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Interim Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
 6 Months Ended
Jun. 30, 2025
Jun. 30, 2024
Cash Flows From Operating Activities:    
Net income $ 56,403,000 $ 53,357,000
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 21,993,000 19,924,000
Equity in earnings of unconsolidated investments (616,000) (651,000)
Distributions from unconsolidated investments 616,000 512,000
Unrealized gains on marketable equity securities (5,921,000) (23,523,000)
Realized gains on sale of marketable securities (480,000) (350,000)
Gain on sale of unconsolidated company 0 (1,024,000)
Gain on sale of property and equipment (3,606,000) 0
Deferred income taxes 1,406,000 (6,041,000)
Stock–based compensation 2,260,000 1,969,000
Changes in operating assets and liabilities:    
Accounts receivable (6,736,000) (842,000)
Inventories 1,147,000 754,000
Prepaid expenses and other assets (23,000) 4,489,000
Operating lease obligations 351,000 120,000
Trade accounts payable (4,214,000) 2,588,000
Accrued payroll 18,925,000 (1,873,000)
Amounts due to third party payors (191,000) (151,000)
Accrued risk reserves 5,366,000 5,995,000
Other current liabilities 17,129,000 1,300,000
Other noncurrent liabilities 1,077,000 (8,328,000)
Net cash provided by operating activities 102,074,000 60,307,000
Cash Flows From Investing Activities:    
Purchases of property and equipment (16,341,000) (13,788,000)
Proceeds from the sale of unconsolidated company 0 2,100,000
Collections of (investments in) notes receivable 465,000 (210,000)
Investments in unconsolidated companies (3,205,000) (4,856,000)
Purchases of marketable securities (47,276,000) (18,898,000)
Proceeds from sale of marketable securities 43,455,000 34,662,000
Net cash used in investing activities (22,902,000) (990,000)
Cash Flows From Financing Activities:    
Repayments under credit facility (27,000,000) 0
Principal payments under finance lease obligations 0 (860,000)
Dividends paid to common stockholders (18,854,000) (18,137,000)
Issuance of common shares 6,462,000 11,239,000
Repurchase of common shares (6,384,000) (11,402,000)
Entrance fee deposits (refunds) 44,000 (520,000)
Net cash used in financing activities (45,732,000) (19,680,000)
Net Increase in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents 33,440,000 39,637,000
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 130,362,000 165,605,000
Balance Sheet Classifications:    
Cash and cash equivalents 110,992,000 136,214,000
Restricted Cash and Cash Equivalents 19,370,000 29,391,000
Total Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents $ 130,362,000 $ 165,605,000