Net Real Estate Investments

53,396

53,142

437,730

446,397

Investments in limited liability companies ("LLCs")

5,019

4,671

Other Assets:

Cash and cash equivalents

5,036

3,387

Base and bonus rent and other receivables from UHS

2,739

2,680

Rent receivable - other

7,469

6,422

Intangible assets (net of accumulated amortization of $27.6 million and $28.7 million, respectively)

17,407

20,559

Deferred charges and other assets, net

8,356

5,892

Total Assets

483,756

490,008

Liabilities:

Line of credit borrowings

196,400

181,050

Mortgage notes payable, non-recourse to us, net

64,881

^[2]

75,359

Accrued interest

450

540

Accrued expenses and other liabilities

11,765

12,188

Tenant reserves, deposits and deferred and prepaid rents

11,650

10,310

Total Liabilities

285,146

279,447

Equity:

Preferred shares of beneficial interest, $.01 par value; 5,000,000 shares authorized; none issued and outstanding

Common shares, $.01 par value; 95,000,000 shares authorized; issued and outstanding: 2018 - 13,746,803; 2017 - 13,735,369

137

Capital in excess of par value

266,031

265,335

Cumulative net income

642,316

618,120

Cumulative dividends

(710,006)

(673,175)

Accumulated other comprehensive income

132

144

Total Equity

198,610

210,561

Total Liabilities and Equity

$ 483,756

$ 490,008

[1]	The aggregate cost for federal income tax purposes is $593 million (unaudited) with a net book value of $384 million (unaudited).
[2]	All mortgage loans require monthly principal payments through maturity and either fully amortize or include a balloon principal payment upon maturity.

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Statement Of Financial Position [Abstract]
Intangible assets, accumulated amortization	$ 27.6	$ 28.7
Preferred shares of beneficial interest, par value	$ 0.01	$ 0.01
Preferred shares of beneficial interest, shares authorized	5,000,000	5,000,000
Preferred shares of beneficial interest, issued	0	0
Preferred shares of beneficial interest, outstanding	0	0
Common shares, par value	$ 0.01	$ 0.01
Common shares, shares authorized	95,000,000	95,000,000
Common shares, issued	13,746,803	13,735,369
Common shares, outstanding	13,746,803	13,735,369

CONSOLIDATED STATEMENTS OF INCOME - USD ($)
$ in Thousands

12 Months Ended

Dec. 31, 2018

Dec. 31, 2017

Dec. 31, 2016

Revenues:

Base rental - Non-related parties

$ 41,267

$ 40,335

$ 37,060

Bonus rental - UHS facilities

4,988

4,917

4,723

Revenues, Total

76,210

72,348

67,081

Expenses:

Depreciation and amortization

24,976

25,116

22,956

Other operating expenses

20,723

19,511

18,220

Transaction costs

107

528

Hurricane related expenses

4,967

Hurricane insurance recoveries

(4,967)

Costs and Expenses, Total

49,505

48,311

44,967

Income before equity in income of unconsolidated limited liability companies ("LLCs"), interest expense, hurricane insurance recovery proceeds and gain

26,705

24,037

22,114

Equity in income of unconsolidated LLCs

^[1]

1,771

2,416

4,456

Hurricane insurance recovery proceeds in excess of damaged property write-downs

4,535

2,033

Hurricane business interruption insurance recovery proceeds

1,162

Gain on Arlington transaction

27,196

Interest expense, net

(9,977)

(10,063)

(9,355)

Net income

$ 24,196

$ 45,619

$ 17,215

Basic earnings per share

$ 1.76

$ 3.35

$ 1.28

Diluted earnings per share

$ 1.76

$ 3.35

$ 1.28

Weighted average number of shares outstanding - Basic

13,722

13,625

13,464

Weighted average number of share equivalents

Weighted average number of shares and equivalents outstanding - Diluted

13,722

13,625

13,468

Management Service

Expenses:

Advisory fees to UHS

$ 3,806

$ 3,577

$ 3,263

UHS Facilities

Revenues:

Base rental - UHS facilities

16,738

16,888

16,299

UHS Facilities | Tenant Reimbursements And Other

Revenues:

Tenant reimbursements and other

1,273

1,010

886

Revenues:

Tenant reimbursements and other

$ 11,944

$ 9,198

$ 8,113

[1]	Our share of net income during 2017 and 2016 includes approximately $284,000 and, $1.2 million , respectively, of interest income earned by us on an advance made to Arlington Medical Properties, LLC.

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Statement Of Income And Comprehensive Income [Abstract]
Net Income	$ 24,196	$ 45,619	$ 17,215
Other comprehensive (loss)/income:
Unrealized derivative (loss)/gains on interest rate caps	(12)	39	199
Total other comprehensive(loss)/income:	(12)	39	199
Total comprehensive income	$ 24,184	$ 45,658	$ 17,414

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

Organization and Summary of Significant Accounting Policies

CONSOLIDATED STATEMENTS OF CHANGES IN EQUITY - USD ($) shares in Thousands, $ in Thousands	Total	Common stock	Capital in excess of par value	Cumulative net income	Cumulative dividends	Accumulated other comprehensive income/(loss)
Balance at Dec. 31, 2015	$ 195,042	$ 133	$ 241,700	$ 555,286	$ (601,983)	$ (94)
Balance, Shares at Dec. 31, 2015		13,327
Shares of Beneficial Interest:
Issued	13,508	$ 3	13,505
Issued (in shares)		272
Partial settlement of dividend equivalent rights	(30)		(30)
Restricted stock-based compensation expense	481		481
Dividends ($2.68/share) in 2018, ($2.64/share) in 2017 and ($2.60/share) in 2016	(35,138)				(35,138)
Comprehensive income:
Net income	17,215			17,215
Unrealized gain on interest rate cap	199					199
Subtotal - comprehensive income	17,414			17,215		199
Balance at Dec. 31, 2016	191,277	$ 136	255,656	572,501	(637,121)	105
Balance, Shares at Dec. 31, 2016		13,599
Shares of Beneficial Interest:
Issued	9,142	$ 1	9,141
Issued (in shares)		136
Restricted stock-based compensation expense	538		538
Dividends ($2.68/share) in 2018, ($2.64/share) in 2017 and ($2.60/share) in 2016	(36,054)				(36,054)
Comprehensive income:
Net income	45,619			45,619
Unrealized gain on interest rate cap	39					39
Subtotal - comprehensive income	45,658			45,619		39
Balance at Dec. 31, 2017	210,561	$ 137	265,335	618,120	(673,175)	144
Balance, Shares at Dec. 31, 2017		13,735
Shares of Beneficial Interest:
Issued	125		125
Issued (in shares)		12
Restricted stock-based compensation expense	571		571
Dividends ($2.68/share) in 2018, ($2.64/share) in 2017 and ($2.60/share) in 2016	(36,831)				(36,831)
Comprehensive income:
Net income	24,196			24,196
Unrealized gain on interest rate cap	(12)					(12)
Subtotal - comprehensive income	24,184			24,196		(12)
Balance at Dec. 31, 2018	$ 198,610	$ 137	$ 266,031	$ 642,316	$ (710,006)	$ 132
Balance, Shares at Dec. 31, 2018		13,747

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)	12 Months Ended
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Cash flows from operating activities:
Net income	$ 24,196,000	$ 45,619,000	$ 17,215,000
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	24,763,000	25,091,000	23,008,000
Amortization of debt premium	(50,000)	(139,000)	(225,000)
Stock-based compensation expense	571,000	538,000	481,000
Hurricane related expenses		4,967,000
Hurricane insurance recoveries		(4,967,000)
Hurricane insurance recovery proceeds in excess of damaged property write-downs	(4,535,000)	(2,033,000)
Gain on Arlington transaction		(27,196,000)
Changes in assets and liabilities:
Rent receivable	(1,106,000)	(1,490,000)	(1,204,000)
Accrued expenses and other liabilities	(823,000)	441,000	3,000
Tenant reserves, deposits and deferred and prepaid rents	1,219,000	4,989,000	1,377,000
Accrued interest	(90,000)	(86,000)	122,000
Leasing costs paid	(1,383,000)	(769,000)	(627,000)
Other, net	166,000	1,040,000	583,000
Net cash provided by operating activities	42,928,000	46,005,000	40,733,000
Cash flows from investing activities:
Investments in LLCs	(820,000)	(532,000)	(5,454,000)
Repayments of advances made to LLCs		216,000	851,000
Cash distributions in excess of income from LLCs	834,000	1,187,000	1,362,000
Additions to real estate investments, net	(8,263,000)	(15,313,000)	(11,204,000)
Cash proceeds received from divestiture of property, net	0	65,220,000	0
Hurricane insurance recoveries for damaged real estate property		4,967,000
Hurricane insurance recovery proceeds in excess of damaged property write-downs	4,535,000	2,033,000
Hurricane remediation payments	(192,000)	(1,387,000)
Net cash paid for acquisition of properties	(4,053,000)	(9,040,000)	(60,389,000)
Cash paid to acquire minority interests in majority-owned LLCs		(7,890,000)
Net cash (used in)/provided by investing activities	(7,959,000)	39,461,000	(74,834,000)
Cash flows from financing activities:
Net borrowings on line of credit	15,350,000		59,350,000
Net repayments on line of credit		(20,450,000)
Proceeds from mortgage notes payable	13,000,000	22,600,000
Repayments of mortgage notes payable	(23,397,000)	(61,021,000)	(3,230,000)
Financing costs paid	(1,671,000)	(446,000)	(307,000)
Dividends paid	(36,831,000)	(36,054,000)	(35,138,000)
Partial settlement of dividends equivalent rights			(30,000)
Issuance of shares of beneficial interest, net	229,000	9,362,000	13,492,000
Net cash (used in)/provided by financing activities	(33,320,000)	(86,009,000)	34,137,000
Increase/(decrease) in cash and cash equivalents	1,649,000	(543,000)	36,000
Cash and cash equivalents, beginning of period	3,387,000	3,930,000	3,894,000
Cash and cash equivalents, end of period	5,036,000	3,387,000	3,930,000
Supplemental disclosures of cash flow information:
Interest paid	$ 9,469,000	$ 9,692,000	8,895,000
Supplemental disclosures of non-cash transactions:
Financing assumed in acquisition			$ 7,499,000

Organization and Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2018

Accounting Policies [Abstract]

(1) ORGANIZATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

Nature of Operations

Universal Health Realty Income Trust and subsidiaries (the “Trust”) is organized as a Maryland real estate investment trust. We invest in healthcare and human service related facilities currently including acute care hospitals, rehabilitation hospitals, sub-acute facilities, free-standing emergency departments, childcare centers and medical/office buildings. As of February 27, 2019, we have sixty-nine real estate investments located in twenty states consisting of:

•

six hospital facilities consisting of three acute care, one rehabilitation and two sub-acute;

•

four free-standing emergency departments (“FEDs”);

•

fifty-five medical/office buildings (“MOBs”), including four owned by unconsolidated limited liability companies (“LLCs”)/limited liability partnerships (“LPs”), and;

•

four preschool and childcare centers.

Our future results of operations could be unfavorably impacted by government regulations and deterioration in general economic conditions which could result in increases in the number of people unemployed and/or uninsured. Should that occur, it may result in decreased occupancy rates at our medical office buildings as well as a reduction in the revenues earned by the operators of our hospital facilities which would unfavorably impact our future bonus rentals (on the three Universal Health Services, Inc. hospital facilities) and may potentially have a negative impact on the future lease renewal terms and the underlying value of the hospital properties. Management is unable to predict the effect, if any, that these factors may have on the operating results of our lessees or on their ability to meet their obligations under the terms of their leases with us. Management’s estimate of future cash flows from our leased properties could be materially affected in the near term, if certain of the leases are not renewed or renewed with less favorable terms at the end of their lease terms.

Purchase Accounting for Acquisition of Investments in Real Estate

Purchase accounting is applied to the assets and liabilities related to all real estate investments acquired from third parties. In accordance with current accounting guidance, we account for our property acquisitions as acquisitions of assets, which requires the capitalization of acquisition costs to the underlying assets. The fair value of the real estate acquired is allocated to the acquired tangible assets, consisting primarily of land, building and tenant improvements, and identified intangible assets and liabilities, consisting of the value of in-place leases, above-market and below-market leases, and acquired ground leases, based in each case on their fair values. Loan premiums, in the case of above market rate assumed loans, or loan discounts, in the case of below market assumed loans, are recorded based on the fair value of any loans assumed in connection with acquiring the real estate.

The fair values of the tangible assets of an acquired property are determined based on comparable land sales for land and replacement costs adjusted for physical and market obsolescence for the improvements. The fair values of the tangible assets of an acquired property are also determined by valuing the property as if it were vacant, and the “as-if-vacant” value is then allocated to land, building and tenant improvements based on management’s determination of the relative fair values of these assets. Management determines the as-if-vacant fair value of a property based on assumptions that a market participant would use, which is similar to methods used by independent appraisers. In addition, there is intangible value related to having tenants leasing space in the purchased property, which is referred to as in-place lease value. Such value results primarily from the buyer of a leased property avoiding the costs associated with leasing the property and also avoiding rent losses and unreimbursed operating expenses during the hypothetical lease-up period. Factors considered by management in performing these analyses include an estimate of carrying costs during the expected lease-up periods considering current market conditions and costs to execute similar leases. In estimating carrying costs, management includes real estate taxes, insurance and other operating expenses and estimates of lost rental revenue during the expected lease-up periods based on current market demand. Management also estimates costs to execute similar leases including leasing commissions, tenant improvements, legal and other related costs. The value of in-place leases are amortized to expense over the remaining terms of the existing leases.

In allocating the fair value of the identified intangible assets and liabilities of an acquired property, above-market and below-market in-place lease values are recorded based on the present value (using an interest rate which reflects the risks associated with the leases acquired) of the difference between (i) the contractual amounts to be paid pursuant to the in-place leases and (ii) estimated fair market lease rates from the perspective of a market participant for the corresponding in-place leases, measured, for above-market leases, over a period equal to the remaining non-cancelable term of the lease and, for below-market leases, over a period equal to the initial term plus any below market fixed rate renewal periods. The capitalized above-market lease values are amortized as a reduction of rental income over the remaining non-cancelable terms of the respective leases. The capitalized below-market lease values, also referred to as acquired lease obligations, are amortized as an increase to rental income over the initial terms of the respective leases.

At December 31, 2018, our net intangible assets total $17.4 million (net of $27.6 million accumulated amortization) and primarily consist of the value of in-place leases. At December 31, 2018, our net intangible value of in-place leases total $15.6 million (net of $27.1 million of accumulated amortization) and will be amortized over the remaining lease terms (aggregate weighted average of 4.6 years at December 31, 2018) and are expected to result in estimated aggregate amortization expense of, $3.1 million, $2.9 million $2.5 million, $1.8 million and $1.4 million for 2019, 2020, 2021, 2022 and 2023, respectively. Amortization expense on intangible values of in place leases was $3.8 million for the year ended December 31, 2018, $4.9 million for the year ended December 31, 2017 and $5.1 million for the year ended December 31, 2016. The remaining amount of our net intangible assets primarily consists of above-market leases. At December 31, 2018, our net intangible value of above-market leases total $1.6 million (net of $386,000 of accumulated amortization) and will be amortized over the remaining lease terms (aggregate weighted average of approximately 8.6 years at December 31, 2018) and are expected to result in estimated aggregate amortization offset to rental revenue of $186,000 for each of 2019, 2020 and 2021 and $181,000 and $178,000 in 2022 and 2023, respectively. Amortization offset to rental revenue on intangible values of above-market leases was $176,000, $173,000 and $95,000 for the years ended December 31, 2018, 2017 and 2016, respectively. Depreciation is computed using the straight-line method over the estimated useful lives of the buildings and capital improvements. The estimated original useful lives of our buildings ranges from 25-45 years and the estimated original useful lives of capital improvements ranges from 3-35 years. On a consolidated basis, depreciation expense was $20.5 million for the year ended December 31, 2018, $19.7 million for the year ended December 31, 2017 and $17.4 million for the year ended December 31, 2016.

Cash and Cash Equivalents

We consider all highly liquid investment instruments with original maturities of three months or less to be cash equivalents.

Asset Impairment

We review each of our properties for indicators that its carrying amount may not be recoverable. Examples of such indicators may include a significant decrease in the market price of the property, a change in the expected holding period for the property, a significant adverse change in how the property is being used or expected to be used based on the underwriting at the time of acquisition, an accumulation of costs significantly in excess of the amount originally expected for the acquisition or development of the property, or a history of operating or cash flow losses of the property. When such impairment indicators exist, we review an estimate of the future undiscounted net cash flows (excluding interest charges) expected to result from the real estate investment’s use and eventual disposition and compare that estimate to the carrying value of the property. We consider factors such as future operating income, trends and prospects, as well as the effects of leasing demand, competition and other factors. If our future undiscounted net cash flow evaluation indicates that we are unable to recover the carrying value of a real estate investment, an impairment loss is recorded to the extent that the carrying value exceeds the estimated fair value of the property. The evaluation of anticipated cash flows is highly subjective and is based in part on assumptions regarding future occupancy, rental rates and capital requirements that could differ materially from actual results in future periods. Since cash flows on properties considered to be long-lived assets to be held and used are considered on an undiscounted basis to determine whether the carrying value of a property is recoverable, our strategy of holding properties over the long-term directly decreases the likelihood of their carrying values not being recoverable and therefore requiring the recording of an impairment loss. If our strategy changes or market conditions otherwise dictate an earlier sale date, an impairment loss may be recognized and such loss could be material. If we determine that the asset fails the recoverability test, the affected assets must be reduced to their fair value.

We generally estimate the fair value of rental properties utilizing a discounted cash flow analysis that includes projections of future revenues, expenses and capital improvement costs that a market participant would use based on the highest and best use of the asset, which is similar to the income approach that is commonly utilized by appraisers. In certain cases, we may supplement this analysis by obtaining outside broker opinions of value or third party appraisals.

In considering whether to classify a property as held for sale, we consider factors such as whether management has committed to a plan to sell the property, the property is available for immediate sale in its present condition for a price that is reasonable in relation to its current value, the sale of the property is probable, and actions required for management to complete the plan indicate that it is unlikely that any significant changes will made to the plan. If all the criteria are met, we classify the property as held for sale. Upon being classified as held for sale, depreciation and amortization related to the property ceases and it is recorded at the lower of its carrying amount or fair value less cost to sell. The assets and related liabilities of the property are classified separately on the consolidated balance sheets for the most recent reporting period. Only those assets held for sale that constitute a strategic shift or that will have a major effect on our operations are classified as discontinued operations.

An other than temporary impairment of an investment in an unconsolidated LLC is recognized when the carrying value of the investment is not considered recoverable based on evaluation of the severity and duration of the decline in value, including projected declines in cash flow. To the extent impairment has occurred, the excess carrying value of the asset over its estimated fair value is charged to income.

Investments in Limited Liability Companies (“LLCs”)

In accordance with accounting principles generally accepted in the United States of America (U.S. GAAP) and guidance relating to accounting for investments and real estate ventures, we account for our unconsolidated investments in LLCs/LPs which we do not control using the equity method. The third-party members in these investments have equal voting rights with regards to issues such as, but not limited to: (i) divestiture of property; (ii) annual budget approval, and; (iii) financing commitments. These investments, which represent 33% to 95% non-controlling ownership interests, are recorded initially at our cost and subsequently adjusted for our net equity in the net income, cash contributions to, and distributions from, the investments. Pursuant to certain agreements, allocations of sales proceeds and profits and losses of some of the LLC investments may be allocated disproportionately as compared to ownership interests after specified preferred return rate thresholds have been satisfied.

In the Condensed Consolidated Statements of Cash Flows, distributions and equity in net income are presented net as cash flows from operating activities. Cumulative distributions received exceeding cumulative equity in earnings represent returns of investments and are classified as cash flows from investing activities in the Condensed Consolidated Statements of Cash Flows.

