Note 8 - Long-term Leases (Details Textual)	3 Months Ended		9 Months Ended
	Sep. 30, 2024 USD ($)	Sep. 30, 2023 USD ($)	Sep. 30, 2024 USD ($)	Sep. 30, 2023 USD ($)
Lessee, Operating Lease, Liability, to be Paid, Year One	$ 35,858,000		$ 35,858,000
Lessee, Operating Lease, Liability, to be Paid, Year Two	35,183,000		35,183,000
Lessee, Operating Lease, Liability, to be Paid, Year Three	10,471,000		10,471,000
Operating Lease, Expense	$ 10,886,000	$ 10,094,000	$ 31,804,000	$ 30,087,000
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	$ 32,625,000		$ 32,625,000
Lessee, Operating Lease, Liability, to be Paid, Year Two	32,225,000		32,225,000
Lessee, Operating Lease, Liability, to be Paid, Year Three	31,975,000		31,975,000
Both NHI Lease Agreements [Member]
Operating Lease, Expense	$ 10,085,000	$ 9,300,000	$ 29,371,000	$ 27,719,000