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Property and Equipment (Tables)
12 Months Ended
Dec. 31, 2023
Property, Plant and Equipment [Abstract]  
Property and Equipment
Property and equipment comprised the following:
 December 31,
 20232022
Land$35,216 $32,656 
Buildings436,460 427,962 
Leasehold improvements4,058,987 3,925,244 
Equipment and information systems, including internally developed software4,125,235 3,759,274 
New center and capital asset projects in progress177,149 376,633 
 8,833,047 8,521,769 
Less accumulated depreciation(5,759,514)(5,265,372)
 $3,073,533 $3,256,397