At December 31, 2018, we have non-controlling equity investments or commitments in four jointly-owned LLCs/LPs which own MOBs. As of December 31, 2018, we accounted for these LLCs/LPs on an unconsolidated basis pursuant to the equity method since they are not variable interest entities and we do not have a controlling voting interest. The majority of these entities are joint-ventures between us and non-related parties that hold minority ownership interests in the entities. Each entity is generally self-sustained from a cash flow perspective and generates sufficient cash flow to meet its operating cash flow requirements and service the third-party debt (if applicable) that is non-recourse to us. Although there is typically no ongoing financial support required from us to these entities since they are cash-flow sufficient, we may, from time to time, provide funding for certain purposes such as, but not limited to, significant capital expenditures, leasehold improvements and debt financing. Although we are not obligated to do so, if approved by us at our sole discretion, additional cash fundings are typically advanced as equity or member loans. These entities maintain property insurance on the properties.

Federal Income Taxes

No provision has been made for federal income tax purposes since we qualify as a real estate investment trust under Sections 856 to 860 of the Internal Revenue Code of 1986, and intend to continue to remain so qualified. To qualify as a REIT, we must meet certain organizational and operational requirements, including a requirement to distribute at least 90% of our annual REIT taxable income to shareholders. As a REIT, we generally will not be subject to federal, state or local income tax on income that we distribute as dividends to our shareholders. We have historically distributed, and intend to continue to distribute, 100% of our annual REIT taxable income to our shareholders.

We are subject to a federal excise tax computed on a calendar year basis. The excise tax equals 4% of the amount by which 85% of our ordinary income plus 95% of any capital gain income for the calendar year exceeds cash distributions during the calendar year, as defined. No provision for excise tax has been reflected in the financial statements as no tax was due.

Earnings and profits, which determine the taxability of dividends to shareholders, will differ from net income reported for financial reporting purposes due to the differences for federal tax purposes in the cost basis of assets and in the estimated useful lives used to compute depreciation and the recording of provision for impairment losses.

The aggregate gross cost basis and net book value of the properties for federal income tax purposes are approximately $593 million and $384 million, respectively, at December 31, 2018. The aggregate cost basis and net book value of the properties for federal income tax purposes were approximately $584 million and $384 million, respectively, at December 31, 2017.

Stock-Based Compensation

We expense the grant-date fair value of restricted stock awards over the vesting period. We recognize the grant-date fair value of equity-based compensation and account for these transactions using the fair-value based method.

The expense associated with share-based compensation arrangements is a non-cash charge. In the Consolidated Statements of Cash Flows, stock-based compensation expense is an adjustment to reconcile net income to cash provided by operating activities.

Fair Value

Fair value is a market-based measurement, not an entity-specific measurement and determined based upon the assumptions that market participants would use in pricing the asset or liability. As a basis for considering market participant assumptions in fair value measurements, accounting requirements establish a fair value hierarchy that distinguishes between market participant assumptions based on market data obtained from sources independent of the reporting entity (observable inputs that are classified within Level 1 and 2 of the hierarchy) and the reporting entity’s own assumptions about market participant assumptions (unobservable inputs classified within Level 3 of the hierarchy). In instances when it is necessary to establish the fair value of our real estate investments and investments in LLCs we use unobservable inputs which are typically based on our own assumptions.

The fair value of our real estate investments, components of real estate investments and debt assumed in conjunction with acquisition and impairment activity, are considered to be Level 3 valuations as they are primarily based upon an income capitalization approach. Significant inputs into the models used to determine fair value of real estate investments and components of real estate investments include future cash flow projections, holding period, terminal capitalization rate and discount rates. Additionally the fair value of land takes into consideration comparable sales, as adjusted for site specific factors. The fair value of real estate investments is based upon significant judgments made by management, and accordingly, we typically obtain assistance from third party valuation specialists. Significant inputs into the models used to determine the fair value of assumed mortgages included the outstanding balance, term, stated interest rate and current market rate of the mortgage.

The carrying amounts reported in the balance sheet for cash, receivables, and short-term borrowings approximate their fair values due to the short-term nature of these instruments. Accordingly, these items are excluded from the fair value disclosures included elsewhere in these notes to the consolidated financial statements.

Concentration of Revenues

The rental revenue earned pursuant to the lease on McAllen Medical Center, which is leased to a related party (see Note 2), generated approximately 9% during 2018, 10% during 2017 and 11% during 2016, of our consolidated revenues.

Use of Estimates

The preparation of financial statements in conformity with generally accepted accounting principles in the United States of America requires us to make estimates and assumptions that affect the amounts reported in our consolidated financial statements and accompanying notes. Actual results could differ from those estimates.

New Accounting Standards

Except as noted below there were no new accounting pronouncements that impacted, or are expected to impact us.

On January 1, 2018, we adopted ASU No. 2016-15, Classification of Certain Cash Receipts and Cash Payments, which adds or clarifies guidance of the classification of certain cash receipts and payments in the statement of cash flows, and ASU 2016-18, Restricted Cash, which requires an entity to show the changes in total cash, cash equivalents, restricted cash and restricted cash equivalents in the statement of cash flows. We adopted these ASUs by applying a retrospective transition method.

In February 2016, the FASB issued ASU 2016-02, Leases ("ASU 2016-02"), which sets out the principles for the recognition, measurement, presentation and disclosure of leases for both parties to a contract (i.e. lessees and lessors). ASU 2016-02 supersedes existing leasing standards.

For lessors, the accounting under ASU 2016-02 will remain largely unchanged from current GAAP; however ASU 2016-02 requires that lessors expense certain initial direct costs, which are capitalizable under existing leasing standards, as incurred. Under the new standard, only the incremental costs of signing a lease will be capitalizable, which is consistent with our current practice.

ASU 2016-02 also specifies that payments for certain lease-related services, which are often included in lease agreements, represent "non-lease" components that will become subject to the guidance in ASC 606, when ASU 2016-02 becomes effective. However, on July 30, 2018 the FASB issued targeted amendments via ASU 2018-11, one of which provides lessors an optional election to not separate "non-lease" components from the related lease components when certain criteria are met and instead account for those components as a single component. We have concluded that we met the criteria to account for lease and non-lease components as a single lease component.

ASU 2016-02 requires lessees to apply a dual approach, classifying leases as either finance or operating leases based on the principle of whether or not the lease is effectively a financed purchase of the leased asset by the lessee. This classification will determine whether the lease expense is recognized based on an effective interest method or on a straight-line basis over the term of the lease. A lessee is also required to record a right-of-use ("ROU") asset and a lease liability for all leases with an initial term of greater than 12 months regardless of classification. ASU 2016-02 will impact the accounting and disclosure requirements for ground leases where we are the lessee. As discussed further in footnote 4, at December 31, 2018 we have fourteen ground leases that will require us to measure and record a ROU asset and lease liability on January 1, 2019. We are finalizing our discount rate analysis which is a key driver in the measurement of the ROU asset and lease liability.

A set of practical expedients for implementation, which must be elected as a package and for all leases, may also be elected. These practical expedients include (i) relief from re-assessing whether an expired or existing contract meets the definition of a lease, (ii) relief from re-assessing the classification of expired or existing leases at the adoption date and (iii) allowing previously capitalized initial direct leasing costs to continue to be amortized.

ASU 2016-02 and any subsequent amendments will be effective for us on January 1, 2019. The targeted amendments issued on July 30, 2018, also provide a transitional option that will permit lessors to use the effective date of ASU 2016-02 as the date of initial application, without restating comparative periods, and to recognize a cumulative effect adjustment as of the effective date. We expect to apply the practical expedients as well as the optional relief provided by the targeted amendments.

On January 1, 2018, we adopted ASU 2014-09, Revenue From Contracts With Customers (“ASU 2014-09”), which outlines a comprehensive model for entities to use in accounting for revenue arising from contracts with customers. We adopted the standard on January 1, 2018, using the modified retrospective approach, which requires a cumulative-effect adjustment to equity as of the date of adoption. ASU 2014-09 states that “an entity recognizes revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services.” While ASU 2014-09 specifically references contracts with customers, it may apply to certain other transactions such as the sale of real estate or equipment. The adoption of this standard did not have a significant impact on our consolidated financial statements and no cumulative adjustment was recorded upon adoption, as a substantial portion of our revenue is generated through leasing arrangements, which is specifically excluded from ASU 2014-09.

Our revenues consist primarily of property operating revenues, which are comprised of minimum rent (base rentals) and bonus rentals and reimbursements from tenants for their pro-rata share of expenses such as common area maintenance costs, real estate taxes and utilities. We apply FASB ASC Topic 606, “Revenue from Contracts with Customers” with respect to certain portions of tenant reimbursement and other property income, which totaled $11.5 million, $10.2 million and $9.0 million for the periods ended December 31, 2018, 2017 and 2016, respectively. The 2018 tenant reimbursement and other property income amounts also include a $1.7 million early lease termination fee recorded during the second quarter of 2018. Tenant reimbursements for operating expenses are accrued as revenue and generally due monthly from tenants. Since payments with respect to tenant reimbursement income are generally due monthly, no contract assets or liabilities have been recognized. Revenue consisting of rental income from leasing arrangements are specifically excluded from FASB ASC Topic 606.

Relationship with UHS and Related Party Transactions

12 Months Ended

Dec. 31, 2018

Relationship with UHS and Related Party Transactions

(2) RELATIONSHIP WITH UHS AND RELATED PARTY TRANSACTIONS

Leases: We commenced operations in 1986 by purchasing properties from certain subsidiaries of UHS and immediately leasing the properties back to the respective subsidiaries. Most of the leases were entered into at the time we commenced operations and provided for initial terms of 13 to 15 years with up to six additional 5-year renewal terms. The current base rentals and lease and renewal terms for each of the three hospital facilities leased to subsidiaries of UHS are provided below. The base rents are paid monthly and each lease also provides for additional or bonus rents which are computed and paid on a quarterly basis based upon a computation that compares current quarter revenue to a corresponding quarter in the base year. The three hospital leases with subsidiaries of UHS are unconditionally guaranteed by UHS and are cross-defaulted with one another.

The combined revenues generated from the leases on the UHS hospital facilities accounted for approximately 24% of our consolidated revenue for the five years ended December 31, 2018 (approximately 21%, 22% and 24% for the years ended December 31, 2018, 2017 and 2016 respectively). In addition, we have seventeen MOBs, or free-standing emergency departments (“FEDs”), that are either wholly or jointly-owned by us, that include tenants which are subsidiaries of UHS. The aggregate revenues generated from UHS-related tenants comprised approximately 32% of our consolidated revenue for the five years ended December 31, 2018 (approximately 30%, 32% and 33% for the years ended December 31, 2018, 2017 and 2016, respectively).

Pursuant to the Master Lease Document by and among us and certain subsidiaries of UHS, dated December 24, 1986 (the “Master Lease”), which governs the leases of all hospital properties with subsidiaries of UHS, UHS has the option to renew the leases at the lease terms described below by providing notice to us at least 90 days prior to the termination of the then current term. UHS also has the right to purchase the respective leased facilities at the end of the lease terms or any renewal terms at the appraised fair market value. In addition, the Master Lease, as amended during 2006, includes a change of control provision whereby UHS has the right, upon one month’s notice should a change of control of the Trust occur, to purchase any or all of the three leased hospital properties listed below at their appraised fair market value. Additionally, UHS has rights of first refusal to: (i) purchase the respective leased facilities during and for 180 days after the lease terms at the same price, terms and conditions of any third-party offer, or; (ii) renew the lease on the respective leased facility at the end of, and for 180 days after, the lease term at the same terms and conditions pursuant to any third-party offer.

The table below details the existing lease terms and renewal options for our three acute care hospitals operated by wholly-owned subsidiaries of UHS:

	Annual Minimum Rent		End of Lease Term	Renewal Term (years)
McAllen Medical Center	$	5,485,000	December, 2026		5	(a)
Wellington Regional Medical Center	$	3,030,000	December, 2021		10	(b)
Southwest Healthcare System, Inland Valley Campus	$	2,648,000	December, 2021		10	(b)

(a)	UHS has one 5-year renewal option at existing lease rates (through 2031).

(b)	UHS has two 5-year renewal options at fair market value lease rates (2022 through 2031).

Management cannot predict whether the leases with subsidiaries of UHS, which have renewal options at existing lease rates or fair market value lease rates, or any of our other leases, will be renewed at the end of their lease term. If the leases are not renewed at their current rates or the fair market value lease rates, we would be required to find other operators for those facilities and/or enter into leases on terms potentially less favorable to us than the current leases. In addition, if subsidiaries of UHS exercise their options to purchase the respective leased hospital or FED facilities upon expiration of the lease terms, our future revenues could decrease if we were unable to earn a favorable rate of return on the sale proceeds received, as compared to the rental revenue currently earned pursuant to these leases.

In April, 2017, the recently constructed Henderson Medical Plaza MOB received its certificate of occupancy. Henderson Medical Plaza is located on the campus of the Henderson Hospital Medical Center, a newly constructed acute care hospital that is owned and operated by a subsidiary of UHS and was completed and opened during the fourth quarter of 2016. A ground lease has been executed between the limited liability company that owns the MOB and a subsidiary of UHS, the terms of which include a seventy-five year lease term with two, ten-year renewal options at the lessee’s option at an adjusting lease rate. We have invested net cash of approximately $12.8 million on the development and construction of this MOB as of December 31, 2018.

Officers and Employees: Our officers are all employees of a wholly-owned subsidiary of UHS and although as of December 31, 2018 we had no salaried employees, our officers do typically receive annual stock-based compensation awards in the form of restricted stock. In special circumstances, if warranted and deemed appropriate by the Compensation Committee of the Board of Trustees, our officers may also receive one-time compensation awards in the form of restricted stock and/or cash bonuses.

Advisory Agreement: UHS of Delaware, Inc. (the “Advisor”), a wholly-owned subsidiary of UHS, serves as Advisor to us under an advisory agreement dated December 24, 1986, and as amended and restated as of January 1, 2019 (the “Advisory Agreement”). Pursuant to the Advisory Agreement, the Advisor is obligated to present an investment program to us, to use its best efforts to obtain investments suitable for such program (although it is not obligated to present any particular investment opportunity to us), to provide administrative services to us and to conduct our day-to-day affairs. All transactions between us and UHS must be approved by the Trustees who are unaffiliated with UHS (the “Independent Trustees”). In performing its services under the Advisory Agreement, the Advisor may utilize independent professional services, including accounting, legal, tax and other services, for which the Advisor is reimbursed directly by us. The Advisory Agreement may be terminated for any reason upon sixty days written notice by us or the Advisor. The Advisory Agreement expires on December 31 of each year; however, it is renewable by us, subject to a determination by the Independent Trustees, that the Advisor’s performance has been satisfactory.

Pursuant to the terms of the original advisory agreement, which was in effect from inception through December 31, 2018, in addition to the advisory fee as discussed below, the Advisor was entitled to an annual incentive fee equal to 20% of the amount by which cash available for distribution to shareholders for each year, as defined in the agreement, exceeded 15% of our equity as shown on our consolidated balance sheet, determined in accordance with generally accepted accounting principles without reduction for return of capital dividends. Cash available for distribution to shareholders was defined as net cash flow from operations less deductions for, among other things, amounts required to discharge our debt and liabilities and reserves for replacement and capital improvements to our properties and investments. Since the incentive fee requirements were not achieved at any time from our inception through December 31, 2018, no incentive fees were paid during that time. Given that the incentive fee requirements have never been achieved, and were deemed unlikely to be achieved in the future, the amended and restated advisory agreement that became effective on January 1, 2019, among other things, eliminated the incentive fee provision.

Our advisory fee for 2018, 2017 and 2016 was computed at 0.70% of our average invested real estate assets, as derived from our consolidated balance sheet. Based upon a review of our advisory fee and other general and administrative expenses, as compared to an industry peer group, the advisory fee computation remained unchanged for 2019, as compared to the last three years. The average real estate assets for advisory fee calculation purposes exclude certain items from our consolidated balance sheet such as, among other things, accumulated depreciation, cash and cash equivalents, base and bonus rent receivables, deferred charges and other assets. The advisory fee is payable quarterly, subject to adjustment at year-end based upon our audited financial statements. Advisory fees incurred and paid (or payable) to UHS amounted to $3.8 million during 2018, $3.6 million during 2017 and $3.3 million during 2016 and were based upon average invested real estate assets of $544 million, $511 million and $466 million during 2018, 2017 and 2016, respectively.

Share Ownership: As of December 31, 2018 and 2017, UHS owned 5.7% of our outstanding shares of beneficial interest.

SEC reporting requirements of UHS: UHS is subject to the reporting requirements of the Securities and Exchange Commission (“SEC”) and is required to file annual reports containing audited financial information and quarterly reports containing unaudited financial information. Since the aggregate revenues generated from UHS-related tenants comprised approximately 32% of our consolidated revenue for the five years ended December 31, 2018 (approximately 30%, 32% and 33% for the years ended December 31, 2018, 2017 and 2016, respectively), and since a subsidiary of UHS is our Advisor, you are encouraged to obtain the publicly available filings for Universal Health Services, Inc. from the SEC’s website. These filings are the sole responsibility of UHS and are not incorporated by reference herein.

Acquisitions, Dispositions and Property Exchange Transaction

12 Months Ended

Dec. 31, 2018

Business Combinations [Abstract]

Acquisitions, Dispositions and Property Exchange Transaction

(3) ACQUISITIONS, DISPOSITIONS AND PROPERTY EXCHANGE TRANSACTION

2018:

Acquisition:

During 2018, we acquired the Beaumont Medical Sleep Center Building located in Southfield, Michigan for a purchase price of approximately $4.1 million. This building is 100% leased under the terms of a triple net lease with a remaining initial lease term of approximately 9.5 years at the time or purchase, with two, five year renewal options.

Disposition:

There were no dispositions during 2018.

2017:

Acquisitions:

During 2017, we paid approximately $9.0 million to:

•

purchase the Las Palmas Del Sol Emergency Center – West, an FED located in El Paso, Texas for a purchase price of approximately $4.2 million (including approximately $60,000 of transaction costs). This FED is 100% leased under the terms of a ten year triple net lease that had a remaining lease term of approximately 9 years at the time of purchase, with two, five year renewal options.

•

purchase the Health Center at Hamburg located in Hamburg, Pennsylvania for a purchase price of approximately $4.8 million (including approximately $96,000 of transactions costs). This medical office building is 100% leased under the terms of a fifteen year triple net lease and had a remaining lease term of approximately 8.5 years at the time of purchase, with two, five year renewal options.

The aggregate purchase price for these acquisitions was allocated to the assets acquired and liabilities assumed consisting of tangible property and intangible assets and liabilities, based on the fair values estimated at the acquisition dates. The intangible assets consist of the value of the in-place leases at the properties at the time of acquisition, and the intangible liabilities consist of the value of a below-market lease at the time of acquisition. The value of the in-place leases of each property will be amortized over the remaining term of the respective lease at the time of acquisition (aggregate weighted average of 7.4 years at December 31, 2018). The below market lease, which is reflected below as below market intangibles will be amortized over the remaining term of the respective lease. The estimated aggregate allocation, including transaction costs, is as follows:


Land	$1,496
Buildings and improvements	8,434
Intangible assets	1,598
Below-market lease intangibles	(2,488)

Net cash paid	$9,040

Disposition:

During March, 2017, Arlington Medical Properties, LLC, a formerly jointly-owned limited liability company in which we held an 85% noncontrolling ownership interest, sold the real estate assets of St. Mary’s Professional Office Building (“St. Mary’s”) as part of a series of planned tax deferred like-kind exchange transactions pursuant to Section 1031 of the Internal Revenue Code, as discussed below. St. Mary’s is a multi-tenant medical office building located in Reno, Nevada. A third party member owned the remaining 15% of Arlington Medical Properties LLC, which we acquired prior to the divestiture of St. Mary’s for a purchase price of $7.9 million. The divestiture of St. Mary’s generated an aggregate of approximately $57.3 million of net cash proceeds to us (approximately $11.3 million of which was held as restricted cash by a qualified 1031 exchange intermediary until the third quarter of 2017). These proceeds, which were net of closing costs and the purchase price paid for the minority member’s ownership interest in the LLC, include repayment to us of a $21.4 million member loan. Our results of operations for the year ended December 31, 2017 include a net gain of $27.2 million (net of related transaction costs) recorded in connection with this transaction.

