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Note 11 - Debt (Details Textual) - USD ($) $ in Thousands |  |  |  |  |  |  |  |  |  |  |  |  | 3 Months Ended | 9 Months Ended |
--- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | ---
Sep. 26, 2024 | Jul. 23, 2024 | May 24, 2024 | Oct. 26, 2023 | Mar. 13, 2023 | Mar. 02, 2023 | Feb. 28, 2023 | Nov. 18, 2022 | Nov. 16, 2022 | Oct. 01, 2021 | Dec. 01, 2020 | Dec. 16, 2003 | Sep. 30, 2024 | Mar. 31, 2024 | Sep. 30, 2023 | Sep. 30, 2024 | Sep. 30, 2023 | Dec. 31, 2023
Long-Term Debt, Gross |  |  |  |  |  |  |  |  |  |  |  |  | $ 60,282 |  |  | $ 60,282 |  | $ 46,296
Gain (Loss) on Extinguishment of Debt |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  | $ 0 | (160) | $ 31,616 |
Long-Term Debt |  |  |  |  |  |  |  |  |  |  |  |  | 58,459 |  |  | 58,459 |  | 44,416
Interest Expense, Debt |  |  |  |  |  |  |  |  |  |  |  |  | 1,173 |  | 1,061 | 3,480 | 5,119 |
Reclassification out of Accumulated Other Comprehensive Income [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Gain (Loss) on Extinguishment of Debt |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  | $ 0 | 0 | 27,177 |
Subordinated Debt [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Face Amount |  |  |  |  |  |  |  |  |  |  |  | $ 90,500 |  |  |  |  |  |
Long-Term Debt, Gross |  |  |  |  |  |  |  |  |  |  |  |  | 15,000 |  |  | 15,000 |  | 15,000
Gain (Loss) on Extinguishment of Debt |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | $ 31,600 |
Long-Term Debt |  |  |  |  |  |  |  |  |  |  |  |  | 13,681 |  |  | 13,681 |  | 13,594
Debt Instrument, Term (Year) |  |  |  |  |  |  |  |  |  |  |  | 30 years |  |  |  |  |  |
Subordinated Liabilities, Period Increase (Decrease) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 100 |  |
Fair Value, Option, Changes in Fair Value, Loss |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 100 |  |
Fair Value, Option, Changes in Fair Value, Gain |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 100 |  |
Repayments of Subordinated Debt |  |  |  |  |  | $ 56,500 |  |  |  |  |  |  |  |  |  |  |  |
Credit for Previous Debt Repayment |  |  |  |  |  | 2,300 |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Repaid, Principal |  |  |  |  |  | 75,500 |  |  |  |  |  |  |  |  |  |  |  |
Interest Expense, Debt |  |  |  |  | $ 5,000 | $ 23,000 |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Principal Value |  |  |  |  |  |  |  |  |  |  |  |  | 15,000 |  |  | $ 15,000 |  |
London Interbank Offered Rate [Member] | Minimum [Member] | Subordinated Debt [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Basis Spread on Variable Rate |  |  |  |  |  |  |  |  |  |  |  | 3.85% |  |  |  |  |  |
London Interbank Offered Rate [Member] | Maximum [Member] | Subordinated Debt [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Basis Spread on Variable Rate |  |  |  |  |  |  |  |  |  |  |  | 4.20% |  |  |  |  |  |
Ravix Bank Loan [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Interest Rate During Period |  |  |  |  |  |  |  |  |  | 3.75% |  |  |  |  |  | 8.50% |  |
Ravix Bank Loan [Member] | Prime Rate [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Basis Spread on Variable Rate |  |  |  |  |  |  |  |  |  | 0.50% |  |  |  |  |  |  |  |
Ravix Bank Loan [Member] | Ravix Financial, Inc [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Face Amount |  |  |  |  |  |  |  |  |  | $ 6,000 |  |  |  |  |  |  |  |
Debt Issuance Costs, Net, Total |  |  |  |  |  |  |  |  |  | 200 |  |  |  |  |  |  |  |
Ravix Bank Loan [Member] | Ravix Financial, Inc [Member] | Revolving Credit Facility [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Long-Term Debt, Gross |  |  |  |  |  |  |  |  |  | $ 1,000 |  |  |  |  |  |  |  |
Amended Ravix Bank Loan [Member] | Ravix Financial, Inc [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Face Amount |  |  |  |  |  |  |  |  | $ 6,000 |  |  |  |  |  |  |  |  |
Debt Instrument, Interest Rate During Period |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 8.75% |  |
Debt Issuance Costs, Net, Total |  |  |  |  |  |  |  |  | $ 100 |  |  |  |  |  |  |  |  |
Amended Ravix Bank Loan [Member] | Ravix Financial, Inc [Member] | Prime Rate [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Basis Spread on Variable Rate |  |  |  |  |  |  |  |  | 0.75% |  |  |  |  |  |  |  |  |
Amended Ravix Bank Loan [Member] | Ravix Financial, Inc [Member] | Revolving Credit Facility [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Face Amount |  | $ 500 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Long-Term Debt, Gross |  |  |  |  |  |  |  |  | $ 1,000 |  |  |  |  |  |  |  |  |
Debt Instrument, Interest Rate During Period |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 8.50% |  |
Repayments of Debt |  | $ 1,500 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Amended Ravix Bank Loan [Member] | Ravix Financial, Inc [Member] | Revolving Credit Facility [Member] | Prime Rate [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Basis Spread on Variable Rate |  |  |  |  |  |  |  |  | 0.50% |  |  |  |  |  |  |  |  |
The SNS Loan [Member] | Nursing Service LLC [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Face Amount |  |  |  |  |  |  |  | $ 6,500 |  |  |  |  |  |  |  |  |  |
Debt Instrument, Interest Rate During Period |  |  |  |  |  |  |  | 5.00% |  |  |  |  |  |  |  | 8.50% |  |
Debt Issuance Costs, Net, Total |  |  |  |  |  |  |  | $ 100 |  |  |  |  |  |  |  |  |  |
The SNS Loan [Member] | Nursing Service LLC [Member] | Prime Rate [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Basis Spread on Variable Rate |  |  |  |  |  |  |  | 0.50% |  |  |  |  |  |  |  |  |  |
