Real Estate and Lending Activities - Summary of Status Update on Current Development Projects (Detail) (USD $) In Thousands, unless otherwise specified	9 Months Ended
	Sep. 30, 2014
Business Acquisition [Line Items]
Original Commitment	$ 164,025
Costs Incurred as of September 30, 2014	3,716
First Choice ER - Commerce City [Member] | Denver, CO [Member] | Acute Care Hospital [Member] | Adeptus Health [Member]
Business Acquisition [Line Items]
Original Commitment	5,372
Costs Incurred as of September 30, 2014	1,924
Estimated Completion Date	4Q 2014
Medical West, an affiliate of UAB [Member] | Hoover Al [Member] | Acute Care Hospital And Medical Office Building [Member] | Medical West, an Affiliate of UAB [Member]
Business Acquisition [Line Items]
Original Commitment	8,653
Costs Incurred as of September 30, 2014	257
Estimated Completion Date	2Q 2015
First Choice ER Summerwood [Member] | Houston, TX [Member] | Acute Care Hospital [Member] | Adeptus Health [Member]
Business Acquisition [Line Items]
Original Commitment	6,015
Costs Incurred as of September 30, 2014	1,535
Estimated Completion Date	2Q 2015
First Choice Various [Member] | Various [Member] | Acute Care Hospital [Member] | Adeptus Health [Member]
Business Acquisition [Line Items]
Original Commitment	$ 143,985
Estimated Completion Date	Various