Note 3 - Net Patient Revenues - Revenue Dissagregation (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Revenue, concentration percentage	100.00%	100.00%	100.00%	100.00%
Net Patient Revenues [Member]
Net patient revenues	$ 230,654	$ 227,085	$ 462,346	$ 454,339
Medicare [Member]
Revenue, concentration percentage	35.00%	35.00%	36.00%	35.00%
Inpatient Services [Member] | Net Patient Revenues [Member]
Net patient revenues	$ 215,617	$ 211,057	$ 431,968	$ 422,497
Managed Care [Member]
Revenue, concentration percentage	12.00%	13.00%	12.00%	13.00%
Homecare [Member] | Net Patient Revenues [Member]
Net patient revenues	$ 15,037	$ 16,028	$ 30,378	$ 31,842
Medicaid [Member]
Revenue, concentration percentage	26.00%	26.00%	26.00%	26.00%
Private Pay and Other [Member]
Revenue, concentration percentage	27.00%	26.00%	26.00%	26.00%