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Acquisition Level 1 (Notes)
9 Months Ended
Sep. 30, 2023
Business Combinations [Abstract]  
Business Combination Disclosure [Text Block]
Acquisitions
We spent $72.5 million and $13.5 million net of cash acquired, for several business acquisitions during the nine months ended September 30, 2023 and 2022, respectively, and $41.1 million and $8.9 million, net of cash acquired, for several real estate acquisitions during the nine months ended September 30, 2023 and 2022, respectively.
Divestiture-Related Activities
As divestitures occur in the normal course of business, gains or losses on the sale of such locations are recognized in the unaudited Condensed Consolidated Statement of Operations line item Gains on divestitures and impairment charges, net, which comprised the following:
Three months ended September 30,Nine months ended September 30,
2023202220232022
 (In thousands)
Gains on divestitures, net$2,542 $14,403 $10,187 $15,492 
Impairment losses— — — (306)
Gains on divestitures and impairment charges, net$2,542 $14,403 $10,187 $15,186