The SNS Loan [Member] | Nursing Service LLC [Member] | Revolving Credit Facility [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Long-Term Debt, Gross |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  | $ 0 |  | 0
Line of Credit Facility, Maximum Borrowing Capacity |  |  |  |  |  |  |  | $ 1,000 |  |  |  |  |  |  |  |  |  |
DDI Loan [Member] | Digital Diagnostics Imaging, Inc. ("DDI") [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Face Amount |  |  |  | $ 5,600 |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Interest Rate During Period |  |  |  | 5.00% |  |  |  |  |  |  |  |  |  |  |  | 8.50% |  |
Debt Issuance Costs, Net, Total |  |  |  | $ 100 |  |  |  |  |  |  |  |  |  |  |  |  |  |
DDI Loan [Member] | Digital Diagnostics Imaging, Inc. ("DDI") [Member] | Prime Rate [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Basis Spread on Variable Rate |  |  |  | 0.50% |  |  |  |  |  |  |  |  |  |  |  |  |  |
DDI Loan [Member] | Digital Diagnostics Imaging, Inc. ("DDI") [Member] | Revolving Credit Facility [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Long-Term Debt, Gross |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | $ 0
Line of Credit Facility, Maximum Borrowing Capacity |  |  |  | $ 400 |  |  |  |  |  |  |  |  |  |  |  |  |  |
Image Solutions Loan [Member] | Image Solutions, LLC [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Face Amount | $ 7,750 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Long-Term Debt, Gross |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  | $ 0 |  |
Debt Instrument, Interest Rate During Period | 8.50% |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Issuance Costs, Net, Total | $ 200 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Image Solutions Loan [Member] | Image Solutions, LLC [Member] | Minimum [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Interest Rate During Period | 7.25% |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Image Solutions Loan [Member] | Image Solutions, LLC [Member] | Prime Rate [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Basis Spread on Variable Rate | 0.50% |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Image Solutions Loan [Member] | Image Solutions, LLC [Member] | Revolving Credit Facility [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Line of Credit Facility, Maximum Borrowing Capacity | $ 500 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
KWH Bank Loan [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Face Amount |  |  | $ 15,000 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Interest Rate During Period |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 7.73% |  |
Debt Issuance Costs, Net, Total |  |  | 100 |  |  |  |  |  |  |  | $ 400 |  |  |  |  |  |  |
Repayments of Debt |  |  | 9,600 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, LIBOR Floor |  |  |  |  |  |  |  |  |  |  | 0.75% |  |  |  |  |  |  |
Gain (Loss) on Extinguishment of Debt |  |  |  |  |  |  |  |  |  |  |  |  | (200) |  |  |  |  |
Long-Term Debt |  |  |  |  |  |  |  |  |  |  |  |  | 5,500 |  |  | $ 5,500 |  |
KWH Bank Loan [Member] | Delayed Draw Term Loan (DDTL) [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Face Amount |  |  | 6,000 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Repayments of Debt |  |  | 3,100 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Minimum Draw Amount |  |  | 2,000 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
KWH Bank Loan [Member] | Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate [Member] | Minimum [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Basis Spread on Variable Rate |  |  |  |  |  |  |  |  |  |  | 2.62% |  |  |  |  |  |  |
KWH Bank Loan [Member] | Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate [Member] | Maximum [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Basis Spread on Variable Rate |  |  |  |  |  |  |  |  |  |  | 3.12% |  |  |  |  |  |  |
KWH Bank Loan [Member] | Revolving Credit Facility [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Proceeds from Lines of Credit |  |  |  |  |  |  |  |  |  |  |  |  |  | $ 500 |  |  |  |
Repayments of Lines of Credit |  |  | $ 1,000 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Line of Credit Facility, Current Borrowing Capacity |  |  |  |  |  |  |  |  |  |  |  |  | 1,000 |  |  | 1,000 |  |
Long-Term Debt |  |  |  |  |  |  |  |  |  |  |  |  | $ 1,000 |  |  | $ 1,000 |  |
KWH Bank Loan [Member] | PWI Holdings [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Long-Term Debt, Gross |  |  |  |  |  |  |  |  |  |  | $ 25,700 |  |  |  |  |  |  |
KWH Bank Loan [Member] | PWI Holdings [Member] | Term Loan [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Long-Term Debt, Gross |  |  |  |  |  |  |  |  |  |  | 24,700 |  |  |  |  |  |  |
KWH Bank Loan [Member] | PWI Holdings [Member] | Revolving Credit Facility [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Long-Term Debt, Gross |  |  |  |  |  |  |  |  |  |  | $ 1,000 |  |  |  |  |  |  |
Second Amendment to KWH Loan [Member] | Revolving Credit Facility [Member] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Face Amount |  |  |  |  |  |  | $ 10,000 |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Minimum Draw Amount |  |  |  |  |  |  | $ 2,000 |  |  |  |  |  |  |  |  |  |  |
Debt Instrument, Interest Rate, Stated Percentage |  |  |  |  |  |  | 3.75% |  |  |  |  |  |  |  |  |  |  |
Proceeds from Lines of Credit |  |  |  |  |  |  |  |  |  |  |  |  |  | $ 3,500 |  |  |  |

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