National HealthCare (NHC) 10-K 21 Feb 14 2013 FY Annual report Financial data

Document_And_Entity_Informatio

Document And Entity Information (USD $)	12 Months Ended
	Dec. 31, 2013	Feb. 19, 2014	Jun. 30, 2013
Document and Entity Information [Abstract]	'	'	'
Entity Registrant Name	'NATIONAL HEALTHCARE CORP	'	'
Document Type	'10-K	'	'
Current Fiscal Year End Date	'--12-31	'	'
Entity Common Stock, Shares Outstanding	'	14,080,796	'
Entity Public Float	'	'	$346,000,000
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	31-Dec-13	'	'
Document Fiscal Year Focus	'2013	'	'
Document Fiscal Period Focus	'FY	'	'

Consolidated_Statements_of_Inc

Consolidated Statements of Income (USD $)	12 Months Ended
In Thousands, except Share data, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Revenues:	'	'	'
Net patient revenues	$735,837	$705,386	$715,489
Other revenues	53,120	55,616	57,753
Net operating revenues	788,957	761,002	773,242
Costs and Expenses:	'	'	'
Salaries, wages and benefits	453,560	426,934	428,672
Other operating	194,989	196,230	196,639
Facility rent	39,449	39,355	39,736
Depreciation and amortization	28,547	29,792	28,901
Interest	331	455	443
Total costs and expenses	716,876	692,766	694,391
Income Before Non-Operating Income	72,081	68,236	78,851
Non-Operating Income	30,095	25,245	20,533
Income Before Income Taxes	102,176	93,481	99,384
Income Tax Provision	-37,563	-34,181	-34,394
Net Income	64,613	59,300	64,990
Dividends to Preferred Stockholders	-8,671	-8,671	-8,671
Net Income Available to Common Stockholders	$55,942	$50,629	$56,319
Earnings Per Common Share:	'	'	'
Basic (in Dollars per share)	$4.05	$3.65	$4.09
Diluted (in Dollars per share)	$3.87	$3.57	$3.96
Weighted Average Common Shares Outstanding:	'	'	'
Basic (in Shares)	13,829,626	13,852,709	13,774,628
Diluted (in Shares)	16,698,803	16,598,816	16,414,023
Dividends Declared Per Common Share (in Dollars per share)	$1.26	$2.20	$1.18

Consolidated_Statements_of_Com

Consolidated Statements of Comprehensive Income (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Net Income	$64,613	$59,300	$64,990
Other Comprehensive Income (Loss):	'	'	'
Unrealized gains (losses) on investments in marketable securities	-7,211	24,739	1,352
Reclassification adjustment for realized gains on sale of securities	-39	-1,640	-754
Income tax (expense) benefit related to items of other comprehensive income (loss)	2,627	-8,993	-183
Other comprehensive income (loss), net of tax	-4,623	14,106	415
Comprehensive Income	$59,990	$73,406	$65,405

Consolidated_Balance_Sheets

Consolidated Balance Sheets (USD $)	Dec. 31, 2013	Dec. 31, 2012
Current Assets:	'	'
Cash and cash equivalents	$81,705,000	$66,701,000
Restricted cash and cash equivalents	13,929,000	11,563,000
Marketable securities	105,009,000	107,250,000
Restricted marketable securities	142,003,000	135,207,000
Accounts receivable, less allowance for doubtful accounts of $4,972 and $3,166, respectively	85,511,000	76,959,000
Inventories	7,146,000	6,660,000
Prepaid expenses and other assets	1,208,000	1,132,000
Notes receivable	417,000	5,840,000
Federal income tax receivable	'	5,933,000
Total current assets	436,928,000	417,245,000
Property and Equipment:	'	'
Property and equipment, at cost	734,682,000	675,455,000
Accumulated depreciation and amortization	-277,884,000	-254,548,000
Net property and equipment	456,798,000	420,907,000
Other Assets:	'	'
Deposits	1,153,000	143,000
Goodwill	17,600,000	17,600,000
Notes receivable	14,961,000	15,949,000
Deferred income taxes	14,531,000	12,817,000
Investments in limited liability companies	38,754,000	40,039,000
Total other assets	86,999,000	86,548,000
Total assets	980,725,000	924,700,000
Current Liabilities:	'	'
Trade accounts payable	13,050,000	10,555,000
Accrued payroll	63,462,000	37,243,000
Amounts due to third party payors	21,619,000	19,267,000
Accrued risk reserves	110,557,000	110,331,000
Deferred income taxes	21,157,000	24,474,000
Other current liabilities	13,784,000	20,411,000
Dividends payable	6,730,000	6,480,000
Total current liabilities	250,359,000	228,761,000
Long-term debt	10,000,000	10,000,000
Refundable entrance fees	10,720,000	10,680,000
Obligation to provide future services	3,689,000	1,791,000
Other noncurrent liabilities	14,525,000	13,890,000
Deferred revenue	3,320,000	3,430,000
Stockholders’ Equity:	'	'
Series A convertible preferred stock; $.01 par value; 25,000,000 shares authorized; 10,837,665 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; 14,078,028 and 14,158,127 shares, respectively, issued and outstanding	140,000	141,000
Capital in excess of par value	153,061,000	154,692,000
Retained earnings	318,216,000	279,993,000
Accumulated other comprehensive income	46,185,000	50,808,000
Total stockholders’ equity	688,112,000	656,148,000
Total liabilities and stockholders’ equity	$980,725,000	$924,700,000

Consolidated_Balance_Sheets_Pa

Consolidated Balance Sheets (Parentheticals) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, except Share data, unless otherwise specified
Allowance for doubtful accounts (in Dollars)	$4,972	$3,166
Series A Convertible Preferred Stock; par value (in Dollars per share)	$0.01	$0.01
Series A Convertible Preferred Stock; shares authorized	25,000,000	25,000,000
Series A Convertible Preferred Stock; shares issued	10,837,665	10,838,412
Series A Convertible Preferred Stock; shares outstanding	10,837,665	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	30,000,000	30,000,000
Common stock, shares issued	14,078,028	14,158,127
Common stock, shares outstanding	14,078,028	14,158,127

Consolidated_Statements_of_Cas

Consolidated Statements of Cash Flows (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Cash Flows From Operating Activities:	'	'	'
Net income	$64,613,000	$59,300,000	$64,990,000
Depreciation and amortization	28,547,000	29,792,000	28,901,000
Provision for doubtful accounts receivable	5,226,000	2,455,000	2,430,000
Equity in earnings of unconsolidated investments	-14,188,000	-13,616,000	-9,674,000
Distributions from unconsolidated investments	15,473,000	6,317,000	10,828,000
Gains on sale of marketable securities	-39,000	-1,640,000	-754,000
Gain on recovery of notes receivable	-5,454,000	'	'
Deferred income taxes	-2,404,000	1,416,000	2,577,000
Stock-based compensation	2,298,000	2,366,000	2,751,000
Restricted cash and cash equivalents	-10,405,000	-7,636,000	-7,830,000
Accounts receivable	-13,778,000	-7,263,000	5,032,000
Income tax receivable	5,933,000	537,000	-3,779,000
Inventories	-486,000	759,000	434,000
Prepaid expenses and other assets	-76,000	-77,000	169,000
Trade accounts payable	2,495,000	831,000	-1,113,000
Accrued payroll	26,219,000	-16,418,000	2,008,000
Amounts due to third party payors	2,352,000	481,000	-860,000
Other current liabilities and accrued risk reserves	-6,401,000	11,675,000	-9,129,000
Obligation to provide future services	1,898,000	-2,461,000	-1,800,000
Other noncurrent liabilities	635,000	-2,354,000	-2,617,000
Deferred revenue	-110,000	-91,000	-206,000
Net cash provided by operating activities	102,348,000	64,373,000	82,358,000
Cash Flows From Investing Activities:	'	'	'
Additions to and acquisitions of property and equipment	-43,438,000	-22,003,000	-23,372,000
Acquisition of real estate of six skilled nursing facilities	-21,000,000	'	'
Acquisition of non-controlling interest in hospice business	'	-7,500,000	-7,500,000
Collections of notes receivable, net	11,865,000	660,000	1,222,000
Decrease in restricted cash and cash equivalents	8,039,000	46,660,000	9,235,000
Purchases of marketable securities	-93,155,000	-111,691,000	-57,597,000
Sale of marketable securities	81,389,000	62,649,000	46,266,000
Net cash used in investing activities	-56,300,000	-31,225,000	-31,746,000
Cash Flows From Financing Activities:	'	'	'
Tax expense from stock-based compensation	-225,000	-267,000	-52,000
Dividends paid to preferred stockholders	-8,671,000	-8,671,000	-8,671,000
Dividends paid to common stockholders	-17,469,000	-30,849,000	-15,952,000
Issuance of common shares	991,000	13,412,000	8,392,000
Repurchase of common shares	-4,700,000	'	'
Entrance fee deposits (refunds)	40,000	-1,310,000	-1,704,000
(Increase) decrease in deposits	-1,010,000	230,000	-95,000
Net cash used in financing activities	-31,044,000	-27,455,000	-18,082,000
Net Increase in Cash and Cash Equivalents	15,004,000	5,693,000	32,530,000
Cash and Cash Equivalents, Beginning of Period	66,701,000	61,008,000	28,478,000
Cash and Cash Equivalents, End of Period	81,705,000	66,701,000	61,008,000
Supplemental Information:	'	'	'
Cash payments for interest	497,000	383,000	501,000
Cash payments for income taxes	34,273,000	34,142,000	40,798,000
Effective January 1, 2012, NHC assigned the assets and liabilities of eight Solaris Hospice programs to Caris in exchange for an additional limited partnership interest.	'	'	'
Current assets assigned	'	1,862,000	'
Property and equipment assigned	'	303,000	'
Current liabilities assigned	'	-799,000	'
Goodwill	'	2,945,000	'
Investment in limited liability company	'	($4,311,000)	'

Consolidated_Statements_of_Sto

Consolidated Statements of Stockholders' Equity (USD $)	Preferred Stock [Member]	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	Accumulated Other Comprehensive Income (Loss) [Member]	Total
In Thousands, except Share data
Balance at January 1, 2011 at Dec. 31, 2010	$170,548	$136	$128,061	$220,329	$36,287	$555,361
Balance at January 1, 2011 (in Shares) at Dec. 31, 2010	10,840,608	13,637,258	'	'	'	'
Net income	'	'	'	64,990	'	64,990
Other comprehensive income (loss)	'	'	'	'	415	415
Stock-based compensation	'	'	2,751	'	'	2,751
Tax expense from exercise of stock options	'	'	-52	'	'	-52
Shares sold b options exercised	'	2	8,390	'	'	8,392
Shares sold b options exercised (in Shares)	'	224,969	'	'	'	-224,969
Shares issued in conversion of preferred stock to common stock	-33	'	33	'	'	'
Shares issued in conversion of preferred stock to common stock (in Shares)	-2,118	511	'	'	'	'
Dividends declared to preferred stockholders	'	'	'	-8,671	'	-8,671
Dividends declared to common stockholders	'	'	'	-16,317	'	-16,317
Balance at Dec. 31, 2011	170,515	138	139,183	260,331	36,702	606,869
Balance (in Shares) at Dec. 31, 2011	10,838,490	13,862,738	'	'	'	'
Net income	'	'	'	59,300	'	59,300
Other comprehensive income (loss)	'	'	'	'	14,106	14,106
Stock-based compensation	'	'	2,366	'	'	2,366
Tax expense from exercise of stock options	'	'	-267	'	'	-267
Shares sold b options exercised	'	3	13,409	'	'	13,412
Shares sold b options exercised (in Shares)	'	295,371	'	'	'	-295,371
Shares issued in conversion of preferred stock to common stock	-1	'	1	'	'	'
Shares issued in conversion of preferred stock to common stock (in Shares)	-78	18	'	'	'	'
Dividends declared to preferred stockholders	'	'	'	-8,671	'	-8,671
Dividends declared to common stockholders	'	'	'	-30,967	'	-30,967
Balance at Dec. 31, 2012	170,514	141	154,692	279,993	50,808	656,148
Balance (in Shares) at Dec. 31, 2012	10,838,412	14,158,127	'	'	'	'
Net income	'	'	'	64,613	'	64,613
Other comprehensive income (loss)	'	'	'	'	-4,623	-4,623
Stock-based compensation	'	'	2,298	'	'	2,298
Tax expense from exercise of stock options	'	'	-225	'	'	-225
Shares sold b options exercised	'	'	991	'	'	991
Shares sold b options exercised (in Shares)	'	19,722	'	'	'	-21,522
Shares issued in conversion of preferred stock to common stock	-4	'	4	'	'	'
Shares issued in conversion of preferred stock to common stock (in Shares)	-747	179	'	'	'	'
Dividends declared to preferred stockholders	'	'	'	-8,671	'	-8,671
Dividends declared to common stockholders	'	'	'	-17,719	'	-17,719
Repurchase of common shares	'	-1	-4,699	'	'	-4,700
Repurchase of common shares (in Shares)	'	-100,000	'	'	'	'
Balance at Dec. 31, 2013	$170,510	$140	$153,061	$318,216	$46,185	$688,112
Balance (in Shares) at Dec. 31, 2013	10,837,665	14,078,028	'	'	'	'

Consolidated_Statements_of_Sto1

Consolidated Statements of Stockholders' Equity (Parentheticals) (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Dividends declared to common stockholders per share	$1.26	$2.20	$1.18
Preferred Stock [Member]	'	'	'
Dividends declared to preferred stockholders per share	$0.80	$0.80	$0.80
Common Stock [Member]	'	'	'
Dividends declared to common stockholders per share	$1.26	$2.20	$1.18

