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Note 1 - Summary of Significant Accounting Policies (Details Textual) - USD ($)
12 Months Ended
Dec. 31, 2016
Dec. 31, 2015
Dec. 31, 2014
Number of States in which Entity Operates 10    
Homecare Services Anticipated Payment Deferred Revenue Percentage 60.00%    
Provision for Doubtful Accounts $ 5,967,000 $ 6,583,000 $ 6,228,000
General and Administrative Expense 29,300,000 34,500,000 $ 34,900,000
Continuing Care Retirement Communities Advance Fees, Obligation for Future Services, Amount $ 3,236,000 3,440,000  
Refundable Advance Fees [Member]      
Nonrefundable Resident Entry Fee Percentage 10.00%    
Customer Refundable Fees $ 9,924,000 9,865,000  
Original Entry Fee [Member]      
Refundable Resident Entry Fee Percentage 90.00%    
Appreciation [Member]      
Appreciation of Apartment Over Original Residents Entry Fee Percentage 40.00%    
Building and Building Improvements [Member] | Minimum [Member]      
Property, Plant and Equipment, Useful Life 20 years    
Building and Building Improvements [Member] | Maximum [Member]      
Property, Plant and Equipment, Useful Life 40 years    
Equipment and Furniture [Member] | Minimum [Member]      
Property, Plant and Equipment, Useful Life 3 years    
Equipment and Furniture [Member] | Maximum [Member]      
Property, Plant and Equipment, Useful Life 15 years    
Medicare and Medicaid [Member]      
Allowance for Doubtful Accounts Receivable $ 17,019,000 $ 16,654,000  
Caris [Member]      
Equity Method Investment, Ownership Percentage 75.10%