Leases - Lease Cost (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Operating Leases
Facility operating expense	$ 12,606	$ 19,241	$ 18,677
Facility lease expense	174,358	224,033	269,666
Operating lease expense	186,964	243,274	288,343
Operating lease expense adjustment	23,280	136,276	19,453
Changes in operating lease assets and liabilities for lessor capital expenditure reimbursements	(30,965)	(22,242)	(31,305)
Operating net cash outflows from operating leases	179,279	357,308	276,491
Payments for lease restructuring		119,200
Financing Leases
Depreciation and amortization	30,542	32,647	46,646
Interest expense: financing lease obligations	46,282	48,534	66,353
Financing lease expense	76,824	81,181	112,999
Operating cash outflows from financing leases	46,282	48,534	66,353
Financing cash outflows from financing leases	19,874	18,867	22,242
Changes in financing lease assets and liabilities for lessor capital expenditure reimbursement	(11,135)	(5,603)	(3,504)
Total net cash outflows from financing leases	$ 55,021	$ 61,798	$ 85,091