Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
CASH FLOWS FROM OPERATING ACTIVITIES:
NET LOSS	$ (7,396)	$ (4,827)	$ (1,811)
Loss from discontinued operations	(42)	(28)	(67)
Loss from continuing operations	(7,354)	(4,799)	(1,744)
Adjustments to reconcile loss from continuing operations to net cash provided by (used in) operating activities:
Depreciation and amortization	11,201	10,902	8,292
Provision for doubtful accounts	0	8,958	7,163
Deferred income tax provision (benefit)	(615)	5,997	(1,569)
Provision for self-insured professional liability, net of cash payments	2,325	1,342	1,968
Stock based and deferred compensation	1,127	1,027	1,012
Debt retirement costs	267	0	351
Provision for leases, net of cash payments	(106)	(936)	(1,773)
Lease termination costs, net of cash payments	0	0	1,863
Equity in net income of investment in unconsolidated affiliate	0	0	(271)
Litigation contingency expense	6,400	0	0
Gain on sale of assets and unconsolidated affiliate	(5,133)	(733)	(1,366)
Gain on bargain purchase	0	(925)	0
Deferred bonus	0	761	350
Other	415	523	576
Changes in other assets and liabilities affecting operating activities:
Receivables	(2,289)	(10,721)	(25,551)
Prepaid expenses and other assets	(5,857)	385	(1,620)
Trade accounts payable and accrued expenses	6,010	1,589	10,224
Net cash provided by (used in) continuing operations	6,391	13,370	(2,095)
Net cash used in discontinued operations	(740)	(1,310)	(3,523)
Net cash provided by (used in) operating activities	5,651	12,060	(5,618)
CASH FLOWS FROM INVESTING ACTIVITIES:
Purchase of property and equipment	(8,578)	(9,730)	(6,022)
Nursing center acquisitions	0	0	(7,550)
Acquisition of property and equipment through business combination	0	(8,750)	0
Proceeds from sale of assets and unconsolidated affiliate	19,008	1,100	2,068
Change in restricted cash	0	0	1,658
Net cash provide by (used in) continuing operations	10,430	(17,380)	(9,846)
Net cash used in discontinued operations	0	0	0
Net cash provided by (used in) investing activities	10,430	(17,380)	(9,846)
CASH FLOWS FROM FINANCING ACTIVITIES:
Repayment of debt obligations	(36,683)	(30,154)	(73,374)
Proceeds from issuance of debt	21,689	37,067	92,789
Financing costs	(146)	(195)	(2,162)
Issuance and redemption of employee equity awards	(217)	(94)	(105)
Payment of common stock dividends	(1,055)	(1,384)	(1,366)
Payment for preferred stock restructuring	(508)	(659)	(640)
Net cash provided by (used in) continuing operations	(16,920)	4,581	15,142
Net cash used in discontinued operations	0	0	0
Net cash provided by (used in) financing activities	(16,920)	4,581	15,142
NET DECREASE IN CASH AND RESTRICTED CASH	(839)	(739)	(322)
CASH AND RESTRICTED CASH, beginning of period	3,524	4,263	4,585
CASH AND RESTRICTED CASH, end of period	2,685	3,524	4,263
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION:
Cash payments of interest, net of amounts capitalized	6,074	5,404	3,965
Cash payments of income taxes	498	847	549
SUPPLEMENTAL INFORMATION ON NON-CASH INVESTING AND FINANCING TRANSACTIONS:
Acquisition of equipment through capital lease	689	507	1,851
Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents [Abstract]
Restricted cash	0	0	1,658
Total cash and restricted cash shown in the consolidated statements of cash flows	$ 3,524	$ 4,263	$ 4,585