Note 19 - Variable Interest Entity (Details Textual)	12 Months Ended
	Dec. 31, 2018 USD ($)	Dec. 31, 2017 USD ($)	Dec. 31, 2010 USD ($)
Number of Variable Interest Entities	1
Number of Patient Beds in Facility			120
Lessee, Operating Lease, Term of Contract	10 years		10 years
Number of Additional Lease Options			5
Lessee, Operating Lease, Renewal Term			5 years
Notes, Loans and Financing Receivable, Gross, Current			$ 4,500,000
Increase (Decrease) in Notes Payable, Current, Total	$ 11,047,000	$ 8,408,000