Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income	$ 55,338	$ 188,886	$ 159,207
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	150,861	144,572	156,501
Asset impairments	60,628	4,706	1,580
Amortization of debt issuance costs and other non-cash interest	5,519	3,351	3,419
Expenses associated with debt repayments and refinancing transactions	7,141	602	1,016
Deferred income taxes	4,945	(1,162)	(4,436)
Loss (gain) on sale of real estate assets	13,023	(287)
Other expenses and non-cash items	13,616	13,320	7,909
Non-cash revenue and other income	(7,301)	(11,292)	(14,509)
Non-cash equity compensation	17,264	17,267	13,132
Changes in assets and liabilities, net:
Accounts receivable, prepaid expenses and other assets	16,769	(16,938)	(19,470)
Accounts payable, accrued expenses and other liabilities	17,727	11,359	18,531
Net cash provided by operating activities	355,530	354,384	322,880
CASH FLOWS FROM INVESTING ACTIVITIES:
Expenditures for facility development and expansions	(27,591)	(136,128)	(58,239)
Expenditures for other capital improvements	(56,196)	(57,192)	(63,438)
Acquisitions, net of cash acquired	(8,849)	(48,396)	(175,588)
Net proceeds from sale of assets	113,602	4,295	12,911
Increase in other assets	(7,998)	(7,168)	(6,703)
Net cash provided by (used in) investing activities	12,968	(244,589)	(291,057)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from issuance of debt and borrowings from credit facility	374,000	1,146,691	809,831
Scheduled principal repayments	(32,254)	(14,121)	(7,816)
Principal repayments of credit facility	(520,000)	(648,000)	(603,500)
Defeasance of non-recourse mortgage notes	(51,311)
Satisfaction and discharge of senior notes		(325,000)
Payment of debt defeasance, issuance and other refinancing and related costs	(11,162)	(4,296)	(6,087)
Payment of lease obligations for financing leases	(543)	(538)	(3,744)
Contingent consideration for acquisition of businesses		(7,398)	(1,500)
Proceeds from exercise of stock options		876	2,367
Proceeds from sale/leaseback			7,783
Purchase and retirement of common stock	(3,575)	(3,531)	(3,005)
Dividends paid	(105,978)	(209,522)	(204,198)
Net cash used in financing activities	(350,823)	(64,839)	(9,869)
NET INCREASE IN CASH, CASH EQUIVALENTS AND RESTRICTED CASH	17,675	44,956	21,954
CASH, CASH EQUIVALENTS AND RESTRICTED CASH, beginning of period	119,093	74,137	52,183
CASH, CASH EQUIVALENTS AND RESTRICTED CASH, end of period	136,768	119,093	74,137
NON-CASH INVESTING AND FINANCING ACTIVITIES:
Debt assumed on acquisition of property	52,217		157,280
Establishment of right of use assets and lease liabilities	116,263	137,946
Cash paid during the period for:
Interest (net of amounts capitalized of $0.5 million, $6.0 million, and $1.0 million in 2020, 2019, and 2018, respectively)	88,132	85,698	71,787
Income taxes paid	$ 1,322	$ 16,437	$ 13,303