National HealthCare (NHC) 10-Q 5 Nov 14 2014 Q3 Quarterly report Financial data

Document_And_Entity_Informatio

Document And Entity Information	9 Months Ended
	Sep. 30, 2014	Oct. 30, 2014
Document and Entity Information [Abstract]	'	'
Entity Registrant Name	'NATIONAL HEALTHCARE CORP	'
Document Type	'10-Q	'
Current Fiscal Year End Date	'--12-31	'
Entity Common Stock, Shares Outstanding	'	14,098,343
Amendment Flag	'false	'
Entity Central Index Key	'0001047335	'
Entity Current Reporting Status	'Yes	'
Entity Voluntary Filers	'No	'
Entity Filer Category	'Accelerated Filer	'
Entity Well-known Seasoned Issuer	'No	'
Document Period End Date	30-Sep-14	'
Document Fiscal Year Focus	'2014	'
Document Fiscal Period Focus	'Q3	'

Interim_Condensed_Consolidated

Interim Condensed Consolidated Statements of Income (Unaudited) (USD $)	3 Months Ended		9 Months Ended
	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Revenues:	'	'	'	'
Net patient revenues	$207,772,000	$182,966,000	$613,173,000	$539,797,000
Other revenues	10,451,000	12,806,000	32,136,000	42,364,000
Net operating revenues	218,223,000	195,772,000	645,309,000	582,161,000
Cost and Expenses:	'	'	'	'
Salaries, wages and benefits	128,938,000	113,739,000	374,277,000	330,160,000
Other operating	55,365,000	45,752,000	166,803,000	148,891,000
Facility rent	9,913,000	9,889,000	29,712,000	29,627,000
Depreciation and amortization	8,639,000	7,045,000	25,144,000	20,973,000
Interest	632,000	82,000	1,566,000	248,000
Total costs and expenses	203,487,000	176,507,000	597,502,000	529,899,000
Income Before Non-Operating Income	14,736,000	19,265,000	47,807,000	52,262,000
Non-Operating Income	3,937,000	11,171,000	12,790,000	24,421,000
Income Before Income Taxes	18,673,000	30,436,000	60,597,000	76,683,000
Income Tax Provision	-5,844,000	-10,559,000	-22,028,000	-28,659,000
Net Income	12,829,000	19,877,000	38,569,000	48,024,000
Dividends to Preferred Stockholders	-2,167,000	-2,167,000	-6,502,000	-6,503,000
Net Income Available to Common Stockholders	$10,662,000	$17,710,000	$32,067,000	$41,521,000
Earnings Per Common Share:	'	'	'	'
Basic (in Dollars per share)	$0.77	$1.28	$2.32	$3
Diluted (in Dollars per share)	$0.75	$1.19	$2.25	$2.88
Weighted Average Common Shares Outstanding:	'	'	'	'
Basic (in Shares)	13,805,430	13,820,449	13,838,891	13,832,706
Diluted (in Shares)	14,236,512	16,686,915	14,230,031	16,701,491
Dividends Declared Per Common Share (in Dollars per share)	$0.34	$0.32	$1	$0.94

Interim_Condensed_Consolidated1

Interim Condensed Consolidated Statements of Comprehensive Income (Unaudited) (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Net Income	$12,829	$19,877	$38,569	$48,024
Other Comprehensive Income (Loss):	'	'	'	'
Unrealized gains (losses) on investments in marketable securities	-9,707	-5,629	5,584	-3,471
Reclassification adjustment for realized gains on sale of securities	'	911	-172	527
Income tax (expense) benefit related to items of other comprehensive income	3,761	1,889	-2,035	993
Other comprehensive income (loss), net of tax	-5,946	-2,829	3,377	-1,951
Comprehensive Income	$6,883	$17,048	$41,946	$46,073

Interim_Condensed_Consolidated2

Interim Condensed Consolidated Balance Sheets (Current Period Unaudited) (USD $)	Sep. 30, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified
Current Assets:	'	'
Cash and cash equivalents	$76,917	$81,705
Restricted cash and cash equivalents	10,075	10,298
Marketable securities	108,529	105,009
Restricted marketable securities	14,235	14,027
Accounts receivable, less allowance for doubtful accounts of $6,864 and $4,972, respectively	73,417	79,856
Inventories	7,362	7,146
Prepaid expenses	1,913	1,208
Notes receivable	435	417
Federal income tax receivable	5,953	'
Total current assets	298,836	299,666
Property and Equipment:	'	'
Property and equipment, at cost	806,470	734,682
Accumulated depreciation and amortization	-299,057	-277,884
Net property and equipment	507,413	456,798
Other Assets:	'	'
Restricted cash and cash equivalents	3,631	3,631
Restricted marketable securities	139,138	127,976
Deposits and other assets	7,056	6,808
Goodwill	17,600	17,600
Notes receivable	12,664	14,961
Deferred income taxes	21,438	18,164
Investments in limited liability companies	35,226	38,754
Total other assets	236,753	227,894
Total assets	1,043,002	984,358
Current Liabilities:	'	'
Trade accounts payable	13,607	13,050
Capital lease obligations, current portion	3,042	'
Accrued payroll	54,423	63,462
Amounts due to third party payors	24,112	21,619
Accrued risk reserves, current portion	24,310	24,325
Deferred income taxes	25,582	24,790
Other current liabilities	14,269	13,784
Dividends payable	6,998	6,730
Total current liabilities	166,343	167,760
Long-term debt	10,000	10,000
Capital lease obligations, less current portion	34,297	'
Accrued risk reserves, less current portion	88,526	86,232
Refundable entrance fees	10,320	10,720
Obligation to provide future services	3,689	3,689
Other noncurrent liabilities	15,631	14,525
Deferred revenue	4,079	3,320
Stockholders’ Equity:	'	'
Series A Convertible Preferred Stock; $.01 par value; 25,000,000 shares authorized; 10,836,659 and 10,837,665 shares, respectively, issued and outstanding; stated at liquidation value of $15.75 per share	170,494	170,510
Common stock, $.01 par value; 30,000,000 shares authorized; 14,098,343 and 14,078,028 shares, respectively, issued and outstanding	140	140
Capital in excess of par value	153,819	153,061
Retained earnings	336,102	318,216
Accumulated other comprehensive income	49,562	46,185
Total stockholders’ equity	710,117	688,112
Total liabilities and stockholders’ equity	$1,043,002	$984,358

Interim_Condensed_Consolidated3

Interim Condensed Consolidated Balance Sheets (Current Period Unaudited) (Parentheticals) (USD $)	Sep. 30, 2014	Dec. 31, 2013
In Thousands, except Share data, unless otherwise specified
Allowance for doubtful accounts (in Dollars)	$6,864	$4,972
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	10,836,659	10,837,665
Series A Convertible Preferred Stock; shares outstanding	10,836,659	10,837,665
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	14,098,343	14,078,028
Common stock, shares outstanding	14,098,343	14,078,028

Interim_Condensed_Consolidated4

Interim Condensed Consolidated Statements of Cash Flows (Unaudited) (USD $)	9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013
Cash Flows From Operating Activities:	'	'
Net income	$38,569	$48,024
Adjustments to reconcile net income to net cash provided by operating activities:	'	'
Depreciation and amortization	25,144	20,973
Provision for doubtful accounts receivable	5,001	2,331
Equity in earnings of unconsolidated investments	-5,069	-11,542
Distributions from unconsolidated investments	10,272	15,456
Gain on recovery of notes receivable	'	-5,454
(Gains) losses on sale of restricted marketable securities	-172	527
Deferred income taxes	-4,517	-2,130
Stock-based compensation	1,547	1,812
Changes in operating assets & liabilities, net of the effect of acquisitions:	'	'
Restricted cash and cash equivalents	-6,033	-8,721
Accounts receivable	1,438	-5,199
Income tax receivable	-5,953	5,933
Inventories	-216	-418
Prepaid expenses	-705	-884
Trade accounts payable	557	1,967
Accrued payroll	-9,039	19,402
Amounts due to third party payors	2,493	1,742
Other current liabilities and accrued risk reserves	2,764	5,662
Other noncurrent liabilities	1,106	136
Deferred revenue	759	547
Net cash provided by operating activities	57,946	90,164
Cash Flows From Investing Activities:	'	'
Additions to property and equipment	-36,727	-33,981
Investments in unconsolidated limited liability companies	-1,675	'
Acquisition of non-controlling interest	-768	'
Acquisition of six skilled nursing facilities	'	-21,000
Investments in notes receivable	-767	'
Collections of notes receivable	3,046	13,813
Change in restricted cash and cash equivalents	6,256	8,135
Purchase of restricted marketable securities	-36,947	-68,978
Sale of restricted marketable securities	27,641	57,904
Net cash used in investing activities	-39,941	-44,107
Cash Flows From Financing Activities:	'	'
Tax benefit (expense) from stock-based compensation	201	-225
Principal payments under capital lease obligations	-1,693	'
Dividends paid to preferred stockholders	-6,502	-6,503
Dividends paid to common stockholders	-13,913	-12,973
Issuance of common shares	6,757	270
Repurchase of common shares	-6,995	-4,700
Entrance fee refunds	-400	-80
Change in deposits	-248	-137
Net cash used in financing activities	-22,793	-24,348
Net (Decrease) Increase in Cash and Cash Equivalents	-4,788	21,709
Cash and Cash Equivalents, Beginning of Period	81,705	66,701
Cash and Cash Equivalents, End of Period	76,917	88,410
Supplemental disclosure of non-cash investing and financing activities:	'	'
Buildings, personal property, and obligations recorded under capital lease agreements	$39,032	'

Interim_Condensed_Consolidated5

Interim Condensed Consolidated Statements of Stockholders’ Equity (Unaudited) (USD $)	Preferred Stock [Member]	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	Accumulated Other Comprehensive Income (Loss) [Member]	Total
In Thousands, except Share data
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	'	'	'	48,024	'	48,024
Other comprehensive income	'	'	'	'	-1,951	-1,951
Stock-based compensation	'	'	1,812	'	'	1,812
Tax expense from exercise of stock options	'	'	-225	'	'	-225
Shares sold – options exercised	'	'	270	'	'	270
Shares sold – options exercised (in Shares)	'	5,150	'	'	'	'
Repurchase of common stock	'	-1	-4,699	'	'	-4,700
Repurchase of common stock (in Shares)	'	-100,000	'	'	'	'
Shares issued in conversion of preferred stock to common stock	-4	'	4	'	'	'
Shares issued in conversion of preferred stock to common stock (in Shares)	-717	172	'	'	'	'
Dividends declared to preferred stockholders	'	'	'	-6,503	'	-6,503
Dividends declared to common stockholders	'	'	'	-13,219	'	-13,219
Balance at Sep. 30, 2013	170,510	140	151,854	308,295	48,857	679,656
Balance (in Shares) at Sep. 30, 2013	10,837,695	14,063,449	'	'	'	'
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	'	'	'	'
Net income	'	'	'	38,569	'	38,569
Other comprehensive income	'	'	'	'	3,377	3,377
Stock-based compensation	'	'	1,547	'	'	1,547
Tax expense from exercise of stock options	'	'	201	'	'	201
Shares sold – options exercised	'	1	6,756	'	'	6,757
Shares sold – options exercised (in Shares)	'	145,074	'	'	'	145,074
Repurchase of common stock	'	-1	-6,994	'	'	-6,995
Repurchase of common stock (in Shares)	'	-125,000	'	'	'	'
Shares issued in conversion of preferred stock to common stock	-16	'	16	'	'	'
Shares issued in conversion of preferred stock to common stock (in Shares)	-1,006	241	'	'	'	'
Acquisition of non-controlling interest	'	'	-768	'	'	-768
Dividends declared to preferred stockholders	'	'	'	-6,502	'	-6,502
Dividends declared to common stockholders	'	'	'	-14,181	'	-14,181
Balance at Sep. 30, 2014	$170,494	$140	$153,819	$336,102	$49,562	$710,117
Balance (in Shares) at Sep. 30, 2014	10,836,659	14,098,343	'	'	'	'

Interim_Condensed_Consolidated6

Interim Condensed Consolidated Statements of Stockholders’ Equity (Unaudited) (Parentheticals) (USD $)	9 Months Ended
	Sep. 30, 2014	Sep. 30, 2013
Dividends declared to common stockholders per share	$1	$0.94
Preferred Stock [Member]	'	'
Dividends declared to preferred stockholders per share	$0.60	$0.60
Common Stock [Member]	'	'
Dividends declared to common stockholders per share	$1	$0.94

Note_1_Description_of_Business

Note 1 - Description of Business	9 Months Ended
	Sep. 30, 2014
Disclosure Text Block [Abstract]	'
Organization, Consolidation and Presentation of Financial Statements Disclosure [Text Block]	'
	Note 1 - Description of Business
	National HealthCare Corporation (“NHC” or the “Company”) is a leading provider of senior health care services. We operate or manage, through certain affiliates, 73 long-term care centers with a total of 9,410 licensed beds, 18 assisted living facilities, five independent living facilities, and 37 homecare programs. We operate specialized care units within certain of our healthcare centers such as Alzheimer's disease care units and sub-acute nursing units. We also have a non-controlling ownership interest in a hospice care business that services NHC owned health care centers and others. In addition, we provide insurance services, management and accounting services, and we lease properties to operators of skilled nursing centers. We operate in 10 states and are located primarily in the southeastern United States.