Summary of Like-Kind Exchange Transactions Pursuant to Section 1031 of the IRS Code:

During 2016 and 2017, as part of a series of planned tax deferred like-kind exchange transactions pursuant to Section 1031 of the Internal Revenue Code in connection with the divestiture of St. Mary’s, we acquired two MOBs during 2016 (2704 North Tenaya Way located in Nevada and Frederick Memorial Hospital Crestwood located in Maryland, as discussed below) and an MOB and an FED during 2017 (Health Center at Hamburg located in Pennsylvania and Las Palmas Del Sol Emergency Center located in Texas, as discussed above). These acquisitions were planned and executed in accordance with the provisions of Section 1031 of the Internal Revenue Code. Therefore, we believe they qualify as tax deferred like-kind exchange transactions in connection with the divestiture of St. Mary’s in March, 2017.

2016:

Acquisitions:

During 2016, we paid approximately $60.4 million in cash, and assumed approximately $7.1 million of third-party debt that is non-recourse to us, to:

•

purchase the 2704 North Tenaya Way MOB located in Las Vegas, Nevada, during the fourth quarter for a total purchase price of approximately $15.3 million, including the assumption of approximately $7.1 million of third-party debt that is non-recourse to us. The property consists of approximately 45,000 rentable square feet and is fully occupied pursuant to the terms of a triple net lease that had a remaining lease term of approximately 7.1 years at the time of acquisition.

•

purchase the Frederick Memorial Hospital Crestwood, an MOB located in Frederick, Maryland, during the third quarter for approximately $24.3 million. The property, which consists of approximately 62,300 rentable square feet, is fully occupied pursuant to the terms of triple net leases that had an average remaining lease term of approximately 12 years at the time of acquisition.

•

purchase the Chandler Corporate Center III located in Chandler, Arizona, during the second quarter for approximately $18.0 million. The property, which consists of 82,000 rentable square feet, is currently 92% occupied by one tenant pursuant to the terms of a twelve year escalating triple net lease, with a ten year fair-market value renewal option. The lease had a remaining lease term of approximately 11.3 years at the time of acquisition.

•

purchase the Madison Professional Office Building located in Madison, Alabama, during the first quarter for approximately $10.1 million, including a $150,000 deposit paid in 2015. This multi-tenant property consists of approximately 30,100 rentable square feet and is fully occupied with an average remaining lease term of approximately 6.2 years at the time of acquisition.

The aggregate purchase price for these acquisitions was allocated to the assets acquired and liabilities assumed consisting of tangible property and intangible assets and liabilities, based on the fair value estimated or finalized at acquisition as detailed in the table below. Previous reported estimated purchase price allocations that were finalized in the fourth quarter of 2016 did not have a material impact on our consolidated financial statements. The intangible assets include the value of in-place leases at the properties at the time of acquisition as well as the above market lease values. The value of the in-place leases will be amortized over the average remaining lease terms of approximately 6 to 12 years at the time of acquisition (aggregate weighted average of 6.6 years at December 31, 2018). The above/below market leases, which are reflected below as intangible assets/below-market intangibles will be amortized over the remaining term of the respective leases. The estimated aggregate allocation is as follows:


Land	$9,914
Buildings and improvements	50,117
Intangible assets	9,211
Below-market lease intangibles	(1,287)
Deposit paid in 2015………………………………………...………………………………..	(150)
Debt (including fair value adjustment of $362)…...……..……………………………….…..	(7,499)
Financing fees paid on debt acquired……………...……..……………………………….…..	83

Net cash paid	$60,389

As of December 31, 2018, our net intangible assets total $17.4 million (net of $27.6 million accumulated amortization) and primarily consists of the amount related to acquired, in-place leases which have a weighted average remaining amortization period of 4.6 years.

Dispositions:

There were no dispositions during 2016.

Leases

12 Months Ended

Dec. 31, 2018

Leases [Abstract]

Leases

(4) LEASES

As Lessor:

As lessor, all of our leases are classified as operating leases with initial terms typically ranging from 3 to 15 years with up to five additional, five-year renewal options. Under the terms of the leases, we earn fixed monthly base rents and pursuant to the leases with subsidiaries of UHS, we may earn periodic bonus rents. The bonus rents from the subsidiaries of UHS, which are based upon each facility’s net revenue in excess of base amounts, are computed and paid on a quarterly basis based upon a computation that compares current quarter revenue to the corresponding quarter in the base year.

Minimum future base rents from non-cancelable leases related to properties included in our financial statements on a consolidated basis, excluding increases resulting from changes in the consumer price index, bonus rents and the impact of straight line rent adjustments, are as follows (amounts in thousands):

2019	$	56,494
2020		50,291
2021		45,357
2022		30,089
2023		24,972
Thereafter		67,288
Total minimum base rents	$	274,491

Some of the leases contain gross terms where operating expenses are included in the base rent amounts. Other leases contain net terms where the operating expenses are assessed separately from the base rentals. The table above contains a mixture of both gross and net leases, and does not include any separately calculated operating expense reimbursements. Under the terms of the hospital leases, the lessees are required to pay all operating costs of the properties including property insurance and real estate taxes. Tenants of the medical office buildings generally are required to pay their pro-rata share of the property’s operating costs.

As Lessee:

As of December 31, 2018, we are the lessee with various third parties, including subsidiaries of UHS, in connection with ground leases for land at fourteen of our consolidated properties. Total consolidated amounts expensed relating to the applicable leases in 2018, 2017 and 2016 was approximately $474,000, $460,000 and $450,000, respectively. Total future minimum payments under our ground lease commitments on a consolidated basis due in each of the next five years and thereafter are as follows (amounts in thousands):

2019	$	474
2020		474
2021		474
2022		474
2023		474
Thereafter		25,582
Total ground lease expense	$	27,952

Debt and Financial Instruments

12 Months Ended

Dec. 31, 2018

Debt Disclosure [Abstract]

Debt and Financial Instruments

(5) DEBT AND FINANCIAL INSTRUMENTS

Debt:

Management routinely monitors and analyzes the Trust’s capital structure in an effort to maintain the targeted balance among capital resources including the level of borrowings pursuant to our $300 million revolving credit facility, the level of borrowings pursuant to non-recourse mortgage debt secured by the real property of our properties and our level of equity including consideration of additional equity issuances. This ongoing analysis considers factors such as the current debt market and interest rate environment, the current/projected occupancy and financial performance of our properties, the current loan-to-value ratio of our properties, the Trust’s current stock price, the capital resources required for anticipated acquisitions and the expected capital to be generated by anticipated divestitures. This analysis, together with consideration of the Trust’s current balance of revolving credit agreement borrowings, non-recourse mortgage borrowings and equity, assists management in deciding which capital resource to utilize when events such as refinancing of specific debt components occur or additional funds are required to finance the Trust’s growth.

On March 27, 2018, we entered into a revolving credit agreement (“Credit Agreement”) which, among other things, increased our borrowing capacity by $50 million to $300 million and extended the maturity date from our previously existing facility. The replacement Credit Agreement, which is scheduled to mature in March, 2022, includes a $40 million sublimit for letters of credit and a $30 million sub limit for swingline/short-term loans. The Credit Agreement also provides for options to extend the maturity date for two additional six month periods. Additionally, the Credit Agreement includes an option to increase the total facility borrowing capacity up to an additional $50 million, subject to lender agreement. Borrowings under the Credit Agreement are guaranteed by certain subsidiaries of the Trust. In addition, borrowings under the Credit Agreement are secured by first priority security interests in and liens on all equity interests in certain of the Trust’s wholly-owned subsidiaries. Borrowings made pursuant to the Credit Agreement will bear interest, at our option, at one, two, three, or six month LIBOR plus an applicable margin ranging from 1.10% to 1.35% or at the Base Rate plus an applicable margin ranging from 0.10% to 0.35%. The Credit Agreement defines “Base Rate” as the greater of: (a) the administrative agent’s prime rate; (b) the federal funds effective rate plus 1/2 of 1%, and; (c) one month LIBOR plus 1%. A facility fee of 0.15% to 0.35% will be charged on the total commitment of the Credit Agreement. The margins over LIBOR, Base Rate and the facility fee are based upon our total leverage ratio. At December 31, 2018, the applicable margin over the LIBOR rate was 1.2%, the margin over the Base Rate was 0.2%, and the facility fee was 0.20%.

At December 31, 2018, we had $196.4 million of outstanding borrowings outstanding against our revolving credit agreement and $103.6 million of available borrowing capacity. The carrying amount and fair value of borrowings outstanding pursuant to the Credit Agreement was $196.4 million at December 31, 2018. There are no compensating balance requirements. The average amount outstanding under our Credit Agreement during the years ended December 31, 2018, 2017 and 2016 was $191.4 million, $182.4 million and $164.2 million, respectively, with corresponding effective interest rates of 3.5%, 2.8% and 2.3%, respectively, including commitment fees.

The Credit Agreement contains customary affirmative and negative covenants, including limitations on certain indebtedness, liens, acquisitions and other investments, fundamental changes, asset dispositions and dividends and other distributions. The Credit Agreement also contains restrictive covenants regarding the Trust’s ratio of total debt to total assets, the fixed charge coverage ratio, the ratio of total secured debt to total asset value, the ratio of total unsecured debt to total unencumbered asset value, and minimum tangible net worth, as well as customary events of default, the occurrence of which may trigger an acceleration of amounts outstanding under the Credit Agreement. We are in compliance with all of the covenants at December 31, 2018 and 2017. We also believe that we would remain in compliance if the full amount of our commitment was borrowed.

The following table includes a summary of the required compliance ratios at December 31, 2018 and 2017, giving effect to the covenants contained in the Credit Agreements in effect on the respective dates (dollar amounts in thousands):

			December 31, 2018									December 31, 2017
		Covenant				UHT					Covenant				UHT
Tangible net worth		$		125,000		$		181,203			$		136,170		$		190,002
Total leverage	< 60				%		41.3		%	< 60				%		41.2		%
Secured leverage	< 30				%		9.8		%	< 30				%		11.7		%
Unencumbered leverage	< 60				%		37.6		%	< 60				%		37.7		%
Fixed charge coverage	> 1.50x						4.3x			> 1.50x						3.8x

As indicated on the following table, we have various mortgages, all of which are non-recourse to us and are not cross-collateralized, included on our consolidated balance sheet as of December 31, 2018 and 2017 (amounts in thousands):

	As of 12/31/2018							As of 12/31/2017
Facility Name	Interest Rate			Maturity Date	Outstanding Balance (in thousands)(a.)			Outstanding Balance (in thousands)
Sparks Medical Building/Vista Medical Terrace floating rate mortgage loan (b.)		4.63	%	February, 2018	$	-		$	4,130
Centennial Hills Medical Office Building floating rate mortgage loan (c.)		4.63	%	April, 2018		-			9,764
Vibra Hospital-Corpus Christi fixed rate mortgage loan (d.)		6.50	%	July, 2019		2,519			2,624
700 Shadow Lane and Goldring MOBs fixed rate mortgage loan		4.54	%	June, 2022		5,861			6,059
BRB Medical Office Building fixed rate mortgage loan		4.27	%	December, 2022		5,928			6,126
Desert Valley Medical Center fixed rate mortgage loan		3.62	%	January, 2023		4,806			4,946
2704 North Tenaya Way fixed rate mortgage loan		4.95	%	November, 2023		6,871			7,007
Summerlin Hospital Medical Office Building III fixed rate mortgage loan		4.03	%	April, 2024		13,198			13,199
Tuscan Professional Building fixed rate mortgage loan		5.56	%	June, 2025		4,020			4,519
Phoenix Children’s East Valley Care Center fixed rate mortgage loan		3.95	%	January, 2030		9,194			9,400
Rosenberg Children's Medical Plaza fixed rate mortgage loan (e.)		4.42	%	September, 2033		12,948			7,968
Total, excluding net debt premium and net financing fees						65,345			75,742
Less net financing fees						(711	)		(680	)
Plus net debt premium						247			297
Total mortgage notes payable, non-recourse to us, net					$	64,881		$	75,359

(a)

All mortgage loans require monthly principal payments through maturity and either fully amortize or include a balloon principal payment upon maturity.

(b)

On February 13, 2018, upon its maturity, a $4.1 million floating rate mortgage loan on the Sparks Medical Building/Vista Medical Terrace was fully repaid utilizing borrowings under our Credit Agreement.

(c)

On April 5, 2018, upon its maturity, a $9.7 million floating rate mortgage loan on the Centennial Hills Medical Office Building was fully repaid utilizing borrowings under our Credit Agreement.

(d)

Notice has been provided to the lender to prepay the loan on April 2, 2019 without penalty. We will repay the balance utilizing borrowings under our Credit Agreement.

(e)

On May 2, 2018, upon its maturity, a $7.9 million fixed rate mortgage loan on the Rosenberg Children’s Medical Plaza was fully repaid utilizing borrowings under our Credit Agreement. In August, 2018, we refinanced this property with a $13.0 million fixed rate mortgage, with a maturity date of September, 2033.

The mortgages reflected above are non-recourse to us and are secured by the real property of the buildings as well as property leases and rents. We consider these mortgages to be “Level 2” in the fair value hierarchy as outlined in the authoritative guidance for disclosures in connection with debt instruments. Changes in market rates on our fixed rate debt impacts the fair value of debt, but it has no impact on interest incurred or cash flow.

The nine mortgages outstanding as of December 31, 2018 had a combined carrying-value of approximately $65.3 million and a combined fair value of approximately $64.9 million. At December 31, 2017, we had eleven mortgages outstanding that had a combined carrying-value of $75.7 million and a combined fair value of approximately $76.3 million.

As of December 31, 2018, our aggregate consolidated scheduled debt repayments (including mortgages) are as follows (amounts in thousands):

2019	$	4,199
2020		1,913
2021		2,081
2022 (a.)		208,597
2023		11,892
Later		33,063
Total	$	261,745

(a)

Includes repayment of $196.4 million of outstanding borrowings under the terms of our $300 million revolving credit agreement.

Financial Instruments:

During the second quarter of 2016, we entered into an interest rate cap on the total notional amount of $30 million whereby we paid a premium of $115,000. In exchange for the premium payment, the counterparties agreed to pay us the difference between 1.50% and one-month LIBOR if one-month LIBOR rises above 1.50% during the term of the cap. This interest rate cap became effective in January, 2017, and expires in March, 2019. From inception through December 31, 2018, we received or accrued approximately $145,000 in payments due to us by the counterparties (all recorded during 2018) which were reflected as reductions to our interest expense.

During the third quarter of 2016, we entered into an interest rate cap agreement on a total notional amount of $30 million whereby we paid a premium of $55,000. In exchange for the premium payment, the counterparties agreed to pay us the difference between 1.5% and one-month LIBOR if one-month LIBOR rises above 1.5% during the term of the cap. This interest rate cap became effective in October, 2016 and expires in March, 2019. From inception through December 31, 2018, we received or accrued approximately $145,000 in payments due to us by the counterparties (all recorded during 2018) which were reflected as reductions to our interest expense.

On or before the expiration date of the $60 million interest rate caps we plan to replace the caps with interest rate swaps or interest rate caps on a notional amount of at least $60 million.

Dividends and Equity Issuance Program

12 Months Ended

Dec. 31, 2018

Equity [Abstract]

Dividends and Equity Issuance Program

(6) DIVIDENDS AND EQUITY ISSUANCE PROGRAM

Dividends:

During each of the last three years, dividends were declared and paid by us as follows:

•

2018: $2.68 per share of which $2.35 per share was ordinary income and $.33 per share was total capital gain (total capital gain amount includes Unrecaptured Section 1250 gain of $.30 per share).

•

2017: $2.64 per share of which $1.47 per share was ordinary income and $1.17 per share was total capital gain (total capital gain amount includes Unrecaptured Section 1250 gain of $.453 per share).

•

2016: $2.60 per share of which $2.00 per share was ordinary income and $.60 per share was a return of capital distribution.

Equity Issuance Program:

We maintained an at-the-market equity issuance program (“ATM”) pursuant to the terms of which we could sell, from time-to-time, common shares of our beneficial interest up to an aggregate sales price of approximately $23.3 million to or through Merrill Lynch, Pierce, Fenner and Smith, Incorporated (“Merrill Lynch”), as sales agent and/or principal. The common shares were offered pursuant to the Registration Statement filed with the Securities and Exchange Commission, which became effective during the fourth quarter of 2015. During the third quarter of 2017, we met our aggregate sales threshold of $23.3 million pursuant to this program and no shares were issued pursuant to the ATM in 2018.

Pursuant to the ATM Program, during the twelve months ended December 31, 2017, there were 127,499 shares issued at an average price of $74.71 per share which generated approximately $9.1 million of net cash proceeds (net of approximately $400,000, consisting of compensation of $238,000 to Merrill Lynch, as well as $162,000 of other various fees and expenses). Since inception of this ATM program, including shares issued under a prior Registration Statement filed with the Securities and Exchange Commission in November 2012, we have issued 957,415 shares at an average price of $52.22 per share, which generated approximately $47.9 million of net proceeds (net of approximately $2.1 million, consisting of compensation of $1.25 million to Merrill Lynch as well as $840,000 of other various fees and expenses).

During 2016, pursuant to the ATM Program, there were 249,016 shares issued at an average price of $55.30 per share (all of which were issued during the second quarter), which generated approximately $13.2 million of net cash proceeds (net of approximately $558,000, consisting of compensation of $344,000 to Merrill Lynch, as well as $214,000 of other various fees and expenses).

Incentive Plans

12 Months Ended

Dec. 31, 2018

Postemployment Benefits [Abstract]

Incentive Plans

(7) INCENTIVE PLANS

During 2007, upon the expiration of our 1997 Incentive Plan, as discussed below, our Board of Trustees and shareholders approved the Universal Health Realty Income Trust 2007 Restricted Stock Plan which was amended and restated in 2016 (the “2007 Plan”). An aggregate of 125,000 shares were authorized for issuance under this plan and a total of 95,295 shares, net of cancellations, have been issued pursuant to the terms of this plan, 76,310 of which have vested as of December 31, 2018. At December 31, 2018 there are 29,705 shares remaining for issuance under the terms of the 2007 Plan.

During 2018, there were 10,580 restricted Shares of Beneficial Interest, net of cancellations, issued to the Trustees, officers and other personnel of the Trust pursuant to the 2007 Plan at a weighted average grant price of $61.77 per share ($653,526 in the aggregate). These restricted shares are scheduled to vest in June of 2020 (the second anniversary of the date of grant)

During 2017, there were 8,405 restricted Shares of Beneficial Interest, net of cancellations, issued to the Trustees, officers and other personnel of the Trust pursuant to the 2007 Plan at a weighted average grant price of $73.46 per share ($617,431 in the aggregate). These restricted shares are scheduled to vest in June of 2019 (the second anniversary of the date of grant).

During 2016, there were 8,755 restricted Shares of Beneficial Interest, net of cancellations, issued to the Trustees, officers and other personnel of the Trust pursuant to the 2007 Plan at a weighted average grant price of $56.34 per share ($493,257 in the aggregate). These restricted shares vested in June of 2018 (the second anniversary of the date of grant).

