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Real Estate Activities - 2018 Activity - Additional Information (Detail)
$ in Thousands, € in Millions
1 Months Ended 3 Months Ended 5 Months Ended 12 Months Ended
Dec. 17, 2019
USD ($)
Hospital
Aug. 31, 2018
EUR (€)
Aug. 28, 2018
EUR (€)
Hospital
Nov. 29, 2017
Hospital
Jun. 22, 2017
EUR (€)
Mar. 31, 2017
USD ($)
Aug. 31, 2018
USD ($)
Hospital
Aug. 31, 2018
EUR (€)
Hospital
Mar. 31, 2018
USD ($)
Jan. 30, 2017
EUR (€)
Oct. 31, 2016
USD ($)
Dec. 31, 2018
EUR (€)
Hospital
Jan. 30, 2017
EUR (€)
Hospital
Dec. 31, 2019
USD ($)
Dec. 31, 2018
USD ($)
Hospital
Dec. 31, 2017
USD ($)
Business Acquisition [Line Items]                                
Ownership interest in joint venture under the equity method value included in other assets | $                           $ 926,990 $ 520,058  
Gain on sale of real estate | $           $ 7,400                    
Mortgage financing | $                           61,712 $ 50,783 $ 717,928
Acute Care Hospital [Member]                                
Business Acquisition [Line Items]                                
Number of facilities acquired | Hospital 10                              
Gain on sale of real estate | $                           $ 41,600    
Purchase price of acquisition | $ $ 700,000                              
General Acute Care Hospital and Healthcare System [Member]                                
Business Acquisition [Line Items]                                
Number of facilities acquired | Hospital                             5  
Mortgage financing | $                 $ 764,400   $ 764,400          
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 value included in other assets   € 210.0           € 210.0                
Shareholder loan to joint venture   290.0           290.0                
Gain on sale of real estate               500.0                
Germany [Member] | Acute Care Hospital [Member] | MEDIAN [Member]                                
Business Acquisition [Line Items]                                
Purchase price of acquisition         € 19.4                      
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   € 23.0 € 44.1      
Germany [Member] | Rehabilitation Hospital with Covenant Health System [Member] | MEDIAN [Member]                                
Business Acquisition [Line Items]                                
Number of facilities acquired | Hospital       3                        
Term of lease     27 years 27 years                        
Germany [Member] | Inpatient Rehabilitation Hospital [Member]                                
Business Acquisition [Line Items]                                
Number of facilities acquired | Hospital     3                          
Purchase price of acquisition     € 17.3                          
Germany [Member] | Fair Value [Member] | Acute Care Hospital [Member]                                
Business Acquisition [Line Items]                                
Aggregate fair value of ownership interest   € 1,635.0           € 1,635.0                
Pasco, Washington [Member] | Acute Care Hospital [Member]                                
Business Acquisition [Line Items]                                
Purchase price of acquisition | $             $ 17,500                  
Massachusetts [Member] | General Acute Care Hospital and Healthcare System [Member]                                
Business Acquisition [Line Items]                                
Number of facilities acquired | Hospital                             4  
Texas [Member] | General Acute Care Hospital and Healthcare System [Member] | Steward [Member]                                
Business Acquisition [Line Items]                                
Number of facilities acquired | Hospital                             1  
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%           50.00%                
Number of facilities acquired | Hospital             71 71                
Proceeds from joint venture               € 1,140.0                
Gain on sale of real estate   € 500.0