Condensed Consolidated Statements Of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2026	Sep. 30, 2025
Cash flows from operating activities:
Net income	$ 156,564	$ 155,873
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	125,387	114,666
Other non-operating (gains) losses	(1,886)	1,275
Loss on extinguishment and modification of debt	0	515
Amortization of deferred financing costs and debt discounts	2,432	3,568
Deferred income taxes	10,202	14,884
Equity-based compensation	24,194	30,183
Income from non-consolidated affiliates	(12,251)	(1,409)
Changes in operating assets and liabilities, net of effect of acquisitions and divestitures:
Accounts receivable	(9,129)	16,594
Inventories	1,961	(6,308)
Prepaid expenses and other current assets	54,879	(47,361)
Accounts payable and other accrued expenses and liabilities	(79,925)	(15,716)
Accrued salaries and benefits	(13,988)	(19,689)
Net cash provided by operating activities	258,440	247,075
Cash flows from investing activities:
Purchases of property and equipment	(115,576)	(127,909)
Other	8,357	(92)
Net cash used in investing activities	(107,219)	(128,001)
Cash flows from financing activities:
Proceeds from insurance financing arrangements	23,493	15,607
Payments of principal on insurance financing arrangements	(14,434)	(10,751)
Payments of principal on long-term debt	(10,778)	(4,506)
Debt issuance costs	0	(2,573)
Distributions to noncontrolling interests	(68,371)	(62,366)
Repurchase of common stock	(24,011)	0
Other	(483)	(1,829)
Net cash used in financing activities	(94,584)	(66,418)
Net increase in cash and cash equivalents	56,637	52,656
Cash and cash equivalents at beginning of period	709,601	556,785
Cash and cash equivalents at end of period	766,238	609,441
Supplemental Cash Flow Information:
Non-cash purchases of property and equipment	$ 693	$ 13,509