Note 8 - Long-term Leases (Details Textual)	3 Months Ended		9 Months Ended
	Sep. 30, 2023 USD ($)	Sep. 30, 2022 USD ($)	Sep. 30, 2023 USD ($)	Sep. 30, 2022 USD ($)
Lessee, Operating Lease, Liability, to be Paid, Year One	$ 34,765,000		$ 34,765,000
Lessee, Operating Lease, Liability, to be Paid, Year Two	33,699,000		33,699,000
Lessee, Operating Lease, Liability, to be Paid, Year Three	32,991,000		32,991,000
Lessee, Operating Lease, Liability, to be Paid, Year Four	8,510,000		8,510,000
Operating Lease, Expense	$ 10,094,000	$ 10,294,000	$ 30,087,000	$ 30,770,000
Two Leases with NHI [Member]
Number of Skilled Nursing Centers Leased from NHI	28		28
Number of Assisted Living Centers Leased from NHI	5		5
Number of Independent Living Centers Leased from NHI	3		3
Lease One With NHI [Member]
Number of Skilled Nursing Facilities Subleased	4		4
NHI Lease Agreement [Member]
Lessee, Operating Lease, Liability, to be Paid, Year One	$ 34,075,000		$ 34,075,000
Lessee, Operating Lease, Liability, to be Paid, Year Two	32,625,000		32,625,000
Lessee, Operating Lease, Liability, to be Paid, Year Three	32,225,000		32,225,000
Lessee, Operating Lease, Liability, to be Paid, Year Four	31,975,000		31,975,000
Both NHI Lease Agreements [Member]
Operating Lease, Expense	$ 9,300,000	$ 9,478,000	$ 27,719,000	$ 28,293,000
Senior Healthcare Facilities [Member]
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%