Consolidated Statements of Cash Flows - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Cash Flows From Operating Activities:
Net income	$ 139,087,000	$ 41,990,000	$ 67,976,000
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	40,672,000	42,018,000	42,419,000
Equity in earnings of unconsolidated investments	(5,111,000)	(12,342,000)	(9,744,000)
Distributions from unconsolidated investments	6,314,000	10,050,000	3,902,000
Unrealized losses (gains) on marketable equity securities	13,863,000	23,966,000	(12,230,000)
Gains on sale of marketable securities	(1,042,000)	(195,000)	(127,000)
Gains on acquisitions of equity method investments	(95,202,000)	(1,707,000)	(1,975,000)
Gain on sale of skilled nursing facility	0	(2,784,000)	0
Deferred income taxes	6,294,000	10,593,000	(4,052,000)
Impairment of assets	8,225,000	0	0
Stock–based compensation	2,620,000	2,453,000	1,878,000
Changes in operating assets and liabilities:
Accounts receivable	4,090,000	4,529,000	4,299,000
Federal income tax receivable	0	0	(2,560,000)
Inventories	199,000	(1,249,000)	29,000
Prepaid expenses and other assets	(3,298,000)	4,727,000	(287,000)
Trade accounts payable	(2,083,000)	1,429,000	(856,000)
Accrued payroll	17,292,000	15,948,000	2,208,000
Amounts due to third party payors	649,000	1,200,000	(1,000,000)
Accrued risk reserves	(1,489,000)	3,454,000	540,000
Provider relief funds	(6,625,000)	16,068,000	0
Contract liabilities	(36,231,000)	51,253,000	0
Other current liabilities	(1,380,000)	5,898,000	780,000
Other noncurrent liabilities	(11,862,000)	7,146,000	799,000
Net cash provided by operating activities	62,394,000	203,259,000	100,103,000
Cash Flows From Investing Activities:
Purchases of property and equipment	(39,399,000)	(21,873,000)	(26,400,000)
Proceeds from the sale of skilled nursing facility	0	6,750,000	0
Investments in unconsolidated companies	(350,000)	(305,000)	(222,000)
Acquisitions of equity method investments	(28,713,000)	(6,648,000)	(15,589,000)
Investments in notes receivable	0	(425,000)	(5,462,000)
Collections of notes receivable	8,840,000	2,483,000	1,379,000
Purchases of marketable securities	(108,187,000)	(84,854,000)	(12,471,000)
Sale of marketable securities	101,920,000	40,994,000	44,500,000
Net cash used in investing activities	(65,889,000)	(63,878,000)	(14,265,000)
Cash Flows From Financing Activities:
Borrowings under credit facility	0	40,000,000	0
Principal payments under credit facility	0	(50,000,000)	(45,000,000)
Principal payments under finance lease obligations	(4,423,000)	(4,166,000)	(3,923,000)
Dividends paid to common stockholders	(32,030,000)	(31,921,000)	(31,208,000)
Issuance of common shares	3,441,000	1,756,000	2,346,000
Repurchase of common shares	(836,000)	(53,000)	(872,000)
Noncontrolling interest contributions (distributions)	(964,000)	2,488,000	(468,000)
Entrance fee deposits (refunds)	(452,000)	7,000	(623,000)
Net cash used in financing activities	(35,264,000)	(41,889,000)	(79,748,000)
Net Increase (Decrease) in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents	(38,759,000)	97,492,000	6,090,000
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period	158,502,000	61,010,000	54,920,000
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period	119,743,000	158,502,000	61,010,000
Balance Sheet Classifications:
Cash and cash equivalents	107,607,000	147,093,000	50,334,000
Restricted Cash and Cash Equivalents	12,136,000	11,409,000	10,676,000
Total Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents	119,743,000	158,502,000	61,010,000
Supplemental Information:
Cash payments for interest	845,000	1,425,000	3,118,000
Cash payments for income taxes	22,881,000	16,524,000	20,889,000
Non-cash activities include:
Noncontrolling interest contribution of land	$ 2,840,000	$ 0	$ 0