We expense the grant-date fair value restricted stock awards under the straight-line method over the stated vesting period of the award. In connection with these grants, we recorded compensation expense of approximately $571,000, $538,000 and $481,000 during 2018, 2017 and 2016, respectively. The remaining expenses associated with these grants is approximately $592,000 and will be recorded over the remaining weighted average vesting period for outstanding restricted Shares of Beneficial Interest of approximately one year at December 31, 2018.

Prior to its expiration in 2007, the Universal Health Realty Income Trust 1997 Incentive Plan (the “1997 Plan”) provided for the granting of stock options and dividend equivalents rights (“DERs”) to employees of the Trust, including officers and trustees. Awards granted pursuant to the 1997 Plan prior to its termination date remained exercisable, in accordance with the terms of the outstanding agreements. All stock options were granted with an exercise price equal to the fair market value on the date of the grant. The options granted vested ratably at 25% per year beginning one year after the date of grant, and expired in ten years. DERs on outstanding awards were earned in amounts equal to the cash or stock dividends declared subsequent to the date of grant. As of December 31, 2017 or 2016, there were no options outstanding under the 1997 Plan. During 2018 and 2017, no expense was recorded in connection with the DERs. The net expense recorded in connection with the DERs did not have a material impact on our consolidated financial statements during the year ended December 31, 2016.

Prior to 2008, stock options to purchase shares of beneficial interest had been granted to eligible individuals, including our officers and Trustees. Information with respect to these options, before adjustment to the option price to give effect to the dividend equivalent rights, is summarized as follows:

Outstanding Options	Number of Shares			Exercise Weighted- Average Price		Grant Price Range (High-Low)
Balance, January 1, 2016		23,000		$	36.53	$36.53/$36.53
Exercised		(23,000	)		36.53	$36.53/$36.53
Balance, January 1, 2017		—			—		—
Exercised		—			—		—
Balance, January 1, 2018		—			—		—
Exercised		—			—		—
Outstanding options vested and exercisable as of December 31, 2018		—			—		—

There were no stock options outstanding or exercised during 2018 or 2017. During 2016, there were 23,000 stock options exercised with a total in-the-money value of $520,420.

Summarized Financial Information of Equity Affiliates

12 Months Ended

Dec. 31, 2018

Equity Method Investments And Joint Ventures [Abstract]

Summarized Financial Information of Equity Affiliates

(8) SUMMARIZED FINANCIAL INFORMATION OF EQUITY AFFILIATES

In accordance with the accounting principles generally accepted in the United States of American (U.S. GAAP) and guidance relating to accounting for investments and real estate ventures, we account for our unconsolidated investments in LLCs/LPs which we do not control using the equity method of accounting. The third-party members in these investments have equal voting rights with regards to issues such as, but not limited to: (i) divestiture of property; (ii) annual budget approval, and; (iii) financing commitments. These investments, which represent 33% to 95% non-controlling ownership interests, are recorded initially at our cost and subsequently adjusted for our net equity in the net income, cash contributions to, and distributions from, the investments. Pursuant to certain agreements, allocations of sales proceeds and profits and losses of some of the LLC investments may be allocated disproportionately as compared to ownership interests after specified preferred return rate thresholds have been satisfied.

In the Consolidated Statements of Cash Flows, distributions and equity in net income are presented net as cash flows from operating activities. Cumulative distributions received exceeding cumulative equity in earnings represent returns of investments and are classified as cash flows from investing activities in the Consolidated Statements of Cash Flows.

The following property table represents the four LLCs or LPs in which we own a noncontrolling interest and were accounted for under the equity method as of December 31, 2018:

Name of LLC/LP	Ownership			Property Owned by LLC
Suburban Properties		33	%	St. Matthews Medical Plaza II
Brunswick Associates (a.)(d.)		74	%	Mid Coast Hospital MOB
Grayson Properties (b.)(e.)		95	%	Texoma Medical Plaza
FTX MOB Phase II (c.)		95	%	Forney Medical Plaza II

(a.)	This LLC has a third-party term loan of $8.3 million, which is non-recourse to us, outstanding as of December 31, 2018.

(b.)	This building is on the campus of a UHS hospital and has tenants that include subsidiaries of UHS. This LP has a third-party term loan of $13.9 million, which is non-recourse to us, outstanding as of December 31, 2018.

(c.)	We have committed to invest up to $2.5 million in equity and debt financing, of which $2.1 million has been funded as of December 31, 2018. This LP has a third-party term loan of $5.1 million, which is non-recourse to us, outstanding as of December 31, 2018.

(d.)	At December 31, 2018, we are the lessee with a third party on a ground lease for land.

(e.)	At December 31, 2018, we are the lessee with a UHS-related party on a ground lease for land.

Below are the combined statements of income for the LLCs/LPs accounted for under the equity method at December 31, 2018, 2017 and 2016. The 2017 amounts include the financial results of Arlington Medical Properties, LLC, through the March 13, 2017 divestiture date. The 2016 amounts include the financial results of Arlington Medical Properties, LLC for the full year.

	For the Year Ended December 31,
	2018		2017		2016
	(amounts in thousands)
Revenues	$	9,592	$	10,673	$	15,252
Operating expenses		3,557		3,883		5,439
Depreciation and amortization		1,772		1,988		2,554
Interest, net		1,311		1,570		2,565
Net income	$	2,952	$	3,232	$	4,694
Our share of net income (a.)	$	1,771	$	2,416	$	4,456

(a.)

Our share of net income during 2017 and 2016 includes approximately $284,000 and, $1.2 million , respectively, of interest income earned by us on an advance made to Arlington Medical Properties, LLC. This advance was repaid to us effective with the previously mentioned Arlington Medical Properties, LLC transaction during March, 2017.

Below are the combined balance sheets for the four LLCs that were accounted for under the equity method as of December 31, 2018 and 2017:

	December 31,
	2018			2017
	(amounts in thousands)
Net property, including construction in progress	$	31,818		$	33,111
Other assets		3,251			3,560
Total assets	$	35,069		$	36,671

Other liabilities	$	2,717		$	3,067
Mortgage notes payable, non-recourse to us		27,256			27,839
Equity		5,096			5,765
Total liabilities and equity	$	35,069		$	36,671

Investments in LLCs before amounts included in accrued expenses and other liabilities		5,019			4,671
Amounts included in accrued expenses and other liabilities		(2,258	)		(1,895	)
Our share of equity in LLCs, net	$	2,761		$	2,776

As of December 31, 2018, aggregate principal amounts due on mortgage notes payable by unconsolidated LLCs, which are accounted for under the equity method and are non-recourse to us, are as follows (amounts in thousands):

2019	$	621
2020		5,419
2021		13,557
2022		216
2023		224
2024 and thereafter		7,219
Total	$	27,256

	Mortgage Loan Balance (a.)
Name of LLC/LP	12/31/2018		12/31/2017		Maturity Date
FTX MOB Phase II (5.00% fixed rate mortgage loan)	$	5,067	$	5,202	October, 2020
Grayson Properties (5.034% fixed rate mortgage loan)		13,929		14,191	September, 2021
Brunswick Associates (3.64% fixed rate mortgage loan)		8,260		8,446	December, 2024
	$	27,256	$	27,839

(a)

All mortgage loans require monthly principal payments through maturity and include a balloon principal payment upon maturity.

Pursuant to the operating and/or partnership agreements of the four LLCs/LPs in which we continue to hold non-controlling ownership interests, the third-party member and the Trust, at any time, potentially subject to certain conditions, have the right to make an offer (“Offering Member”) to the other member(s) (“Non-Offering Member”) in which it either agrees to: (i) sell the entire ownership interest of the Offering Member to the Non-Offering Member (“Offer to Sell”) at a price as determined by the Offering Member (“Transfer Price”), or; (ii) purchase the entire ownership interest of the Non-Offering Member (“Offer to Purchase”) at the equivalent proportionate Transfer Price. The Non-Offering Member has 60 to 90 days to either: (i) purchase the entire ownership interest of the Offering Member at the Transfer Price, or; (ii) sell its entire ownership interest to the Offering Member at the equivalent proportionate Transfer Price. The closing of the transfer must occur within 60 to 90 days of the acceptance by the Non-Offering Member.

Segment Reporting

12 Months Ended

Dec. 31, 2018

Segment Reporting [Abstract]

Segment Reporting

(9) SEGMENT REPORTING

Our primary business is investing in and leasing healthcare and human service facilities through direct ownership or through joint ventures, which aggregate into a single reportable segment. We actively manage our portfolio of healthcare and human service facilities and may from time to time make decisions to sell lower performing properties not meeting our long-term investment objectives. The proceeds of sales are typically reinvested in new developments or acquisitions, which we believe will meet our planned rate of return. It is our intent that all healthcare and human service facilities will be owned or developed for investment purposes. Our revenue and net income are generated from the operation of our investment portfolio.

Our portfolio is located throughout the United States, however, we do not distinguish or group our operations on a geographical basis for purposes of allocating resources or measuring performance. We review operating and financial data for each property on an individual basis; therefore, we define an operating segment as our individual properties. Individual properties have been aggregated into one reportable segment based upon their similarities with regard to both the nature and economics of the facilities, tenants and operational processes, as well as long-term average financial performance. No individual property meets the requirements necessary to be considered its own segment.

Impact of Hurricane Harvey

12 Months Ended

Dec. 31, 2018

Extraordinary And Unusual Items [Abstract]

Impact of Hurricane Harvey

(10) IMPACT OF HURRICANE HARVEY

In late August, 2017, five of our medical office buildings located in the Houston, Texas area incurred extensive water damage as a result of Hurricane Harvey. Until various times during the second quarter of 2018, these properties were temporarily closed and non-operational as we continued to reconstruct and restore them to operational condition. As of June 30, 2018, reconstruction on all of the occupied space in these properties had been completed and operations resumed.

During 2018, pursuant to the terms of a global settlement with our commercial property insurance carrier, we received $5.5 million of additional insurance recovery proceeds bringing the aggregate hurricane-related insurance recoveries to $12.5 million. The aggregate insurance proceeds recoveries, which are net of applicable deductibles, covered substantially all of the costs incurred related to the remediation, repair and reconstruction of each of these properties as well as business interruption for the lost income related to each of these properties during the period they were non-operational.

Included in our financial results for the year ended December 31, 2018 are approximately $1.2 million of business interruption insurance recovery proceeds, covering the period of late August, 2017 through June 30, 2018, approximately $500,000 of which relates to 2017. These business interruption insurance recovery proceeds are included in net cash provided by operating activities in our condensed consolidated statement of cash flows for the year ended December 31, 2018. Additionally, the year ended December 31, 2018 includes approximately $4.5 million of hurricane insurance recoveries in excess of property damage write-downs, which are included in net cash provided by investing activities in our condensed consolidated statement of cash flows for the year ended December 31, 2018. Included in our financial results for the year ended December 31, 2017 are hurricane related expenses of approximately $5.0 million consisting of $3.6 million related to property damage and $1.4 million related to remediation and demolition expenses. Also included in our financial results for the twelve-month period ended December 31, 2017 are aggregate hurricane related insurance recoveries of approximately $7.0 million, consisting of $5.0 million related to recovery of hurricane related expenses and $2.0 million related to recovery proceeds in excess of the damaged property write-downs.

Quarterly Results

12 Months Ended

Dec. 31, 2018

Quarterly Financial Information Disclosure [Abstract]

Quarterly Results

(11) QUARTERLY RESULTS (unaudited)

	2018
	First Quarter		Second Quarter		Third Quarter		Fourth Quarter		Total
	(amounts in thousands, except per share amounts)
Revenues	$	18,539	$	20,111	$	18,828	$	18,732	$	76,210
Net income before gain and excess insurance recovery proceeds	$	4,101	$	5,611	$	4,374	$	4,413	$	18,499
Hurricane insurance recovery proceeds in excess of damaged property write-downs	$	4,535	$	—	$	—	$	—	$	4,535
Hurricane business interruption insurance recovery proceeds	$	968	$	194	$	—	$	—	$	1,162
Net income	$	9,604	$	5,805	$	4,374	$	4,413	$	24,196
Total basic earnings per share	$	0.70	$	0.42	$	0.32	$	0.32	$	1.76
Total diluted earnings per share	$	0.70	$	0.42	$	0.32	$	0.32	$	1.76

	2017
	First Quarter		Second Quarter		Third Quarter		Fourth Quarter		Total
	(amounts in thousands, except per share amounts)
Revenues	$	17,750	$	18,145	$	18,194	$	18,259	$	72,348
Net income before gain and excess insurance recovery proceeds	$	4,366	$	4,033	$	3,960	$	4,031	$	16,390
Gain on Arlington transaction	$	27,196	$	—	$	—	$	—	$	27,196
Hurricane insurance recovery proceeds in excess of damaged property write-downs	$	—	$	—	$	—	$	2,033	$	2,033
Net income	$	31,562	$	4,033	$	3,960	$	6,064	$	45,619
Total basic earnings per share	$	2.32	$	0.30	$	0.29	$	0.44	$	3.35
Total diluted earnings per share	$	2.32	$	0.30	$	0.29	$	0.44	$	3.35

Real Estate and Accumulated Depreciation

12 Months Ended

Dec. 31, 2018

Real Estate And Accumulated Depreciation Disclosure [Abstract]

Real Estate and Accumulated Depreciation

Schedule III

Universal Health Realty Income Trust

Real Estate and Accumulated Depreciation — December 31, 2018

(amounts in thousands)

										Gross amount at										Date of
										which carried										Completion of
	Initial Cost									at end of period								Accumulated		Construction,
Description	Encumbrance (c.)		Land		Building & Improv.		Adjustments to Basis (a.)			Land		Building & Improvements		CIP		Total		Depreciation as of Dec. 31, 2018		Acquisition or Significant improvement	Date Acquired	Average Depreciable Life
Inland Valley Regional Medical Center Wildomar, California		—	$	2,050	$	10,701	$	14,596		$	2,050	$	25,297			$	27,347	$	14,017	2007	1986	43 Years
McAllen Medical Center McAllen, Texas		—		4,720		31,442		10,189			6,281		40,070				46,351		28,166	1994	1986	42 Years
Wellington Regional Medical Center West Palm Beach, Florida		—		1,190		14,652		17,370			1,663		31,549				33,212		20,561	2006	1986	42 Years
HealthSouth Deaconess Rehabilitation Hospital Evansville, Indiana		—		500		6,945		1,062			500		8,007				8,507		5,881	1993	1989	40 Years
Kindred Chicago Central Hospital Central Chicago, Illinois		—		158		6,404		1,838			158		8,242				8,400		8,242	1993	1986	25 Years
Family Doctor’s Medical Office Building Shreveport, Louisiana		—		54		1,526		494			54		2,020				2,074		1,092	1991	1995	45 Years
Kelsey-Seybold Clinic at King’s Crossing Kingwood, Texas (d.)		—		439		1,618		(1,209	)		439		409				848		10	1995	1995	45 Years
Professional Buildings at King’s Crossing Kingwood, Texas (d.)		—		439		1,837		(395	)		439		1,442				1,881		63	1995	1995	45 Years
Chesterbrook Academy Audubon, Pennsylvania		—		307		996		—			307		996				1,303		498	1996	1996	45 Years
Chesterbrook Academy New Britain, Pennsylvania		—		250		744		—			250		744				994		377	1991	1996	45 Years
Chesterbrook Academy Uwchlan, Pennsylvania		—		180		815		—			180		815				995		410	1992	1996	45 Years
Chesterbrook Academy Newtown, Pennsylvania		—		195		749		—			195		749				944		379	1992	1996	45 Years
The Southern Crescent Center I (b.)		—		1,130		5,092		(2,271	)		1,130		2,821				3,951		2,529	1994	1996	45 Years
The Southern Crescent Center II (b.) Riverdale, Georgia		—		—		—		5,213			806		4,407				5,213		2,723	2000	1998	35 Years
The Cypresswood Professional Center Spring, Texas (e.)		—		573		3,842		(2,667	)		573		1,175				1,748		53	1997	1997	35 Years
701 South Tonopah Building Las Vegas, Nevada (f.)		—		—		1,579		68			—		1,647				1,647		1,225	1999	1999	25 Years
Danbury Medical Plaza Danbury, Connecticut		—		1,151		5,176		1,042			1,151		6,218				7,369		3,783	2000	2000	30 Years
Vibra Hospital of Corpus Christi Corpus Christi, Texas		2,519		1,104		5,508		—			1,104		5,508				6,612		1,714	2008	2008	35 Years
Apache Junction Medical Plaza Apache Junction, AZ		—		240		3,590		1,210			240		4,800				5,040		1,625	2004	2004	30 Years
Auburn Medical Office Building II Auburn, WA (g.)		—		—		10,200		176			—		10,376				10,376		2,399	2009	2009	36 Years
BRB Medical Office Building Kingwood, Texas		5,928		430		8,970		51			430		9,021				9,451		2,056	2010	2010	37 Years
Centennial Hills Medical Office Building Las Vegas, NV (f.)		—		—		19,890		1,994			—		21,884		2		21,886		5,526	2006	2006	34 Years
Desert Springs Medical Plaza Las Vegas, NV		—		1,200		9,560		1,438			1,200		10,998		124		12,322		3,172	1998	1998	30 Years
700 Shadow Lane & Goldring MOBs Las Vegas, NV		5,861		400		11,300		3,701			400		15,001		717		16,118		4,360	2003	2003	30 Years
Spring Valley Hospital MOB I Las Vegas, NV (f.)		—		—		9,500		1,231			—		10,731		84		10,815		2,774	2004	2004	35 Years

