Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income	$ 146,912	$ 117,968
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	107,768	116,114
Asset impairments	4,706	1,580
Amortization of debt issuance costs and other non-cash interest	2,566	2,562
Expenses associated with debt refinancing transactions		1,016
Deferred income taxes	(4,004)	(1,495)
Non-cash revenue and other income	(8,594)	(11,571)
Non-cash equity compensation	12,715	9,758
Other expenses and non-cash items	9,135	5,476
Changes in assets and liabilities, net:
Accounts receivable, prepaid expenses and other assets	(8,014)	15,318
Accounts payable, accrued expenses and other liabilities	41,110	29,504
Income taxes payable	(228)	(1,659)
Net cash provided by operating activities	304,072	284,571
CASH FLOWS FROM INVESTING ACTIVITIES:
Expenditures for facility development and expansions	(122,078)	(35,750)
Expenditures for other capital improvements	(35,635)	(44,144)
Acquisitions, net of cash acquired	(39,290)	(161,057)
Proceeds from sale of assets	4,291	12,606
Increase in other assets	(5,342)	(2,291)
Net cash used in investing activities	(198,054)	(230,636)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from issuance of debt and borrowings from credit facility	428,564	690,863
Scheduled principal repayments	(9,937)	(4,959)
Other principal repayments of debt	(358,000)	(523,500)
Payment of debt issuance and other refinancing and related costs	(115)	(6,033)
Payment of lease obligations for financing leases	(403)	(2,679)
Contingent consideration for acquisition of businesses	(7,398)	(1,500)
Dividends paid	(157,133)	(153,019)
Purchase and retirement of common stock	(3,530)	(2,544)
Proceeds from exercise of stock options	875	1,981
Net cash used in financing activities	(107,077)	(1,390)
NET INCREASE (DECREASE) IN CASH, CASH EQUIVALENTS AND RESTRICTED CASH	(1,059)	52,545
CASH, CASH EQUIVALENTS AND RESTRICTED CASH, beginning of period	74,137	52,183
CASH, CASH EQUIVALENTS AND RESTRICTED CASH, end of period	73,078	104,728
NON-CASH INVESTING AND FINANCING ACTIVITIES
Debt assumed on acquisition of property		157,280
Establishment of right of use assets and lease liabilities	104,720
Cash paid during the period for:
Interest (net of amounts capitalized of $4.3 million and $0.4 million in 2019 and 2018, respectively)	47,937	38,155
Income taxes paid	$ 12,253	$ 9,288