Property and Equipment (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Property, Plant and Equipment [Abstract]
Land	$ 34,009	$ 37,924
Buildings	496,455	400,616
Leasehold improvements	3,828,404	3,865,729
Equipment and information systems, including internally developed software	3,292,176	3,081,298
New center and capital asset projects in progress	592,063	616,686
Property, plant and equipment, gross, total	8,243,107	8,002,253
Less accumulated depreciation	(4,763,135)	(4,480,429)
Property and equipment, net	$ 3,479,972	$ 3,521,824

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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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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