Note_2_Summary_of_Significant_

Note 2 - Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2014
Accounting Policies [Abstract]	'
Significant Accounting Policies [Text Block]	'
	Note 2 - Summary of Significant Accounting Policies
	The listing below is not intended to be a comprehensive list of all of our significant accounting policies. In many cases, the accounting treatment of a particular transaction is specifically dictated by generally accepted accounting principles, with limited need for management’s judgment in their application. There are also areas in which management’s judgment in selecting any available alternative would not produce a materially different result. See our audited December 31, 2013 consolidated financial statements and notes thereto which contain accounting policies and other disclosures required by generally accepted accounting principles. Our audited December 31, 2013 consolidated financial statements are available at our web site: www.nhccare.com.
	Basis of Presentation
	The unaudited interim condensed consolidated financial statements to which these notes are attached include all normal, recurring adjustments which are necessary to fairly present the financial position, results of operations and cash flows of NHC. All significant intercompany transactions and balances have been eliminated in consolidation. We assume that users of these interim financial statements have read or have access to the audited December 31, 2013 consolidated financial statements and Management’s Discussion and Analysis of Financial Condition and Results of Operations and that the adequacy of additional disclosure needed for a fair presentation, except in regard to material contingencies, may be determined in that context. Accordingly, footnotes and other disclosures which would substantially duplicate the disclosure contained in our most recent annual report to stockholders have been omitted. This interim financial information is not necessarily indicative of the results that may be expected for a full year for a variety of reasons.
	During the second quarter of 2014, the Company revised the presentation of its accrued risk reserves to present only the amount expected to be settled within the next twelve month period as a current liability. Previously, the Company had presented the entire accrued risk reserve balance as a current liability. The Company also recorded a related reclassification to its restricted cash and cash equivalents and restricted marketable securities to reflect its previous and continued expectation to use these assets held by its wholly-owned limited purpose insurance companies to settle the accrued risk reserves. The impact of these adjustments also resulted in an impact on the classification of our deferred tax balances. Accordingly, the Company's accompanying consolidated balance sheet as of December 31, 2013 has been adjusted to reflect these reclassifications. The table below presents the affected balance sheet line items, the respective previously-reported balances, the reclassification amount and the adjusted balances as of December 31, 2013 (in thousands). The reclassifications were not material to the financial conditions, results of operations or liquidity for any periods presented.
		Previously Reported Balance		Reclassification Amount			As-Adjusted Balance
	Restricted cash and cash equivalents (current assets section)	$	13,929	$	(3,631	)	$	10,298
	Restricted cash and cash equivalents (other assets section)		-		3,631			3,631
	Restricted marketable securities (current assets section)		142,003		(127,976	)		14,027
	Restricted marketable securities (other assets section)		-		127,976			127,976
	Accounts receivable (current assets section)		85,511		(5,655	)		79,856
	Deposits and other assets (other assets section)		1,153		5,655			6,808
	Accrued risk reserves (current liability section)		110,557		(86,232	)		24,325
	Accrued risk reserves (non-current liability section)		-		86,232			86,232
	Deferred income taxes (other assets section)		14,531		3,633			18,164
	Deferred income taxes (current liabilities section)		21,157		3,633			24,790
	Estimates and Assumptions
	The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires us to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates and could cause our reported net income to vary significantly from period to period.
	Revenue Recognition - Third Party Payors
	Approximately 65% of our net patient revenues are derived from Medicare, Medicaid, and other government programs. Amounts earned under these programs are subject to review by the Medicare and Medicaid intermediaries or their agents. In our opinion, adequate provision has been made for any adjustments that may result from these reviews. Any differences between our original estimates of reimbursements and subsequent revisions are reflected in operations in the period in which the revisions are made often due to final determination or the period of payment no longer being subject to audit or review. We have made provisions of approximately $24,112,000 and $21,619,000 as of September 30, 2014 and December 31, 2013, respectively, for various Medicare and Medicaid current and prior year cost reports and claims reviews.
	Revenue Recognition - Private Pay
	For private pay patients in skilled nursing or assisted living facilities, we bill room and board in advance with payment being due in the month the services are performed. Charges for ancillary, pharmacy, therapy and other services to private patients are billed in the month following the performance of services; however, all billings are recognized as revenue when the services are performed.
	Revenue Recognition - Subordination of Fees and Uncertain Collections
	We provide management services to certain senior care facilities and to others we provide accounting and financial services. We generally charge 6% to 7% of net operating revenues for our management services and a predetermined fixed rate per bed for the accounting and financial services. Our policy is to recognize revenues associated with both management services and accounting and financial services on an accrual basis as the services are provided. However, under the terms of our management contracts, payments for our management services are subject to subordination to other expenditures of the long-term care center being managed. Furthermore, for certain of the third parties with whom we have contracted to provide services and which we have determined that collection is not reasonably assured, our policy is to recognize income only in the period in which the amounts are realized. We may receive payment for the unpaid and unrecognized management fees in whole or in part in the future only if cash flows from the operating and investing activities of the centers or proceeds from the sale of the centers are sufficient to pay the fees. There can be no assurance that such future cash flows will occur. The realization of such previously unrecognized revenue could cause our reported net income to vary significantly from period to period.
	We agree to subordinate our fees to the other expenses of a managed center because we believe we know how to improve the quality of patient services and finances of a senior healthcare center. We believe subordinating our fees demonstrates to the owner and employees of the managed center how confident we are of the impact we can have in making the center operations successful. We may continue to provide services to certain managed centers despite not being fully paid currently so that we may be able to collect unpaid fees in the future from improved operating results and because the incremental savings from discontinuing services to a center may be small compared to the potential benefit. Also, we may benefit from providing other ancillary services to the managed center.
	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.
	Capital leases are recorded at the lower of fair market value or the present value of future minimum lease payments. Capital leases are amortized in accordance with the provision codified within Accounting Standards Codification (“ASC”) Subtopic 840-30, Leases - Capital Leases. Amortization of capital lease assets is included in depreciation and amortization expense.
	Accrued Risk Reserves
	We are principally self-insured for risks related to workers’ compensation insurance and professional and general liability claims. Our accrued risk reserves primarily represent the accrual for self-insured risks associated with workers’ compensation insurance and professional and general liability claims. The accrued risk reserves include a liability for reported claims and estimates for incurred but unreported claims. Our policy is to use an external, independent actuary to estimate our exposure for claims obligations (for both asserted and unasserted claims). We reassess our accrued risk reserves on a quarterly basis.
	Professional liability remains an area of particular concern to us. The long term care industry has seen an increase in personal injury/wrongful death claims based on alleged negligence by nursing homes and their employees in providing care to residents. As of September 30, 2014, we and/or our managed centers are defendants in 38 such claims inclusive of years 2005 through September 30, 2014. It remains possible that those pending matters plus potential unasserted claims could exceed our reserves, which could have a material adverse effect on our consolidated financial position, results of operations and cash flows. It is also possible that future events could cause us to make significant adjustments or revisions to these reserve estimates and cause our reported net income to vary significantly from period to period.
	We maintain insurance coverage for incidents occurring in all centers owned or leased by us. The coverages include both primary policies and excess policies. In all years, settlements, if any, in excess of available insurance policy limits and our own reserves would be expensed by us.
	Continuing Care Contracts and Refundable Entrance Fee
	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 contracts provide 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 to residents when they relocate from our community and the apartment is re-occupied. Refundable entrance fees are classified as non-current liabilities and non-refundable entrance fees are classified as deferred revenue in the Company's consolidated balance sheets. The balances of refundable entrance fees as of September 30, 2014 and December 31, 2013 were $10,320,000 and $10,720,000, respectively.
	Obligation to Provide Future Services
	We annually estimate the present value of the net cost of future services and the use of facilities to be provided to the current CCRC residents and compare that amount with the balance of non-refundable deferred revenue from entrance fees received. If the present value of the net cost of future services exceeds the related anticipated revenues, a liability is recorded (obligation to provide future services) with a corresponding charge to income. As of September 30, 2014 and December 31, 2013, we have recorded a future service obligation in the amount of $3,689,000.
	Deferred Revenue
	Deferred revenue includes the deferred gain on the sale of assets to National, the non-refundable portion (10%) of CCRC entrance fees being amortized over the remaining life expectancies of the residents, and premiums received within our workers’ compensation and professional liability companies that are not yet earned.
	New Accounting Pronouncements
	In May 2014, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2014-09 “Revenue from Contracts with Customers”. This update is the result of a collaborative effort by the FASB and the International Accounting Standards Board to simplify revenue recognition guidance, remove inconsistencies in the application of revenue recognition, and to improve comparability of revenue recognition practices across entities, industries, jurisdictions, and capital markets. The FASB is amending the Accounting Standards Codification and creating a new Topic 606, “Revenue from Contracts with Customers”. The core principle of the guidance is that an entity should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. For a public entity, the amendments in this update are effective for annual reporting periods beginning after December 15, 2016, including interim periods within that reporting period. Early application is not permitted. The Company is currently evaluating the impact of this guidance on our consolidated financial statements and control framework.
	In April 2014, the FASB issued ASU No. 2014-08, “Reporting Discontinued Operations and Disclosures of Disposals of Components of an Entity.” This standard changes the requirements for reporting discontinued operations by raising the threshold for a disposal to qualify as a discontinued operation and requires new disclosures of both discontinued operations and certain other disposals that do not meet the definition of a discontinued operation. The standard limits discontinued operations reporting to disposals of components of an entity that represent strategic shifts that have (or will have) a major effect on an entity’s operations and financial results. This standard is effective for the Company on a prospective basis for annual periods beginning on January 1, 2015 and interim periods within that year. Early adoption is permitted, but only for disposals (or classifications as held for sale) that have not been reported in financial statements previously issued. When adopted, the Company does not expect this standard to have a material impact on our consolidated financial statements.

