CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018
Cash Flows from Operating Activities
Net income (loss)	$ (98,661)	$ (622,743)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Debt modification and extinguishment costs	2,739	44
Depreciation and amortization, net	192,702	236,655
Goodwill and asset impairment	4,160	446,466
Equity in loss of unconsolidated ventures	1,517	5,567
Distributions from unconsolidated ventures from cumulative share of net earnings	1,530	1,147
Amortization of deferred gain	0	(2,179)
Amortization of entrance fees	(772)	(837)
Proceeds from deferred entrance fee revenue	1,739	1,398
Deferred income tax (benefit) provision	470	(991)
Operating lease expense adjustment	(8,812)	(12,169)
Change in fair value of derivatives	175	143
Gain on sale of assets, net	(2,144)	(66,753)
Loss on facility lease termination and modification, net	2,006	133,423
Non-cash stock-based compensation expense	12,386	14,675
Non-cash interest expense on financing lease obligations	0	6,446
Non-cash management contract termination gain	(640)	(5,076)
Other	(4,401)	(156)
Changes in operating assets and liabilities:
Accounts receivable, net	(3,997)	10,956
Prepaid expenses and other assets, net	30,823	14,303
Prepaid insurance premiums financed with notes payable	(12,090)	(12,425)
Trade accounts payable and accrued expenses	(43,385)	(24,019)
Refundable fees and deferred revenue	(17,226)	8,305
Operating lease assets and liabilities for lessor capital expenditure reimbursements	1,000	0
Operating lease assets and liabilities for lease termination	0	(33,596)
Net cash provided by (used in) operating activities	59,119	98,584
Cash Flows from Investing Activities
Change in lease security deposits and lease acquisition deposits, net	(83)	(2,962)
Purchase of marketable securities	(98,059)	0
Sale of marketable securities	55,000	273,273
Capital expenditures, net of related payables	(122,297)	(120,458)
Acquisition of assets, net of related payables and cash received	0	(271,320)
Investment in unconsolidated ventures	(4,204)	(8,864)
Distributions received from unconsolidated ventures	5,305	9,397
Proceeds from sale of assets, net	52,430	130,897
Proceeds from notes receivable	31,609	1,393
Property insurance proceeds	0	156
Net cash provided by (used in) investing activities	(80,299)	11,512
Cash Flows from Financing Activities
Proceeds from debt	158,231	279,919
Repayment of debt and financing lease obligations	(238,036)	(466,267)
Proceeds from line of credit	0	200,000
Repayment of line of credit	0	(200,000)
Purchase of treasury stock, net of related payables	(18,401)	0
Payment of financing costs, net of related payables	(3,342)	(3,191)
Proceeds from refundable entrance fees, net of refunds	0	52
Payments for lease termination	0	(10,548)
Payments of employee taxes for withheld shares	(3,105)	(2,715)
Other	574	770
Net cash provided by (used in) financing activities	(104,079)	(201,980)
Net increase (decrease) in cash, cash equivalents and restricted cash	(125,259)	(91,884)
Cash, cash equivalents and restricted cash at beginning of period	450,218	282,546
Cash, cash equivalents and restricted cash at end of period	$ 324,959	$ 190,662