Depreciation 6,408      
Encumbrances $ 0      
Date of Construction 2007      
Date Acquired Feb. 14, 2011      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2007 [Member] | Mesa, AZ [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 6,140      
Initial costs, buildings 99,275      
Additions subsequent to acquisition, Improvements 4,152      
Land at cost 6,140      
Buildings at cost 103,427      
Total at cost 109,567      
Accumulated Depreciation 32,867      
Encumbrances $ 0      
Date of Construction 2007      
Date Acquired Sep. 26, 2013      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2015 [Member] | Hoover, AL [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Freestanding ER      
Initial costs, land $ 0      
Initial costs, buildings 1,034      
Additions subsequent to acquisition, Improvements 296      
Land at cost 0      
Buildings at cost 1,330      
Total at cost 1,330      
Accumulated Depreciation 388      
Encumbrances $ 0      
Date of Construction 2015      
Date Acquired May 01, 2015      
Life on which depreciation in latest income statements is computed (Years) 34 years      
1978 [Member] | Kansas City, MO [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 10,497      
Initial costs, buildings 64,419      
Land at cost 10,497      
Buildings at cost 64,419      
Total at cost 74,916      
Accumulated Depreciation 17,920      
Encumbrances $ 0      
Date of Construction 1978      
Date Acquired Feb. 13, 2015      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1978 [Member] | Norwalk, CA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 7,946      
Initial costs, buildings 30,465      
Additions subsequent to acquisition, Improvements 7,104      
Land at cost 7,946      
Buildings at cost 37,569      
Total at cost 45,515      
Accumulated Depreciation 4,158      
Encumbrances $ 0      
Date of Construction 1978      
Date Acquired Jul. 06, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1978 [Member] | San Antonio, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 7,061      
Initial costs, buildings 10,851      
Additions subsequent to acquisition, Improvements 7,982      
Land at cost 7,061      
Buildings at cost 18,833      
Total at cost 25,894      
Accumulated Depreciation 6,730      
Encumbrances $ 0      
Date of Construction 1978      
Date Acquired Sep. 29, 2017      
Life on which depreciation in latest income statements is computed (Years) 41 years      
1977 [Member] | Braunfels, Germany [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,314      
Initial costs, buildings 14,415      
Additions subsequent to acquisition, Improvements 8      
Land at cost 2,314      
Buildings at cost 14,423      
Total at cost 16,737      
Accumulated Depreciation 3,825      
Encumbrances $ 0      
Date of Construction 1977      
Date Acquired Jun. 30, 2015      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1977 [Member] | London, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 13,179      
Initial costs, buildings 86,016      
Land at cost 13,179      
Buildings at cost 86,016      
Total at cost 99,195      
Accumulated Depreciation 12,913      
Encumbrances $ 44,446      
Date of Construction 1977      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1965 [Member] | Rochdale, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 3,786      
Initial costs, buildings 43,135      
Land at cost 3,786      
Buildings at cost 43,135      
Total at cost 46,921      
Accumulated Depreciation 6,530      
Encumbrances $ 23,581      
Date of Construction 1965      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1714 [Member] | Bromley, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 7,646      
Initial costs, buildings 16,428      
Land at cost 7,646      
Buildings at cost 16,428      
Total at cost 24,074      
Accumulated Depreciation 2,053      
Encumbrances $ 0      
Date of Construction 1714      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2012 [Member] | Carrollton, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 4,941      
Initial costs, buildings 52,227      
Land at cost 4,941      
Buildings at cost 52,227      
Total at cost 57,168      
Accumulated Depreciation 5,940      
Encumbrances $ 0      
Date of Construction 2012      
Date Acquired Oct. 19, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2012 [Member] | Casper, WY [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 1,581      
Land at cost 1,581      
Total at cost 1,581      
Encumbrances $ 0      
Date of Construction 2012      
Date Acquired Feb. 29, 2012      
2012 [Member] | Dewsburry, UK        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property ehavioral health facility      
Initial costs, land $ 1,185      
Initial costs, buildings 10,795      
Land at cost 1,185      
Buildings at cost 10,795      
Total at cost 11,980      
Accumulated Depreciation 802      
Encumbrances $ 0      
Date of Construction 2012      
Date Acquired Apr. 14, 2023      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2012 [Member] | Dublin, OH [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 5,118      
Initial costs, buildings 69,346      
Land at cost 5,118      
Buildings at cost 69,346      
Total at cost 74,464      
Accumulated Depreciation 7,804      
Encumbrances $ 0      
Date of Construction 2012      
Date Acquired Oct. 19, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2012 [Member] | Florence, AZ [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 900      
Initial costs, buildings 28,462      
Additions subsequent to acquisition, Improvements 105      
Land at cost 900      
Buildings at cost 28,567      
Total at cost 29,467      
Accumulated Depreciation 9,817      
Encumbrances $ 0      
Date of Construction 2012      
Date Acquired Feb. 07, 2012      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2012 [Member] | Lafayette, IN [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 2,829      
Initial costs, buildings 10,795      
Land at cost 2,829      
Buildings at cost 10,795      
Total at cost 13,624      
Accumulated Depreciation 1,504      
Encumbrances $ 0      
Date of Construction 2012      
Date Acquired Oct. 19, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2012 [Member] | Overlook, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,452      
Initial costs, buildings 9,666      
Additions subsequent to acquisition, Improvements 7      
Land at cost 2,452      
Buildings at cost 9,673      
Total at cost 12,125      
Accumulated Depreciation 3,112      
Encumbrances $ 0      
Date of Construction 2012      
Date Acquired Feb. 01, 2013      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2012 [Member] | San Antonio, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,248      
Initial costs, buildings 5,880      
Land at cost 2,248      
Buildings at cost 5,880      
Total at cost 8,128      
Accumulated Depreciation 1,936      
Encumbrances $ 0      
Date of Construction 2012      
Date Acquired Oct. 02, 2012      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2012 [Member] | Reading, United Kingdom [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 27,515      
Initial costs, buildings 88,165      
Land at cost 27,515      
Buildings at cost 88,165      
Total at cost 115,680      
Accumulated Depreciation 11,241      
Encumbrances $ 23,813      
Date of Construction 2012      
Date Acquired Dec. 18, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2003 [Member] | Bury, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 9,007      
Initial costs, buildings 20,524      
Land at cost 9,007      
Buildings at cost 20,524      
Total at cost 29,531      
Accumulated Depreciation 2,664      
Encumbrances $ 0      
Date of Construction 2003      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2003 [Member] | Newark, NJ [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 32,957      
