Leases - Lease Costs (Details) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Leases [Abstract]
Facility operating expense	$ 4,850	$ 4,625
Facility lease expense	64,481	68,668
Operating lease expense	69,331	73,293
Operating lease expense adjustment	6,733	4,383
Changes in operating lease assets and liabilities for lessor capital expenditure reimbursements	(4,088)	0
Operating cash flows from operating leases	71,976	77,676
Depreciation and amortization	9,144	11,678
Interest expense: financing lease obligations	13,282	16,743
Financing lease expense	22,426	28,421
Operating cash flows from financing leases	13,282	16,743
Financing cash flows from financing leases	5,087	5,453
Changes in financing lease assets and liabilities for lessor capital expenditure reimbursement	1,739		$ 0
Total cash flows from financing leases	$ 20,108	$ 22,196