Note 6 - Business Segments - Summary of Financial Information by Reporting Segment (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Revenues:
Net patient revenues	$ 235,264,000	$ 230,654,000	$ 471,375,000	$ 462,346,000
Other revenues	11,887,000	11,488,000	24,061,000	22,757,000
Net operating revenues	247,151,000	242,142,000	495,436,000	485,103,000
Costs and expenses:
Salaries, wages and benefits	147,878,000	145,466,000	289,266,000	285,561,000
Other operating	67,598,000	62,589,000	137,030,000	127,761,000
Rent	10,197,000	10,272,000	20,435,000	20,501,000
Depreciation and amortization	10,335,000	10,397,000	20,852,000	20,739,000
Interest	954,000	1,253,000	1,880,000	2,493,000
Total costs and expenses	236,962,000	229,977,000	469,463,000	457,055,000
Income (loss) from operations	10,189,000	12,165,000	25,973,000	28,048,000
Non-operating income (loss)	8,272,000	5,654,000	14,273,000	2,589,000
Unrealized gains (losses) on marketable equity securities	(54,000)	12,448,000	6,784,000	(3,069,000)
Income before income taxes	18,407,000	30,267,000	47,030,000	27,568,000
Inpatient Services Segment [Member]
Revenues:
Net patient revenues	220,887,000	215,617,000	442,521,000	431,968,000
Other revenues	242,000	181,000	473,000	451,000
Net operating revenues	221,129,000	215,798,000	442,994,000	432,419,000
Costs and expenses:
Salaries, wages and benefits	130,720,000	128,115,000	256,821,000	251,495,000
Other operating	60,172,000	56,069,000	122,801,000	113,904,000
Rent	8,229,000	8,267,000	16,520,000	16,524,000
Depreciation and amortization	9,471,000	9,571,000	19,124,000	19,032,000
Interest	319,000	383,000	668,000	780,000
Total costs and expenses	208,911,000	202,405,000	415,934,000	401,735,000
Income (loss) from operations	12,218,000	13,393,000	27,060,000	30,684,000
Non-operating income (loss)	0	0	0	0
Unrealized gains (losses) on marketable equity securities	0	0	0	0
Income before income taxes	12,218,000	13,393,000	27,060,000	30,684,000
Homecare Services Segment [Member]
Revenues:
Net patient revenues	14,377,000	15,037,000	28,854,000	30,378,000
Other revenues	0	0	0	0
Net operating revenues	14,377,000	15,037,000	28,854,000	30,378,000
Costs and expenses:
Salaries, wages and benefits	8,480,000	8,611,000	16,506,000	16,642,000
Other operating	4,674,000	4,740,000	8,926,000	10,019,000
Rent	489,000	485,000	951,000	973,000
Depreciation and amortization	61,000	44,000	122,000	82,000
Interest	0	0	0	0
Total costs and expenses	13,704,000	13,880,000	26,505,000	27,716,000
Income (loss) from operations	673,000	1,157,000	2,349,000	2,662,000
Non-operating income (loss)	0	0	0	0
Unrealized gains (losses) on marketable equity securities	0	0	0	0
Income before income taxes	673,000	1,157,000	2,349,000	2,662,000
Other Segments [Member]
Revenues:
Net patient revenues	0	0	0	0
Other revenues	11,645,000	11,307,000	23,588,000	22,306,000
Net operating revenues	11,645,000	11,307,000	23,588,000	22,306,000
Costs and expenses:
Salaries, wages and benefits	8,678,000	8,740,000	15,939,000	17,424,000
Other operating	2,752,000	1,780,000	5,303,000	3,838,000
Rent	1,479,000	1,520,000	2,964,000	3,004,000
Depreciation and amortization	803,000	782,000	1,606,000	1,625,000
Interest	635,000	870,000	1,212,000	1,713,000
Total costs and expenses	14,347,000	13,692,000	27,024,000	27,604,000
Income (loss) from operations	(2,702,000)	(2,385,000)	(3,436,000)	(5,298,000)
Non-operating income (loss)	8,272,000	5,654,000	14,273,000	2,589,000
Unrealized gains (losses) on marketable equity securities	(54,000)	12,448,000	6,784,000	(3,069,000)
Income before income taxes	$ 5,516,000	$ 15,717,000	$ 17,621,000	$ (5,778,000)