Initial costs, buildings 24,553      
Land at cost 32,957      
Buildings at cost 24,553      
Total at cost 57,510      
Accumulated Depreciation 3,294      
Encumbrances $ 0      
Date of Construction 2003      
Date Acquired May 02, 2016      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2003 [Member] | Youngstown, OH [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 3,555      
Initial costs, buildings 3,565      
Additions subsequent to acquisition, Improvements 488      
Land at cost 3,555      
Buildings at cost 4,053      
Total at cost 7,608      
Accumulated Depreciation 2,823      
Encumbrances $ 0      
Date of Construction 2003      
Date Acquired May 01, 2017      
Life on which depreciation in latest income statements is computed (Years) 41 years      
1954 [Member] | Norwalk, CA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 6,982      
Initial costs, buildings 14,308      
Land at cost 6,982      
Buildings at cost 14,308      
Total at cost 21,290      
Accumulated Depreciation $ 36      
Date of Construction 1954      
Date Acquired Aug. 23, 2019      
Life on which depreciation in latest income statements is computed (Years) 37 years      
1990 [Member] | Carmarthen, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 963      
Initial costs, buildings 27,071      
Land at cost 963      
Buildings at cost 27,071      
Total at cost 28,034      
Accumulated Depreciation 4,101      
Encumbrances $ 16,025      
Date of Construction 1990      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1990 [Member] | Darlington, United Kingdom [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 5,534      
Initial costs, buildings 27,888      
Land at cost 5,534      
Buildings at cost 27,888      
Total at cost 33,422      
Accumulated Depreciation 3,305      
Encumbrances $ 0      
Date of Construction 1990      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1990 [Member] | Gloucester, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 5,906      
Initial costs, buildings 64,960      
Land at cost 5,906      
Buildings at cost 64,960      
Total at cost 70,866      
Accumulated Depreciation 10,894      
Encumbrances $ 0      
Date of Construction 1990      
Date Acquired Aug. 16, 2019      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1990 [Member] | Hemel Hempstead, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 13,220      
Initial costs, buildings 6,672      
Land at cost 13,220      
Buildings at cost 6,672      
Total at cost 19,892      
Accumulated Depreciation 1,048      
Encumbrances $ 0      
Date of Construction 1990      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1990 [Member] | Leeds, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 2,413      
Initial costs, buildings 10,078      
Land at cost 2,413      
Buildings at cost 10,078      
Total at cost 12,491      
Accumulated Depreciation 1,267      
Encumbrances $ 0      
Date of Construction 1990      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1990 [Member] | Melton Mowbray, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 6,035      
Initial costs, buildings 16,916      
Land at cost 6,035      
Buildings at cost 16,916      
Total at cost 22,951      
Accumulated Depreciation 2,177      
Encumbrances $ 0      
Date of Construction 1990      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1990 [Member] | Reading, United Kingdom [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 36,829      
Initial costs, buildings 48,872      
Land at cost 36,829      
Buildings at cost 48,872      
Total at cost 85,701      
Accumulated Depreciation 8,085      
Encumbrances $ 0      
Date of Construction 1990      
Date Acquired Aug. 16, 2019      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1953 [Member] | Port Huron, MI        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,531      
Initial costs, buildings 14,252      
Land at cost 2,531      
Buildings at cost 14,252      
Total at cost 16,783      
Accumulated Depreciation 4,869      
Encumbrances $ 0      
Date of Construction 1953      
Date Acquired Dec. 31, 2015      
Life on which depreciation in latest income statements is computed (Years) 30 years      
1849 [Member] | Cheadle, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 31,557      
Initial costs, buildings 100,349      
Land at cost 31,557      
Buildings at cost 100,349      
Total at cost 131,906      
Accumulated Depreciation 12,217      
Encumbrances $ 0      
Date of Construction 1849      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2019 [Member] | Clarksville, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 2,460      
Initial costs, buildings 25,540      
Land at cost 2,460      
Buildings at cost 25,540      
Total at cost 28,000      
Accumulated Depreciation 3,550      
Encumbrances $ 0      
Date of Construction 2019      
Date Acquired Dec. 17, 2020      
Life on which depreciation in latest income statements is computed (Years) 39 years      
2019 [Member] | Mesa, AZ [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,604      
Initial costs, buildings 16,400      
Land at cost 2,604      
Buildings at cost 16,400      
Total at cost 19,004      
Accumulated Depreciation 1,556      
Encumbrances $ 0      
Date of Construction 2019      
Date Acquired Apr. 18, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2019 [Member] | Overland Park, KS [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 3,191      
Initial costs, buildings 14,263      
Land at cost 3,191      
Buildings at cost 14,263      
Total at cost 17,454      
Accumulated Depreciation 2,152      
Encumbrances $ 0      
Date of Construction 2019      
Date Acquired Jun. 10, 2019      
Life on which depreciation in latest income statements is computed (Years) 50 years      
2011 [Member] | Cologne Germany [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 4,710      
Initial costs, buildings 15,923      
Land at cost 4,710      
Buildings at cost 15,923      
Total at cost 20,633      
Accumulated Depreciation 3,444      
Encumbrances $ 0      
Date of Construction 2011      
Date Acquired Jun. 23, 2017      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2011 [Member] | New Braunfels, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 1,853      
Initial costs, buildings 10,622      
Land at cost 1,853      
Buildings at cost 10,622      
Total at cost 12,475      
Accumulated Depreciation 1,402      
Encumbrances $ 0      
Date of Construction 2011      
Date Acquired Feb. 29, 2012      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1959 [Member] | Coral Gables, FL [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 26,215      
Initial costs, buildings 84,584      
Additions subsequent to acquisition, Improvements 2,624      
Land at cost 26,215      
Buildings at cost 87,208      
Total at cost 113,423      
Accumulated Depreciation 9,771      
Encumbrances $ 0      
Date of Construction 1959      
Date Acquired Aug. 01, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1959 [Member] | Norwalk, CA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,811      
Initial costs, buildings 5,940      
Land at cost 2,811      
Buildings at cost 5,940      
Total at cost 8,751      
Accumulated Depreciation 835      
Encumbrances $ 0      
Date of Construction 1959      
Date Acquired Jul. 06, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1994 [Member] | Dahlen, Germany [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 1,428      
Initial costs, buildings 12,065      
Land at cost 1,428      
Buildings at cost 12,065      
Total at cost 13,493      
Accumulated Depreciation 1,796      
Encumbrances $ 0      
Date of Construction 1994      
Date Acquired Jul. 08, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1994 [Member] | Worthing, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 7,108      
