Note 6 - Long-term Leases (Details Textual)			1 Months Ended	12 Months Ended
	Jun. 01, 2014 USD ($)	Jan. 01, 2007 USD ($)	Sep. 30, 2013 USD ($)	Dec. 31, 2019 USD ($)	Dec. 31, 2018 USD ($)	Dec. 31, 2017 USD ($)	Dec. 31, 2010
Lessee, Operating Lease, Term of Contract							10 years
Number of Additional Lease Options							5
Number of Facilities Under Capitalized Lease	3
Number of Capitalized Lease Agreements	3
Capital Leases, Future Minimum Payments, Net Minimum Payments, Total	$ 5,200,000
Lessee, Operating Lease, Renewal Term							5 years
Two Leases with NHI [Member]
Number of Skilled Nursing Centers Leased from NHI				35
Number of Assisted Living Centers Leased from NHI				7
Number of Independent Living Centers Leased from NHI				3
Number of Lease Agreements with NHI				2
Lease One With NHI [Member]
Number of Skilled Nursing Facilities Subleased				4
Lessee, Operating Lease, Term of Contract		15 years
Number of Additional Lease Options		3
Operating Leases, Rent Expense, Minimum Rentals		$ 30,750,000
Operating Lease Additional Percentage Rent Percentage		4.00%
Lessee, Operating Lease, Renewal Term		5 years
Term of Additional Lease Option	5 years
Lease Two with NHI [Member]
Lessee, Operating Lease, Term of Contract			15 years
Operating Leases, Rent Expense, Minimum Rentals			$ 3,450,000	$ 34,200,000
Operating Lease Additional Percentage Rent Percentage			4.00%
Number of Skilled Nursing Centers			7
Facility Purchase Price			$ 49,000,000
Both NHI Lease Agreements [Member]
Operating Leases Percentage Rent Expense				$ 3,587,000	$ 3,713,000	$ 3,057,000
Capital Lease [Member]
Number of Additional Lease Options	2
Initial Lease Term	10 years
Capital Lease Additional Percentage Rent Percentage	4.00%