Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income	$ 117,968	$ 136,700
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	116,114	109,564
Asset impairments	1,580	614
Amortization of debt issuance costs and other non-cash interest	2,562	2,349
Expenses associated with debt refinancing transactions	1,016
Deferred income taxes	(1,495)	(1,725)
Non-cash revenue and other income	(11,571)	(10,210)
Non-cash equity compensation	9,758	12,203
Other expenses and non-cash items	5,476	2,975
Changes in assets and liabilities, net:
Accounts receivable, prepaid expenses and other assets	15,318	(899)
Accounts payable, accrued expenses and other liabilities	29,504	13,482
Income taxes payable	(1,659)	(918)
Net cash provided by operating activities	284,571	264,135
CASH FLOWS FROM INVESTING ACTIVITIES:
Expenditures for facility development and expansions	(35,750)	(16,543)
Expenditures for other capital improvements	(44,144)	(35,214)
Acquisitions, net of cash acquired	(161,057)	(29,174)
Proceeds from sale of assets	12,606	931
Increase in other assets	(2,291)	(2,444)
Payments received on direct financing lease and notes receivable		684
Net cash used in investing activities	(230,636)	(81,760)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from issuance of debt and borrowings from credit facility	690,863	197,500
Scheduled principal repayments	(4,959)	(7,500)
Other principal repayments of debt	(523,500)	(215,500)
Payment of debt issuance and other refinancing and related costs	(6,033)	(65)
Payment of lease obligations	(2,679)	(1,791)
Contingent consideration for acquisition of businesses	(1,500)
Dividends paid	(153,019)	(150,691)
Purchase and retirement of common stock	(2,544)	(5,818)
Proceeds from exercise of stock options	1,981	6,514
Net cash used in financing activities	(1,390)	(177,351)
NET INCREASE IN CASH, CASH EQUIVALENTS AND RESTRICTED CASH	52,545	5,024
CASH, CASH EQUIVALENTS AND RESTRICTED CASH, beginning of period	52,183	37,711
CASH, CASH EQUIVALENTS AND RESTRICTED CASH, end of period	104,728	42,735
NON-CASH INVESTING AND FINANCING ACTIVITIES:
Debt assumed on acquisition of property	157,280
Cash paid during the period for:
Interest (net of amounts capitalized of $414 and $0 in 2018 and 2017, respectively)	38,155	40,130
Income taxes paid	$ 9,288	$ 5,015