Initial costs, buildings 31,908      
Land at cost 7,108      
Buildings at cost 31,908      
Total at cost 39,016      
Accumulated Depreciation 4,827      
Encumbrances $ 18,509      
Date of Construction 1994      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2001 [Member] | Darlington, United Kingdom [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,210      
Initial costs, buildings 37,911      
Land at cost 2,210      
Buildings at cost 37,911      
Total at cost 40,121      
Accumulated Depreciation 5,265      
Encumbrances $ 36,188      
Date of Construction 2001      
Date Acquired Aug. 07, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2001 [Member] | Norwood, MA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 6,860      
Land at cost 6,860      
Total at cost $ 6,860      
Date Acquired Jun. 27, 2018      
Life on which depreciation in latest income statements is computed (Years) 46 years      
1935 [Member] | Darlington, United Kingdom [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 22,488      
Initial costs, buildings 51,083      
Land at cost 22,488      
Buildings at cost 51,083      
Total at cost 73,571      
Accumulated Depreciation 6,731      
Encumbrances $ 0      
Date of Construction 1935      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1960 [Member] | Darlington, United Kingdom [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 5,534      
Initial costs, buildings 27,888      
Land at cost 5,534      
Buildings at cost 27,888      
Total at cost 33,422      
Accumulated Depreciation 3,305      
Encumbrances $ 0      
Date of Construction 1960      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1960 [Member] | Houston, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 3,274      
Initial costs, buildings 27,324      
Additions subsequent to acquisition, Improvements 32,499      
Land at cost 3,274      
Buildings at cost 59,823      
Total at cost 63,097      
Accumulated Depreciation 24,422      
Encumbrances $ 0      
Date of Construction 1960      
Date Acquired Aug. 10, 2007      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1960 [Member] | Huntington Park, CA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 3,935      
Initial costs, buildings 6,103      
Land at cost 3,935      
Buildings at cost 6,103      
Total at cost 10,038      
Accumulated Depreciation 829      
Encumbrances $ 0      
Date of Construction 1960      
Date Acquired Jul. 06, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1960 [Member] | London, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 6,521      
Initial costs, buildings 16,570      
Land at cost 6,521      
Buildings at cost 16,570      
Total at cost 23,091      
Accumulated Depreciation 2,051      
Encumbrances $ 0      
Date of Construction 1960      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1960 [Member] | Meyersdale, PA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 390      
Initial costs, buildings 4,280      
Land at cost 390      
Buildings at cost 4,280      
Total at cost 4,670      
Accumulated Depreciation 1,096      
Encumbrances $ 0      
Date of Construction 1960      
Date Acquired Dec. 17, 2019      
Life on which depreciation in latest income statements is computed (Years) 30 years      
1960 [Member] | Sherman, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 3,363      
Initial costs, buildings 10,931      
Land at cost 3,363      
Buildings at cost 10,931      
Total at cost 14,294      
Accumulated Depreciation 4,962      
Encumbrances $ 0      
Date of Construction 1960      
Date Acquired Oct. 31, 2014      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1960 [Member] | Valencia, Spain [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 27,603      
Initial costs, buildings 25,848      
Land at cost 27,603      
Buildings at cost 25,848      
Total at cost 53,451      
Accumulated Depreciation 1,240      
Encumbrances $ 0      
Date of Construction 1960      
Date Acquired May 06, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1840 [Member] | Diss, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 3,080      
Initial costs, buildings 10,984      
Land at cost 3,080      
Buildings at cost 10,984      
Total at cost 14,064      
Accumulated Depreciation 1,516      
Encumbrances $ 0      
Date of Construction 1840      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1993 [Member] | Dormagen Germany [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 2,032      
Initial costs, buildings 6,010      
Land at cost 2,032      
Buildings at cost 6,010      
Total at cost 8,042      
Accumulated Depreciation 1,172      
Encumbrances $ 0      
Date of Construction 1993      
Date Acquired Aug. 28, 2018      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1993 [Member] | San Bernardino, CA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,209      
Initial costs, buildings 37,498      
Land at cost 2,209      
Buildings at cost 37,498      
Total at cost 39,707      
Accumulated Depreciation 6,488      
Encumbrances $ 0      
Date of Construction 1993      
Date Acquired Aug. 30, 2019      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1830 [Member] | Bromley, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 7,646      
Initial costs, buildings 16,428      
Land at cost 7,646      
Buildings at cost 16,428      
Total at cost 24,074      
Accumulated Depreciation 2,053      
Encumbrances $ 0      
Date of Construction 1830      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1969 [Member] | Culver City, CA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 37,885      
Initial costs, buildings 178,101      
Land at cost 37,885      
Buildings at cost 178,101      
Total at cost 215,986      
Accumulated Depreciation 517      
Encumbrances $ 0      
Date of Construction 1969      
Date Acquired Aug. 23, 2019      
Life on which depreciation in latest income statements is computed (Years) 29 years      
1969 [Member] | Hialeah, FL [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 75,339      
Initial costs, buildings 222,271      
Additions subsequent to acquisition, Improvements 2,564      
Land at cost 75,339      
Buildings at cost 224,835      
Total at cost 300,174      
Accumulated Depreciation 28,114      
Encumbrances $ 0      
Date of Construction 1969      
Date Acquired Aug. 01, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1969 [Member] | Huntington Park, CA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 3,935      
Initial costs, buildings 6,103      
Land at cost 3,935      
Buildings at cost 6,103      
Total at cost 10,038      
Accumulated Depreciation 829      
Encumbrances $ 0      
Date of Construction 1969      
Date Acquired Jul. 06, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2021 [Member] | Bromley, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 7,646      
Initial costs, buildings 16,428      
Land at cost 7,646      
Buildings at cost 16,428      
Total at cost 24,074      
Accumulated Depreciation 2,053      
Encumbrances $ 0      
Date of Construction 2021      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2021 [Member] | McKinney, Texas [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Date Acquired Oct. 19, 2021      
2021 [Member] | Preston, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 9,251      
Initial costs, buildings 33,685      
Land at cost 9,251      
Buildings at cost 33,685      
Total at cost 42,936      
Accumulated Depreciation 3,583      
Encumbrances $ 0      
Date of Construction 2021      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2021 [Member] | Stockton, California [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 2,717      
Initial costs, buildings 50,681      
Land at cost 2,717      
Buildings at cost 50,681      
Total at cost 53,398      
Accumulated Depreciation 3,379      
Encumbrances $ 0      
