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Interim Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
 3 Months Ended
Mar. 31, 2025
Mar. 31, 2024
Cash Flows From Operating Activities:    
Net income $ 32,290,000 $ 26,251,000
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 10,978,000 10,586,000
Equity in earnings of unconsolidated investments 0 (67,000)
Unrealized gains on marketable equity securities (10,982,000) (14,399,000)
Gains on sale of marketable securities (241,000) (344,000)
Gain on sale of unconsolidated company 0 (1,024,000)
Deferred income taxes (1,356,000) (2,484,000)
Stock–based compensation 1,027,000 793,000
Changes in operating assets and liabilities:    
Accounts receivable (6,416,000) (17,119,000)
Inventories 960,000 623,000
Prepaid expenses and other assets 445,000 3,153,000
Operating lease obligations 175,000 55,000
Trade accounts payable (3,847,000) 1,503,000
Accrued payroll 3,541,000 (19,954,000)
Amounts due to third party payors (1,454,000) 1,619,000
Accrued risk reserves 4,581,000 4,978,000
Contract liabilities 0 7,667,000
Other current liabilities 5,919,000 1,311,000
Other noncurrent liabilities 923,000 1,530,000
Net cash provided by operating activities 39,255,000 9,646,000
Cash Flows From Investing Activities:    
Purchases of property and equipment (6,137,000) (5,955,000)
Proceeds from sale of unconsolidated company 0 2,100,000
Investments in unconsolidated companies (2,419,000) (1,488,000)
Collections of notes receivable 7,000 16,000
Purchases of marketable securities (11,062,000) (8,703,000)
Proceeds from sale of marketable securities 12,288,000 11,615,000
Net cash used in investing activities (7,323,000) (2,415,000)
Cash Flows From Financing Activities:    
Repayments under credit facility (3,000,000) 0
Principal payments under finance lease obligations 0 (860,000)
Dividends paid to common stockholders (9,420,000) (9,051,000)
Issuance of common stock 1,278,000 8,412,000
Repurchase of common shares (1,722,000) (9,900,000)
Entrance fee deposits (refunds) 171,000 (668,000)
Net cash used in financing activities (12,693,000) (12,067,000)
Net Increase/(Decrease) in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents 19,239,000 (4,836,000)
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period 96,922,000 125,968,000
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period 116,161,000 121,132,000
Balance Sheet Classifications:    
Cash and cash equivalents 90,386,000 93,982,000
Restricted Cash and Cash Equivalents 25,775,000 27,150,000
Total Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents $ 116,161,000 $ 121,132,000