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Leases - Lease Cost (Details) - USD ($) $ in Thousands | 12 Months Ended
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Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019
Operating Leases |  |  |
Facility operating expense | $ 12,606 | $ 19,241 | $ 18,677
Facility lease expense | 174,358 | 224,033 | 269,666
Operating lease expense | 186,964 | 243,274 | 288,343
Operating lease expense adjustment | 23,280 | 136,276 | 19,453
Changes in operating lease assets and liabilities for lessor capital expenditure reimbursements | (30,965) | (22,242) | (31,305)
Operating net cash outflows from operating leases | 179,279 | 357,308 | 276,491
Payments for lease restructuring |  | 119,200 |
Financing Leases |  |  |
Depreciation and amortization | 30,542 | 32,647 | 46,646
Interest expense: financing lease obligations | 46,282 | 48,534 | 66,353
Financing lease expense | 76,824 | 81,181 | 112,999
Operating cash outflows from financing leases | 46,282 | 48,534 | 66,353
Financing cash outflows from financing leases | 19,874 | 18,867 | 22,242
Changes in financing lease assets and liabilities for lessor capital expenditure reimbursement | (11,135) | (5,603) | (3,504)
Total net cash outflows from financing leases | $ 55,021 | $ 61,798 | $ 85,091

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