Note 5 - Accounts Receivable (Details Textual) - USD ($) $ in Thousands	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017
Annual Cap of Rural Health Care Support		$ 571,000	$ 400,000
Percentage of Refund Available		100.00%	84.40%
Accounts Receivable, Net, Current, Total	$ 28,568			$ 32,535
Rural Health Care Customers [Member]
Accounts Receivable, Net, Current, Total	$ 6,564			$ 8,580

Amount due from customers or clients, within one year of the balance sheet date (or the normal operating cycle, whichever is longer), for goods or services (including trade receivables) that have been delivered or sold in the normal course of business, reduced to the estimated net realizable fair value by an allowance established by the entity of the amount it deems uncertain of collection.

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 8
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=109196051&loc=SL49130549-203045

Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02(3))
-URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682

Name:	us-gaap_AccountsReceivableNetCurrent
Namespace Prefix:	us-gaap_
Data Type:	xbrli:monetaryItemType
Balance Type:	debit
Period Type:	instant