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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