National HealthCare (NHC) 10-Q 5 Nov 13 2013 Q3 Quarterly report Financial data

Document_And_Entity_Informatio

Document And Entity Information	9 Months Ended
	Sep. 30, 2013	Nov. 01, 2013
Document and Entity Information [Abstract]	'	'
Entity Registrant Name	'NATIONAL HEALTHCARE CORP	'
Document Type	'10-Q	'
Current Fiscal Year End Date	'--12-31	'
Entity Common Stock, Shares Outstanding	'	14,063,556
Amendment Flag	'false	'
Entity Central Index Key	'0001047335	'
Entity Current Reporting Status	'Yes	'
Entity Voluntary Filers	'No	'
Entity Filer Category	'Accelerated Filer	'
Entity Well-known Seasoned Issuer	'No	'
Document Period End Date	30-Sep-13	'
Document Fiscal Year Focus	'2013	'
Document Fiscal Period Focus	'Q3	'

Interim_Condensed_Consolidated

Interim Condensed Consolidated Statements of Income (unaudited) (USD $)	3 Months Ended		9 Months Ended
	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012
Net patient revenues	$182,966,000	$175,361,000	$539,797,000	$525,211,000
Other revenues	12,806,000	13,946,000	42,364,000	41,814,000
Net operating revenues	195,772,000	189,307,000	582,161,000	567,025,000
Cost and Expenses:	'	'	'	'
Salaries, wages and benefits	113,739,000	106,844,000	330,160,000	318,028,000
Other operating	45,752,000	48,519,000	148,891,000	149,271,000
Facility rent	9,889,000	9,813,000	29,627,000	29,507,000
Depreciation and amortization	7,045,000	7,402,000	20,973,000	22,168,000
Interest	82,000	119,000	248,000	345,000
Total costs and expenses	176,507,000	172,697,000	529,899,000	519,319,000
Income Before Non–Operating Income	19,265,000	16,610,000	52,262,000	47,706,000
Non–Operating Income	11,171,000	6,771,000	24,421,000	18,546,000
Income Before Income Taxes	30,436,000	23,381,000	76,683,000	66,252,000
Income Tax Provision	-10,559,000	-6,185,000	-28,659,000	-22,847,000
Net Income	19,877,000	17,196,000	48,024,000	43,405,000
Dividends to Preferred Stockholders	-2,167,000	-2,167,000	-6,503,000	-6,503,000
Net Income Available to Common Stockholders	$17,710,000	$15,029,000	$41,521,000	$36,902,000
Earnings Per Common Share:	'	'	'	'
Basic (in Dollars per share)	$1.28	$1.08	$3	$2.67
Diluted (in Dollars per share)	$1.19	$1.04	$2.88	$2.62
Weighted Average Common Shares Outstanding:	'	'	'	'
Basic (in Shares)	13,820,449	13,852,403	13,832,706	13,846,022
Diluted (in Shares)	16,686,915	16,605,285	16,701,491	16,578,535
Dividends Declared Per Common Share (in Dollars per share)	$0.32	$0.30	$0.94	$0.90

Interim_Condensed_Consolidated1

Interim Condensed Consolidated Statements of Comprehensive Income (unaudited) (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012
Net Income	$19,877	$17,196	$48,024	$43,405
Other Comprehensive Income (Loss):	'	'	'	'
Unrealized gains (losses) on investments in marketable securities	-5,629	1,170	-3,471	15,177
Reclassification adjustment for realized (gains) losses on sale of securities	911	53	527	-934
Income tax (expense) benefit related to items of other comprehensive income (loss)	1,889	-465	993	-5,524
Other comprehensive income (loss), net of tax	-2,829	758	-1,951	8,719
Comprehensive Income	$17,048	$17,954	$46,073	$52,124

Interim_Condensed_Consolidated2

Interim Condensed Consolidated Balance Sheets (USD $)	Sep. 30, 2013	Dec. 31, 2012
Current Assets:	'	'
Cash and cash equivalents	$88,410,000	$66,701,000
Restricted cash and cash equivalents	12,149,000	11,563,000
Marketable securities	108,199,000	107,250,000
Restricted marketable securities	141,861,000	135,207,000
Accounts receivable, less allowance for doubtful accounts of $4,156 and $3,166, respectively	79,827,000	76,959,000
Inventories	7,078,000	6,660,000
Prepaid expenses and other assets	2,016,000	1,132,000
Notes receivable	376,000	5,840,000
Federal income tax receivable	'	5,933,000
Total current assets	439,916,000	417,245,000
Property and Equipment:	'	'
Property and equipment, at cost	725,732,000	675,455,000
Accumulated depreciation and amortization	-270,818,000	-254,548,000
Net property and equipment	454,914,000	420,907,000
Other Assets:	'	'
Deposits	280,000	143,000
Goodwill	17,600,000	17,600,000
Notes receivable	13,054,000	15,949,000
Deferred income taxes	14,083,000	12,817,000
Investments in limited liability companies	36,125,000	40,039,000
Total other assets	81,142,000	86,548,000
Total assets	975,972,000	924,700,000
Current Liabilities:	'	'
Trade accounts payable	12,522,000	10,555,000
Accrued payroll	56,645,000	37,243,000
Amounts due to third party payors	21,009,000	19,267,000
Accrued risk reserves	118,714,000	110,331,000
Deferred income taxes	22,617,000	24,474,000
Other current liabilities	17,689,000	20,411,000
Dividends payable	6,726,000	6,480,000
Total current liabilities	255,922,000	228,761,000
Long–term debt	10,000,000	10,000,000
Refundable entrance fees	10,600,000	10,680,000
Obligation to provide future services	1,791,000	1,791,000
Other noncurrent liabilities	14,026,000	13,890,000
Deferred revenue	3,977,000	3,430,000
Stockholders’ Equity:	'	'
Series A Convertible Preferred Stock; $.01 par value; 25,000,000 shares authorized; 10,837,695 and 10,838,412 shares, respectively, issued and outstanding; stated at liquidation value of $15.75 per share	170,510,000	170,514,000
Common stock, $.01 par value; 30,000,000 shares authorized; 14,063,449 and 14,158,127 shares, respectively, issued and outstanding	140,000	141,000
Capital in excess of par value	151,854,000	154,692,000
Retained earnings	308,295,000	279,993,000
Accumulated other comprehensive income	48,857,000	50,808,000
Total stockholders’ equity	679,656,000	656,148,000
Total liabilities and stockholders’ equity	$975,972,000	$924,700,000

Interim_Condensed_Consolidated3

Interim Condensed Consolidated Balance Sheets (Parentheticals) (USD $)	Sep. 30, 2013	Dec. 31, 2012
In Thousands, except Share data, unless otherwise specified
Allowance for doubtful accounts (in Dollars)	$4,156	$3,166
Series A Convertible Preferred Stock; par value (in Dollars per share)	$0.01	$0.01
Series A Convertible Preferred Stock; shares authorized (in Shares)	25,000,000	25,000,000
Series A Convertible Preferred Stock; shares issued (in Shares)	10,837,695	10,838,412
Series A Convertible Preferred Stock; shares outstanding (in Shares)	10,837,695	10,838,412
Series A Convertible Preferred Stock; liquidation value (in Dollars per share)	$15.75	$15.75
Common stock, par value (in Dollars per share)	$0.01	$0.01
Common stock, shares authorized (in Shares)	30,000,000	30,000,000
Common stock, shares issued (in Shares)	14,063,449	14,158,127
Common stock, shares outstanding (in Shares)	14,063,449	14,158,127

Interim_Condensed_Consolidated4

Interim Condensed Consolidated Statements of Cash Flows (unaudited) (USD $)	9 Months Ended
	Sep. 30, 2013	Sep. 30, 2012
Cash Flows From Operating Activities:	'	'
Net income	$48,024,000	$43,405,000
Adjustments to reconcile net income to net cash provided by operating activities:	'	'
Depreciation and amortization	20,973,000	22,168,000
Provision for doubtful accounts receivable	2,331,000	1,773,000
Equity in earnings of unconsolidated investments	-11,542,000	-10,079,000
Distributions from unconsolidated investments	15,456,000	6,301,000
Gain on recovery of notes receivable	-5,454,000	'
(Gains) losses on sale of marketable securities	527,000	-934,000
Deferred income taxes	-2,130,000	-375,000
Stockbbased compensation	1,812,000	1,925,000
Changes in operating assets and liabilities:	'	'
Restricted cash and cash equivalents	-8,721,000	-6,270,000
Accounts receivable	-5,199,000	2,971,000
Income tax receivable	5,933,000	3,779,000
Inventories	-418,000	940,000
Prepaid expenses and other assets	-884,000	-672,000
Trade accounts payable	1,967,000	-4,288,000
Accrued payroll	19,402,000	-3,386,000
Amounts due to third party payors	1,742,000	2,238,000
Other current liabilities and accrued risk reserves	5,662,000	3,635,000
Other noncurrent liabilities	136,000	-2,668,000
Deferred revenue	547,000	866,000
Net cash provided by operating activities	90,164,000	61,329,000
Cash Flows From Investing Activities:	'	'
Additions to property and equipment	-33,981,000	-14,888,000
Acquisition of six skilled nursing facilities	-21,000,000	'
Acquisition of non-controlling interest in hospice business	'	-7,500,000
Collections of notes receivable	13,813,000	336,000
Change in restricted cash and cash equivalents	8,135,000	20,940,000
Purchase of marketable securities	-68,978,000	-65,778,000
Sale of marketable securities	57,904,000	42,604,000
Net cash used in investing activities	-44,107,000	-24,286,000
Cash Flows From Financing Activities:	'	'
Tax expense from stockbbased compensation	-225,000	-271,000
Dividends paid to preferred stockholders	-6,503,000	-6,503,000
Dividends paid to common stockholders	-12,973,000	-12,536,000
Issuance of common shares	270,000	5,960,000
Repurchase of common shares	-4,700,000	'
Entrance fee refunds	-80,000	-1,211,000
Change in deposits	-137,000	217,000
Net cash used in financing activities	-24,348,000	-14,344,000
Net Increase in Cash and Cash Equivalents	21,709,000	22,699,000
Cash and Cash Equivalents, Beginning of Period	66,701,000	61,008,000
Cash and Cash Equivalents, End of Period	$88,410,000	$83,707,000

Interim_Condensed_Consolidated5

Interim Condensed Consolidated Statements of Stockholders' Equity (unaudited) (USD $)	Preferred Stock [Member]	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	Accumulated Other Comprehensive Income (Loss) [Member]	Total
Balance at Dec. 31, 2011	$170,515,000	$138,000	$139,183,000	$260,331,000	$36,702,000	$606,869,000
Balance (in Shares) at Dec. 31, 2011	10,838,490	13,862,738	'	'	'	'
Net income	'	'	'	43,405,000	'	43,405,000
Other comprehensive income (loss)	'	'	'	'	8,719,000	8,719,000
Stockbbased compensation	'	'	1,925,000	'	'	1,925,000
Tax expense from exercise of stock options	'	'	-271,000	'	'	-271,000
Shares sold b options exercised	'	1,000	5,959,000	'	'	5,960,000
Shares sold b options exercised (in Shares)	'	130,150	'	'	'	'
Shares issued in conversion of preferred stock to common stock	-1,000	'	1,000	'	'	'
Shares issued in conversion of preferred stock to common stock (in Shares)	-78	18	'	'	'	'
Dividends declared to preferred stockholders	'	'	'	-6,503,000	'	-6,503,000
Dividends declared to common stockholders	'	'	'	-12,587,000	'	-12,587,000
Balance at Sep. 30, 2012	170,514,000	139,000	146,797,000	284,646,000	45,421,000	647,517,000
Balance (in Shares) at Sep. 30, 2012	10,838,412	13,992,906	'	'	'	'
Balance at Dec. 31, 2012	170,514,000	141,000	154,692,000	279,993,000	50,808,000	656,148,000
Balance (in Shares) at Dec. 31, 2012	10,838,412	14,158,127	'	'	'	'
Net income	'	'	'	48,024,000	'	48,024,000
Other comprehensive income (loss)	'	'	'	'	-1,951,000	-1,951,000
Stockbbased compensation	'	'	1,812,000	'	'	1,812,000
Tax expense from exercise of stock options	'	'	-225,000	'	'	-225,000
Shares sold b options exercised	'	'	270,000	'	'	270,000
Shares sold b options exercised (in Shares)	'	5,150	'	'	'	-7,150
Shares issued in conversion of preferred stock to common stock	-4,000	'	4,000	'	'	'
Shares issued in conversion of preferred stock to common stock (in Shares)	-717	172	'	'	'	'
Dividends declared to preferred stockholders	'	'	'	-6,503,000	'	-6,503,000
Dividends declared to common stockholders	'	'	'	-13,219,000	'	-13,219,000
Repurchase of common stock	'	-1,000	-4,699,000	'	'	-4,700,000
Repurchase of common stock (in Shares)	'	-100,000	'	'	'	'
Balance at Sep. 30, 2013	$170,510,000	$140,000	$151,854,000	$308,295,000	$48,857,000	$679,656,000
Balance (in Shares) at Sep. 30, 2013	10,837,695	14,063,449	'	'	'	'

Interim_Condensed_Consolidated6

Interim Condensed Consolidated Statements of Stockholders' Equity (unaudited) (Parentheticals) (USD $)	9 Months Ended
	Sep. 30, 2013	Sep. 30, 2012
Dividends declared to common stockholders per share (in Dollars per share)	$0.94	$0.90
Preferred Stock [Member]	'	'
Dividends declared to preferred stockholders per share (in Dollars per share)	'	$0.60
Dividends declared to common stockholders per share (in Dollars per share)	$0.60	'
Common Stock [Member]	'	'
Dividends declared to preferred stockholders per share (in Dollars per share)	$0.94	'
Dividends declared to common stockholders per share (in Dollars per share)	'	$0.90

Note_1_Description_of_Business

Note 1 - Description of Business	9 Months Ended
	Sep. 30, 2013
Disclosure Text Block [Abstract]	'
Organization, Consolidation and Presentation of Financial Statements Disclosure [Text Block]	'
	Note 1 – Description of Business
	National HealthCare Corporation (“NHC” or the “Company”) is a leading provider of senior health care services. We operate or manage, through certain affiliates, 68 skilled nursing centers with 8,803 beds in nine states and provide other senior health care services in one additional state. These operations are provided by separately funded and maintained subsidiaries. We provide health care services to patients in a variety of settings including skilled nursing centers, managed care specialty units, sub–acute care units, Alzheimer's care units, homecare programs, assisted living centers and independent living centers. We also have a non-controlling ownership interest in a hospice care business that services NHC owned health care centers and others. In addition, we provide insurance services, management and accounting services, and lease properties to operators of skilled nursing centers.

