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Income Taxes - Significant Components of Deferred Income Tax Assets and Liabilities (Detail) - USD ($)
$ in Thousands
Dec. 31, 2020
Dec. 31, 2019
Income Tax Disclosure [Abstract]    
Allowance for uncollectible accounts $ 79,755 $ 170,123
Reserves and accruals 64,445 54,685
Stock-based compensation 7,517 11,493
Operating loss and other carryforwards 16,767 6,691
Capital loss carryforwards 447,854 17,082
Operating lease assets 15,042 15,389
Property and equipment 3,044 3,986
Other 571  
Deferred tax assets before valuation allowance 634,995 279,449
Less: Valuation allowance (458,708) (19,286)
Deferred tax assets, net of valuation allowance 176,287 260,163
Gross deferred tax liabilities:    
Amortization (152,969) (144,587)
Accounting method changes (16,352) (71,532)
Operating lease liabilities (14,057) (13,405)
Other (183) (463)
Total deferred tax liabilities (183,561) (229,987)
Net deferred tax assets $ (7,274)  
Net deferred tax liabilities   $ 30,176