Note_3_Other_Revenues

Note 3 - Other Revenues	9 Months Ended
	Sep. 30, 2014
Other Revenues [Abstract]	'
Other Revenues [Text Block]	'
	Note 3 - Other Revenues
	Other revenues are outlined in the table below. Revenues from management and accounting services include management and accounting fees provided to managed and other health care centers. Revenues from rental income include health care real estate properties owned by us and leased to third party operators. Revenues from insurance services include premiums for workers’ compensation and professional liability insurance policies that our wholly-owned limited purpose insurance subsidiaries have written for certain health care centers to which we provide management or accounting services. "Other" revenues include miscellaneous health care related earnings.
	Other revenues include the following:
		Three Months Ended					Nine Months Ended
		30-Sep					30-Sep
	(in thousands)	2014		2013			2014		2013
	Management and accounting services fees	$	3,822	$	5,234		$	11,825	$	14,662
	Rental income		4,748		4,886			14,266		14,387
	Insurance services		1,787		2,729			5,437		12,792
	Other		94		(43	)		608		523
		$	10,451	$	12,806		$	32,136	$	42,364
	Management Fees from National
	We manage five skilled nursing facilities owned by National Health Corporation ("National"). For the three months and nine months ended September 30, 2014, we recognized management fees and interest on management fees of $884,000 and $2,679,000, respectively, from these centers. For the three months and nine months ended September 30, 2013, we recognized management fees and interest on management fees of $860,000 and $2,637,000, respectively, from these centers.
	Because the amount collectable cannot be reasonably determined when the management services are provided, and because we cannot estimate the timing or amount of expected future collections, the unpaid fees from the five centers owned by National will be recognized as revenues only when the collectability of these fees can be reasonably assured. Under the terms of our management agreement with National, the payment of these fees to us may be subordinated to other expenditures of the five long-term care centers. We continue to manage these centers so that we may be able to collect our fees in the future and because the incremental savings from discontinuing services to a center may be small compared to the potential benefit. We may receive payment for the unrecognized management fees in whole or in part in the future only if cash flows from the operating and investing activities of the five centers or the proceeds from the sale of the centers are sufficient to pay the fees. There can be no assurance that such future improved cash flows will occur.
	Management Fees and Financial and Accounting Services from Other Healthcare Centers
	In February 2014, we assumed management of a 121-bed skilled nursing facility located in Des Peres, Missouri. In June 2014, we began managing a 75-unit assisted living facility located in Augusta, Georgia. As of September 30, 2014, we provide management services to six healthcare centers (other than the five National centers) operated by third party owners. For the three months and nine months ended September 30, 2014, we recognized management fees of $562,000 and $1,664,000, respectively, from these centers. For the three months and nine months ended September 30, 2013, we recognized management fees of $1,125,000 and $4,124,000, respectively, from 21 healthcare centers we managed during the 2013 periods. The decrease in management services revenues is due to the discontinuation of management services to the non-profit entities SeniorTrust and ElderTrust. Effective September 1, 2013, we began leasing and operating the former ElderTrust facilities from National Health Investors, Inc. ("NHI"). Effective September 1, 2013 and thereafter, the revenues from these seven facilities have been included in net patient revenues in the consolidated statements of income.
	Effective October 1, 2014, the Company will no longer provide accounting and financial services to seven healthcare facilities. At September 30, 2014, we provided accounting and financial services to 27 healthcare facilities. No management services are provided for entities in which we provide accounting and financial services. We expect other revenues in the consolidated statements of income to decrease by approximately $1,600,000 annually, or $400,000 quarterly, from the discontinuation of these services.
	Insurance Services
	For workers’ compensation insurance services, the premium revenues reflected in the interim condensed consolidated statements of income for the three and nine months ended September 30, 2014 are $1,082,000 and $3,362,000. For the three months and nine months ended September 30, 2013, the workers' compensation premium revenues reflected in the interim condensed consolidated statements of income were $1,218,000 and $6,607,000. For the nine months ended September 30, 2013, there was a positive insurance settlement reached with one of the states in which we provide workers' compensation insurance. The 2013 prior period event helped increase other revenues in the amount of $2,769,000. Associated losses and expenses are reflected in the interim condensed consolidated statements of income as "Salaries, wages and benefits."
	For professional liability insurance services, the premium revenues reflected in the interim condensed consolidated statements of income for the three months and nine months ended September 30, 2014 are $705,000 and $2,076,000. For the three months and nine months ended September 30, 2013, the professional liability insurance premium revenues reflected in the interim condensed consolidated statements of income were $654,000 and $2,539,000. Associated losses and expenses including those for self-insurance are included in the interim condensed consolidated statements of income as "Other operating costs and expenses".

Note_4_NonOperating_Income

Note 4 - Non-Operating Income	9 Months Ended
	Sep. 30, 2014
Disclosure Text Block [Abstract]	'
Other Nonoperating Income and Expense [Text Block]	'
	Note 4 - Non-Operating Income
	Non-operating income is outlined in the table below. Non-operating income includes equity in earnings of unconsolidated investments, dividends and other realized gains and losses on marketable securities, and interest income. Our most significant equity method investment is a 75.1% non-controlling ownership interest in Caris HealthCare L.P. (“Caris”), a business that specializes in hospice care services.
		Three Months Ended				Nine Months Ended
		30-Sep				30-Sep
	(in thousands)	2014		2013		2014		2013
	Equity in earnings of unconsolidated investments	$	1,414	$	3,947	$	5,069	$	11,542
	Dividends and other net realized gains and losses on sales of securities		1,392		408		4,350		3,314
	Interest income		1,131		1,362		3,371		4,111
	Gain on the recovery of notes receivable		-		5,454		-		5,454
		$	3,937	$	11,171	$	12,790	$	24,421

Note_5_LongTerm_Leases

Note 5 - Long-Term Leases	9 Months Ended
	Sep. 30, 2014
Leases [Abstract]	'
Leases of Lessee Disclosure [Text Block]	'
	Note 5 - Long-Term Leases
	Capital Leases
	Effective March 1, 2014, NHC began leasing and operating three senior healthcare facilities in the state of Missouri under three separate lease agreements. Two of the healthcare facilities are skilled nursing facilities that also include assisted living facilities and the third healthcare facility is a memory care facility. Each of the leases is a ten year lease with two five-year renewal options. Under the terms of the leases, base rent totals $5,200,000 annually with rent thereafter escalating by 4% of the increase in facility revenue over the 2014 base year. The leases also contain certain non-performance default provisions which result in capital lease classification. However, the initial measurement and recording of the capital lease assets and obligations does not include any expected payments under such default provisions, as the Company does not expect to incur an obligation for such payments.
	Fixed assets recorded under the capital leases, which are included in property and equipment in the interim condensed consolidated balance sheets, are as follows:
		30-Sep-14			31-Dec-13
		(in thousands)
	Buildings and personal property	$	39,032		$	−
	Accumulated amortization		(2,290	)		−
		$	36,742		$	−
	Operating Leases
	At September 30, 2014, NHC leases from NHI the real property of 35 skilled nursing facilities, seven assisted living facilities and three independent living facilities under two separate lease agreements. Base rent expense under both lease agreements totals $34,200,000 annually with rent thereafter escalating by 4% of the increase in facility revenue over the base year. Total facility rent expense to NHI was $27,400,000 and $26,982,000 for the nine months ended September 30, 2014 and 2013, respectively.
	Minimum Lease Payments
	The approximate future minimum lease payments required under all leases that have remaining non-cancelable lease terms at September 30, 2014 are as follows:
		Operating Leases			Capital Leases
		(in thousands)
	2015	$	34,200		$	5,200
	2016		34,200			5,200
	2017		34,200			5,200
	2018		34,200			5,200
	2019		34,200			5,200
	Thereafter		253,700			22,967
	Total minimum lease payments	$	424,700		$	48,967
	Less: Amounts representing interest					(11,628	)
	Present value of minimum lease payments					37,339
	Less: Current portion					(3,042	)
	Long-term capital lease obligations				$	34,297

Note_6_Other_Operating_Expense

Note 6 - Other Operating Expenses	9 Months Ended
	Sep. 30, 2014
Other Operating Expenses [Abstract]	'
Other Operating Expenses [Text Block]	'
	Note 6 - Other Operating Expenses
	Other operating expenses include the costs of care and services that we provide to the residents of our facilities and the costs of maintaining our facilities. Our primary patient care costs include drugs, medical supplies, purchased professional services, food, and professional liability insurance and licensing fees. The primary facility costs include utilities and property insurance.

Note_7_Earnings_Per_Share

Note 7 - Earnings Per Share	9 Months Ended
	Sep. 30, 2014
Earnings Per Share [Abstract]	'
Earnings Per Share [Text Block]	'
	Note 7 - Earnings per Share
	Basic net income per share is computed based on the weighted average number of common shares outstanding for each period presented. Diluted net income per share reflects the potential dilution that would have occurred if securities to issue common stock were exercised, converted, or resulted in the issuance of common stock that would have then shared in our earnings.
	The following table summarizes the earnings and the weighted average number of common shares used in the calculation of basic and diluted earnings per share.
		Three Months Ended September 30						Nine Months Ended September 30
	(in thousands, except for share and per share amounts)	2014			2013			2014			2013
	Basic:
	Weighted average common shares outstanding		13,805,430			13,820,449			13,838,891			13,832,706
	Net income	$	12,829		$	19,877		$	38,569		$	48,024
	Dividends to preferred stockholders		(2,167	)		(2,167	)		(6,502	)		(6,503	)
	Net income available to common stockholders	$	10,662		$	17,710		$	32,067		$	41,521
	Earnings per common share, basic	$	0.77		$	1.28		$	2.32		$	3
	Diluted:
	Weighted average common shares outstanding		13,805,430			13,820,449			13,838,891			13,832,706
	Dilutive effect of stock options		82,764			7,970			63,944			8,397
	Dilutive effect of restricted stock		2,814			3,840			3,657			4,640
	Dilutive effect of contingent issuable stock		345,504			231,500			323,539			232,495
	Convertible preferred stock		-			2,623,156			-			2,623,253
	Assumed average common shares outstanding		14,236,512			16,686,915			14,230,031			16,701,491
	Net income available to common stockholders	$	10,662		$	17,710		$	32,067		$	41,521
	Add dilutive preferred stock dividends for effect of assumed conversion of preferred stock		-			2,167			-			6,503
	Net income for diluted earnings per common share	$	10,662		$	19,877		$	32,067		$	48,024
	Earnings per common share, diluted	$	0.75		$	1.19		$	2.25		$	2.88
	In the above table, options to purchase 12,890 and 989,275 shares of our common stock have been excluded for the nine months ended September 30, 2014 and 2013, respectively, due to their anti-dilutive impact. We have also excluded 2,622,905 of common shares issuable upon the conversion of preferred stock for the three months and nine months ended September 30, 2014 due to their anti-dilutive impact.

Note_8_Investments_in_Marketab

Note 8 - Investments in Marketable Securities	9 Months Ended
	Sep. 30, 2014
Investments, Debt and Equity Securities [Abstract]	'
Investments in Debt and Marketable Equity Securities (and Certain Trading Assets) Disclosure [Text Block]	'
	Note 8 - Investments in Marketable Securities
	Our investments in marketable securities are classified as available for sale securities. Realized gains and losses from securities sales are recognized in results of operations upon disposition of the securities using the specific identification method on a trade date basis. Refer to Note 9 for a description of the Company's methodology for determining the fair value of marketable securities.
	Marketable securities and restricted marketable securities consist of the following:
		30-Sep-14				31-Dec-13
	(in thousands)	Amortized		Fair		Amortized		Fair
		Cost		Value		Cost		Value
	Investments available for sale:
	Marketable equity securities	$	30,176	$	108,529	$	30,176	$	105,009
	Restricted investments available for sale:
	Corporate debt securities		70,406		70,512		65,852		65,006
	Commercial mortgage-backed securities		54,977		54,545		46,977		45,856
	U.S. Treasury securities		16,062		16,061		22,932		22,841
	State and municipal securities		11,918		12,255		8,123		8,300
		$	183,539	$	261,902	$	174,060	$	247,012
	Included in the available for sale marketable equity securities are the following (in thousands, except share amounts):
		30-Sep-14						31-Dec-13
		Shares		Cost		Fair		Shares		Cost		Fair
						Value						Value
	NHI Common Stock		1,630,642	$	24,734	$	93,175		1,630,642	$	24,734	$	91,479
	The amortized cost and estimated fair value of debt securities classified as available for sale, by contractual maturity, are as follows:
		30-Sep-14				31-Dec-13
	(in thousands)	Cost		Fair		Cost		Fair
				Value				Value
	Maturities:
	Within 1 year	$	12,616	$	12,665	$	9,279	$	9,324
	1 to 5 years		94,482		95,060		91,787		92,011
	6 to 10 years		45,296		44,811		40,387		38,335
	Over 10 years		969		837		2,431		2,333
		$	153,363	$	153,373	$	143,884	$	142,003
	Gross unrealized gains related to available for sale securities are $79,591,000 and $75,702,000 as of September 30, 2014 and December 31, 2013, respectively. Gross unrealized losses related to available for sale securities are $1,228,000 and $2,750,000 as of September 30, 2014 and December 31, 2013, 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. As a result, the Company recognized no other-than-temporary impairment during the nine months ended September 30, 2014 or the year ended December 31, 2013.
	Proceeds from the sale of investments in restricted marketable securities during the nine months ended September 30, 2014 and 2013 were $27,641,000 and $57,904,000, respectively. Investment gains of $172,000 and investment losses of $527,000 were realized on these sales during the nine months ended September 30, 2014 and 2013, respectively.

