Condensed Consolidated Statements of Cash Flows (unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Operating activities
Net income	$ 433,639	$ 242,391
Adjustments to reconcile net income to net cash provided by operating activities:
Distributions from unconsolidated subsidiaries	27,772	21,720
Depreciation and amortization	150,702	154,133
Provision for expected credit losses	172	281
Equity in earnings of unconsolidated subsidiaries	(33,180)	(19,677)
Gain on sale or disposal of assets and businesses	(87)	(24,723)
Stock compensation expense	22,002	20,828
Amortization of debt discount, premium and issuance costs	1,655	1,635
Deferred income taxes	(11,965)	(14,556)
Changes in operating assets and liabilities, net of effects of business combinations:
Accounts receivable	645	(91,413)
Other current assets	(1,822)	(22,815)
Other assets	(3,124)	16,335
Accounts payable	22,914	24,246
Accrued expenses	84,796	117,781
Government advances	(165,470)	318,116
Unearned government assistance	(80,193)	66,938
Income taxes	13,524	9,415
Net cash provided by operating activities	461,980	820,635
Investing activities
Business combinations, net of cash acquired	(26,830)	(14,076)
Purchases of property and equipment	(125,386)	(105,572)
Investment in businesses	(16,367)	(25,857)
Proceeds from sale of assets and businesses	11,257	83,320
Net cash used in investing activities	(157,326)	(62,185)
Financing activities
Borrowings on revolving facilities	0	470,000
Payments on revolving facilities	0	(470,000)
Payments on term loans	0	(39,843)
Borrowings of other debt	19,515	35,086
Principal payments on other debt	(22,910)	(42,820)
Dividends paid to common stockholders	(33,816)	0
Repurchase of common stock	(66,050)	(14,242)
Proceeds from issuance of non-controlling interests	19,926	1,686
Distributions to and purchases of non-controlling interests	(50,397)	(28,196)
Purchase of membership interests of Concentra Group Holdings Parent	0	(366,203)
Net cash provided by (used in) financing activities	(133,732)	(454,532)
Net increase in cash and cash equivalents	170,922	303,918
Cash and cash equivalents at beginning of period	577,061	335,882
Cash and cash equivalents at end of period	747,983	639,800
Supplemental Information
Cash paid for interest	118,570	140,174
Cash paid for taxes	$ 136,857	$ 81,945