Real Estate and Loans Receivable - 2013 Activity - Additional Information (Detail)	12 Months Ended								12 Months Ended				12 Months Ended	0 Months Ended				12 Months Ended			0 Months Ended			12 Months Ended
	Dec. 31, 2013 USD ($)	Dec. 31, 2012 USD ($)		Dec. 31, 2011 USD ($)		May 04, 2012 Bed	Dec. 31, 2010 USD ($)	Jun. 13, 2012 Ernest [Member] Bed	Dec. 31, 2013 Non U S [Member] USD ($)	Dec. 31, 2013 2013 Activity [Member] USD ($)	Jul. 18, 2013 2013 Activity [Member] Corpus Christi Rehabilitation Hospital [Member] USD ($)	Jul. 18, 2013 2013 Activity [Member] Corpus Christi Rehabilitation Hospital [Member] Commitment [Member] USD ($)	Dec. 31, 2013 2013 Activity [Member] Ernest [Member] USD ($)	Nov. 29, 2013 2013 Activity [Member] RHM Portfolio Acquisition [Member] USD ($)	Nov. 29, 2013 2013 Activity [Member] RHM Portfolio Acquisition [Member] EUR (€)	Dec. 12, 2013 2013 Activity [Member] Dallas Medical Center [Member] USD ($) RenewalOptions	Jun. 11, 2013 2013 Activity [Member] Kansas [Member] USD ($) Hospital RenewalOptions	Dec. 31, 2013 2013 Activity [Member] Kansas [Member]	Dec. 31, 2013 2013 Activity [Member] Minimum [Member] Ernest [Member]	Dec. 31, 2013 2013 Activity [Member] Maximum [Member] Ernest [Member]	Nov. 29, 2013 2013 Activity [Member] From 2015 through 2017 [Member] RHM Portfolio Acquisition [Member]	Nov. 29, 2013 2013 Activity [Member] After 2017 [Member] RHM Portfolio Acquisition [Member]	Sep. 26, 2013 2013 Activity [Member] Acute Care Iasis Hospital [Member] USD ($) Facility Contract	Dec. 31, 2013 2013 Activity [Member] Acute Care Iasis Hospital [Member]	Dec. 31, 2013 2013 Activity [Member] Acute Care Iasis Hospital [Member] Maximum [Member]	Dec. 31, 2013 2013 Activity [Member] Business Acquisitions [Member] USD ($)	Dec. 31, 2013 2013 Activity [Member] Olympia Medical Center [Member] Bed
Significant Acquisitions and Disposals [Line Items]
Purchase price of Acquisition											$ 10,500,000	$ 500,000		$ 237,800,000	€ 175,000,000		$ 75,000,000						$ 281,300,000
Applicable transfer taxes on purchase price															9,000,000
Term of lease													20 years	27 years	27 years	10 years		10 years
Rent escalations percentage																					2.00%	0.50%
Cumulative increases in the German consumer price index														70.00%	70.00%
Real estate assets gross	1,733,194,000	1,189,552,000	[1]	1,191,096,000	[2]		990,635,000		240,500,000
Revenue from real estate assets									1,800,000
Purchase price of real estate																25,000,000
Number of lease extensions options in current lease contract																2	2						2
Term of lease extensions, Years													5 years			5 years		5 years
Number of facilities acquired																	2						3
Improvement costs	1,578,336,000	1,052,479,000																					2,000,000
Initial leaseback term																								15 years
Maximum rent increase percent																	2.00%		2.00%	5.00%					2.50%
Lease renewal option																								5 years
Lease maturity year																								2019
Extended lease maturity year																								2028
Loan on property													5.3
Mortgage financing	20,000,000	203,650,000								20,000,000
Number of beds						26		40																			204
Revenue contributed by the acquired entity																										13,600,000
Income contributed by the acquired entity	133,258,000	135,402,000																								10,600,000
Acquisition related costs	19,494,000	5,420,000		4,184,000																						19,500,000
Acquisition-related costs on consummated deals																										$ 18,000,000

[1] Includes real estate cost included in real estate held for sale of $28,617 at December 31, 2012. Excludes intangible lease assets that are included in real estate held for sale of $858 for 2012.

[2] Includes real estate cost included in real estate held for sale of $96,766 at December 31, 2011. Excludes intangible lease assets that are included in real estate held for sale of $3,012 for 2011.