Property and Equipment (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Property, Plant and Equipment [Abstract]
Land	$ 36,480	$ 37,384
Buildings	392,256	467,181
Leasehold improvements	3,545,224	3,164,943
Equipment and information systems, including internally developed software	2,880,645	2,586,564
New center and capital asset projects in progress	588,345	661,695
Property, plant and equipment, gross, total	7,442,950	6,917,767
Less accumulated depreciation	(3,969,566)	(3,524,098)
Property and equipment, net	$ 3,473,384	$ 3,393,669

Amount of accumulated depreciation, depletion and amortization for physical assets used in the normal conduct of business to produce goods and services.

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Amount before accumulated depreciation of building structures held for productive use including addition, improvement, or renovation to the structure, including, but not limited to, interior masonry, interior flooring, electrical, and plumbing.

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Amount of structure or a modification to a structure under construction. Includes recently completed structures or modifications to structures that have not been placed into service.

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Amount before accumulated depletion of real estate held for productive use, excluding land held for sale.

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Amount before accumulated depreciation of additions or improvements to assets held under a lease arrangement.

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Amount before accumulated depreciation of tangible personal property used to produce goods and services, including, but is not limited to, tools, dies and molds, computer and office equipment.

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No definition available.

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Amount before accumulated depreciation, depletion and amortization of physical assets used in the normal conduct of business and not intended for resale. Examples include, but are not limited to, land, buildings, machinery and equipment, office equipment, and furniture and fixtures.

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