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Real Estate and Lending Activities - 2018 Activity - Additional Information (Detail)
$ in Thousands, € in Millions
1 Months Ended 3 Months Ended 5 Months Ended 9 Months Ended
Aug. 31, 2018
USD ($)
Aug. 28, 2018
EUR (€)
Hospital
Jun. 06, 2018
EUR (€)
Hospital
Mar. 31, 2017
USD ($)
Jan. 30, 2017
EUR (€)
Aug. 31, 2018
USD ($)
Hospital
Aug. 31, 2018
EUR (€)
Hospital
Mar. 31, 2018
USD ($)
Oct. 31, 2016
USD ($)
RenewalOption
Dec. 31, 2018
EUR (€)
Hospital
Sep. 30, 2018
USD ($)
Hospital
Jun. 30, 2018
Hospital
Jan. 30, 2017
EUR (€)
Hospital
Sep. 30, 2018
USD ($)
Business Acquisition [Line Items]                            
Gain on sale of real estate | $       $ 7,400                    
Germany [Member] | Acute Care Hospital [Member]                            
Business Acquisition [Line Items]                            
Gain on sale of real estate | $                     $ 695,200     $ 719,400
Purchase price of acquisition     € 23.0                      
Germany [Member] | Rehabilitation Hospital with Covenant Health System [Member]                            
Business Acquisition [Line Items]                            
Number of facilities acquired | Hospital     4                   6  
Purchase price of acquisition         € 8.4               € 44.1  
Primotop Holdings S.a.r.l. [Member] | Germany [Member] | Acute Care Hospital [Member]                            
Business Acquisition [Line Items]                            
Gain on sale of real estate | $ $ 500                          
2018 [Member] | General Acute Care Hospital and Healthcare System [Member]                            
Business Acquisition [Line Items]                            
Number of facilities acquired | Hospital                     4 4    
Term of lease                 15 years          
Mortgage financing | $               $ 525,400 $ 525,400          
Number of lease extension options | RenewalOption                 3          
Term of lease extension, years                 5 years          
2018 [Member] | Germany [Member] | Acute Care Hospital [Member]                            
Business Acquisition [Line Items]                            
Ownership interest in joint venture under the equity method             50.00%              
Ownership interest in joint venture under the equity method value included in other assets             € 211.0              
Shareholder loan to joint venture             290.0              
Gain on sale of real estate             500.0              
2018 [Member] | Germany [Member] | Acute Care Hospital [Member] | Fair Value [Member]                            
Business Acquisition [Line Items]                            
Aggregate fair value of ownership interest             € 1,635.0              
2018 [Member] | Germany [Member] | Rehabilitation Hospital with Covenant Health System [Member]                            
Business Acquisition [Line Items]                            
Number of facilities acquired | Hospital   3                        
Purchase price of acquisition   € 17.3                        
2018 [Member] | Germany [Member] | Rehabilitation Hospital with Covenant Health System [Member] | MEDIAN [Member]                            
Business Acquisition [Line Items]                            
Term of lease   27 years                        
Lease rent increase percentage   70.00%                        
Lease rate   1.00%                        
2018 [Member] | Germany [Member] | Rehabilitation Hospital with Covenant Health System [Member] | Scenario, Forecast [Member]                            
Business Acquisition [Line Items]                            
Number of facilities acquired | Hospital                   4        
Purchase price of acquisition                   € 23.0        
2018 [Member] | Pasco, Washington [Member] | Acute Care Hospital [Member]                            
Business Acquisition [Line Items]                            
Purchase price of acquisition | $           $ 17,500                
2018 [Member] | Massachusetts [Member] | General Acute Care Hospital and Healthcare System [Member]                            
Business Acquisition [Line Items]                            
Number of facilities acquired | Hospital                     3 3    
2018 [Member] | Texas [Member] | General Acute Care Hospital and Healthcare System [Member] | Steward Health Care System LLC [Member]                            
Business Acquisition [Line Items]                            
Number of facilities acquired | Hospital                     1 1    
2018 [Member] | Primotop Holdings S.a.r.l. [Member] | Germany [Member] | Acute Care Hospital [Member]                            
Business Acquisition [Line Items]                            
Ownership interest in joint venture under the equity method             50.00%              
Number of facilities acquired | Hospital           71 71              
Proceeds from joint venture             € 1,140.0