Note_2_Summary_of_Significant_

Note 2 - Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2013
Accounting Policies [Abstract]	'
Significant Accounting Policies [Text Block]	'
	Note 2 – Summary of Significant Accounting Policies
	The listing below is not intended to be a comprehensive list of all of our significant accounting policies. In many cases, the accounting treatment of a particular transaction is specifically dictated by generally accepted accounting principles, with limited need for management’s judgment in their application. There are also areas in which management’s judgment in selecting any available alternative would not produce a materially different result. See our audited December 31, 2012 consolidated financial statements and notes thereto which contain accounting policies and other disclosures required by generally accepted accounting principles. Our audited December 31, 2012 consolidated financial statements are available at our web site: www.nhccare.com.
	Basis of Presentation
	The unaudited condensed consolidated financial statements to which these notes are attached include all normal, recurring adjustments which are necessary to fairly present the financial position, results of operations and cash flows of NHC. All significant intercompany transactions and balances have been eliminated in consolidation. We assume that users of these interim financial statements have read or have access to the audited December 31, 2012 consolidated financial statements and Management’s Discussion and Analysis of Financial Condition and Results of Operations and that the adequacy of additional disclosure needed for a fair presentation, except in regard to material contingencies, may be determined in that context. Accordingly, footnotes and other disclosures which would substantially duplicate the disclosure contained in our most recent annual report to stockholders have been omitted. This interim financial information is not necessarily indicative of the results that may be expected for a full year for a variety of reasons.
	Estimates and Assumptions
	The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires us to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates and could cause our reported net income to vary significantly from period to period.
	Change in Accounting Principle
	Effective January 1, 2013, the Company recorded the cumulative effect of a change in accounting principle related to the adoption of ASU No. 2012-01, Continuing Care Retirement Communities — Refundable Advance Fees. This standard is intended to clarify the accounting for advance fees (“entrance fees”) received by a continuing care retirement community (“CCRC”). The updated guidance states the estimated amount of entrance fees that are expected to be refunded to current CCRC residents under the terms of the resident agreements shall be accounted for and reported as a liability (“refundable entrance fees”). Previously, we accounted for both the 10% non-refundable and the refundable portions of the entrance fees as deferred revenue, amortizing the deferred revenue over the life expectancy of the resident and the estimated useful life of the building, respectively, in accordance with ASC Topic 954-430, Health Care Entities-Deferred Revenue. The Company believes recording the refundable entrance fees as a liability, which includes 90% of the original entry fee paid plus 40% of any estimated appreciation if the apartment exceeds the original resident’s entry fee, more clearly aligns how we have historically operated the CCRC. Also, with the adoption of ASU No. 2012-01, our future service obligation calculation for the CCRC was modified. Because the future service obligation calculation includes an offset for unamortized deferred revenue, the reclassification of refundable entrance fee amounts from deferred revenue to a liability has a direct impact on the future revenues input of the calculation. With the loss of deferred revenue, the present value of the CCRC’s expenses exceeds the present value of the CCRC’s revenues, which creates the recording of a future service obligation.
	As described in the guidance for accounting changes, the comparative interim consolidated financial statements of prior periods are adjusted to apply the new accounting method retrospectively. The following tables present the effect on the interim condensed consolidated financial statements of the accounting change that was retrospectively adopted on January 1, 2013:
	Consolidated Balance Sheet
	(in thousands)
		31-Dec-12
		As			Effect of			As Adjusted
		Previously			Accounting
		Reported			Change
	Deferred income taxes	$	10,564		$	2,253		$	12,817
	Total assets		922,447			2,253			924,700
	Refundable entrance fees	–				10,680			10,680
	Deferred revenue		10,124			(6,694	)		3,430
	Obligation to provide future services	–				1,791			1,791
	Retained earnings		283,517			(3,524	)		279,993
	Total stockholders' equity		659,672			(3,524	)		656,148
	Total liabilities and stockholders' equity	$	922,447		$	2,253		$	924,700
	Interim Condensed Consolidated Statement of Income
	(in thousands, except share and per share amounts)
		Three Months Ended September 30, 2012									Nine Months Ended September 30, 2012
		As			Effect of			As			As			Effect of			As
		Previously			Accounting			Adjusted			Previously			Accounting			Adjusted
		Reported			Change						Reported			Change
	Other revenues	$	14,007		$	(61	)	$	13,946		$	42,008		$	(194	)	$	41,814
	Net operating revenues		189,368			(61	)		189,307			567,219			(194	)		567,025
	Income Before Non-Operating Income		16,671			(61	)		16,610			47,900			(194	)		47,706
	Income Before Income Taxes		23,442			(61	)		23,381			66,446			(194	)		66,252
	Income Tax Provision		(6,209	)		24			(6,185	)		(22,923	)		76			(22,847	)
	Net Income		17,233			(37	)		17,196			43,523			(118	)		43,405
	Net Income Available to Common Shareholders	$	15,066		$	(37	)	$	15,029		$	37,020			(118	)	$	36,902
	Basic Earnings Per Share	$	1.09		$	(0.01	)	$	1.08		$	2.67		$	0		$	2.67
	Diluted Earnings Per Share	$	1.04		$	0		$	1.04		$	2.63		$	(0.01	)	$	2.62
	Interim Condensed Consolidated Statement of Comprehensive Income
	(in thousands)
		Three Months Ended September 30, 2012									Nine Months Ended September 30, 2012
		As			Effect of			As			As			Effect of			As
		Previously			Accounting			Adjusted			Previously			Accounting			Adjusted
		Reported			Change						Reported			Change
	Net Income	$	17,233		$	(37	)	$	17,196		$	43,523		$	(118	)	$	43,405
	Comprehensive Income	$	17,991		$	(37	)	$	17,954		$	52,242		$	(118	)	$	52,124
	Interim Condensed Consolidated Statement of Cash Flows
	(in thousands)
		Nine Months Ended September 30, 2012
		As			Effect of			As
		Previously			Accounting			Adjusted
		Reported			Change
	Cash Flows From Operating Activities:
	Net income	$	43,523		$	(118	)	$	43,405
	Deferred income taxes		(299	)		(76	)		(375	)
	Deferred revenue		959			(93	)		866
	Net cash provided by operating activities		61,616			(287	)		61,329
	Cash Flows From Financing Activities:
	Entrance fee deposits		(1,498	)		287			(1,211	)
	Net cash used in financing activities	$	(14,631	)	$	287		$	(14,344	)
	Interim Condensed Consolidated Statements of Stockholders' Equity
	(in thousands)
		Nine Months Ended September 30, 2012
	As			Effect of			As
	Previously			Accounting			Adjusted
	Reported			Change
Retained Earnings
Balance at January 1, 2012	$	265,198		$	(4,867	)	$	260,331
Revenue Recognition – Third Party Payors
Approximately 67% of our net patient revenues are derived from Medicare, Medicaid, and other government programs. Amounts earned under these programs are subject to review by the Medicare and Medicaid intermediaries or their agents. In our opinion, adequate provision has been made for any adjustments that may result from these reviews. Any differences between our original estimates of reimbursements and subsequent revisions are reflected in operations in the period in which the revisions are made often due to final determination or the period of payment no longer being subject to audit or review. We have made provisions of approximately $21,009,000 and $19,267,000 as of September 30, 2013 and December 31, 2012, respectively, for various Medicare and Medicaid current and prior year cost reports and claims reviews.
Revenue Recognition – Private Pay
For private pay patients in skilled nursing or assisted living facilities, we bill room and board in advance with payment being due in the month the services are performed. Charges for ancillary, pharmacy, therapy and other services to private patients are billed in the month following the performance of services; however, all billings are recognized as revenue when the services are performed.
Revenue Recognition – Subordination of Fees and Uncertain Collections
We provide management services to certain long–term care facilities and to others we provide accounting and financial services. We generally charge 6% to 7% of net operating revenues for our management services and a predetermined fixed rate per bed for the accounting and financial services. Our policy is to recognize revenues associated with both management services and accounting and financial services on an accrual basis as the services are provided. However, under the terms of our management contracts, payments for our management services are subject to subordination to other expenditures of the long–term care center being managed. Furthermore, for certain of the third parties with whom we have contracted to provide services and which we have determined that collection is not reasonably assured, our policy is to recognize income only in the period in which the amounts are realized. We may receive payment for the unpaid and unrecognized management fees in whole or in part in the future only if cash flows from the operating and investing activities of the centers or proceeds from the sale of the centers are sufficient to pay the fees. There can be no assurance that such future cash flows will occur. The realization of such previously unrecognized revenue could cause our reported net income to vary significantly from period to period.
We agree to subordinate our fees to the other expenses of a managed center because we believe we know how to improve the quality of patient services and finances of a long–term care center. We believe subordinating our fees demonstrates to the owner and employees of the managed center how confident we are of the impact we can have in making the center operations successful. We may continue to provide services to certain managed centers despite not being fully paid currently so that we may be able to collect unpaid fees in the future from improved operating results and because the incremental savings from discontinuing services to a center may be small compared to the potential benefit. Also, we may benefit from providing other ancillary services to the managed center.
Accrued Risk Reserves
We are principally self–insured for risks related to employee health insurance, workers’ compensation and professional and general liability claims. Our accrued risk reserves primarily represent the accrual for self–insured risks associated with employee health insurance, workers’ compensation and professional and general liability claims. The accrued risk reserves include a liability for reported claims and estimates for incurred but unreported claims. Our policy with respect to our workers’ compensation and professional and general liability claims is to use an external, independent actuary to estimate our exposure for claims obligations (for both asserted and unasserted claims). Our health insurance reserve is based on our known claims incurred and an estimate of incurred but unreported claims determined by our analysis of historical claims paid. We reassess our accrued risk reserves on a quarterly basis.
Professional liability remains an area of particular concern to us. The entire long term care industry has seen an increase in personal injury/wrongful death claims based on alleged negligence by nursing homes and their employees in providing care to residents. As of September 30, 2013, we and/or our managed centers are defendants in 30 such claims inclusive of years 2005 through September 30, 2013. It remains possible that those pending matters plus potential unasserted claims could exceed our reserves, which could have a material adverse effect on our consolidated financial position, results of operations and cash flows. It is also possible that future events could cause us to make significant adjustments or revisions to these reserve estimates and cause our reported net income to vary significantly from period to period.
We maintain insurance coverage for incidents occurring in all centers owned or leased by us. The coverages include both primary policies and excess policies. In all years, settlements, if any, in excess of available insurance policy limits and our own reserves would be expensed by us.
Continuing Care Contracts and Refundable Entrance Fees
We have one continuing care retirement center (“CCRC”) within our operations. Residents at this retirement center may enter into continuing care contracts with us. The contract provides that 10% of the resident entry fee becomes non-refundable upon occupancy, and the remaining refundable portion of the entry fee is calculated using the lessor of the price at which the apartment is re-assigned or 90% of the original entry fee, plus 40% of any appreciation if the apartment exceeds the original resident’s entry fee. In each case, we amortize the non-refundable part of these fees into revenue over the actuarially determined remaining life of the resident, which is the expected period of occupancy by the resident. We pay the refundable portion of our entry fees when residents relocate from our community and the apartment is re-occupied. Refundable entrance fees are classified as non-current liabilities and non-refundable entrance fees are classified as deferred revenue in the Company's consolidated balance sheets. The balances of refundable entrance fees as of September 30, 2013 and December 31, 2012 were $10,600,000 and $10,680,000, respectively.
Obligation to Provide Future Services
The CCRC annually calculates the present value of the net cost of future services and the use of facilities to be provided to the current residents and compares that amount with the balance of non-refundable deferred revenue from entrance fees received. If the present value of the net cost of future services exceeds the related anticipated revenues, a liability is recorded (obligation to provide future services) with a corresponding charge to income. With the recent adoption of ASU No. 2012–01, our future service obligation calculation was modified and we now have a liability recorded in the amount of $1,791,000 as of September 30, 2013 and December 31, 2012.
Deferred Revenue
Deferred revenue includes the deferred gain on the sale of assets to National, the non-refundable portion (10%) of CCRC entrance fees being amortized over the remaining life expectancies of the residents, and premiums received within our workers’ compensation and professional liability companies that are not yet earned.
New Accounting Pronouncements
In February 2013, the Financial Accounting Standards Board (“FASB”) issued Accounting Standard Update (“ASU”) No. 2013–02, which is included in Codification under ASC 220, “Comprehensive Income”. The objective of this updated standard is to improve the reporting of reclassifications out of accumulated other comprehensive income. The standard states that disclosure of reclassification amounts required by U.S. GAAP to be reclassified out of accumulated other comprehensive income to net income in their entirety in the same reporting period, should be provided in one location, by component of other comprehensive income. Presentation of such amounts is permitted on either the face of the financial statement where net income is presented or as a separate tabular disclosure in the notes to the financial statements, and should be disclosed by respective line item of net income affected. This accounting standard update became effective beginning in our first quarter of fiscal 2013. The adoption of this accounting standard update resulted in financial statement presentation changes only. The Company has reclassified realized gains on the sale of marketable securities out of accumulated other comprehensive income; as such, these investment gains are classified as "non-operating income" in our consolidated statements of income.
In July 2012, the FASB issued ASU No. 2012–01, which is included in the Codification under ASC subtopic 954-430, “Health Care Entities—Deferred Revenue”. This revised standard is intended to clarify the accounting for refundable advance fees (“refundable entrance fees”) received by a continuing care retirement community. The guidance states that refundable portion of entrance fees should be accounted for as deferred revenue when the refund of the fee is contingent upon the resale of the contract holder’s unit, limited to the proceeds received by the resale, and the legal environment and management’s policy and practice support the withholding of refunds under said conditions. In the event that the refund is contingent upon reoccupancy, but not limited to the proceeds of the resale, then the fees should be accounted for and reported as a liability. This accounting standard update became effective beginning in our first quarter of fiscal 2013. The adoption of this accounting standard resulted in a change of accounting principle which was applied retrospectively, including the cumulative effect of this change recognized through beginning retained earnings. See the beginning of Note 2 under “Change in Accounting Principle” for further discussion on the adoption of ASU No. 2012-01.
Reclassifications
Certain prior period amounts have been reclassified to conform to the current financial statement presentation, with no effect on the Company's consolidated financial position or results of operations.

Note_3_Other_Revenues

Note 3 - Other Revenues	9 Months Ended
	Sep. 30, 2013
Other Revenues [Abstract]	'
Other Revenues	'
	Note 3 – Other Revenues
	Other revenues are outlined in the table below. Revenues from management and accounting services include management and accounting fees provided to managed and other health care centers. Revenues from rental income include health care real estate properties owned by us and leased to third party operators. Revenues from insurance services include premiums for workers’ compensation, health insurance, and professional liability insurance policies that our wholly–owned limited purpose insurance subsidiaries have written for certain health care centers to which we provide management or accounting services. "Other" revenues include miscellaneous health care related earnings.
	Other revenues include the following:
		Three Months Ended						Nine Months Ended
		30-Sep						30-Sep
	(in thousands)	2013			2012			2013		2012
	Management and accounting services fees	$	5,234		$	5,125		$	14,662	$	15,104
	Rental income		4,886			4,963			14,387		14,486
	Insurance services		2,729			3,972			12,792		11,803
	Other		(43	)		(114	)		523		421
		$	12,806		$	13,946		$	42,364	$	41,814
	Management Fees from National
	We manage five skilled nursing facilities owned by National Health Corporation ("National"). For the three months and nine months ended September 30, 2013, we recognized management fees and interest on management fees of $860,000 and $2,637,000, respectively, from these centers. For the three months and nine months ended September 30, 2012, we recognized management fees and interest on management fees of $850,000 and $2,564,000, respectively, from these centers.
	Because the amount collectable could not be reasonably determined when the management services were provided, and because we cannot estimate the timing or amount of expected future collections, the unpaid fees from the five centers owned by National will be recognized as revenues only when the collectability of these fees can be reasonably assured. Under the terms of our management agreement with National, the payment of these fees to us may be subordinated to other expenditures of the five long–term care centers. We continue to manage these centers so that we may be able to collect our fees in the future and because the incremental savings from discontinuing services to a center may be small compared to the potential benefit. We may receive payment for the unrecognized management fees in whole or in part in the future only if cash flows from the operating and investing activities of the five centers or the proceeds from the sale of the centers are sufficient to pay the fees. There can be no assurance that such future improved cash flows will occur.
	Management Fees from Other Nursing Centers
	For the three months and nine months ended September 30, 2013, we recognized $787,000 and $3,131,000, respectively, of management fees from fourteen skilled nursing facilities owned by two non-profit organizations (ElderTrust and SeniorTrust) where a court-appointed receiver was custodian over the assets of the organizations. For the three months and nine months ended September 30, 2012, we recognized management fees of $1,422,000 and $4,251,000, respectively, from these centers.
	On September 1, 2013 and with court approval, we began operating seven of the health care centers located in the states of Massachusetts and New Hampshire. We previously managed these seven facilities for ElderTrust. The Massachusetts and New Hampshire health care centers were paying approximately $3,200,000 annually in management fees to NHC. We do not anticipate a material change to our future results of operations and cash flows from the transition of us managing the seven health care centers to us operating the seven health care facilities.
	During the first and second quarters of 2013, SeniorTrust sold its seven skilled nursing facilities in Missouri and Kansas and terminated their respective NHC management agreements. At the time of the separation, the Missouri and Kansas health care centers were paying approximately $2,200,000 annually in management fees to NHC. We anticipate the loss of management fee revenue from the Missouri and Kansas health care centers to be adverse to our future results of operations and cash flows.
	Rental Income and Accounting Services Fees
	As part of the litigation settlement described in Note 17, we agreed to no longer sublease The Health Center at Standifer Place and Standifer Place Assisted Living facility in Chattanooga, Tennessee to a third party non-profit organization. On October 1, 2013, we terminated the current sublease with the third party non-profit organization and then re-leased the two health care facilities to a third-party for-profit operator. We do not expect the transaction to have a material effect on our future results of operations and cash flows.