									Gross amount at										Date of
									which carried										Completion of
	Initial Cost								at end of period								Accumulated		Construction,
Description	Encumbrance (c.)		Land		Building & Improv.		Adjustments to Basis (a.)		Land		Building & Improvements		CIP		Total		Depreciation as of Dec. 31, 2018		Acquisition or Significant improvement	Date Acquired	Average Depreciable Life
Spring Valley Hospital MOB II Las Vegas, NV (f.)		—		—		9,800		503		—		10,303				10,303		2,705	2006	2006	34 Years
Summerlin Hospital MOB I Las Vegas, NV		—		460		15,440		1,790		460		17,230		13		17,703		4,827	1999	1999	30 Years
Summerlin Hospital MOB II Las Vegas, NV		—		370		16,830		1,484		370		18,314		12		18,696		5,139	2000	2000	30 Years
Summerlin Hospital MOB III Las Vegas, NV (f.)		13,198		—		14,900		2,176		—		17,076		48		17,124		3,825	2009	2009	36 Years
Emory at Dunwoody Building Dunwoody, GA		—		782		3,455		—		782		3,455				4,237		920	2011	2011	35 Years
Forney Medical Plaza Forney, TX		—		910		11,960		57		910		12,017				12,927		3,417	2011	2011	35 Years
Lake Pointe Medical Arts Building Rowlett, TX		—		1,100		9,000		144		1,100		9,144				10,244		2,304	2011	2011	35 Years
Tuscan Professional Building Irving, TX		4,020		1,100		12,525		1,475		1,100		14,000	122			15,222		3,335	2011	2011	35 Years
Peace Health Medical Clinic Bellingham, WA		—		1,900		24,910		—		1,900		24,910				26,810		5,846	2012	2012	35 Years
Northwest Texas Professional Office Tower Amarillo, TX (f.)		—		—		7,180		49		—		7,229				7,229		1,450	2012	2012	35 Years
Ward Eagle Office Village Farmington Hills, MI		—		220		3,220		63		220		3,283				3,503		645	2013	2013	35 Years
5004 Poole Road MOB Denison, TX		—		96		529		—		96		529				625		99	2013	2013	35 Years
Desert Valley Medical Center Phoenix, AZ		4,806		2,280		4,624		958		2,280		5,582		5		7,867		1,038	1996	1996	30 Years
Hanover Emergency Center Mechanicsville, VA		—		1,300		6,224		—		1,300		6,224				7,524		908	2014	2014	35 Years
Haas Medical Office Park Ottumwa, IA (g.)		—		—		3,571		—		—		3,571				3,571		463	2015	2015	35 Years
South Texas ER at Mission Mission, TX		—		1,441		4,696		—		1,441		4,696				6,137		616	2015	2015	35 Years
North Valley Medical Plaza Phoenix, AZ		—		930		6,929		1,856		930		8,785	301			10,016		1,450	2010	2010	30 Years
Northwest Medical Center at Sugar Creek Bentonville, AR		—		1,100		2,870		—		1,100		2,870				3,970		478	2014	2014	35 Years
The Children’s Clinic at Springdale Springdale, AR		—		610		1,570		—		610		1,570				2,180		262	2014	2014	35 Years
Rosenberg Children’s Medical Plaza Phoenix, AZ (g.)		12,948		—		23,302		34		—		23,336				23,336		3,468	2001	2001	35 Years
Phoenix Children’s East Valley Care Center Phoenix, AZ		9,194		1,050		10,900		—		1,050		10,900				11,950		1,616	2006	2006	35 Years
Palmdale Medical Plaza Palmdale, CA (f.)		—		—		10,555		1,745		—		12,300		67		12,367		2,105	2008	2008	34 Years
Piedmont-Roswell Physician Center Sandy Springs, GA		—		2,338		2,128		—		2,338		2,128				4,466		336	2015	2015	30 Years
Piedmont-Vinings Physician Center Vinings, GA		—		1,348		2,418		—		1,348		2,418				3,766		369	2015	2015	30 Years
Santa Fe Professional Plaza Scottsdale, AZ		—		1,090		1,960		382		1,090		2,342		13		3,445		491	1999	1999	30 Years
Sierra San Antonio Medical Plaza Fontana, CA (g.)		—		—		11,538		692		—		12,230	98			12,328		2,090	2006	2006	30 Years
Vista Medical Terrace & Sparks MOB Sparks, NV (f.)		—		—		9,276		1,349		—		10,625				10,625		2,287	2008	2008	30 Years
South Texas ER at Weslaco Weslaco ,TX		—		1,749		4,879		—		1,749		4,879				6,628		649	2015	2015	35 Years
Chandler Corporate Center III Chandler, AZ		—		2,328		14,131		—		2,328		14,131				16,459		1,731	2016	2016	35 Years
Frederick Crestwood MOB Frederick, MD		—		2,265		18,731		—		2,265		18,731				20,996		1,662	2016	2016	35 Years
Madison Professional Office Building Madison, AL		—		2,296		6,411		—		2,296		6,411				8,707		730	2016	2016	35 Years
Tenaya Medical Office Building Las Vegas, NV		6,871		3,032		10,602		—		3,032		10,602				13,634		845	2016	2016	35 Years
Hendserson Medical Plaza Henderson, NV (f.)		—		—		10,718		7,170		—		17,888		5		17,893		1,060	2017	2017	35 Years
Hamburg Medical Building Hamburg, PA		—		696		3,406		—		696		3,406				4,102		201	2017	2017	35 Years
Las Palmas Del Sol Emergency Center - West El Paso, TX		—		801		5,029		—		801		5,029				5,830		246	2017	2017	35 Years
Beaumont Medical Sleep Center Building Southfield, MI		—		254		2,968		—		254		2,968				3,222		68	2018	2018	35 Years
TOTALS (h.)	$	65,345	$	50,556	$	481,821	$	77,058	$	53,396	$	556,039	$	1,611	$	611,046	$	173,316

a.	Consists of costs subsequent to acquisition that were capitalized, divested or written down in connection with asset impairments and hurricane related damage.

b.	During 2008, a $4.6 million provision for asset impairment was recorded in connection with the real estate assets of Southern Crescent Center I & Southern Crescent Center II.

c.	Consists of outstanding balances as of December 31, 2018 on third-party debt that is non-recourse to us.

d.	Carrying value of depreciable assets were written down to zero as a result of substantial damage from Hurricane Harvey during the third quarter of 2017.

e.	Carrying value of depreciable assets were written down as a result of substantial damage from Hurricane Harvey during the third quarter of 2017.

f.	At December 31, 2018, we are the lessee with a UHS-related party on a ground lease for land.

g.	At December 31, 2018, we are the lessee with a third party on a ground lease for land.

h.	The aggregate cost for federal income tax purposes is $593 million (unaudited) with a net book value of $384 million (unaudited).

UNIVERSAL HEALTH REALTY INCOME TRUST

NOTES TO SCHEDULE III

DECEMBER 31, 2018

(amounts in thousands)

(1) RECONCILIATION OF REAL ESTATE PROPERTIES

The following table reconciles the Real Estate Properties from January 1, 2016 to December 31, 2018:

	2018			2017			2016
Balance at January 1,	$	599,776		$	585,828		$	511,657
Additions (a.)		8,641			12,492			14,186
Acquisitions		3,222			9,931			60,031
Disposals/Divestitures (b.)		(593	)		(8,475	)		(46	)
Balance at December 31,	$	611,046		$	599,776		$	585,828

(2) RECONCILIATION OF ACCUMULATED DEPRECIATION

The following table reconciles the Accumulated Depreciation from January 1, 2016 to December 31, 2018:

	2018			2017			2016
Balance at January 1,	$	153,379		$	138,588		$	121,161
Disposals/Divestitures (b.)		(593	)		(4,896	)		(9	)
Depreciation expense		20,530			19,687			17,436
Balance at December 31,	$	173,316		$	153,379		$	138,588

(a)

Included in the additions during 2018, 2017 and 2016, were approximately $313,000, $3.0 million and $9.5 million, respectively, related to Henderson Medical Plaza, which was completed and opened during 2017. Additionally, 2018 includes approximately $2.7 million of hurricane-related reconstruction costs.

(b)

2017 includes property damage write-downs resulting from substantial damage from Hurricane Harvey during the third quarter of 2017, as discussed in Note 10 to the consolidated financial statements – Impact of Hurricane Harvey.

Organization and Summary of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2018

Accounting Policies [Abstract]

Nature of Operations

•

six hospital facilities consisting of three acute care, one rehabilitation and two sub-acute;

•

four free-standing emergency departments (“FEDs”);

•

fifty-five medical/office buildings (“MOBs”), including four owned by unconsolidated limited liability companies (“LLCs”)/limited liability partnerships (“LPs”), and;

•

four preschool and childcare centers.

Purchase Accounting for Acquisition of Investments in Real Estate

Cash and Cash Equivalents

We consider all highly liquid investment instruments with original maturities of three months or less to be cash equivalents.

Asset Impairment

Investments in Limited Liability Companies ("LLCs")

Investments in Limited Liability Companies (“LLCs”)

Federal Income Taxes

Stock-Based Compensation

Fair Value

Concentration of Revenues

Use of Estimates

New Accounting Standards

Except as noted below there were no new accounting pronouncements that impacted, or are expected to impact us.

Relationship with UHS and Related Party Transactions (Tables)

12 Months Ended

Dec. 31, 2018

Existing Lease Terms and Renewal Options for Each of UHS Hospital Facilities

The table below details the existing lease terms and renewal options for our three acute care hospitals operated by wholly-owned subsidiaries of UHS:

	Annual Minimum Rent		End of Lease Term	Renewal Term (years)
McAllen Medical Center	$	5,485,000	December, 2026		5	(a)
Wellington Regional Medical Center	$	3,030,000	December, 2021		10	(b)
Southwest Healthcare System, Inland Valley Campus	$	2,648,000	December, 2021		10	(b)

(a)	UHS has one 5-year renewal option at existing lease rates (through 2031).

(b)	UHS has two 5-year renewal options at fair market value lease rates (2022 through 2031).

Acquisitions, Dispositions and Property Exchange Transaction (Tables)

12 Months Ended

Dec. 31, 2018

2017 Acquisitions

Allocation of Purchase Price to Assets Acquired and Liabilities Assumed


Land	$1,496
Buildings and improvements	8,434
Intangible assets	1,598
Below-market lease intangibles	(2,488)

Net cash paid	$9,040

2016 Acquisitions

Allocation of Purchase Price to Assets Acquired and Liabilities Assumed


Land	$9,914
Buildings and improvements	50,117
Intangible assets	9,211
Below-market lease intangibles	(1,287)
Deposit paid in 2015………………………………………...………………………………..	(150)
Debt (including fair value adjustment of $362)…...……..……………………………….…..	(7,499)
Financing fees paid on debt acquired……………...……..……………………………….…..	83

Net cash paid	$60,389

Leases (Tables)

12 Months Ended

Dec. 31, 2018

Leases [Abstract]

Schedule of Minimum Future Base Rents from Non-Cancelable Leases

2019	$	56,494
2020		50,291
2021		45,357
2022		30,089
2023		24,972
Thereafter		67,288
Total minimum base rents	$	274,491

Schedule of Future Minimum Payments Under Ground Lease Commitments on Consolidated and Unconsolidated Leases

Total future minimum payments under our ground lease commitments on a consolidated basis due in each of the next five years and thereafter are as follows (amounts in thousands):

2019	$	474
2020		474
2021		474
2022		474
2023		474
Thereafter		25,582
Total ground lease expense	$	27,952

Debt and Financial Instruments (Tables)

12 Months Ended

Dec. 31, 2018

Debt Disclosure [Abstract]

Summary of Required Compliance Ratios Giving Effect to New Covenants in Credit Agreements

			December 31, 2018									December 31, 2017
		Covenant				UHT					Covenant				UHT
Tangible net worth		$		125,000		$		181,203			$		136,170		$		190,002
Total leverage	< 60				%		41.3		%	< 60				%		41.2		%
Secured leverage	< 30				%		9.8		%	< 30				%		11.7		%
Unencumbered leverage	< 60				%		37.6		%	< 60				%		37.7		%
Fixed charge coverage	> 1.50x						4.3x			> 1.50x						3.8x

Outstanding Mortgages, Excluding Net Debt Premium

	As of 12/31/2018							As of 12/31/2017
Facility Name	Interest Rate			Maturity Date	Outstanding Balance (in thousands)(a.)			Outstanding Balance (in thousands)
Sparks Medical Building/Vista Medical Terrace floating rate mortgage loan (b.)		4.63	%	February, 2018	$	-		$	4,130
Centennial Hills Medical Office Building floating rate mortgage loan (c.)		4.63	%	April, 2018		-			9,764
Vibra Hospital-Corpus Christi fixed rate mortgage loan (d.)		6.50	%	July, 2019		2,519			2,624
700 Shadow Lane and Goldring MOBs fixed rate mortgage loan		4.54	%	June, 2022		5,861			6,059
BRB Medical Office Building fixed rate mortgage loan		4.27	%	December, 2022		5,928			6,126
Desert Valley Medical Center fixed rate mortgage loan		3.62	%	January, 2023		4,806			4,946
2704 North Tenaya Way fixed rate mortgage loan		4.95	%	November, 2023		6,871			7,007
Summerlin Hospital Medical Office Building III fixed rate mortgage loan		4.03	%	April, 2024		13,198			13,199
Tuscan Professional Building fixed rate mortgage loan		5.56	%	June, 2025		4,020			4,519
Phoenix Children’s East Valley Care Center fixed rate mortgage loan		3.95	%	January, 2030		9,194			9,400
Rosenberg Children's Medical Plaza fixed rate mortgage loan (e.)		4.42	%	September, 2033		12,948			7,968
Total, excluding net debt premium and net financing fees						65,345			75,742
Less net financing fees						(711	)		(680	)
Plus net debt premium						247			297
Total mortgage notes payable, non-recourse to us, net					$	64,881		$	75,359

(a)

All mortgage loans require monthly principal payments through maturity and either fully amortize or include a balloon principal payment upon maturity.

(b)

(c)

On April 5, 2018, upon its maturity, a $9.7 million floating rate mortgage loan on the Centennial Hills Medical Office Building was fully repaid utilizing borrowings under our Credit Agreement.

(d)

Notice has been provided to the lender to prepay the loan on April 2, 2019 without penalty. We will repay the balance utilizing borrowings under our Credit Agreement.

(e)

Aggregate Consolidated Scheduled Debt Repayments

As of December 31, 2018, our aggregate consolidated scheduled debt repayments (including mortgages) are as follows (amounts in thousands):

2019	$	4,199
2020		1,913
2021		2,081
2022 (a.)		208,597
2023		11,892
Later		33,063
Total	$	261,745

(a)

Includes repayment of $196.4 million of outstanding borrowings under the terms of our $300 million revolving credit agreement.

Options Before Adjustment to Option Price to Give Effect to Dilutive Equivalent Rights

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

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+ Details

Incentive Plans (Tables)

12 Months Ended

Dec. 31, 2018

Postemployment Benefits [Abstract]

Information with respect to these options, before adjustment to the option price to give effect to the dividend equivalent rights, is summarized as follows:

Outstanding Options	Number of Shares			Exercise Weighted- Average Price		Grant Price Range (High-Low)
Balance, January 1, 2016		23,000		$	36.53	$36.53/$36.53
Exercised		(23,000	)		36.53	$36.53/$36.53
Balance, January 1, 2017		—			—		—
Exercised		—			—		—
Balance, January 1, 2018		—			—		—
Exercised		—			—		—
Outstanding options vested and exercisable as of December 31, 2018		—			—		—

Summarized Financial Information of Equity Affiliates (Tables)

12 Months Ended

Dec. 31, 2018

Equity Method Investments And Joint Ventures [Abstract]

Limited Liability Companies Accounted for Under Equity Method

The following property table represents the four LLCs or LPs in which we own a noncontrolling interest and were accounted for under the equity method as of December 31, 2018:

Name of LLC/LP	Ownership			Property Owned by LLC
Suburban Properties		33	%	St. Matthews Medical Plaza II
Brunswick Associates (a.)(d.)		74	%	Mid Coast Hospital MOB
Grayson Properties (b.)(e.)		95	%	Texoma Medical Plaza
FTX MOB Phase II (c.)		95	%	Forney Medical Plaza II

(a.)	This LLC has a third-party term loan of $8.3 million, which is non-recourse to us, outstanding as of December 31, 2018.

(b.)	This building is on the campus of a UHS hospital and has tenants that include subsidiaries of UHS. This LP has a third-party term loan of $13.9 million, which is non-recourse to us, outstanding as of December 31, 2018.

(c.)	We have committed to invest up to $2.5 million in equity and debt financing, of which $2.1 million has been funded as of December 31, 2018. This LP has a third-party term loan of $5.1 million, which is non-recourse to us, outstanding as of December 31, 2018.

(d.)	At December 31, 2018, we are the lessee with a third party on a ground lease for land.

(e.)	At December 31, 2018, we are the lessee with a UHS-related party on a ground lease for land.

Combined Statements of Income for LLCs/LPs Accounted Under Equity Method

Below are the combined statements of income for the LLCs/LPs accounted for under the equity method at December 31, 2018, 2017 and 2016.

	For the Year Ended December 31,
	2018		2017		2016
	(amounts in thousands)
Revenues	$	9,592	$	10,673	$	15,252
Operating expenses		3,557		3,883		5,439
Depreciation and amortization		1,772		1,988		2,554
Interest, net		1,311		1,570		2,565
Net income	$	2,952	$	3,232	$	4,694
Our share of net income (a.)	$	1,771	$	2,416	$	4,456

(a.)

Combined Balance Sheets for LLCs Accounted Under Equity Method

Below are the combined balance sheets for the four LLCs that were accounted for under the equity method as of December 31, 2018 and 2017:

	December 31,
	2018			2017
	(amounts in thousands)
Net property, including construction in progress	$	31,818		$	33,111
Other assets		3,251			3,560
Total assets	$	35,069		$	36,671

Other liabilities	$	2,717		$	3,067
Mortgage notes payable, non-recourse to us		27,256			27,839
Equity		5,096			5,765
Total liabilities and equity	$	35,069		$	36,671

Investments in LLCs before amounts included in accrued expenses and other liabilities		5,019			4,671
Amounts included in accrued expenses and other liabilities		(2,258	)		(1,895	)
Our share of equity in LLCs, net	$	2,761		$	2,776

Aggregate Principal Amounts due on Mortgage and Construction Notes Payable by Unconsolidated LLC's Accounted Under Equity Method

2019	$	621
2020		5,419
2021		13,557
2022		216
2023		224
2024 and thereafter		7,219
Total	$	27,256

	Mortgage Loan Balance (a.)
Name of LLC/LP	12/31/2018		12/31/2017		Maturity Date
FTX MOB Phase II (5.00% fixed rate mortgage loan)	$	5,067	$	5,202	October, 2020
Grayson Properties (5.034% fixed rate mortgage loan)		13,929		14,191	September, 2021
Brunswick Associates (3.64% fixed rate mortgage loan)		8,260		8,446	December, 2024
	$	27,256	$	27,839

(a)

All mortgage loans require monthly principal payments through maturity and include a balloon principal payment upon maturity.