Note_9_Fair_Value_Measurements

Note 9 - Fair Value Measurements	9 Months Ended
	Sep. 30, 2014
Fair Value Disclosures [Abstract]	'
Fair Value Disclosures [Text Block]	'
	Note 9 - Fair Value Measurements
	The accounting standard for fair value measurements provides a framework for measuring fair value and requires expanded disclosures regarding fair value measurements. Fair value is defined as the price that would be received for an asset or the exit price that would be paid to transfer a liability in the principal or most advantageous market in an orderly transaction between market participants on the measurement date. This accounting standard establishes a fair value hierarchy, which requires an entity to maximize the use of observable inputs, where available. The following summarizes the three levels of inputs that may be used to measure fair value:
	Level 1 - The valuation is based on quoted prices in active markets for identical instruments.
	Level 2 - The valuation is based on observable inputs such as quoted prices for similar instruments in active markets, quoted prices for identical or similar instruments in markets that are not active, and model-based valuation techniques for which all significant assumptions are observable in the market.
	Level 3 - The valuation is based on unobservable inputs that are supported by minimal or no market activity and that are significant to the fair value of the instrument. Level 3 valuations are typically performed using pricing models, discounted cash flow methodologies, or similar techniques that incorporate management’s own estimates of assumptions that market participants would use in pricing the instrument, or valuations that require significant management judgment or estimation.
	A financial instrument’s level within the fair value hierarchy is based on the lowest level of input that is significant to the fair value measurement.
	Valuation of Marketable Securities
	The Company determines fair value for marketable securities with Level 1 inputs through quoted market prices. The Company determines fair value for marketable securities with Level 2 inputs through broker or dealer quotations or alternative pricing sources with reasonable levels of price transparency. Our Level 2 marketable securities have been initially valued at the transaction price and subsequently valued, at the end of each month, typically utilizing third party pricing services or other market observable data. The pricing services utilize industry standard valuation models, including both income and market based approaches and observable market inputs to determine value. These observable market inputs include reportable trades, benchmark yields, credit spreads, broker/dealer quotes, bids, offers, and other industry and economic events.
	We validated the prices provided by our broker by reviewing their pricing methods, obtaining market values from other pricing sources, analyzing pricing data in certain instances and confirming that the relevant markets are active. After completing our validation procedures, we did not adjust or override any fair value measurements provided by our broker as of September 30, 2014. We did not have any transfers of assets between Level 1 and Level 2 of the fair value measurement hierarchy during the nine months ended September 30, 2014.
	Other
	The carrying amounts of cash and cash equivalents, restricted cash and cash equivalents, accounts receivable, and accounts payable approximate fair value due to their short-term nature. The estimated fair value of notes receivable approximates the carrying value based principally on their underlying interest rates and terms, maturities, collateral and credit status of the receivables. Our long-term debt approximates fair value due to variable interest rates, but fair value is also determined using Level 2 inputs through alternative pricing sources. At September 30, 2014, there were no material differences between the carrying amounts and fair values of NHC’s financial instruments.
	The following table summarizes fair value measurements by level at September 30, 2014 and December 31, 2013 for assets and liabilities measured at fair value on a recurring basis (in thousands):
		Fair Value Measurements Using
	30-Sep-14	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	$	76,917	$	76,917	$	-	$	-
	Restricted cash and cash equivalents		13,706		13,706		-		-
	Marketable equity securities		108,529		108,529		-		-
	Corporate debt securities		70,512		-		70,512		-
	Commercial mortgage-backed securities		54,545		-		54,545		-
	U.S. Treasury securities		16,061		16,061		-		-
	State and municipal securities		12,255		-		12,255		-
	Total financial assets	$	352,525	$	215,213	$	137,312	$	-
		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	$	-

Note_10_LongTerm_Debt

Note 10 - Long-Term Debt	9 Months Ended
	Sep. 30, 2014
Debt Disclosure [Abstract]	'
Debt Disclosure [Text Block]	'
	Note 10 - Long-Term Debt
	Long-term debt consists of the following:
		Weighted			Maturities		30-Sep-14		31-Dec-14
		Average
		Interest Rate
		Variable					(dollars in thousands)
	Revolving Credit Facility, interest payable monthly		0.9	%		2015	$	-	$	-
	Unsecured term note payable to National, interest payable quarterly, principal payable at maturity		2.8	%		2018		10,000		10,000
								10,000		10,000
	Less current portion							-		-
							$	10,000	$	10,000

Note_11_75000000_Revolving_Cre

Note 11 - $75,000,000 Revolving Credit Facility	9 Months Ended
	Sep. 30, 2014
Revolving Credit Facility [Abstract]	'
Revolving Credit Facility [Text Block]	'
	Note 11 - $75,000,000 Revolving Credit Facility
	Effective October 22, 2014, we extended the maturity of our Credit Agreement (the "Credit Agreement") with Bank of America, N.A., as lender (the "Lender"). The Credit Agreement provides for a $75,000,000 revolving credit facility (the "Credit Facility"), of which up to $5,000,000 may be utilized for letters of credit.
	Borrowings bear interest at either, (i) the Eurodollar rate plus 0.70% or (ii) the prime rate. Letter of credit fees are equal to 0.10% times the maximum amount available to be drawn under outstanding letters of credit.
	Commitment fees are payable on the daily unused portion of the Credit Facility at a rate of ten (10) basis points per annum. NHC is permitted to prepay the loans outstanding under the Credit Facility at any time, without penalty.
	The Credit Facility matures on October 21, 2015. We currently anticipate renewing the credit agreement at that time and while we have had no indication from the lender there is any question about renewal, there has been no commitment at this time. If the Lender elects to consent to such extension, subject to certain conditions, the maturity date will be extended to the date which is 364 days after the then maturity date.
	NHC’s obligations under the Credit Agreement are guaranteed by certain NHC subsidiaries and are secured by pledges by NHC and the guarantors of (i) 100% of the equity interests of domestic subsidiaries and (ii) up to 65% of the voting equity interests and 100% of the non-voting equity interests of foreign subsidiaries, in each case, held by NHC or the guarantors.
	The Credit Agreement contains customary representations and warranties, and covenants, including covenants that restrict, among other things, asset dispositions, mergers and acquisitions, dividends, restricted payments, debt, liens, investments and affiliate transactions. The Credit Agreement contains customary events of default.
	The Credit Facility is available for general corporate purposes, including working capital and acquisitions.

Note_12_Stock_Repurchase_Progr

Note 12 - Stock Repurchase Program	9 Months Ended
	Sep. 30, 2014
Disclosure Text Block Supplement [Abstract]	'
Treasury Stock [Text Block]	'
	Note 12 - Stock Repurchase Program
	On August 5, 2014 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. The program expires on August 31, 2015. 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. On August 11, 2014, the Company repurchased 125,000 shares of its common stock for a total cost of $6,995,000. The shares were funded from cash on hand and were cancelled and returned to the status of authorized but unissued.
	On August 1, 2013, the Board of Directors of the Company authorized a new stock repurchase program that allowed the Company to repurchase up to $25 million of its common stock over a one year period. The program expired on July 31, 2014. No repurchases of common stock were 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_13_StockBased_Compensatio

Note 13 - Stock-Based Compensation	9 Months Ended
	Sep. 30, 2014
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]	'
Disclosure of Compensation Related Costs, Share-based Payments [Text Block]	'
	Note 13 - Stock-Based Compensation
	NHC recognizes stock-based compensation expense for all stock options and restricted stock granted over the requisite service period using the fair value for these grants as estimated at the date of grant either using the Black-Scholes pricing model for stock options or the quoted market price for restricted stock.
	The 2005 and 2010 Stock-Based Compensation Plans
	The Compensation Committee of the Board of Directors (“the Committee”) has the authority to select the participants to be granted options; to designate whether the option granted is an incentive stock option (“ISO”), a non-qualified option, or a stock appreciation right; to establish the number of shares of common stock that may be issued upon exercise of the option; to establish the vesting provision for any award; and to establish the term any award may be outstanding. The exercise price of any ISO’s granted will not be less than the fair market value of the shares of common stock on the date granted and the term of an ISO may not be any more than ten years. The exercise price of any non-qualified options granted will not be less than the fair market value of the shares of common stock on the date granted unless so determined by the Committee.
	In May 2005, our stockholders approved the 2005 Stock Option, Employee Stock Purchase, Physician Stock Purchase and Stock Appreciation Rights Plan (“the 2005 Plan”) pursuant to which 1,200,000 shares of our common stock were available to grant as stock-based payments to key employees, directors, and non-employee consultants. At September 30, 2014, 220,620 shares were available for future grants under the 2005 Plan.
	In May 2010, our stockholders approved the 2010 Omnibus Equity Incentive Plan (“the 2010 Plan”) pursuant to which 1,200,000 shares of our common stock were available to grant as stock-based payments to key employees, directors, and non-employee consultants. The shares granted during the nine months ended September 30, 2014 consisted of 45,000 shares to the Directors of the Company and 12,890 shares through the Employee Stock Purchase Plan. At September 30, 2014, 398,370 shares were available for future grants under the 2010 Plan.
	Compensation expense is recognized only for the awards that ultimately vest. Stock-based compensation totaled $377,000 and $1,547,000 for the three months and nine months ended September 30, 2014, respectively. Stock-based compensation totaled $453,000 and $1,812,000 for the three months and nine months ended September 30, 2013, respectively. At September 30, 2014, we had $2,480,000 of unrecognized compensation cost related to unvested stock-based compensation awards, which consisted of $2,356,000 for stock options and $124,000 for restricted stock. This expense will be recognized over the remaining weighted average vesting period, which is approximately 1.4 years for stock options and 0.6 years for restricted stock. Stock-based compensation is included in “Salaries, wages and benefits” in the interim condensed consolidated statements of income.
	Stock Options
	The following table summarizes the significant assumptions used to value the options granted for the nine months ended September 30, 2014 and for the year ended December 31, 2013.
			2014			2013
	Risk-free interest rate			0.52	%		0.25	%
	Expected volatility			17.3	%		31.1	%
	Expected life, in years			2.2			2.1
	Expected dividend yield			2.68	%		2.81	%
	The following table summarizes our outstanding stock options for the nine months ended September 30, 2014 and for the year ended December 31, 2013.
			Number of			Weighted			Aggregate
			Shares			Average			Intrinsic
						Exercise Price			Value
	Options outstanding at January 1, 2013			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			-
	Options granted			58,090			53.11			-
	Options exercised			(145,074	)		45.32			-
	Options cancelled			(20,000	)		46.69			-
	Options outstanding at September 30, 2014			967,568		$	47.01		$	8,227,000
	Options exercisable at September 30, 2014			158,573		$	48.06		$	1,182,000
		Options			Exercise Prices	Weighted Average			Weighted Average
		Outstanding				Exercise Price			Remaining Contractual
		30-Sep-14							Life in Years
			909,678		$44.80 - $47.45	$	46.62			1.6
			57,890		$52.93 - $53.72		53.11			3.7
			967,568			$	47.01			1.7
	Restricted Stock
	The following table summarizes our restricted stock activity for the nine months ended September 30, 2014 and for the year ended December 31, 2013.
			Number of			Weighted			Aggregate Intrinsic Value
			Shares			Average Grant Date Fair Value
	Non-vested restricted shares at January 1, 2013			18,000		$	34.46		$	-
	Award shares granted			-			-			-
	Award shares vested			6,000			34.46			-
	Non-vested restricted shares at December 31, 2013			12,000			34.46			-
	Award shares granted			-			-			-
	Award shares vested			6,000			34.46			-
	Non-vested restricted shares at September 30, 2014			6,000		$	34.46		$	126,000
	The weighted average remaining contractual life of restricted stock at September 30, 2014 is 0.6 years.

