CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Cash Flows from Operating Activities
Net income (loss)	$ (100,032)	$ (108,303)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Depreciation and amortization, net	87,226	85,806
Asset impairment	9,075	10,677
Equity in (earnings) loss of unconsolidated ventures	4,894	531
Distributions from unconsolidated ventures from cumulative share of net earnings	561	0
Amortization of entrance fees	(726)	(364)
Proceeds from deferred entrance fee revenue	1,036	670
Deferred income tax (benefit) provision	(2,304)	319
Operating lease expense adjustment	(8,307)	(4,664)
Change in fair value of derivatives	(3,403)	(42)
Loss (gain) on sale of assets, net	294	(1,112)
Non-cash stock-based compensation expense	3,885	4,783
Other	(43)	(1,416)
Changes in operating assets and liabilities:
Accounts receivable, net	1,185	(5,768)
Prepaid expenses and other assets, net	(4,734)	(6,769)
Prepaid insurance premiums financed with notes payable	(16,629)	(12,985)
Trade accounts payable and accrued expenses	(2,630)	(500)
Refundable fees and deferred revenue	5,907	7,717
Operating lease assets and liabilities for lessor capital expenditure reimbursements	1,490	7,563
Net cash provided by (used in) operating activities	(23,255)	(23,857)
Cash Flows from Investing Activities
Change in lease security deposits and lease acquisition deposits, net	155	(62)
Purchase of marketable securities	(125,990)	(79,932)
Sale and maturities of marketable securities	129,000	117,995
Capital expenditures, net of related payables	(39,956)	(40,361)
Investment in unconsolidated ventures	(82)	(5,206)
Proceeds from sale of assets, net	710	3,760
Net cash provided by (used in) investing activities	(36,163)	(3,806)
Cash Flows from Financing Activities
Proceeds from debt	25,258	18,575
Repayment of debt and financing lease obligations	(21,440)	(49,924)
Payment of financing costs, net of related payables	(76)	(87)
Payments of employee taxes for withheld shares	(4,145)	(4,329)
Other	0	203
Net cash provided by (used in) financing activities	(403)	(35,562)
Net increase (decrease) in cash, cash equivalents, and restricted cash	(59,821)	(63,225)
Cash, cash equivalents, and restricted cash at beginning of period	438,314	465,148
Cash, cash equivalents, and restricted cash at end of period	$ 378,493	$ 401,923