Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income	$ 159,230	$ 173,256
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	127,328	108,315
Asset impairments		955
Amortization of debt issuance costs and other non-cash interest	2,362	2,186
Expenses associated with debt refinancing transactions		701
Deferred income taxes	(2,149)	1,243
Non-cash revenue and other income	(4,522)	(2,143)
Income tax benefit of equity compensation	(1,492)	(529)
Non-cash equity compensation	14,029	11,516
Other expenses and non-cash items	3,636	2,372
Changes in assets and liabilities, net:
Accounts receivable, prepaid expenses and other assets	20,680	(9,686)
Accounts payable, accrued expenses and other liabilities	(19,114)	16,911
Income taxes payable	1,199	644
Net cash provided by operating activities	301,187	305,741
CASH FLOWS FROM INVESTING ACTIVITIES:
Expenditures for facility development and expansions	(30,885)	(143,847)
Expenditures for other capital improvements	(32,774)	(39,087)
Capitalized lease payments		(34,470)
Acquisition of businesses, net of cash acquired	(43,769)	(13,795)
Decrease in restricted cash	240	1,251
Proceeds from sale of assets	8,192	501
Decrease in other assets	1,158	2,106
Payments received on direct financing lease and notes receivable	1,875	1,662
Net cash used in investing activities	(95,963)	(225,679)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from issuance of debt	291,250	522,000
Principal repayments of debt	(316,000)	(402,000)
Payment of debt issuance and other refinancing and related costs	(68)	(4,575)
Payment of lease obligations	(10,561)	(3,156)
Contingent consideration for acquisition of businesses	(1,073)
Dividends paid	(192,021)	(187,451)
Income tax benefit of equity compensation	1,492	529
Purchase and retirement of common stock	(3,991)	(9,454)
Decrease in restricted cash for dividends	550	500
Proceeds from exercise of stock options	2,638	7,554
Net cash used in financing activities	(227,784)	(76,053)
NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS	(22,560)	4,009
CASH AND CASH EQUIVALENTS, beginning of period	65,291	74,393
CASH AND CASH EQUIVALENTS, end of period	42,731	78,402
Cash paid during the period for:
Interest (net of amounts capitalized of $378 and $4,546 in 2016 and 2015, respectively)	38,226	20,397
Income taxes paid (refunded)	$ (2,162)	$ 6,858