Date of Construction 2021      
Date Acquired Nov. 23, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2020 [Member] | Darlington, United Kingdom [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 22,488      
Initial costs, buildings 51,083      
Land at cost 22,488      
Buildings at cost 51,083      
Total at cost 73,571      
Accumulated Depreciation 6,731      
Encumbrances $ 0      
Date of Construction 2020      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2020 [Member] | Gilbert, AZ [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 4,790      
Initial costs, buildings 45,933      
Additions subsequent to acquisition, Improvements 9,647      
Land at cost 4,790      
Buildings at cost 55,580      
Total at cost 60,370      
Accumulated Depreciation 5,272      
Encumbrances $ 0      
Date of Construction 2020      
Date Acquired Oct. 19, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2020 [Member] | Houston, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 6,063      
Initial costs, buildings 19,881      
Additions subsequent to acquisition, Improvements 2,565      
Land at cost 6,063      
Buildings at cost 22,446      
Total at cost 28,509      
Accumulated Depreciation 2,806      
Encumbrances $ 0      
Date of Construction 2020      
Date Acquired Oct. 25, 2019      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2020 [Member] | Idaho Falls, ID [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 1,880      
Initial costs, buildings 108,498      
Additions subsequent to acquisition, Improvements 15,146      
Land at cost 1,880      
Buildings at cost 123,644      
Total at cost 125,524      
Accumulated Depreciation 16,083      
Encumbrances $ 0      
Date of Construction 2020      
Date Acquired Dec. 19, 2017      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2020 [Member] | Tadley, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 22,140      
Initial costs, buildings 20,174      
Land at cost 22,140      
Buildings at cost 20,174      
Total at cost 42,314      
Accumulated Depreciation 2,982      
Encumbrances $ 0      
Date of Construction 2020      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2020 [Member] | Woking, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 7,663      
Initial costs, buildings 4,954      
Land at cost 7,663      
Buildings at cost 4,954      
Total at cost 12,617      
Accumulated Depreciation 683      
Encumbrances $ 0      
Date of Construction 2020      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1986 [Member] | Halsall, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,132      
Initial costs, buildings 32,980      
Land at cost 2,132      
Buildings at cost 32,980      
Total at cost 35,112      
Accumulated Depreciation 5,546      
Encumbrances $ 0      
Date of Construction 1986      
Date Acquired Aug. 16, 2019      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1986 [Member] | Rowley, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 3,078      
Initial costs, buildings 19,371      
Land at cost 3,078      
Buildings at cost 19,371      
Total at cost 22,449      
Accumulated Depreciation 3,359      
Encumbrances $ 0      
Date of Construction 1986      
Date Acquired Aug. 16, 2019      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1999 [Member] | Hartsville, SC [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,050      
Initial costs, buildings 43,970      
Land at cost 2,050      
Buildings at cost 43,970      
Total at cost 46,020      
Accumulated Depreciation 13,211      
Encumbrances $ 0      
Date of Construction 1999      
Date Acquired Aug. 31, 2015      
Life on which depreciation in latest income statements is computed (Years) 34 years      
1924 [Member] | Hastings, PA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 603      
Initial costs, buildings 8,834      
Land at cost 603      
Buildings at cost 8,834      
Total at cost 9,437      
Accumulated Depreciation 2,179      
Encumbrances $ 0      
Date of Construction 1924      
Date Acquired Dec. 17, 2019      
Life on which depreciation in latest income statements is computed (Years) 30 years      
1924 [Member] | Johnstown, PA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 8,877      
Initial costs, buildings 247,158      
Land at cost 8,877      
Buildings at cost 247,158      
Total at cost 256,035      
Accumulated Depreciation 50,152      
Encumbrances $ 0      
Date of Construction 1924      
Date Acquired Dec. 17, 2019      
Life on which depreciation in latest income statements is computed (Years) 30 years      
1924 [Member] | Roaring Springs, PA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 1,446      
Initial costs, buildings 9,549      
Land at cost 1,446      
Buildings at cost 9,549      
Total at cost 10,995      
Accumulated Depreciation 2,432      
Encumbrances $ 0      
Date of Construction 1924      
Date Acquired Dec. 17, 2019      
Life on which depreciation in latest income statements is computed (Years) 30 years      
1950 [Member] | Hialeah, FL [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 18,802      
Initial costs, buildings 105,316      
Additions subsequent to acquisition, Improvements 4,784      
Land at cost 18,802      
Buildings at cost 110,100      
Total at cost 128,902      
Accumulated Depreciation 12,422      
Encumbrances $ 0      
Date of Construction 1950      
Date Acquired Aug. 01, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1950 [Member] | Houston, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 29,706      
Initial costs, buildings 101,846      
Additions subsequent to acquisition, Improvements 90,935      
Land at cost 29,706      
Buildings at cost 192,781      
Total at cost 222,487      
Accumulated Depreciation 24,195      
Encumbrances $ 0      
Date of Construction 1950      
Date Acquired Sep. 29, 2017      
Life on which depreciation in latest income statements is computed (Years) 41 years      
1950 [Member] | Ottumwa, IA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,377      
Initial costs, buildings 48,697      
Land at cost 2,377      
Buildings at cost 48,697      
Total at cost 51,074      
Accumulated Depreciation 10,869      
Encumbrances $ 0      
Date of Construction 1950      
Date Acquired Dec. 17, 2019      
Life on which depreciation in latest income statements is computed (Years) 30 years      
1950 [Member] | Sharon, PA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 6,179      
Initial costs, buildings 9,066      
Additions subsequent to acquisition, Improvements 8,513      
Land at cost 6,179      
Buildings at cost 17,579      
Total at cost 23,758      
Accumulated Depreciation 4,430      
Encumbrances $ 0      
Date of Construction 1950      
Date Acquired May 01, 2017      
Life on which depreciation in latest income statements is computed (Years) 41 years      
1950 [Member] | Surrey, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 15,926      
Initial costs, buildings 9,663      
Land at cost 15,926      
Buildings at cost 9,663      
Total at cost 25,589      
Accumulated Depreciation 1,007      
Encumbrances $ 0      
Date of Construction 1950      
Date Acquired Dec. 09, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1991 [Member] | Fresno, CA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 5,507      
Initial costs, buildings 70,473      
Land at cost 5,507      
Buildings at cost 70,473      
Total at cost 75,980      
Accumulated Depreciation 12,025      
Encumbrances $ 0      
Date of Construction 1991      
Date Acquired Aug. 30, 2019      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1991 [Member] | Heidelberg, Germany [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 6,636      
Initial costs, buildings 37,907      
Land at cost 6,636      
Buildings at cost 37,907      
Total at cost 44,543      
Accumulated Depreciation 9,051      
Encumbrances $ 0      