Note_4_NonOperating_Income

Note 4 - Non-Operating Income	9 Months Ended
	Sep. 30, 2013
Nonoperating Income [Abstract]	'
Nonoperating Income [Text Block]	'
	Note 4 – Non–Operating Income
	Non–operating income is outlined in the table below. Non–operating income includes equity in earnings of unconsolidated investments, dividends and other realized gains and losses on marketable securities, interest income, and the gain on the recovery of notes receivable. Our most significant equity method investment is a 75.1% non–controlling ownership interest in Caris HealthCare L.P. (“Caris”), a business that specializes in hospice care services. The gain on the recovery of notes receivable was due to the collection of certain notes receivable. In accordance with ASC 310, NHC had previously written down these notes due to deteriorated credit qualities.
		Three Months Ended				Nine Months Ended
		30-Sep				30-Sep
	(in thousands)	2013		2012		2013		2012
	Equity in earnings of unconsolidated investments	$	3,947	$	4,063	$	11,542	$	10,079
	Dividends and other net realized gains and losses on sales of securities		408		1,607		3,314		5,074
	Interest income		1,362		1,101		4,111		3,393
	Gain on the recovery of notes receivable		5,454		-		5,454		-
		$	11,171	$	6,771	$	24,421	$	18,546

Note_5_New_Lease_Commitment_wi

Note 5 - New Lease Commitment with National Health Investors, Inc.	9 Months Ended
	Sep. 30, 2013
Leases [Abstract]	'
Leases of Lessee Disclosure [Text Block]	'
	Note 5 – New Lease Commitment with National Health Investors, Inc.
	On September 1, 2013, NHC began leasing and operating seven skilled nursing facilities in New Hampshire and Massachusetts from National Health Investors, Inc. ("NHI"). The 15 year lease term consists of base rent of $3,450,000 annually with rent escalating by 4% of the increase in facility revenue over a 2014 base year. Additionally, NHC has the option to purchase the facilities from NHI in the 13th year of the lease for a purchase price of $49,000,000.
	In addition to the 15 year lease described above for the seven skilled nursing facilities, NHC has a separate master lease agreement with NHI that leases the real property of 32 long-term health care centers, six assisted living centers and three independent living centers.
	Total facility rent expense to NHI was $27,260,000 and $27,218,000 for the nine months ended September 30, 2013 and 2012, respectively. The approximate future minimum base rent to be paid by us under the NHI non-cancelable operating leases at September 30, 2013 are as follows:
		Total NHI
		Lease
		Commitments
	2014	$	34,200,000
	2015		34,200,000
	2016		34,200,000
	2017		34,200,000
	2018		34,200,000
	Thereafter		287,900,000

Note_6_Other_Operating_Expense

Note 6 - Other Operating Expenses	9 Months Ended
	Sep. 30, 2013
Other Operating Expenses [Abstract]	'
Other Operating Expenses [Text Block]	'
	Note 6 – Other Operating Expenses
	Other operating expenses include the costs of care and services that we provide to the residents of our facilities and the costs of maintaining our facilities. Our primary patient care costs include drugs, medical supplies, purchased professional services, food, and professional liability insurance and licensing fees. The primary facility costs include utilities and property insurance.

Note_7_Earnings_per_Share

Note 7 - Earnings per Share	9 Months Ended
	Sep. 30, 2013
Earnings Per Share [Abstract]	'
Earnings Per Share [Text Block]	'
	Note 7 – Earnings per Share
	Basic net income per share is computed based on the weighted average number of common shares outstanding for each period presented. Diluted net income per share reflects the potential dilution that would have occurred if securities to issue common stock were exercised, converted, or resulted in the issuance of common stock that would have then shared in our earnings.
	The following table summarizes the earnings and the weighted average number of common shares used in the calculation of basic and diluted earnings per share.
		Three Months Ended September 30						Nine Months Ended September 30
	(in thousands, except for share and per share amounts)	2013			2012			2013			2012
	Basic:
	Weighted average common shares outstanding		13,820,449			13,852,403			13,832,706			13,846,022
	Net income	$	19,877		$	17,196		$	48,024		$	43,405
	Dividends to preferred stockholders		(2,167	)		(2,167	)		(6,503	)		(6,503	)
	Net income available to common stockholders		17,710			15,029			41,521			36,902
	Earnings per common share, basic	$	1.28		$	1.08		$	3		$	2.67
	Diluted:
	Weighted average common shares outstanding		13,820,449			13,852,403			13,832,706			13,846,022
	Dilutive effect of stock options		7,970			7,912			8,397			8,971
	Dilutive effect of restricted stock		3,840			4,641			4,640			5,417
	Dilutive effect of contingent issuable stock		231,500			117,000			232,495			94,796
	Convertible preferred stock		2,623,156			2,623,329			2,623,253			2,623,329
	Assumed average common shares outstanding		16,686,915			16,605,285			16,701,491			16,578,535
	Net income available to common stockholders	$	17,710		$	15,029		$	41,521		$	36,902
	Add dilutive preferred stock dividends for effect of assumed conversion of preferred stock		2,167			2,167			6,503			6,503
	Net income for diluted earnings per common share	$	19,877		$	17,196		$	48,024		$	43,405
	Earnings per common share, diluted	$	1.19		$	1.04		$	2.88		$	2.62
	In the above table, options to purchase 989,275 and 1,237,144 shares of our common stock have been excluded for 2013 and 2012, respectively, due to their anti–dilutive impact.

Note_8_Investments_in_Marketab

Note 8 - Investments in Marketable Securities	9 Months Ended
	Sep. 30, 2013
Investments, Debt and Equity Securities [Abstract]	'
Investments in Debt and Marketable Equity Securities (and Certain Trading Assets) Disclosure [Text Block]	'
	Note 8 – Investments in Marketable Securities
	Our investments in marketable securities are classified as available for sale securities. Realized gains and losses from securities sales are recognized in results of operations upon disposition of the securities using the specific identification method on a trade date basis. Refer to Note 9 for a description of the Company's methodology for determining the fair value of marketable securities.
	Marketable securities and restricted marketable securities consist of the following:
		30-Sep-13				31-Dec-12
	(in thousands)	Amortized		Fair		Amortized		Fair
		Cost		Value		Cost		Value
	Investments available for sale:
	Marketable equity securities	$	30,176	$	108,199	$	30,176	$	107,250
	Restricted investments available for sale:
	Corporate debt securities		62,613		62,075		61,453		62,876
	Commercial mortgage–backed securities		47,830		47,293		47,194		48,063
	U.S. Treasury securities		24,031		24,145		16,218		16,604
	State and municipal securities		8,151		8,348		7,213		7,664
		$	172,801	$	250,060	$	162,254	$	242,457
	Included in the available for sale marketable equity securities are the following (in thousands, except share amounts):
		30-Sep-13						31-Dec-12
		Shares		Cost		Fair		Shares		Cost		Fair
						Value						Value
	NHI Common Stock		1,630,642	$	24,734	$	92,767		1,630,642	$	24,734	$	92,180
	The amortized cost and estimated fair value of debt securities classified as available for sale, by contractual maturity, are as follows:
		30-Sep-13				31-Dec-12
	(in thousands)	Cost		Fair Value		Cost		Fair
								Value
	Maturities:
	Within 1 year	$	10,178	$	10,255	$	8,868	$	8,918
	1 to 5 years		86,227		86,902		80,910		82,801
	6 to 10 years		43,658		42,180		40,670		41,856
	Over 10 years		2,562		2,524		1,630		1,632
		$	142,625	$	141,861	$	132,078	$	135,207
	Gross unrealized gains related to available for sale securities are $79,466,000 and $80,296,000 as of September 30, 2013 and December 31, 2012, respectively. Gross unrealized losses related to available for sale securities are $2,207,000 and $93,000 as of September 30, 2013 and December 31, 2012, respectively. For the marketable securities in gross unrealized loss positions, (a) it is more likely than not that the Company will not be required to sell the investment securities before recovery of the unrealized losses, and (b) the Company expects that the contractual principal and interest will be received on the investment securities. These securities have also been in an unrealized loss position for a period of less than twelve months. As a result, the Company recognized no other-than-temporary impairment during the nine months ended September 30, 2013 or the year ended December 31, 2012.
	Proceeds from the sale of investments in restricted marketable securities during the nine months ended September 30, 2013 and 2012 were $57,904,000 and $42,604,000, respectively. Investment losses of $911,000 and $527,000 were realized on these sales during the three months and nine months ended September 30, 2013, respectively. Investment gains (losses) of $(53,000) and $934,000 were realized on these sales during the three months and nine months ended September 30, 2012, respectively.

Note_9_Fair_Value_Measurements

Note 9 - Fair Value Measurements	9 Months Ended
	Sep. 30, 2013
Fair Value Disclosures [Abstract]	'
Fair Value Disclosures [Text Block]	'
	Note 9 – Fair Value Measurements
	The accounting standard for fair value measurements provides a framework for measuring fair value and requires expanded disclosures regarding fair value measurements. Fair value is defined as the price that would be received for an asset or the exit price that would be paid to transfer a liability in the principal or most advantageous market in an orderly transaction between market participants on the measurement date. This accounting standard establishes a fair value hierarchy, which requires an entity to maximize the use of observable inputs, where available. The following summarizes the three levels of inputs that may be used to measure fair value:
	Level 1 – The valuation is based on quoted prices in active markets for identical instruments.
	Level 2 – The valuation is based on observable inputs such as quoted prices for similar instruments in active markets, quoted prices for identical or similar instruments in markets that are not active, and model–based valuation techniques for which all significant assumptions are observable in the market.
	Level 3 – The valuation is based on unobservable inputs that are supported by minimal or no market activity and that are significant to the fair value of the instrument. Level 3 valuations are typically performed using pricing models, discounted cash flow methodologies, or similar techniques that incorporate management’s own estimates of assumptions that market participants would use in pricing the instrument, or valuations that require significant management judgment or estimation.
	A financial instrument’s level within the fair value hierarchy is based on the lowest level of input that is significant to the fair value measurement.
	Valuation of Marketable Securities
	The Company determines fair value for marketable securities with Level 1 inputs through quoted market prices. The Company determines fair value for marketable securities with Level 2 inputs through broker or dealer quotations or alternative pricing sources with reasonable levels of price transparency. Our Level 2 marketable securities have been initially valued at the transaction price and subsequently valued, at the end of each month, typically utilizing third party pricing services or other market observable data. The pricing services utilize industry standard valuation models, including both income and market based approaches and observable market inputs to determine value. These observable market inputs include reportable trades, benchmark yields, credit spreads, broker/dealer quotes, bids, offers, and other industry and economic events.
	We validated the prices provided by our broker by reviewing their pricing methods, obtaining market values from other pricing sources, analyzing pricing data in certain instances and confirming that the relevant markets are active. After completing our validation procedures, we did not adjust or override any fair value measurements provided by our broker as of September 30, 2013. We did not have any transfers of assets between Level 1 and Level 2 of the fair value measurement hierarchy during the nine months ended September 30, 2013.
	Other
	The carrying amounts of cash and cash equivalents, restricted cash and cash equivalents, accounts receivable, and accounts payable approximate fair value due to their short–term nature. The estimated fair value of notes receivable approximates the carrying value based principally on their underlying interest rates and terms, maturities, collateral and credit status of the receivables. Our long–term debt approximates fair value due to variable interest rates, but fair value is also determined using Level 2 inputs through alternative pricing sources. At September 30, 2013, there were no material differences between the carrying amounts and fair values of NHC’s financial instruments.
	The following table summarizes fair value measurements by level at September 30, 2013 and December 31, 2012 for assets and liabilities measured at fair value on a recurring basis (in thousands):
		Fair Value Measurements Using
	30-Sep-13	Fair		Quoted Prices in		Significant		Significant Unobservable Inputs
		Value		Active Markets		Other		(Level 3)
				For Identical		Observable
				Assets		Inputs
				(Level 1)		(Level 2)
	Cash and cash equivalents	$	88,410	$	88,410	–			–
	Restricted cash and cash equivalents		12,149		12,149	–		–
	Marketable equity securities		108,199		108,199	–		–
	Corporate debt securities		62,075	–			62,075	–
	Commercial mortgage–backed securities		47,293	–			47,293	–
	U.S. Treasury securities		24,145		24,145	–		–
	State and municipal securities		8,348	–			8,348	–
	Total financial assets	$	350,619	$	232,903	$	117,716	–
		Fair Value Measurements Using
	31-Dec-12	Fair		Quoted Prices in Active Markets		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs
		Value		For Identical Assets				(Level 3)
				(Level 1)
	Cash and cash equivalents	$	66,701	$	66,701	–			–
	Restricted cash and cash equivalents		11,563		11,563	–		–
	Marketable equity securities		107,250		107,250	–		–
	Corporate debt securities		62,876	–			62,876	–
	Commercial mortgage–backed securities		48,063	–			48,063	–
	U.S. Treasury securities		16,604		16,604	–		–
	State and municipal securities		7,664	–			7,664	–
	Total financial assets	$	320,721	$	202,118	$	118,603	–

Note_10_LongTerm_Debt

Note 10 - Long-Term Debt	9 Months Ended
	Sep. 30, 2013
Debt Disclosure [Abstract]	'
Debt Disclosure [Text Block]	'
	Note 10 – Long–Term Debt
	Long–term debt consists of the following:
		Weighted			Maturities		9/30/13		12/31/12
		Average
		Interest Rate
		Maturities
		(Variable)
							(dollars in thousands)
	Revolving Credit Facility, interest payable monthly		0.9	%		2014	–		–
	Unsecured term note payable to National, interest payable quarterly, principal payable at maturity		2.8	%		2018		10,000		10,000
								10,000		10,000
	Less current portion						–		–
							$	10,000	$	10,000

Note_11_75000000_Revolving_Cre

Note 11 - $75,000,000 Revolving Credit Facility	9 Months Ended
	Sep. 30, 2013
Revolving Credit Facility [Abstract]	'
Revolving Credit Facility [Text Block]	'
	Note 11 – $75,000,000 Revolving Credit Facility
	Effective October 23, 2013, we extended the maturity of our Credit Agreement (the "Credit Agreement") with Bank of America, N.A., as lender (the "Lender"). The Credit Agreement provides for a $75,000,000 revolving credit facility (the "Credit Facility"), of which up to $5,000,000 may be utilized for letters of credit.
	Borrowings bear interest at either, (i) the Eurodollar rate plus 0.70% or (ii) the prime rate. Letter of credit fees are equal to 0.10% times the maximum amount available to be drawn under outstanding letters of credit.
	Commitment fees are payable on the daily unused portion of the Credit Facility at a rate of ten (10) basis points per annum. NHC is permitted to prepay the loans outstanding under the Credit Facility at any time, without penalty.
	The Credit Facility matures on October 22, 2014. We currently anticipate renewing the credit agreement at that time and while we have had no indication from the lender there is any question about renewal, there has been no commitment at this time. If the Lender elects to consent to such extension, subject to certain conditions, the maturity date will be extended to the date which is 364 days after the then maturity date.
	NHC’s obligations under the Credit Agreement are guaranteed by certain NHC subsidiaries and are secured by pledges by NHC and the guarantors of (i) 100% of the equity interests of domestic subsidiaries and (ii) up to 65% of the voting equity interests and 100% of the non–voting equity interests of foreign subsidiaries, in each case, held by NHC or the guarantors.
	The Credit Agreement contains customary representations and warranties, and covenants, including covenants that restrict, among other things, asset dispositions, mergers and acquisitions, dividends, restricted payments, debt, liens, investments and affiliate transactions. The Credit Agreement contains customary events of default.
	The Credit Facility is available for general corporate purposes, including working capital and acquisitions.

