Note 3 - Net Patient Revenues (Details Textual) - USD ($)	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017	Dec. 31, 2017
Provision for Doubtful Accounts	$ 959,000	$ 1,178,000
Medicare and Medicaid [Member]
Allowance for Doubtful Accounts Receivable, Ending Balance	$ 17,155,000		$ 17,389,000