Condensed Consolidated Statements of Cash Flows $ in Thousands	3 Months Ended
	Mar. 31, 2017 USD ($)	Mar. 31, 2016 USD ($)
Cash flows from operating activities:
Net income (loss)	$ 42,062	$ (31,111)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation	187,989	172,382
Stock-based compensation	38,323	34,061
Amortization of intangible assets	29,017	28,152
Amortization of debt issuance costs and debt discounts	11,580	5,508
Provision for allowance for doubtful accounts	6,710	1,885
Gain on asset sales	0	(5,242)
Loss on debt extinguishment	3,503	0
Other items	3,677	5,169
Changes in operating assets and liabilities:
Accounts receivable	(39,664)	(11,312)
Income taxes, net	(20,637)	(28,656)
Accounts payable and accrued expenses	(65,414)	(40,217)
Other assets and liabilities	50,225	(25,785)
Net cash provided by operating activities	247,371	104,834
Cash flows from investing activities:
Purchases of investments	(26,256)	(10,875)
Sales and maturities of investments	19,152	14,294
Business acquisitions, net of cash and restricted cash acquired	(36,041)	(1,601,326)
Purchases of real estate	(41,739)	(16,408)
Purchases of other property, plant and equipment	(277,242)	(197,700)
Proceeds from sale of assets	47,767	22,825
Net cash used in investing activities	(314,359)	(1,789,190)
Cash flows from financing activities:
Proceeds from employee equity awards	20,074	16,304
Payment of dividends	(148,083)	(124,836)
Proceeds from public offering of common stock, net of offering costs	2,126,258	0
Proceeds from senior notes	1,250,000	0
Proceeds from loans payable	1,059,800	701,250
Repayment of capital lease and other financing obligations	(16,596)	(33,232)
Repayment of mortgage and loans payable	(21,510)	(936,353)
Debt extinguishment costs	(3,132)	0
Debt issuance costs	(40,665)	(65)
Other financing activities	(900)	0
Net cash provided by (used) in financing activities	4,225,246	(376,932)
Effect of foreign currency exchange rates on cash, cash equivalents and restricted cash	11,541	(9,501)
Net increase (decrease) in cash, cash equivalents and restricted cash	4,169,799	(2,070,789)
Cash, cash equivalents and restricted cash at beginning of period	773,247	2,718,427
Cash, cash equivalents and restricted cash at end of period	4,943,046	647,638
Cash and cash equivalents	4,923,259	633,758
Current portion of restricted cash included in other current assets	9,927	3,420
Non-current portion of restricted cash included in other assets	$ 9,860	$ 10,460