Note_12_Stock_Repurchase_Progr

Note 12 - Stock Repurchase Program	9 Months Ended
	Sep. 30, 2013
Disclosure Text Block Supplement [Abstract]	'
Treasury Stock [Text Block]	'
	Note 12 - Stock Repurchase Program
	On August 1, 2012, the Board of Directors of the Company approved a stock repurchase program authorizing the Company to repurchase up to $25 million of its outstanding shares of common stock. On February 19, 2013, the Company repurchased 100,000 shares for a total cost of $4.7 million. These were the only shares repurchased pursuant to the program’s authorization. The shares were funded from cash on hand and were cancelled and returned to the status of authorized but unissued. This program expired on July 31, 2013.
	On August 1, 2013, the Board of Directors of the Company authorized a new stock repurchase program that will allow the Company to repurchase up to $25 million of its common stock over a one year period. The program expires on July 31, 2014. Under the stock repurchase program, the Company may repurchase its common stock from time to time, in amounts and at prices the Company deems appropriate, subject to market conditions and other considerations. The Company’s repurchases may be executed using open market purchases, privately negotiated agreements or other transactions. The Company intends to fund repurchases under the new stock repurchase program from cash on hand, available borrowings or proceeds from potential debt or other capital market sources. The stock repurchase program may be suspended or discontinued at any time without prior notice. As of September 30, 2013, no repurchases of common stock have been executed under this program.

Note_13_StockBased_Compensatio

Note 13 - Stock-Based Compensation	9 Months Ended
	Sep. 30, 2013
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]	'
Disclosure of Compensation Related Costs, Share-based Payments [Text Block]	'
	Note 13 – Stock–Based Compensation
	NHC recognizes stock–based compensation expense for all stock options and restricted stock granted over the requisite service period using the fair value for these grants as estimated at the date of grant either using the Black–Scholes pricing model for stock options or the quoted market price for restricted stock.
	The 2005 and 2010 Stock–Based Compensation Plans
	The Compensation Committee of the Board of Directors (“the Committee”) has the authority to select the participants to be granted options; to designate whether the option granted is an incentive stock option (“ISO”), a non–qualified option, or a stock appreciation right; to establish the number of shares of common stock that may be issued upon exercise of the option; to establish the vesting provision for any award; and to establish the term any award may be outstanding. The exercise price of any ISO’s granted will not be less than the fair market value of the shares of common stock on the date granted and the term of an ISO may not be any more than ten years. The exercise price of any non–qualified options granted will not be less than the fair market value of the shares of common stock on the date granted unless so determined by the Committee.
	In May 2005, our stockholders approved the 2005 Stock Option, Employee Stock Purchase, Physician Stock Purchase and Stock Appreciation Rights Plan (“the 2005 Plan”) pursuant to which 1,200,000 shares of our common stock were available to grant as stock–based payments to key employees, directors, and non–employee consultants. At September 30, 2013, 245,620 shares were available for future grants under the 2005 Plan.
	In May 2010, our stockholders approved the 2010 Omnibus Equity Incentive Plan (“the 2010 Plan”) pursuant to which 1,200,000 shares of our common stock were available to grant as stock–based payments to key employees, directors, and non–employee consultants. The shares granted during the nine months ended September 30, 2013 consisted of 45,000 shares to the directors of the Company and 15,275 shares through the Employee Stock Purchase Plan. At September 30, 2013, 410,457 shares were available for future grants under the 2010 Plan.
	Compensation expense is recognized only for the awards that ultimately vest. Stock–based compensation totaled $453,000 and $1,812,000 for the three months and nine months ended September 30, 2013, respectively. Stock-based compensation totaled $527,000 and $1,925,000 for the three months and nine months ended September 30, 2012, respectively. At September 30, 2013, we had $4,425,000 of unrecognized compensation cost related to unvested stock–based compensation awards, which consisted of $4,094,000 for stock options and $331,000 for restricted stock. This expense will be recognized over the remaining weighted average vesting period, which is approximately 2.4 years for stock options and 1.1 years for restricted stock. Stock–based compensation is included in “Salaries, wages and benefits” in the interim condensed consolidated statements of income.
	Stock Options
	The following table summarizes the significant assumptions used to value the options granted for the nine months ended September 30, 2013 and for the year ended December 31, 2012.
			2013				2012
	Risk–free interest rate			0.25	%			0.28	%
	Expected volatility			31.1	%			38.8	%
	Expected life, (in years)		2.1				2.1
	Expected dividend yield			2.81	%			2.91	%
	The following table summarizes our outstanding stock options for the nine months ended September 30, 2013 and for the year ended December 31, 2012.
			Number of				Weighted			Aggregate
			Shares				Average			Intrinsic
							Exercise Price			Value
	Options outstanding at January 1, 2012			1,482,077			$	46.92		–
	Options granted			63,516				44.24		–
	Options exercised			(295,371	)			45.41		–
	Options cancelled			(115,620	)			50.99		–
	Options outstanding at December 31, 2012			1,134,602				46.75		–
	Options granted			60,375				47.97		–
	Options exercised			(7,150	)			37.7		–
	Options cancelled			(98,000	)			51.11		–
	Options outstanding at September 30, 2013			1,089,827			$	46.48		$	900,000
	Options exercisable at September 30, 2013			145,552			$	44.84		$	361,000
	Options				Exercise Prices							Weighted Average		Weighted Average
	Outstanding											Exercise Price		Remaining Contractual
	30-Sep-13													Life in Years
		21,750				$37.70						$	37.7		0.6
		1,052,802			$44.80	-	$47.45						46.62		2.6
		15,275				$49.50							49.5		0.3
		1,089,827										$	46.49		2.5
	Restricted Stock
	The following table summarizes our restricted stock activity for the nine months ended September 30, 2013 and for the year ended December 31, 2012.
			Number of				Weighted			Aggregate
			Shares				Average Grant			Intrinsic
							Date Fair			Value
							Value
	Non–vested restricted shares at January 1, 2012			24,000			$	34.46		–
	Award shares granted		–				–			–
	Award shares vested			6,000				34.46		–
	Non–vested restricted shares at December 31, 2012			18,000				34.46		–
	Award shares granted		–				–			–
	Award shares vested			6,000				34.46		–
	Non–vested restricted shares at September 30, 2013			12,000			$	34.46		$	154,000
	The weighted average remaining contractual life of restricted stock at September 30, 2013 is 1.1 years.

Note_14_Accounting_for_Uncerta

Note 14 - Accounting for Uncertainty in Income Taxes	9 Months Ended
	Sep. 30, 2013
Income Tax Disclosure [Abstract]	'
Income Tax Disclosure [Text Block]	'
	Note 14 – Accounting for Uncertainty in Income Taxes
	Uncertain tax positions may arise where tax laws may allow for alternative interpretations or where the timing of recognition of income is subject to judgment. We believe we have made adequate provision for unrecognized tax benefits related to uncertain tax positions. However, because of uncertainty of interpretation by various tax authorities and the possibility that there are issues that have not been recognized by management, we cannot guarantee we have accurately estimated our tax liabilities. We believe that our liabilities reflect the anticipated outcome of known uncertain tax positions in conformity with ASC Topic 740, Income Taxes. Our liabilities for unrecognized tax benefits are presented in the consolidated balance sheets within Other Noncurrent Liabilities.
	At September 30, 2013, we had $12,196,000 of unrecognized tax benefits, composed of $7,996,000 of deferred tax assets and $4,200,000 of permanent differences. Accrued interest and penalties of $1,830,000 relate to unrecognized tax benefits at September 30, 2013. Unrecognized tax benefits of $4,200,000, net of federal benefit, at September 30, 2013, attributable to permanent differences, would favorably impact our effective tax rate if recognized. Accrued interest and penalties of $1,594,000 relate to these permanent differences at September 30, 2013. We do not expect to recognize significant increases or decreases in unrecognized tax benefits within the twelve months beginning September 30, 2013, except for the effect of decreases related to the lapse of statute of limitations estimated at $2,330,000, composed of temporary differences of $1,390,000, and permanent tax differences of $940,000. Interest and penalties of $544,000 relate to these temporary and permanent difference changes within 12 months beginning September 30, 2013.
	Interest and penalties expense related to U.S. federal and state income tax returns are included within income tax expense.
	The Company is no longer subject to U.S. federal and state examinations by tax authorities for years before 2010 (with certain state exceptions). Currently, there are no U.S. federal or state returns under examination.
	Our deferred tax assets have been evaluated for realization based on historical taxable income, tax planning strategies, the expected timing of reversals of existing temporary differences and future taxable income anticipated. Our deferred tax assets are more likely than not to be realized in full due to the existence of sufficient taxable income of the appropriate character under the tax law. As such, there is no need for a valuation allowance.

Note_15_Contingencies_and_Guar

Note 15 - Contingencies and Guarantees	9 Months Ended
	Sep. 30, 2013
Commitments and Contingencies Disclosure [Abstract]	'
Commitments and Contingencies Disclosure [Text Block]	'
	Note 15 – Guarantees and Contingencies
	Accrued Risk Reserves
	We are self–insured for risks related to health insurance and have wholly–owned limited purpose insurance companies that insure risks related to workers’ compensation and general and professional liability insurance claims both for our owned or leased entities and certain of the entities to which we provide management or accounting services. The liability we have recognized for reported claims and estimates for incurred but unreported claims totals $118,714,000 and $110,331,000 at September 30, 2013 and December 31, 2012, respectively. This liability is classified as a current liability based on the uncertainty regarding the timing of potential payments. The liability is included in accrued risk reserves in the interim condensed consolidated balance sheets and is subject to adjustment for actual claims incurred. It is possible that these claims plus unasserted claims could exceed our insurance coverages and our reserves, which could have a material adverse effect on our consolidated financial position, results of operations and cash flows.
	As a result of the terms of our insurance policies and our use of wholly–owned limited purpose insurance companies, we have retained significant insurance risk with respect to workers’ compensation and general and professional liability. We use independent actuaries to estimate our exposures for claims obligations (for both asserted and unasserted claims) related to deductibles and exposures in excess of coverage limits, and we maintain reserves for these obligations. Such estimates are based on many variables including historical and statistical information and other factors.
	Workers’ Compensation
	For workers’ compensation, we utilize a wholly–owned Tennessee domiciled property/casualty insurance company to write coverage for NHC affiliates and for third–party customers. Policies are written for a duration of twelve months and cover only risks related to workers’ compensation losses. All customers are companies which operate in the senior care industry. Business is written on a direct basis. Direct business coverage is written for statutory limits and the insurance company’s losses in excess of $1,000,000 per claim are covered by reinsurance.
	For these workers’ compensation insurance operations, the premium revenues reflected in the interim condensed consolidated statements of income within "Other Revenues" for the three months and nine months ended September 30, 2013 are $1,218,000 and $6,607,000, respectively. During the 2013 year, there was a non-recurring positive insurance settlement reached with one of the states in which we provide workers' compensation insurance. This event helped increase other revenues in the amount of $2,769,000 for the nine months ended September 30, 2013. For the three months and nine months ended September 30, 2012, workers' compensation premium revenues reflected within "Other Revenues" were $1,409,000 and $4,094,000, respectively. Associated losses and expenses are reflected in the interim condensed consolidated statements of income as "Salaries, wages and benefits."
	General and Professional Liability Lawsuits and Insurance
	The senior care industry has experienced increases in both the number of personal injury/wrongful death claims and in the severity of awards based upon alleged negligence by nursing facilities and their employees in providing care to residents. As of September 30, 2013, we and/or our managed centers are currently defendants in 30 such claims covering the years 2005 through September 30, 2013.
	In 2002, due to the unavailability and/or prohibitive cost of third–party professional liability insurance coverage, we established and capitalized a wholly–owned licensed liability insurance company incorporated in the Cayman Island, for the purpose of managing our losses related to these risks. Thus, since 2002, insurance coverage for incidents occurring at all NHC owned providers, and most providers managed by us, is provided through this wholly–owned insurance company.
	Insurance coverage for all years includes both primary policies and excess policies. Beginning in 2003, both primary and excess coverage is provided through our wholly–owned insurance company. The primary coverage is in the amount of $1.0 million per incident, $3.0 million per location with an annual primary policy aggregate limit that is adjusted on an annual basis. The excess coverage is $7.5 million annual excess in the aggregate applicable to years 2005–2007, $9.0 million annual excess in the aggregate for years 2008–2010 and $4.0 million excess per occurrence for 2011–2013.
	Beginning in 2008 and continuing through September 30, 2013, additional insurance is purchased through third party providers that serve to supplement the coverage provided through our wholly–owned captive insurance company.
	For these professional liability insurance operations, the premium revenues reflected in the interim condensed consolidated statements of income as "Other Revenues" for the three months and nine months ended September 30, 2013 are $654,000 and $2,539,000, respectively. For the three months and nine months ended September 30, 2012, professional liability premium revenues reflected within "Other Revenues" were $1,051,000 and $3,152,000, respectively. Associated losses and expenses including those for self–insurance are included in the interim condensed consolidated statements of income as "Other operating costs and expenses".
	Potential Breach of Patient Information
	During the third quarter of 2013, officials at one of our owned centers, NHC HealthCare, Mauldin located in Greenville, South Carolina, reported a possible breach of patient information due to a damaged backup tape that was not encrypted. The information on this tape included patient names, social security numbers, birth dates, home addresses and medical information. The facility began an immediate investigation of the incident and security measures have been revised to prevent future incidents of this nature. All affected patients have been notified as well as media outlets in the immediate area.
	Also during the third quarter of 2013, officials at one of our managed centers, NHC HealthCare, Oak Ridge in Oak Ridge, Tennessee reported a possible breach of patient information due to a missing backup tape that was not encrypted. The information on this tape included patient names, social security numbers, birth dates, home addresses and medical information. The facility began an immediate investigation and security measures have been revised to prevent future incidents. All affected patients were notified as well as media outlets in the immediate area.

Note_16_Asset_Purchase_Acquisi

Note 16 - Asset Purchase Acquisition	9 Months Ended
	Sep. 30, 2013
Business Combinations [Abstract]	'
Business Combination Disclosure [Text Block]	'
	Note 16 – Asset Purchase Acquisition
	On September 1, 2013, NHC purchased the real property of six skilled health care centers from National Health Investors, Inc. ("NHI") for $21 million in cash. The six centers, which are located in Columbia (2), Knoxville and Springfield, Tennessee; Madisonville, Kentucky and Rossville, Georgia, had been leased and operated by NHC since 1991 and have a total of 650 beds. With the purchase of the six skilled health care centers, NHC’s master lease payment with NHI decreases annually by $2.95 million.

Note_17_Settlement_of_SeniorTr

Note 17 - Settlement of SeniorTrust of Florida, Inc. and ElderTrust of Florida, Inc. Litigation	9 Months Ended
	Sep. 30, 2013
Disclosure Text Block Supplement [Abstract]	'
Legal Matters and Contingencies [Text Block]	'
	Note 17 – Settlement of SeniorTrust of Florida, Inc. and ElderTrust of Florida, Inc. Litigation
	On April 26, 2013, the Company entered into a settlement agreement concerning litigation with two management services clients, ElderTrust of Florida, Inc. (“ElderTrust”), and SeniorTrust of Florida, Inc. (“SeniorTrust”), both Tennessee not-for-profit corporations. NHC’s transactions with these entities have been previously disclosed in NHC’s Forms 10-Q and Forms 10-K and were the subject of a Civil Investigative Demand by the Office of the Tennessee Attorney General issued in July, 2009. As part of the negotiated settlement, NHC paid $6,650,000 to resolve the claims, which payment and associated legal fees required the recording of $5,195,000 of operating expenses in the quarter ending March 31, 2013.
	Also as part of the settlement, NHC purchased at a discount the remaining assets and liabilities of the two not-for-profit entities and then in the third quarter of 2013 closed out those assets and obligations, providing for an orderly wind-down and liquidation. As a result of this latter provision in the settlement agreement and related settlement activities, in the quarter ended September 30, 2013 the company recorded a decrease to other operating expenses in the amount of $5,257,000. As a result and for the nine months ending September 30, 2013, the settlement with ElderTrust and SeniorTrust has had an immaterial impact on NHC’s consolidated statement of income. The Company recorded for all periods, including periods prior to 2013, that its net losses related to the settlement activities totaled approximately $2,505,000.
	On September 1, 2013 and with court approval, NHC began leasing and operating ElderTrust’s seven skilled nursing facilities in New Hampshire and Massachusetts. At the time of the settlement agreement, ElderTrust was paying approximately $3,200,000 annually in management fees to NHC. We do not anticipate a material change to our future results of operations and cash flows from the transition of managing the seven health care facilities to leasing and operating the seven health care facilities.
	During the first and second quarters of 2013, SeniorTrust sold its seven skilled nursing facilities in Missouri and Kansas and terminated their respective NHC management agreements. At the time of the settlement agreement, SeniorTrust was paying approximately $2,200,000 annually in management and accounting fees for these seven. We anticipate the loss of management fee revenue from the Missouri and Kansas skilled nursing facilities to be adverse to our future results of operations and cash flows.
	In summary and combining all the transactions in the negotiated settlement, we estimate our future results of operations and cash flows will be adversely affected by approximately $2,200,000 annually, or $1,350,000 annually net of income taxes. Under the negotiated settlement, we do not admit to any wrongdoing, nor do the opposing parties make any claims as to the validity of their charges.

