Note 18 - Transactions With Related Parties (Details Textual) - USD ($) $ in Millions	12 Months Ended
Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Ripco [Member]
Related Party Transaction, Amounts of Transaction	$ 0.2	$ 0.4	$ 0.2
Prohealth [Member]
Property Subject to or Available for Operating Lease, Number of Units	2
Prohealth [Member] \| Annual Base Rent for Leased Properties [Member]
Related Party Transaction, Amounts of Transaction	$ 0.4	$ 0.4	$ 0.4
Officer [Member] \| Ripco [Member]
Ownership Perecnatge	50.00%

Amount of transactions with related party during the financial reporting period.

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 850
-SubTopic 10
-Section 50
-Paragraph 1
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=6457730&loc=d3e39549-107864

Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 850
-SubTopic 10
-Section 50
-Paragraph 4
-URI http://asc.fasb.org/extlink&oid=6457730&loc=d3e39622-107864

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 850
-SubTopic 10
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=6457730&loc=d3e39603-107864

Name:	us-gaap_RelatedPartyTransactionAmountsOfTransaction
Namespace Prefix:	us-gaap_
Data Type:	xbrli:monetaryItemType
Balance Type:	debit
Period Type:	duration