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Leases - Lease Costs (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended
--- | --- | ---
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021
Leases [Abstract] |  |  |  |
Facility operating expense | $ 1,561 | $ 4,520 | $ 3,084 | $ 9,362
Facility lease expense | 41,538 | 43,864 | 83,102 | 88,282
Operating lease expense | 43,099 | 48,384 | 86,186 | 97,644
Operating lease expense adjustment | 8,308 | 5,326 | 16,615 | 9,990
Changes in operating lease assets and liabilities for lessor capital expenditure reimbursements | (3,367) | (7,943) | (4,857) | (15,506)
Operating net cash outflows from operating leases | 48,040 | 45,767 | 97,944 | 92,128
Depreciation and amortization | 7,607 | 7,594 | 15,273 | 15,224
Interest expense: financing lease obligations | 11,994 | 11,492 | 24,052 | 22,875
Financing lease expense | 19,601 | 19,086 | 39,325 | 38,099
Operating cash outflows from financing leases | 11,994 | 11,492 | 24,052 | 22,875
Financing cash outflows from financing leases | 5,610 | 4,864 | 11,100 | 9,653
Changes in financing lease assets and liabilities for lessor capital expenditure reimbursement | (3,770) | (2,057) | (6,977) | (3,446)
Total net cash outflows from financing leases | $ 13,834 | $ 14,299 | $ 28,175 | $ 29,082

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- Definition Amount of interest expense on finance lease liability. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 842 -SubTopic 20 -Section 50 -Paragraph 4 -Subparagraph (a) -URI https://asc.fasb.org/extlink&oid=128292326&loc=SL77918686-209980 Reference 2: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 842 -SubTopic 20 -Section 45 -Paragraph 4 -Subparagraph (a) -URI https://asc.fasb.org/extlink&oid=123391704&loc=SL77918638-209977 Reference 3: http://www.xbrl.org/2003/role/exampleRef -Publisher FASB -Name Accounting Standards Codification -Topic 842 -SubTopic 20 -Section 55 -Paragraph 53 -URI https://asc.fasb.org/extlink&oid=123414884&loc=SL77918982-209971 + Details
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