Accounting_Policies_by_Policy_

Accounting Policies, by Policy (Policies)	9 Months Ended
	Sep. 30, 2013
Accounting Policies, by Policy (Policies) [Line Items]	'
Basis of Accounting, Policy [Policy Text Block]	'
	Basis of Presentation
	The unaudited condensed consolidated financial statements to which these notes are attached include all normal, recurring adjustments which are necessary to fairly present the financial position, results of operations and cash flows of NHC. All significant intercompany transactions and balances have been eliminated in consolidation. We assume that users of these interim financial statements have read or have access to the audited December 31, 2012 consolidated financial statements and Management’s Discussion and Analysis of Financial Condition and Results of Operations and that the adequacy of additional disclosure needed for a fair presentation, except in regard to material contingencies, may be determined in that context. Accordingly, footnotes and other disclosures which would substantially duplicate the disclosure contained in our most recent annual report to stockholders have been omitted. This interim financial information is not necessarily indicative of the results that may be expected for a full year for a variety of reasons.
Use of Estimates, Policy [Policy Text Block]	'
	Estimates and Assumptions
	The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires us to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates and could cause our reported net income to vary significantly from period to period.
Revenue Recognition, Policy [Policy Text Block]	'
	Change in Accounting Principle
	Effective January 1, 2013, the Company recorded the cumulative effect of a change in accounting principle related to the adoption of ASU No. 2012-01, Continuing Care Retirement Communities — Refundable Advance Fees. This standard is intended to clarify the accounting for advance fees (“entrance fees”) received by a continuing care retirement community (“CCRC”). The updated guidance states the estimated amount of entrance fees that are expected to be refunded to current CCRC residents under the terms of the resident agreements shall be accounted for and reported as a liability (“refundable entrance fees”). Previously, we accounted for both the 10% non-refundable and the refundable portions of the entrance fees as deferred revenue, amortizing the deferred revenue over the life expectancy of the resident and the estimated useful life of the building, respectively, in accordance with ASC Topic 954-430, Health Care Entities-Deferred Revenue. The Company believes recording the refundable entrance fees as a liability, which includes 90% of the original entry fee paid plus 40% of any estimated appreciation if the apartment exceeds the original resident’s entry fee, more clearly aligns how we have historically operated the CCRC. Also, with the adoption of ASU No. 2012-01, our future service obligation calculation for the CCRC was modified. Because the future service obligation calculation includes an offset for unamortized deferred revenue, the reclassification of refundable entrance fee amounts from deferred revenue to a liability has a direct impact on the future revenues input of the calculation. With the loss of deferred revenue, the present value of the CCRC’s expenses exceeds the present value of the CCRC’s revenues, which creates the recording of a future service obligation.
	As described in the guidance for accounting changes, the comparative interim consolidated financial statements of prior periods are adjusted to apply the new accounting method retrospectively. The following tables present the effect on the interim condensed consolidated financial statements of the accounting change that was retrospectively adopted on January 1, 2013:
	Consolidated Balance Sheet
	(in thousands)
		31-Dec-12
		As			Effect of			As Adjusted
		Previously			Accounting
		Reported			Change
	Deferred income taxes	$	10,564		$	2,253		$	12,817
	Total assets		922,447			2,253			924,700
	Refundable entrance fees	–				10,680			10,680
	Deferred revenue		10,124			(6,694	)		3,430
	Obligation to provide future services	–				1,791			1,791
	Retained earnings		283,517			(3,524	)		279,993
	Total stockholders' equity		659,672			(3,524	)		656,148
	Total liabilities and stockholders' equity	$	922,447		$	2,253		$	924,700
	Interim Condensed Consolidated Statement of Income
	(in thousands, except share and per share amounts)
		Three Months Ended September 30, 2012									Nine Months Ended September 30, 2012
		As			Effect of			As			As			Effect of			As
		Previously			Accounting			Adjusted			Previously			Accounting			Adjusted
		Reported			Change						Reported			Change
	Other revenues	$	14,007		$	(61	)	$	13,946		$	42,008		$	(194	)	$	41,814
	Net operating revenues		189,368			(61	)		189,307			567,219			(194	)		567,025
	Income Before Non-Operating Income		16,671			(61	)		16,610			47,900			(194	)		47,706
	Income Before Income Taxes		23,442			(61	)		23,381			66,446			(194	)		66,252
	Income Tax Provision		(6,209	)		24			(6,185	)		(22,923	)		76			(22,847	)
	Net Income		17,233			(37	)		17,196			43,523			(118	)		43,405
	Net Income Available to Common Shareholders	$	15,066		$	(37	)	$	15,029		$	37,020			(118	)	$	36,902
	Basic Earnings Per Share	$	1.09		$	(0.01	)	$	1.08		$	2.67		$	0		$	2.67
	Diluted Earnings Per Share	$	1.04		$	0		$	1.04		$	2.63		$	(0.01	)	$	2.62
	Interim Condensed Consolidated Statement of Comprehensive Income
	(in thousands)
		Three Months Ended September 30, 2012									Nine Months Ended September 30, 2012
		As			Effect of			As			As			Effect of			As
		Previously			Accounting			Adjusted			Previously			Accounting			Adjusted
		Reported			Change						Reported			Change
	Net Income	$	17,233		$	(37	)	$	17,196		$	43,523		$	(118	)	$	43,405
	Comprehensive Income	$	17,991		$	(37	)	$	17,954		$	52,242		$	(118	)	$	52,124
	Interim Condensed Consolidated Statement of Cash Flows
	(in thousands)
		Nine Months Ended September 30, 2012
		As			Effect of			As
		Previously			Accounting			Adjusted
		Reported			Change
	Cash Flows From Operating Activities:
	Net income	$	43,523		$	(118	)	$	43,405
	Deferred income taxes		(299	)		(76	)		(375	)
	Deferred revenue		959			(93	)		866
	Net cash provided by operating activities		61,616			(287	)		61,329
	Cash Flows From Financing Activities:
	Entrance fee deposits		(1,498	)		287			(1,211	)
	Net cash used in financing activities	$	(14,631	)	$	287		$	(14,344	)
	Interim Condensed Consolidated Statements of Stockholders' Equity
	(in thousands)
		Nine Months Ended September 30, 2012
		As			Effect of			As
		Previously			Accounting			Adjusted
		Reported			Change
Contractual Adjustments and Third Party Settlements, Policy [Policy Text Block]	'
	Revenue Recognition – Third Party Payors
	Approximately 67% of our net patient revenues are derived from Medicare, Medicaid, and other government programs. Amounts earned under these programs are subject to review by the Medicare and Medicaid intermediaries or their agents. In our opinion, adequate provision has been made for any adjustments that may result from these reviews. Any differences between our original estimates of reimbursements and subsequent revisions are reflected in operations in the period in which the revisions are made often due to final determination or the period of payment no longer being subject to audit or review. We have made provisions of approximately $21,009,000 and $19,267,000 as of September 30, 2013 and December 31, 2012, respectively, for various Medicare and Medicaid current and prior year cost reports and claims reviews.
Revenue Recognition for Alternative Revenue Programs, Policy [Policy Text Block]	'
	Revenue Recognition – Private Pay
	For private pay patients in skilled nursing or assisted living facilities, we bill room and board in advance with payment being due in the month the services are performed. Charges for ancillary, pharmacy, therapy and other services to private patients are billed in the month following the performance of services; however, all billings are recognized as revenue when the services are performed.
Premiums Receivable, Allowance for Doubtful Accounts, Estimation Methodology, Policy [Policy Text Block]	'
	Revenue Recognition – Subordination of Fees and Uncertain Collections
	We provide management services to certain long–term care facilities and to others we provide accounting and financial services. We generally charge 6% to 7% of net operating revenues for our management services and a predetermined fixed rate per bed for the accounting and financial services. Our policy is to recognize revenues associated with both management services and accounting and financial services on an accrual basis as the services are provided. However, under the terms of our management contracts, payments for our management services are subject to subordination to other expenditures of the long–term care center being managed. Furthermore, for certain of the third parties with whom we have contracted to provide services and which we have determined that collection is not reasonably assured, our policy is to recognize income only in the period in which the amounts are realized. We may receive payment for the unpaid and unrecognized management fees in whole or in part in the future only if cash flows from the operating and investing activities of the centers or proceeds from the sale of the centers are sufficient to pay the fees. There can be no assurance that such future cash flows will occur. The realization of such previously unrecognized revenue could cause our reported net income to vary significantly from period to period.
	We agree to subordinate our fees to the other expenses of a managed center because we believe we know how to improve the quality of patient services and finances of a long–term care center. We believe subordinating our fees demonstrates to the owner and employees of the managed center how confident we are of the impact we can have in making the center operations successful. We may continue to provide services to certain managed centers despite not being fully paid currently so that we may be able to collect unpaid fees in the future from improved operating results and because the incremental savings from discontinuing services to a center may be small compared to the potential benefit. Also, we may benefit from providing other ancillary services to the managed center.
Liability Reserve Estimate, Policy [Policy Text Block]	'
	Accrued Risk Reserves
	We are principally self–insured for risks related to employee health insurance, workers’ compensation and professional and general liability claims. Our accrued risk reserves primarily represent the accrual for self–insured risks associated with employee health insurance, workers’ compensation and professional and general liability claims. The accrued risk reserves include a liability for reported claims and estimates for incurred but unreported claims. Our policy with respect to our workers’ compensation and professional and general liability claims is to use an external, independent actuary to estimate our exposure for claims obligations (for both asserted and unasserted claims). Our health insurance reserve is based on our known claims incurred and an estimate of incurred but unreported claims determined by our analysis of historical claims paid. We reassess our accrued risk reserves on a quarterly basis.
	Professional liability remains an area of particular concern to us. The entire long term care industry has seen an increase in personal injury/wrongful death claims based on alleged negligence by nursing homes and their employees in providing care to residents. As of September 30, 2013, we and/or our managed centers are defendants in 30 such claims inclusive of years 2005 through September 30, 2013. It remains possible that those pending matters plus potential unasserted claims could exceed our reserves, which could have a material adverse effect on our consolidated financial position, results of operations and cash flows. It is also possible that future events could cause us to make significant adjustments or revisions to these reserve estimates and cause our reported net income to vary significantly from period to period.
	We maintain insurance coverage for incidents occurring in all centers owned or leased by us. The coverages include both primary policies and excess policies. In all years, settlements, if any, in excess of available insurance policy limits and our own reserves would be expensed by us.
Continuing Care Retirement Communities, Advance Fees, Policy [Policy Text Block]	'
	Obligation to Provide Future Services
	The CCRC annually calculates the present value of the net cost of future services and the use of facilities to be provided to the current residents and compares that amount with the balance of non-refundable deferred revenue from entrance fees received. If the present value of the net cost of future services exceeds the related anticipated revenues, a liability is recorded (obligation to provide future services) with a corresponding charge to income. With the recent adoption of ASU No. 2012–01, our future service obligation calculation was modified and we now have a liability recorded in the amount of $1,791,000 as of September 30, 2013 and December 31, 2012.
Revenue Recognition, Deferred Revenue [Policy Text Block]	'
	Deferred Revenue
	Deferred revenue includes the deferred gain on the sale of assets to National, the non-refundable portion (10%) of CCRC entrance fees being amortized over the remaining life expectancies of the residents, and premiums received within our workers’ compensation and professional liability companies that are not yet earned.
New Accounting Pronouncements, Policy [Policy Text Block]	'
	New Accounting Pronouncements
	In February 2013, the Financial Accounting Standards Board (“FASB”) issued Accounting Standard Update (“ASU”) No. 2013–02, which is included in Codification under ASC 220, “Comprehensive Income”. The objective of this updated standard is to improve the reporting of reclassifications out of accumulated other comprehensive income. The standard states that disclosure of reclassification amounts required by U.S. GAAP to be reclassified out of accumulated other comprehensive income to net income in their entirety in the same reporting period, should be provided in one location, by component of other comprehensive income. Presentation of such amounts is permitted on either the face of the financial statement where net income is presented or as a separate tabular disclosure in the notes to the financial statements, and should be disclosed by respective line item of net income affected. This accounting standard update became effective beginning in our first quarter of fiscal 2013. The adoption of this accounting standard update resulted in financial statement presentation changes only. The Company has reclassified realized gains on the sale of marketable securities out of accumulated other comprehensive income; as such, these investment gains are classified as "non-operating income" in our consolidated statements of income.
	In July 2012, the FASB issued ASU No. 2012–01, which is included in the Codification under ASC subtopic 954-430, “Health Care Entities—Deferred Revenue”. This revised standard is intended to clarify the accounting for refundable advance fees (“refundable entrance fees”) received by a continuing care retirement community. The guidance states that refundable portion of entrance fees should be accounted for as deferred revenue when the refund of the fee is contingent upon the resale of the contract holder’s unit, limited to the proceeds received by the resale, and the legal environment and management’s policy and practice support the withholding of refunds under said conditions. In the event that the refund is contingent upon reoccupancy, but not limited to the proceeds of the resale, then the fees should be accounted for and reported as a liability. This accounting standard update became effective beginning in our first quarter of fiscal 2013. The adoption of this accounting standard resulted in a change of accounting principle which was applied retrospectively, including the cumulative effect of this change recognized through beginning retained earnings. See the beginning of Note 2 under “Change in Accounting Principle” for further discussion on the adoption of ASU No. 2012-01.
Reclassification, Policy [Policy Text Block]	'
	Reclassifications
	Certain prior period amounts have been reclassified to conform to the current financial statement presentation, with no effect on the Company's consolidated financial position or results of operations.
Refundable Advance Fees [Member]	'
Accounting Policies, by Policy (Policies) [Line Items]	'
Continuing Care Retirement Communities, Advance Fees, Policy [Policy Text Block]	'
	Continuing Care Contracts and Refundable Entrance Fees
	We have one continuing care retirement center (“CCRC”) within our operations. Residents at this retirement center may enter into continuing care contracts with us. The contract provides that 10% of the resident entry fee becomes non-refundable upon occupancy, and the remaining refundable portion of the entry fee is calculated using the lessor of the price at which the apartment is re-assigned or 90% of the original entry fee, plus 40% of any appreciation if the apartment exceeds the original resident’s entry fee. In each case, we amortize the non-refundable part of these fees into revenue over the actuarially determined remaining life of the resident, which is the expected period of occupancy by the resident. We pay the refundable portion of our entry fees when residents relocate from our community and the apartment is re-occupied. Refundable entrance fees are classified as non-current liabilities and non-refundable entrance fees are classified as deferred revenue in the Company's consolidated balance sheets. The balances of refundable entrance fees as of September 30, 2013 and December 31, 2012 were $10,600,000 and $10,680,000, respectively.