Quarterly Results (Tables)

12 Months Ended

Dec. 31, 2018

Quarterly Financial Information Disclosure [Abstract]

Quarterly Results for Operating Activities

	2018
	First Quarter		Second Quarter		Third Quarter		Fourth Quarter		Total
	(amounts in thousands, except per share amounts)
Revenues	$	18,539	$	20,111	$	18,828	$	18,732	$	76,210
Net income before gain and excess insurance recovery proceeds	$	4,101	$	5,611	$	4,374	$	4,413	$	18,499
Hurricane insurance recovery proceeds in excess of damaged property write-downs	$	4,535	$	—	$	—	$	—	$	4,535
Hurricane business interruption insurance recovery proceeds	$	968	$	194	$	—	$	—	$	1,162
Net income	$	9,604	$	5,805	$	4,374	$	4,413	$	24,196
Total basic earnings per share	$	0.70	$	0.42	$	0.32	$	0.32	$	1.76
Total diluted earnings per share	$	0.70	$	0.42	$	0.32	$	0.32	$	1.76

	2017
	First Quarter		Second Quarter		Third Quarter		Fourth Quarter		Total
	(amounts in thousands, except per share amounts)
Revenues	$	17,750	$	18,145	$	18,194	$	18,259	$	72,348
Net income before gain and excess insurance recovery proceeds	$	4,366	$	4,033	$	3,960	$	4,031	$	16,390
Gain on Arlington transaction	$	27,196	$	—	$	—	$	—	$	27,196
Hurricane insurance recovery proceeds in excess of damaged property write-downs	$	—	$	—	$	—	$	2,033	$	2,033
Net income	$	31,562	$	4,033	$	3,960	$	6,064	$	45,619
Total basic earnings per share	$	2.32	$	0.30	$	0.29	$	0.44	$	3.35
Total diluted earnings per share	$	2.32	$	0.30	$	0.29	$	0.44	$	3.35

Organization and Summary of Significant Accounting Policies - Additional Information (Detail)	3 Months Ended	12 Months Ended
	Jun. 30, 2018 USD ($)	Dec. 31, 2018 USD ($) Property	Dec. 31, 2017 USD ($)	Dec. 31, 2016 USD ($)	Feb. 27, 2019 Property State
Significant Accounting Policies [Line Items]
Net intangible assets		$ 17,407,000	$ 20,559,000
Intangible assets, accumulated amortization		27,600,000	28,700,000
Depreciation expense		$ 20,500,000	19,700,000	$ 17,400,000
Percentage of annual REIT taxable income distributed and continue to distribute to remain exempt from federal income taxes		100.00%
Federal excise tax rate when amount of 85% of ordinary income plus 95% of any capital gain income exceeds cash distributions		4.00%
Gross cost basis of properties for federal income tax purposes		$ 593,000,000	584,000,000
Net book value of the properties for federal income tax purposes		$ 384,000,000	384,000,000
Number of properties subject to ground leases \| Property		14
Topic 606
Significant Accounting Policies [Line Items]
Cumulative adjustment		$ 0
Contract assets		0
Contract liabilities		0
Lease termination fee	$ 1,700,000
Topic 606 \| Tenant Reimbursement and Other Property Income
Significant Accounting Policies [Line Items]
Revenue from contracts with customers		$ 11,500,000	10,200,000	9,000,000
Minimum
Significant Accounting Policies [Line Items]
Percentage of annual REIT taxable income that should be distributed to remain exempt from federal income taxes		90.00%
Minimum \| 4 Unconsolidated Limited Liability Companies / Limited Partner
Significant Accounting Policies [Line Items]
Non-controlling equity interest, ownership percentage		33.00%
Maximum \| 4 Unconsolidated Limited Liability Companies / Limited Partner
Significant Accounting Policies [Line Items]
Non-controlling equity interest, ownership percentage		95.00%
Buildings \| Minimum
Significant Accounting Policies [Line Items]
Estimated original useful lives of property plant and equipment		25 years
Buildings \| Maximum
Significant Accounting Policies [Line Items]
Estimated original useful lives of property plant and equipment		45 years
Capital Improvements \| Minimum
Significant Accounting Policies [Line Items]
Estimated original useful lives of property plant and equipment		3 years
Capital Improvements \| Maximum
Significant Accounting Policies [Line Items]
Estimated original useful lives of property plant and equipment		35 years
In Place Leases
Significant Accounting Policies [Line Items]
Net intangible assets		$ 15,600,000
Intangible assets, accumulated amortization		$ 27,100,000
Intangible asset, useful life		4 years 7 months 6 days
Intangible assets, estimated aggregate amortization expenses for 2019		$ 3,100,000
Intangible assets, estimated aggregate amortization expenses for 2020		2,900,000
Intangible assets, estimated aggregate amortization expenses for 2021		2,500,000
Intangible assets, estimated aggregate amortization expenses for 2022		1,800,000
Intangible assets, estimated aggregate amortization expenses for 2023		1,400,000
Amortization expense, intangible assets		$ 3,800,000	4,900,000	5,100,000
Intangible asset, useful life		4 years 7 months 6 days
Above-Market Leases
Significant Accounting Policies [Line Items]
Net intangible assets		$ 1,600,000
Intangible assets, accumulated amortization		$ 386,000
Intangible asset, useful life		8 years 7 months 6 days
Intangible assets, estimated aggregate amortization expenses for 2019		$ 186,000
Intangible assets, estimated aggregate amortization expenses for 2020		186,000
Intangible assets, estimated aggregate amortization expenses for 2021		186,000
Intangible assets, estimated aggregate amortization expenses for 2022		181,000
Intangible assets, estimated aggregate amortization expenses for 2023		178,000
Amortization expense, intangible assets		$ 176,000	$ 173,000	$ 95,000
Intangible asset, useful life		8 years 7 months 6 days
McAllen Medical Center \| Customer Concentration Risk \| Revenues
Significant Accounting Policies [Line Items]
Percentage of rental revenue		9.00%	10.00%	11.00%
Medical office buildings \| Limited Liability Companies
Significant Accounting Policies [Line Items]
Number of real estate investments \| Property		4
Subsequent Event
Significant Accounting Policies [Line Items]
Number of real estate investments \| Property					69
Number of states that real estate investments are located \| State					20
Subsequent Event \| Hospitals
Significant Accounting Policies [Line Items]
Number of real estate investments \| Property					6
Subsequent Event \| Hospitals \| Acute Care
Significant Accounting Policies [Line Items]
Number of real estate investments \| Property					3
Subsequent Event \| Hospitals \| Rehabilitation
Significant Accounting Policies [Line Items]
Number of real estate investments \| Property					1
Subsequent Event \| Hospitals \| Sub-acute
Significant Accounting Policies [Line Items]
Number of real estate investments \| Property					2
Subsequent Event \| Mission and Weslaco Freestanding Emergency Departments
Significant Accounting Policies [Line Items]
Number of real estate investments \| Property					4
Subsequent Event \| Medical office buildings
Significant Accounting Policies [Line Items]
Number of real estate investments \| Property					55
Subsequent Event \| Medical office buildings \| Majority Owned Subsidiary Unconsolidated
Significant Accounting Policies [Line Items]
Number of real estate investments \| Property					4
Subsequent Event \| Medical office buildings \| Limited Liability Companies ("LLCs")/ Limited Liability Partnerships ("LPs")
Significant Accounting Policies [Line Items]
Number of real estate investments \| Property					4
Subsequent Event \| Preschool and childcare Centers
Significant Accounting Policies [Line Items]
Number of real estate investments \| Property					4

Relationship with UHS and Related Party Transactions - Additional Information (Detail)	1 Months Ended	12 Months Ended			60 Months Ended
	Apr. 30, 2017 Time	Dec. 31, 2018 USD ($) Property Time	Dec. 31, 2017 USD ($) Property	Dec. 31, 2016 USD ($) Option	Dec. 31, 2018 USD ($) Time
Related Party Transaction [Line Items]
Annual advisory fee as percentage of average invested real estate assets		0.70%	0.70%	0.70%	0.70%
Management Service
Related Party Transaction [Line Items]
Advisory fee		$ 3,806,000	$ 3,577,000	$ 3,263,000
Maximum
Related Party Transaction [Line Items]
Number of term renewal options \| Option				5
Universal Health Services, Inc
Related Party Transaction [Line Items]
Number of term renewal options \| Time		6			6
Additional renewal terms		5 years
Number of medical office buildings and free standing emergency departments \| Property		17
Option to renew lease, notice period prior to termination date of current term		90 days
Period to purchase respective leased facilities at same price after lease terms		180 days
Renewal period of respective leased facilities at same price after lease terms		180 days
Number of renewal options at existing lease rates \| Time		3
Percentage ownership of outstanding shares		5.70%	5.70%		5.70%
Universal Health Services, Inc \| Henderson Medical Plaza
Related Party Transaction [Line Items]
Number of term renewal options \| Time	2
Additional renewal terms	10 years
Ground lease agreement period	75 years
Amount invested in MOB under construction		$ 12,800,000			$ 12,800,000
Universal Health Services, Inc \| Customer Concentration Risk \| Revenues
Related Party Transaction [Line Items]
Percentage of revenues generated from leases and tenants		21.00%	22.00%	24.00%	24.00%
Universal Health Services, Inc \| Customer Concentration Risk \| Revenues \| Tenants
Related Party Transaction [Line Items]
Percentage of revenues generated from leases and tenants		30.00%	32.00%	33.00%	32.00%
Universal Health Services, Inc \| Hospital Facilities Leased
Related Party Transaction [Line Items]
Number of hospital facilities leased \| Property			3
Universal Health Services, Inc \| Minimum
Related Party Transaction [Line Items]
Initial lease terms		13 years
Universal Health Services, Inc \| Maximum
Related Party Transaction [Line Items]
Initial lease terms		15 years
Universal Health Services of Delaware Inc
Related Party Transaction [Line Items]
Annual incentive fee to Advisor as percentage of cash available for distribution		20.00%			20.00%
Incentive fees		$ 0
Average invested real estate assets		544,000,000	$ 511,000,000	$ 466,000,000
Universal Health Services of Delaware Inc \| Management Service
Related Party Transaction [Line Items]
Advisory fee		$ 3,800,000	$ 3,600,000	$ 3,300,000
Universal Health Services of Delaware Inc \| Minimum
Related Party Transaction [Line Items]
Percentage of equity to be exceeded for incentive distribution		15.00%			15.00%

Existing Lease Terms and Renewal Options for Each of UHS Hospital Facilities (Detail)

12 Months Ended

Dec. 31, 2018

USD ($)

Universal Health Services, Inc | McAllen Medical Center

5 years

Annual Minimum Rent

$ 5,485,000

End of Lease Term

2026-12

Universal Health Services, Inc | Wellington Regional Medical Center

5 years

^[1]

Annual Minimum Rent

$ 3,030,000

End of Lease Term

2021-12

Universal Health Services, Inc | Southwest Healthcare System, Inland Valley Campus

10 years

^[2]

Annual Minimum Rent

$ 2,648,000

End of Lease Term

2021-12

10 years

^[2]

[1]	UHS has one 5-year renewal option at existing lease rates (through 2031).
[2]	UHS has two 5-year renewal options at fair market value lease rates (2022 through 2031).

Existing Lease Terms and Renewal Options for Each of UHS Hospital Facilities (Parenthetical) (Detail) - Universal Health Services, Inc	12 Months Ended
	Dec. 31, 2018 Time RenewalOption
Operating Leased Assets [Line Items]
Number of renewal option at existing lease rates	3
McAllen Medical Center
Operating Leased Assets [Line Items]
Number of renewal option at existing lease rates	1
Renewal option term at existing lease rates	5 years
Renewal option at existing lease rates expiration year	2031
Wellington Regional Medical Center And Southwest Healthcare System
Operating Leased Assets [Line Items]
Number of renewal options at fair market value lease rates \| RenewalOption	2
Renewal options term at fair market value lease rates	5 years
Wellington Regional Medical Center And Southwest Healthcare System \| Minimum
Operating Leased Assets [Line Items]
Renewal options at fair market value lease rates expiration year	2022
Wellington Regional Medical Center And Southwest Healthcare System \| Maximum
Operating Leased Assets [Line Items]
Renewal options at fair market value lease rates expiration year	2031

Acquisitions, Dispositions and Property Exchange Transaction - Additional Information (Detail)	1 Months Ended	3 Months Ended				12 Months Ended
	Mar. 31, 2017 USD ($)	Dec. 31, 2016 USD ($) ft² Option	Sep. 30, 2016 USD ($) ft²	Jun. 30, 2016 USD ($) ft²	Mar. 31, 2016 USD ($) ft²	Dec. 31, 2018 USD ($) Time	Dec. 31, 2017 USD ($) Time	Dec. 31, 2016 USD ($) ft² Property Option	Dec. 31, 2015 USD ($)	Sep. 30, 2017 USD ($)	Mar. 12, 2017
Business Acquisitions And Dispositions [Line Items]
Total purchase price							$ 9,000,000
Cash received from dispositions						$ 0	65,220,000	$ 0
Acquired intangible assets include in-place leases amortization period						6 years 7 months 6 days
Repayment of loan							21,400,000
Total cash paid								60,400,000
Non-recourse third-party debt		$ 7,100,000						$ 7,100,000
Fair-market value renewal option, term						5 years
Net intangible assets						$ 17,400,000
Intangible assets, accumulated amortization						$ 27,600,000	28,700,000
Minimum
Business Acquisitions And Dispositions [Line Items]
Acquired intangible assets include in-place leases amortization period						6 years
Maximum
Business Acquisitions And Dispositions [Line Items]
Number of term renewal options \| Option		5						5
Acquired intangible assets include in-place leases amortization period						12 years
In Place Leases
Business Acquisitions And Dispositions [Line Items]
Intangible asset, useful life						4 years 7 months 6 days
Acquired intangible assets include in-place leases amortization period						4 years 7 months 6 days
Intangible assets, accumulated amortization						$ 27,100,000
St. Mary's Professional Office Building
Business Acquisitions And Dispositions [Line Items]
Net cash proceeds received from divestiture										$ 57,300,000
Gain on divestiture of property							27,200,000
St. Mary's Professional Office Building \| Restricted Cash
Business Acquisitions And Dispositions [Line Items]
Net cash proceeds received from divestiture										$ 11,300,000
Arlington Medical Properties
Business Acquisitions And Dispositions [Line Items]
Total purchase price	$ 7,900,000
Ownership prior to minority interest purchase	85.00%
Remaining percentage owned by third party member											15.00%
Beaumont Medical Sleep Center Building
Business Acquisitions And Dispositions [Line Items]
Total purchase price						$ 4,100,000
Percentage of building area leased						100.00%
Initial lease terms						9 years 6 months
Number of term renewal options \| Time						2,000,000
Additional renewal terms						5 years
Las Palmas Del Sol Emergency Center in El Paso
Business Acquisitions And Dispositions [Line Items]
Total purchase price							$ 4,200,000
Percentage of building area leased							100.00%
Number of term renewal options \| Time							2
Additional renewal terms							5 years
Transaction costs							$ 60,000
Triple net lease agreement period							10 years
Intangible asset, useful life							9 years
The Health Center at Hamburg
Business Acquisitions And Dispositions [Line Items]
Total purchase price							$ 4,800,000
Percentage of building area leased							100.00%
Number of term renewal options \| Time							2
Additional renewal terms							5 years
Transaction costs							$ 96,000
Triple net lease agreement period							15 years
Intangible asset, useful life							8 years 6 months
2017 Acquisitions
Business Acquisitions And Dispositions [Line Items]
Acquired intangible assets include in-place leases amortization period						7 years 4 months 24 days
2704 North Tenaya Way and Frederick Memorial Hospital Crestwood
Business Acquisitions And Dispositions [Line Items]
Number of assets acquired \| Property								2
2704 North Tenaya Way
Business Acquisitions And Dispositions [Line Items]
Total purchase price		$ 15,300,000
Non-recourse third-party debt		$ 7,100,000						$ 7,100,000
Net rentable area \| ft²		45,000						45,000
2704 North Tenaya Way \| Lease Agreements
Business Acquisitions And Dispositions [Line Items]
Intangible asset, useful life		7 years 1 month 6 days
Frederick Memorial Hospital Crestwood
Business Acquisitions And Dispositions [Line Items]
Total purchase price			$ 24,300,000
Net rentable area \| ft²			62,300
Frederick Memorial Hospital Crestwood \| Lease Agreements
Business Acquisitions And Dispositions [Line Items]
Intangible asset, useful life			12 years
Chandler Corporate Center III
Business Acquisitions And Dispositions [Line Items]
Total purchase price				$ 18,000,000
Net rentable area \| ft²				82,000
Occupied percentage of property				92.00%
Lease rent escalation period				12 years
Fair-market value renewal option, term				10 years
Chandler Corporate Center III \| Lease Agreements
Business Acquisitions And Dispositions [Line Items]
Intangible asset, useful life				11 years 3 months 18 days
Madison Professional Office Building
Business Acquisitions And Dispositions [Line Items]
Total purchase price					$ 10,100,000
Net rentable area \| ft²					30,100
Deposits on real estate assets									$ 150,000
Madison Professional Office Building \| Lease Agreements
Business Acquisitions And Dispositions [Line Items]
Intangible asset, useful life					6 years 2 months 12 days

Allocation of Purchase Price to Assets Acquired and Liabilities Assumed (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
2017 Acquisitions
Business Acquisition [Line Items]
Land	$ 1,496
Buildings and improvements	8,434
Intangible assets	1,598
Below-market lease intangibles	(2,488)
Net cash paid	$ 9,040
2016 Acquisitions
Business Acquisition [Line Items]
Land		$ 9,914
Buildings and improvements		50,117
Intangible assets		9,211
Below-market lease intangibles		(1,287)
Deposit paid		(150)
Debt (including fair value adjustment of $362)		(7,499)
Financing fees paid on debt acquired		83
Net cash paid		$ 60,389

Leases - Additional Information (Detail)	12 Months Ended
Leases - Additional Information (Detail)	Dec. 31, 2018 USD ($) Property	Dec. 31, 2017 USD ($)	Dec. 31, 2016 USD ($) Option
Leases Disclosure [Line Items]
Fair-market value renewal option, term	5 years
Number of properties subject to ground leases \| Property	14
Amount of expenses relating to applicable leases \| $	$ 474,000	$ 460,000	$ 450,000
Minimum
Leases Disclosure [Line Items]
Operating Lease Terms	3 years
Maximum
Leases Disclosure [Line Items]
Operating Lease Terms	15 years
Number of term renewal options \| Option			5

Schedule of Minimum Future Base Rents from Non-cancelable Leases (Detail) $ in Thousands	Dec. 31, 2018 USD ($)
Leases [Abstract]
2019	$ 56,494
2020	50,291
2021	45,357
2022	30,089
2023	24,972
Thereafter	67,288
Total minimum base rents	$ 274,491

Schedule of Future Minimum Payments Under Ground Lease Commitments on Consolidated and Unconsolidated Leases (Detail) $ in Thousands	Dec. 31, 2018 USD ($)
Leases [Abstract]
2019	$ 474
2020	474
2021	474
2022	474
2023	474
Thereafter	25,582
Total ground lease expense	$ 27,952

Debt and Financial Instruments - Additional Information (Detail)

3 Months Ended

12 Months Ended

30 Months Ended

33 Months Ended

Mar. 27, 2018

USD ($)

Option

Sep. 30, 2016

USD ($)

Derivative

Jun. 30, 2016

USD ($)

Derivative

Dec. 31, 2018

USD ($)

MortgageLoan

Dec. 31, 2017

USD ($)

MortgageLoan

Dec. 31, 2016

USD ($)

Dec. 31, 2018

USD ($)

MortgageLoan

Dec. 31, 2018

USD ($)

MortgageLoan

Proceeds from Lines of Credit

$ 15,350,000

$ 59,350,000

Outstanding borrowings under revolving credit agreement

196,400,000

$ 181,050,000

$ 196,400,000

Available borrowing capacity

103,600,000

$ 103,600,000

Average amounts outstanding under our revolving credit agreement

$ 191,400,000

$ 182,400,000

$ 164,200,000

Effective interest rate

3.50%

2.80%

2.30%

3.50%

Line of credit, fair value of borrowings outstanding

$ 196,400,000

Balance of Non Recourse Mortgages

65,345,000

^[1]

$ 75,742,000

65,345,000

^[1]

65,345,000

^[1]

Interest Rate Cap

Number of interest rate cap agreements | Derivative

Notional amount

$ 30,000,000

Premium paid

$ 55,000

$ 115,000

Expiration date of interest rate cap

Mar. 31, 2019

Derivative interest rate cap, payment received or accrued from counterparties

145,000

Interest Rate Swap

Interest Rate Swaps Interest Rate Caps

Notional amount

60,000,000

Notional amount

$ 60,000,000

Level 2

Number of real property mortgages | MortgageLoan

Mortgage debt

$ 65,300,000

Mortgage loan fair value

64,900,000

$ 76,300,000

64,900,000

Number of non-recourse mortgages | MortgageLoan

Balance of Non Recourse Mortgages

$ 75,700,000

LIBOR | Interest Rate Cap

Derivative instruments, LIBOR rate

1.50%

Credit Agreement

$ 300,000,000

Credit Agreement

Increase in borrowing capacity

$ 300,000,000

$ 50,000,000

Unsecured revolving amended credit agreement terminated date

2022-03

Number of additional six month extension options | Option

Proceeds from Lines of Credit

$ 50,000,000

Credit facility, Interest Rate Terms

one, two, three, or six month LIBOR plus an applicable margin ranging from 1.10% to 1.35% or at the Base Rate plus an applicable margin ranging from 0.10% to 0.35%.

Base rate description

the greater of: (a) the administrative agent’s prime rate; (b) the federal funds effective rate plus 1/2 of 1%, and; (c) one month LIBOR plus 1%

Facility fee payable on commitment

0.20%

Credit Agreement | LIBOR

Credit Agreement | Base Rate

1.20%

Credit Agreement | Swingline/Short-Term Loans

0.20%

Credit Agreement | Letters of Credit

30,000,000

Credit Agreement | Minimum

$ 40,000,000

Facility fee payable on commitment

0.15%

Credit Agreement | Minimum | LIBOR

Margin points added to the base rate

1.10%

1.00%

Credit Agreement | Minimum | Base Rate

Credit Agreement | Minimum | Federal Funds Effective Rate

0.10%

Margin points added to the base rate

0.50%

Credit Agreement | Maximum

Facility fee payable on commitment

0.35%

Credit Agreement | Maximum | LIBOR

Credit Agreement | Maximum | Base Rate

1.35%

0.35%

[1]	All mortgage loans require monthly principal payments through maturity and either fully amortize or include a balloon principal payment upon maturity.