Note_14_Income_Taxes

Note 14 - Income Taxes	9 Months Ended
	Sep. 30, 2014
Income Tax Disclosure [Abstract]	'
Income Tax Disclosure [Text Block]	'
	Note 14 - Income Taxes
	The income tax provision for the three months ended September 30, 2014 is $5,844,000 (an effective income tax rate of 31.3%). The income tax provision and effective tax rate for the three months ended September 30, 2014 were favorably impacted by adjustments to unrecognized tax benefits of $16,000, excluding statute of limitation expirations and unfavorably impacted by permanent differences including nondeductible expenses of $460,000 resulting in an increase in the provision. The income tax provision and effective tax rate for 2014 were favorably impacted by statute of limitation expirations resulting in a benefit to the provision of $1,542,000 or 8.3% of income before taxes in 2014. The income tax provision for the three months ended September 30, 2013 was $10,559,000 (an effective income tax rate of 34.7%). The income tax provision and effective tax rate for the three months ended September 30, 2013 were favorably impacted by adjustments to unrecognized tax benefits of $54,000, excluding statute of limitation expirations and unfavorably impacted by permanent differences including nondeductible expenses of $410,000 resulting in an increase in the provision. The income tax provision and effective tax rate for 2013 were favorably impacted by statute of limitation expirations resulting in a benefit to the provision of $1,605,000 or 5.3% of income before taxes in 2013.
	The income tax provision for the nine months ended September 30, 2014 is $22,028,000 (an effective income tax rate of 36.4%). The income tax provision and effective tax rate for the nine months ended September 30, 2014 were unfavorably impacted by adjustments to unrecognized tax benefits of $290,000 and permanent differences including nondeductible expenses of $557,000 resulting in an increase in the provision. The income tax provision and effective tax rate for 2014 were favorably impacted by statute of limitation expirations resulting in a benefit to the provision of $1,542,000 or 2.5% of income before taxes in 2014. The income tax provision for the nine months ended September 30, 2013 was $28,659,000 (an effective income tax rate of 37.4%). The income tax provision and effective tax rate for the nine months ended September 30, 2013 were unfavorably impacted by adjustments to unrecognized tax benefits of $260,000 and permanent differences including nondeductible expenses of $490,000 resulting in an increase in the provision. The income tax provision and effective tax rate for 2013 were favorably impacted by statute of limitation expirations resulting in a benefit to the provision of $1,605,000 or 2.1% of income before taxes in 2013.
	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 made adequate provision for unrecognized tax benefits related to uncertain tax positions. However, because of uncertainty of interpretation by various tax authorities and the possibility that there are issues that have not been recognized by management, we cannot guarantee we have accurately estimated our tax liabilities. We believe that our liabilities reflect the anticipated outcome of known uncertain tax positions in conformity with ASC Topic 740, Income Taxes. Our liabilities for unrecognized tax benefits are presented in the consolidated balance sheets within Other Noncurrent Liabilities.
	At September 30, 2014, we had $13,534,000 of unrecognized tax benefits, composed of $8,695,000 of deferred tax assets and $4,839,000 of permanent differences. Accrued interest and penalties of $2,096,000 relate to unrecognized tax benefits at September 30, 2014. Unrecognized tax benefits of $4,839,000 net of federal benefit, at September 30, 2014, attributable to permanent differences, would favorably impact our effective tax rate if recognized. Accrued interest and penalties of $1,858,000 relate to these permanent differences at September 30, 2014. We do not expect to recognize significant increases or decreases in unrecognized tax benefits within the twelve months beginning October 1, 2014, except for the effect of decreases related to the lapse of statute of limitations estimated at $2,585,000, composed of temporary differences of $1,520,000, and permanent tax differences of $1,065,000. Interest and penalties of $585,000 relate to these temporary and permanent difference changes within 12 months beginning September 30, 2014.
	Interest and penalties expense related to U.S. federal and state income tax returns are included within income tax expense.
	The Company is no longer subject to U.S. federal and state examinations by tax authorities for years before 2011 (with certain state exceptions). Currently, there are no U.S. federal or state returns under examination.

Note_15_Guarantees_and_Conting

Note 15 - Guarantees and Contingencies	9 Months Ended
	Sep. 30, 2014
Commitments and Contingencies Disclosure [Abstract]	'
Commitments and Contingencies Disclosure [Text Block]	'
	Note 15 - Guarantees and Contingencies
	Accrued Risk Reserves
	We are self-insured for risks related to health insurance and have wholly-owned limited purpose insurance companies that insure risks related to workers’ compensation and general and professional liability insurance claims both for our owned or leased entities and certain of the entities to which we provide management or accounting services. The liability we have recognized for reported claims and estimates for incurred but unreported claims totals $112,836,000 and $110,557,000 at September 30, 2014 and December 31, 2013, respectively. The liability is included in accrued risk reserves in the interim condensed consolidated balance sheets and is subject to adjustment for actual claims incurred. It is possible that these claims plus unasserted claims could exceed our insurance coverages and our reserves, which could have a material adverse effect on our consolidated financial position, results of operations and cash flows.
	As a result of the terms of our insurance policies and our use of wholly-owned limited purpose insurance companies, we have retained significant insurance risk with respect to workers’ compensation and general and professional liability. We use independent actuaries to estimate our exposures for claims obligations (for both asserted and unasserted claims) related to deductibles and exposures in excess of coverage limits, and we maintain reserves for these obligations. Such estimates are based on many variables including historical and statistical information and other factors.
	Workers’ Compensation
	For workers’ compensation, we utilize a wholly-owned Tennessee domiciled property/casualty insurance company to write coverage for NHC affiliates and for third-party customers. Policies are written for a duration of twelve months and cover only risks related to workers’ compensation losses. All customers are companies which operate in the senior care industry. Business is written on a direct basis. Direct business coverage is written for statutory limits and the insurance company’s losses in excess of $1,000,000 per claim are covered by reinsurance.
	General and Professional Liability Lawsuits and Insurance
	The senior care industry has experienced increases in both the number of personal injury/wrongful death claims and in the severity of awards based upon alleged negligence by nursing facilities and their employees in providing care to residents. As of September 30, 2014, we and/or our managed centers are currently defendants in 38 such claims.
	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 Islands, 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 2011-2014.
	Beginning in 2008 and continuing through September 30, 2014, additional insurance is purchased through third party providers that serve to supplement the coverage provided through our wholly-owned captive insurance company.
	Other Matters
	On December 19, 2013, the Company was served with a civil investigative demand (“CID”) from the U.S. Department of Justice and the Office of the U.S. Attorney for the Eastern District of Tennessee (“DOJ Investigation”) requesting the production of documents and interrogatory responses regarding the billing for and medical necessity of certain rehabilitative therapy services. Based upon our review, the CID appears to relate to services provided at our facilities based in Knoxville, Tennessee.
	On October 7, 2014, the Company received a subpoena from the Office of Inspector General of the United Department of Health and Human Services (“OIG Subpoena”) related to the current DOJ Investigation.  The OIG Subpoena requests certain financial and organizational documents from the Company and certain of its subsidiaries and SNFs and medical records from certain of the Company’s Tennessee-based SNFs.
	The Company is 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, in the opinion of management, 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.

Accounting_Policies_by_Policy_

Accounting Policies, by Policy (Policies)	9 Months Ended
	Sep. 30, 2014
Accounting Policies, by Policy (Policies) [Line Items]	'
Basis of Accounting, Policy [Policy Text Block]	'
	Basis of Presentation
	The unaudited interim condensed consolidated financial statements to which these notes are attached include all normal, recurring adjustments which are necessary to fairly present the financial position, results of operations and cash flows of NHC. All significant intercompany transactions and balances have been eliminated in consolidation. We assume that users of these interim financial statements have read or have access to the audited December 31, 2013 consolidated financial statements and Management’s Discussion and Analysis of Financial Condition and Results of Operations and that the adequacy of additional disclosure needed for a fair presentation, except in regard to material contingencies, may be determined in that context. Accordingly, footnotes and other disclosures which would substantially duplicate the disclosure contained in our most recent annual report to stockholders have been omitted. This interim financial information is not necessarily indicative of the results that may be expected for a full year for a variety of reasons.
	During the second quarter of 2014, the Company revised the presentation of its accrued risk reserves to present only the amount expected to be settled within the next twelve month period as a current liability. Previously, the Company had presented the entire accrued risk reserve balance as a current liability. The Company also recorded a related reclassification to its restricted cash and cash equivalents and restricted marketable securities to reflect its previous and continued expectation to use these assets held by its wholly-owned limited purpose insurance companies to settle the accrued risk reserves. The impact of these adjustments also resulted in an impact on the classification of our deferred tax balances. Accordingly, the Company's accompanying consolidated balance sheet as of December 31, 2013 has been adjusted to reflect these reclassifications. The table below presents the affected balance sheet line items, the respective previously-reported balances, the reclassification amount and the adjusted balances as of December 31, 2013 (in thousands). The reclassifications were not material to the financial conditions, results of operations or liquidity for any periods presented.
		Previously Reported Balance		Reclassification Amount			As-Adjusted Balance
	Restricted cash and cash equivalents (current assets section)	$	13,929	$	(3,631	)	$	10,298
	Restricted cash and cash equivalents (other assets section)		-		3,631			3,631
	Restricted marketable securities (current assets section)		142,003		(127,976	)		14,027
	Restricted marketable securities (other assets section)		-		127,976			127,976
	Accounts receivable (current assets section)		85,511		(5,655	)		79,856
	Deposits and other assets (other assets section)		1,153		5,655			6,808
	Accrued risk reserves (current liability section)		110,557		(86,232	)		24,325
	Accrued risk reserves (non-current liability section)		-		86,232			86,232
	Deferred income taxes (other assets section)		14,531		3,633			18,164
	Deferred income taxes (current liabilities section)		21,157		3,633			24,790
Contractual Adjustments and Third Party Settlements, Policy [Policy Text Block]	'
	Revenue Recognition - Third Party Payors
	Approximately 65% of our net patient revenues are derived from Medicare, Medicaid, and other government programs. Amounts earned under these programs are subject to review by the Medicare and Medicaid intermediaries or their agents. In our opinion, adequate provision has been made for any adjustments that may result from these reviews. Any differences between our original estimates of reimbursements and subsequent revisions are reflected in operations in the period in which the revisions are made often due to final determination or the period of payment no longer being subject to audit or review. We have made provisions of approximately $24,112,000 and $21,619,000 as of September 30, 2014 and December 31, 2013, respectively, for various Medicare and Medicaid current and prior year cost reports and claims reviews.
Revenue Recognition for Alternative Revenue Programs, Policy [Policy Text Block]	'
	Revenue Recognition - Private Pay
	For private pay patients in skilled nursing or assisted living facilities, we bill room and board in advance with payment being due in the month the services are performed. Charges for ancillary, pharmacy, therapy and other services to private patients are billed in the month following the performance of services; however, all billings are recognized as revenue when the services are performed.
Premiums Receivable, Allowance for Doubtful Accounts, Estimation Methodology, Policy [Policy Text Block]	'
	Revenue Recognition - Subordination of Fees and Uncertain Collections
	We provide management services to certain senior care facilities and to others we provide accounting and financial services. We generally charge 6% to 7% of net operating revenues for our management services and a predetermined fixed rate per bed for the accounting and financial services. Our policy is to recognize revenues associated with both management services and accounting and financial services on an accrual basis as the services are provided. However, under the terms of our management contracts, payments for our management services are subject to subordination to other expenditures of the long-term care center being managed. Furthermore, for certain of the third parties with whom we have contracted to provide services and which we have determined that collection is not reasonably assured, our policy is to recognize income only in the period in which the amounts are realized. We may receive payment for the unpaid and unrecognized management fees in whole or in part in the future only if cash flows from the operating and investing activities of the centers or proceeds from the sale of the centers are sufficient to pay the fees. There can be no assurance that such future cash flows will occur. The realization of such previously unrecognized revenue could cause our reported net income to vary significantly from period to period.
	We agree to subordinate our fees to the other expenses of a managed center because we believe we know how to improve the quality of patient services and finances of a senior healthcare center. We believe subordinating our fees demonstrates to the owner and employees of the managed center how confident we are of the impact we can have in making the center operations successful. We may continue to provide services to certain managed centers despite not being fully paid currently so that we may be able to collect unpaid fees in the future from improved operating results and because the incremental savings from discontinuing services to a center may be small compared to the potential benefit. Also, we may benefit from providing other ancillary services to the managed center.
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.
	Capital leases are recorded at the lower of fair market value or the present value of future minimum lease payments. Capital leases are amortized in accordance with the provision codified within Accounting Standards Codification (“ASC”) Subtopic 840-30, Leases - Capital Leases. Amortization of capital lease assets is included in depreciation and amortization expense.
Liability Reserve Estimate, Policy [Policy Text Block]	'
	Accrued Risk Reserves
	We are principally self-insured for risks related to workers’ compensation insurance and professional and general liability claims. Our accrued risk reserves primarily represent the accrual for self-insured risks associated with workers’ compensation insurance and professional and general liability claims. The accrued risk reserves include a liability for reported claims and estimates for incurred but unreported claims. Our policy is to use an external, independent actuary to estimate our exposure for claims obligations (for both asserted and unasserted claims). We reassess our accrued risk reserves on a quarterly basis.
	Professional liability remains an area of particular concern to us. The long term care industry has seen an increase in personal injury/wrongful death claims based on alleged negligence by nursing homes and their employees in providing care to residents. As of September 30, 2014, we and/or our managed centers are defendants in 38 such claims inclusive of years 2005 through September 30, 2014. It remains possible that those pending matters plus potential unasserted claims could exceed our reserves, which could have a material adverse effect on our consolidated financial position, results of operations and cash flows. It is also possible that future events could cause us to make significant adjustments or revisions to these reserve estimates and cause our reported net income to vary significantly from period to period.
	We maintain insurance coverage for incidents occurring in all centers owned or leased by us. The coverages include both primary policies and excess policies. In all years, settlements, if any, in excess of available insurance policy limits and our own reserves would be expensed by us.
Continuing Care Retirement Communities, Advance Fees, Policy [Policy Text Block]	'
	Continuing Care Contracts and Refundable Entrance Fee
	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 contracts provide 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 to residents when they relocate from our community and the apartment is re-occupied. Refundable entrance fees are classified as non-current liabilities and non-refundable entrance fees are classified as deferred revenue in the Company's consolidated balance sheets. The balances of refundable entrance fees as of September 30, 2014 and December 31, 2013 were $10,320,000 and $10,720,000, respectively.
	Obligation to Provide Future Services
	We annually estimate the present value of the net cost of future services and the use of facilities to be provided to the current CCRC residents and compare that amount with the balance of non-refundable deferred revenue from entrance fees received. If the present value of the net cost of future services exceeds the related anticipated revenues, a liability is recorded (obligation to provide future services) with a corresponding charge to income. As of September 30, 2014 and December 31, 2013, we have recorded a future service obligation in the amount of $3,689,000.
Revenue Recognition, Deferred Revenue [Policy Text Block]	'
	Deferred Revenue
	Deferred revenue includes the deferred gain on the sale of assets to National, the non-refundable portion (10%) of CCRC entrance fees being amortized over the remaining life expectancies of the residents, and premiums received within our workers’ compensation and professional liability companies that are not yet earned.
New Accounting Pronouncements, Policy [Policy Text Block]	'
	New Accounting Pronouncements
	In May 2014, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2014-09 “Revenue from Contracts with Customers”. This update is the result of a collaborative effort by the FASB and the International Accounting Standards Board to simplify revenue recognition guidance, remove inconsistencies in the application of revenue recognition, and to improve comparability of revenue recognition practices across entities, industries, jurisdictions, and capital markets. The FASB is amending the Accounting Standards Codification and creating a new Topic 606, “Revenue from Contracts with Customers”. The core principle of the guidance is that an entity should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. For a public entity, the amendments in this update are effective for annual reporting periods beginning after December 15, 2016, including interim periods within that reporting period. Early application is not permitted. The Company is currently evaluating the impact of this guidance on our consolidated financial statements and control framework.
	In April 2014, the FASB issued ASU No. 2014-08, “Reporting Discontinued Operations and Disclosures of Disposals of Components of an Entity.” This standard changes the requirements for reporting discontinued operations by raising the threshold for a disposal to qualify as a discontinued operation and requires new disclosures of both discontinued operations and certain other disposals that do not meet the definition of a discontinued operation. The standard limits discontinued operations reporting to disposals of components of an entity that represent strategic shifts that have (or will have) a major effect on an entity’s operations and financial results. This standard is effective for the Company on a prospective basis for annual periods beginning on January 1, 2015 and interim periods within that year. Early adoption is permitted, but only for disposals (or classifications as held for sale) that have not been reported in financial statements previously issued. When adopted, the Company does not expect this standard to have a material impact on our consolidated financial statements.
Refundable Advance Fees [Member]	'
Accounting Policies, by Policy (Policies) [Line Items]	'
Use of Estimates, Policy [Policy Text Block]	'
	Estimates and Assumptions
	The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires us to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates and could cause our reported net income to vary significantly from period to period.

