Leases - Lease Costs (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Leases [Abstract]
Facility operating expense	$ 1,634	$ 4,755	$ 10,996	$ 14,540
Facility lease expense	43,226	51,620	131,508	178,480
Operating lease expense	44,860	56,375	142,504	193,020
Operating lease expense adjustment	6,273	117,322	16,263	132,276
Changes in operating lease assets and liabilities for lessor capital expenditure reimbursements	(11,551)	(3,131)	(27,057)	(13,640)
Operating net cash outflows from operating leases	39,582	170,566	131,710	311,656
Payments for lease restructuring		119,200		119,200
Depreciation and amortization	7,677	7,818	22,901	24,999
Interest expense: financing lease obligations	11,674	11,908	34,549	37,082
Financing lease expense	19,351	19,726	57,450	62,081
Operating cash outflows from financing leases	11,674	11,908	34,549	37,082
Financing cash outflows from financing leases	5,039	4,548	14,692	14,312
Changes in financing lease assets and liabilities for lessor capital expenditure reimbursement	(4,136)	(923)	(7,583)	(4,337)
Total net cash outflows from financing leases	$ 12,577	$ 15,533	$ 41,658	$ 47,057