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Income Taxes - Significant Components of Deferred Income Tax Assets and Liabilities (Detail) - USD ($)
$ in Thousands
Dec. 31, 2022
Dec. 31, 2021
Income Tax Disclosure [Abstract]    
Allowance for uncollectible accounts $ 152,526 $ 135,280
Reserves and accruals 66,969 55,549
Stock-based compensation 3,694 3,303
Operating loss and other carryforwards 28,773 29,045
Capital loss carryforwards 422,793 428,805
Operating lease assets 19,096 18,960
Property and equipment 2,481 1,967
Other 256 686
Deferred tax assets before valuation allowance 696,588 673,595
Less: Valuation allowance (429,260) (441,529)
Deferred tax assets, net of valuation allowance 267,328 232,066
Gross deferred tax liabilities:    
Amortization (176,398) (168,505)
Operating lease liabilities (16,510) (16,439)
Other (2,133) (187)
Total deferred tax liabilities (195,041) (185,131)
Net deferred tax assets $ 72,287 $ 46,935