Note_2_Summary_of_Significant_1

Note 2 - Summary of Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2014
Accounting Policies [Abstract]	'
Schedule of Error Corrections and Prior Period Adjustments [Table Text Block]	'
		Previously Reported Balance		Reclassification Amount			As-Adjusted Balance
	Restricted cash and cash equivalents (current assets section)	$	13,929	$	(3,631	)	$	10,298
	Restricted cash and cash equivalents (other assets section)		-		3,631			3,631
	Restricted marketable securities (current assets section)		142,003		(127,976	)		14,027
	Restricted marketable securities (other assets section)		-		127,976			127,976
	Accounts receivable (current assets section)		85,511		(5,655	)		79,856
	Deposits and other assets (other assets section)		1,153		5,655			6,808
	Accrued risk reserves (current liability section)		110,557		(86,232	)		24,325
	Accrued risk reserves (non-current liability section)		-		86,232			86,232
	Deferred income taxes (other assets section)		14,531		3,633			18,164
	Deferred income taxes (current liabilities section)		21,157		3,633			24,790

Note_3_Other_Revenues_Tables

Note 3 - Other Revenues (Tables)	9 Months Ended
	Sep. 30, 2014
Other Revenues [Abstract]	'
Schedule of Other Revenues [Table Text Block]	'
		Three Months Ended					Nine Months Ended
		30-Sep					30-Sep
	(in thousands)	2014		2013			2014		2013
	Management and accounting services fees	$	3,822	$	5,234		$	11,825	$	14,662
	Rental income		4,748		4,886			14,266		14,387
	Insurance services		1,787		2,729			5,437		12,792
	Other		94		(43	)		608		523
		$	10,451	$	12,806		$	32,136	$	42,364

Note_4_NonOperating_Income_Tab

Note 4 - Non-Operating Income (Tables)	9 Months Ended
	Sep. 30, 2014
Disclosure Text Block [Abstract]	'
Schedule of Other Nonoperating Income, by Component [Table Text Block]	'
		Three Months Ended				Nine Months Ended
		30-Sep				30-Sep
	(in thousands)	2014		2013		2014		2013
	Equity in earnings of unconsolidated investments	$	1,414	$	3,947	$	5,069	$	11,542
	Dividends and other net realized gains and losses on sales of securities		1,392		408		4,350		3,314
	Interest income		1,131		1,362		3,371		4,111
	Gain on the recovery of notes receivable		-		5,454		-		5,454
		$	3,937	$	11,171	$	12,790	$	24,421

Note_5_LongTerm_Leases_Tables

Note 5 - Long-Term Leases (Tables)	9 Months Ended
	Sep. 30, 2014
Leases [Abstract]	'
Schedule of Capital Leased Assets [Table Text Block]	'
		30-Sep-14			31-Dec-13
		(in thousands)
	Buildings and personal property	$	39,032		$	−
	Accumulated amortization		(2,290	)		−
		$	36,742		$	−
Schedule of Future Minimum Lease Payments for Capital Leases [Table Text Block]	'
		Operating Leases			Capital Leases
		(in thousands)
	2015	$	34,200		$	5,200
	2016		34,200			5,200
	2017		34,200			5,200
	2018		34,200			5,200
	2019		34,200			5,200
	Thereafter		253,700			22,967
	Total minimum lease payments	$	424,700		$	48,967
	Less: Amounts representing interest					(11,628	)
	Present value of minimum lease payments					37,339
	Less: Current portion					(3,042	)
	Long-term capital lease obligations				$	34,297

Note_7_Earnings_Per_Share_Tabl

Note 7 - Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 2014
Earnings Per Share [Abstract]	'
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	'
		Three Months Ended September 30						Nine Months Ended September 30
	(in thousands, except for share and per share amounts)	2014			2013			2014			2013
	Basic:
	Weighted average common shares outstanding		13,805,430			13,820,449			13,838,891			13,832,706
	Net income	$	12,829		$	19,877		$	38,569		$	48,024
	Dividends to preferred stockholders		(2,167	)		(2,167	)		(6,502	)		(6,503	)
	Net income available to common stockholders	$	10,662		$	17,710		$	32,067		$	41,521
	Earnings per common share, basic	$	0.77		$	1.28		$	2.32		$	3
	Diluted:
	Weighted average common shares outstanding		13,805,430			13,820,449			13,838,891			13,832,706
	Dilutive effect of stock options		82,764			7,970			63,944			8,397
	Dilutive effect of restricted stock		2,814			3,840			3,657			4,640
	Dilutive effect of contingent issuable stock		345,504			231,500			323,539			232,495
	Convertible preferred stock		-			2,623,156			-			2,623,253
	Assumed average common shares outstanding		14,236,512			16,686,915			14,230,031			16,701,491
	Net income available to common stockholders	$	10,662		$	17,710		$	32,067		$	41,521
	Add dilutive preferred stock dividends for effect of assumed conversion of preferred stock		-			2,167			-			6,503
	Net income for diluted earnings per common share	$	10,662		$	19,877		$	32,067		$	48,024
	Earnings per common share, diluted	$	0.75		$	1.19		$	2.25		$	2.88

Note_8_Investments_in_Marketab1

Note 8 - Investments in Marketable Securities (Tables)	9 Months Ended
	Sep. 30, 2014
Investments, Debt and Equity Securities [Abstract]	'
Available-for-sale Securities [Table Text Block]	'
		30-Sep-14				31-Dec-13
	(in thousands)	Amortized		Fair		Amortized		Fair
		Cost		Value		Cost		Value
	Investments available for sale:
	Marketable equity securities	$	30,176	$	108,529	$	30,176	$	105,009
	Restricted investments available for sale:
	Corporate debt securities		70,406		70,512		65,852		65,006
	Commercial mortgage-backed securities		54,977		54,545		46,977		45,856
	U.S. Treasury securities		16,062		16,061		22,932		22,841
	State and municipal securities		11,918		12,255		8,123		8,300
		$	183,539	$	261,902	$	174,060	$	247,012
Schedule of Available-for-sale Securities Reconciliation [Table Text Block]	'
		30-Sep-14						31-Dec-13
		Shares		Cost		Fair		Shares		Cost		Fair
						Value						Value
	NHI Common Stock		1,630,642	$	24,734	$	93,175		1,630,642	$	24,734	$	91,479
Investments Classified by Contractual Maturity Date [Table Text Block]	'
		30-Sep-14				31-Dec-13
	(in thousands)	Cost		Fair		Cost		Fair
				Value				Value
	Maturities:
	Within 1 year	$	12,616	$	12,665	$	9,279	$	9,324
	1 to 5 years		94,482		95,060		91,787		92,011
	6 to 10 years		45,296		44,811		40,387		38,335
	Over 10 years		969		837		2,431		2,333
		$	153,363	$	153,373	$	143,884	$	142,003

Note_9_Fair_Value_Measurements1

Note 9 - Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2014
Fair Value Disclosures [Abstract]	'
Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis [Table Text Block]	'
		Fair Value Measurements Using
	30-Sep-14	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	$	76,917	$	76,917	$	-	$	-
	Restricted cash and cash equivalents		13,706		13,706		-		-
	Marketable equity securities		108,529		108,529		-		-
	Corporate debt securities		70,512		-		70,512		-
	Commercial mortgage-backed securities		54,545		-		54,545		-
	U.S. Treasury securities		16,061		16,061		-		-
	State and municipal securities		12,255		-		12,255		-
	Total financial assets	$	352,525	$	215,213	$	137,312	$	-
		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	$	-

Note_10_LongTerm_Debt_Tables

Note 10 - Long-Term Debt (Tables)	9 Months Ended
	Sep. 30, 2014
Debt Disclosure [Abstract]	'
Schedule of Debt [Table Text Block]	'
		Weighted			Maturities		30-Sep-14		31-Dec-14
		Average
		Interest Rate
		Variable					(dollars in thousands)
	Revolving Credit Facility, interest payable monthly		0.9	%		2015	$	-	$	-
	Unsecured term note payable to National, interest payable quarterly, principal payable at maturity		2.8	%		2018		10,000		10,000
								10,000		10,000
	Less current portion							-		-
							$	10,000	$	10,000