Date of Construction 1991      
Date Acquired Jun. 22, 2016      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1991 [Member] | Redding, CA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Long term acute care hospital      
Initial costs, land $ 1,856      
Initial costs, buildings 25,586      
Land at cost 1,856      
Buildings at cost 25,586      
Total at cost 27,442      
Accumulated Depreciation 77      
Encumbrances $ 0      
Date of Construction 1991      
Date Acquired Nov. 17, 2025      
Life on which depreciation in latest income statements is computed (Years) 30 years      
1700 [Member] | Frome, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 11,531      
Initial costs, buildings 11,337      
Land at cost 11,531      
Buildings at cost 11,337      
Total at cost 22,868      
Accumulated Depreciation 1,895      
Encumbrances $ 0      
Date of Construction 1700      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1966 [Member] | Gardena, CA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 14,010      
Initial costs, buildings 65,282      
Additions subsequent to acquisition, Improvements 211      
Land at cost 14,010      
Buildings at cost 65,493      
Total at cost 79,503      
Accumulated Depreciation 7,938      
Encumbrances $ 0      
Date of Construction 1966      
Date Acquired Jul. 06, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1900 [Member] | Glasgow, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 1,512      
Initial costs, buildings 16,531      
Land at cost 1,512      
Buildings at cost 16,531      
Total at cost 18,043      
Accumulated Depreciation 2,016      
Encumbrances $ 0      
Date of Construction 1900      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1900 [Member] | London, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 6,521      
Initial costs, buildings 16,570      
Land at cost 6,521      
Buildings at cost 16,570      
Total at cost 23,091      
Accumulated Depreciation 2,051      
Encumbrances $ 0      
Date of Construction 1900      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1900 [Member] | York, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 22,899      
Initial costs, buildings 75,966      
Land at cost 22,899      
Buildings at cost 75,966      
Total at cost 98,865      
Accumulated Depreciation 9,030      
Encumbrances $ 0      
Date of Construction 1900      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1796 [Member] | Godalming, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 9,903      
Initial costs, buildings 20,090      
Land at cost 9,903      
Buildings at cost 20,090      
Total at cost 29,993      
Accumulated Depreciation 2,621      
Encumbrances $ 0      
Date of Construction 1796      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1886 [Member] | Grefath, Germany [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 1,277      
Initial costs, buildings 3,222      
Land at cost 1,277      
Buildings at cost 3,222      
Total at cost 4,499      
Accumulated Depreciation 642      
Encumbrances $ 0      
Date of Construction 1886      
Date Acquired Aug. 28, 2018      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1998 [Member] | Kuhlungsborn Germany [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 7,138      
Initial costs, buildings 18,355      
Land at cost 7,138      
Buildings at cost 18,355      
Total at cost 25,493      
Accumulated Depreciation $ 1,354      
Date of Construction 1998      
Date Acquired Jun. 01, 2023      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1998 [Member] | Hassocks, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 5,805      
Initial costs, buildings 30,350      
Land at cost 5,805      
Buildings at cost 30,350      
Total at cost 36,155      
Accumulated Depreciation 4,198      
Encumbrances $ 0      
Date of Construction 1998      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1885 [Member] | Heidelberg, Germany [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 6,636      
Initial costs, buildings 37,907      
Land at cost 6,636      
Buildings at cost 37,907      
Total at cost 44,543      
Accumulated Depreciation 9,051      
Encumbrances $ 0      
Date of Construction 1885      
Date Acquired Jun. 22, 2016      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1901 [Member] | Hemel Hempstead, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 13,220      
Initial costs, buildings 6,672      
Land at cost 13,220      
Buildings at cost 6,672      
Total at cost 19,892      
Accumulated Depreciation 1,048      
Encumbrances $ 0      
Date of Construction 1901      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2005 [Member] | Port Arthur, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 11,432      
Initial costs, buildings 76,746      
Additions subsequent to acquisition, Improvements 6,877      
Land at cost 11,432      
Buildings at cost 83,623      
Total at cost 95,055      
Accumulated Depreciation 25,305      
Encumbrances $ 0      
Date of Construction 2005      
Date Acquired Sep. 26, 2013      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2005 [Member] | Tomball, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Long term acute care hospital      
Initial costs, land $ 1,299      
Initial costs, buildings 16,185      
Land at cost 1,299      
Buildings at cost 16,185      
Total at cost 17,484      
Accumulated Depreciation 8,684      
Encumbrances $ 0      
Date of Construction 2005      
Date Acquired Dec. 21, 2010      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2002 [Member] | Idaho Falls, ID [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 1,822      
Initial costs, buildings 37,467      
Additions subsequent to acquisition, Improvements 72,789      
Land at cost 1,822      
Buildings at cost 110,256      
Total at cost 112,078      
Accumulated Depreciation 23,598      
Encumbrances $ 0      
Date of Construction 2002      
Date Acquired Apr. 01, 2008      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2002 [Member] | San Antonio, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 7,061      
Initial costs, buildings 10,851      
Additions subsequent to acquisition, Improvements 7,982      
Land at cost 7,061      
Buildings at cost 18,833      
Total at cost 25,894      
Accumulated Depreciation 6,730      
Encumbrances $ 0      
Date of Construction 2002      
Date Acquired Sep. 29, 2017      
Life on which depreciation in latest income statements is computed (Years) 41 years      
1892 [Member] | Hinckley, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 2,610      
Initial costs, buildings 17,786      
Land at cost 2,610      
Buildings at cost 17,786      
Total at cost 20,396      
Accumulated Depreciation $ 2,167      
Date of Construction 1892      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2000 [Member] | Cadiz Spain [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 319      
Initial costs, buildings 7,234      
Land at cost 319      
Buildings at cost 7,234      
Total at cost 7,553      
Accumulated Depreciation 711      
Encumbrances $ 0      
Date of Construction 2000      
Date Acquired Apr. 29, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2000 [Member] | Montclair, NJ [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 7,900      
Initial costs, buildings 99,640      
Additions subsequent to acquisition, Improvements 577      
Land at cost 8,477      
Buildings at cost 99,640      
Total at cost 108,117      
Accumulated Depreciation 29,917      
Encumbrances $ 0      
Date of Construction 2000      
Date Acquired Apr. 01, 2014      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2000 [Member] | Nottingham, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 10,754      
Initial costs, buildings 3,436      
Land at cost 10,754      
Buildings at cost 3,436      
Total at cost 14,190      
Accumulated Depreciation 432      