Summary of Required Compliance Ratios in Connection with Terms of Credit Agreements (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Covenant, Tangible net worth	$ 125,000	$ 136,170
Tangible net worth	$ 181,203	$ 190,002
Total leverage	41.30%	41.20%
Secured leverage	9.80%	11.70%
Unencumbered leverage	37.60%	37.70%
Fixed charge coverage	4.30%	3.80%
Maximum
Debt Instrument [Line Items]
Covenant, Total leverage	60.00%	60.00%
Covenant, Secured leverage	30.00%	30.00%
Covenant, Unencumbered leverage	60.00%	60.00%
Minimum
Debt Instrument [Line Items]
Covenant, Fixed charge coverage	1.50%	1.50%

Summary of Outstanding Mortgages, Excluding Net Debt Premium (Detail) - USD ($)
$ in Thousands

12 Months Ended

Dec. 31, 2018

Dec. 31, 2017

2033-09

Total mortgage notes payable, non-recourse to us, net

$ 65,345

^[1]

$ 75,742

Less net financing fees

(711)

^[1]

(680)

Plus net debt premium

247

^[1]

297

$ 64,881

^[1]

75,359

Sparks Medical Building/Vista Medical Terrace Floating Rate Mortgage Loan

^[2]

4.63%

^[2]

2018-02

Centennial Hills Medical Office Building Floating Rate Mortgage Loan

^[2]

4,130

^[3]

4.63%

^[3]

2018-04

Vibra Hospital-Corpus Christi Fixed Rate Mortgage Loan

^[3]

9,764

^[4]

6.50%

^[4]

2019-07

700 Shadow Lane and Goldring MOBs Fixed Rate Mortgage Loan

^[4]

$ 2,519

^[1]

2,624

4.54%

2022-06

BRB Medical Office Building Fixed Rate Mortgage Loan

$ 5,861

^[1]

6,059

4.27%

2022-12

Desert Valley Medical Center Fixed Rate Mortgage Loan

$ 5,928

^[1]

6,126

3.62%

2023-01

2704 North Tenaya Way Fixed Rate Mortgage Loan

$ 4,806

^[1]

4,946

4.95%

2023-11

Summerlin Hospital Medical Office Building III Fixed Rate Mortgage Loan

$ 6,871

^[1]

7,007

4.03%

2024-04

Tuscan Professional Building Fixed Rate Mortgage Loan

$ 13,198

^[1]

13,199

5.56%

2025-06

Phoenix Children’s East Valley Care Center Fixed Rate Mortgage Loan

$ 4,020

^[1]

4,519

3.95%

2030-01

Rosenberg Children's Medical Plaza Fixed Rate Mortgage Loan

$ 9,194

^[1]

9,400

^[5]

4.42%

^[5]

2033-09

^[5]

$ 12,948

^[1]

$ 7,968

[1]	All mortgage loans require monthly principal payments through maturity and either fully amortize or include a balloon principal payment upon maturity.
[2]	On February 13, 2018, upon its maturity, a $4.1 million floating rate mortgage loan on the Sparks Medical Building/Vista Medical Terrace was fully repaid utilizing borrowings under our Credit Agreement.
[3]	On April 5, 2018, upon its maturity, a $9.7 million floating rate mortgage loan on the Centennial Hills Medical Office Building was fully repaid utilizing borrowings under our Credit Agreement.
[4]	Notice has been provided to the lender to prepay the loan on April 2, 2019 without penalty. We will repay the balance utilizing borrowings under our Credit Agreement.
[5]	On May 2, 2018, upon its maturity, a $7.9 million fixed rate mortgage loan on the Rosenberg Children’s Medical Plaza was fully repaid utilizing borrowings under our Credit Agreement. In August, 2018, we refinanced this property with a $13.0 million fixed rate mortgage, with a maturity date of September, 2033.

Summary of Outstanding Mortgages, Excluding Net Debt Premium (Parenthetical) (Detail) - USD ($)
$ in Thousands

1 Months Ended

12 Months Ended

May 02, 2018

Apr. 05, 2018

Feb. 13, 2018

Aug. 31, 2018

Dec. 31, 2018

Dec. 31, 2017

Dec. 31, 2016

Proceeds from mortgage notes payable

$ 23,397

$ 61,021

$ 3,230

$ 13,000

$ 22,600

Sparks Medical Building/Vista Medical Terrace Floating Rate Mortgage Loan

2033-09

$ 4,100

Centennial Hills Medical Office Building Floating Rate Mortgage Loan

^[1]

2018-02

$ 9,700

Rosenberg Children's Medical Plaza Fixed Rate Mortgage Loan

^[2]

2018-04

$ 7,900

^[3]

2033-09

[1]	On February 13, 2018, upon its maturity, a $4.1 million floating rate mortgage loan on the Sparks Medical Building/Vista Medical Terrace was fully repaid utilizing borrowings under our Credit Agreement.
[2]	On April 5, 2018, upon its maturity, a $9.7 million floating rate mortgage loan on the Centennial Hills Medical Office Building was fully repaid utilizing borrowings under our Credit Agreement.
[3]	On May 2, 2018, upon its maturity, a $7.9 million fixed rate mortgage loan on the Rosenberg Children’s Medical Plaza was fully repaid utilizing borrowings under our Credit Agreement. In August, 2018, we refinanced this property with a $13.0 million fixed rate mortgage, with a maturity date of September, 2033.

Aggregate Consolidated Scheduled Debt Repayment (Detail)
$ in Thousands

Dec. 31, 2018

USD ($)

Debt Disclosure [Abstract]

$ 4,199

1,913

2,081

208,597

^[1]

2023

11,892

Later

33,063

$ 261,745

[1]	Includes repayment of $196.4 million of outstanding borrowings under the terms of our $300 million revolving credit agreement

Aggregate Consolidated Scheduled Debt Repayment (Parenthetical) (Detail) - USD ($)	Dec. 31, 2018	Dec. 31, 2017
Schedule Of Equity Method Investments [Line Items]
Line of credit borrowings	$ 196,400,000	$ 181,050,000
New Revolving Credit Facility Agreement
Schedule Of Equity Method Investments [Line Items]
Outstanding borrowing	$ 300,000,000

The carrying value as of the balance sheet date of the current and noncurrent portions of long-term obligations drawn from a line of credit, which is a bank's commitment to make loans up to a specific amount. Examples of items that might be included in the application of this element may consist of letters of credit, standby letters of credit, and revolving credit arrangements, under which borrowings can be made up to a maximum amount as of any point in time conditional on satisfaction of specified terms before, as of and after the date of drawdowns on the line. Includes short-term obligations that would normally be classified as current liabilities but for which (a) postbalance sheet date issuance of a long term obligation to refinance the short term obligation on a long term basis, or (b) the enterprise has entered into a financing agreement that clearly permits the enterprise to refinance the short-term obligation on a long term basis and the following conditions are met (1) the agreement does not expire within 1 year and is not cancelable by the lender except for violation of an objectively determinable provision, (2) no violation exists at the BS date, and (3) the lender has entered into the financing agreement is expected to be financially capable of honoring the agreement.

Schedule Of Equity Method Investments [Line Items]

Dividends and Equity Issuance Program - Additional Information (Detail) - USD ($)	3 Months Ended	12 Months Ended			63 Months Ended
	Jun. 30, 2016	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2018	Sep. 30, 2017
Dividends and Equity Issuance [Line Items]
Declared and paid dividends, per share		$ 2.68	$ 2.64	$ 2.60
Ordinary income per share		2.35	1.47	2.00
Capital gain per share		$ 0.33	$ 1.17	$ 0.60
Securities, aggregate sales price		$ 23,300,000			$ 23,300,000
At-The-Market Equity Issuance Program (ATM)
Dividends and Equity Issuance [Line Items]
Aggregate sales of threshold amount						$ 23,300,000
Share issued	249,016	0	127,499	249,016	957,415
Average sale price per share	$ 55.30		$ 74.71	$ 55.30	$ 52.22
Net cash proceeds from stock issued			$ 9,100,000	$ 13,200,000	$ 47,900,000
Payment of stock issuance cost			400,000	558,000	2,100,000
Payments for stock issuance			238,000	344,000	1,250,000
At-The-Market Equity Issuance Program (ATM) \| Other Expense
Dividends and Equity Issuance [Line Items]
Payments for stock issuance			$ 162,000	$ 214,000	$ 840,000
Capital gain
Dividends and Equity Issuance [Line Items]
Unrecaptured Section 1250 gain dividends per share		$ 0.30	$ 0.453

Incentive Plans - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Equity Incentive Plan [Line Items]
Number of options outstanding	0	0	0	23,000
Number of stock options exercised during the period, shares	0	0	23,000
Value of stock options exercised during the period			$ 520,420
Incentive Plan 2007
Equity Incentive Plan [Line Items]
Number of shares authorized for issuance	125,000
Shares issued, net of cancellation	95,295
Number of shares vested	76,310
Number of shares remaining for issuance	29,705
Restricted shares issued, net of cancellation	10,580	8,405	8,755
Restricted shares issued, weighted average grant price	$ 61.77	$ 73.46	$ 56.34
Restricted shares of beneficial interest, net of cancellations, issued, value	$ 653,526	$ 617,431	$ 493,257
Restricted shares, Vesting Period	2020-06	2019-06	2018-06
Compensation expenses	$ 571,000	$ 538,000	$ 481,000
Compensation expenses remained to be recognized in future	$ 592,000
Compensation expenses not yet recognized, period of recognition	1 year
1997 Plan
Equity Incentive Plan [Line Items]
Compensation expenses	$ 0	$ 0
Options granted, vesting percentage per year starting from one year from date of grant		25.00%
Options, expiration period		10 years
Number of options outstanding		0	0

Options Before Adjustment to Option Price to Give Effect to Dilutive Equivalence (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of Shares, Outstanding Options, Beginning balance	0	0	23,000
Number of Shares, Outstanding Options, Exercised	0	0	(23,000)
Number of Shares, Outstanding Options, Ending balance	0	0	0
Exercise Weighted-Average Price, Outstanding Options, Beginning balance			$ 36.53
Exercise Weighted-Average Price, Outstanding Options, Exercised			36.53
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Grant Price, Outstanding Options, Beginning balance			36.53
Grant Price, Outstanding Options, Exercised			36.53
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Grant Price, Outstanding Options, Beginning balance			36.53
Grant Price, Outstanding Options, Exercised			$ 36.53

Summarized Financial Information of Equity Affiliates - Additional Information (Detail) - Property	12 Months Ended
	Dec. 31, 2018	Mar. 31, 2017	Mar. 12, 2017
Arlington Medical Properties
Schedule Of Equity Method Investments [Line Items]
Non-controlling equity interest, ownership percentage		85.00%
Remaining percentage owned by third party member			15.00%
Limited Liability Companies \| Medical office buildings
Schedule Of Equity Method Investments [Line Items]
Number of real estate investments	4
Minimum
Schedule Of Equity Method Investments [Line Items]
Number of days for Non-Offering Member either to purchase or sell its entire ownership interest to or from Offering Member	60 days
Maximum
Schedule Of Equity Method Investments [Line Items]
Number of days for Non-Offering Member either to purchase or sell its entire ownership interest to or from Offering Member	90 days
4 Unconsolidated Limited Liability Companies / Limited Partner \| Minimum
Schedule Of Equity Method Investments [Line Items]
Non-controlling equity interest, ownership percentage	33.00%
4 Unconsolidated Limited Liability Companies / Limited Partner \| Maximum
Schedule Of Equity Method Investments [Line Items]
Non-controlling equity interest, ownership percentage	95.00%

Limited Liability Companies Accounted for Under Equity Method (Detail) - Equity Method Investments

12 Months Ended

Dec. 31, 2018

Suburban Properties

33.00%

Schedule Of Equity Method Investments [Line Items]

St. Matthews Medical Plaza II

Brunswick Associates

74.00%

^[1],[2]

Schedule Of Equity Method Investments [Line Items]

Mid Coast Hospital MOB

^[1],[2]

Grayson Properties

95.00%

^[3],[4]

FTX MOB Phase II limited partnership

Texoma Medical Plaza

^[3],[4]

Schedule Of Equity Method Investments [Line Items]

95.00%

^[5]

Equity Method Investments And Joint Ventures [Abstract]

Forney Medical Plaza II

^[5]

[1]	At December 31, 2018, we are the lessee with a third party on a ground lease for land.
[2]	This LLC has a third-party term loan of $8.3 million, which is non-recourse to us, outstanding as of December 31, 2018.
[3]	At December 31, 2018, we are the lessee with a UHS-related party on a ground lease for land.
[4]	This building is on the campus of a UHS hospital and has tenants that include subsidiaries of UHS. This LP has a third-party term loan of $13.9 million, which is non-recourse to us, outstanding as of December 31, 2018.
[5]	We have committed to invest up to $2.5 million in equity and debt financing, of which $2.1 million has been funded as of December 31, 2018. This LP has a third-party term loan of $5.1 million, which is non-recourse to us, outstanding as of December 31, 2018.

Limited Liability Companies Accounted for Under Equity Method (Parenthetical) (Detail) $ in Millions	Dec. 31, 2018 USD ($)
Brunswick Associates
Schedule Of Equity Method Investments [Line Items]
Third-party term loan	$ 8.3
Grayson Properties
Schedule Of Equity Method Investments [Line Items]
Third-party term loan	13.9
FTX MOB Phase II limited partnership
Schedule Of Equity Method Investments [Line Items]
Third-party term loan	5.1
Committed investment in equity and debt financing, funded	2.5
Commitment to investment	$ 2.1

Combined Statements of Income for LLCs/LPs Accounted Under Equity Method (Detail) - USD ($)
$ in Thousands

12 Months Ended

Dec. 31, 2018

Dec. 31, 2017

Dec. 31, 2016

Revenues

$ 9,592

$ 10,673

$ 15,252

Operating expenses

3,557

3,883

5,439

Depreciation and amortization

1,772

1,988

2,554

Interest, net

1,311

1,570

2,565

Net income

2,952

3,232

4,694

Our share of net income

^[1]

$ 1,771

$ 2,416

$ 4,456

[1]	Our share of net income during 2017 and 2016 includes approximately $284,000 and, $1.2 million , respectively, of interest income earned by us on an advance made to Arlington Medical Properties, LLC.

This item represents the entity's proportionate share for the period of the net income (loss) of its investee (such as unconsolidated subsidiaries and joint ventures) to which the equity method of accounting is applied. This item includes income or expense related to stock-based compensation based on the investor's grant of stock to employees of an equity method investee.

Schedule Of Equity Method Investments [Line Items]

Combined Balance Sheets for LLCs Accounted Under Equity Method (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Equity Method Investments And Joint Ventures [Abstract]
Net property, including construction in progress	$ 31,818	$ 33,111
Other assets	3,251	3,560
Total assets	35,069	36,671
Other liabilities	2,717	3,067
Mortgage notes payable, non-recourse to us	27,256	27,839
Equity	5,096	5,765
Total liabilities and equity	35,069	36,671
Investments in LLCs before amounts included in accrued expenses and other liabilities	5,019	4,671
Amounts included in accrued expenses and other liabilities	(2,258)	(1,895)
Our share of equity in LLCs, net	$ 2,761	$ 2,776

Aggregate Principal Amounts Due on Mortgage Notes Payable by Unconsolidated LLCs, Accounted Under Equity Method (Detail) - USD ($)
$ in Thousands

12 Months Ended

Dec. 31, 2018

Dec. 31, 2017

$ 4,199

1,913

2,081

^[1]

208,597

2023

11,892

2024 and thereafter

33,063

261,745

$ 27,256

$ 27,839

Equity Method Investments

2033-09

Schedule Of Equity Method Investments [Line Items]

$ 621

5,419

13,557

216

224

7,219

27,256

Equity Method Investments | FTX MOB Phase II

^[2]

27,256

27,839

Schedule Of Equity Method Investments [Line Items]

^[2]

$ 5,067

5,202

Equity Method Investments | Grayson Properties

^[2]

2020-10

Schedule Of Equity Method Investments [Line Items]

^[2]

$ 13,929

14,191

Equity Method Investments | Brunswick Associates

2021-09

Schedule Of Equity Method Investments [Line Items]

^[2]

$ 8,260

$ 8,446

2024-12

[1]	Includes repayment of $196.4 million of outstanding borrowings under the terms of our $300 million revolving credit agreement
[2]	All mortgage loans require monthly principal payments through maturity and include a balloon principal payment upon maturity.

Aggregate Principal Amounts Due on Mortgage Notes Payable by Unconsolidated LLCs, Accounted Under Equity Method (Parenthetical) (Detail)	Dec. 31, 2018
5.00% Fixed Rate Mortgage Loan \| FTX MOB Phase II
Schedule Of Equity Method Investments [Line Items]
Loan interest rate fixed percentage	5.00%
5.034% Fixed Rate Mortgage Loan \| Grayson Properties
Schedule Of Equity Method Investments [Line Items]
Loan interest rate fixed percentage	5.034%
3.64% Fixed Rate Mortgage Loan \| Brunswick Associates
Schedule Of Equity Method Investments [Line Items]
Loan interest rate fixed percentage	3.64%

Impact of Hurricane Harvey - Additional Information (Detail)	3 Months Ended			4 Months Ended	10 Months Ended	12 Months Ended
	Jun. 30, 2018 USD ($)	Mar. 31, 2018 USD ($)	Dec. 31, 2017 USD ($)	Dec. 31, 2017 USD ($)	Jun. 30, 2018 USD ($)	Dec. 31, 2018 USD ($)	Dec. 31, 2017 USD ($)	Aug. 31, 2017 Building
Unusual Or Infrequent Item [Line Items]
Hurricane related insurance recoveries	$ 194,000	$ 968,000				$ 1,162,000
Hurricane related expenses							$ 4,967,000
Hurricane insurance recoveries in excess of property damage write-downs		$ 4,535,000	$ 2,033,000			4,535,000	2,033,000
Hurricane Harvey, Extensive Water Damage \| Houston, Texas
Unusual Or Infrequent Item [Line Items]
Number of medical office buildings \| Building								5
Hurricane Harvey
Unusual Or Infrequent Item [Line Items]
Additional insurance recovery proceeds						5,500,000
Hurricane related insurance recoveries						12,500,000	7,000,000
Hurricane related expenses							5,000,000
Property damage expenses							3,600,000
Remediation and demolition expenses							1,400,000
Hurricane insurance recoveries in excess of property damage write-downs							$ 2,000,000
Hurricane Harvey \| Business Interruption
Unusual Or Infrequent Item [Line Items]
Hurricane related insurance recoveries					$ 1,200,000
Hurricane insurance recoveries in excess of property damage write-downs						$ 4,500,000
Hurricane Harvey \| 2017 business interruption
Unusual Or Infrequent Item [Line Items]
Hurricane related insurance recoveries				$ 500,000

Quarterly Results (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Quarterly Financial Information Disclosure [Abstract]
Revenues	$ 18,732	$ 18,828	$ 20,111	$ 18,539	$ 18,259	$ 18,194	$ 18,145	$ 17,750	$ 76,210	$ 72,348	$ 67,081
Net income before gain and excess insurance recovery proceeds	4,413	4,374	5,611	4,101	4,031	3,960	4,033	4,366	18,499	16,390
Gain on Arlington transaction								27,196		27,196
Hurricane insurance recovery proceeds in excess of damaged property write-downs				4,535	2,033				4,535	2,033
Hurricane business interruption insurance recovery proceeds			194	968					1,162
Net income	$ 4,413	$ 4,374	$ 5,805	$ 9,604	$ 6,064	$ 3,960	$ 4,033	$ 31,562	$ 24,196	$ 45,619	$ 17,215
Total basic earnings per share	$ 0.32	$ 0.32	$ 0.42	$ 0.70	$ 0.44	$ 0.29	$ 0.30	$ 2.32	$ 1.76	$ 3.35	$ 1.28
Total diluted earnings per share	$ 0.32	$ 0.32	$ 0.42	$ 0.70	$ 0.44	$ 0.29	$ 0.30	$ 2.32	$ 1.76	$ 3.35	$ 1.28

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

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+ Details

The amount of net income (loss) for the period available to each share of common stock or common unit outstanding during the reporting period and to each share or unit that would have been outstanding assuming the issuance of common shares or units for all dilutive potential common shares or units outstanding during the reporting period.

