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v3.23.3

Leases - Lease Costs (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended
--- | --- | ---
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022
Leases [Abstract] |  |  |  |
Facility operating expense | $ 1,853 | $ 1,621 | $ 5,211 | $ 4,705
Facility lease expense | 53,145 | 41,317 | 149,784 | 124,419
Operating lease expense | 54,998 | 42,938 | 154,995 | 129,124
Operating lease expense adjustment | 11,458 | 8,714 | 33,820 | 25,329
Changes in operating lease assets and liabilities for lessor capital expenditure reimbursements | 0 | (4,367) | (2,244) | (9,224)
Operating net cash outflows from operating leases | 66,456 | 47,285 | 186,571 | 145,229
Depreciation and amortization | 1,159 | 7,405 | 8,902 | 22,678
Interest expense: financing lease obligations | 4,950 | 11,916 | 16,955 | 35,968
Financing lease expense | 6,109 | 19,321 | 25,857 | 58,646
Operating cash outflows from financing leases | 4,950 | 11,916 | 16,955 | 35,968
Financing cash outflows from financing leases | 244 | 5,506 | 8,222 | 16,606
Changes in financing lease assets and liabilities for lessor capital expenditure reimbursement | 0 | (2,727) | 0 | (9,704)
Total net cash outflows from financing leases | $ 5,194 | $ 14,695 | $ 25,177 | $ 42,870

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