Note_1_Summary_of_Significant_

Note 1 - Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2013
Accounting Policies [Abstract]	'
Significant Accounting Policies [Text Block]	'
	Note 1 - Summary of Significant Accounting Policies
	Nature of Operations
	National HealthCare Corporation ("NHC" or "the Company") operates, manages or provides services to skilled nursing facilities and associated assisted living centers, retirement centers and home health care programs located in 10 Southeastern, Northeastern and Midwestern states in the United States. The most significant part of our business relates to skilled and intermediate nursing care in which setting we provide assisted living and retirement services, rehabilitative therapy services, and home health care. We also have a non-controlling ownership interest in a hospice care business that services NHC owned health care centers and others. The long-term health care environment has continually undergone changes with regard to Federal and state reimbursement programs and other payor sources, compliance regulations, competition among other health care providers and patient care litigation issues. We continually monitor these industry developments as well as other factors that affect our business.
	Principles of Consolidation and Basis of Presentation
	The consolidated financial statements which are prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) include our wholly owned and controlled subsidiaries and affiliates. Variable interest entities (“VIEs”) in which we have an interest have been consolidated when we have been identified as the primary beneficiary. Investments in ventures in which we have the ability to exercise significant influence but do not have control over are accounted for using the equity method. Equity method investments are initially recorded at cost and subsequently are adjusted for our share of the venture’s earnings or losses and cash distributions. Our most significant equity method investment is a 75.1% non-controlling ownership interest in Caris Healthcare, LP (“Caris”), a business that specializes in hospice care services. Investments in entities in which we lack the ability to exercise significant influence are included in the consolidated financial statements at cost unless there has been a decline in the market value of our investment that is deemed to be other than temporary. All material intercompany transactions and balances have been eliminated in consolidation.
	Use of Estimates
	The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires management 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.
	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 consolidated financial statements of prior periods are adjusted to apply the new accounting method retrospectively. The following tables present the effect on the consolidated financial statements of the accounting change that was retrospectively adopted on January 1, 2013:
	Consolidated Balance Sheet
	(in thousands)
		Year Ended December 31, 2012
		As Previously Reported			Effect of Accounting Change			As Adjusted
	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 Statements of Income
	(in thousands, except share and per share amounts)
		Year Ended December 31, 2012									Year Ended December 31, 2011
		As Previously Reported			Effect of Accounting Change			As Adjusted			As Previously Reported			Effect of Accounting Change			As Adjusted
	Other revenues	$	55,876		$	(260	)	$	55,616		$	58,048		$	(295	)	$	57,753
	Net operating revenues		761,262			(260	)		761,002			773,537			(295	)		773,242
	Other operating expenses		(198,691			2,461			(196,230	)		(198,439	)		1,800			(196,639	)
	Total costs and expenses		(695,227	)		2,461			(692,766	)		(696,191	)		1,800			(694,391	)
	Income Before Non-Operating Income		66,035			2,201			68,236			77,346			1,505			78,851
	Income Before Income Taxes		91,280			2,201			93,481			97,879			1,505			99,384
	Income Tax Provision		(33,323	)		(858	)		(34,181	)		(33,807	)		(587	)		(34,394	)
	Net Income		57,957			1,343			59,300			64,072			918			64,990
	Net Income Available to Common Shareholders	$	49,286		$	1,343		$	50,629		$	55,401		$	918		$	56,319
	Basic Earnings Per Share	$	3.56		$	0.09		$	3.65		$	4.02		$	0.07		$	4.09
	Diluted Earnings Per Share	$	3.49		$	0.08		$	3.57		$	3.9		$	0.06		$	3.96
	Consolidated Statements of Comprehensive Income
	(in thousands)
		Year Ended December 31, 2012									Year Ended December 31, 2011
		As Previously Reported			Effect of Accounting Change			As Adjusted			As Previously Reported			Effect of Accounting Change			As Adjusted
	Net Income	$	57,957		$	1,343		$	59,300		$	64,072		$	918		$	64,990
	Comprehensive Income	$	72,063		$	1,343		$	73,406		$	64,487		$	918		$	65,405
	Consolidated Statements of Cash Flows
	(in thousands)
		Year Ended December 31, 2012									Year Ended December 31, 2011
		As Previously Reported			Effect of Accounting Change			As Adjusted			As Previously Reported			Effect of Accounting Change			As Adjusted
	Cash Flows from Operating Activities:
	Net Income	$	57,957		$	1,343		$	59,300		$	64,072		$	918		$	64,990
	Deferred income taxes		558			858			1,416			1,990			587			2,577
	Obligation to provide future services		-			(2,461	)		(2,461	)		-			(1,800	)		(1,800	)
	Deferred revenue		(31	)		(60	)		(91	)		(35	)		(171	)		(206	)
	Net cash provided by operating activities		64,693			(320	)		64,373			82,824			(466	)		82,358
	Cash Flows From Financing Activities:
	Entrance fee refunds		(1,630	)		320			(1,310	)		(2,170	)		466			(1,704	)
	Net cash used in financing activities	$	(27,775	)	$	320		$	(27,455	)	$	(18,548	)	$	466		$	(18,082	)
	Consolidated Statements of Stockholders' Equity
	(in thousands)
		Years Ended December 31, 2012 and 2011
		As Previously Reported			Effect of Accounting Change			As Adjusted
	Retained Earnings
	Balance at January 1, 2011	$	226,114		$	(5,785	)	$	220,329
	Net income		64,072			918			64,990
Balance at December 31, 2011		265,198			(4,867	)		260,331
Net income		57,957			1,343			59,300
Balance at December 31, 2012	$	283,517		$	(3,524	)	$	279,993
Net Patient Revenues and Accounts Receivable
Revenues are derived from services rendered to patients for long-term care, including skilled and intermediate nursing, rehabilitation therapy, hospice, assisted living and retirement and home health care services.
Revenues are recorded when services are provided based on established rates adjusted to amounts expected to be received under governmental programs and other third-party contractual arrangements based on contractual terms. These revenues and receivables are stated at amounts estimated by management to be at their net realizable value.
For private pay patients in skilled nursing, assisted living and independent living facilities, the Company bills one month in advance for room and board charges, with the remittance being due on receipt of the statement and generally by the 10th day of the month the services are performed. A portion of the episodic Medicare payments for home health services are also received in advance of the services being rendered. All advance billings are initially deferred and then are recognized as revenue when the services are performed.
We receive payments from the Medicare program under a prospective payment system ("PPS"). For skilled nursing services, Medicare pays a fixed fee per Medicare patient per day, based on the acuity level of the patient, to cover all post-hospital extended care routine service costs, ancillary costs and capital related costs.
Medicaid program payments for long-term care services are generally based on fixed per diem rates subject to program cost ceilings.
For homecare services, Medicare pays based on the acuity level of the patient and based on episodes of care. An episode of care is defined as a length of care up to 60 days with multiple continuous episodes allowed. The services covered by the episode payment include all disciplines of care, in addition to medical supplies, within the scope of the home health benefit. We are allowed to make a request for anticipated payment at the start of care equal to 60% of the expected payment for the initial episode. The remaining balance due is paid following the submission of the final claim at the end of the episode. Revenues are recognized when services are provided based on the number of days of service rendered in the episode. Deferred revenue is recorded for payments received for which the related services have not yet been provided.
Laws and regulations governing the Medicare and Medicaid programs are complex and subject to interpretation. Noncompliance with such laws and regulations can be subject to regulatory actions including fines, penalties, and exclusion from the Medicare and Medicaid programs. We believe that we are in material compliance with all applicable laws and regulations.
Medicare program revenues, as well as certain Medicaid program revenues, are subject to audit and retroactive adjustment by government representatives. The Medicare PPS methodology requires that patients be assigned to Resource Utilization Groups ("RUGs") based on the acuity level of the patient to determine the amount paid to us for patient services. The assignment of patients to the various RUG categories is subject to post-payment review by Medicare intermediaries or their agents. In our opinion, adequate provision has been made for any adjustments that may result from these reviews. Retroactive adjustments are estimated in the recording of revenues in the period the related services are rendered. 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 believe currently that any differences between the net revenues recorded and final determination will not materially affect the consolidated financial statements. We have made provisions of approximately $21,619,000 and $19,267,000 as of December 31, 2013 and 2012, respectively, for various Medicare and Medicaid current and prior year cost reports and claims reviews.
Approximately 65% of our net patient revenues are derived from participation in Medicare and Medicaid programs and other government programs.
Other Revenues
As discussed in Note 4 other revenues include revenues from the provision of insurance, management and accounting services to other long-term care providers, and rental income. Our insurance revenues consist of premiums that are generally paid in advance and then amortized into income as earned over the related policy period. We charge for management services based on a percentage of net revenues. We charge for accounting services based on a monthly fee or a fixed fee per bed of the long-term care center under contract. We generally record other revenues on the accrual basis based on the terms of our contractual arrangements. However, with respect to management and accounting services revenue from certain long-term care providers, including but not limited to National Health Corporation ("National") as discussed in Note 4, where collection is not reasonably assured based on insufficient historical collections and the lack of expected future collections, our policy is to recognize income only in the period in which collection is assured and the amounts at question are believed by management to be fixed and determined.
Certain management contracts, including, but not limited to contracts with National, subordinate the payment of management fees earned under those contracts to other expenditures of the long-term care center and to the availability of cash provided by the facility’s operations. Revenues from management services provided to the facilities that generate insufficient cash flow to pay the management fee, as prioritized under the contractual arrangement, are not recognized until such time as the amount of revenue earned is fixed or determinable and collectability is reasonably assured. This recognition policy could cause our reported revenues and net income from management services to vary significantly from period to period.
We recognize rental income based on the terms of our operating leases. Under certain of our leases, we receive contingent rent, which is based on the increase in revenues of a lessee over a base year. We recognize contingent rent annually or monthly, as applicable, when, based on the actual revenue of the lessee, receipt of such income is assured. We identify leased real estate properties as nonperforming if a required payment is not received within 30 days of the date it is due. Our policy related to rental income on non-performing leased real estate properties is to recognize rental income in the period when the income is received.
Non-Operating Income
As discussed in Note 5, non-operating income includes equity in earnings of unconsolidated investments, dividends and realized gains on securities, interest income, and other miscellaneous non-operating income.
Provision for Doubtful Accounts
We evaluate the collectability of our accounts receivable based on factors such as payor type, historical collection trends and aging categories. We review these factors and determine an estimated provision for doubtful accounts. Historically, bad debts have resulted primarily from uncollectible private balances or from uncollectible coinsurance and deductibles. Receivables that are deemed to be uncollectible are written off against the allowance. The allowance for doubtful accounts balance is assessed on a quarterly basis, with changes in estimated losses being recorded in the consolidated statements of income in the period first identified.
The Company includes provisions for doubtful accounts in operating expenses in its consolidated statements of income. The provisions for doubtful accounts were $5,226,000, $2,455,000, and $2,430,000 for 2013, 2012 and 2011, respectively.
Property and Equipment
Property and equipment are recorded at cost. Depreciation is provided by the straight-line method over the expected useful lives of the assets estimated as follows: buildings and improvements, 20-40 years and equipment and furniture, 3-15 years. Leasehold improvements are amortized over periods that do not exceed the non-cancelable respective lease terms using the straight-line method.
Expenditures for repairs and maintenance are charged against income as incurred. Betterments, which significantly extend the useful life, are capitalized. We remove the costs and related allowances for accumulated depreciation or amortization from the accounts for properties sold or retired, and any resulting gains or losses are included in income.
In accordance with Accounting Standards Codification ("ASC") Topic 360, Property, Plant, and Equipment, we evaluate the recoverability of the carrying values of our properties on a property by property basis. We review our properties for recoverability when events or circumstances, including significant physical changes in the property, significant adverse changes in general economic conditions, and significant deteriorations of the underlying cash flows of the property, indicate that the carrying amount of the property may not be recoverable. The need to recognize an impairment is based on estimated future undiscounted cash flows from a property over the remaining useful life compared to the carrying value of that property. If recognition of an impairment is necessary, it is measured as the amount by which the carrying amount of the property exceeds the estimated fair value of the property.
Mortgage and Other Notes Receivable
In accordance with ASC Topic 310, Receivables, NHC evaluates the carrying values of its mortgage and other notes receivable on an instrument by instrument basis. On a quarterly basis, NHC reviews its notes receivable for recoverability when events or circumstances, including the non-receipt of contractual principal and interest payments, significant deteriorations of the financial condition of the borrower and significant adverse changes in general economic conditions, indicate that the carrying amount of the note receivable may not be recoverable. If necessary, an impairment is measured as the amount by which the carrying amount exceeds the discounted cash flows expected to be received under the note receivable or, if foreclosure is probable, the fair value of the collateral securing the note receivable.
Investments in Marketable Securities and Restricted Marketable Securities
Our investments in marketable securities and restricted marketable securities include available for sale securities, which are recorded at fair value. Unrealized gains and losses on available for sale securities that are deemed temporary are recorded as a separate component of stockholders’ equity. If any adjustment to fair value reflects a significant decline in the value of the security, we consider all available evidence to evaluate the extent to which the decline is "other than temporary". Credit losses are identified when we do not expect to receive cash flows sufficient to recover the amortized cost basis of a security. In the event of a credit loss, only the amount associated with the credit loss is recognized in earnings, with the amount of loss relating to other factors recorded as a separate component of stockholders’ equity.
Goodwill
The Company accounts for goodwill under ASC Topic 350, Intangibles – Goodwill and Other. Under the provisions of this guidance, goodwill and intangible assets with indefinite useful lives are not amortized but are subject to impairment tests based on their estimated fair value. Unamortized goodwill is continually reviewed for impairment in accordance with ASC. The Company performs its annual impairment assessment on the first day of the fourth quarter.
Income Taxes
We utilize ASC Topic 740, Income Taxes, which requires an asset and liability approach for financial accounting and reporting for income taxes. Under this guidance, deferred tax assets and liabilities are determined based upon differences between financial reporting and tax basis of assets and liabilities and are measured using the enacted tax laws that will be in effect when the differences are expected to reverse. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. See Note 13 for further discussion of our accounting for income taxes.
Also under ASC Topic 740, Income Taxes, tax positions are evaluated for recognition using a more-than-likely-than-not threshold, and those tax positions requiring recognition are measured at the largest amount of tax benefit that is greater than 50 percent likely of being realized upon ultimate settlement with a taxing authority that has full knowledge of all relevant information. Liabilities for income tax matters include amounts for income taxes, applicable penalties, and interest thereon and are the result of the potential alternative interpretations of tax laws and the judgmental nature of the timing of recognition of taxable income.
Concentration of Credit Risks
Our credit risks primarily relate to cash and cash equivalents, restricted cash and cash equivalents, accounts receivable, marketable securities, restricted marketable securities and notes receivable. Cash and cash equivalents are primarily held in bank accounts and overnight investments. Restricted cash and cash equivalents is primarily invested in commercial paper and certificates of deposit with financial institutions and other interest bearing accounts. Accounts receivable consist primarily of amounts due from patients (funded through Medicare, Medicaid, other contractual programs and through private payors) and from other health care companies for management, accounting and other services. We perform continual credit evaluations of our clients and maintain allowances for doubtful accounts on these accounts receivable. Marketable securities and restricted marketable securities are held primarily in accounts with brokerage institutions. Notes receivable relate primarily to secured loans with health care facilities (recorded as notes receivable in the consolidated balance sheets) as discussed in Note 11.
At any point in time we have funds in our operating accounts and restricted cash accounts that are with third party financial institutions. These balances in the U.S. may exceed the Federal Deposit Insurance Corporation (FDIC) insurance limits. While we monitor the cash balances in our operating accounts, these cash and restricted cash balances could be impacted if the underlying financial institutions fail or could be subject to other adverse conditions in the financial markets.
Our financial instruments, principally our notes receivable, are subject to the possibility of loss of the carrying values as a result of the failure of other parties to perform according to their contractual obligations. We obtain various collateral and other protective rights, and continually monitor these rights in order to reduce such possibilities of loss. We evaluate the need to provide reserves for potential losses on our financial instruments based on management's periodic review of the portfolio on an instrument by instrument basis. See Note 11 for additional information on the notes receivable.
Cash and Cash Equivalents
Cash equivalents include highly liquid investments with an original maturity of three months or less when purchased.
Restricted Cash and Cash Equivalents and Restricted Marketable Securities
Restricted cash and cash equivalents and restricted marketable securities primarily represent assets that are held by our wholly-owned limited purpose insurance companies for workers' compensation and professional liability claims.
Inventories
Inventories consist generally of food and supplies and are valued at the lower of cost or market, with cost determined on a first-in, first-out (FIFO) basis.
Other Current Liabilities
Other current liabilities primarily represent accruals for current federal and state income taxes, real estate taxes and other current liabilities.
Accrued Risk Reserves
We are principally self-insured for risks related to employee health insurance and utilize wholly-owned limited purpose insurance companies for workers’ compensation and professional liability claims. Accrued risk reserves primarily represent the accrual for risks associated with employee health insurance, workers’ compensation and professional liability claims. The accrued risk reserves include a liability for unpaid reported claims and estimates for incurred but unreported claims. Our policy with respect to a significant portion of our workers’ compensation and professional and general liability claims is to use an actuary to estimate our exposure for claims obligation (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, with changes in estimated losses being recorded in the consolidated statements of income in the period first identified.
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 December 31, 2013 and December 31, 2012 were $10,720,000 and $10,680,000, respectively.
Stock-Based Compensation
Stock-based awards granted include stock options, restricted stock units, and stock purchased under our employee stock purchase plan. Stock-based compensation cost is measured at the grant date, based on the fair value of the awards, and is recognized as expense over the requisite service period only for those equity awards expected to vest.
The fair value of the restricted stock units is determined based on the stock price on the date of grant. We estimated the fair value of stock options and stock purchased under our employee stock purchase plan using the Black-Scholes model. This model utilizes the estimated fair value of common stock and requires that, at the date of grant, we use the expected term of the grant, the expected volatility of the price of our common stock, risk-free interest rates and expected dividend yield of our common stock. The fair value is amortized on a straight-line basis over the requisite service periods of the awards.
Other Noncurrent Liabilities
Other noncurrent liabilities include reserves primarily related to various uncertain income tax positions (see Note 13).
Deferred Revenue
Deferred revenue includes the deferred gain on the sale of assets to National (as discussed in Note 3) and entrance fees that have been and are currently being received upon reservation and occupancy in the independent living centers we operate. The non-refundable portion (10%) of the entrance fee is included in deferred revenue and is being recognized over the remaining life expectancies of the residents.
Comprehensive Income
ASC Topic 220, Comprehensive Income, requires that changes in the amounts of certain items, including unrealized gains and losses on marketable securities, be shown in the consolidated financial statements as comprehensive income. We report comprehensive income in the consolidated statements of comprehensive income and also in the consolidated statements of stockholders’ equity.
Segment Disclosures
ASC Topic 280, Segment Reporting, establishes standards for the way that public business enterprises report information about operating segments in annual and interim financial reports issued to stockholders. Management believes that substantially all of our operations are part of the long-term health care industry segment. See Note 4 for a detail of other revenues provided within the long-term health care industry segment. Information about the costs and expenses associated with each of the components of other revenues is not separately identifiable.
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 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 1 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, results of operations, or cash flows.

Note_2_Relationship_With_Natio

Note 2 - Relationship With National Health Investors, Inc.	12 Months Ended
	Dec. 31, 2013
Leases [Abstract]	'
Leases of Lessee Disclosure [Text Block]	'
	Note 2 - Relationship with National Health Investors, Inc.
	In 1991, we formed National Health Investors, Inc. ("NHI") as a wholly-owned subsidiary. We then transferred to NHI certain healthcare facilities owned by NHC and distributed the shares of NHI to NHC’s stockholders. The distribution had the effect of separating NHC and NHI into two independent public companies. As a result of the distribution, all of the outstanding shares of NHI were distributed to the then NHC investors. NHI is listed on the New York Stock Exchange under the symbol NHI.
	Leases
	At December 31, 2013, we lease from NHI the real property of 35 skilled nursing facilities, seven assisted living centers and three independent living centers under two separate lease agreements. As part of the first lease agreement, we sublease four Florida skilled nursing facilities to four separate corporations, none of which we own or control.
	On January 1, 2007, a 15-year lease extension began which included three additional five-year renewal options. On December 26, 2012, NHC extended the lease agreement through the first of the three additional five-year renewal options, which extended the lease date through 2026. The two additional five-year renewal options on the lease still remain. Under the terms of the lease, base rent totals $30,750,000 with rent thereafter escalating by 4% of the increase in facility revenue over a 2007 base year. The percentage rent is based on a quarterly calculation of revenue increases and is payable on a quarterly basis. Percentage rent expense for 2013, 2012, and 2011 was approximately $2,526,000, $2,591,000, and $2,969,000, respectively.
	On September 1, 2013 and under the second lease agreement, NHC began operating seven skilled nursing facilities in New Hampshire and Massachusetts. 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 seven facilities from NHI in the 13th year of the lease for a purchase price of $49,000.000.
	Each lease with NHI is a "triple net lease" under which we are responsible for paying all taxes, utilities, insurance premium costs, repairs and other charges relating to the ownership of the facilities. We are obligated at our expense to maintain adequate insurance on the facilities' assets.
	We have a right of first refusal with NHI to purchase any of the properties transferred from us should NHI receive an offer from an unrelated party during the term of the lease or up to 180 days after termination of the related lease.
	Base rent expense under both lease agreements totals $34,200,000. At December 31, 2013, the approximate future minimum base rent to be paid by us on non-cancelable operating leases with NHI are as follows:
		Total		Total
		Commitments		Commitments
		Including		Excluding
		Florida Facilities		Florida Facilities
	2014	$	34,200,000	$	29,448,000
	2015		34,200,000		29,448,000
	2016		34,200,000		34,200,000
	2017		34,200,000		34,200,000
	2018		34,200,000		34,200,000
	Thereafter		279,350,000		279,350,000
	Investment in NHI Common Stock
	At December 31, 2013 and 2012, we own 1,630,642 shares (or 5.9%) of NHI’s outstanding common stock. We account for our investment in NHI common stock as available for sale marketable securities in accordance with the provisions of ASC Topic 320, Investments.
	Asset Acquisition from NHI
	On September 1, 2013, NHC purchased the real property of six skilled nursing facilities from NHI for $21 million in cash. The six facilities, 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 nursing facilities, NHC’s lease payment under the first lease agreement decreased annually by $2.95 million.

Note_3_Relationship_With_Natio

Note 3 - Relationship With National Health Corporation	12 Months Ended
	Dec. 31, 2013
Related Party Transactions [Abstract]	'
Related Party Transactions Disclosure [Text Block]	'
	Note 3 - Relationship with National Health Corporation
	National Health Corporation ("National"), which is wholly-owned by the National Health Corporation Leveraged Employee Stock Ownership Plan ("ESOP"), was formed in 1986 and is our administrative services affiliate and contractor. As discussed below, all of the personnel conducting our business, including our executive management team, are employees of National and have ownership interests in National only through their participation as employees in the ESOP.
	Management Contracts
	We currently manage five skilled nursing facilities for National under a management contract. We manage the centers for management fees that are comparable to those in the industry. The management contract has been extended until January 1, 2018. See Note 4 for additional information regarding management fees recognized from National.
	Financing Activities
	During 1991, we borrowed $10,000,000 from National. The term note payable currently requires quarterly interest payments at the prime rate minus .85 percent. The entire principal is due at maturity in 2018.
	In conjunction with our management contract, we have entered into a line of credit arrangement whereby we may have amounts due from National from time to time. The maximum loan commitment under the line of credit is $2,000,000. The interest rate on the line of credit is prime plus one percent and the final maturity is January 20, 2018. At December 31, 2013, National did not have an outstanding balance on the line of credit.
	The maximum line of credit commitment amount of $2,000,000 is also the amount of a deferred gain that has been outstanding since NHC sold certain assets to National in 1988. The amount of the deferred gain is expected to remain deferred until the management contract with National expires, currently scheduled in January 2018. The deferred gain is included in deferred revenue in the consolidated balance sheets.
	Payroll and Related Services
	The personnel conducting our business, including our executive management team, are employees of National and have ownership interests in National only through their participation in the ESOP. National provides payroll services to NHC, provides employee fringe benefits, and maintains certain liability insurance. We pay to National all the costs of personnel employed for our benefit, as well as an administrative fee equal to 1% of payroll costs. Such costs of personnel totaling approximately $453,560,000, $426,934,000, and $428,672,000 for 2013, 2012 and 2011 respectively, are reflected as salaries, wages and benefits in the accompanying consolidated statements of income. The administrative fee paid to National for 2013, 2012, and 2011 was $3,693,000, $3,862,000, and $3,608,000, respectively. National owes us $5,785,000 and $5,149,000 at December 31, 2013 and 2012, respectively, as a result of the differences between interim payments for payroll and benefits services costs made during the current and previous years and such actual costs. The amounts are included in accounts receivable in the consolidated balance sheets.
	National’s Ownership of Our Stock
	At December 31, 2013, National owns 1,171,147 shares (or approximately 8.3%) of our outstanding common stock and 1,271,147 shares (or approximately 11.7%) of our outstanding preferred stock.
	Consolidation Considerations
	Because of the contractual and management relationships between NHC and National as described in this note above, we have considered whether National should be consolidated by NHC under the guidance provided in ASC Topic 810, Consolidation. We do not consolidate National because (1) NHC does not have any obligation or rights (current or future) to absorb losses or to receive benefits from National. The ESOP participants bear the current and future financial gain or burden of National, (2) National’s equity at risk is sufficient to finance its activities without past or future subordinated support from NHC or other parties, and (3) the equity holders of National (that is collectively the ESOP, its trustees, and the ESOP participants) possess the characteristics of a controlling financial interest, including voting rights that are proportional to their economic interests. Supporting the assertions above is the following: (1) substantive independent trustees are appointed for the benefit of the ESOP participants when decisions must be made that may create the appearance of a conflict of interest between NHC and the ESOP, and (2) National was designed, formed and is operated for the purpose of creating variability and passing that variability along to the ESOP participants—that is, to provide retirement benefits and value to the employees of NHC and NHC’s affiliates. The contractual and management relationships between NHC and National are with the skilled nursing facilities that are substantially less than 50% of the fair value of the total assets of National. NHC does not have a variable interest in National as a whole.

Note_4_Other_Revenues

Note 4 - Other Revenues	12 Months Ended
	Dec. 31, 2013
Other Revenues [Abstract]	'
Other Revenues [Text Block]	'
	Note 4 - Other Revenues
	Other revenues are outlined in the table below. Revenues from insurance services include premiums for workers’ compensation and professional liability insurance policies that our wholly-owned limited purpose insurance subsidiaries have written for certain skilled nursing facilities to which we provide management or accounting services. Revenues from management and accounting services include management and accounting fees provided to managed and other skilled nursing facilities. Revenues from rental income include health care real estate properties owned by us and leased to third party operators. Other revenues include miscellaneous health care related earnings.
		Year Ended December 31,
		2013		2012		2011
		(in thousands)
	Insurance services	$	15,143	$	15,671	$	15,657
	Management and accounting service fees		18,160		20,042		21,601
	Rental income		19,132		19,314		19,545
	Other		685		589		950
		$	53,120	$	55,616	$	57,753
	Management Fees from National
	We have managed skilled nursing facilities for National since 1988, and we currently manage five centers. See Note 3 regarding our relationship with National.
	During 2013, 2012 and 2011, National paid and we recognized approximately $3,491,000, $3,397,000, and $3,539,000, respectively, of management fees and interest on management fees, which amounts are included in management and accounting service fees. Unrecognized and unpaid management fees and interest on management fees from National total $21,349,000, $21,333,000, and $21,289,000 at December 31, 2013, 2012 and 2011, respectively. We have recognized approximately $37,621,000 of management fees and interest from these facilities since 1988.
	The unpaid fees from these five facilities, 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, 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 skilled nursing facilities. We continue to manage these facilities so that we may be able to collect our fees in the future and because the incremental savings from discontinuing services to a facility 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 centers or 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
	During 2013, 2012, and 2011, we recognized $3,131,000, $5,660,000, and $6,138,000, respectively, of management fees and interest from fourteen skilled nursing facilities previously owned by two non-profit organizations (ElderTrust and SeniorTrust).
	During 2012, a receiver was appointed for the fourteen skilled nursing facilities and the Board of Directors’ of the respective nonprofit organizations were removed of their custodial responsibility. Consequently, the appointed receiver for each of the nonprofit organizations filed a lawsuit against us and another party. During 2013, the Company reached a settlement agreement related to this litigation; see Note 16 for details related to this settlement.
	On September 1, 2013 and with court approval, NHC began leasing and operating seven of the skilled nursing facilities 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
	In 2007, NHC acquired all of the net assets of National Health Realty, Inc., which was a health care real estate investment trust. The properties acquired in the acquisition are the properties that have generated the majority of the rental income for NHC for the years ended December 31, 2013, 2012, and 2011. The health care properties currently owned and leased to third party operators include nine skilled nursing facilities and four assisted living communities. We renewed the rental agreements in 2011 for a five year period, which ends on December 31, 2015.
	Also, as part of the litigation settlement described in Note 16 with ElderTrust and SeniorTrust, the Company 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, the Company 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_5_NonOperating_Income

Note 5 - Non-Operating Income	12 Months Ended
	Dec. 31, 2013
Disclosure Text Block [Abstract]	'
Other Nonoperating Income and Expense [Text Block]	'
	Note 5 – 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 securities, interest income, and other miscellaneous non-operating income. Our most significant equity method investment is a 75.1% non-controlling ownership interest in Caris, a business that specializes in hospice care services. See Note 17 for additional disclosures regarding Caris. The gain on the recovery of notes receivable was due to the collection of certain notes receivable. NHC had previously written down these notes due to their deteriorated credit qualities.
		Year Ended December 31,
		2013		2012		2011
		(in thousands)
	Equity in earnings of unconsolidated investments	$	14,188	$	13,616	$	9,674
	Dividends and net realized gains on sales of securities		5,216		7,006		5,875
	Interest income		5,237		4,623		4,984
	Gain on the recovery of notes receivable		5,454	–		–
		$	30,095	$	25,245	$	20,533

Note_6_Other_Operating_Expense

Note 6 - Other Operating Expenses	12 Months Ended
	Dec. 31, 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, professional insurance and licensing fees. The primary facility costs include utilities and property insurance.

