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Note 4 - Net Patient Revenues (Details Textual) - USD ($)
 3 Months Ended 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Sep. 30, 2024
Sep. 30, 2023
Dec. 31, 2023
Revenue from Contract with Customer, Including Assessed Tax $ 328,674,000 $ 277,005,000 $ 894,415,000 $ 804,617,000  
Accounts Receivable, Allowance for Credit Loss 10,859,000   10,859,000   $ 8,054,000
Medicare and Medicaid [Member]          
Accounts Receivable, Allowance for Credit Loss 18,815,000   18,815,000   $ 18,369,000
Medicaid [Member]          
Revenue from Contract with Customer, Including Assessed Tax $ 5,267,000 $ 4,232,000 $ 11,314,000 $ 15,362,000