Note_2_Summary_of_Significant_1

Note 2 - Summary of Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2013
Consolidated Balance Sheet [Member]	'
Note 2 - Summary of Significant Accounting Policies (Tables) [Line Items]	'
Schedule of New Accounting Pronouncements and Changes in Accounting Principles [Table Text Block]	'
	Consolidated Balance Sheet
	(in thousands)
		31-Dec-12
		As			Effect of			As Adjusted
		Previously			Accounting
		Reported			Change
	Deferred income taxes	$	10,564		$	2,253		$	12,817
	Total assets		922,447			2,253			924,700
	Refundable entrance fees	–				10,680			10,680
	Deferred revenue		10,124			(6,694	)		3,430
	Obligation to provide future services	–				1,791			1,791
	Retained earnings		283,517			(3,524	)		279,993
	Total stockholders' equity		659,672			(3,524	)		656,148
	Total liabilities and stockholders' equity	$	922,447		$	2,253		$	924,700
Consolidated Statement of Income [Member]	'
Note 2 - Summary of Significant Accounting Policies (Tables) [Line Items]	'
Schedule of New Accounting Pronouncements and Changes in Accounting Principles [Table Text Block]	'
		Three Months Ended September 30, 2012									Nine Months Ended September 30, 2012
		As			Effect of			As			As			Effect of			As
		Previously			Accounting			Adjusted			Previously			Accounting			Adjusted
		Reported			Change						Reported			Change
	Other revenues	$	14,007		$	(61	)	$	13,946		$	42,008		$	(194	)	$	41,814
	Net operating revenues		189,368			(61	)		189,307			567,219			(194	)		567,025
	Income Before Non-Operating Income		16,671			(61	)		16,610			47,900			(194	)		47,706
	Income Before Income Taxes		23,442			(61	)		23,381			66,446			(194	)		66,252
	Income Tax Provision		(6,209	)		24			(6,185	)		(22,923	)		76			(22,847	)
	Net Income		17,233			(37	)		17,196			43,523			(118	)		43,405
	Net Income Available to Common Shareholders	$	15,066		$	(37	)	$	15,029		$	37,020			(118	)	$	36,902
	Basic Earnings Per Share	$	1.09		$	(0.01	)	$	1.08		$	2.67		$	0		$	2.67
	Diluted Earnings Per Share	$	1.04		$	0		$	1.04		$	2.63		$	(0.01	)	$	2.62
Consolidated Statement Of Comprehensive Income [Member]	'
Note 2 - Summary of Significant Accounting Policies (Tables) [Line Items]	'
Schedule of New Accounting Pronouncements and Changes in Accounting Principles [Table Text Block]	'
		Three Months Ended September 30, 2012									Nine Months Ended September 30, 2012
		As			Effect of			As			As			Effect of			As
		Previously			Accounting			Adjusted			Previously			Accounting			Adjusted
		Reported			Change						Reported			Change
	Net Income	$	17,233		$	(37	)	$	17,196		$	43,523		$	(118	)	$	43,405
	Comprehensive Income	$	17,991		$	(37	)	$	17,954		$	52,242		$	(118	)	$	52,124
Consolidated Statement Of Cash Flows [Member]	'
Note 2 - Summary of Significant Accounting Policies (Tables) [Line Items]	'
Schedule of New Accounting Pronouncements and Changes in Accounting Principles [Table Text Block]	'
		Nine Months Ended September 30, 2012
		As			Effect of			As
		Previously			Accounting			Adjusted
		Reported			Change
	Cash Flows From Operating Activities:
	Net income	$	43,523		$	(118	)	$	43,405
	Deferred income taxes		(299	)		(76	)		(375	)
	Deferred revenue		959			(93	)		866
	Net cash provided by operating activities		61,616			(287	)		61,329
	Cash Flows From Financing Activities:
	Entrance fee deposits		(1,498	)		287			(1,211	)
	Net cash used in financing activities	$	(14,631	)	$	287		$	(14,344	)
Consolidated Statement Or Stockholders' Equity [Member]	'
Note 2 - Summary of Significant Accounting Policies (Tables) [Line Items]	'
Schedule of New Accounting Pronouncements and Changes in Accounting Principles [Table Text Block]	'
		Nine Months Ended September 30, 2012
		As			Effect of			As
		Previously			Accounting			Adjusted
		Reported			Change
	Retained Earnings
	Balance at January 1, 2012	$	265,198		$	(4,867	)	$	260,331

Note_3_Other_Revenues_Tables

Note 3 - Other Revenues (Tables)	9 Months Ended
	Sep. 30, 2013
Other Revenues [Abstract]	'
Schedule of Other Revenues	'
		Three Months Ended						Nine Months Ended
		30-Sep						30-Sep
	(in thousands)	2013			2012			2013		2012
	Management and accounting services fees	$	5,234		$	5,125		$	14,662	$	15,104
	Rental income		4,886			4,963			14,387		14,486
	Insurance services		2,729			3,972			12,792		11,803
	Other		(43	)		(114	)		523		421
		$	12,806		$	13,946		$	42,364	$	41,814

Note_4_NonOperating_Income_Tab

Note 4 - Non-Operating Income (Tables)	9 Months Ended
	Sep. 30, 2013
Nonoperating Income [Abstract]	'
Schedule of Other Nonoperating Income, by Component [Table Text Block]	'
		Three Months Ended				Nine Months Ended
		30-Sep				30-Sep
	(in thousands)	2013		2012		2013		2012
	Equity in earnings of unconsolidated investments	$	3,947	$	4,063	$	11,542	$	10,079
	Dividends and other net realized gains and losses on sales of securities		408		1,607		3,314		5,074
	Interest income		1,362		1,101		4,111		3,393
	Gain on the recovery of notes receivable		5,454		-		5,454		-
		$	11,171	$	6,771	$	24,421	$	18,546

Note_5_New_Lease_Commitment_wi1

Note 5 - New Lease Commitment with National Health Investors, Inc. (Tables)	9 Months Ended
	Sep. 30, 2013
Leases [Abstract]	'
Schedule of Future Minimum Rental Payments for Operating Leases [Table Text Block]	'
		Total NHI
		Lease
		Commitments
	2014	$	34,200,000
	2015		34,200,000
	2016		34,200,000
	2017		34,200,000
	2018		34,200,000
	Thereafter		287,900,000

Note_7_Earnings_per_Share_Tabl

Note 7 - Earnings per Share (Tables)	9 Months Ended
	Sep. 30, 2013
Earnings Per Share [Abstract]	'
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	'
		Three Months Ended September 30						Nine Months Ended September 30
	(in thousands, except for share and per share amounts)	2013			2012			2013			2012
	Basic:
	Weighted average common shares outstanding		13,820,449			13,852,403			13,832,706			13,846,022
	Net income	$	19,877		$	17,196		$	48,024		$	43,405
	Dividends to preferred stockholders		(2,167	)		(2,167	)		(6,503	)		(6,503	)
	Net income available to common stockholders		17,710			15,029			41,521			36,902
	Earnings per common share, basic	$	1.28		$	1.08		$	3		$	2.67
	Diluted:
	Weighted average common shares outstanding		13,820,449			13,852,403			13,832,706			13,846,022
	Dilutive effect of stock options		7,970			7,912			8,397			8,971
	Dilutive effect of restricted stock		3,840			4,641			4,640			5,417
	Dilutive effect of contingent issuable stock		231,500			117,000			232,495			94,796
	Convertible preferred stock		2,623,156			2,623,329			2,623,253			2,623,329
	Assumed average common shares outstanding		16,686,915			16,605,285			16,701,491			16,578,535
	Net income available to common stockholders	$	17,710		$	15,029		$	41,521		$	36,902
	Add dilutive preferred stock dividends for effect of assumed conversion of preferred stock		2,167			2,167			6,503			6,503
	Net income for diluted earnings per common share	$	19,877		$	17,196		$	48,024		$	43,405
	Earnings per common share, diluted	$	1.19		$	1.04		$	2.88		$	2.62

Note_8_Investments_in_Marketab1

Note 8 - Investments in Marketable Securities (Tables)	9 Months Ended
	Sep. 30, 2013
Investments, Debt and Equity Securities [Abstract]	'
Available-for-sale Securities [Table Text Block]	'
		30-Sep-13				31-Dec-12
	(in thousands)	Amortized		Fair		Amortized		Fair
		Cost		Value		Cost		Value
	Investments available for sale:
	Marketable equity securities	$	30,176	$	108,199	$	30,176	$	107,250
	Restricted investments available for sale:
	Corporate debt securities		62,613		62,075		61,453		62,876
	Commercial mortgage–backed securities		47,830		47,293		47,194		48,063
	U.S. Treasury securities		24,031		24,145		16,218		16,604
	State and municipal securities		8,151		8,348		7,213		7,664
		$	172,801	$	250,060	$	162,254	$	242,457
Schedule of Available-for-sale Securities Reconciliation [Table Text Block]	'
		30-Sep-13						31-Dec-12
		Shares		Cost		Fair		Shares		Cost		Fair
						Value						Value
	NHI Common Stock		1,630,642	$	24,734	$	92,767		1,630,642	$	24,734	$	92,180
Investments Classified by Contractual Maturity Date [Table Text Block]	'
		30-Sep-13				31-Dec-12
	(in thousands)	Cost		Fair Value		Cost		Fair
								Value
	Maturities:
	Within 1 year	$	10,178	$	10,255	$	8,868	$	8,918
	1 to 5 years		86,227		86,902		80,910		82,801
	6 to 10 years		43,658		42,180		40,670		41,856
	Over 10 years		2,562		2,524		1,630		1,632
		$	142,625	$	141,861	$	132,078	$	135,207

Note_9_Fair_Value_Measurements1

Note 9 - Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2013
Fair Value Disclosures [Abstract]	'
Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis [Table Text Block]	'
		Fair Value Measurements Using
	30-Sep-13	Fair		Quoted Prices in		Significant		Significant Unobservable Inputs
		Value		Active Markets		Other		(Level 3)
				For Identical		Observable
				Assets		Inputs
				(Level 1)		(Level 2)
	Cash and cash equivalents	$	88,410	$	88,410	–			–
	Restricted cash and cash equivalents		12,149		12,149	–		–
	Marketable equity securities		108,199		108,199	–		–
	Corporate debt securities		62,075	–			62,075	–
	Commercial mortgage–backed securities		47,293	–			47,293	–
	U.S. Treasury securities		24,145		24,145	–		–
	State and municipal securities		8,348	–			8,348	–
	Total financial assets	$	350,619	$	232,903	$	117,716	–
		Fair Value Measurements Using
	31-Dec-12	Fair		Quoted Prices in Active Markets		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs
		Value		For Identical Assets				(Level 3)
				(Level 1)
	Cash and cash equivalents	$	66,701	$	66,701	–			–
	Restricted cash and cash equivalents		11,563		11,563	–		–
	Marketable equity securities		107,250		107,250	–		–
	Corporate debt securities		62,876	–			62,876	–
	Commercial mortgage–backed securities		48,063	–			48,063	–
	U.S. Treasury securities		16,604		16,604	–		–
	State and municipal securities		7,664	–			7,664	–
	Total financial assets	$	320,721	$	202,118	$	118,603	–

Note_10_LongTerm_Debt_Tables

Note 10 - Long-Term Debt (Tables)	9 Months Ended
	Sep. 30, 2013
Debt Disclosure [Abstract]	'
Schedule of Debt [Table Text Block]	'
		Weighted			Maturities		9/30/13		12/31/12
		Average
		Interest Rate
		Maturities
		(Variable)
							(dollars in thousands)
	Revolving Credit Facility, interest payable monthly		0.9	%		2014	–		–
	Unsecured term note payable to National, interest payable quarterly, principal payable at maturity		2.8	%		2018		10,000		10,000
								10,000		10,000
	Less current portion						–		–
							$	10,000	$	10,000

Note_13_StockBased_Compensatio1

Note 13 - Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2013
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]	'
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Method Used	'
			2013				2012
	Risk–free interest rate			0.25	%			0.28	%
	Expected volatility			31.1	%			38.8	%
	Expected life, (in years)		2.1				2.1
	Expected dividend yield			2.81	%			2.91	%
Schedule of Share-based Compensation, Stock Options, Activity [Table Text Block]	'
			Number of				Weighted			Aggregate
			Shares				Average			Intrinsic
							Exercise Price			Value
	Options outstanding at January 1, 2012			1,482,077			$	46.92		–
	Options granted			63,516				44.24		–
	Options exercised			(295,371	)			45.41		–
	Options cancelled			(115,620	)			50.99		–
	Options outstanding at December 31, 2012			1,134,602				46.75		–
	Options granted			60,375				47.97		–
	Options exercised			(7,150	)			37.7		–
	Options cancelled			(98,000	)			51.11		–
	Options outstanding at September 30, 2013			1,089,827			$	46.48		$	900,000
	Options exercisable at September 30, 2013			145,552			$	44.84		$	361,000
Schedule of Share-based Compensation, Shares Authorized under Stock Option Plans, by Exercise Price Range [Table Text Block]	'
	Options				Exercise Prices							Weighted Average		Weighted Average
	Outstanding											Exercise Price		Remaining Contractual
	30-Sep-13													Life in Years
		21,750				$37.70						$	37.7		0.6
		1,052,802			$44.80	-	$47.45						46.62		2.6
		15,275				$49.50							49.5		0.3
		1,089,827										$	46.49		2.5
Schedule of Share-based Compensation, Restricted Stock Units Award Activity [Table Text Block]	'
			Number of				Weighted			Aggregate
			Shares				Average Grant			Intrinsic
							Date Fair			Value
							Value
	Non–vested restricted shares at January 1, 2012			24,000			$	34.46		–
	Award shares granted		–				–			–
	Award shares vested			6,000				34.46		–
	Non–vested restricted shares at December 31, 2012			18,000				34.46		–
	Award shares granted		–				–			–
	Award shares vested			6,000				34.46		–
	Non–vested restricted shares at September 30, 2013			12,000			$	34.46		$	154,000

Note_1_Description_of_Business1

Note 1 - Description of Business (Details)	Sep. 30, 2013
Disclosure Text Block [Abstract]	'
Number of Skilled Nursing Centers	68
Number Of Beds	8,803
Number of States in which Entity Operates	9

Note_2_Summary_of_Significant_2

Note 2 - Summary of Significant Accounting Policies (Details) (USD $)	9 Months Ended
	Sep. 30, 2013	Dec. 31, 2012
Note 2 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'
Appreciation of Apartment Over Original Resident's Entry Fee, Percentage	40.00%	'
Continuing Care Retirement Communities Advance Fees, Obligation for Future Services, Amount (in Dollars)	$1,791,000	$1,791,000
Medicare and Medicaid [Member]	'	'
Note 2 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'
Allowance for Doubtful Accounts Receivable (in Dollars)	21,009,000	19,267,000
Medicare and Medicaid [Member]	'	'
Note 2 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'
Concentration Risk, Percentage	67.00%	'
Refundable Advance Fees [Member]	'	'
Note 2 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'
Customer Refundable Fees (in Dollars)	$10,600,000	$10,680,000
Minimum [Member]	'	'
Note 2 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'
Management Services Fees	6.00%	'
Maximum [Member]	'	'
Note 2 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'
Management Services Fees	7.00%	'

Note_2_Summary_of_Significant_3

Note 2 - Summary of Significant Accounting Policies (Details) - Effect of Accounting Change on Interim Financial Statements: Consolidated Balance Sheet (USD $)	Sep. 30, 2013	Dec. 31, 2012	Sep. 30, 2012	Dec. 31, 2011
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'
Total assets	$975,972,000	$924,700,000	'	'
Deferred revenue	3,977,000	3,430,000	'	'
Obligation to provide future services	1,791,000	1,791,000	'	'
Retained earnings	308,295,000	279,993,000	'	'
Total stockholders' equity	679,656,000	656,148,000	647,517,000	606,869,000
Total liabilities and stockholders' equity	975,972,000	924,700,000	'	'
Previously Reported [Member]	'	'	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'
Deferred income taxes	'	10,564,000	'	'
Total assets	'	922,447,000	'	'
Deferred revenue	'	10,124,000	'	'
Retained earnings	'	283,517,000	265,198,000	'
Total stockholders' equity	'	659,672,000	'	'
Total liabilities and stockholders' equity	'	922,447,000	'	'
Adjustments for New Accounting Principle, Early Adoption [Member]	'	'	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'
Deferred income taxes	'	2,253,000	'	'
Total assets	'	2,253,000	'	'
Refundable entrance fees	'	10,680,000	'	'
Deferred revenue	'	-6,694,000	'	'
Obligation to provide future services	'	1,791,000	'	'
Retained earnings	'	-3,524,000	'	'
Total stockholders' equity	'	-3,524,000	'	'
Total liabilities and stockholders' equity	'	2,253,000	'	'
As Adjusted [Member]	'	'	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'
Deferred income taxes	'	12,817,000	'	'
Total assets	'	924,700,000	'	'
Refundable entrance fees	'	10,680,000	'	'
Deferred revenue	'	3,430,000	'	'
Obligation to provide future services	'	1,791,000	'	'
Retained earnings	'	279,993,000	260,331,000	'
Total stockholders' equity	'	656,148,000	'	'
Total liabilities and stockholders' equity	'	$924,700,000	'	'