Note_7_Earnings_Per_Share

Note 7 - Earnings Per Share	12 Months Ended
	Dec. 31, 2013
Earnings Per Share [Abstract]	'
Earnings Per Share [Text Block]	'
	Note 7 - Earnings Per Share
	We compute earnings per share using the two-class method. Under the two-class method, earnings per common share are computed by dividing net income available to common stockholders by the weighted average number of common shares outstanding for the period.
	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.
		Year Ended December 31,
		2013		2012		2011
		(dollars in thousands, except share and per share amounts)
				(as adjusted)		(as adjusted)
	Basic:
	Weighted average common shares outstanding		13,829,626		13,852,709		13,774,628
	Net income	$	64,613	$	59,300	$	64,990
	Dividends to preferred stockholders		8,671		8,671		8,671
	Net income available to common stockholders	$	55,942	$	50,629	$	56,319
	Earnings per common share, basic	$	4.05	$	3.65	$	4.09
	Diluted:
	Weighted average common shares outstanding		13,829,626		13,852,709		13,774,628
	Dilutive effect of stock options		9,091		8,019		9,934
	Dilutive effect of restricted stock		4,740		5,526		6,009
	Dilutive effect of contingent issuable stock		232,118		109,233	–
	Convertible preferred stock		2,623,228		2,623,329		2,623,452
	Assumed average common shares outstanding		16,698,803		16,598,816		16,414,023
	Net income available to common stockholders	$	55,942	$	50,629	$	56,319
	Add dilutive preferred stock dividends for effect of assumed conversion of preferred stock		8,671		8,671		8,671
	Net income for diluted earnings per common share	$	64,613	$	59,300	$	64,990
	Earnings per common share, diluted	$	3.87	$	3.57	$	3.96
	Excluded in the above table are 929,000; 1,068,302; and 1,420,620 shares associated with stock options for 2013, 2012, and 2011, respectively, due to their antidilutive impact.

Note_8_Investments_in_Marketab

Note 8 - Investments in Marketable Securities	12 Months Ended
	Dec. 31, 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 include available for sale securities. Realized gains and losses from securities sales are determined on the specific identification of the securities. Marketable securities and restricted marketable securities consist of the following:
		31-Dec-13				31-Dec-12
	(in thousands)	Amortized		Fair		Amortized		Fair
		Cost		Value		Cost		Value
	Investments available for sale:
	Marketable equity securities	$	30,176	$	105,009	$	30,176	$	107,250
	Restricted investments available for sale:
	Corporate debt securities		65,852		65,006		61,453		62,876
	Commercial mortgage-backed securities		46,977		45,856		47,194		48,063
	U.S. Treasury securities		22,932		22,841		16,218		16,604
	State and municipal securities		8,123		8,300		7,213		7,664
		$	174,060	$	247,012	$	162,254	$	242,457
	Included in the available for sale marketable equity securities are the following:
	(in thousands, except share amounts)
		31-Dec-13						31-Dec-12
		Shares		Cost		Fair		Shares		Cost		Fair
						Value						Value
	NHI Common Stock		1,630,642	$	24,734	$	91,479		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:
		31-Dec-13				31-Dec-12
	(in thousands)	Cost		Fair Value		Cost		Fair Value
	Maturities:
	Within 1 year	$	9,279	$	9,324	$	8,868	$	8,918
	1 to 5 years		91,787		92,011		80,910		82,801
	6 to 10 years		40,387		38,335		40,670		41,856
	Over 10 years		2,431		2,333		1,630		1,632
		$	143,884	$	142,003	$	132,078	$	135,207
	Gross unrealized gains related to available for sale securities are $75,702,000 and $80,296,000 as of December 31, 2013 and 2012, respectively. Gross unrealized losses related to available for sale securities were $2,750,000 and $93,000 as of December 31, 2013 and 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 impairments for the years ended December 31, 2013 and 2012.
	Proceeds from the sale of investments in marketable securities during the years ended December 31, 2013, 2012 and 2011 were $81,389,000, $62,649,000, and $46,266,000, respectively. Net investment gains of $39,000, $1,640,000, and $754,000 were realized on these sales during the years ended December 31, 2013, 2012, and 2011, respectively.

Note_9_Fair_Value_Measurements

Note 9 - Fair Value Measurements	12 Months Ended
	Dec. 31, 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 December 31, 2013 or 2012. We did not have any transfers of assets between Level 1 and Level 2 of the fair value measurement hierarchy during the twelve months ended December 31, 2013 or 2012.
	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. At December 31, 2013 and 2012, 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 December 31, 2013 and December 31, 2012 for assets and liabilities measured at fair value on a recurring basis (in thousands):
		Fair Value Measurements Using
	31-Dec-13	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	$	81,705	$	81,705	$	–	$	–
	Restricted cash and cash equivalents		13,929		13,929	–		–
	Marketable equity securities		105,009		105,009	–		–
	Corporate debt securities		65,006	–			65,006	–
	Commercial mortgage-backed securities		45,856	–			45,856	–
	U.S. Treasury securities		22,841		22,841	–		–
	State and municipal securities		8,300	–			8,300	–
	Total financial assets	$	342,646	$	223,484	$	119,162	$	–
		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_Property_and_Equipment

Note 10 - Property and Equipment	12 Months Ended
	Dec. 31, 2013
Property, Plant and Equipment [Abstract]	'
Property, Plant and Equipment Disclosure [Text Block]	'
	Note 10 - Property and Equipment
	Property and equipment, at cost, consists of the following:
		December 31,
		2013			2012
		(in thousands)
	Land	$	57,272		$	50,711
	Leasehold improvements		94,066			90,925
	Buildings and improvements		427,471			396,228
	Furniture and equipment		134,255			126,288
	Construction in progress		21,618			11,303
			734,682			675,455
	Less: Accumulated depreciation		(277,884	)		(254,548	)
		$	456,798		$	420,907

Note_11_Notes_Receivable

Note 11 - Notes Receivable	12 Months Ended
	Dec. 31, 2013
Receivables [Abstract]	'
Loans, Notes, Trade and Other Receivables Disclosure [Text Block]	'
	Note 11 - Notes Receivable
	At December 31, 2013 and 2012, we have notes receivable from managed and other skilled nursing facilities totaling $15,378,000 and $21,789,000, respectively, reflected in the accompanying consolidated balance sheets. The notes are first and second mortgages with interest rates ranging from prime plus 2% to 8.5% fixed rate with periodic payments required prior to maturity. The notes mature in the years from 2014 through 2016. The proceeds of the notes were used by the skilled nursing facilities for construction costs, development costs incurred during construction, and working capital.

Note_12_LongTerm_Debt

Note 12 - Long-Term Debt	12 Months Ended
	Dec. 31, 2013
Debt Disclosure [Abstract]	'
Debt Disclosure [Text Block]	'
	Note 12 - Long-Term Debt
	Long-Term Debt
	Long-term debt consists of the following (dollars in thousands):
		Weighted			December 31,
		Average
		Interest Rate	Maturities		2013		2012
		Variable,
	Revolving Credit Facility, interest payable monthly	0.90%	2014		–		–
	Unsecured term note payable to National, interest payable quarterly, principal payable at maturity	2.80%	2018			10,000		10,000
						10,000		10,000
	Less current portion				–		–
					$	10,000	$	10,000
	$75,000,000 Revolving Credit Agreement
	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 base rate. Letter of credit fees are equal to 0.10% times the maximum amount available to be drawn under outstanding letters of credit. The rates and fees are unchanged from those in effect prior to the extension.
	Commitment fees are payable on the daily unused portion of the Credit Facility at a rate of twenty (20) 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. Between 90 and 120 days prior to the maturity date, NHC may request the extension of the maturity date. 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.
	The aggregate maturities of long-term debt for the five years subsequent to December 31, 2013 are as follows:
			Long-Term
			Debt
			(in thousands)
	2014			−
	2015			−
	2016			−
	2017			−
	2018			10,000
		Total	$	10,000

Note_13_Income_Taxes

Note 13 - Income Taxes	12 Months Ended
	Dec. 31, 2013
Income Tax Disclosure [Abstract]	'
Income Tax Disclosure [Text Block]	'
	Note 13 - Income Taxes
	The provision for income taxes is comprised of the following components:
		Year Ended December 31,
		2013			2012			2011
		(in thousands)
					(as adjusted)			(as adjusted)
	Current Tax Provision
	Federal	$	34,680		$	29,147		$	29,311
	State		5,588			4,010			3,131
			40,268			33,157			32,442
	Deferred Tax Provision
	Federal		(2,226	)		892			1,719
	State		(479	)		132			233
			(2,705	)		1,024			1,952
	Income Tax Provision	$	37,563		$	34,181		$	34,394
	The deferred tax assets and liabilities, consisting of temporary differences tax effected at the respective income tax rates, are as follows:
		December 31,
		2013			2012
		(in thousands)
					(as adjusted)
	Current deferred tax asset:
	Allowance for doubtful accounts receivable	$	1,802		$	1,022
	Accrued expenses		7,489			7,490
			9,291			8,512
	Current deferred tax liability:
	Unrealized gains on marketable securities		(28,526	)		(31,154	)
	Other		(1,922	)		(1,832	)
			(30,448	)		(32,986	)
	Net current deferred tax liability	$	(21,157	)	$	(24,474	)
	Noncurrent deferred tax asset:
	Financial reporting depreciation in excess of tax depreciation	$	5,872		$	4,086
	Deferred gain on sale of assets (net)		(3,135	)		(3,135	)
	Tax basis intangible asset in excess of financial reporting basis		127			663
	Stock-based compensation		2,214			1,682
	Long-term investments		(2,276	)		(1,387	)
	Nonrefundable entrance fees		45			-
	Refundable entrance fees		1,647			1,555
	Obligation to provide future services		1,439			698
	Accrued expenses		2,502			2,132
	Deferred revenue		6,096			6,523
	Net noncurrent deferred tax asset	$	14,531			12,817
	A reconciliation of income tax expense and the amount computed by applying the statutory federal income tax rate to income before income taxes is as follows:
		Year Ended December 31,
		2013			2012			2011
		(in thousands)
					(as adjusted)			(as adjusted)
	Tax provision at federal statutory rate	$	35,762		$	32,718		$	34,784
	Increase (decrease) in income taxes
	resulting from:
	State, net of federal benefit		2,325			3,261			3,246
	Nondeductible expenses		197			118			188
	Insurance expense		35			39			26
	Other, net		(258	)		823			57
	Unrecognized tax benefits		1,107			409			85
	Expiration of statute of limitations		(1,605	)		(3,187	)		(3,992	)
			1,801			1,463			(390	)
	Effective income tax expense	$	37,563			34,181		$	34,394
	The exercise of non-qualified stock options results in state and federal income tax benefits to the Company related to the difference between the market price at the date of exercise and the option exercise price. During 2013, 2012 and 2011, $(225,000), $(267,000), and $(52,000), respectively, attributable to the tax benefit of stock options exercised and restricted stock, was credited to additional paid-in capital.
	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.
	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 adequate provisions 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.
	Also under ASC Topic 740, tax positions are evaluated for recognition using a more–likely–than–not threshold, and those tax positions requiring recognition are measured at the largest amount of tax benefit that is greater than 50 percent likely of being realized upon ultimate settlement with a taxing authority that has full knowledge of all relevant information.
	In accordance with current guidance, the Company has established a liability for unrecognized tax benefits, which are differences between a tax position taken or expected to be taken in a tax return and the benefit recognized and measured. Generally a liability is created for an unrecognized tax benefit because it represents a company’s potential future obligation to a taxing authority for a tax position that was not recognized per above.
	A reconciliation of the beginning and ending amount of unrecognized tax benefits is as follows (in thousands):
	Deferred Tax Asset			Liability For Unrecognized Tax Benefits			Liability For Interest and Penalties			Liability Total
Balance, January 1, 2011	$	10,089		$	14,511		$	4,350		$	18,861
Additions based on tax positions related to the current year		−			1,452			183			1,635
Additions for tax positions of prior years		(70	)		189			(449	)		(260	)
Reductions for statute of limitation expirations		(93	)		(2,387	)		(1,605	)		(3,992	)
Balance, December 31, 2011		9,926			13,765			2,479			16,244
Additions based on tax positions related to the current year		−			1,695			185			1,880
Additions for tax positions of prior years		728			845			170			1,015
Reductions for statute of limitation expirations		(1,999	)		(4,309	)		(940	)		(5,249	)
Balance, December 31, 2012		8,655			11,996			1,894			13,890
Additions based on tax positions related to the current year					1,832			198			2,030
Additions for tax positions of prior years		2,120			1,427			641			2,068
Reductions for statute of limitation expirations		(2,177	)		(2,802	)		(661	)		(3,463	)
Balance, December 31, 2013	$	8,598		$	12,453		$	2,072		$	14,525
During the year ended December 31, 2013, we have recognized a $2,802,000 decrease in unrecognized tax benefits (including $1,817,000 of temporary differences and $985,000 of permanent differences) and an accompanying $661,000 decrease of related interest and penalties due to the effect of statute of limitations lapse. The favorable impact on our tax provision was $1,605,000 composed of $976,000 tax and $451,000 interest and penalties on permanent differences and $178,000 interest and penalties on temporary differences.
At December 31, 2013, we had $12,453,000 of unrecognized tax benefits, composed of $8,253,000 of deferred tax assets and $4,200,000 of permanent differences. Accrued interest and penalties of $2,072,000 related to unrecognized tax benefits at December 31, 2013. Unrecognized tax benefits of $4,200,000, net of federal benefit, at December 31, 2013, attributable to permanent differences, would favorably impact our effective tax rate if recognized. Accrued interest and penalties of $1,835,000 relate to these permanent differences at December 31, 2013. We do not expect to recognize significant increases or decreases in unrecognized tax benefits within the twelve months beginning December 31, 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 differences of $940,000. Interest and penalties of $566,000 relate to these temporary and permanent difference changes within 12 months beginning December 31, 2013.
During the year ended December 31, 2012, we have recognized a $4,309,000 decrease in unrecognized tax benefits (including $1,999,000 of temporary differences and $2,310,000 of permanent differences) and an accompanying $940,000 decrease of related interest and penalties due to the effect of statute of limitations lapse. The favorable impact on our tax provision was $3,187,000 composed of $2,310,000 tax and $707,000 interest and penalties on permanent differences and $170,000 interest and penalties on temporary differences.
At December 31, 2012, we had $11,996,000 of unrecognized tax benefits, composed of $8,292,000 of deferred tax assets and $3,704,000 of permanent differences. Accrued interest and penalties of $1,894,000 related to unrecognized tax benefits at December 31, 2012. Unrecognized tax benefits of $3,704,000, net of federal benefit, at December 31, 2012, attributable to permanent differences, would favorably impact our effective tax rate if recognized. Accrued interest and penalties of $1,531,000 relate to these permanent differences at December 31, 2012.
During the year ended December 31, 2011, we have recognized a $2,387,000 decrease in unrecognized tax benefits (including $-0- of temporary differences and $2,387,000 of permanent differences) and an accompanying $1,605,000 decrease of related interest and penalties due to the effect of statute of limitations lapse. The favorable impact on our tax provision was $3,992,000 composed of $2,387,000 tax and $1,605,000 interest and penalties on permanent differences and $-0- interest and penalties on temporary differences.
At December 31, 2011, we had $13,765,000 of unrecognized tax benefits, composed of $9,308,000 of deferred tax assets and $4,457,000 of permanent differences. Accrued interest and penalties of $2,479,000 related to unrecognized tax benefits at December 31, 2011. Unrecognized tax benefits of $4,457,000, net of federal benefit, at December 31, 2011, attributable to permanent differences, would favorably impact our effective tax rate if recognized. Accrued interest and penalties of $1,650,000 relate to these permanent differences at December 31, 2011.
Interest and penalties expense related to U.S. federal and state income tax returns are included within income tax expense. Interest and penalties expense (benefit) was $178,000; $(585,000); and $(1,871,000); for the years ended December 31, 2013, 2012, and 2011, respectively.
The Company is no longer subject to U.S. federal and state examinations by tax authorities for years before 2010 (with few state exceptions). Currently, there are no U.S. federal and state returns under examination.

Note_14_Stock_Repurchase_Progr

Note 14 - Stock Repurchase Program	12 Months Ended
	Dec. 31, 2013
Disclosure Text Block Supplement [Abstract]	'
Treasury Stock [Text Block]	'
	Note 14 - Stock Repurchase Program
	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 December 31, 2013, no repurchases of common stock have been executed under this 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.

Note_15_StockBased_Compensatio

Note 15 - Stock-Based Compensation	12 Months Ended
	Dec. 31, 2013
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]	'
Disclosure of Compensation Related Costs, Share-based Payments [Text Block]	'
	Note 15 - Stock-Based Compensation
	NHC recognizes stock-based compensation 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 100% of 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 100% of 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 December 31, 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. At December 31, 2013, 411,260 shares were available for future grants under the 2010 Plan.
	Under both the 2005 and 2010 Plans, the individual restricted stock and option grant awards vest over periods up to five years. The term of the options outstanding under both Plans is five years from the date of the grant. Our policy is to issue new shares to satisfy option exercises.
	Additionally, we have an employee stock purchase plan that allows employees to purchase our shares of stock through payroll deductions. The plan allows employees to terminate participation at any time.
	Compensation expense is recognized only for the awards that ultimately vest. Stock-based compensation totaled $2,298,000, $2,366,000, and $2,751,000 for the years ended December 31, 2013, 2012, and 2011, respectively. The expense for the 2013 year consisted of $2,091,000 for stock options and $207,000 for restricted stock.
	At December 31, 2013, we had $3,936,000 of unrecognized compensation cost related to unvested stock-based compensation awards, which consisted of $3,657,000 for stock options and $279,000 for restricted stock. This expense will be recognized over the remaining weighted average vesting period, which is approximately 2.2 years for stock options and 0.8 years for restricted stock. Stock-based compensation is included in salaries, wages and benefits in the consolidated statements of income. Tax deductions for the options exercised and restricted stock vested totaled $196,000, $404,000, and $1,054,000 for the years ended December 31, 2013, 2012, and 2011, respectively.
	Stock Options
	The Company is required to estimate the fair value of stock-based awards on the date of grant. The fair value of each option award is estimated using the Black–Scholes option valuation model with the weighted average assumptions indicated in the following table. Each grant is valued as a single award with an expected term based upon expected employment and termination behavior. Compensation cost is recognized over the requisite service period in a manner consistent with the option vesting provisions. The straight–line attribution method requires that compensation expense is recognized at least equal to the portion of the grant–date fair value that is vested at that date. The expected volatility is derived using weekly historical data for periods immediately preceding the date of grant. The risk–free interest rate is the approximate yield on the United States Treasury Strips having a life equal to the expected option life on the date of grant. The expected life is an estimate of the number of years an option will be held before it is exercised. The following table summarizes the assumptions used to value the options granted in the periods shown.
		Year Ended December 31,
		2013				2012				2011
	Risk-free interest rate		0.25	%			0.28	%			2.02	%
	Expected volatility		31.3	%			38.8	%			23.7	%
	Expected life, in years		2.1				2.1				4.8
	Expected dividend yield		2.81	%			2.91	%			3.62	%
	The following table summarizes option activity:
		Number of Shares				Weighted Average Exercise Price				Aggregate Intrinsic Value
	Options outstanding at January 1, 2011		472,327			$	43.07			$	−
	Options granted		1,264,719				46.58				−
	Options exercised		(224,969	)			37.3				−
	Options cancelled		(30,000	)			44.25				−
	Options outstanding at December 31, 2011		1,482,077				46.92				−
	Options granted		63,516				44.28				−
	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		59,472				47.95				−
	Options exercised		(21,522	)			45.63				−
	Options cancelled		(98,000	)			51.11				−
	Options outstanding at December 31, 2013		1,074,552				46.44				8,027,000
	Options exercisable		145,552			$	44.84			$	1,320,000
	Options		Exercise Prices					Weighted Average				Weighted Average
	Outstanding							Exercise Price				Remaining Contractual
	31-Dec-13											Life in Years
	21,750			$37.70					$37.70				0.3
	1,052,802		$44.80	-	$47.45				$46.62				2.4
	1,074,552								$46.44				2.3
	At December 31, 2013, 145,552 options outstanding are exercisable. Exercise prices on the options range from $37.70 to $47.45. The weighted average remaining contractual life of all options outstanding at December 31, 2013 is 2.3 years. The total intrinsic value of shares exercised during the year ended December 31, 2013 was $336,000.
	Restricted Stock
	The following table summarizes restricted stock activity:
		Number of				Weighted Average Grant Date Fair Value				Aggregate Intrinsic Value
		Shares
	Unvested restricted shares at January 1, 2011		30,000			$	34.46			–
	Award shares granted	–				–				–
	Award shares vested		6,000				34.46			–
	Unvested restricted shares at December 31, 2011		24,000				34.46			–
	Award shares granted	–				–				–
	Award shares vested		6,000				34.46			–
	Unvested restricted shares at December 31, 2012		18,000				34.46			–
	Award shares granted	–				–				–
	Award shares vested		6,000				34.46			–
	Unvested restricted shares at December 31, 2013		12,000			$	34.46			$	233,000
	The weighted average remaining contractual life of restricted stock at December 31, 2013 is 0.8 years.

