Note 3 - Net Patient Revenues - Revenue Disaggregation (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Net patient revenues	$ 235,090	$ 234,827	$ 706,465	$ 697,173
Revenue, concentration percentage	100.00%	100.00%	100.00%	100.00%
Medicare [Member]
Revenue, concentration percentage	32.00%	34.00%	33.00%	35.00%
Inpatient Services [Member]
Net patient revenues	$ 222,246	$ 220,099	$ 664,768	$ 652,066
Managed Care [Member]
Revenue, concentration percentage	12.00%	12.00%	12.00%	12.00%
Homecare [Member]
Net patient revenues	$ 12,844	$ 14,728	$ 41,697	$ 45,107
Medicaid [Member]
Revenue, concentration percentage	28.00%	27.00%	27.00%	26.00%
Private Pay and Other [Member]
Revenue, concentration percentage	28.00%	27.00%	28.00%	27.00%