Encumbrances $ 0      
Date of Construction 1980      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
2000 [Member] | Warren, OH [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 2,417      
Initial costs, buildings 15,857      
Additions subsequent to acquisition, Improvements 1,737      
Land at cost 2,417      
Buildings at cost 17,594      
Total at cost 20,011      
Accumulated Depreciation 4,367      
Encumbrances $ 0      
Date of Construction 2000      
Date Acquired May 01, 2017      
Life on which depreciation in latest income statements is computed (Years) 46 years      
2000 [Member] | Willenhall, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 7,715      
Initial costs, buildings 17,212      
Land at cost 7,715      
Buildings at cost 17,212      
Total at cost 24,927      
Accumulated Depreciation 2,094      
Encumbrances $ 0      
Date of Construction 2000      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1975 [Member] | Lauderdale Lakes, FL [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 10,657      
Initial costs, buildings 150,313      
Additions subsequent to acquisition, Improvements 2,168      
Land at cost 10,657      
Buildings at cost 152,481      
Total at cost 163,138      
Accumulated Depreciation 18,902      
Encumbrances $ 0      
Date of Construction 1975      
Date Acquired Aug. 01, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1987 [Member] | London, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 9,252      
Initial costs, buildings 4,390      
Land at cost 9,252      
Buildings at cost 60,527      
Total at cost 69,779      
Accumulated Depreciation 9,111      
Encumbrances $ 40,474      
Date of Construction 1984      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1987 [Member] | Orpington, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 10,942      
Initial costs, buildings 45,210      
Land at cost 10,942      
Buildings at cost 45,210      
Total at cost 56,152      
Accumulated Depreciation 6,846      
Encumbrances $ 26,061      
Date of Construction 1987      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1996 [Member] | Mcminnville, OR [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 5,000      
Initial costs, buildings 97,900      
Land at cost 5,000      
Buildings at cost 97,900      
Total at cost 102,900      
Accumulated Depreciation 24,113      
Encumbrances $ 0      
Date of Construction 1996      
Date Acquired Aug. 31, 2015      
Life on which depreciation in latest income statements is computed (Years) 41 years      
1996 [Member] | Poole, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,461      
Initial costs, buildings 40,625      
Land at cost 2,461      
Buildings at cost 40,625      
Total at cost 43,086      
Accumulated Depreciation 7,102      
Encumbrances $ 13,804      
Date of Construction 1996      
Date Acquired Apr. 03, 2019      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1955 [Member] | Los Angeles, CA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 10,579      
Initial costs, buildings 62,948      
Land at cost 10,579      
Buildings at cost 62,948      
Total at cost 73,527      
Accumulated Depreciation 144      
Encumbrances $ 0      
Date of Construction 1955      
Date Acquired Aug. 23, 2019      
Life on which depreciation in latest income statements is computed (Years) 37 years      
1955 [Member] | Miami, FL [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 44,400      
Initial costs, buildings 107,203      
Additions subsequent to acquisition, Improvements 3,444      
Land at cost 44,400      
Buildings at cost 110,647      
Total at cost 155,047      
Accumulated Depreciation 14,913      
Encumbrances $ 0      
Date of Construction 1955      
Date Acquired Aug. 01, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1955 [Member] | Windsor, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 12,896      
Initial costs, buildings 110,846      
Land at cost 12,896      
Buildings at cost 110,846      
Total at cost 123,742      
Accumulated Depreciation 16,670      
Encumbrances $ 0      
Date of Construction 1955      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1988 [Member] | Miami, FL [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 20,430      
Initial costs, buildings 30,276      
Additions subsequent to acquisition, Improvements 10,947      
Land at cost 20,430      
Buildings at cost 41,223      
Total at cost 61,653      
Accumulated Depreciation 3,276      
Encumbrances $ 0      
Date of Construction 1988      
Date Acquired Apr. 25, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1988 [Member] | Palestine, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 1,848      
Initial costs, buildings 95,257      
Land at cost 1,848      
Buildings at cost 95,257      
Total at cost 97,105      
Accumulated Depreciation 14,978      
Encumbrances $ 0      
Date of Construction 1988      
Date Acquired Dec. 17, 2019      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1920 [Member] | Montclair, NJ [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 7,900      
Initial costs, buildings 99,640      
Additions subsequent to acquisition, Improvements 577      
Land at cost 8,477      
Buildings at cost 99,640      
Total at cost 108,117      
Accumulated Depreciation 29,917      
Encumbrances $ 0      
Date of Construction 1920      
Date Acquired Apr. 01, 2014      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1920 [Member] | Pasco, WA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,594      
Initial costs, buildings 13,195      
Land at cost 2,594      
Buildings at cost 13,195      
Total at cost 15,789      
Accumulated Depreciation 3,306      
Encumbrances $ 0      
Date of Construction 1920      
Date Acquired Aug. 31, 2018      
Life on which depreciation in latest income statements is computed (Years) 30 years      
1920 [Member] | Newark, NJ [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 32,957      
Initial costs, buildings 24,553      
Land at cost 32,957      
Buildings at cost 24,553      
Total at cost 57,510      
Accumulated Depreciation 3,294      
Encumbrances $ 0      
Date of Construction 1920      
Date Acquired May 02, 2016      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1919 [Member] | Newark, NJ [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 32,957      
Initial costs, buildings 24,553      
Land at cost 32,957      
Buildings at cost 24,553      
Total at cost 57,510      
Accumulated Depreciation 3,294      
Encumbrances $ 0      
Date of Construction 1919      
Date Acquired May 02, 2016      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1958 [Member] | Miami, FL [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 20,430      
Initial costs, buildings 30,276      
Additions subsequent to acquisition, Improvements 10,947      
Land at cost 20,430      
Buildings at cost 41,223      
Total at cost 61,653      
Accumulated Depreciation 3,276      
Encumbrances $ 0      
Date of Construction 1958      
Date Acquired Apr. 25, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1958 [Member] | Norwalk, CA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 7,946      
Initial costs, buildings 30,465      
Additions subsequent to acquisition, Improvements 7,104      
Land at cost 7,946      
Buildings at cost 37,569      
Total at cost 45,515      
Accumulated Depreciation 4,158      
Encumbrances $ 0      
Date of Construction 1958      
Date Acquired Jul. 06, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1958 [Member] | Van Nuys, CA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 8,041      
Initial costs, buildings 18,436      
Land at cost 8,041      
Buildings at cost 18,436      
Total at cost 26,477      
Accumulated Depreciation 48      
Encumbrances $ 0      
Date of Construction 1958      
Date Acquired Aug. 23, 2019      