Note_16_Contingencies_and_Guar

Note 16 - Contingencies and Guarantees	12 Months Ended
	Dec. 31, 2013
Commitments and Contingencies Disclosure [Abstract]	'
Commitments and Contingencies Disclosure [Text Block]	'
	Note 16 - Contingencies and Guarantees
	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 $110,557,000 and $110,331,000 at December 31, 2013 and 2012, respectively. This liability is classified as current based on the uncertainty regarding the timing of potential payments. The liability is included in accrued risk reserves in the consolidated balance sheets. The amounts are 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 would have a material adverse effect on our 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 long-term care industry. Business is written on a direct basis. For 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 consolidated financial statements as other revenues for 2013, 2012 and 2011, respectively, are $7,720,000, $5,438,000, and $4,910,000. Associated losses and expenses are reflected in the consolidated financial statements as salaries, wages and benefits.
	General and Professional Liability Insurance and Lawsuits
	The long term care industry has experienced significant 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 December 31, 2013, we and/or our managed centers are currently defendants in 28 such claims covering the years 2006 through December 31, 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 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 consolidated financial statements as other revenues for 2013, 2012 and 2011, respectively, are $3,418,000, $4,203,000, and $4,383,000. Associated losses and expenses including those for self-insurance are included in the consolidated financial statements as other operating costs and expenses.
	SeniorTrust of Florida, Inc. Lawsuit and ElderTrust of Florida, Inc. Lawsuit
	On September 4, 2012, SeniorTrust of Florida, Inc. ("SeniorTrust"), a Tennessee non-profit corporation, and ten non-profit limited liability company subsidiaries of SeniorTrust (the "SeniorTrust Subsidiaries") filed a lawsuit against the Company and another party. The complaint of SeniorTrust and the SeniorTrust Subsidiaries alleged that the Company and another party exercised dominion and control over SeniorTrust, the SeniorTrust Subsidiaries and their board of directors for a period prior to sometime in 2008 and that the Company and another party used that control to cause one of SeniorTrust Subsidiaries to enter into sale, purchase, financing and management transactions with the Company and another party on terms adverse to SeniorTrust and one or more SeniorTrust Subsidiaries. As part of its complaint, SeniorTrust and the SeniorTrust Subsidiaries sought a declaratory judgment and asserted claims for breach of fiduciary duty, fraud, conflict of interest, conversion, and unjust enrichment. They claimed they had sustained substantial compensatory and punitive damages.
	On January 16, 2013, we received notice that the receiver of ElderTrust of Florida, Inc. (“ElderTrust”), a Tennessee non-profit corporation, had filed a lawsuit against the Company and another party. The complaint primarily asserted that the Company and another party caused ElderTrust to enter into transactions on adverse terms.
	On April 26, 2013, the Company entered into a settlement agreement concerning litigation with SeniorTrust and ElderTrust. 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, for the year ending December 31, 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, a net loss related to the settlement activities of approximately $2,505,000.
	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.
	During the fourth quarter of 2013, officials at Network Pharmacy, Knoxville reported a possible breach of patient information due to a stolen laptop that was not encrypted. The information on this laptop included patient names, dates of birth, and personal 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 outlet in the immediate area.
	Other Matters
	On December 19, 2013, the Company was served with a civil investigative demand from the U.S. Department of Justice and the Office of the U.S. Attorney for the Eastern District of Tennessee requesting the production of documents and interrogatory responses regarding the billing and medical necessity of certain rehabilitative therapy services.  Based upon our review, the request appears to relate to services provided at our facilities based in Knoxville, Tennessee. We are cooperating fully with these requests.  Because we are in the early stages of this investigation, we are unable to evaluate the outcome of this investigation.
	There is certain additional litigation incidental to our business, none of which, based upon information available to date, would be material to our financial position, results of operations, or cash flows. In addition, the long-term care industry is continuously subject to scrutiny by governmental regulators, which could result in litigation or claims related to regulatory compliance matters.
	Debt Guarantees
	At December 31, 2013, no agreement to guarantee the debt of other parties exists.

Note_17_Equity_Method_Investme

Note 17 - Equity Method Investment in Caris HealthCare, L.P.	12 Months Ended
	Dec. 31, 2013
Disclosure Text Block Supplement [Abstract]	'
Cost and Equity Method Investments Disclosure [Text Block]	'
	Note 17 – Equity Method Investment in Caris HealthCare, L.P.
	As of December 31, 2013, we have a 75.1% non-controlling ownership interest in Caris, a business that specializes in hospice care services in NHC owned health care centers and in other settings. The carrying value of our investment is $37,185,000 and $38,463,000 at December 31, 2013 and 2012, respectively. The carrying amounts are included in investments in limited liability companies in the consolidated balance sheets. The difference between the carrying value of our investment and our capital account balance in Caris is due to the additional limited partner ownership interest the Company acquired from current and former partners. Summarized financial information of Caris for the years ended December 31, 2013, 2012, and 2011 is provided below.
		December 31,
		2013		2012		2011
		( in thousands)
	Current assets	$	25,212	$	30,731	$	18,219
	Noncurrent assets		11,685		9,051		978
	Liabilities		8,879		9,365		7,623
	Partners’ capital		28,018		30,417		11,574
	Revenue		58,918		59,422		44,454
	Expenses		40,112		40,341		28,018
	Net income		18,806		19,081		16,436
	Consolidation Considerations
	Due to our ownership percentage in Caris, we have considered whether Caris should be consolidated by NHC under the guidance provided in ASC Topic 810, Consolidation. We do not consolidate Caris because (1) Caris’ equity at risk is sufficient to finance its activities without additional subordinated financial support, (2) the general partner of the Partnership has the power to direct the activities that most significantly impact the economic performance of Caris, and (3) the equity holders of Caris possess the characteristics of a controlling financial interest, including voting rights that are proportional to their economic interests. Supporting the assertions above is the following: (1) the ownership percentage of the general partner remains equally divided between NHC and another party, (2) the general partner manages and controls the Partnership with full and complete discretion, and (3) the limited partners have no right or power to take part in the control of the business of the Partnership, which is where our ownership percentage increases have occurred.

Note_18_Variable_Interest_Enti

Note 18 - Variable Interest Entity	12 Months Ended
	Dec. 31, 2013
Variable Interest Entity [Abstract]	'
Variable Interest Entity [Text Block]	'
	Note 18 – Variable Interest Entity
	Accounting guidance requires that a variable interest entity (“VIE”), according to the provisions of ASC Topic 810, Consolidation, must be consolidated by the primary beneficiary. The primary beneficiary is the party that has both the power to direct activities of a VIE that most significantly impact the entity’s economic performance and the obligation to absorb losses of the entity or the right to receive benefits from the entity that could potentially be significant to the VIE. We perform ongoing qualitative analysis to determine if we are the primary beneficiary of a VIE. At December 31, 2013, we are the primary beneficiary of one VIE and therefore consolidate that entity.
	Springfield, Missouri Lease
	In December 2010, we signed an operating agreement to lease Springfield Rehabilitation and Health Care Center, a 120-bed skilled nursing facility located in Springfield, Missouri. The terms of the lease include a ten year lease and include five additional, five year lease options as well as a purchase option. The operating lease agreement was established on the same date third party owners purchased the real estate of the 120-bed skilled nursing facility. The third party owners purchased the real estate for $4,500,000, which is the amount NHC loaned the owners to purchase the facility under the terms of the lease agreement and the mortgage note. The risks and rewards associated with the operations of the facility and any appreciation or deprecation in the value of the real estate of the facility is borne by NHC. At December 31, 2013 and 2012, the $4,500,000 mortgage note receivable from the third party owners is eliminated in our consolidated financial statements. Land and buildings and improvements of $4,500,000 have been recorded in our consolidated financial statements, as well as the operations of the facility since December 1, 2010, because we are the primary beneficiary in the relationship.

Note_19_Series_A_Convertible_P

Note 19 - Series A Convertible Preferred Stock	12 Months Ended
	Dec. 31, 2013
Disclosure Text Block Supplement [Abstract]	'
Preferred Stock [Text Block]	'
	Note 19 - Series A Convertible Preferred Stock
	On October 31, 2007, NHC issued $170,555,000 of NHC Series A Convertible Preferred Stock (the "Preferred Stock") with a liquidation preference of $15.75. Each share of the Preferred Stock is entitled to annual preferred dividends of $0.80 per share. Dividends on the Preferred Stock are cumulative.
	The Preferred Stock, which is listed on the NYSE MKT exchange with the symbol "NHC.PRA", is convertible at any time at the option of the stockholder into NHC common stock at a conversion price of $65.07. Each share of the Preferred Stock will be convertible into 0.24204 of a share of NHC common stock. After the fifth anniversary of the closing date, NHC will have the option to redeem the Preferred Stock, in whole or in part, for $15.75 cash per share (plus accrued but unpaid dividends); provided that the Preferred Stock will not be redeemable prior to the eighth anniversary of the closing date unless the average closing price for NHC common stock for 20 trading sessions equals or exceeds the conversion price. The conversion price will be adjusted to reflect any future NHC common stock splits or stock dividends.

Note_20_Series_B_Junior_Partic

Note 20 - Series B Junior Participating Preferred Stock	12 Months Ended
	Dec. 31, 2013
Stockholder Rights Plan Disclosure [Abstract]	'
Stockholder Rights Plan Disclosure [Text Block]	'
	Note 20 – Series B Junior Participating Preferred Stock
	On August 2, 2007, the NHC Board of Directors approved the adoption of a stockholder rights plan and declared a dividend distribution of one right (a "Right") for each outstanding share of NHC common stock to stockholders of record at the close of business on August 2, 2007. Each Right entitles the registered holder to purchase from NHC a unit consisting of one one-ten thousandth of a share of Series B Junior Participating Preferred Stock, $0.01 par value at a purchase price of $250 per Unit, subject to adjustment. The description and terms of the Rights are set forth in a rights agreement between NHC and Computershare Trust Company, N.A., as rights agent, dated as of August 2, 2007, as may be amended, restated or otherwise modified from time to time. No shares have been issued pursuant to this stockholder rights plan.

Note_21_Selected_Quarterly_Fin

Note 21 - Selected Quarterly Financial Data	12 Months Ended
	Dec. 31, 2013
Quarterly Financial Information Disclosure [Abstract]	'
Quarterly Financial Information [Text Block]	'
	Note 21 - Selected Quarterly Financial Data
	(unaudited, in thousands, except per share amounts)
	The following table sets forth selected quarterly financial data for the two most recent fiscal years.
	2013	1st Quarter		2nd Quarter		3rd Quarter		4th Quarter
	Net Operating Revenues	$	194,378	$	192,011	$	195,772	$	206,796
	Income Before Non-Operating Income		15,996		17,001		19,265		19,819
	Non-Operating Income		6,618		6,632		11,171		5,674
	Net Income		13,805		14,342		19,877		16,589
	Preferred Dividends		2,168		2,168		2,167		2,168
	Net Income Available to Common Stockholders		11,637		12,174		17,710		14,421
	Basic Earnings Per Share		0.84		0.88		1.28		1.04
	Diluted Earnings Per Share		0.82		0.86		1.19		0.99
	2012	1st Quarter		2nd Quarter		3rd Quarter		4th Quarter
	Net Operating Revenues	$	190,050	$	187,668	$	189,307	$	193,977
	Income Before Non-Operating Income		14,706		16,390		16,610		20,530
	Non-Operating Income		5,868		5,907		6,771		6,699
	Net Income		12,654		13,555		17,196		15,895
	Preferred Dividends		2,168		2,168		2,167		2,168
	Net Income Available to Common Stockholders		10,486		11,387		15,029		13,727
	Basic Earnings Per Share		0.76		0.82		1.08		0.99
	Diluted Earnings Per Share		0.75		0.81		1.04		0.95