Note_13_StockBased_Compensatio1

Note 13 - Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2014
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]	'
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions [Table Text Block]	'
			2014			2013
	Risk-free interest rate			0.52	%		0.25	%
	Expected volatility			17.3	%		31.1	%
	Expected life, in years			2.2			2.1
	Expected dividend yield			2.68	%		2.81	%
Schedule of Share-based Compensation, Stock Options, Activity [Table Text Block]	'
			Number of			Weighted			Aggregate
			Shares			Average			Intrinsic
						Exercise Price			Value
	Options outstanding at January 1, 2013			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			-
	Options granted			58,090			53.11			-
	Options exercised			(145,074	)		45.32			-
	Options cancelled			(20,000	)		46.69			-
	Options outstanding at September 30, 2014			967,568		$	47.01		$	8,227,000
	Options exercisable at September 30, 2014			158,573		$	48.06		$	1,182,000
Schedule of Share-based Compensation, Shares Authorized under Stock Option Plans, by Exercise Price Range [Table Text Block]	'
		Options			Exercise Prices	Weighted Average			Weighted Average
		Outstanding				Exercise Price			Remaining Contractual
		30-Sep-14							Life in Years
			909,678		$44.80 - $47.45	$	46.62			1.6
			57,890		$52.93 - $53.72		53.11			3.7
			967,568			$	47.01			1.7
Schedule of Share-based Compensation, Restricted Stock and Restricted Stock Units Activity [Table Text Block]	'
			Number of			Weighted			Aggregate Intrinsic Value
			Shares			Average Grant Date Fair Value
	Non-vested restricted shares at January 1, 2013			18,000		$	34.46		$	-
	Award shares granted			-			-			-
	Award shares vested			6,000			34.46			-
	Non-vested restricted shares at December 31, 2013			12,000			34.46			-
	Award shares granted			-			-			-
	Award shares vested			6,000			34.46			-
	Non-vested restricted shares at September 30, 2014			6,000		$	34.46		$	126,000

Note_1_Description_of_Business1

Note 1 - Description of Business (Details)	Sep. 30, 2014
Disclosure Text Block [Abstract]	'
Number of Skilled Nursing Centers Leased From NHI	73
Number Of Beds	9,410
Number of Assisted Living Facilities	18
Number of Independent Living Facilities	5
Number of Homecare Programs	37
Number of States in which Entity Operates	10

Note_2_Summary_of_Significant_2

Note 2 - Summary of Significant Accounting Policies (Details) (USD $)	9 Months Ended
	Sep. 30, 2014	Dec. 31, 2013
Note 2 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'
Concentration Risk, Percentage	65.00%	'
Malpractice Loss Contingency, Number of Claims	38	'
Continuing Care Retirement Communities Advance Fees, Obligation for Future Services, Amount (in Dollars)	$3,689,000	$3,689,000
Medicare and Medicaid [Member]	'	'
Note 2 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'
Allowance for Doubtful Accounts Receivable (in Dollars)	24,112,000	21,619,000
Building and Building Improvements [Member] | Minimum [Member]	'	'
Note 2 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'
Property, Plant and Equipment, Useful Life	'20 years	'
Building and Building Improvements [Member] | Maximum [Member]	'	'
Note 2 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'
Property, Plant and Equipment, Useful Life	'40 years	'
Equipment and Furniture [Member] | Minimum [Member]	'	'
Note 2 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'
Property, Plant and Equipment, Useful Life	'3 years	'
Equipment and Furniture [Member] | Maximum [Member]	'	'
Note 2 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'
Property, Plant and Equipment, Useful Life	'15 years	'
Refundable Advance Fees [Member]	'	'
Note 2 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'
Nonrefundable Resident Entry Fee Percentage	10.00%	'
Customer Refundable Fees (in Dollars)	$10,320,000	$10,720,000
Original Entry Fee [Member]	'	'
Note 2 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'
Refundable Resident Entry Fee Percentage	90.00%	'
Appreciation [Member]	'	'
Note 2 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'
Appreciation of Apartment Over Original Resident's Entry Fee, Percentage	40.00%	'
Minimum [Member]	'	'
Note 2 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'
Management Services Fees	6.00%	'
Maximum [Member]	'	'
Note 2 - Summary of Significant Accounting Policies (Details) [Line Items]	'	'
Management Services Fees	7.00%	'

Note_2_Summary_of_Significant_3

Note 2 - Summary of Significant Accounting Policies (Details) - Reclassified Balance Sheet Items (USD $)	Sep. 30, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified
Restricted cash and cash equivalents (current assets section)	$10,075	$10,298
Restricted cash and cash equivalents (other assets section)	3,631	3,631
Restricted marketable securities (current assets section)	14,235	14,027
Restricted marketable securities (other assets section)	139,138	127,976
Accounts receivable (current assets section)	73,417	79,856
Deposits and other assets (other assets section)	7,056	6,808
Accrued risk reserves (current liability section)	24,310	24,325
Accrued risk reserves (non-current liability section)	88,526	86,232
Deferred income taxes (other assets section)	21,438	18,164
Deferred income taxes (current liabilities section)	25,582	24,790
Scenario, Previously Reported [Member]	'	'
Restricted cash and cash equivalents (current assets section)	'	13,929
Restricted marketable securities (current assets section)	'	142,003
Accounts receivable (current assets section)	'	85,511
Deposits and other assets (other assets section)	'	1,153
Accrued risk reserves (current liability section)	'	110,557
Deferred income taxes (other assets section)	'	14,531
Deferred income taxes (current liabilities section)	'	21,157
Restatement Adjustment [Member]	'	'
Restricted cash and cash equivalents (current assets section)	'	-3,631
Restricted cash and cash equivalents (other assets section)	'	3,631
Restricted marketable securities (current assets section)	'	-127,976
Restricted marketable securities (other assets section)	'	127,976
Accounts receivable (current assets section)	'	-5,655
Deposits and other assets (other assets section)	'	5,655
Accrued risk reserves (current liability section)	'	-86,232
Accrued risk reserves (non-current liability section)	'	86,232
Deferred income taxes (other assets section)	'	3,633
Deferred income taxes (current liabilities section)	'	$3,633

Note_3_Other_Revenues_Details

Note 3 - Other Revenues (Details) (USD $)

9 Months Ended

9 Months Ended

3 Months Ended

9 Months Ended

3 Months Ended

9 Months Ended

3 Months Ended

9 Months Ended

3 Months Ended

9 Months Ended

3 Months Ended

Sep. 30, 2014

Oct. 01, 2014

Sep. 30, 2014

Sep. 30, 2014

Sep. 30, 2014

Sep. 30, 2013

Sep. 30, 2014

Sep. 30, 2013

Sep. 30, 2014

Sep. 30, 2014

Sep. 30, 2013

Sep. 30, 2014

Sep. 30, 2013

Sep. 30, 2014

Sep. 30, 2013

Sep. 30, 2014

Sep. 30, 2013

Sep. 30, 2014

Sep. 30, 2013

Sep. 30, 2013

Cancelled Accounting and Financial Servicies [Member]

Accounting and Financial Services Provided [Member]

Workers Compensation Premium Revenue [Member]

Workers Compensation Premium Revenue [Member]

Workers Compensation Premium Revenue [Member]

Workers Compensation Premium Revenue [Member]

Workers Compensation Premium Revenue [Member]

Professional Liability Insurance [Member]

Professional Liability Insurance [Member]

Professional Liability Insurance [Member]

National [Member]

National [Member]

National [Member]

National [Member]

Other Nursing Centers [Member]

Other Nursing Centers [Member]

Other Nursing Centers [Member]

Other Nursing Centers [Member]

Professional Liability Insurance [Member]

Des Peres, Missouri [Member]

Note 3 - Other Revenues (Details) [Line Items]

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Number of Skilled Nursing Centers

'

'

'

'

'

'

'

'

'

'

'

5

'

5

'

'

21

'

21

'

Management Fees Revenue

'

'

'

'

'

'

'

'

'

'

'

$884,000

$860,000

$2,679,000

$2,637,000

$562,000

$1,125,000

$1,664,000

$4,124,000

'

Number of Skilled Nursing Centers Leased From NHI

73

'

'

'

'

'

'

'

'

'

'

'

'

'

'

7

'

7

'

'

Number of Healthcare Facilities

'

7

27

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Expected Revenue Increase (Decrease) Annually

1,600,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Expected Revenue Increase (Decrease) Quarterly

400,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Health Care Organization, Premium Revenue

'

'

'

$2,769,000

$1,082,000

$1,218,000

$3,362,000

$6,607,000

$705,000

$2,076,000

$2,539,000

'

'

'

'

'

'

'

'

$654,000

Note_3_Other_Revenues_Details_

Note 3 - Other Revenues (Details) - Other Revenues (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Note 3 - Other Revenues (Details) - Other Revenues [Line Items]	'	'	'	'
Other Revenues	$10,451	$12,806	$32,136	$42,364
Management and Accounting Services Fees [Member]	'	'	'	'
Note 3 - Other Revenues (Details) - Other Revenues [Line Items]	'	'	'	'
Other Revenues	3,822	5,234	11,825	14,662
Rental Income [Member]	'	'	'	'
Note 3 - Other Revenues (Details) - Other Revenues [Line Items]	'	'	'	'
Other Revenues	4,748	4,886	14,266	14,387
Insurance Services [Member]	'	'	'	'
Note 3 - Other Revenues (Details) - Other Revenues [Line Items]	'	'	'	'
Other Revenues	1,787	2,729	5,437	12,792
Other Income [Member]	'	'	'	'
Note 3 - Other Revenues (Details) - Other Revenues [Line Items]	'	'	'	'
Other Revenues	$94	($43)	$608	$523

Note_4_NonOperating_Income_Det

Note 4 - Non-Operating Income (Details) (Caris [Member])	Sep. 30, 2014
Caris [Member]	'
Note 4 - Non-Operating Income (Details) [Line Items]	'
Equity Method Investment, Ownership Percentage	75.10%

Note_4_NonOperating_Income_Det1

Note 4 - Non-Operating Income (Details) - Non-Operating Income (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Note 4 - Non-Operating Income (Details) - Non-Operating Income [Line Items]	'	'	'	'
Non-operating Income	$3,937	$11,171	$12,790	$24,421
Equity in Earnings of Unconsolidated Investments [Member]	'	'	'	'
Note 4 - Non-Operating Income (Details) - Non-Operating Income [Line Items]	'	'	'	'
Non-operating Income	1,414	3,947	5,069	11,542
Dividends and Other Net Realized Gains and Losses on Sales of Securities [Member]	'	'	'	'
Note 4 - Non-Operating Income (Details) - Non-Operating Income [Line Items]	'	'	'	'
Non-operating Income	1,392	408	4,350	3,314
Interest Income [Member]	'	'	'	'
Note 4 - Non-Operating Income (Details) - Non-Operating Income [Line Items]	'	'	'	'
Non-operating Income	1,131	1,362	3,371	4,111
Gain on Recovery of Notes Receivable [Member]	'	'	'	'
Note 4 - Non-Operating Income (Details) - Non-Operating Income [Line Items]	'	'	'	'
Non-operating Income	'	$5,454	'	$5,454

