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Real Estate Activities and Lending Activities - 2018 Activity - Additional Information (Detail)
$ in Thousands, € in Millions
1 Months Ended 3 Months Ended 9 Months Ended
Aug. 23, 2019
USD ($)
Aug. 31, 2018
EUR (€)
Hospital
Aug. 28, 2018
Hospital
Aug. 31, 2018
EUR (€)
Hospital
Mar. 31, 2018
USD ($)
Oct. 31, 2016
USD ($)
Sep. 30, 2018
USD ($)
Hospital
Jun. 30, 2018
Hospital
Sep. 30, 2019
USD ($)
Hospital
Sep. 30, 2018
USD ($)
Dec. 31, 2018
USD ($)
Business Acquisition [Line Items]                      
Ownership interest in joint venture under the equity method | $                 $ 777,102   $ 520,058
Purchase price of acquisition | $ $ 1,400,000                    
Acute Care Hospital [Member]                      
Business Acquisition [Line Items]                      
Number of facilities acquired                 3    
General Acute Care Hospital and Healthcare System [Member]                      
Business Acquisition [Line Items]                      
Number of facilities acquired             4 4      
Mortgage financing | $         $ 525,400 $ 525,400          
Acute Care Hospital and Inpatient Rehabilitation Hospital [Member]                      
Business Acquisition [Line Items]                      
Purchase price of acquisition | $                   $ 38,000  
Germany [Member] | Acute Care Hospital [Member]                      
Business Acquisition [Line Items]                      
Ownership interest in joint venture under the equity method   50.00%   50.00%              
Ownership interest in joint venture under the equity method | €   € 211   € 211              
Shareholder loan to joint venture | €   290   290              
Gain on sale of real estate       500     $ 695,200     $ 719,300  
Germany [Member] | Acute Care Hospital [Member] | Fair Value [Member]                      
Business Acquisition [Line Items]                      
Aggregate fair value of ownership interest | €   € 1,635   € 1,635              
Germany [Member] | Inpatient Rehabilitation Hospital [Member]                      
Business Acquisition [Line Items]                      
Number of facilities acquired     3           1    
Germany [Member] | Primotop Holdings S.a.r.l. [Member] | Acute Care Hospital [Member]                      
Business Acquisition [Line Items]                      
Ownership interest in joint venture under the equity method   50.00%   50.00%              
Number of facilities acquired       71              
Proceeds from joint venture | €       € 1,140              
Gain on sale of real estate | €   € 500                  
Massachusetts [Member] | General Acute Care Hospital and Healthcare System [Member]                      
Business Acquisition [Line Items]                      
Number of facilities acquired             3 3      
Texas [Member] | General Acute Care Hospital and Healthcare System [Member] | Steward Health Care System LLC [Member]                      
Business Acquisition [Line Items]                      
Number of facilities acquired             1 1      
Washington [Member] | Acute Care Hospital [Member]                      
Business Acquisition [Line Items]                      
Number of facilities acquired   1