Accounting_Policies_by_Policy_

Accounting Policies, by Policy (Policies)	12 Months Ended
	Dec. 31, 2013
Accounting Policies, by Policy (Policies) [Line Items]	'
Business Description and Basis of Presentation [Text Block]	'
	Nature of Operations
	National HealthCare Corporation ("NHC" or "the Company") operates, manages or provides services to skilled nursing facilities and associated assisted living centers, retirement centers and home health care programs located in 10 Southeastern, Northeastern and Midwestern states in the United States. The most significant part of our business relates to skilled and intermediate nursing care in which setting we provide assisted living and retirement services, rehabilitative therapy services, and home health care. We also have a non-controlling ownership interest in a hospice care business that services NHC owned health care centers and others. The long-term health care environment has continually undergone changes with regard to Federal and state reimbursement programs and other payor sources, compliance regulations, competition among other health care providers and patient care litigation issues. We continually monitor these industry developments as well as other factors that affect our business.
Basis of Accounting, Policy [Policy Text Block]	'
	Principles of Consolidation and Basis of Presentation
	The consolidated financial statements which are prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) include our wholly owned and controlled subsidiaries and affiliates. Variable interest entities (“VIEs”) in which we have an interest have been consolidated when we have been identified as the primary beneficiary. Investments in ventures in which we have the ability to exercise significant influence but do not have control over are accounted for using the equity method. Equity method investments are initially recorded at cost and subsequently are adjusted for our share of the venture’s earnings or losses and cash distributions. Our most significant equity method investment is a 75.1% non-controlling ownership interest in Caris Healthcare, LP (“Caris”), a business that specializes in hospice care services. Investments in entities in which we lack the ability to exercise significant influence are included in the consolidated financial statements at cost unless there has been a decline in the market value of our investment that is deemed to be other than temporary. All material intercompany transactions and balances have been eliminated in consolidation.
Use of Estimates, Policy [Policy Text Block]	'
	Use of Estimates
	The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires management 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.
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 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 1 under “Change in Accounting Principle” for further discussion on the adoption of ASU No. 2012-01.
Revenue Recognition, Policy [Policy Text Block]	'
	Net Patient Revenues and Accounts Receivable
	Revenues are derived from services rendered to patients for long-term care, including skilled and intermediate nursing, rehabilitation therapy, hospice, assisted living and retirement and home health care services.
	Revenues are recorded when services are provided based on established rates adjusted to amounts expected to be received under governmental programs and other third-party contractual arrangements based on contractual terms. These revenues and receivables are stated at amounts estimated by management to be at their net realizable value.
	For private pay patients in skilled nursing, assisted living and independent living facilities, the Company bills one month in advance for room and board charges, with the remittance being due on receipt of the statement and generally by the 10th day of the month the services are performed. A portion of the episodic Medicare payments for home health services are also received in advance of the services being rendered. All advance billings are initially deferred and then are recognized as revenue when the services are performed.
	We receive payments from the Medicare program under a prospective payment system ("PPS"). For skilled nursing services, Medicare pays a fixed fee per Medicare patient per day, based on the acuity level of the patient, to cover all post-hospital extended care routine service costs, ancillary costs and capital related costs.
	Medicaid program payments for long-term care services are generally based on fixed per diem rates subject to program cost ceilings.
	For homecare services, Medicare pays based on the acuity level of the patient and based on episodes of care. An episode of care is defined as a length of care up to 60 days with multiple continuous episodes allowed. The services covered by the episode payment include all disciplines of care, in addition to medical supplies, within the scope of the home health benefit. We are allowed to make a request for anticipated payment at the start of care equal to 60% of the expected payment for the initial episode. The remaining balance due is paid following the submission of the final claim at the end of the episode. Revenues are recognized when services are provided based on the number of days of service rendered in the episode. Deferred revenue is recorded for payments received for which the related services have not yet been provided.
	Laws and regulations governing the Medicare and Medicaid programs are complex and subject to interpretation. Noncompliance with such laws and regulations can be subject to regulatory actions including fines, penalties, and exclusion from the Medicare and Medicaid programs. We believe that we are in material compliance with all applicable laws and regulations.
	Medicare program revenues, as well as certain Medicaid program revenues, are subject to audit and retroactive adjustment by government representatives. The Medicare PPS methodology requires that patients be assigned to Resource Utilization Groups ("RUGs") based on the acuity level of the patient to determine the amount paid to us for patient services. The assignment of patients to the various RUG categories is subject to post-payment review by Medicare intermediaries or their agents. In our opinion, adequate provision has been made for any adjustments that may result from these reviews. Retroactive adjustments are estimated in the recording of revenues in the period the related services are rendered. 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 believe currently that any differences between the net revenues recorded and final determination will not materially affect the consolidated financial statements. We have made provisions of approximately $21,619,000 and $19,267,000 as of December 31, 2013 and 2012, respectively, for various Medicare and Medicaid current and prior year cost reports and claims reviews.
	Approximately 65% of our net patient revenues are derived from participation in Medicare and Medicaid programs and other government programs.
Revenue Recognition for Alternative Revenue Programs, Policy [Policy Text Block]	'
	Other Revenues
	As discussed in Note 4 other revenues include revenues from the provision of insurance, management and accounting services to other long-term care providers, and rental income. Our insurance revenues consist of premiums that are generally paid in advance and then amortized into income as earned over the related policy period. We charge for management services based on a percentage of net revenues. We charge for accounting services based on a monthly fee or a fixed fee per bed of the long-term care center under contract. We generally record other revenues on the accrual basis based on the terms of our contractual arrangements. However, with respect to management and accounting services revenue from certain long-term care providers, including but not limited to National Health Corporation ("National") as discussed in Note 4, where collection is not reasonably assured based on insufficient historical collections and the lack of expected future collections, our policy is to recognize income only in the period in which collection is assured and the amounts at question are believed by management to be fixed and determined.
	Certain management contracts, including, but not limited to contracts with National, subordinate the payment of management fees earned under those contracts to other expenditures of the long-term care center and to the availability of cash provided by the facility’s operations. Revenues from management services provided to the facilities that generate insufficient cash flow to pay the management fee, as prioritized under the contractual arrangement, are not recognized until such time as the amount of revenue earned is fixed or determinable and collectability is reasonably assured. This recognition policy could cause our reported revenues and net income from management services to vary significantly from period to period.
	We recognize rental income based on the terms of our operating leases. Under certain of our leases, we receive contingent rent, which is based on the increase in revenues of a lessee over a base year. We recognize contingent rent annually or monthly, as applicable, when, based on the actual revenue of the lessee, receipt of such income is assured. We identify leased real estate properties as nonperforming if a required payment is not received within 30 days of the date it is due. Our policy related to rental income on non-performing leased real estate properties is to recognize rental income in the period when the income is received.
Non-Operating Income [Policy Text Block]	'
	Non-Operating Income
	As discussed in Note 5, non-operating income includes equity in earnings of unconsolidated investments, dividends and realized gains on securities, interest income, and other miscellaneous non-operating income.
Premiums Receivable, Allowance for Doubtful Accounts, Estimation Methodology, Policy [Policy Text Block]	'
	Provision for Doubtful Accounts
	We evaluate the collectability of our accounts receivable based on factors such as payor type, historical collection trends and aging categories. We review these factors and determine an estimated provision for doubtful accounts. Historically, bad debts have resulted primarily from uncollectible private balances or from uncollectible coinsurance and deductibles. Receivables that are deemed to be uncollectible are written off against the allowance. The allowance for doubtful accounts balance is assessed on a quarterly basis, with changes in estimated losses being recorded in the consolidated statements of income in the period first identified.
	The Company includes provisions for doubtful accounts in operating expenses in its consolidated statements of income. The provisions for doubtful accounts were $5,226,000, $2,455,000, and $2,430,000 for 2013, 2012 and 2011, respectively.
Property, Plant and Equipment, Policy [Policy Text Block]	'
	Property and Equipment
	Property and equipment are recorded at cost. Depreciation is provided by the straight-line method over the expected useful lives of the assets estimated as follows: buildings and improvements, 20-40 years and equipment and furniture, 3-15 years. Leasehold improvements are amortized over periods that do not exceed the non-cancelable respective lease terms using the straight-line method.
	Expenditures for repairs and maintenance are charged against income as incurred. Betterments, which significantly extend the useful life, are capitalized. We remove the costs and related allowances for accumulated depreciation or amortization from the accounts for properties sold or retired, and any resulting gains or losses are included in income.
	In accordance with Accounting Standards Codification ("ASC") Topic 360, Property, Plant, and Equipment, we evaluate the recoverability of the carrying values of our properties on a property by property basis. We review our properties for recoverability when events or circumstances, including significant physical changes in the property, significant adverse changes in general economic conditions, and significant deteriorations of the underlying cash flows of the property, indicate that the carrying amount of the property may not be recoverable. The need to recognize an impairment is based on estimated future undiscounted cash flows from a property over the remaining useful life compared to the carrying value of that property. If recognition of an impairment is necessary, it is measured as the amount by which the carrying amount of the property exceeds the estimated fair value of the property.
Finance, Loans and Leases Receivable, Policy [Policy Text Block]	'
	Mortgage and Other Notes Receivable
	In accordance with ASC Topic 310, Receivables, NHC evaluates the carrying values of its mortgage and other notes receivable on an instrument by instrument basis. On a quarterly basis, NHC reviews its notes receivable for recoverability when events or circumstances, including the non-receipt of contractual principal and interest payments, significant deteriorations of the financial condition of the borrower and significant adverse changes in general economic conditions, indicate that the carrying amount of the note receivable may not be recoverable. If necessary, an impairment is measured as the amount by which the carrying amount exceeds the discounted cash flows expected to be received under the note receivable or, if foreclosure is probable, the fair value of the collateral securing the note receivable.
Marketable Securities, Policy [Policy Text Block]	'
	Investments in Marketable Securities and Restricted Marketable Securities
	Our investments in marketable securities and restricted marketable securities include available for sale securities, which are recorded at fair value. Unrealized gains and losses on available for sale securities that are deemed temporary are recorded as a separate component of stockholders’ equity. If any adjustment to fair value reflects a significant decline in the value of the security, we consider all available evidence to evaluate the extent to which the decline is "other than temporary". Credit losses are identified when we do not expect to receive cash flows sufficient to recover the amortized cost basis of a security. In the event of a credit loss, only the amount associated with the credit loss is recognized in earnings, with the amount of loss relating to other factors recorded as a separate component of stockholders’ equity.
Goodwill and Intangible Assets, Goodwill, Policy [Policy Text Block]	'
	Goodwill
	The Company accounts for goodwill under ASC Topic 350, Intangibles – Goodwill and Other. Under the provisions of this guidance, goodwill and intangible assets with indefinite useful lives are not amortized but are subject to impairment tests based on their estimated fair value. Unamortized goodwill is continually reviewed for impairment in accordance with ASC. The Company performs its annual impairment assessment on the first day of the fourth quarter.
Income Tax, Policy [Policy Text Block]	'
	Income Taxes
	We utilize ASC Topic 740, Income Taxes, which requires an asset and liability approach for financial accounting and reporting for income taxes. Under this guidance, deferred tax assets and liabilities are determined based upon differences between financial reporting and tax basis of assets and liabilities and are measured using the enacted tax laws that will be in effect when the differences are expected to reverse. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. See Note 13 for further discussion of our accounting for income taxes.
	Also under ASC Topic 740, Income Taxes, tax positions are evaluated for recognition using a more-than-likely-than-not threshold, and those tax positions requiring recognition are measured at the largest amount of tax benefit that is greater than 50 percent likely of being realized upon ultimate settlement with a taxing authority that has full knowledge of all relevant information. Liabilities for income tax matters include amounts for income taxes, applicable penalties, and interest thereon and are the result of the potential alternative interpretations of tax laws and the judgmental nature of the timing of recognition of taxable income.
Concentration Risk, Credit Risk, Policy [Policy Text Block]	'
	Concentration of Credit Risks
	Our credit risks primarily relate to cash and cash equivalents, restricted cash and cash equivalents, accounts receivable, marketable securities, restricted marketable securities and notes receivable. Cash and cash equivalents are primarily held in bank accounts and overnight investments. Restricted cash and cash equivalents is primarily invested in commercial paper and certificates of deposit with financial institutions and other interest bearing accounts. Accounts receivable consist primarily of amounts due from patients (funded through Medicare, Medicaid, other contractual programs and through private payors) and from other health care companies for management, accounting and other services. We perform continual credit evaluations of our clients and maintain allowances for doubtful accounts on these accounts receivable. Marketable securities and restricted marketable securities are held primarily in accounts with brokerage institutions. Notes receivable relate primarily to secured loans with health care facilities (recorded as notes receivable in the consolidated balance sheets) as discussed in Note 11.
	At any point in time we have funds in our operating accounts and restricted cash accounts that are with third party financial institutions. These balances in the U.S. may exceed the Federal Deposit Insurance Corporation (FDIC) insurance limits. While we monitor the cash balances in our operating accounts, these cash and restricted cash balances could be impacted if the underlying financial institutions fail or could be subject to other adverse conditions in the financial markets.
	Our financial instruments, principally our notes receivable, are subject to the possibility of loss of the carrying values as a result of the failure of other parties to perform according to their contractual obligations. We obtain various collateral and other protective rights, and continually monitor these rights in order to reduce such possibilities of loss. We evaluate the need to provide reserves for potential losses on our financial instruments based on management's periodic review of the portfolio on an instrument by instrument basis. See Note 11 for additional information on the notes receivable.
Cash and Cash Equivalents, Policy [Policy Text Block]	'
	Cash and Cash Equivalents
	Cash equivalents include highly liquid investments with an original maturity of three months or less when purchased.
Cash and Restricted Cash and Cash Equivalents and Restricted Marketable Securities [Policy Text Block]	'
	Restricted Cash and Cash Equivalents and Restricted Marketable Securities
	Restricted cash and cash equivalents and restricted marketable securities primarily represent assets that are held by our wholly-owned limited purpose insurance companies for workers' compensation and professional liability claims.
Inventory, Policy [Policy Text Block]	'
	Inventories
	Inventories consist generally of food and supplies and are valued at the lower of cost or market, with cost determined on a first-in, first-out (FIFO) basis.
Other Current Liabilities [Policy Text Block]	'
	Other Current Liabilities
	Other current liabilities primarily represent accruals for current federal and state income taxes, real estate taxes and other current liabilities.
Liability Reserve Estimate, Policy [Policy Text Block]	'
	Accrued Risk Reserves
	We are principally self-insured for risks related to employee health insurance and utilize wholly-owned limited purpose insurance companies for workers’ compensation and professional liability claims. Accrued risk reserves primarily represent the accrual for risks associated with employee health insurance, workers’ compensation and professional liability claims. The accrued risk reserves include a liability for unpaid reported claims and estimates for incurred but unreported claims. Our policy with respect to a significant portion of our workers’ compensation and professional and general liability claims is to use an actuary to estimate our exposure for claims obligation (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, with changes in estimated losses being recorded in the consolidated statements of income in the period first identified.
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 December 31, 2013 and December 31, 2012 were $10,720,000 and $10,680,000, respectively.
Share-based Compensation, Option and Incentive Plans Policy [Policy Text Block]	'
	Stock-Based Compensation
	Stock-based awards granted include stock options, restricted stock units, and stock purchased under our employee stock purchase plan. Stock-based compensation cost is measured at the grant date, based on the fair value of the awards, and is recognized as expense over the requisite service period only for those equity awards expected to vest.
	The fair value of the restricted stock units is determined based on the stock price on the date of grant. We estimated the fair value of stock options and stock purchased under our employee stock purchase plan using the Black-Scholes model. This model utilizes the estimated fair value of common stock and requires that, at the date of grant, we use the expected term of the grant, the expected volatility of the price of our common stock, risk-free interest rates and expected dividend yield of our common stock. The fair value is amortized on a straight-line basis over the requisite service periods of the awards.
Income Tax Uncertainties, Policy [Policy Text Block]	'
	Other Noncurrent Liabilities
	Other noncurrent liabilities include reserves primarily related to various uncertain income tax positions (see Note 13).
Revenue Recognition, Deferred Revenue [Policy Text Block]	'
	Deferred Revenue
	Deferred revenue includes the deferred gain on the sale of assets to National (as discussed in Note 3) and entrance fees that have been and are currently being received upon reservation and occupancy in the independent living centers we operate. The non-refundable portion (10%) of the entrance fee is included in deferred revenue and is being recognized over the remaining life expectancies of the residents.
Comprehensive Income, Policy [Policy Text Block]	'
	Comprehensive Income
	ASC Topic 220, Comprehensive Income, requires that changes in the amounts of certain items, including unrealized gains and losses on marketable securities, be shown in the consolidated financial statements as comprehensive income. We report comprehensive income in the consolidated statements of comprehensive income and also in the consolidated statements of stockholders’ equity.
Segment Reporting, Policy [Policy Text Block]	'
	Segment Disclosures
	ASC Topic 280, Segment Reporting, establishes standards for the way that public business enterprises report information about operating segments in annual and interim financial reports issued to stockholders. Management believes that substantially all of our operations are part of the long-term health care industry segment. See Note 4 for a detail of other revenues provided within the long-term health care industry segment. Information about the costs and expenses associated with each of the components of other revenues is not separately identifiable.
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, results of operations, or cash flows.
Refundable Advance Fees [Member]	'
Accounting Policies, by Policy (Policies) [Line Items]	'
New Accounting Pronouncements, 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 consolidated financial statements of prior periods are adjusted to apply the new accounting method retrospectively. The following tables present the effect on the consolidated financial statements of the accounting change that was retrospectively adopted on January 1, 2013:
	Consolidated Balance Sheet
	(in thousands)
		Year Ended December 31, 2012
		As Previously Reported			Effect of Accounting Change			As Adjusted
	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 Statements of Income
	(in thousands, except share and per share amounts)
		Year Ended December 31, 2012									Year Ended December 31, 2011
		As Previously Reported			Effect of Accounting Change			As Adjusted			As Previously Reported			Effect of Accounting Change			As Adjusted
	Other revenues	$	55,876		$	(260	)	$	55,616		$	58,048		$	(295	)	$	57,753
	Net operating revenues		761,262			(260	)		761,002			773,537			(295	)		773,242
	Other operating expenses		(198,691			2,461			(196,230	)		(198,439	)		1,800			(196,639	)
	Total costs and expenses		(695,227	)		2,461			(692,766	)		(696,191	)		1,800			(694,391	)
	Income Before Non-Operating Income		66,035			2,201			68,236			77,346			1,505			78,851
	Income Before Income Taxes		91,280			2,201			93,481			97,879			1,505			99,384
	Income Tax Provision		(33,323	)		(858	)		(34,181	)		(33,807	)		(587	)		(34,394	)
	Net Income		57,957			1,343			59,300			64,072			918			64,990
	Net Income Available to Common Shareholders	$	49,286		$	1,343		$	50,629		$	55,401		$	918		$	56,319
	Basic Earnings Per Share	$	3.56		$	0.09		$	3.65		$	4.02		$	0.07		$	4.09
	Diluted Earnings Per Share	$	3.49		$	0.08		$	3.57		$	3.9		$	0.06		$	3.96
	Consolidated Statements of Comprehensive Income
	(in thousands)
		Year Ended December 31, 2012									Year Ended December 31, 2011
		As Previously Reported			Effect of Accounting Change			As Adjusted			As Previously Reported			Effect of Accounting Change			As Adjusted
	Net Income	$	57,957		$	1,343		$	59,300		$	64,072		$	918		$	64,990
	Comprehensive Income	$	72,063		$	1,343		$	73,406		$	64,487		$	918		$	65,405
	Consolidated Statements of Cash Flows
	(in thousands)
		Year Ended December 31, 2012									Year Ended December 31, 2011
		As Previously Reported			Effect of Accounting Change			As Adjusted			As Previously Reported			Effect of Accounting Change			As Adjusted
	Cash Flows from Operating Activities:
	Net Income	$	57,957		$	1,343		$	59,300		$	64,072		$	918		$	64,990
	Deferred income taxes		558			858			1,416			1,990			587			2,577
	Obligation to provide future services		-			(2,461	)		(2,461	)		-			(1,800	)		(1,800	)
	Deferred revenue		(31	)		(60	)		(91	)		(35	)		(171	)		(206	)
	Net cash provided by operating activities		64,693			(320	)		64,373			82,824			(466	)		82,358
	Cash Flows From Financing Activities:
	Entrance fee refunds		(1,630	)		320			(1,310	)		(2,170	)		466			(1,704	)
	Net cash used in financing activities	$	(27,775	)	$	320		$	(27,455	)	$	(18,548	)	$	466		$	(18,082	)
	Consolidated Statements of Stockholders' Equity
	(in thousands)
		Years Ended December 31, 2012 and 2011
		As Previously Reported			Effect of Accounting Change			As Adjusted
	Retained Earnings
	Balance at January 1, 2011	$	226,114		$	(5,785	)	$	220,329
	Net income		64,072			918			64,990
	Balance at December 31, 2011		265,198			(4,867	)		260,331
	Net income		57,957			1,343			59,300
	Balance at December 31, 2012	$	283,517		$	(3,524	)	$	279,993

Note_1_Summary_of_Significant_1

Note 1 - Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2013
Consolidated Balance Sheet [Member]	'
Note 1 - 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)
		Year Ended December 31, 2012
		As Previously Reported			Effect of Accounting Change			As Adjusted
	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 1 - Summary of Significant Accounting Policies (Tables) [Line Items]	'
Schedule of New Accounting Pronouncements and Changes in Accounting Principles [Table Text Block]	'
	Consolidated Statements of Income
	(in thousands, except share and per share amounts)
		Year Ended December 31, 2012									Year Ended December 31, 2011
		As Previously Reported			Effect of Accounting Change			As Adjusted			As Previously Reported			Effect of Accounting Change			As Adjusted
	Other revenues	$	55,876		$	(260	)	$	55,616		$	58,048		$	(295	)	$	57,753
	Net operating revenues		761,262			(260	)		761,002			773,537			(295	)		773,242
	Other operating expenses		(198,691			2,461			(196,230	)		(198,439	)		1,800			(196,639	)
	Total costs and expenses		(695,227	)		2,461			(692,766	)		(696,191	)		1,800			(694,391	)
	Income Before Non-Operating Income		66,035			2,201			68,236			77,346			1,505			78,851
	Income Before Income Taxes		91,280			2,201			93,481			97,879			1,505			99,384
	Income Tax Provision		(33,323	)		(858	)		(34,181	)		(33,807	)		(587	)		(34,394	)
	Net Income		57,957			1,343			59,300			64,072			918			64,990
	Net Income Available to Common Shareholders	$	49,286		$	1,343		$	50,629		$	55,401		$	918		$	56,319
	Basic Earnings Per Share	$	3.56		$	0.09		$	3.65		$	4.02		$	0.07		$	4.09
	Diluted Earnings Per Share	$	3.49		$	0.08		$	3.57		$	3.9		$	0.06		$	3.96
Consolidated Statement Of Comprehensive Income [Member]	'
Note 1 - Summary of Significant Accounting Policies (Tables) [Line Items]	'
Schedule of New Accounting Pronouncements and Changes in Accounting Principles [Table Text Block]	'
	Consolidated Statements of Comprehensive Income
	(in thousands)
		Year Ended December 31, 2012									Year Ended December 31, 2011
		As Previously Reported			Effect of Accounting Change			As Adjusted			As Previously Reported			Effect of Accounting Change			As Adjusted
	Net Income	$	57,957		$	1,343		$	59,300		$	64,072		$	918		$	64,990
	Comprehensive Income	$	72,063		$	1,343		$	73,406		$	64,487		$	918		$	65,405
Consolidated Statement Of Cash Flows [Member]	'
Note 1 - Summary of Significant Accounting Policies (Tables) [Line Items]	'
Schedule of New Accounting Pronouncements and Changes in Accounting Principles [Table Text Block]	'
	Consolidated Statements of Cash Flows
	(in thousands)
		Year Ended December 31, 2012									Year Ended December 31, 2011
		As Previously Reported			Effect of Accounting Change			As Adjusted			As Previously Reported			Effect of Accounting Change			As Adjusted
	Cash Flows from Operating Activities:
	Net Income	$	57,957		$	1,343		$	59,300		$	64,072		$	918		$	64,990
	Deferred income taxes		558			858			1,416			1,990			587			2,577
	Obligation to provide future services		-			(2,461	)		(2,461	)		-			(1,800	)		(1,800	)
	Deferred revenue		(31	)		(60	)		(91	)		(35	)		(171	)		(206	)
	Net cash provided by operating activities		64,693			(320	)		64,373			82,824			(466	)		82,358
	Cash Flows From Financing Activities:
	Entrance fee refunds		(1,630	)		320			(1,310	)		(2,170	)		466			(1,704	)
	Net cash used in financing activities	$	(27,775	)	$	320		$	(27,455	)	$	(18,548	)	$	466		$	(18,082	)
Consolidated Statement Or Stockholders' Equity [Member]	'
Note 1 - Summary of Significant Accounting Policies (Tables) [Line Items]	'
Schedule of New Accounting Pronouncements and Changes in Accounting Principles [Table Text Block]	'
	Consolidated Statements of Stockholders' Equity
	(in thousands)
		Years Ended December 31, 2012 and 2011
		As Previously Reported			Effect of Accounting Change			As Adjusted
	Retained Earnings
	Balance at January 1, 2011	$	226,114		$	(5,785	)	$	220,329
	Net income		64,072			918			64,990
	Balance at December 31, 2011		265,198			(4,867	)		260,331
	Net income		57,957			1,343			59,300
	Balance at December 31, 2012	$	283,517		$	(3,524	)	$	279,993

Note_2_Relationship_With_Natio1

Note 2 - Relationship With National Health Investors, Inc. (Tables)	12 Months Ended
	Dec. 31, 2013
Leases [Abstract]	'
Schedule of Future Minimum Rental Payments for Operating Leases [Table Text Block]	'
		Total		Total
		Commitments		Commitments
		Including		Excluding
		Florida Facilities		Florida Facilities
	2014	$	34,200,000	$	29,448,000
	2015		34,200,000		29,448,000
	2016		34,200,000		34,200,000
	2017		34,200,000		34,200,000
	2018		34,200,000		34,200,000
	Thereafter		279,350,000		279,350,000

Note_4_Other_Revenues_Tables

Note 4 - Other Revenues (Tables)	12 Months Ended
	Dec. 31, 2013
Other Revenues [Abstract]	'
Schedule of Other Revenues [Table Text Block]	'
		Year Ended December 31,
		2013		2012		2011
		(in thousands)
	Insurance services	$	15,143	$	15,671	$	15,657
	Management and accounting service fees		18,160		20,042		21,601
	Rental income		19,132		19,314		19,545
	Other		685		589		950
		$	53,120	$	55,616	$	57,753

Note_5_NonOperating_Income_Tab

Note 5 - Non-Operating Income (Tables)	12 Months Ended
	Dec. 31, 2013
Disclosure Text Block [Abstract]	'
Schedule of Other Nonoperating Income, by Component [Table Text Block]	'
		Year Ended December 31,
		2013		2012		2011
		(in thousands)
	Equity in earnings of unconsolidated investments	$	14,188	$	13,616	$	9,674
	Dividends and net realized gains on sales of securities		5,216		7,006		5,875
	Interest income		5,237		4,623		4,984
	Gain on the recovery of notes receivable		5,454	–		–
		$	30,095	$	25,245	$	20,533

Note_7_Earnings_Per_Share_Tabl

Note 7 - Earnings Per Share (Tables)	12 Months Ended
	Dec. 31, 2013
Earnings Per Share [Abstract]	'
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	'
		Year Ended December 31,
		2013		2012		2011
		(dollars in thousands, except share and per share amounts)
				(as adjusted)		(as adjusted)
	Basic:
	Weighted average common shares outstanding		13,829,626		13,852,709		13,774,628
	Net income	$	64,613	$	59,300	$	64,990
	Dividends to preferred stockholders		8,671		8,671		8,671
	Net income available to common stockholders	$	55,942	$	50,629	$	56,319
	Earnings per common share, basic	$	4.05	$	3.65	$	4.09
	Diluted:
	Weighted average common shares outstanding		13,829,626		13,852,709		13,774,628
	Dilutive effect of stock options		9,091		8,019		9,934
	Dilutive effect of restricted stock		4,740		5,526		6,009
	Dilutive effect of contingent issuable stock		232,118		109,233	–
	Convertible preferred stock		2,623,228		2,623,329		2,623,452
	Assumed average common shares outstanding		16,698,803		16,598,816		16,414,023
	Net income available to common stockholders	$	55,942	$	50,629	$	56,319
	Add dilutive preferred stock dividends for effect of assumed conversion of preferred stock		8,671		8,671		8,671
	Net income for diluted earnings per common share	$	64,613	$	59,300	$	64,990
	Earnings per common share, diluted	$	3.87	$	3.57	$	3.96

Note_8_Investments_in_Marketab1

Note 8 - Investments in Marketable Securities (Tables)	12 Months Ended
	Dec. 31, 2013
Investments, Debt and Equity Securities [Abstract]	'
Available-for-sale Securities [Table Text Block]	'
		31-Dec-13				31-Dec-12
	(in thousands)	Amortized		Fair		Amortized		Fair
		Cost		Value		Cost		Value
	Investments available for sale:
	Marketable equity securities	$	30,176	$	105,009	$	30,176	$	107,250
	Restricted investments available for sale:
	Corporate debt securities		65,852		65,006		61,453		62,876
	Commercial mortgage-backed securities		46,977		45,856		47,194		48,063
	U.S. Treasury securities		22,932		22,841		16,218		16,604
	State and municipal securities		8,123		8,300		7,213		7,664
		$	174,060	$	247,012	$	162,254	$	242,457
Schedule of Available-for-sale Securities Reconciliation [Table Text Block]	'
		31-Dec-13						31-Dec-12
		Shares		Cost		Fair		Shares		Cost		Fair
						Value						Value
	NHI Common Stock		1,630,642	$	24,734	$	91,479		1,630,642	$	24,734	$	92,180
Investments Classified by Contractual Maturity Date [Table Text Block]	'
		31-Dec-13				31-Dec-12
	(in thousands)	Cost		Fair Value		Cost		Fair Value
	Maturities:
	Within 1 year	$	9,279	$	9,324	$	8,868	$	8,918
	1 to 5 years		91,787		92,011		80,910		82,801
	6 to 10 years		40,387		38,335		40,670		41,856
	Over 10 years		2,431		2,333		1,630		1,632
		$	143,884	$	142,003	$	132,078	$	135,207

