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Property and Equipment (Tables)
12 Months Ended
Dec. 31, 2018
Property, Plant and Equipment [Abstract]  
Property, Plant and Equipment [Table Text Block]
Property and equipment, net consist of the following:
 
December 31,
 
2018
 
2017
Land
$
60,420

 
$
49,081

Buildings and improvements
411,096

 
342,641

Equipment
202,346

 
181,530

Furniture and fixtures
5,079

 
5,244

Leasehold improvements
112,935

 
97,221

Construction in progress
9,729

 
5,460

 
801,605

 
681,177

Less: accumulated depreciation
(182,731
)
 
(144,093
)
Property and equipment, net
$
618,874

 
$
537,084