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Note 7 - Long-term Leases (Details Textual)
 3 Months Ended
Mar. 31, 2025
USD ($)
Mar. 31, 2024
USD ($)
Lessee, Operating Lease, Liability, to be Paid, Year One $ 35,718,000  
Lessee, Operating Lease, Liability, to be Paid, Year Two 27,047,000  
Operating Lease, Expense $ 11,365,000 $ 10,348,000
NHI Lease Agreement [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  
Number of Skilled Nursing Facilities Subleased 4  
Lessee, Operating Lease, Liability, to be Paid, Year One $ 32,225,000  
Lessee, Operating Lease, Liability, to be Paid, Year Two 31,975,000  
Operating Lease, Expense $ 9,911,000 $ 9,472,000