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Note 7 - Long-term Leases (Details Textual)
 3 Months Ended
Mar. 31, 2024
USD ($)
Mar. 31, 2023
USD ($)
Lessee, Operating Lease, Liability, to be Paid, Year One $ 34,351,000  
Lessee, Operating Lease, Liability, to be Paid, Year Two 33,590,000  
Lessee, Operating Lease, Liability, to be Paid, Year Three 24,933,000  
Operating Lease, Expense $ 10,348,000 $ 10,092,000
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 $ 9,472,000 $ 9,295,000