Note_9_Fair_Value_Measurements1

Note 9 - Fair Value Measurements (Tables)	12 Months Ended
	Dec. 31, 2013
Fair Value Disclosures [Abstract]	'
Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis [Table Text Block]	'
		Fair Value Measurements Using
	31-Dec-13	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	$	81,705	$	81,705	$	–	$	–
	Restricted cash and cash equivalents		13,929		13,929	–		–
	Marketable equity securities		105,009		105,009	–		–
	Corporate debt securities		65,006	–			65,006	–
	Commercial mortgage-backed securities		45,856	–			45,856	–
	U.S. Treasury securities		22,841		22,841	–		–
	State and municipal securities		8,300	–			8,300	–
	Total financial assets	$	342,646	$	223,484	$	119,162	$	–
		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_Property_and_Equipment1

Note 10 - Property and Equipment (Tables)	12 Months Ended
	Dec. 31, 2013
Property, Plant and Equipment [Abstract]	'
Property, Plant and Equipment [Table Text Block]	'
		December 31,
		2013			2012
		(in thousands)
	Land	$	57,272		$	50,711
	Leasehold improvements		94,066			90,925
	Buildings and improvements		427,471			396,228
	Furniture and equipment		134,255			126,288
	Construction in progress		21,618			11,303
			734,682			675,455
	Less: Accumulated depreciation		(277,884	)		(254,548	)
		$	456,798		$	420,907

Note_12_LongTerm_Debt_Tables

Note 12 - Long-Term Debt (Tables)	12 Months Ended
	Dec. 31, 2013
Debt Disclosure [Abstract]	'
Schedule of Debt [Table Text Block]	'
		Weighted			December 31,
		Average
		Interest Rate	Maturities		2013		2012
		Variable,
	Revolving Credit Facility, interest payable monthly	0.90%	2014		–		–
	Unsecured term note payable to National, interest payable quarterly, principal payable at maturity	2.80%	2018			10,000		10,000
						10,000		10,000
	Less current portion				–		–
					$	10,000	$	10,000
Schedule of Maturities of Long-term Debt [Table Text Block]	'
			Long-Term
			Debt
			(in thousands)
	2014			−
	2015			−
	2016			−
	2017			−
	2018			10,000
		Total	$	10,000

Note_13_Income_Taxes_Tables

Note 13 - Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2013
Income Tax Disclosure [Abstract]	'
Schedule of Components of Income Tax Expense (Benefit) [Table Text Block]	'
		Year Ended December 31,
		2013			2012			2011
		(in thousands)
					(as adjusted)			(as adjusted)
	Current Tax Provision
	Federal	$	34,680		$	29,147		$	29,311
	State		5,588			4,010			3,131
			40,268			33,157			32,442
	Deferred Tax Provision
	Federal		(2,226	)		892			1,719
	State		(479	)		132			233
			(2,705	)		1,024			1,952
	Income Tax Provision	$	37,563		$	34,181		$	34,394
Schedule of Deferred Tax Assets and Liabilities [Table Text Block]	'
		December 31,
		2013			2012
		(in thousands)
					(as adjusted)
	Current deferred tax asset:
	Allowance for doubtful accounts receivable	$	1,802		$	1,022
	Accrued expenses		7,489			7,490
			9,291			8,512
	Current deferred tax liability:
	Unrealized gains on marketable securities		(28,526	)		(31,154	)
	Other		(1,922	)		(1,832	)
			(30,448	)		(32,986	)
	Net current deferred tax liability	$	(21,157	)	$	(24,474	)
	Noncurrent deferred tax asset:
	Financial reporting depreciation in excess of tax depreciation	$	5,872		$	4,086
	Deferred gain on sale of assets (net)		(3,135	)		(3,135	)
	Tax basis intangible asset in excess of financial reporting basis		127			663
	Stock-based compensation		2,214			1,682
	Long-term investments		(2,276	)		(1,387	)
	Nonrefundable entrance fees		45			-
	Refundable entrance fees		1,647			1,555
	Obligation to provide future services		1,439			698
	Accrued expenses		2,502			2,132
	Deferred revenue		6,096			6,523
	Net noncurrent deferred tax asset	$	14,531			12,817
Schedule of Effective Income Tax Rate Reconciliation [Table Text Block]	'
		Year Ended December 31,
		2013			2012			2011
		(in thousands)
					(as adjusted)			(as adjusted)
	Tax provision at federal statutory rate	$	35,762		$	32,718		$	34,784
	Increase (decrease) in income taxes
	resulting from:
	State, net of federal benefit		2,325			3,261			3,246
	Nondeductible expenses		197			118			188
	Insurance expense		35			39			26
	Other, net		(258	)		823			57
	Unrecognized tax benefits		1,107			409			85
	Expiration of statute of limitations		(1,605	)		(3,187	)		(3,992	)
			1,801			1,463			(390	)
	Effective income tax expense	$	37,563			34,181		$	34,394
Schedule of Unrecognized Tax Benefits Roll Forward [Table Text Block]	'
		Deferred Tax Asset			Liability For Unrecognized Tax Benefits			Liability For Interest and Penalties			Liability Total
	Balance, January 1, 2011	$	10,089		$	14,511		$	4,350		$	18,861
	Additions based on tax positions related to the current year		−			1,452			183			1,635
	Additions for tax positions of prior years		(70	)		189			(449	)		(260	)
	Reductions for statute of limitation expirations		(93	)		(2,387	)		(1,605	)		(3,992	)
	Balance, December 31, 2011		9,926			13,765			2,479			16,244
	Additions based on tax positions related to the current year		−			1,695			185			1,880
	Additions for tax positions of prior years		728			845			170			1,015
	Reductions for statute of limitation expirations		(1,999	)		(4,309	)		(940	)		(5,249	)
	Balance, December 31, 2012		8,655			11,996			1,894			13,890
	Additions based on tax positions related to the current year					1,832			198			2,030
	Additions for tax positions of prior years		2,120			1,427			641			2,068
	Reductions for statute of limitation expirations		(2,177	)		(2,802	)		(661	)		(3,463	)
	Balance, December 31, 2013	$	8,598		$	12,453		$	2,072		$	14,525

Note_15_StockBased_Compensatio1

Note 15 - Stock-Based Compensation (Tables)	12 Months Ended
	Dec. 31, 2013
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]	'
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions [Table Text Block]	'
		Year Ended December 31,
		2013				2012				2011
	Risk-free interest rate		0.25	%			0.28	%			2.02	%
	Expected volatility		31.3	%			38.8	%			23.7	%
	Expected life, in years		2.1				2.1				4.8
	Expected dividend yield		2.81	%			2.91	%			3.62	%
Schedule of Share-based Compensation, Stock Options, Activity [Table Text Block]	'
		Number of Shares				Weighted Average Exercise Price				Aggregate Intrinsic Value
	Options outstanding at January 1, 2011		472,327			$	43.07			$	−
	Options granted		1,264,719				46.58				−
	Options exercised		(224,969	)			37.3				−
	Options cancelled		(30,000	)			44.25				−
	Options outstanding at December 31, 2011		1,482,077				46.92				−
	Options granted		63,516				44.28				−
	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		59,472				47.95				−
	Options exercised		(21,522	)			45.63				−
	Options cancelled		(98,000	)			51.11				−
	Options outstanding at December 31, 2013		1,074,552				46.44				8,027,000
	Options exercisable		145,552			$	44.84			$	1,320,000
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
	31-Dec-13											Life in Years
	21,750			$37.70					$37.70				0.3
	1,052,802		$44.80	-	$47.45				$46.62				2.4
	1,074,552								$46.44				2.3
Schedule of Share-based Compensation, Restricted Stock and Restricted Stock Units Activity [Table Text Block]	'
		Number of				Weighted Average Grant Date Fair Value				Aggregate Intrinsic Value
		Shares
	Unvested restricted shares at January 1, 2011		30,000			$	34.46			–
	Award shares granted	–				–				–
	Award shares vested		6,000				34.46			–
	Unvested restricted shares at December 31, 2011		24,000				34.46			–
	Award shares granted	–				–				–
	Award shares vested		6,000				34.46			–
	Unvested restricted shares at December 31, 2012		18,000				34.46			–
	Award shares granted	–				–				–
	Award shares vested		6,000				34.46			–
	Unvested restricted shares at December 31, 2013		12,000			$	34.46			$	233,000

Note_17_Equity_Method_Investme1

Note 17 - Equity Method Investment in Caris HealthCare, L.P. (Tables)	12 Months Ended
	Dec. 31, 2013
Disclosure Text Block Supplement [Abstract]	'
Equity Method Investments [Table Text Block]	'
		December 31,
		2013		2012		2011
		( in thousands)
	Current assets	$	25,212	$	30,731	$	18,219
	Noncurrent assets		11,685		9,051		978
	Liabilities		8,879		9,365		7,623
	Partners’ capital		28,018		30,417		11,574
	Revenue		58,918		59,422		44,454
	Expenses		40,112		40,341		28,018
	Net income		18,806		19,081		16,436

Note_21_Selected_Quarterly_Fin1

Note 21 - Selected Quarterly Financial Data (Tables)	12 Months Ended
	Dec. 31, 2013
Quarterly Financial Information Disclosure [Abstract]	'
Schedule of Quarterly Financial Information [Table Text Block]	'
	2013	1st Quarter		2nd Quarter		3rd Quarter		4th Quarter
	Net Operating Revenues	$	194,378	$	192,011	$	195,772	$	206,796
	Income Before Non-Operating Income		15,996		17,001		19,265		19,819
	Non-Operating Income		6,618		6,632		11,171		5,674
	Net Income		13,805		14,342		19,877		16,589
	Preferred Dividends		2,168		2,168		2,167		2,168
	Net Income Available to Common Stockholders		11,637		12,174		17,710		14,421
	Basic Earnings Per Share		0.84		0.88		1.28		1.04
	Diluted Earnings Per Share		0.82		0.86		1.19		0.99
	2012	1st Quarter		2nd Quarter		3rd Quarter		4th Quarter
	Net Operating Revenues	$	190,050	$	187,668	$	189,307	$	193,977
	Income Before Non-Operating Income		14,706		16,390		16,610		20,530
	Non-Operating Income		5,868		5,907		6,771		6,699
	Net Income		12,654		13,555		17,196		15,895
	Preferred Dividends		2,168		2,168		2,167		2,168
	Net Income Available to Common Stockholders		10,486		11,387		15,029		13,727
	Basic Earnings Per Share		0.76		0.82		1.08		0.99
	Diluted Earnings Per Share		0.75		0.81		1.04		0.95

Note_1_Summary_of_Significant_2

Note 1 - Summary of Significant Accounting Policies (Details) (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Note 1 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'	'
Homecare Services Anticipated Payment Deferred RevenuePercentage	60.00%	'	'
Provision for Doubtful Accounts	$5,226,000	$2,455,000	$2,430,000
Caris [Member]	'	'	'
Note 1 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'	'
Equity Method Investment, Ownership Percentage	75.10%	'	'
Building and Building Improvements [Member] | Minimum [Member]	'	'	'
Note 1 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'	'
Property, Plant and Equipment, Useful Life	'20 years	'	'
Building and Building Improvements [Member] | Maximum [Member]	'	'	'
Note 1 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'	'
Property, Plant and Equipment, Useful Life	'40 years	'	'
Equipment [Member] | Minimum [Member]	'	'	'
Note 1 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'	'
Property, Plant and Equipment, Useful Life	'3 years	'	'
Equipment [Member] | Maximum [Member]	'	'	'
Note 1 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'	'
Property, Plant and Equipment, Useful Life	'15 years	'	'
Medicare and Medicaid [Member]	'	'	'
Note 1 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'	'
Allowance for Doubtful Accounts Receivable	21,619,000	19,267,000	'
Refundable Advance Fees [Member]	'	'	'
Note 1 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'	'
Nonrefundable Resident Entry Fee Percentage	10.00%	'	'
Customer Refundable Fees	$10,720,000	$10,680,000	'
Original Entry Fee [Member]	'	'	'
Note 1 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'	'
Refundable Resident Entry Fee Percentage	90.00%	'	'
Appreciation [Member]	'	'	'
Note 1 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'	'
Appreciation of Apartment Over Original Resident's Entry Fee, Percentage	40.00%	'	'
Percent of Revenues Derived From Medicare, Medicaid, and Other Government Programs [Member]	'	'	'
Note 1 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'	'
Concentration Risk, Percentage	65.00%	'	'

Note_1_Summary_of_Significant_3

Note 1 - Summary of Significant Accounting Policies (Details) - Effect of Accounting Change on Interim Financial Statements: Consolidated Balance Sheet (USD $)	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'
Deferred income taxes	$14,531,000	$12,817,000	'	'
Total assets	980,725,000	924,700,000	'	'
Deferred revenue	3,320,000	3,430,000	'	'
Retained earnings	318,216,000	279,993,000	'	'
Total stockholders' equity	688,112,000	656,148,000	606,869,000	555,361,000
Total liabilities and stockholders' equity	980,725,000	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	226,114,000
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	220,329,000
Total stockholders' equity	'	656,148,000	'	'
Total liabilities and stockholders' equity	'	$924,700,000	'	'

Note_1_Summary_of_Significant_4

Note 1 - Summary of Significant Accounting Policies (Details) - Effect of Accounting Change on Interim Financial Statements: Interim Condensed Consolidated Statement of Income (USD $)	3 Months Ended								12 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'	'	'	'	'	'	'	'
Other revenues	'	'	'	'	'	'	'	'	$53,120	$55,616	$57,753
Net operating revenues	206,796	195,772	192,011	194,378	193,977	189,307	187,668	190,050	788,957	761,002	773,242
Total costs and expenses	'	'	'	'	'	'	'	'	-716,876	-692,766	-694,391
Income Before Non-Operating Income	19,819	19,265	17,001	15,996	20,530	16,610	16,390	14,706	72,081	68,236	78,851
Income Tax Provision	'	'	'	'	'	'	'	'	-37,563	-34,181	-34,394
Net Income	16,589	19,877	14,342	13,805	15,895	17,196	13,555	12,654	64,613	59,300	64,990
Net Income Available to Common Shareholders	14,421	17,710	12,174	11,637	13,727	15,029	11,387	10,486	55,942	50,629	56,319
Basic Earnings Per Share (in Dollars per share)	$1.04	$1.28	$0.88	$0.84	$0.99	$1.08	$0.82	$0.76	$4.05	$3.65	$4.09
Diluted Earnings Per Share (in Dollars per share)	$0.99	$1.19	$0.86	$0.82	$0.95	$1.04	$0.81	$0.75	$3.87	$3.57	$3.96
Previously Reported [Member]	'	'	'	'	'	'	'	'	'	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'	'	'	'	'	'	'	'
Other revenues	'	'	'	'	'	'	'	'	'	55,876	58,048
Net operating revenues	'	'	'	'	'	'	'	'	'	761,262	773,537
Other operating expenses	'	'	'	'	'	'	'	'	'	198,691	-198,439
Total costs and expenses	'	'	'	'	'	'	'	'	'	-695,227	-696,191
Income Before Non-Operating Income	'	'	'	'	'	'	'	'	'	66,035	77,346
Income Before Income Taxes	'	'	'	'	'	'	'	'	'	91,280	97,879
Income Tax Provision	'	'	'	'	'	'	'	'	'	-33,323	-33,807
Net Income	'	'	'	'	'	'	'	'	'	57,957	64,072
Net Income Available to Common Shareholders	'	'	'	'	'	'	'	'	'	49,286	55,401
Basic Earnings Per Share (in Dollars per share)	'	'	'	'	'	'	'	'	'	$3.56	$4.02
Diluted Earnings Per Share (in Dollars per share)	'	'	'	'	'	'	'	'	'	$3.49	$3.90
Adjustments for New Accounting Pronouncement [Member]	'	'	'	'	'	'	'	'	'	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'	'	'	'	'	'	'	'
Other revenues	'	'	'	'	'	'	'	'	'	-260	-295
Net operating revenues	'	'	'	'	'	'	'	'	'	-260	-295
Other operating expenses	'	'	'	'	'	'	'	'	'	2,461	1,800
Total costs and expenses	'	'	'	'	'	'	'	'	'	2,461	1,800
Income Before Non-Operating Income	'	'	'	'	'	'	'	'	'	2,201	1,505
Income Before Income Taxes	'	'	'	'	'	'	'	'	'	2,201	1,505
Income Tax Provision	'	'	'	'	'	'	'	'	'	-858	-587
Net Income	'	'	'	'	'	'	'	'	'	1,343	918
Net Income Available to Common Shareholders	'	'	'	'	'	'	'	'	'	1,343	918
Basic Earnings Per Share (in Dollars per share)	'	'	'	'	'	'	'	'	'	$0.09	$0.07
Diluted Earnings Per Share (in Dollars per share)	'	'	'	'	'	'	'	'	'	$0.08	$0.06
As Adjusted [Member]	'	'	'	'	'	'	'	'	'	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'	'	'	'	'	'	'	'
Other revenues	'	'	'	'	'	'	'	'	'	55,616	57,753
Net operating revenues	'	'	'	'	'	'	'	'	'	761,002	773,242
Other operating expenses	'	'	'	'	'	'	'	'	'	-196,230	-196,639
Total costs and expenses	'	'	'	'	'	'	'	'	'	-692,766	-694,391
Income Before Non-Operating Income	'	'	'	'	'	'	'	'	'	68,236	78,851
Income Before Income Taxes	'	'	'	'	'	'	'	'	'	93,481	99,384
Income Tax Provision	'	'	'	'	'	'	'	'	'	-34,181	-34,394
Net Income	'	'	'	'	'	'	'	'	'	59,300	64,990
Net Income Available to Common Shareholders	'	'	'	'	'	'	'	'	'	$50,629	$56,319
Basic Earnings Per Share (in Dollars per share)	'	'	'	'	'	'	'	'	'	$3.65	$4.09
Diluted Earnings Per Share (in Dollars per share)	'	'	'	'	'	'	'	'	'	$3.57	$3.96

Note_1_Summary_of_Significant_5

Note 1 - 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								12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'	'	'	'	'	'	'	'
Net Income	$16,589	$19,877	$14,342	$13,805	$15,895	$17,196	$13,555	$12,654	$64,613	$59,300	$64,990
Comprehensive Income	'	'	'	'	'	'	'	'	59,990	73,406	65,405
Previously Reported [Member]	'	'	'	'	'	'	'	'	'	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'	'	'	'	'	'	'	'
Net Income	'	'	'	'	'	'	'	'	'	57,957	64,072
Comprehensive Income	'	'	'	'	'	'	'	'	'	72,063	64,487
Adjustments for New Accounting Pronouncement [Member]	'	'	'	'	'	'	'	'	'	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'	'	'	'	'	'	'	'
Net Income	'	'	'	'	'	'	'	'	'	1,343	918
Comprehensive Income	'	'	'	'	'	'	'	'	'	1,343	918
As Adjusted [Member]	'	'	'	'	'	'	'	'	'	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'	'	'	'	'	'	'	'
Net Income	'	'	'	'	'	'	'	'	'	59,300	64,990
Comprehensive Income	'	'	'	'	'	'	'	'	'	$73,406	$65,405

Note_1_Summary_of_Significant_6

Note 1 - Summary of Significant Accounting Policies (Details) - Effect of Accounting Change on Interim Financial Statements: Interim Condensed Consolidated Statement of Cash Flows (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'
Net Income	$64,613	$59,300	$64,990
Deferred income taxes	2,404	-1,416	-2,577
Obligation to provide future services	1,898	-2,461	-1,800
Deferred revenue	-110	-91	-206
Net cash provided by operating activities	102,348	64,373	82,358
Entrance fee refunds	40	-1,310	-1,704
Net cash used in financing activities	-31,044	-27,455	-18,082
Previously Reported [Member]	'	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'
Net Income	'	57,957	64,072
Deferred income taxes	'	558	1,990
Deferred revenue	'	-31	-35
Net cash provided by operating activities	'	64,693	82,824
Entrance fee refunds	'	-1,630	-2,170
Net cash used in financing activities	'	-27,775	-18,548
Adjustments for New Accounting Pronouncement [Member]	'	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'
Net Income	'	1,343	918
Deferred income taxes	'	858	587
Obligation to provide future services	'	-2,461	-1,800
Deferred revenue	'	-60	-171
Net cash provided by operating activities	'	-320	-466
Entrance fee refunds	'	320	466
Net cash used in financing activities	'	320	466
As Adjusted [Member]	'	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'
Net Income	'	59,300	64,990
Deferred income taxes	'	1,416	2,577
Obligation to provide future services	'	-2,461	-1,800
Deferred revenue	'	-91	-206
Net cash provided by operating activities	'	64,373	82,358
Entrance fee refunds	'	-1,310	-1,704
Net cash used in financing activities	'	($27,455)	($18,082)

