Note 2 - Summary of Significant Accounting Policies - Effect of Accounting Change (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Net operating revenues	$ 242,961	$ 238,538
Other operating expenses	65,172	63,178
Total costs and expenses	227,078	222,674
Net income	(2,899)	12,633
Previously Reported [Member]
Net operating revenues		239,243
Other operating expenses		63,883
Total costs and expenses		223,379
Net income		12,633
Restatement Adjustment [Member]
Net operating revenues		(705)
Other operating expenses		(705)
Total costs and expenses		(705)
Net income
Net Patient Revenues [Member]
Revenues	$ 231,692	227,254
Net Patient Revenues [Member] | Previously Reported [Member]
Revenues		227,959
Net Patient Revenues [Member] | Restatement Adjustment [Member]
Revenues		$ (705)