Allowance for Doubtful Accounts - Schedule of Changes in Allowance for Notes Receivable (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2023
Accounts receivable
Allowance for doubtful accounts, beginning balance	$ 84,087	$ 68,407	$ 80,819	$ 66,601
Write-Offs	(11,955)	(8,365)	(12,988)	(11,818)
Bad Debt Expense	31,561	10,378	35,862	15,637
Allowance for doubtful accounts, ending balance	103,693	70,420	103,693	70,420
Notes receivable
Allowance for doubtful accounts, beginning balance	11,500	8,460	10,880	6,863
Write-Offs	(69)	(103)	(69)	(154)
Bad Debt Expense	161	885	781	2,533
Allowance for doubtful accounts, ending balance	11,592	9,242	11,592	9,242
Total accounts and notes receivable
Allowance for doubtful accounts, beginning balance	95,587	76,867	91,699	73,464
Write-Offs	(12,024)	(8,468)	(13,057)	(11,972)
Bad Debt Expense	31,722	11,263	36,643	18,170
Allowance for doubtful accounts, ending balance	115,285	79,662	115,285	79,662
Accounts receivable recovered after write off	100	100	100	100
LaVie Care Centers, LLC
Accounts receivable
Bad Debt Expense	17,600
Standard notes receivable
Notes receivable
Allowance for doubtful accounts, beginning balance	3,047	6,425	3,510	6,052
Write-Offs	0	(101)	0	(101)
Bad Debt Expense	(60)	684	(523)	1,057
Allowance for doubtful accounts, ending balance	2,987	7,008	2,987	7,008
Delinquent notes receivable
Notes receivable
Allowance for doubtful accounts, beginning balance	3,698		2,615
Write-Offs	(69)		(69)
Bad Debt Expense	221		1,304
Allowance for doubtful accounts, ending balance	3,850		3,850
Total accounts and notes receivable
Financing receivable, allowance for credit loss, transfers					$ 2,600
Elevated risk notes receivable
Notes receivable
Allowance for doubtful accounts, beginning balance	4,755	2,035	4,755	811
Write-Offs	0	(2)	0	(53)
Bad Debt Expense	0	201	0	1,476
Allowance for doubtful accounts, ending balance	$ 4,755	$ 2,234	$ 4,755	$ 2,234