Note_2_Summary_of_Significant_4

Note 2 - Summary of Significant Accounting Policies (Details) - Effect of Accounting Change on Interim Financial Statements: Interim Condensed Consolidated Statement of Income (USD $)	3 Months Ended		9 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'
Other revenues	$12,806	$13,946	$42,364	$41,814
Net operating revenues	195,772	189,307	582,161	567,025
Income Before Non-Operating Income	19,265	16,610	52,262	47,706
Income Tax Provision	10,559	6,185	28,659	22,847
Net Income	19,877	17,196	48,024	43,405
Net Income Available to Common Shareholders	17,710	15,029	41,521	36,902
Basic Earnings Per Share (in Dollars per share)	$1.28	$1.08	$3	$2.67
Diluted Earnings Per Share (in Dollars per share)	$1.19	$1.04	$2.88	$2.62
Previously Reported [Member]	'	'	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'
Other revenues	'	14,007	'	42,008
Net operating revenues	'	189,368	'	567,219
Income Before Non-Operating Income	'	16,671	'	47,900
Income Before Income Taxes	'	23,442	'	66,446
Income Tax Provision	'	-6,209	'	-22,923
Net Income	'	17,233	'	43,523
Net Income Available to Common Shareholders	'	15,066	'	37,020
Basic Earnings Per Share (in Dollars per share)	'	$1.09	'	$2.67
Diluted Earnings Per Share (in Dollars per share)	'	$1.04	'	$2.63
Adjustments for New Accounting Pronouncement [Member]	'	'	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'
Other revenues	'	-61	'	-194
Net operating revenues	'	-61	'	-194
Income Before Non-Operating Income	'	-61	'	-194
Income Before Income Taxes	'	-61	'	-194
Income Tax Provision	'	24	'	76
Net Income	'	-37	'	-118
Net Income Available to Common Shareholders	'	-37	'	-118
Basic Earnings Per Share (in Dollars per share)	'	($0.01)	'	$0
Diluted Earnings Per Share (in Dollars per share)	'	$0	'	($0.01)
As Adjusted [Member]	'	'	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'
Other revenues	'	13,946	'	41,814
Net operating revenues	'	189,307	'	567,025
Income Before Non-Operating Income	'	16,610	'	47,706
Income Before Income Taxes	'	23,381	'	66,252
Income Tax Provision	'	-6,185	'	-22,847
Net Income	'	17,196	'	43,405
Net Income Available to Common Shareholders	'	$15,029	'	$36,902
Basic Earnings Per Share (in Dollars per share)	'	$1.08	'	$2.67
Diluted Earnings Per Share (in Dollars per share)	'	$1.04	'	$2.62

Note_2_Summary_of_Significant_5

Note 2 - Summary of Significant Accounting Policies (Details) - Effect of Accounting Change on Interim Financial Statements: Interim Condensed Consolidated Statement of Comprehensive Income (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'
Net Income	$19,877	$17,196	$48,024	$43,405
Comprehensive Income	17,048	17,954	46,073	52,124
Previously Reported [Member]	'	'	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'
Net Income	'	17,233	'	43,523
Comprehensive Income	'	17,991	'	52,242
Adjustments for New Accounting Pronouncement [Member]	'	'	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'
Net Income	'	-37	'	-118
Comprehensive Income	'	-37	'	-118
As Adjusted [Member]	'	'	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'
Net Income	'	17,196	'	43,405
Comprehensive Income	'	$17,954	'	$52,124

Note_2_Summary_of_Significant_6

Note 2 - Summary of Significant Accounting Policies (Details) - Effect of Accounting Change on Interim Financial Statements: Interim Condensed Consolidated Statement of Cash Flows (USD $)	9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2013	Sep. 30, 2012
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'
Net income	$48,024	$43,405
Deferred income taxes	2,130	375
Deferred revenue	547	866
Net cash provided by operating activities	90,164	61,329
Entrance fee deposits	-80	-1,211
Net cash used in financing activities	-24,348	-14,344
Previously Reported [Member]	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'
Net income	'	43,523
Deferred income taxes	'	-299
Deferred revenue	'	959
Net cash provided by operating activities	'	61,616
Entrance fee deposits	'	-1,498
Net cash used in financing activities	'	-14,631
Adjustments for New Accounting Pronouncement [Member]	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'
Net income	'	-118
Deferred income taxes	'	-76
Deferred revenue	'	-93
Net cash provided by operating activities	'	-287
Entrance fee deposits	'	287
Net cash used in financing activities	'	287
As Adjusted [Member]	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'
Net income	'	43,405
Deferred income taxes	'	-375
Deferred revenue	'	866
Net cash provided by operating activities	'	61,329
Entrance fee deposits	'	-1,211
Net cash used in financing activities	'	($14,344)

Note_2_Summary_of_Significant_7

Note 2 - Summary of Significant Accounting Policies (Details) - Effect of Accounting Change on Interim Financial Statements: Interim Condensed Consolidated Statements of Stockholders' Equity (USD $)	Sep. 30, 2013	Dec. 31, 2012	Dec. 31, 2012	Sep. 30, 2012	Sep. 30, 2012	Dec. 31, 2012	Sep. 30, 2012
In Thousands, unless otherwise specified			Previously Reported [Member]	Previously Reported [Member]	Adjustments for New Accounting Pronouncement [Member]	As Adjusted [Member]	As Adjusted [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'	'	'	'
Balance at January 1, 2012	$308,295	$279,993	$283,517	$265,198	($4,867)	$279,993	$260,331

Note_3_Other_Revenues_Details

Note 3 - Other Revenues (Details) (USD $)	9 Months Ended	3 Months Ended		9 Months Ended		3 Months Ended	6 Months Ended	9 Months Ended
	Sep. 30, 2013	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2013
		National [Member]	National [Member]	National [Member]	National [Member]	Other Nursing Centers [Member]	Other Nursing Centers [Member]	Other Nursing Centers [Member]	Other Nursing Centers [Member]	Elder Trust [Member]	Centers in Missouri and Kansas [Member]
Note 3 - Other Revenues (Details) [Line Items]	'	'	'	'	'	'	'	'	'	'	'
Number of Skilled Nursing Centers	68	5	'	5	'	'	'	'	'	'	'
Management Fees Revenue	'	$860,000	$850,000	$2,637,000	$2,564,000	$787,000	$1,422,000	$3,131,000	$4,251,000	'	'
Annual Management Fees At Time Of Settlement	$3,200,000	'	'	'	'	'	'	'	'	$3,200,000	$2,200,000

Note_3_Other_Revenues_Details_

Note 3 - Other Revenues (Details) - Other Revenues (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012
Note 3 - Other Revenues (Details) - Other Revenues [Line Items]	'	'	'	'
Other Revenues	$12,806	$13,946	$42,364	$41,814
Management and Accounting Services Fees [Member]	'	'	'	'
Note 3 - Other Revenues (Details) - Other Revenues [Line Items]	'	'	'	'
Other Revenues	5,234	5,125	14,662	15,104
Rental Income [Member]	'	'	'	'
Note 3 - Other Revenues (Details) - Other Revenues [Line Items]	'	'	'	'
Other Revenues	4,886	4,963	14,387	14,486
Insurance Services [Member]	'	'	'	'
Note 3 - Other Revenues (Details) - Other Revenues [Line Items]	'	'	'	'
Other Revenues	2,729	3,972	12,792	11,803
Other Income [Member]	'	'	'	'
Note 3 - Other Revenues (Details) - Other Revenues [Line Items]	'	'	'	'
Other Revenues	($43)	($114)	$523	$421

Note_4_NonOperating_Income_Det

Note 4 - Non-Operating Income (Details) (Caris [Member])	Sep. 30, 2013
Caris [Member]	'
Note 4 - Non-Operating Income (Details) [Line Items]	'
Equity Method Investment, Ownership Percentage	75.10%

Note_4_NonOperating_Income_Det1

Note 4 - Non-Operating Income (Details) - Non-operating income (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012
Note 4 - Non-Operating Income (Details) - Non-operating income [Line Items]	'	'	'	'
Non-operating Income	$11,171	$6,771	$24,421	$18,546
Equity in Earnings of Unconsolidated Investments [Member]	'	'	'	'
Note 4 - Non-Operating Income (Details) - Non-operating income [Line Items]	'	'	'	'
Non-operating Income	3,947	4,063	11,542	10,079
Dividends and Other Net Realized Gains and Losses on Sales of Securities [Member]	'	'	'	'
Note 4 - Non-Operating Income (Details) - Non-operating income [Line Items]	'	'	'	'
Non-operating Income	408	1,607	3,314	5,074
Interest Income [Member]	'	'	'	'
Note 4 - Non-Operating Income (Details) - Non-operating income [Line Items]	'	'	'	'
Non-operating Income	1,362	1,101	4,111	3,393
Gain On Recovery Of Notes Receivable [Member]	'	'	'	'
Note 4 - Non-Operating Income (Details) - Non-operating income [Line Items]	'	'	'	'
Non-operating Income	$5,454	'	$5,454	'

Note_5_New_Lease_Commitment_wi2

Note 5 - New Lease Commitment with National Health Investors, Inc. (Details) (USD $)	1 Months Ended		3 Months Ended		9 Months Ended
	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012
Note 5 - New Lease Commitment with National Health Investors, Inc. (Details) [Line Items]	'	'	'	'	'	'
Number of Skilled Nursing Centers	68	'	68	'	68	'
Lessee Leasing Arrangements, Operating Leases, Term of Contract	'15 years	'	'	'	'	'
Operating Leases, Rent Expense, Minimum Rentals (in Dollars)	$3,450,000	'	'	'	'	'
Operating Lease Annual Percent Increase	4.00%	'	'	'	'	'
Facility Purchase Price (in Dollars)	49,000,000	'	'	'	'	'
Number Of Long Term Healthcare Centers	32	'	'	'	'	'
Number Of Assisted Living Centers	6	'	'	'	'	'
Number Of Independent Living Centers	3	'	'	'	'	'
Operating Leases, Rent Expense (in Dollars)	$27,260,000	$27,218,000	$9,889,000	$9,813,000	$29,627,000	$29,507,000
National Health Investors, Inc. [Member]	'	'	'	'	'	'
Note 5 - New Lease Commitment with National Health Investors, Inc. (Details) [Line Items]	'	'	'	'	'	'
Number of Skilled Nursing Centers	7	'	7	'	7	'

Note_5_New_Lease_Commitment_wi3

Note 5 - New Lease Commitment with National Health Investors, Inc. (Details) - Future minimum payments under operating lease (NHI Lease Commitments [Member], USD $)	Sep. 30, 2013
In Thousands, unless otherwise specified
NHI Lease Commitments [Member]	'
Note 5 - New Lease Commitment with National Health Investors, Inc. (Details) - Future minimum payments under operating lease [Line Items]	'
2014	$34,200,000
2015	34,200,000
2016	34,200,000
2017	34,200,000
2018	34,200,000
Thereafter	$287,900,000

Note_7_Earnings_per_Share_Deta

Note 7 - Earnings per Share (Details) (Equity Option [Member])	9 Months Ended
	Sep. 30, 2013	Sep. 30, 2012
Equity Option [Member]	'	'
Note 7 - Earnings per Share (Details) [Line Items]	'	'
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	989,275	1,237,144

Note_7_Earnings_per_Share_Deta1

Note 7 - Earnings per Share (Details) - Summary of Earnings and Weighted Average Number of Common Shares Used in the Calculation of Basic and Diluted Earnings Per Share (USD $)	3 Months Ended		9 Months Ended
In Thousands, except Share data, unless otherwise specified	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012
Note 7 - Earnings per Share (Details) - Summary of Earnings and Weighted Average Number of Common Shares Used in the Calculation of Basic and Diluted Earnings Per Share [Line Items]	'	'	'	'
Weighted average common shares outstanding, basic	13,820,449	13,852,403	13,832,706	13,846,022
Dilutive effect of contingent issuable stock	231,500	117,000	232,495	94,796
Convertible preferred stock	2,623,156	2,623,329	2,623,253	2,623,329
Assumed average common shares outstanding	16,686,915	16,605,285	16,701,491	16,578,535
Net income (in Dollars)	$19,877	$17,196	$48,024	$43,405
Dividends to preferred stockholders (in Dollars)	-2,167	-2,167	-6,503	-6,503
Net income available to common stockholders (in Dollars)	17,710	15,029	41,521	36,902
Add dilutive preferred stock dividends for effect of assumed conversion of preferred stock (in Dollars)	2,167	2,167	6,503	6,503
Net income for diluted earnings per common share (in Dollars)	$19,877	$17,196	$48,024	$43,405
Earnings per common share, diluted (in Dollars per share)	$1.19	$1.04	$2.88	$2.62
Earnings per common share, basic (in Dollars per share)	$1.28	$1.08	$3	$2.67
Equity Option [Member]	'	'	'	'
Note 7 - Earnings per Share (Details) - Summary of Earnings and Weighted Average Number of Common Shares Used in the Calculation of Basic and Diluted Earnings Per Share [Line Items]	'	'	'	'
Dilutive effect of securities	7,970	7,912	8,397	8,971
Restricted Stock [Member]	'	'	'	'
Note 7 - Earnings per Share (Details) - Summary of Earnings and Weighted Average Number of Common Shares Used in the Calculation of Basic and Diluted Earnings Per Share [Line Items]	'	'	'	'
Dilutive effect of securities	3,840	4,641	4,640	5,417

Note_8_Investments_in_Marketab2

Note 8 - Investments in Marketable Securities (Details) (USD $)	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012	Dec. 31, 2012
Investments, Debt and Equity Securities [Abstract]	'	'	'	'	'
Available-for-sale Securities, Gross Unrealized Gain	'	'	$79,466,000	'	$80,296,000
Available-for-sale Securities, Gross Unrealized Loss	'	'	2,207,000	'	93,000
Proceeds from Sale and Maturity of Marketable Securities	'	'	57,904,000	42,604,000	'
Realized Investment Gains (Losses)	$911,000	($53,000)	$527,000	$934,000	'

Note_8_Investments_in_Marketab3

Note 8 - Investments in Marketable Securities (Details) - Marketable securities and restricted marketable securities (USD $)	Sep. 30, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Restricted investments available for sale:	'	'
	$172,801	$162,254
	250,060	242,457
Corporate Debt Securities [Member]	'	'
Restricted investments available for sale:	'	'
Amortized Cost	62,613	61,453
Fair Value	62,075	62,876
Commercial Mortgage Backed Securities [Member]	'	'
Restricted investments available for sale:	'	'
Amortized Cost	47,830	47,194
Fair Value	47,293	48,063
US Government Corporations and Agencies Securities [Member]	'	'
Restricted investments available for sale:	'	'
Amortized Cost	24,031	16,218
Fair Value	24,145	16,604
State and Municipal Securities [Member]	'	'
Restricted investments available for sale:	'	'
Amortized Cost	8,151	7,213
Fair Value	8,348	7,664
Marketable Equity Securities [Member]	'	'
Investments available for sale:	'	'
Marketable equity securities	30,176	30,176
Marketable equity securities	$108,199	$107,250

Note_8_Investments_in_Marketab4

Note 8 - Investments in Marketable Securities (Details) - Available for Sale Marketable Equity Securities (NHI Common Stock [Member], USD $)	Sep. 30, 2013	Dec. 31, 2012
In Thousands, except Share data, unless otherwise specified
NHI Common Stock [Member]	'	'
Note 8 - Investments in Marketable Securities (Details) - Available for Sale Marketable Equity Securities [Line Items]	'	'
NHI Common Stock (in Shares)	1,630,642	1,630,642
NHI Common Stock	$24,734	$24,734
NHI Common Stock	$92,767	$92,180

