Schedule IV - Mortgage Loans on Real Estate (Details 1) (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013		Dec. 31, 2012		Dec. 31, 2011
Rollforward of Mortgage loans on real estate
Balance at beginning of period	$ 162,191	[1]	$ 97,381		$ 36,599
Additions during period:
New or acquired mortgages	4,241		11,200		85,467
Amortization of loan origination fee	0	[2]	0	[2]	184	[2]
Increased funding on existing mortgages	58,731		78,297		19,164
Additions during period, total	62,972		89,497		104,815
Deductions during period:
Scheduled principal payments	0		(16)		(491)
Principal repayments and reductions	(2,413)	[3]	(14,812)	[3]	(17,232)	[3]
Principal reductions due to acquisitions	(97,203)	[4]	(9,859)	[4]	0	[4]
Conversions to land held for development	0	[5]	0	[5]	(4,371)	[5]
Mortgage eliminated in consolidation	0	[6]	0	[6]	(21,939)	[6]
Deductions during period, total	(99,616)		(24,687)		(44,033)
Balance at end of period	$ 125,547	[1]	$ 162,191	[1]	$ 97,381

[1] Level 2 - Fair value based on quoted prices for similar instruments in active markets; quoted prices for identical or similar instruments in markets that are not active; and model-driven valuations in which significant inputs and significant value drivers are observable in active markets.

[2] Represents the amortization of a loan origination fee prior to the consolidation of the building securing the mortgage note. The mortgage note and related loan amortization fee was eliminated in consolidation until it was repaid in January 2012.

[3] Principal repayments for the years ended December 31, 2013 and 2011 include unscheduled principal reductions on mortgage notes of $2.4 million and $0.5 million, respectively.

[4] On September 27, 2013, the Company acquired an orthopedic facility in Missouri for $102.6 million, including the elimination of the construction mortgage note receivable totaling $97.2 million. In May 2012, the Company purchased a medical office building in Texas. Concurrent with the acquisition, the Company's construction mortgage note receivable totaling $9.9 million, which secured the building, was repaid.

[5] The Company received deeds in lieu of trust on two land parcels located in Iowa during 2011.

[6] In the third quarter of 2011, the Company began consolidating a construction project upon its conclusion that it was the primary beneficiary of the VIE that was constructing the facility. As a result of consolidation of the VIE, the Company also eliminated the construction mortgage note and related interest on its Consolidated Financial Statements. The construction mortgage note was repaid in full in January 2012.