Note_1_Summary_of_Significant_7

Note 1 - Summary of Significant Accounting Policies (Details) - Effect of Accounting Change on Interim Financial Statements: Interim Condensed Consolidated Statements of Stockholders' Equity (USD $)	3 Months Ended								12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'	'	'	'	'	'	'	'
Balance at January 1, 2011	'	'	'	$279,993	'	'	'	'	$279,993	'	'
Net income	16,589	19,877	14,342	13,805	15,895	17,196	13,555	12,654	64,613	59,300	64,990
Balance	318,216	'	'	'	279,993	'	'	'	318,216	279,993	'
Previously Reported [Member]	'	'	'	'	'	'	'	'	'	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'	'	'	'	'	'	'	'
Balance at January 1, 2011	'	'	'	'	'	'	'	265,198	'	265,198	226,114
Net income	'	'	'	'	'	'	'	'	'	57,957	64,072
Balance	'	'	'	'	283,517	'	'	'	'	283,517	265,198
Adjustments for New Accounting Pronouncement [Member]	'	'	'	'	'	'	'	'	'	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'	'	'	'	'	'	'	'
Balance at January 1, 2011	'	'	'	'	'	'	'	-4,867	'	-4,867	-5,785
Net income	'	'	'	'	'	'	'	'	'	1,343	918
Balance	'	'	'	'	-3,524	'	'	'	'	-3,524	-4,867
As Adjusted [Member]	'	'	'	'	'	'	'	'	'	'	'
New Accounting Pronouncements or Change in Accounting Principle [Line Items]	'	'	'	'	'	'	'	'	'	'	'
Balance at January 1, 2011	'	'	'	'	'	'	'	260,331	'	260,331	220,329
Net income	'	'	'	'	'	'	'	'	'	59,300	64,990
Balance	'	'	'	'	$279,993	'	'	'	'	$279,993	$260,331

Note_2_Relationship_With_Natio2

Note 2 - Relationship With National Health Investors, Inc. (Details) (USD $)

12 Months Ended

1 Months Ended

12 Months Ended

1 Months Ended

12 Months Ended

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2011

Dec. 31, 2010

Dec. 31, 2013

Sep. 30, 2013

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2011

Dec. 31, 2007

Sep. 30, 2013

Sep. 30, 2013

Dec. 31, 2013

Dec. 31, 2012

First Lease [Member]

First Lease [Member]

First Lease [Member]

First Lease [Member]

First Lease [Member]

First Lease [Member]

Second Lease [Member]

National Health Investors, Inc. [Member]

National Health Investors, Inc. [Member]

National Health Investors, Inc. [Member]

National Health Investors, Inc. [Member]

National Health Investors, Inc. [Member]

National Health Investors, Inc. [Member]

National Health Investors, Inc. [Member]

National Health Investors, Inc. [Member]

National Health Investors, Inc. [Member]

National Health Investors, Inc. [Member]

FLORIDA

Note 2 - Relationship With National Health Investors, Inc. (Details) [Line Items]

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Number of Skilled Nursing Centers Leased From NHI

'

'

'

'

'

'

35

'

'

'

7

'

'

'

Number of Assisted Living Centers Leased From NHI

'

'

'

'

'

'

7

'

'

'

'

'

'

'

Number of Independent Living Centers Leased From NHI

'

'

'

'

'

'

3

'

'

'

'

'

'

'

Number of Lease Agreements with NHI

'

'

'

'

'

'

2

'

'

'

'

'

'

'

Number of Subleased NHI Properties

'

'

'

'

4

'

'

'

'

'

'

'

'

'

Number of Corporations For Subleased NHI Properties

'

'

'

'

'

'

4

'

'

'

'

'

'

'

Operating Leases, Rent Expense (in Dollars)

$39,449,000

$39,355,000

$39,736,000

'

'

'

'

'

'

$30,750,000

'

$34,200,000

'

'

Operating Lease Additional Percentage Rent Percentage

'

'

'

'

'

'

'

'

'

4.00%

4.00%

'

'

'

Percentage Rent Expense (in Dollars)

'

'

'

'

'

'

2,526,000

2,591,000

2,969,000

'

'

'

'

'

Lessee Leasing Arrangements, Operating Leases, Term of Contract

'

'

'

'10 years

'

'

'

'

'

'

'15 years

'

'

'

Operating Leases, Rent Expense, Minimum Rentals (in Dollars)

'

'

'

'

'

'

'

'

'

'

3,450,000

'

'

'

Facility Purchase Price (in Dollars)

'

'

'

'

'

'

'

'

'

'

49,000

'

'

'

Property PurchaseFirst Refusal Period

'

'

'

'

'

'

'

'

'

'

'180 days

'

'

'

Investment Owned, Balance, Shares (in Shares)

'

'

'

'

'

'

'

'

'

'

'

'

1,630,642

1,630,642

Percent Owned Of Available For Sale Securities

'

'

'

'

'

'

'

'

'

'

'

'

5.90%

5.90%

Asset Acquisition Number of Properties

'

'

'

'

'

'

'

'

'

'

'

6

'

'

Payments to Acquire Property, Plant, and Equipment (in Dollars)

43,438,000

22,003,000

23,372,000

'

'

'

'

'

'

'

'

21,000,000

'

'

Number Of Beds

'

'

'

'

'

'

'

'

'

'

'

650

'

'

Annual Lease Payment Decrease (in Dollars)

'

'

'

'

'

$2,950,000

'

'

'

'

'

'

'

'

Note_2_Relationship_With_Natio3

Note 2 - Relationship With National Health Investors, Inc. (Details) - Future Minimum Payments Under Operating Lease (USD $)	Dec. 31, 2013
In Thousands, unless otherwise specified
Note 2 - Relationship With National Health Investors, Inc. (Details) - Future Minimum Payments Under Operating Lease [Line Items]	'
2014	$29,448,000
2015	29,448,000
2016	34,200,000
2017	34,200,000
2018	34,200,000
Thereafter	279,350,000
NHI Lease Commitments [Member]	'
Note 2 - Relationship 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	$279,350,000

Note_3_Relationship_With_Natio1

Note 3 - Relationship With National Health Corporation (Details) (National [Member], USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Note 3 - Relationship With National Health Corporation (Details) [Line Items]	'	'	'
Deferred Revenue	$2,000,000	'	'
Salaries, Wages and Officers' Compensation	453,560,000	426,934,000	428,672,000
Payment for Administrative Fees	3,693,000	3,862,000	3,608,000
Due from Related Parties	5,785,000	5,149,000	'
Common Stock [Member]	'	'	'
Note 3 - Relationship With National Health Corporation (Details) [Line Items]	'	'	'
Shares, Outstanding (in Shares)	1,171,147	'	'
Equity Owned By Related Parties	8.30%	'	'
Preferred Stock [Member]	'	'	'
Note 3 - Relationship With National Health Corporation (Details) [Line Items]	'	'	'
Shares, Outstanding (in Shares)	'	1,271,147	'
Equity Owned By Related Parties	'	11.70%	'
Prime Rate [Member] | Loans Payable [Member]	'	'	'
Note 3 - Relationship With National Health Corporation (Details) [Line Items]	'	'	'
Debt Instrument, Basis Spread on Variable Rate	0.85%	'	'
Prime Rate [Member] | Line of Credit [Member]	'	'	'
Note 3 - Relationship With National Health Corporation (Details) [Line Items]	'	'	'
Debt Instrument, Basis Spread on Variable Rate	1.00%	'	'
Loans Payable [Member]	'	'	'
Note 3 - Relationship With National Health Corporation (Details) [Line Items]	'	'	'
Notes Payable, Related Parties	10,000,000	'	'
Line of Credit [Member]	'	'	'
Note 3 - Relationship With National Health Corporation (Details) [Line Items]	'	'	'
Line of Credit Facility, Maximum Borrowing Capacity	$2,000,000	'	'

Note_4_Other_Revenues_Details

Note 4 - Other Revenues (Details) (USD $)	12 Months Ended			312 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2013
National [Member]	'	'	'	'
Note 4 - Other Revenues (Details) [Line Items]	'	'	'	'
Management Fees Revenue	$3,491,000	$3,397,000	$3,539,000	$37,621,000
Unbilled Receivables, Current	21,349,000	21,333,000	21,289,000	21,349,000
Other Nursing Centers [Member]	'	'	'	'
Note 4 - Other Revenues (Details) [Line Items]	'	'	'	'
Management Fees Revenue	3,131,000	5,660,000	6,138,000	'
Elder Trust [Member]	'	'	'	'
Note 4 - Other Revenues (Details) [Line Items]	'	'	'	'
Annual Management Fees At Time Of Settlement	3,200,000	'	'	'
Centers in Missouri and Kansas [Member]	'	'	'	'
Note 4 - Other Revenues (Details) [Line Items]	'	'	'	'
Annual Management Fees At Time Of Settlement	$2,200,000	'	'	'

Note_4_Other_Revenues_Details_

Note 4 - Other Revenues (Details) - Other Revenues (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Note 4 - Other Revenues (Details) - Other Revenues [Line Items]	'	'	'
Other Revenues	$53,120	$55,616	$57,753
Insurance Services [Member]	'	'	'
Note 4 - Other Revenues (Details) - Other Revenues [Line Items]	'	'	'
Other Revenues	15,143	15,671	15,657
Management and Accounting Services Fees [Member]	'	'	'
Note 4 - Other Revenues (Details) - Other Revenues [Line Items]	'	'	'
Other Revenues	18,160	20,042	21,601
Rental Income [Member]	'	'	'
Note 4 - Other Revenues (Details) - Other Revenues [Line Items]	'	'	'
Other Revenues	19,132	19,314	19,545
Other Income [Member]	'	'	'
Note 4 - Other Revenues (Details) - Other Revenues [Line Items]	'	'	'
Other Revenues	$685	$589	$950

Note_5_NonOperating_Income_Det

Note 5 - Non-Operating Income (Details) (Caris [Member])	Dec. 31, 2013
Caris [Member]	'
Note 5 - Non-Operating Income (Details) [Line Items]	'
Equity Method Investment, Ownership Percentage	75.10%

Note_5_NonOperating_Income_Det1

Note 5 - Non-Operating Income (Details) - Non-operating Income (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Note 5 - Non-Operating Income (Details) - Non-operating Income [Line Items]	'	'	'
Non-operating Income	$30,095	$25,245	$20,533
Equity in Earnings of Unconsolidated Investments [Member]	'	'	'
Note 5 - Non-Operating Income (Details) - Non-operating Income [Line Items]	'	'	'
Non-operating Income	14,188	13,616	9,674
Dividends and Other Net Realized Gains and Losses on Sales of Securities [Member]	'	'	'
Note 5 - Non-Operating Income (Details) - Non-operating Income [Line Items]	'	'	'
Non-operating Income	5,216	7,006	5,875
Interest Income [Member]	'	'	'
Note 5 - Non-Operating Income (Details) - Non-operating Income [Line Items]	'	'	'
Non-operating Income	5,237	4,623	4,984
Gain On Recovery Of Notes Receivable [Member]	'	'	'
Note 5 - Non-Operating Income (Details) - Non-operating Income [Line Items]	'	'	'
Non-operating Income	$5,454	'	'

Note_7_Earnings_Per_Share_Deta

Note 7 - Earnings Per Share (Details) (Equity Option [Member])	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Equity Option [Member]	'	'	'
Note 7 - Earnings Per Share (Details) [Line Items]	'	'	'
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	929,000	1,068,302	1,420,620

Note_7_Earnings_Per_Share_Deta1

Note 7 - Earnings Per Share (Details) - Summary of Earnings and Weighted Average Number of Common Shares Used in Calculation of Basic and Diluted Earnings Per Share (USD $)	3 Months Ended								12 Months Ended
In Thousands, except Share data, unless otherwise specified	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Note 7 - Earnings Per Share (Details) - Summary of Earnings and Weighted Average Number of Common Shares Used in Calculation of Basic and Diluted Earnings Per Share [Line Items]	'	'	'	'	'	'	'	'	'	'	'
Weighted average common shares outstanding, basic	'	'	'	'	'	'	'	'	13,829,626	13,852,709	13,774,628
Dilutive effect of contingent issuable stock	'	'	'	'	'	'	'	'	232,118	109,233	'
Convertible preferred stock	'	'	'	'	'	'	'	'	2,623,228	2,623,329	2,623,452
Assumed average common shares outstanding	'	'	'	'	'	'	'	'	16,698,803	16,598,816	16,414,023
Net income (in Dollars)	$16,589	$19,877	$14,342	$13,805	$15,895	$17,196	$13,555	$12,654	$64,613	$59,300	$64,990
Dividends to preferred stockholders (in Dollars)	'	'	'	'	'	'	'	'	8,671	8,671	8,671
Net income available to common stockholders (in Dollars)	14,421	17,710	12,174	11,637	13,727	15,029	11,387	10,486	55,942	50,629	56,319
Add dilutive preferred stock dividends for effect of assumed conversion of preferred stock (in Dollars)	'	'	'	'	'	'	'	'	8,671	8,671	8,671
Net income for diluted earnings per common share (in Dollars)	'	'	'	'	'	'	'	'	$64,613	$59,300	$64,990
Earnings per common share, diluted (in Dollars per share)	$0.99	$1.19	$0.86	$0.82	$0.95	$1.04	$0.81	$0.75	$3.87	$3.57	$3.96
Earnings per common share, basic (in Dollars per share)	$1.04	$1.28	$0.88	$0.84	$0.99	$1.08	$0.82	$0.76	$4.05	$3.65	$4.09
Equity Option [Member]	'	'	'	'	'	'	'	'	'	'	'
Note 7 - Earnings Per Share (Details) - Summary of Earnings and Weighted Average Number of Common Shares Used in Calculation of Basic and Diluted Earnings Per Share [Line Items]	'	'	'	'	'	'	'	'	'	'	'
Dilutive effect of securities	'	'	'	'	'	'	'	'	9,091	8,019	9,934
Restricted Stock [Member]	'	'	'	'	'	'	'	'	'	'	'
Note 7 - Earnings Per Share (Details) - Summary of Earnings and Weighted Average Number of Common Shares Used in Calculation of Basic and Diluted Earnings Per Share [Line Items]	'	'	'	'	'	'	'	'	'	'	'
Dilutive effect of securities	'	'	'	'	'	'	'	'	4,740	5,526	6,009

Note_8_Investments_in_Marketab2

Note 8 - Investments in Marketable Securities (Details) (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Investments, Debt and Equity Securities [Abstract]	'	'	'
Available-for-sale Securities, Gross Unrealized Gain	$75,702,000	$80,296,000	'
Available-for-sale Securities, Gross Unrealized Loss	2,750,000	93,000	'
Proceeds from Sale and Maturity of Marketable Securities	81,389,000	62,649,000	46,266,000
Realized Investment Gains (Losses)	$39,000	$1,640,000	$754,000

Note_8_Investments_in_Marketab3

Note 8 - Investments in Marketable Securities (Details) - Marketable Securities and Restricted Marketable Securities (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Restricted investments available for sale:	'	'
	$174,060	$162,254
	247,012	242,457
Equity Securities [Member]	'	'
Investments available for sale:	'	'
Marketable equity securities	30,176	30,176
Marketable equity securities	105,009	107,250
Restricted investments available for sale:	'	'
	105,009	107,250
Corporate Debt Securities [Member]	'	'
Restricted investments available for sale:	'	'
Amortized Cost	65,852	61,453
Fair Value	65,006	62,876
	65,006	62,876
Commercial Mortgage Backed Securities [Member]	'	'
Restricted investments available for sale:	'	'
Amortized Cost	46,977	47,194
Fair Value	45,856	48,063
	45,856	48,063
US Government Corporations and Agencies Securities [Member]	'	'
Restricted investments available for sale:	'	'
Amortized Cost	22,932	16,218
Fair Value	22,841	16,604
US States and Political Subdivisions Debt Securities [Member]	'	'
Restricted investments available for sale:	'	'
Amortized Cost	8,123	7,213
Fair Value	8,300	7,664
	$8,300	$7,664

Note_8_Investments_in_Marketab4

Note 8 - Investments in Marketable Securities (Details) - Available for Sale Marketable Equity Securities (NHI Common Stock [Member], USD $)	Dec. 31, 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	$91,479	$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 $)	Dec. 31, 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	$9,279	$8,868
Within 1 year	9,324	8,918
1 to 5 years	91,787	80,910
1 to 5 years	92,011	82,801
6 to 10 years	40,387	40,670
6 to 10 years	38,335	41,856
Over 10 years	2,431	1,630
Over 10 years	2,333	1,632
	143,884	132,078
	$142,003	$135,207

Note_9_Fair_Value_Measurements2

Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level (USD $)	Dec. 31, 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	$81,705	$66,701
Restricted cash and cash equivalents	13,929	11,563
Available for sale securities	247,012	242,457
Total financial assets	342,646	320,721
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	105,009	107,250
Equity Securities [Member]	'	'
Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level [Line Items]	'	'
Available for sale securities	105,009	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	65,006	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	65,006	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	45,856	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	45,856	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	22,841	'
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	22,841	'
US States and Political Subdivisions 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	8,300	7,664
US States and Political Subdivisions Debt Securities [Member]	'	'
Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level [Line Items]	'	'
Available for sale securities	8,300	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	81,705	66,701
Restricted cash and cash equivalents	13,929	11,563
Total financial assets	223,484	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	$119,162	$118,603

Note_10_Property_and_Equipment2

Note 10 - Property and Equipment (Details) - Property and Equipment at Cost (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Property and Equipment at Cost [Abstract]	'	'
Land	$57,272	$50,711
Leasehold improvements	94,066	90,925
Buildings and improvements	427,471	396,228
Furniture and equipment	134,255	126,288
Construction in progress	21,618	11,303
	734,682	675,455
Less: Accumulated depreciation	-277,884	-254,548
	$456,798	$420,907

Note_11_Notes_Receivable_Detai

Note 11 - Notes Receivable (Details) (USD $)	Dec. 31, 2013	Dec. 31, 2012
Note 11 - Notes Receivable (Details) [Line Items]	'	'
Financing Receivable, Gross (in Dollars)	$15,378,000	$21,789,000
Minimum [Member] | Prime Rate [Member]	'	'
Note 11 - Notes Receivable (Details) [Line Items]	'	'
Loans Receivable, Basis Spread on Variable Rate	2.00%	'
Maximum [Member] | Prime Rate [Member]	'	'
Note 11 - Notes Receivable (Details) [Line Items]	'	'
Loans Receivable, Basis Spread on Variable Rate	8.50%	'

Note_12_LongTerm_Debt_Details

Note 12 - Long-Term Debt (Details) (USD $)	12 Months Ended
	Dec. 31, 2013
Eurodollar [Member] | Revolving Credit Facility [Member]	'
Note 12 - Long-Term Debt (Details) [Line Items]	'
Debt Instrument, Basis Spread on Variable Rate	0.70%
Revolving Credit Facility [Member]	'
Note 12 - Long-Term Debt (Details) [Line Items]	'
Line of Credit Facility, Maximum Borrowing Capacity (in Dollars)	75,000,000
Line of Credit Facility, Unused Capacity, Commitment Fee Percentage (in Basis Points)	0.20%
Line of Credit Facility, Expiration Date	22-Oct-14
Letter of Credit [Member]	'
Note 12 - Long-Term Debt (Details) [Line Items]	'
Line of Credit Facility, Maximum Borrowing Capacity (in Dollars)	5,000,000
Line of Credit Facility, Commitment Fee Percentage	0.10%

Note_12_LongTerm_Debt_Details_

Note 12 - Long-Term Debt (Details) - Long-term Debt (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Note 12 - Long-Term Debt (Details) - Long-term Debt [Line Items]	'	'
Long-term Debt	$10,000	$10,000
	10,000	10,000
Unsecured Term Note Payable [Member]	'	'
Note 12 - Long-Term Debt (Details) - Long-term Debt [Line Items]	'	'
Weighted Average Interest Rate, Variable	2.80%	'
Maturities	'2018	'
Long-term Debt	$10,000	$10,000
Revolving Credit Facility [Member]	'	'
Note 12 - Long-Term Debt (Details) - Long-term Debt [Line Items]	'	'
Weighted Average Interest Rate, Variable	0.90%	'
Maturities	'2014	'

Note_12_LongTerm_Debt_Details_1

Note 12 - Long-Term Debt (Details) - Aggregate Maturities of Long-term Debt (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Aggregate Maturities of Long-term Debt [Abstract]	'	'
2018	$10,000	'
Total	$10,000	$10,000

