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Leases - Lease Cost (Details) - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020
Operating Leases |  |  |
Facility operating expense | $ 6,329 | $ 12,606 | $ 19,241
Facility lease expense | 165,294 | 174,358 | 224,033
Operating lease expense | 171,623 | 186,964 | 243,274
Operating lease expense adjustment | 34,896 | 23,280 | 136,276
Changes in operating lease assets and liabilities for lessor capital expenditure reimbursements | (13,718) | (30,965) | (22,242)
Operating net cash outflows from operating leases | 192,801 | 179,279 | 357,308
Payments for lease restructuring |  |  | 119,200
Financing Leases |  |  |
Depreciation and amortization | 30,065 | 30,542 | 32,647
Interest expense: financing lease obligations | 48,061 | 46,282 | 48,534
Financing lease expense | 78,126 | 76,824 | 81,181
Operating cash outflows from financing leases | 48,061 | 46,282 | 48,534
Financing cash outflows from financing leases | 22,221 | 19,874 | 18,867
Changes in financing lease assets and liabilities for lessor capital expenditure reimbursement | (11,932) | (11,135) | (5,603)
Total net cash outflows from financing leases | $ 58,350 | $ 55,021 | $ 61,798

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