Leases - Lease Costs (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Leases [Abstract]
Facility operating expense	$ 1,561	$ 4,520	$ 3,084	$ 9,362
Facility lease expense	41,538	43,864	83,102	88,282
Operating lease expense	43,099	48,384	86,186	97,644
Operating lease expense adjustment	8,308	5,326	16,615	9,990
Changes in operating lease assets and liabilities for lessor capital expenditure reimbursements	(3,367)	(7,943)	(4,857)	(15,506)
Operating net cash outflows from operating leases	48,040	45,767	97,944	92,128
Depreciation and amortization	7,607	7,594	15,273	15,224
Interest expense: financing lease obligations	11,994	11,492	24,052	22,875
Financing lease expense	19,601	19,086	39,325	38,099
Operating cash outflows from financing leases	11,994	11,492	24,052	22,875
Financing cash outflows from financing leases	5,610	4,864	11,100	9,653
Changes in financing lease assets and liabilities for lessor capital expenditure reimbursement	(3,770)	(2,057)	(6,977)	(3,446)
Total net cash outflows from financing leases	$ 13,834	$ 14,299	$ 28,175	$ 29,082