Note 15 - Contingencies and Guarantees (Detail) (USD $)	12 Months Ended		36 Months Ended			12 Months Ended
	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2007	Sep. 04, 2012	Dec. 31, 2012 Workers Compensation Premium Revenue [Member]	Dec. 31, 2011 Workers Compensation Premium Revenue [Member]	Dec. 31, 2010 Workers Compensation Premium Revenue [Member]	Dec. 31, 2012 Professional Liability Insurance [Member]	Dec. 31, 2011 Professional Liability Insurance [Member]	Dec. 31, 2010 Professional Liability Insurance [Member]	Dec. 31, 2011 Coverage Amount per Incident [Member]	Dec. 31, 2011 Coverage Amount per Location [Member]
Self Insurance Reserve	$ 110,331,000	$ 98,732,000
Direct Business Coverage Statutory Limits	1,000,000
Other Premium Revenue, Net						5,438,000	4,910,000	5,122,000	4,203,000	4,383,000	4,443,000
Primary Insurance Coverage Amount Per Incident												1,000,000
Primary Insurance Coverage Amount Per Location													3,000,000
Annual Excess Coverage	$ 4,000,000	$ 4,000,000	$ 9,000,000	$ 7,500,000
Number of Subsidiaries					10