CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Cash Flows from Operating Activities
Net income (loss)	$ (238,340)	$ (99,364)	$ 81,945
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Loss (gain) on debt modification and extinguishment, net	1,357	1,932	(10,896)
Depreciation and amortization, net	353,890	344,910	365,429
Asset impairment	29,618	23,003	107,308
Equity in (earnings) loss of unconsolidated ventures	10,782	(10,394)	2,107
Distributions from unconsolidated ventures from cumulative share of net earnings	561	6,191	766
Amortization of entrance fees	(2,307)	(1,758)	(2,122)
Proceeds from deferred entrance fee revenue	4,222	3,562	734
Deferred income tax (benefit) provision	(1,324)	(9,837)	(5,840)
Operating lease expense adjustment	(34,896)	(23,280)	(136,276)
Change in fair value of derivatives	(7,659)	152	225
Loss (gain) on sale of assets, net	(74,445)	(288,835)	(374,532)
Loss (gain) on facility operating lease termination, net	0	(2,003)	(2,303)
Non-cash stock-based compensation expense	14,466	16,270	20,747
Property and casualty insurance income	(11,379)	(4,689)	(2,777)
Changes in operating assets and liabilities:
Accounts receivable, net	(4,624)	502	24,277
Prepaid expenses and other assets, net	(21,240)	(15,483)	24,707
Trade accounts payable and accrued expenses	(27,185)	(54,032)	27,294
Refundable fees and deferred revenue	(1,934)	(10,066)	62,614
Operating lease assets and liabilities for lessor capital expenditure reimbursements	13,718	30,965	22,242
Operating lease assets and liabilities for lease termination	0	(2,380)	0
Net cash provided by (used in) operating activities	3,281	(94,634)	205,649
Cash Flows from Investing Activities
Change in lease security deposits and lease acquisition deposits, net	355	(100)	3,569
Purchase of marketable securities	(263,669)	(362,257)	(378,269)
Sale and maturities of marketable securities	398,752	352,988	275,000
Capital expenditures, net of related payables	(196,924)	(176,657)	(185,871)
Acquisition of assets	(6,004)	0	(472,193)
Investment in unconsolidated ventures	(218)	(5,436)	(4,082)
Distributions received from unconsolidated ventures	966	37,113	0
Proceeds from sale of assets, net	4,653	334,006	331,316
Proceeds from notes receivable	0	1,800	5,419
Other	(5,340)	0	0
Net cash provided by (used in) investing activities	(67,429)	181,457	(425,111)
Cash Flows from Financing Activities
Proceeds from debt	254,259	352,962	963,099
Repayment of debt and financing lease obligations	(281,185)	(441,571)	(538,859)
Proceeds from line of credit	0	0	166,381
Repayment of line of credit	0	0	(166,381)
Proceeds from issuance of tangible equity units	139,438	0	0
Purchase of treasury stock, net of related payables	0	0	(18,123)
Purchase of capped call transactions	0	(15,916)	0
Payment of financing costs, net of related payables	(7,077)	(3,904)	(19,649)
Payments of employee taxes for withheld shares	(4,293)	(4,820)	(4,037)
Other	(760)	(408)	482
Net cash provided by (used in) financing activities	100,382	(113,657)	382,913
Net increase (decrease) in cash, cash equivalents, and restricted cash	36,234	(26,834)	163,451
Cash, cash equivalents, and restricted cash at beginning of period	438,314	465,148	301,697
Cash, cash equivalents, and restricted cash at end of period	$ 474,548	$ 438,314	$ 465,148