Leases - Narrative (Details)	12 Months Ended
	Dec. 31, 2022 USD ($) campus state	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)
Property, Plant and Equipment [Line Items]
Extension term	1 year
Variable lease payment	$ 0
Lease expense	19,900,000	$ 7,500,000	$ 2,900,000
Cash paid for amounts included in operating lease liabilities	19,500,000	$ 7,200,000
Present value of operating lease liabilities	$ 218,000
Interest rate	3.75%
Finance lease expense	$ 100,000
RU Segment
Property, Plant and Equipment [Line Items]
Number of campuses | campus	22
Number of states | state	6
HCN Segment | Ohio
Property, Plant and Equipment [Line Items]
Number of campuses | campus	6
HCN Segment | INDIANA
Property, Plant and Equipment [Line Items]
Number of campuses | campus	1