Note 9 - Long-term Leases (Details Textual)	3 Months Ended		9 Months Ended
	Sep. 30, 2021 USD ($)	Sep. 30, 2020 USD ($)	Sep. 30, 2021 USD ($)	Sep. 30, 2020 USD ($)
Operating Lease, Expense	$ 10,204,000	$ 10,320,000	$ 30,437,000	$ 30,972,000
Two Leases with NHI [Member]
Number of Skilled Nursing Centers Leased from NHI	35		35
Number of Assisted Living Centers Leased from NHI	7		7
Number of Independent Living Centers Leased from NHI	3		3
Number of Lease Agreements with NHI	2		2
Lessee, Lease, Annual Base Rent			$ 34,200,000
Lessee, Operating Lease Additional Percentage Rent Percentage			4.00%
Operating Lease, Expense	$ 9,026,000	$ 9,655,000	$ 28,336,000	$ 28,965,000
Lease One With NHI [Member]
Number of Skilled Nursing Facilities Subleased	4		4
Senior Healthcare Facilities [Member]
Number of Facilities under Finance Leases	3		3
Number of Finance Lease Agreements	3		3
Lessee, Finance Lease, Term of Contract (Year)	10 years		10 years
Number of Additional Lease Options	2		2
Lessee, Finance Lease, Annual Base Rent Expense			$ 5,200,000
Lessee, Finance Lease Additional Percentage Rent Percentage			4.00%
Lessee, Finance Lease, Renewal Term (Year)	5 years		5 years