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+ Details

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

Real Estate and Accumulated Depreciation [Line Items]

Schedule III Real Estate and Accumulated Depreciation (Detail) - USD ($)
$ in Thousands

12 Months Ended

Dec. 31, 2018

Dec. 31, 2017

Dec. 31, 2016

Dec. 31, 2015

^[1],[2]

$ 65,345

^[2]

50,556

^[2]

481,821

^[2],[3]

77,058

^[2]

53,396

^[2]

556,039

^[2]

1,611

611,046

^[2]

$ 599,776

$ 585,828

$ 511,657

Inland Valley Regional Medical Center Wildomar, California

173,316

^[2]

$ 153,379

Real Estate and Accumulated Depreciation [Line Items]

2,050

10,701

^[3]

14,596

2,050

25,297

27,347

Date of Completion of Construction, Acquisition or Significant Improvement

$ 14,017

2007

1986

McAllen Medical Center McAllen, Texas

43 years

Real Estate and Accumulated Depreciation [Line Items]

$ 4,720

31,442

^[3]

10,189

6,281

40,070

46,351

Date of Completion of Construction, Acquisition or Significant Improvement

$ 28,166

1994

1986

Wellington Regional Medical Center West Palm Beach, Florida

42 years

Real Estate and Accumulated Depreciation [Line Items]

$ 1,190

14,652

^[3]

17,370

1,663

31,549

33,212

Date of Completion of Construction, Acquisition or Significant Improvement

$ 20,561

2006

1986

HealthSouth Deaconess Rehabilitation Hospital Evansville, Indiana

42 years

Real Estate and Accumulated Depreciation [Line Items]

$ 500

6,945

^[3]

1,062

500

8,007

8,507

Date of Completion of Construction, Acquisition or Significant Improvement

$ 5,881

1993

1989

Kindred Chicago Central Hospital Central Chicago, Illinois

40 years

Real Estate and Accumulated Depreciation [Line Items]

$ 158

6,404

^[3]

1,838

158

8,242

8,400

Date of Completion of Construction, Acquisition or Significant Improvement

$ 8,242

1993

1986

Family Doctor's Medical Office Building Shreveport, Louisiana

25 years

Real Estate and Accumulated Depreciation [Line Items]

$ 54

1,526

^[3]

494

2,020

2,074

Date of Completion of Construction, Acquisition or Significant Improvement

$ 1,092

1991

1995

Kelsey-Seybold Clinic at King's Crossing Kingwood, Texas

45 years

Real Estate and Accumulated Depreciation [Line Items]

^[4]

$ 439

^[4]

1,618

^[3],[4]

(1,209)

^[4]

439

^[4]

409

^[4]

848

Date of Completion of Construction, Acquisition or Significant Improvement

^[4]

$ 10

^[4]

1995

^[4]

1995

Professional Buildings at King's Crossing Kingwood, Texas

^[4]

45 years

Real Estate and Accumulated Depreciation [Line Items]

^[4]

$ 439

^[4]

1,837

^[3],[4]

(395)

^[4]

439

^[4]

1,442

^[4]

1,881

Date of Completion of Construction, Acquisition or Significant Improvement

^[4]

$ 63

^[4]

1995

^[4]

1995

Chesterbrook Academy Audubon, Pennsylvania

^[4]

45 years

Real Estate and Accumulated Depreciation [Line Items]

$ 307

996

307

996

1,303

Date of Completion of Construction, Acquisition or Significant Improvement

$ 498

1996

1996

Chesterbrook Academy New Britain, Pennsylvania

45 years

Real Estate and Accumulated Depreciation [Line Items]

$ 250

744

250

744

994

Date of Completion of Construction, Acquisition or Significant Improvement

$ 377

1991

1996

Chesterbrook Academy Uwchlan, Pennsylvania

45 years

Real Estate and Accumulated Depreciation [Line Items]

$ 180

815

180

815

995

Date of Completion of Construction, Acquisition or Significant Improvement

$ 410

1992

1996

Chesterbrook Academy Newtown, Pennsylvania

45 years

Real Estate and Accumulated Depreciation [Line Items]

$ 195

749

195

749

944

Date of Completion of Construction, Acquisition or Significant Improvement

$ 379

1992

1996

The Southern Crescent Center I

45 years

Real Estate and Accumulated Depreciation [Line Items]

^[5]

$ 1,130

^[5]

5,092

^[3],[5]

(2,271)

^[5]

1,130

^[5]

2,821

^[5]

3,951

Date of Completion of Construction, Acquisition or Significant Improvement

^[5]

$ 2,529

^[5]

1994

^[5]

1996

The Southern Crescent Center II Riverdale, Georgia

^[5]

45 years

Real Estate and Accumulated Depreciation [Line Items]

^[3],[5]

$ 5,213

^[5]

806

^[5]

4,407

^[5]

5,213

Date of Completion of Construction, Acquisition or Significant Improvement

^[5]

$ 2,723

^[5]

2000

^[5]

1998

The Cypresswood Professional Center Spring, Texas

^[5]

35 years

Real Estate and Accumulated Depreciation [Line Items]

^[6]

$ 573

^[6]

3,842

^[3],[6]

(2,667)

^[6]

573

^[6]

1,175

^[6]

1,748

Date of Completion of Construction, Acquisition or Significant Improvement

^[6]

$ 53

^[6]

1997

^[6]

1997

701 South Tonopah Building Las Vegas, Nevada

^[6]

35 years

Real Estate and Accumulated Depreciation [Line Items]

^[7]

$ 1,579

^[3],[7]

^[7]

1,647

^[7]

1,647

Date of Completion of Construction, Acquisition or Significant Improvement

^[7]

$ 1,225

^[7]

1999

^[7]

1999

Danbury Medical Plaza Danbury, Connecticut

^[7]

25 years

Real Estate and Accumulated Depreciation [Line Items]

$ 1,151

5,176

^[3]

1,042

1,151

6,218

7,369

Date of Completion of Construction, Acquisition or Significant Improvement

$ 3,783

2000

2000

Vibra Hospital of Corpus Christi Corpus Christi, Texas

30 years

Real Estate and Accumulated Depreciation [Line Items]

^[1]

$ 2,519

1,104

5,508

1,104

5,508

6,612

Date of Completion of Construction, Acquisition or Significant Improvement

$ 1,714

2008

2008

Apache Junction Medical Plaza Apache Junction, AZ

35 years

Real Estate and Accumulated Depreciation [Line Items]

$ 240

3,590

^[3]

1,210

240

4,800

5,040

Date of Completion of Construction, Acquisition or Significant Improvement

$ 1,625

2004

2004

Auburn Medical Office Building II Auburn, WA

30 years

Real Estate and Accumulated Depreciation [Line Items]

^[8]

$ 10,200

^[3],[8]

176

^[8]

10,376

^[8]

10,376

Date of Completion of Construction, Acquisition or Significant Improvement

^[8]

$ 2,399

^[8]

2009

^[8]

2009

BRB Medical Office Building Kingwood, Texas

^[8]

36 years

Real Estate and Accumulated Depreciation [Line Items]

^[1]

$ 5,928

430

8,970

^[3]

430

9,021

9,451

Date of Completion of Construction, Acquisition or Significant Improvement

$ 2,056

2010

2010

Centennial Hills Medical Office Building Las Vegas, NV

37 years

Real Estate and Accumulated Depreciation [Line Items]

^[7]

$ 19,890

^[3],[7]

1,994

^[7]

21,884

^[7]

^[7]

21,886

Date of Completion of Construction, Acquisition or Significant Improvement

^[7]

$ 5,526

^[7]

2006

^[7]

2006

Desert Springs Medical Plaza Las Vegas, NV

^[7]

34 years

Real Estate and Accumulated Depreciation [Line Items]

$ 1,200

9,560

^[3]

1,438

1,200

10,998

124

12,322

Date of Completion of Construction, Acquisition or Significant Improvement

$ 3,172

1998

1998

700 Shadow Lane & Goldring MOBs Las Vegas, NV

30 years

Real Estate and Accumulated Depreciation [Line Items]

^[1]

$ 5,861

400

11,300

^[3]

3,701

400

15,001

717

16,118

Date of Completion of Construction, Acquisition or Significant Improvement

$ 4,360

2003

2003

Spring Valley Hospital MOB I Las Vegas, NV

30 years

Real Estate and Accumulated Depreciation [Line Items]

^[7]

$ 9,500

^[3],[7]

1,231

^[7]

10,731

^[7]

^[7]

10,815

Date of Completion of Construction, Acquisition or Significant Improvement

^[7]

$ 2,774

^[7]

2004

^[7]

2004

Spring Valley Hospital MOB II Las Vegas, NV

^[7]

35 years

Real Estate and Accumulated Depreciation [Line Items]

^[7]

$ 9,800

^[3],[7]

503

^[7]

10,303

^[7]

10,303

Date of Completion of Construction, Acquisition or Significant Improvement

^[7]

$ 2,705

^[7]

2006

^[7]

2006

Summerlin Hospital MOB I Las Vegas, NV

^[7]

34 years

Real Estate and Accumulated Depreciation [Line Items]

$ 460

15,440

^[3]

1,790

460

17,230

17,703

Date of Completion of Construction, Acquisition or Significant Improvement

$ 4,827

1999

1999

Summerlin Hospital MOB II Las Vegas, NV

30 years

Real Estate and Accumulated Depreciation [Line Items]

$ 370

16,830

^[3]

1,484

370

18,314

18,696

Date of Completion of Construction, Acquisition or Significant Improvement

$ 5,139

2000

2000

Summerlin Hospital MOB III Las Vegas, NV

30 years

Real Estate and Accumulated Depreciation [Line Items]

^[1],[7]

$ 13,198

^[7]

14,900

^[3],[7]

2,176

^[7]

17,076

^[7]

^[7]

17,124

Date of Completion of Construction, Acquisition or Significant Improvement

^[7]

$ 3,825

^[7]

2009

^[7]

2009

Emory at Dunwoody Building Dunwoody, GA

^[7]

36 years

Real Estate and Accumulated Depreciation [Line Items]

$ 782

3,455

782

3,455

4,237

Date of Completion of Construction, Acquisition or Significant Improvement

$ 920

2011

2011

Forney Medical Plaza Forney, TX

35 years

Real Estate and Accumulated Depreciation [Line Items]

$ 910

11,960

^[3]

910

12,017

12,927

Date of Completion of Construction, Acquisition or Significant Improvement

$ 3,417

2011

2011

Lake Pointe Medical Arts Building Rowlett, TX

35 years

Real Estate and Accumulated Depreciation [Line Items]

$ 1,100

9,000

^[3]

144

1,100

9,144

10,244

Date of Completion of Construction, Acquisition or Significant Improvement

$ 2,304

2011

2011

Tuscan Professional Building Irving, TX

35 years

Real Estate and Accumulated Depreciation [Line Items]

^[1]

$ 4,020

1,100

12,525

^[3]

1,475

1,100

14,000

122

15,222

Date of Completion of Construction, Acquisition or Significant Improvement

$ 3,335

2011

2011

Peace Health Medical Clinic Bellingham, WA

35 years

Real Estate and Accumulated Depreciation [Line Items]

$ 1,900

24,910

1,900

24,910

26,810

Date of Completion of Construction, Acquisition or Significant Improvement

$ 5,846

2012

2012

Northwest Texas Professional Office Tower Amarillo TX

35 years

Real Estate and Accumulated Depreciation [Line Items]

^[7]

$ 7,180

^[3],[7]

^[7]

7,229

^[7]

7,229

Date of Completion of Construction, Acquisition or Significant Improvement

^[7]

$ 1,450

^[7]

2012

^[7]

2012

Ward Eagle Office Village Farmington Hills MI

^[7]

35 years

Real Estate and Accumulated Depreciation [Line Items]

$ 220

3,220

^[3]

220

3,283

3,503

Date of Completion of Construction, Acquisition or Significant Improvement

$ 645

2013

2013

5004 Poole Road Medical Office Building Denison, TX

35 years

Real Estate and Accumulated Depreciation [Line Items]

$ 96

529

529

625

Date of Completion of Construction, Acquisition or Significant Improvement

$ 99

2013

2013

Desert Valley Medical Center Phoenix AZ

35 years

Real Estate and Accumulated Depreciation [Line Items]

^[1]

$ 4,806

2,280

4,624

^[3]

958

2,280

5,582

7,867

Date of Completion of Construction, Acquisition or Significant Improvement

$ 1,038

1996

1996

Hanover Emergency Center Mechanicsville, VA

30 years

Real Estate and Accumulated Depreciation [Line Items]

$ 1,300

6,224

1,300

6,224

7,524

Date of Completion of Construction, Acquisition or Significant Improvement

$ 908

2014

2014

Haas Medical Office Park Ottumwa, IA

35 years

Real Estate and Accumulated Depreciation [Line Items]

^[8]

$ 3,571

^[8]

3,571

^[8]

3,571

Date of Completion of Construction, Acquisition or Significant Improvement

^[8]

$ 463

^[8]

2015

^[8]

2015

South Texas ER at Mission, Mission, TX

^[8]

35 years

Real Estate and Accumulated Depreciation [Line Items]

$ 1,441

4,696

1,441

4,696

6,137

Date of Completion of Construction, Acquisition or Significant Improvement

$ 616

2015

2015

North Valley Medical Plaza Phoenix, AZ

35 years

Real Estate and Accumulated Depreciation [Line Items]

$ 930

6,929

^[3]

1,856

930

8,785

301

10,016

Date of Completion of Construction, Acquisition or Significant Improvement

$ 1,450

2010

2010

Northwest Medical Center at Sugar Creek, Bentonville, AR

30 years

Real Estate and Accumulated Depreciation [Line Items]

$ 1,100

2,870

1,100

2,870

3,970

Date of Completion of Construction, Acquisition or Significant Improvement

$ 478

2014

2014

The Children's Clinic at Springdale, Springdale, AR

35 years

Real Estate and Accumulated Depreciation [Line Items]

$ 610

1,570

610

1,570

2,180

Date of Completion of Construction, Acquisition or Significant Improvement

$ 262

2014

2014

Rosenberg Children's Medical Plaza, Phoenix, AZ

35 years

Real Estate and Accumulated Depreciation [Line Items]

^[1],[8]

$ 12,948

^[8]

23,302

^[3],[8]

^[8]

23,336

^[8]

23,336

Date of Completion of Construction, Acquisition or Significant Improvement

^[8]

$ 3,468

^[8]

2001

^[8]

2001

Phoenix Children's East Valley Care Center, Phoenix, AZ

^[8]

35 years

Real Estate and Accumulated Depreciation [Line Items]

^[1]

$ 9,194

1,050

10,900

1,050

10,900

11,950

Date of Completion of Construction, Acquisition or Significant Improvement

$ 1,616

2006

2006

Palmdale Medical Plaza, Palmdale, CA

35 years

Real Estate and Accumulated Depreciation [Line Items]

^[7]

$ 10,555

^[3],[7]

1,745

^[7]

12,300

^[7]

^[7]

12,367

Date of Completion of Construction, Acquisition or Significant Improvement

^[7]

$ 2,105

^[7]

2008

^[7]

2008

Piedmont-Roswell Physician Center Sandy Springs, GA

^[7]

34 years

Real Estate and Accumulated Depreciation [Line Items]

$ 2,338

2,128

2,338

2,128

4,466

Date of Completion of Construction, Acquisition or Significant Improvement

$ 336

2015

2015

Piedmont-Vinings Physician Center Vinings, GA

30 years

Real Estate and Accumulated Depreciation [Line Items]

$ 1,348

2,418

1,348

2,418

3,766

Date of Completion of Construction, Acquisition or Significant Improvement

$ 369

2015

2015

Santa Fe Professional Plaza Scottsdale, AZ

30 years

Real Estate and Accumulated Depreciation [Line Items]

$ 1,090

1,960

^[3]

382

1,090

2,342

3,445

Date of Completion of Construction, Acquisition or Significant Improvement

$ 491

1999

1999

Sierra San Antonio Medical Plaza Fontana, CA

30 years

Real Estate and Accumulated Depreciation [Line Items]

^[8]

$ 11,538

^[3],[8]

692

^[8]

12,230

^[8]

^[8]

12,328

Date of Completion of Construction, Acquisition or Significant Improvement

^[8]

$ 2,090

^[8]

2006

^[8]

2006

Vista Medical Terrace & Sparks MOB Sparks, NV

^[8]

30 years

Real Estate and Accumulated Depreciation [Line Items]

^[7]

$ 9,276

^[3],[7]

1,349

^[7]

10,625

^[7]

10,625

Date of Completion of Construction, Acquisition or Significant Improvement

^[7]

$ 2,287

^[7]

2008

^[7]

2008

South Texas ER at Weslaco, Weslaco, TX

^[7]

30 years

Real Estate and Accumulated Depreciation [Line Items]

$ 1,749

4,879

1,749

4,879

6,628

Date of Completion of Construction, Acquisition or Significant Improvement

$ 649

2015

2015

Chandler Corporate Center III Chandler, AZ

35 years

Real Estate and Accumulated Depreciation [Line Items]

$ 2,328

14,131

2,328

14,131

16,459

Date of Completion of Construction, Acquisition or Significant Improvement

$ 1,731

2016

2016

Frederick Crestwood MOB Frederick, MD

35 years

Real Estate and Accumulated Depreciation [Line Items]

$ 2,265

18,731

2,265

18,731

20,996

Date of Completion of Construction, Acquisition or Significant Improvement

$ 1,662

2016

2016

Madison Professional Office Building Madison, AL

35 years

Real Estate and Accumulated Depreciation [Line Items]

$ 2,296

6,411

2,296

6,411

8,707

Date of Completion of Construction, Acquisition or Significant Improvement

$ 730

2016

2016

Tenaya Medical Office Building Las Vegas, NV

35 years

Real Estate and Accumulated Depreciation [Line Items]

^[1]

$ 6,871

3,032

10,602

3,032

10,602

13,634

Date of Completion of Construction, Acquisition or Significant Improvement

$ 845

2016

2016

Henderson Medical Plaza Henderson, NV

35 years

Real Estate and Accumulated Depreciation [Line Items]

^[7]

$ 10,718

^[3],[7]

7,170

^[7]

17,888

^[7]

^[7]

17,893

Date of Completion of Construction, Acquisition or Significant Improvement

^[7]

$ 1,060

^[7]

2017

^[7]

2017

Hamburg Medical Building Hamburg, PA

^[7]

35 years

Real Estate and Accumulated Depreciation [Line Items]

$ 696

3,406

696

3,406

4,102

Date of Completion of Construction, Acquisition or Significant Improvement

$ 201

2017

2017

Las Palmas Del Sol Emergency Center - West El Paso, TX

35 years

Real Estate and Accumulated Depreciation [Line Items]

$ 801

5,029

801

5,029

5,830

Date of Completion of Construction, Acquisition or Significant Improvement

$ 246

2017

2017

Beaumont Medical Sleep Center Building

35 years

Real Estate and Accumulated Depreciation [Line Items]

$ 254

2,968

254

2,968

3,222

Date of Completion of Construction, Acquisition or Significant Improvement

$ 68

2018

2018