Consolidated Statements of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income	$ 97,918	$ 76,974
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	71,114	76,649
Asset impairments	4,706	1,580
Amortization of debt issuance costs and other non-cash interest	1,712	1,705
Expenses associated with debt refinancing transactions		1,016
Deferred income taxes	(3,911)	1,283
Non-cash revenue and other income	(5,889)	(8,634)
Non-cash equity compensation	8,068	7,466
Other expenses and non-cash items	5,958	3,219
Changes in assets and liabilities, net:
Accounts receivable, prepaid expenses and other assets	(5,840)	23,182
Accounts payable, accrued expenses and other liabilities	(12,560)	2,045
Income taxes payable	5,346	(2,834)
Net cash provided by operating activities	166,622	183,651
CASH FLOWS FROM INVESTING ACTIVITIES:
Expenditures for facility development and expansions	(84,819)	(13,164)
Expenditures for other capital improvements	(23,545)	(30,966)
Acquisitions, net of cash acquired	(38,579)	(50,459)
Proceeds from sale of assets	4,273	149
Increase in other assets	(3,408)	(1,653)
Net cash used in investing activities	(146,078)	(96,093)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from issuance of debt and borrowings from credit facility	349,144	558,521
Scheduled principal repayments	(5,772)	(2,981)
Other principal repayments of debt	(236,000)	(506,500)
Payment of debt issuance and other refinancing and related costs	(93)	(5,337)
Payment of lease obligations for financing leases	(268)	(803)
Contingent consideration for acquisition of businesses	(7,398)	(1,500)
Dividends paid	(104,744)	(102,066)
Purchase and retirement of common stock	(3,530)	(2,544)
Proceeds from exercise of stock options	875
Net cash used in financing activities	(7,786)	(63,210)
NET INCREASE IN CASH, CASH EQUIVALENTS AND RESTRICTED CASH	12,758	24,348
CASH, CASH EQUIVALENTS AND RESTRICTED CASH, beginning of period	74,137	52,183
CASH, CASH EQUIVALENTS AND RESTRICTED CASH, end of period	86,895	76,531
NON-CASH INVESTING AND FINANCING ACTIVITIES
Establishment of right of use assets and lease liabilities	83,064
Cash paid during the period for:
Interest (net of amounts capitalized of $2.7 million and $0.1 million in 2019 and 2018, respectively)	41,000	33,758
Income taxes paid	$ 3,198	$ 7,591