Note 6 - Business Segments - Summary of Financial Information by Reporting Segment (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Revenues:
Net patient revenues	$ 235,090,000	$ 234,827,000	$ 706,465,000	$ 697,173,000
Other revenues	11,977,000	11,499,000	36,038,000	34,256,000
Net operating revenues	247,067,000	246,326,000	742,503,000	731,429,000
Costs and expenses:
Salaries, wages and benefits	152,175,000	149,188,000	441,441,000	434,749,000
Other operating	66,730,000	64,507,000	203,760,000	192,268,000
Rent	10,167,000	10,190,000	30,602,000	30,691,000
Depreciation and amortization	10,663,000	10,437,000	31,515,000	31,176,000
Interest	764,000	1,170,000	2,644,000	3,663,000
Total costs and expenses	240,499,000	235,492,000	709,962,000	692,547,000
Income (loss) from operations	6,568,000	10,834,000	32,541,000	38,882,000
Non-operating income (loss)	6,663,000	8,467,000	20,936,000	11,056,000
Unrealized gains on marketable equity securities	9,312,000	3,486,000	16,096,000	417,000
Income (loss) before income taxes	22,543,000	22,787,000	69,573,000	50,355,000
Inpatient Services Segment [Member]
Revenues:
Net patient revenues	222,246,000	220,099,000	664,768,000	652,066,000
Other revenues	199,000	136,000	672,000	588,000
Net operating revenues	222,445,000	220,235,000	665,440,000	652,654,000
Costs and expenses:
Salaries, wages and benefits	133,949,000	131,418,000	390,770,000	382,913,000
Other operating	60,800,000	57,371,000	183,602,000	171,275,000
Rent	8,234,000	8,255,000	24,754,000	24,780,000
Depreciation and amortization	9,666,000	9,570,000	28,790,000	28,602,000
Interest	312,000	369,000	979,000	1,149,000
Total costs and expenses	212,961,000	206,983,000	628,895,000	608,719,000
Income (loss) from operations	9,484,000	13,252,000	36,545,000	43,935,000
Non-operating income (loss)	0	0	0	0
Unrealized gains on marketable equity securities	0	0	0	0
Income (loss) before income taxes	9,484,000	13,252,000	36,545,000	43,935,000
Homecare Services Segment [Member]
Revenues:
Net patient revenues	12,844,000	14,728,000	41,697,000	45,107,000
Other revenues	0	0	0	0
Net operating revenues	12,844,000	14,728,000	41,697,000	45,107,000
Costs and expenses:
Salaries, wages and benefits	8,630,000	8,367,000	25,136,000	25,009,000
Other operating	4,267,000	4,797,000	13,193,000	14,816,000
Rent	450,000	488,000	1,400,000	1,460,000
Depreciation and amortization	61,000	55,000	183,000	137,000
Interest	0	0	0	0
Total costs and expenses	13,408,000	13,707,000	39,912,000	41,422,000
Income (loss) from operations	(564,000)	1,021,000	1,785,000	3,685,000
Non-operating income (loss)	0	0	0	0
Unrealized gains on marketable equity securities	0	0	0	0
Income (loss) before income taxes	(564,000)	1,021,000	1,785,000	3,685,000
Other Segments [Member]
Revenues:
Net patient revenues	0	0	0	0
Other revenues	11,778,000	11,363,000	35,366,000	33,668,000
Net operating revenues	11,778,000	11,363,000	35,366,000	33,668,000
Costs and expenses:
Salaries, wages and benefits	9,596,000	9,403,000	25,535,000	26,827,000
Other operating	1,663,000	2,339,000	6,965,000	6,177,000
Rent	1,483,000	1,447,000	4,448,000	4,451,000
Depreciation and amortization	936,000	812,000	2,542,000	2,437,000
Interest	452,000	801,000	1,665,000	2,514,000
Total costs and expenses	14,130,000	14,802,000	41,155,000	42,406,000
Income (loss) from operations	(2,352,000)	(3,439,000)	(5,789,000)	(8,738,000)
Non-operating income (loss)	6,663,000	8,467,000	20,936,000	11,056,000
Unrealized gains on marketable equity securities	9,312,000	3,486,000	16,096,000	417,000
Income (loss) before income taxes	$ 13,623,000	$ 8,514,000	$ 31,243,000	$ 2,735,000