Note_8_Investments_in_Marketab5

Note 8 - Investments in Marketable Securities (Details) - Amortized Cost and Estimated Fair Value of Debt Securities as Available for Sale (USD $)	Sep. 30, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Amortized Cost and Estimated Fair Value of Debt Securities as Available for Sale [Abstract]	'	'
Within 1 year	$10,178	$8,868
Within 1 year	10,255	8,918
1 to 5 years	86,227	80,910
1 to 5 years	86,902	82,801
6 to 10 years	43,658	40,670
6 to 10 years	42,180	41,856
Over 10 years	2,562	1,630
Over 10 years	2,524	1,632
	142,625	132,078
	$141,861	$135,207

Note_9_Fair_Value_Measurements2

Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level (USD $)	Sep. 30, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level [Line Items]	'	'
Cash and cash equivalents	$88,410	$66,701
Restricted cash and cash equivalents	12,149	11,563
Available for sale securities	250,060	242,457
Total financial assets	350,619	320,721
Marketable Equity Securities [Member] | Fair Value, Inputs, Level 1 [Member]	'	'
Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level [Line Items]	'	'
Available for sale securities	108,199	107,250
Marketable Equity Securities [Member]	'	'
Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level [Line Items]	'	'
Available for sale securities	108,199	107,250
Corporate Debt Securities [Member] | Fair Value, Inputs, Level 2 [Member]	'	'
Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level [Line Items]	'	'
Available for sale securities	62,075	62,876
Corporate Debt Securities [Member]	'	'
Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level [Line Items]	'	'
Available for sale securities	62,075	62,876
Commercial Mortgage Backed Securities [Member] | Fair Value, Inputs, Level 2 [Member]	'	'
Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level [Line Items]	'	'
Available for sale securities	47,293	48,063
Commercial Mortgage Backed Securities [Member]	'	'
Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level [Line Items]	'	'
Available for sale securities	47,293	48,063
US Treasury Securities [Member] | Fair Value, Inputs, Level 1 [Member]	'	'
Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level [Line Items]	'	'
Cash and cash equivalents	'	16,604
Available for sale securities	24,145	'
US Treasury Securities [Member]	'	'
Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level [Line Items]	'	'
Cash and cash equivalents	'	16,604
Available for sale securities	24,145	'
State and Municipal Securities [Member] | Fair Value, Inputs, Level 2 [Member]	'	'
Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level [Line Items]	'	'
Available for sale securities	8,348	7,664
State and Municipal Securities [Member]	'	'
Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level [Line Items]	'	'
Available for sale securities	8,348	7,664
Fair Value, Inputs, Level 1 [Member]	'	'
Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level [Line Items]	'	'
Cash and cash equivalents	88,410	66,701
Restricted cash and cash equivalents	12,149	11,563
Total financial assets	232,903	202,118
Fair Value, Inputs, Level 2 [Member]	'	'
Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level [Line Items]	'	'
Total financial assets	$117,716	$118,603

Note_10_LongTerm_Debt_Details_

Note 10 - Long-Term Debt (Details) - Long-term Debt (USD $)	9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2013	Dec. 31, 2012
Long-term Debt [Abstract]	'	'
Revolving Credit Facility, interest payable monthly	'0.9%	'
Revolving Credit Facility, interest payable monthly	'2014	'
Unsecured term note payable to National, interest payable quarterly, principal payable at maturity	'2.8%	'
Unsecured term note payable to National, interest payable quarterly, principal payable at maturity	'2018	'
Unsecured term note payable to National, interest payable quarterly, principal payable at maturity	$10,000	$10,000
	10,000	10,000
	$10,000	$10,000

Note_11_75000000_Revolving_Cre1

Note 11 - $75,000,000 Revolving Credit Facility (Details) (USD $)	9 Months Ended
	Sep. 30, 2013
Note 11 - $75,000,000 Revolving Credit Facility (Details) [Line Items]	'
Line of Credit Facility, Maximum Borrowing Capacity (in Dollars)	$75,000,000
Line of Credit Facility, Commitment Fee Percentage (in Basis Points)	0.10%
Eurodollar Rate [Member]	'
Note 11 - $75,000,000 Revolving Credit Facility (Details) [Line Items]	'
Debt Instrument, Basis Spread on Variable Rate	0.70%
Letter of Credit [Member]	'
Note 11 - $75,000,000 Revolving Credit Facility (Details) [Line Items]	'
Debt Instrument, Basis Spread on Variable Rate	0.10%
Letter of Credit [Member]	'
Note 11 - $75,000,000 Revolving Credit Facility (Details) [Line Items]	'
Line of Credit Facility, Maximum Borrowing Capacity (in Dollars)	$5,000,000

Note_12_Stock_Repurchase_Progr1

Note 12 - Stock Repurchase Program (Details) (USD $)	1 Months Ended			9 Months Ended
	Aug. 31, 2013	Feb. 19, 2013	Aug. 31, 2012	Sep. 30, 2013
Disclosure Text Block Supplement [Abstract]	'	'	'	'
Stock Repurchase Program, Authorized Amount	$25,000,000	'	$25,000,000	'
Stock Repurchased During Period, Shares (in Shares)	'	100,000	'	'
Stock Repurchased During Period, Value	'	$4,700,000	'	$4,700,000

Note_13_StockBased_Compensatio2

Note 13 - Stock-Based Compensation (Details) (USD $)

3 Months Ended

9 Months Ended

9 Months Ended

Sep. 30, 2013

Sep. 30, 2012

Sep. 30, 2013

Sep. 30, 2012

Sep. 30, 2013

Sep. 30, 2013

Sep. 30, 2013

Sep. 30, 2013

31-May-05

Sep. 30, 2013

31-May-10

Sep. 30, 2013

Sep. 30, 2013

Employee Stock Option [Member]

Employee Stock Option [Member]

Restricted Stock [Member]

2005 Plan [Member]

2005 Plan [Member]

2010 Plan [Member]

2010 Plan [Member]

Employee Stock Option [Member]

Restricted Stock [Member]

2010 Plan [Member]

Director [Member]

Note 13 - Stock-Based Compensation (Details) [Line Items]

'

'

'

'

'

'

'

'

'

'

'

'

'

Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Authorized (in Shares)

'

'

'

'

'

'

'

'

1,200,000

'

1,200,000

'

'

Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Available for Grant (in Shares)

'

'

'

'

'

'

'

245,620

'

410,457

'

'

'

Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Net of Forfeitures (in Shares)

'

'

'

'

45,000

'

'

'

'

'

'

'

'

Stock Issued During Period, Shares, Employee Stock Purchase Plans (in Shares)

'

'

'

'

'

'

'

'

'

15,275

'

'

'

Share-based Compensation

$453,000

$527,000

$1,812,000

$1,925,000

'

'

'

'

'

'

'

'

'

Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized

$4,425,000

'

$4,425,000

'

'

'

'

'

'

'

'

$4,094,000

$331,000

Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized, Period for Recognition

'

'

'

'

'

'2 years 146 days

'1 year 36 days

'

'

'

'

'

'

Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Remaining Contractual Term

'

'

'2 years 6 months

'

'

'

'1 year 36 days

'

'

'

'

'

'

Note_13_StockBased_Compensatio3

Note 13 - Stock-Based Compensation (Details) - Summary of Assumptions Used To Value Options Granted	9 Months Ended	12 Months Ended
	Sep. 30, 2013	Dec. 31, 2012
Summary of Assumptions Used To Value Options Granted [Abstract]	'	'
Riskbfree interest rate	0.25%	0.28%
Expected volatility	31.10%	38.80%
Expected life, (in years)	'2 years 36 days	'2 years 36 days
Expected dividend yield	2.81%	2.91%

Note_13_StockBased_Compensatio4

Note 13 - Stock-Based Compensation (Details) - Summary of Outstanding Stock Options (USD $)	9 Months Ended	12 Months Ended
	Sep. 30, 2013	Dec. 31, 2012
Summary of Outstanding Stock Options [Abstract]	'	'
Number of Shares	1,134,602	1,482,077
Weighted Average Exercise Price (in Dollars per share)	$46.75	$46.92
Aggregate Intrinsic Value (in Dollars)	$900,000	'
Options exercisable at September 30, 2013	145,552	'
Options exercisable at September 30, 2013 (in Dollars per share)	$44.84	'
Options exercisable at September 30, 2013 (in Dollars)	$361,000	'
Number of Shares	60,375	63,516
Weighted Average Exercise Price (in Dollars per share)	$47.97	$44.24
Number of Shares	-7,150	-295,371
Weighted Average Exercise Price (in Dollars per share)	$37.70	$45.41
Number of Shares	-98,000	-115,620
Weighted Average Exercise Price (in Dollars per share)	$51.11	$50.99
Number of Shares	1,089,827	1,134,602
Weighted Average Exercise Price (in Dollars per share)	$46.48	$46.75

Note_13_StockBased_Compensatio5

Note 13 - Stock-Based Compensation (Details) - Options Outstanding (USD $)	9 Months Ended
	Sep. 30, 2013	Dec. 31, 2012	Dec. 31, 2011
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]	'	'	'
Options Outstanding (in Shares)	1,089,827	1,134,602	1,482,077
Weighted Average Exercise Price	$46.48	$46.75	$46.92
Weighted Average Remaining Contractual Life in Years	'2 years 6 months	'	'
Exercise Price Range 1 [Member]	'	'	'
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]	'	'	'
Options Outstanding (in Shares)	21,750	'	'
Exercise Prices	$37.70	'	'
Weighted Average Exercise Price	$37.70	'	'
Weighted Average Remaining Contractual Life in Years	'219 days	'	'
Exercise Price Range 2 [Member]	'	'	'
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]	'	'	'
Options Outstanding (in Shares)	1,052,802	'	'
Weighted Average Exercise Price	$46.62	'	'
Weighted Average Remaining Contractual Life in Years	'2 years 219 days	'	'
Exercise Price Range 2 [Member] | Minimum [Member]	'	'	'
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]	'	'	'
Exercise Prices, Low range	$44.80	'	'
Exercise Price Range 2 [Member] | Maximum [Member]	'	'	'
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]	'	'	'
Exercise Prices, Upper range	$47.45	'	'
Exercise Price Range 3 [Member]	'	'	'
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]	'	'	'
Options Outstanding (in Shares)	15,275	'	'
Exercise Prices	$49.50	'	'
Weighted Average Exercise Price	$49.50	'	'
Weighted Average Remaining Contractual Life in Years	'109 days	'	'

Note_13_StockBased_Compensatio6

Note 13 - Stock-Based Compensation (Details) - Summary of Restricted Stock Activity (USD $)	9 Months Ended	12 Months Ended
	Sep. 30, 2013	Dec. 31, 2012
Summary of Restricted Stock Activity [Abstract]	'	'
Number of Shares	18,000	24,000
Weighted Average Grant Date Fair Value (in Dollars per share)	$34.46	$34.46
Number of Shares	6,000	6,000
Weighted Average Grant Date Fair Value (in Dollars per share)	$34.46	$34.46
Number of Shares	12,000	18,000
Weighted Average Grant Date Fair Value (in Dollars per share)	$34.46	$34.46
Aggregate Intrinsic Value (in Dollars)	$154,000	'

Note_14_Accounting_for_Uncerta1

Note 14 - Accounting for Uncertainty in Income Taxes (Details) (USD $)	9 Months Ended
	Sep. 30, 2013
Note 14 - Accounting for Uncertainty in Income Taxes (Details) [Line Items]	'
Unrecognized Tax Benefits	$12,196,000
Unrecognized Tax Benefits, Income Tax Penalties and Interest Accrued	1,830,000
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations	2,330,000
Unrecognized Tax Benefits, Period Increase (Decrease)	544,000
Deferred Tax Assets [Member]	'
Note 14 - Accounting for Uncertainty in Income Taxes (Details) [Line Items]	'
Unrecognized Tax Benefits	7,996,000
Permanent Differences [Member]	'
Note 14 - Accounting for Uncertainty in Income Taxes (Details) [Line Items]	'
Unrecognized Tax Benefits	4,200,000
Unrecognized Tax Benefits, Income Tax Penalties and Interest Accrued	1,594,000
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations	940,000
Temorary Difference [Member]	'
Note 14 - Accounting for Uncertainty in Income Taxes (Details) [Line Items]	'
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations	$1,390,000

Note_15_Contingencies_and_Guar1

Note 15 - Contingencies and Guarantees (Details) (USD $)

3 Months Ended

9 Months Ended

12 Months Ended

36 Months Ended

21 Months Ended

3 Months Ended

9 Months Ended

3 Months Ended

9 Months Ended

Sep. 30, 2013

Sep. 30, 2013

Dec. 31, 2012

Dec. 31, 2010

Dec. 31, 2007

Sep. 30, 2013

Sep. 30, 2013

Sep. 30, 2013

Sep. 30, 2012

Sep. 30, 2013

Sep. 30, 2012

Sep. 30, 2013

Sep. 30, 2012

Sep. 30, 2013

Sep. 30, 2012

Coverage Amount per Incident [Member]

Coverage Amount per Location [Member]

Workers Compensation Premium Revenue [Member]

Workers Compensation Premium Revenue [Member]

Workers Compensation Premium Revenue [Member]

Workers Compensation Premium Revenue [Member]

Professional Liability Insurance [Member]

Professional Liability Insurance [Member]

Professional Liability Insurance [Member]

Professional Liability Insurance [Member]

Note 15 - Contingencies and Guarantees (Details) [Line Items]

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Self Insurance Reserve

$118,714,000

$118,714,000

$110,331,000

'

'

'

'

'

'

'

'

'

'

'

'

Direct Business Coverage Statutory Limits

'

1,000,000

'

'

'

'

'

'

'

'

'

'

'

'

'

Premiums Earned, Net, Other Insurance

'

'

'

'

'

'

'

1,218,000

1,409,000

6,607,000

4,094,000

654,000

1,051,000

2,539,000

3,152,000

Increase in Revenue

9

2,769,000

'

'

'

'

'

'

'

'

'

'

'

'

'

Primary Insurance Coverage Amount Per Incident

'

'

'

'

'

1,000,000

'

'

'

'

'

'

'

'

'

Primary Insurance Coverage Amount Per Location

'

'

'

'

'

'

3,000,000

'

'

'

'

'

'

'

'

Annual Excess Coverage

'

'

$4,000,000

$9,000,000

$7,500,000

'

'

'

'

'

'

'

'

'

'

Note_16_Asset_Purchase_Acquisi1

Note 16 - Asset Purchase Acquisition (Details) (USD $)	9 Months Ended		3 Months Ended
	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013
			Six Skilled Health Care Centers from NHI [Member]
Note 16 - Asset Purchase Acquisition (Details) [Line Items]	'	'	'
Number of Skilled Nursing Centers	68	'	6
Payments to Acquire Property, Plant, and Equipment (in Dollars)	$33,981,000	$14,888,000	$21,000,000
Number Of Beds	8,803	'	650
Purchase Commitment Impact On Lease Expense (in Dollars)	'	'	$2,950,000

Note_17_Settlement_of_SeniorTr1

Note 17 - Settlement of SeniorTrust of Florida, Inc. and ElderTrust of Florida, Inc. Litigation (Details) (USD $)	3 Months Ended		9 Months Ended
	Sep. 30, 2013	Mar. 31, 2013	Sep. 30, 2013
Note 17 - Settlement of SeniorTrust of Florida, Inc. and ElderTrust of Florida, Inc. Litigation (Details) [Line Items]	'	'	'
Payments for Legal Settlements	'	$6,650,000	'
Litigation Settlement, Expense	5,195,000	'	'
Estimated Litigation Liability	5,257,000	'	5,257,000
Loss Contingency, Estimate of Possible Loss	2,505,000	'	2,505,000
Annual Management Fees At Time Of Settlement	'	'	3,200,000
Settlement Impact on Results of Operations and Cash Flows	'	'	2,200,000
Settlement Impact On Results Of Operations And Cash Flows Net Of Tax	'	'	1,350,000
Senior Trust [Member]	'	'	'
Note 17 - Settlement of SeniorTrust of Florida, Inc. and ElderTrust of Florida, Inc. Litigation (Details) [Line Items]	'	'	'
Annual Management Fees At Time Of Settlement	'	'	$2,200,000