Note 6 - Long-term Leases (Details Textual)	3 Months Ended		6 Months Ended
	Jun. 30, 2017 USD ($)	Jun. 30, 2016 USD ($)	Jun. 30, 2017 USD ($)	Jun. 30, 2016 USD ($)
Operating Leases, Rent Expense	$ 10,079,000	$ 10,319,000	$ 20,167,000	$ 20,646,000
Two Leases with NHI [Member]
Number of Skilled Nursing Centers Leased from NHI	35		35
Number of Assisted Living Centers Leased from NHI	7		7
Number of Independent Living Centers Leased from NHI	3		3
Number of Lease Agreements with NHI	2		2
Operating Leases, Rent Expense, Minimum Rentals			$ 34,200,000
Operating Lease Additional Percentage Rent Percentage			4.00%
Operating Leases, Rent Expense	$ 9,314,000	$ 9,480,000	$ 18,628,000	$ 18,960,000