Life on which depreciation in latest income statements is computed (Years) 35 years      
1995 [Member] | Barby, Germany [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 1,938      
Initial costs, buildings 21,619      
Land at cost 1,938      
Buildings at cost 21,619      
Total at cost 23,557      
Accumulated Depreciation 1,681      
Encumbrances $ 0      
Date of Construction 1995      
Date Acquired Apr. 19, 2023      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1995 [Member] | Brandis, Germany [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 2,358      
Initial costs, buildings 25,958      
Land at cost 2,358      
Buildings at cost 25,958      
Total at cost 28,316      
Accumulated Depreciation 2,074      
Encumbrances      
Date of Construction 1995      
Date Acquired Apr. 19, 2023      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1995 [Member] | Norwalk, CA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 2,811      
Initial costs, buildings 5,940      
Land at cost 2,811      
Buildings at cost 5,940      
Total at cost 8,751      
Accumulated Depreciation 835      
Encumbrances $ 0      
Date of Construction 1995      
Date Acquired Jul. 06, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1906 [Member] | Royston, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 7,127      
Initial costs, buildings 21,220      
Land at cost 7,127      
Buildings at cost 21,220      
Total at cost 28,347      
Accumulated Depreciation 3,007      
Encumbrances $ 0      
Date of Construction 1906      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1850 [Member] | Preston, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 9,251      
Initial costs, buildings 33,685      
Land at cost 9,251      
Buildings at cost 33,685      
Total at cost 42,936      
Accumulated Depreciation 3,583      
Encumbrances $ 0      
Date of Construction 1850      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1850 [Member] | Usk, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 1,831      
Initial costs, buildings 32,837      
Land at cost 1,831      
Buildings at cost 32,837      
Total at cost 34,668      
Accumulated Depreciation 3,207      
Encumbrances $ 0      
Date of Construction 1850      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1951 [Member] | Remscheid, Germany [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Rehabilitation hospital      
Initial costs, land $ 1,116      
Initial costs, buildings 2,689      
Land at cost 1,116      
Buildings at cost 2,689      
Total at cost 3,805      
Accumulated Depreciation 523      
Encumbrances $ 0      
Date of Construction 1951      
Date Acquired Aug. 28, 2018      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1913 [Member] | Sherman, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 3,363      
Initial costs, buildings 10,931      
Land at cost 3,363      
Buildings at cost 10,931      
Total at cost 14,294      
Accumulated Depreciation 4,962      
Encumbrances $ 0      
Date of Construction 1913      
Date Acquired Oct. 31, 2014      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1820 [Member] | Southampton, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 6,821      
Initial costs, buildings 20,030      
Land at cost 6,821      
Buildings at cost 20,030      
Total at cost 26,851      
Accumulated Depreciation 2,792      
Encumbrances $ 0      
Date of Construction 1820      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1940 [Member] | Houston, TX [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 29,706      
Initial costs, buildings 101,846      
Additions subsequent to acquisition, Improvements 90,935      
Land at cost 29,706      
Buildings at cost 192,781      
Total at cost 222,487      
Accumulated Depreciation 24,195      
Encumbrances $ 0      
Date of Construction 1940      
Date Acquired Sep. 29, 2017      
Life on which depreciation in latest income statements is computed (Years) 41 years      
1940 [Member] | Tempe, AZ [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 6,050      
Initial costs, buildings 10,986      
Additions subsequent to acquisition, Improvements 5,239      
Land at cost 6,050      
Buildings at cost 16,225      
Total at cost 22,275      
Accumulated Depreciation 3,843      
Encumbrances $ 0      
Date of Construction 1940      
Date Acquired Sep. 29, 2017      
Life on which depreciation in latest income statements is computed (Years) 41 years      
1770 [Member] | Usk, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 1,831      
Initial costs, buildings 32,837      
Land at cost 1,831      
Buildings at cost 32,837      
Total at cost 34,668      
Accumulated Depreciation 3,207      
Encumbrances $ 0      
Date of Construction 1770      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1962 [Member] | Hollywood, CA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 62,916      
Initial costs, buildings 37,051      
Land at cost 62,916      
Buildings at cost 37,051      
Total at cost 99,967      
Accumulated Depreciation 95      
Encumbrances $ 0      
Date of Construction 1962      
Date Acquired Aug. 23, 2019      
Life on which depreciation in latest income statements is computed (Years) 34 years      
1962 [Member] | Miami, FL [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 20,430      
Initial costs, buildings 30,276      
Additions subsequent to acquisition, Improvements 10,947      
Land at cost 20,430      
Buildings at cost 41,223      
Total at cost 61,653      
Accumulated Depreciation 3,276      
Encumbrances $ 0      
Date of Construction 1962      
Date Acquired Apr. 25, 2022      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1962 [Member] | West Monroe, LA [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 11,702      
Initial costs, buildings 69,433      
Additions subsequent to acquisition, Improvements 19,116      
Land at cost 12,254      
Buildings at cost 87,997      
Total at cost 100,251      
Accumulated Depreciation 25,540      
Encumbrances $ 0      
Date of Construction 1962      
Date Acquired Sep. 26, 2013      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1911 [Member] | Winchester, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 6,865      
Initial costs, buildings 10,877      
Land at cost 6,865      
Buildings at cost 10,877      
Total at cost 17,742      
Accumulated Depreciation 1,683      
Encumbrances $ 11,033      
Date of Construction 1911      
Date Acquired Jan. 09, 2020      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1800 [Member] | Woking, UK [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Behavioral health facility      
Initial costs, land $ 7,663      
Initial costs, buildings 4,954      
Land at cost 7,663      
Buildings at cost 4,954      
Total at cost 12,617      
Accumulated Depreciation 683      
Encumbrances $ 0      
Date of Construction 1800      
Date Acquired Jun. 25, 2021      
Life on which depreciation in latest income statements is computed (Years) 40 years      
1929 [Member] | Youngstown, OH [Member]        
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]        
Type of property Acute care general hospital      
Initial costs, land $ 3,555      
Initial costs, buildings 3,565      
Additions subsequent to acquisition, Improvements 488      
Land at cost 3,555      
Buildings at cost 4,053      
Total at cost 7,608      
Accumulated Depreciation 2,823      
Encumbrances $ 0      
Date of Construction 1929      
Date Acquired May 01, 2017      
Life on which depreciation in latest income statements is computed (Years) 41 years      
[1] Excludes approximately $530 million, $420 million, and $400 million of construction and building improvements in progress reflected in buildings and improvements at December 31, 2025, 2024 and 2023, respectively. Includes $52.2 million of land and building cost reflected in real estate held for sale at December 31, 2024.
