Note 7 - Long-term Leases (Details Textual)	3 Months Ended
	Mar. 31, 2018 USD ($)	Mar. 31, 2017 USD ($)
Two Leases with NHI [Member]
Number of Skilled Nursing Centers Leased from NHI	35
Number of Assisted Living Centers Leased from NHI	7
Number of Independent Living Centers Leased from NHI	3
Number of Lease Agreements with NHI	2
Operating Leases, Rent Expense, Minimum Rentals	$ 34,200,000
Operating Lease Additional Percentage Rent Percentage	4.00%
Both NHI Lease Agreements [Member]
Operating Leases Percentage Rent Expense	$ 9,478,000	$ 9,314,000