Note_13_Income_Taxes_Details

Note 13 - Income Taxes (Details) (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010
Note 13 - Income Taxes (Details) [Line Items]	'	'	'	'
Adjustment to Additional Paid in Capital, Income Tax Effect from Share-based Compensation, Net	$225,000	$267,000	$52,000	'
Unrecognized Tax Benefits, Period Increase (Decrease)	-2,802,000	-4,309,000	-2,387,000	'
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations	-1,605,000	-3,187,000	-3,992,000	'
Entity Not Subject to Income Taxes, Difference in Bases, Amount	976,000	2,310,000	'	'
Unrecognized Tax Benefits	'	11,996,000	13,765,000	'
Deferred Tax Assets, Net	'	8,292,000	9,308,000	'
Unrecognized Tax Benefits, Income Tax Penalties and Interest Accrued	2,072,000	1,894,000	2,479,000	'
Unrecognized Tax Benefits that Would Impact Effective Tax Rate	4,200,000	3,704,000	4,457,000	'
Income Tax Examination, Penalties and Interest Expense	178,000	585,000	1,871,000	'
Scenario, Forecast [Member] | Permanent Differences [Member]	'	'	'	'
Note 13 - Income Taxes (Details) [Line Items]	'	'	'	'
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations	940,000	'	'	'
Scenario, Forecast [Member] | Temporary Difference [Member]	'	'	'	'
Note 13 - Income Taxes (Details) [Line Items]	'	'	'	'
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations	1,390,000	'	'	'
Scenario, Forecast [Member]	'	'	'	'
Note 13 - Income Taxes (Details) [Line Items]	'	'	'	'
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations	2,330,000	'	'	'
Unrecognized Tax Benefits, Income Tax Penalties and Interest Accrued	566,000	'	'	'
Temporary Difference [Member]	'	'	'	'
Note 13 - Income Taxes (Details) [Line Items]	'	'	'	'
Unrecognized Tax Benefits, Period Increase (Decrease)	1,817,000	'	'	'
Unrecognized Tax Benefits, Income Tax Penalties and Interest Accrued	'	'	0	'
Permanent Differences [Member]	'	'	'	'
Note 13 - Income Taxes (Details) [Line Items]	'	'	'	'
Unrecognized Tax Benefits, Period Increase (Decrease)	985,000	'	-2,387,000	'
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations	'	'	1,605,000	'
Unrecognized Tax Benefits	'	3,704,000	4,457,000	'
Unrecognized Tax Benefits, Income Tax Penalties and Interest Accrued	'	1,531,000	1,650,000	'
Interest and Penalties [Member]	'	'	'	'
Note 13 - Income Taxes (Details) [Line Items]	'	'	'	'
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations	'	'	1,605,000	'
Temporary Difference [Member]	'	'	'	'
Note 13 - Income Taxes (Details) [Line Items]	'	'	'	'
Unrecognized Tax Benefits, Period Increase (Decrease)	'	'	0	'
Liability For Interest and Penalties [Member]	'	'	'	'
Note 13 - Income Taxes (Details) [Line Items]	'	'	'	'
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations	661,000	940,000	1,605,000	'
Unrecognized Tax Benefits	2,072,000	1,894,000	2,479,000	4,350,000
Permanent Differences [Member]	'	'	'	'
Note 13 - Income Taxes (Details) [Line Items]	'	'	'	'
Unrecognized Tax Benefits, Period Increase (Decrease)	'	2,310,000	'	'
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations	451,000	707,000	'	'
Unrecognized Tax Benefits	4,200,000	'	'	'
Unrecognized Tax Benefits, Income Tax Penalties and Interest Accrued	1,835,000	'	'	'
Temporary Difference [Member]	'	'	'	'
Note 13 - Income Taxes (Details) [Line Items]	'	'	'	'
Unrecognized Tax Benefits, Period Increase (Decrease)	'	1,999,000	'	'
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations	178,000	170,000	'	'
Liability For Unrecognized Tax Benefits [Member]	'	'	'	'
Note 13 - Income Taxes (Details) [Line Items]	'	'	'	'
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations	2,802,000	4,309,000	2,387,000	'
Unrecognized Tax Benefits	12,453,000	11,996,000	13,765,000	14,511,000
Deferred Tax Assets [Member]	'	'	'	'
Note 13 - Income Taxes (Details) [Line Items]	'	'	'	'
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations	2,177,000	1,999,000	93,000	'
Unrecognized Tax Benefits	8,598,000	8,655,000	9,926,000	10,089,000
Deferred Tax Assets, Net	$8,253,000	'	'	'

Note_13_Income_Taxes_Details_P

Note 13 - Income Taxes (Details) - Provision for Income Taxes (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Current Tax Provision	'	'	'
Federal	$34,680	$29,147	$29,311
State	5,588	4,010	3,131
	40,268	33,157	32,442
Deferred Tax Provision	'	'	'
Federal	-2,226	892	1,719
State	-479	132	233
	-2,705	1,024	1,952
Income Tax Provision	$37,563	$34,181	$34,394

Note_13_Income_Taxes_Details_D

Note 13 - Income Taxes (Details) - Deferred Tax Assets and Liabilities (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Current deferred tax asset:	'	'
Allowance for doubtful accounts receivable	$1,802	$1,022
Accrued expenses	7,489	7,490
	9,291	8,512
Current deferred tax liability:	'	'
Unrealized gains on marketable securities	-28,526	-31,154
Other	-1,922	-1,832
	-30,448	-32,986
Net current deferred tax liability	-21,157	-24,474
Noncurrent deferred tax asset:	'	'
Financial reporting depreciation in excess of tax depreciation	5,872	4,086
Deferred gain on sale of assets (net)	-3,135	-3,135
Tax basis intangible asset in excess of financial reporting basis	127	663
Stock-based compensation	2,214	1,682
Long-term investments	-2,276	-1,387
Obligation to provide future services	1,439	698
Accrued expenses	2,502	2,132
Deferred revenue	6,096	6,523
Net noncurrent deferred tax asset	14,531	12,817
Nonrefundable Entrance Fees [Member]	'	'
Noncurrent deferred tax asset:	'	'
Entrance fees	45	'
Refundable Entrance Fees [Member]	'	'
Noncurrent deferred tax asset:	'	'
Entrance fees	$1,647	$1,555

Note_13_Income_Taxes_Details_R

Note 13 - Income Taxes (Details) - Reconciliation of Income Tax Expense (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Reconciliation of Income Tax Expense [Abstract]	'	'	'
Tax provision at federal statutory rate	$35,762,000	$32,718,000	$34,784,000
Increase (decrease) in income taxes	'	'	'
State, net of federal benefit	2,325,000	3,261,000	3,246,000
Nondeductible expenses	197,000	118,000	188,000
Insurance expense	35,000	39,000	26,000
Other, net	-258,000	823,000	57,000
Unrecognized tax benefits	1,107,000	409,000	85,000
Expiration of statute of limitations	-1,605,000	-3,187,000	-3,992,000
	1,801,000	1,463,000	-390,000
Effective income tax expense	$37,563,000	$34,181,000	$34,394,000

Note_13_Income_Taxes_Details_R1

Note 13 - Income Taxes (Details) - Reconciliation of Unrecognized Tax Benefits (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Note 13 - Income Taxes (Details) - Reconciliation of Unrecognized Tax Benefits [Line Items]	'	'	'
Balance	$11,996,000	$13,765,000	'
Reductions for statute of limitation expirations	1,605,000	3,187,000	3,992,000
Balance	'	11,996,000	13,765,000
Deferred Tax Assets [Member]	'	'	'
Note 13 - Income Taxes (Details) - Reconciliation of Unrecognized Tax Benefits [Line Items]	'	'	'
Balance	8,655,000	9,926,000	10,089,000
Additions for tax positions of prior years	2,120,000	728,000	-70,000
Reductions for statute of limitation expirations	-2,177,000	-1,999,000	-93,000
Balance	8,598,000	8,655,000	9,926,000
Liability For Unrecognized Tax Benefits [Member]	'	'	'
Note 13 - Income Taxes (Details) - Reconciliation of Unrecognized Tax Benefits [Line Items]	'	'	'
Balance	11,996,000	13,765,000	14,511,000
Additions based on tax positions related to the current year	1,832,000	1,695,000	1,452,000
Additions for tax positions of prior years	1,427,000	845,000	189,000
Reductions for statute of limitation expirations	-2,802,000	-4,309,000	-2,387,000
Balance	12,453,000	11,996,000	13,765,000
Liability For Interest and Penalties [Member]	'	'	'
Note 13 - Income Taxes (Details) - Reconciliation of Unrecognized Tax Benefits [Line Items]	'	'	'
Balance	1,894,000	2,479,000	4,350,000
Additions based on tax positions related to the current year	198,000	185,000	183,000
Additions for tax positions of prior years	641,000	170,000	-449,000
Reductions for statute of limitation expirations	-661,000	-940,000	-1,605,000
Balance	2,072,000	1,894,000	2,479,000
Total Liability [Member]	'	'	'
Note 13 - Income Taxes (Details) - Reconciliation of Unrecognized Tax Benefits [Line Items]	'	'	'
Balance	13,890,000	16,244,000	18,861,000
Additions based on tax positions related to the current year	2,030,000	1,880,000	1,635,000
Additions for tax positions of prior years	2,068,000	1,015,000	-260,000
Reductions for statute of limitation expirations	-3,463,000	-5,249,000	-3,992,000
Balance	$14,525,000	$13,890,000	$16,244,000

Note_14_Stock_Repurchase_Progr1

Note 14 - Stock Repurchase Program (Details) (USD $)	1 Months Ended
In Millions, except Share data, unless otherwise specified	Aug. 31, 2013	Feb. 28, 2013	Aug. 31, 2012
Disclosure Text Block Supplement [Abstract]	'	'	'
Stock Repurchase Program, Authorized Amount	$25	'	$25
Stock Repurchased During Period, Shares (in Shares)	'	100,000	'
Stock Repurchased During Period, Value	'	$4.70	'

Note_15_StockBased_Compensatio2

Note 15 - Stock-Based Compensation (Details) (USD $)

12 Months Ended

12 Months Ended

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2011

Dec. 31, 2013

Dec. 31, 2013

Dec. 31, 2013

Dec. 31, 2013

Dec. 31, 2013

Dec. 31, 2013

31-May-05

Dec. 31, 2013

31-May-10

Dec. 31, 2013

Incentive Stock Option [Member]

Incentive Stock Option [Member]

Nonbqualified Option [Member]

Employee Stock Option [Member]

Restricted Stock [Member]

2005 Plan [Member]

2005 Plan [Member]

2010 Plan [Member]

2010 Plan [Member]

Plans 2005 and 2010 [Member]

Minimum [Member]

Minimum [Member]

Note 15 - Stock-Based Compensation (Details) [Line Items]

'

'

'

'

'

'

'

'

'

'

'

'

'

Share-based Compensation Arrangement by Share-based Payment Award, Purchase Price of Common Stock, Percent

'

'

'

'

100.00%

100.00%

'

'

'

'

'

'

'

Share-based Compensation Arrangement by Share-based Payment Award, Expiration Period

'

'

'

'10 years

'

'

'

'

'

'

'

'

'5 years

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

'

411,260

'

'

Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period

'

'

'

'

'

'

'

'

'

'

'

'

'5 years

Allocated Share-based Compensation Expense

$2,298,000

$2,366,000

$2,751,000

'

'

'

$2,091,000

$207,000

'

'

'

'

'

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

3,936,000

'

'

'

'

'

3,657,000

279,000

'

'

'

'

'

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

'

'

'

'

'

'

'2 years 73 days

'292 days

'

'

'

'

'

Employee Service Share-based Compensation, Tax Benefit Realized from Exercise of Stock Options

196,000

404,000

1,054,000

'

'

'

'

'

'

'

'

'

'

Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercisable, Number (in Shares)

145,552

'

'

'

'

'

'

'

'

'

'

'

'

Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range, Lower Range Limit (in Dollars per share)

$37.70

'

'

'

'

'

'

'

'

'

'

'

'

Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range, Upper Range Limit (in Dollars per share)

$47.45

'

'

'

'

'

'

'

'

'

'

'

'

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

'2 years 109 days

'

'

'

'

'

'

'

'

'

'

'

'

Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period, Intrinsic Value

$336,000

'

'

'

'

'

'

'

'

'

'

'

'

Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Outstanding, Weighted Average Remaining Contractual Terms

'

'

'

'

'

'

'

'292 days

'

'

'

'

'

Note_15_StockBased_Compensatio3

Note 15 - Stock-Based Compensation (Details) - Summary of Assumptions Used To Value Options Granted	9 Months Ended	12 Months Ended
	Sep. 30, 2013	Dec. 31, 2012	Dec. 31, 2011
Summary of Assumptions Used To Value Options Granted [Abstract]	'	'	'
Risk-free interest rate	0.25%	0.28%	2.02%
Expected volatility	31.30%	38.80%	23.70%
Expected life, in years	'2 years 36 days	'2 years 36 days	'4 years 292 days
Expected dividend yield	2.81%	2.91%	3.62%

Note_15_StockBased_Compensatio4

Note 15 - Stock-Based Compensation (Details) - Summary of Outstanding Stock Options (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Summary of Outstanding Stock Options [Abstract]	'	'	'
Options outstanding at January 1, 2011	1,134,602	1,482,077	472,327
Options outstanding at January 1, 2011 (in Dollars per share)	$46.75	$46.92	$43.07
Number of Shares	59,472	63,516	1,264,719
Weighted Average Exercise Price (in Dollars per share)	$47.95	$44.28	$46.58
Number of Shares	-21,522	-295,371	-224,969
Weighted Average Exercise Price (in Dollars per share)	$45.63	$45.41	$37.30
Number of Shares	-98,000	-115,620	-30,000
Weighted Average Exercise Price (in Dollars per share)	$51.11	$50.99	$44.25
Number of Shares	1,074,552	1,134,602	1,482,077
Weighted Average Exercise Price (in Dollars per share)	$46.44	$46.75	$46.92
Aggregate Intrinsic Value (in Dollars)	$8,027,000	'	'
Options exercisable	145,552	'	'
Options exercisable (in Dollars per share)	$44.84	'	'
Options exercisable (in Dollars)	$1,320,000	'	'

Note_15_StockBased_Compensatio5

Note 15 - Stock-Based Compensation (Details) - Options Outstanding	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2013
	USD ($)	Exercise Price Range 1 [Member]	Exercise Price Range 2 [Member]	Exercise Price Range 2 [Member]	Exercise Price Range 2 [Member]
		USD ($)	USD ($)	Minimum [Member]	Maximum [Member]
				USD ($)	AFN
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]	'	'	'	'	'
Options Outstanding (in Shares)	1,074,552	21,750	1,052,802	'	'
Exercise Prices, Lower Range Limit	$37.70	'	'	$44.80	'
Weighted Average Exercise Price	$46.44	$37.70	$46.62	'	'
Exercise Prices, Upper Range Limit (in Afghanis per share)	$47.45	'	'	'	47.45
Weighted Average Remaining Contractual Life in Years	'2 years 109 days	'109 days	'2 years 146 days	'	'

Note_15_StockBased_Compensatio6

Note 15 - Stock-Based Compensation (Details) - Summary of Restricted Stock Activity (Restricted Stock [Member], USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Restricted Stock [Member]	'	'	'
Note 15 - Stock-Based Compensation (Details) - Summary of Restricted Stock Activity [Line Items]	'	'	'
Unvested restricted shares at January 1, 2011	18,000	24,000	30,000
Unvested restricted shares at January 1, 2011 (in Dollars per share)	$34.46	$34.46	$34.46
Number of Shares	6,000	6,000	6,000
Weighted Average Grant Date Fair Value (in Dollars per share)	$34.46	$34.46	$34.46
Number of Shares	12,000	18,000	24,000
Weighted Average Grant Date Fair Value (in Dollars per share)	$34.46	$34.46	$34.46
Aggregate Intrinsic Value (in Dollars)	$233,000	'	'

Note_16_Contingencies_and_Guar1

Note 16 - Contingencies and Guarantees (Details) (USD $)

0 Months Ended

1 Months Ended

3 Months Ended

12 Months Ended

36 Months Ended

12 Months Ended

9 Months Ended

12 Months Ended

Sep. 04, 2012

Apr. 26, 2013

Sep. 30, 2013

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2010

Dec. 31, 2007

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2011

Sep. 30, 2011

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2013

Dec. 31, 2013

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]

Coverage Amount per Incident [Member]

Coverage Amount per Location [Member]

Note 16 - Contingencies and Guarantees (Details) [Line Items]

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Self Insurance Reserve

'

'

'

$110,557,000

$110,331,000

'

'

'

'

'

'

'

'

'

'

Direct Business Coverage Statutory Limits

'

'

'

1,000,000

'

'

'

'

'

'

'

'

'

'

'

Premiums Earned, Net, Other Insurance

'

'

'

'

'

'

'

7,720,000

5,438,000

4,910,000

4,383,000

3,418,000

4,203,000

'

'

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

'

'

'

'

'

'

'

'

Number of Senior Trust Subsidiaries

10

'

2

'

'

'

'

'

'

'

'

'

'

'

'

Payments for Legal Settlements

'

6,650,000

'

'

'

'

'

'

'

'

'

'

'

'

'

Litigation Settlement, Expense

'

5,195,000

'

'

'

'

'

'

'

'

'

'

'

'

'

Decrease in Operating Expense

'

'

5,257,000

'

'

'

'

'

'

'

'

'

'

'

'

Loss Contingency, Loss in Period

'

'

'

$2,505,000

'

'

'

'

'

'

'

'

'

'

'

Note_17_Equity_Method_Investme2

Note 17 - Equity Method Investment in Caris HealthCare, L.P. (Details) (Caris [Member], USD $)	Dec. 31, 2013	Dec. 31, 2012
Caris [Member]	'	'
Note 17 - Equity Method Investment in Caris HealthCare, L.P. (Details) [Line Items]	'	'
Equity Method Investment, Ownership Percentage	75.10%	'
Equity Method Investments	$37,185,000	$38,463,000

Note_17_Equity_Method_Investme3

Note 17 - Equity Method Investment in Caris HealthCare, L.P. (Details) - Summary of Financial Information of Caris (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Summary of Financial Information of Caris [Abstract]	'	'	'
Current assets	$25,212	$30,731	$18,219
Noncurrent assets	11,685	9,051	978
Liabilities	8,879	9,365	7,623
Partnersb capital	28,018	30,417	11,574
Revenue	58,918	59,422	44,454
Expenses	40,112	40,341	28,018
Net income	$18,806	$19,081	$16,436

Note_18_Variable_Interest_Enti1

Note 18 - Variable Interest Entity (Details) (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2010
Variable Interest Entity [Abstract]	'	'	'
Number of Variable Interest Entities	'	'	1
Number Of Patient Beds In Facility	'	'	120
Lessee Leasing Arrangements, Operating Leases, Term of Contract	'	'	'10 years
Number of Additional Lease Options	'	'	5
Lessee Leasing Arrangements, Operating Leases, Renewal Term	'	'	'5 years
Notes, Loans and Financing Receivable, Gross, Current	'	'	$4,500,000
Increase (Decrease) in Notes Payable, Current	4,500,000	4,500,000	'
Land and Land Improvements	'	'	$4,500,000

Note_19_Series_A_Convertible_P1

Note 19 - Series A Convertible Preferred Stock (Details) (USD $)	Dec. 31, 2013	Dec. 31, 2012	Oct. 31, 2007
			Convertible Preferred Stock [Member]
Note 19 - Series A Convertible Preferred Stock (Details) [Line Items]	'	'	'
Preferred Stock, Value, Issued (in Dollars)	$170,510,000	$170,514,000	$170,555,000
Preferred Stock, Liquidation Preference Per Share	$15.75	$15.75	$15.75
Preferred Stock, Dividend Rate, Per-Dollar-Amount	'	'	$0.80
Preferred Stock Conversion Price	'	'	$65.07
Convertible Preferred Stock, Shares Issued upon Conversion (in Shares)	'	'	0.24204
Preferred Stock, Redemption Price Per Share	'	'	$15.75

Note_20_Series_B_Junior_Partic1

Note 20 - Series B Junior Participating Preferred Stock (Details) (USD $)	Dec. 31, 2013	Dec. 31, 2012	Aug. 02, 2007
Note 20 - Series B Junior Participating Preferred Stock (Details) [Line Items]	'	'	'
Dividend Distribution Rights (in Shares)	'	'	1
Preferred Stock, Par or Stated Value Per Share	$0.01	$0.01	'
Series B Junior Participating Preferred Stock [Member]	'	'	'
Note 20 - Series B Junior Participating Preferred Stock (Details) [Line Items]	'	'	'
Preferred Stock, Par or Stated Value Per Share	'	'	0.01
Preferred Stock, Redemption Price Per Share	'	'	250

Note_21_Selected_Quarterly_Fin2

Note 21 - Selected Quarterly Financial Data (Details) - Selected Quarterly Financial Data (USD $)	3 Months Ended								12 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Selected Quarterly Financial Data [Abstract]	'	'	'	'	'	'	'	'	'	'	'
Net Operating Revenues	$206,796	$195,772	$192,011	$194,378	$193,977	$189,307	$187,668	$190,050	$788,957	$761,002	$773,242
Income Before Non-Operating Income	19,819	19,265	17,001	15,996	20,530	16,610	16,390	14,706	72,081	68,236	78,851
Non-Operating Income	5,674	11,171	6,632	6,618	6,699	6,771	5,907	5,868	'	'	'
Net Income	16,589	19,877	14,342	13,805	15,895	17,196	13,555	12,654	64,613	59,300	64,990
Preferred Dividends	2,168	2,167	2,168	2,168	2,168	2,167	2,168	2,168	8,671	8,671	8,671
Net Income Available to Common Stockholders	$14,421	$17,710	$12,174	$11,637	$13,727	$15,029	$11,387	$10,486	$55,942	$50,629	$56,319
Basic Earnings Per Share (in Dollars per share)	$1.04	$1.28	$0.88	$0.84	$0.99	$1.08	$0.82	$0.76	$4.05	$3.65	$4.09
Diluted Earnings Per Share (in Dollars per share)	$0.99	$1.19	$0.86	$0.82	$0.95	$1.04	$0.81	$0.75	$3.87	$3.57	$3.96