v3.25.4
Schedule III - Real Estate Investments and Accumulated Depreciation (Parenthetical) (Detail) - USD ($)
$ in Billions
Dec. 31, 2025
Dec. 31, 2024
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]    
Aggregate cost for federal income tax purposes $ 12.0  
7.000% Senior Secured Notes due 2032 [Member]    
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]    
Senior unsecured notes, interest rate 7.00% 7.00%
8.500% Senior Secured Notes due 2032 [Member]    
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]    
Senior unsecured notes, interest rate 8.50% 8.50%
v3.25.4
Schedule III - Changes in Total Real Estate Assets (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]      
Balance at beginning of period $ 10,086,493 [1] $ 11,813,175 [1] $ 12,300,524
Acquisitions 73,973 0 143,882
Transfers from construction in progress 0 79,385 72,791
Additions 42,326 73,523 87,873
Dispositions (249,587) (1,492,320) (874,519)
Impairments 29,906 (276,572) (67,671)
Other [2] 819,819 (110,698) 150,295
Balance at end of period [1] $ 10,802,930 $ 10,086,493 $ 11,813,175
[1] Excludes approximately $530 million, $420 million, and $400 million of construction and building improvements in progress reflected in buildings and improvements at December 31, 2025, 2024 and 2023, respectively. Includes $52.2 million of land and building cost reflected in real estate held for sale at December 31, 2024.
[2] Includes foreign currency fluctuations for all years. In addition, the 2025 column includes approximately $500 million of real estate related to the six California facilities previously operated by Prospect and classified as financing leases.
v3.25.4
Schedule III - Changes in Accumulated Depreciation (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]      
Balance at beginning of period $ 1,239,897 [1] $ 1,227,619 $ 1,008,340
Depreciation 235,053 242,802 270,816
Depreciation on disposed property (74,103) (220,435) (73,765)
Other 37,747 (10,089) 22,228
Balance at end of period $ 1,438,594 $ 1,239,897 [1] $ 1,227,619
[1] Includes $18.2 million of accumulated depreciation reflected in real estate held for sale at December 31, 2024.
v3.25.4
Schedule III - Changes in Accumulated Depreciation (Parenthetical) (Detail) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]      
Construction and building improvements in progress $ 530.0 $ 420.0 $ 400.0
Land and building cost reflected in real estate held for sale   52.2  
Accumulated depreciation, real estate held for sale   $ 18.2  
California [Member]      
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation [Line Items]      
Real estate related to facilities previously operated by prospect $ 500.0    
v3.25.4
Schedule IV - Schedule of Mortgage Loans on Real Estate (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Mortgage Loans on Real Estate [Line Items]        
Face Amount of Mortgages $ 159,290      
Carrying Amount of Mortgages $ 123,651 $ 119,912 $ 310,101 $ 364,420
Long-Term First Mortgage Loan [Member] | Colombia [Member]        
Mortgage Loans on Real Estate [Line Items]        
Interest Rate 12.23%      
Final Maturity Date 2035      
Face Amount of Mortgages $ 151,692      
Carrying Amount of Mortgages $ 116,113      
Long-Term First Mortgage Loan [Member] | Vibra [Member]        
Mortgage Loans on Real Estate [Line Items]        
Interest Rate 10.00%      
Final Maturity Date 2030      
Face Amount of Mortgages $ 7,598      
Carrying Amount of Mortgages $ 7,538      
v3.25.4
Schedule IV - Schedule of Mortgage Loans on Real Estate (Parenthetical) (Detail) - USD ($)
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Mortgage Loans on Real Estate [Line Items]      
Prior Liens $ 0    
Carrying amount of mortgages, federal income tax purposes 159,300,000    
Fair value of mortgage loans part of ongoing bankruptcy proceedings 99,500,000    
Credit loss reserve 170,000,000 $ 1,500,000,000 $ 10,000,000
Colombia [Member]      
Mortgage Loans on Real Estate [Line Items]      
Reserves/writedowns $ 18,000,000    
v3.25.4
Schedule IV - Changes in Mortgage Loans Net of Allowance for Credit Loss (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Abstract]      
Balance at beginning of year $ 119,912 $ 310,101 $ 364,420
New mortgage loans and additional advances on existing loans 16,498 100,824 155,223
Exchange rate fluctuations 21,722 (17,748) 31,530
Mortgage loans on real estate including additions during year 158,132 393,177 551,173
Collection of principal (16,886) (100,000) (241,072)
Other (17,595) (173,265)  
Deductions during year (34,481) (273,265) (241,072)
Balance at end of year $ 123,651 $ 119,912 $ 310,101
v3.25.4
Schedule IV - Changes in Mortgage Loans Excluding Allowance for Credit Loss (Parenthetical) (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Mortgage Loans on Real Estate [Line Items]      
Advanced to the mortgage loan [1] $ 0 $ 0 $ 22,900
Colombia [Member]      
Mortgage Loans on Real Estate [Line Items]      
Reserves/writedowns 18,000    
Mortgage Loans [Member] | Prospect [Member]      
Mortgage Loans on Real Estate [Line Items]      
Reserves/writedowns   155,000  
Mortgage Loans [Member] | PHP Holdings [Member] | Prospect [Member]      
Mortgage Loans on Real Estate [Line Items]      
Unpaid rent and interest $ 151,000    
Mortgage Loans [Member] | Colombia [Member]      
Mortgage Loans on Real Estate [Line Items]      
Reserves/writedowns   $ 18,000  
[1] The 2023 column includes a $23 million mortgage loan that was converted to fee simple ownership of one property as described under the Lifepoint Transaction below.