Consolidated Statements of Cash Flows - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Cash Flows From Operating Activities:
Net income/(loss)	$ 65,288,000	$ 19,977,000	$ 139,087,000
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	42,034,000	40,489,000	40,672,000
Equity in earnings of unconsolidated investments	(2,015,000)	(477,000)	(5,111,000)
Distributions from unconsolidated investments	470,000	439,000	6,314,000
Unrealized (gains) losses on marketable equity securities	(14,944,000)	15,806,000	13,863,000
(Gains) losses on sale of marketable securities	667,000	1,326,000	(1,042,000)
Gain on acquisition of equity method investment	0	0	(95,202,000)
Gain on sale of property and equipment	(6,230,000)	0	0
Recovery of assets	0	(3,728,000)	8,225,000
Deferred income taxes	(5,768,000)	(5,995,000)	6,294,000
Stock–based compensation	2,782,000	2,612,000	2,620,000
Changes in operating assets and liabilities:
Accounts receivable	(8,559,000)	(3,862,000)	4,090,000
Inventories	(298,000)	1,494,000	199,000
Prepaid expenses and other assets	(669,000)	(11,111,000)	(3,298,000)
Operating lease obligations	(1,244,000)	(430,000)	0
Trade accounts payable	2,236,000	(5,530,000)	(2,083,000)
Accrued payroll	11,600,000	(34,188,000)	17,292,000
Amounts due to third party payors	1,738,000	(964,000)	649,000
Accrued risk reserves	790,000	4,421,000	(1,489,000)
Provider relief funds	0	(9,443,000)	(6,625,000)
Contract liabilities	0	(15,022,000)	(36,231,000)
Other current liabilities	5,376,000	(2,444,000)	(1,380,000)
Other noncurrent liabilities	6,426,000	3,382,000	(11,862,000)
Net cash provided by operating activities	111,216,000	8,742,000	62,394,000
Cash Flows From Investing Activities:
Purchases of property and equipment	(27,901,000)	(30,200,000)	(39,399,000)
Proceeds from the sale of property and equipment	0	4,175,000	0
Acquisition of skilled nursing facility	(2,700,000)	0	0
Investments in unconsolidated companies	(4,661,000)	0	(350,000)
Acquisition of equity method investment	0	0	(28,713,000)
(Investments in) collections of notes receivable	(201,000)	3,879,000	8,840,000
Purchases of marketable securities	(29,501,000)	(33,793,000)	(108,187,000)
Sale of marketable securities	47,396,000	49,961,000	101,920,000
Net cash used in investing activities	(17,568,000)	(5,978,000)	(65,889,000)
Cash Flows From Financing Activities:
Principal payments under finance lease obligations	(4,985,000)	(4,695,000)	(4,423,000)
Dividends paid to common stockholders	(35,560,000)	(34,604,000)	(32,030,000)
Issuance of common shares	313,000	2,114,000	3,441,000
Repurchase of common shares	(2,482,000)	(9,903,000)	(836,000)
Noncontrolling interest contributions (distributions)	0	250,000	(964,000)
Entrance fee deposits (refunds)	169,000	(804,000)	(452,000)
Net cash used in financing activities	(42,545,000)	(47,642,000)	(35,264,000)
Net Increase (Decrease) in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents	51,103,000	(44,878,000)	(38,759,000)
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period	74,865,000	119,743,000	158,502,000
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period	125,968,000	74,865,000	119,743,000
Balance Sheet Classifications:
Cash and cash equivalents	107,076,000	58,667,000	107,607,000
Restricted Cash and Cash Equivalents	18,892,000	16,198,000	12,136,000
Total Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents	125,968,000	74,865,000	119,743,000
Supplemental Information:
Cash payments for interest	290,000	493,000	845,000
Cash payments for income taxes	14,571,000	8,765,000	22,881,000
Non-cash activities include:
Noncontrolling interest contribution of land	$ 0	$ 0	$ 2,840,000