Note 7 - Long-term Leases (Details Textual)	12 Months Ended
	Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Lessee, Operating Lease, Liability, to be Paid, Year One	$ 35,873,000
Lessee, Operating Lease, Liability, to be Paid, Year Two	35,195,000
Lessee, Operating Lease, Liability, to be Paid, Year Three	2,420,000
Operating Lease, Expense	$ 43,182,000	$ 41,525,000	$ 40,977,000
Operating Lease, Weighted Average Remaining Lease Term (Year)	3 years 8 months 12 days	3 years
Operating Lease, Weighted Average Discount Rate, Percent	7.00%	6.60%
Operating Lease, Payments	$ 35,394,000	$ 36,198,000	36,051,000
Two Leases with NHI [Member]
Number of Skilled Nursing Centers Leased from NHI	28
Number of Assisted Living Centers Leased from NHI	5
Number of Independent Living Centers Leased from NHI	3
Lease One With NHI [Member]
Number of Skilled Nursing Facilities Subleased	4
NHI Lease Agreement [Member]
Lessee, Operating Lease, Liability, to be Paid, Year One	$ 32,625,000
Lessee, Operating Lease, Liability, to be Paid, Year Two	32,225,000
Lessee, Operating Lease, Liability, to be Paid, Year Three	31,975,000
Both NHI Lease Agreements [Member]
Operating Lease, Expense	$ 6,289,000	$ 5,549,000	$ 3,887,000