Note_5_LongTerm_Leases_Details

Note 5 - Long-Term Leases (Details) (USD $)	3 Months Ended		9 Months Ended
	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Note 5 - Long-Term Leases (Details) [Line Items]	'	'	'	'
Number of Additional Lease Options	2	'	2	'
Number of Skilled Nursing Centers Leased From NHI	73	'	73	'
Number of Lease Agreements with NHI	2	'	2	'
Operating Leases, Rent Expense (in Dollars)	$9,913,000	$9,889,000	$29,712,000	$29,627,000
Captial Lease [Member] | Skilled Nursing Facility [Member]	'	'	'	'
Note 5 - Long-Term Leases (Details) [Line Items]	'	'	'	'
Number of Facilities Under Capitalized Lease	2	'	2	'
Captial Lease [Member]	'	'	'	'
Note 5 - Long-Term Leases (Details) [Line Items]	'	'	'	'
Number of Facilities Under Capitalized Lease	3	'	3	'
Number of Capitalized Lease Agreements	3	'	3	'
Initial Lease Term	'	'	'10 years	'
Capital Leases, Future Minimum Payments, Net Minimum Payments (in Dollars)	5,200,000	'	5,200,000	'
Capital Lease Additional Percentage Rent Percentage	'	'	4.00%	'
National Health Investors, Inc. [Member]	'	'	'	'
Note 5 - Long-Term Leases (Details) [Line Items]	'	'	'	'
Number of Skilled Nursing Centers Leased From NHI	35	'	35	'
Number of Assisted Living Centers Leased From NHI	7	'	7	'
Number of Independent Living Centers Leased From NHI	3	'	3	'
Operating Leases, Rent Expense, Minimum Rentals (in Dollars)	'	'	34,200,000	'
Operating Lease Additional Percentage Rent Percentage	'	'	4.00%	'
Operating Leases, Rent Expense (in Dollars)	'	'	$27,400,000	$26,982,000

Note_5_LongTerm_Leases_Details1

Note 5 - Long-Term Leases (Details) - Fixed Assets Recorded under Capital Leases (Buildings and Personal Property [Member], USD $)	Sep. 30, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified
Buildings and Personal Property [Member]	'	'
Capital Leased Assets [Line Items]	'	'
Buildings and personal property	$39,032	$0
Accumulated amortization	-2,290	0
	$36,742	$0

Note_5_LongTerm_Leases_Details2

Note 5 - Long-Term Leases (Details) - Future Minimum Lease Payments (USD $)	Sep. 30, 2014
In Thousands, unless otherwise specified
Future Minimum Lease Payments [Abstract]	'
2015	$34,200
2015	5,200
2016	34,200
2016	5,200
2017	34,200
2017	5,200
2018	34,200
2018	5,200
2019	34,200
2019	5,200
Thereafter	253,700
Thereafter	22,967
Total minimum lease payments	424,700
Total minimum lease payments	48,967
Less: Amounts representing interest	-11,628
Present value of minimum lease payments	37,339
Less: Current portion	-3,042
Long-term capital lease obligations	$34,297

Note_7_Earnings_Per_Share_Deta

Note 7 - Earnings Per Share (Details)	9 Months Ended		3 Months Ended	9 Months Ended
	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2014
	Incentive Stock Option [Member]	Incentive Stock Option [Member]	Common Shares Issuable Upon Conversion Of Preferred Stock [Member]	Common Shares Issuable Upon Conversion Of Preferred Stock [Member]
Note 7 - Earnings Per Share (Details) [Line Items]	'	'	'	'
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	12,890	989,275	2,622,905	2,622,905

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		9 Months Ended
In Thousands, except Share data, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
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	13,805,430	13,820,449	13,838,891	13,832,706
Dilutive effect of contingent issuable stock	345,504	231,500	323,539	232,495
Convertible preferred stock	'	2,623,156	'	2,623,253
Assumed average common shares outstanding	14,236,512	16,686,915	14,230,031	16,701,491
Net income (in Dollars)	$12,829	$19,877	$38,569	$48,024
Dividends to preferred stockholders (in Dollars)	-2,167	-2,167	-6,502	-6,503
Net income available to common stockholders (in Dollars)	10,662	17,710	32,067	41,521
Add dilutive preferred stock dividends for effect of assumed conversion of preferred stock (in Dollars)	'	2,167	'	6,503
Net income for diluted earnings per common share (in Dollars)	$10,662	$19,877	$32,067	$48,024
Earnings per common share, diluted (in Dollars per share)	$0.75	$1.19	$2.25	$2.88
Earnings per common share, basic (in Dollars per share)	$0.77	$1.28	$2.32	$3
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	82,764	7,970	63,944	8,397
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	2,814	3,840	3,657	4,640

Note_8_Investments_in_Marketab2

Note 8 - Investments in Marketable Securities (Details) (USD $)	9 Months Ended		12 Months Ended
	Sep. 30, 2014	Sep. 30, 2013	Dec. 31, 2013
Investments, Debt and Equity Securities [Abstract]	'	'	'
Available-for-sale Securities, Gross Unrealized Gain	$79,591,000	'	$75,702,000
Available-for-sale Securities, Gross Unrealized Loss	1,228,000	'	2,750,000
Proceeds from Sale and Maturity of Marketable Securities	27,641,000	57,904,000	'
Realized Investment Gains (Losses)	$172,000	($527,000)	'

Note_8_Investments_in_Marketab3

Note 8 - Investments in Marketable Securities (Details) - Marketable Securities and Restricted Marketable Securities (USD $)	Sep. 30, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified
Restricted investments available for sale:	'	'
Amortized Cost	$153,363	$143,884
	183,539	174,060
	261,902	247,012
Equity Securities [Member]	'	'
Investments available for sale:	'	'
Marketable equity securities	30,176	30,176
Marketable equity securities	108,529	105,009
Restricted investments available for sale:	'	'
	108,529	105,009
Corporate Debt Securities [Member]	'	'
Restricted investments available for sale:	'	'
Amortized Cost	70,406	65,852
Fair Value	70,512	65,006
	70,512	65,006
Commercial Mortgage Backed Securities [Member]	'	'
Restricted investments available for sale:	'	'
Amortized Cost	54,977	46,977
Fair Value	54,545	45,856
	54,545	45,856
US Government Corporations and Agencies Securities [Member]	'	'
Restricted investments available for sale:	'	'
Amortized Cost	16,062	22,932
Fair Value	16,061	22,841
US States and Political Subdivisions Debt Securities [Member]	'	'
Restricted investments available for sale:	'	'
Amortized Cost	11,918	8,123
Fair Value	12,255	8,300
	$12,255	$8,300

Note_8_Investments_in_Marketab4

Note 8 - Investments in Marketable Securities (Details) - Available for Sale Marketable Equity Securities (NHI Common Stock [Member], USD $)	Sep. 30, 2014	Dec. 31, 2013
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	$93,175	$91,479

Note_8_Investments_in_Marketab5

Note 8 - Investments in Marketable Securities (Details) - Amortized Cost and Estimated Fair Value of Debt Securities as Available for Sale (USD $)	Sep. 30, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified
Amortized Cost and Estimated Fair Value of Debt Securities as Available for Sale [Abstract]	'	'
Within 1 year	$12,616	$9,279
Within 1 year	12,665	9,324
1 to 5 years	94,482	91,787
1 to 5 years	95,060	92,011
6 to 10 years	45,296	40,387
6 to 10 years	44,811	38,335
Over 10 years	969	2,431
Over 10 years	837	2,333
	153,363	143,884
	$153,373	$142,003

Note_9_Fair_Value_Measurements2

Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level (USD $)	Sep. 30, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified
Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level [Line Items]	'	'
Cash and cash equivalents	$76,917	$81,705
Restricted cash and cash equivalents	13,706	13,929
Available for sale securities	261,902	247,012
Total financial assets	352,525	342,646
Equity Securities [Member] | Fair Value, Inputs, Level 1 [Member]	'	'
Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level [Line Items]	'	'
Available for sale securities	108,529	105,009
Equity Securities [Member]	'	'
Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level [Line Items]	'	'
Available for sale securities	108,529	105,009
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	70,512	65,006
Corporate Debt Securities [Member]	'	'
Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level [Line Items]	'	'
Available for sale securities	70,512	65,006
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	54,545	45,856
Commercial Mortgage Backed Securities [Member]	'	'
Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level [Line Items]	'	'
Available for sale securities	54,545	45,856
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	16,061	'
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	16,061	'
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	12,255	8,300
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	12,255	8,300
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	76,917	81,705
Restricted cash and cash equivalents	13,706	13,929
Total financial assets	215,213	223,484
Fair Value, Inputs, Level 2 [Member]	'	'
Note 9 - Fair Value Measurements (Details) - Summary of Fair Value Measurements by Level [Line Items]	'	'
Total financial assets	$137,312	$119,162

Note_10_LongTerm_Debt_Details_

Note 10 - Long-Term Debt (Details) - Long-term Debt (USD $)	9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Dec. 31, 2013
Note 10 - 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 10 - 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 10 - Long-Term Debt (Details) - Long-term Debt [Line Items]	'	'
Weighted Average Interest Rate, Variable	0.90%	'
Maturities	'2015	'

Note_11_75000000_Revolving_Cre1

Note 11 - $75,000,000 Revolving Credit Facility (Details) (USD $)	9 Months Ended
	Sep. 30, 2014	Oct. 22, 2014
Note 11 - $75,000,000 Revolving Credit Facility (Details) [Line Items]	'	'
Line of Credit Facility, Maximum Borrowing Capacity	'	$75,000,000
Line of Credit Facility, Commitment Fee Percentage	0.10%	'
Letter of Credit [Member]	'	'
Note 11 - $75,000,000 Revolving Credit Facility (Details) [Line Items]	'	'
Line of Credit Facility, Maximum Borrowing Capacity	'	$5,000,000
Debt Instrument, Basis Spread on Variable Rate	0.10%	'
Eurodollar Rate [Member]	'	'
Note 11 - $75,000,000 Revolving Credit Facility (Details) [Line Items]	'	'
Debt Instrument, Basis Spread on Variable Rate	0.70%	'

Note_12_Stock_Repurchase_Progr1

Note 12 - Stock Repurchase Program (Details) (USD $)	0 Months Ended
	Aug. 11, 2014	Feb. 19, 2013	Aug. 05, 2014	Aug. 01, 2014
Disclosure Text Block Supplement [Abstract]	'	'	'	'
Stock Repurchase Program, Authorized Amount	'	'	$25,000,000	$25,000,000
Stock Repurchased During Period, Shares (in Shares)	125,000	'	'	'
Stock Repurchased During Period, Value	6,995,000	'	'	'
Treasury Stock, Shares, Acquired (in Shares)	'	100,000	'	'
Treasury Stock, Value, Acquired, Cost Method	'	$4,700,000	'	'

Note_13_StockBased_Compensatio2

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

3 Months Ended

9 Months Ended

Sep. 30, 2014

Sep. 30, 2013

Sep. 30, 2014

Sep. 30, 2013

Sep. 30, 2014

Sep. 30, 2014

Sep. 30, 2014

Sep. 30, 2014

Sep. 30, 2014

31-May-05

Sep. 30, 2014

31-May-10

Incentive Stock Option [Member]

Employee Stock Option [Member]

Restricted Stock [Member]

Director [Member]

2005 Plan [Member]

2005 Plan [Member]

2010 Plan [Member]

2010 Plan [Member]

Minimum [Member]

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

'

'

'

'

'

'

'

'

'

'

'

'

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

'

'

'

'

'10 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)

'

'

'

'

'

'

'

'

220,620

'

398,370

'

Share-based Compensation Arrangement by Share-based Payment Award, Shares Issued in Period (in Shares)

'

'

'

'

'

'

'

45,000

'

'

'

'

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

'

'

12,890

'

'

'

'

'

'

'

'

'

Allocated Share-based Compensation Expense

$377,000

$453,000

$1,547,000

$1,812,000

'

'

'

'

'

'

'

'

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

$2,480,000

'

$2,480,000

'

'

$2,356,000

$124,000

'

'

'

'

'

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

'

'

'

'

'

'1 year 146 days

'219 days

'

'

'

'

'

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

'

'

'

'

'

'

'219 days

'

'

'

'

'

Note_13_StockBased_Compensatio3

Note 13 - Stock-Based Compensation (Details) - Summary of Assumptions used to Value Options Granted	9 Months Ended	12 Months Ended
	Sep. 30, 2014	Dec. 31, 2013
Summary of Assumptions used to Value Options Granted [Abstract]	'	'
Risk-free interest rate	0.52%	0.25%
Expected volatility	17.30%	31.10%
Expected life, in years	'2 years 73 days	'2 years 36 days
Expected dividend yield	2.68%	2.81%

Note_13_StockBased_Compensatio4

Note 13 - Stock-Based Compensation (Details) - Summary of Outstanding Stock Options (USD $)	9 Months Ended	12 Months Ended
	Sep. 30, 2014	Dec. 31, 2013
Summary of Outstanding Stock Options [Abstract]	'	'
Options outstanding at January 1, 2013	1,074,552	1,134,602
Options outstanding at January 1, 2013	$46.44	$46.75
Number of Shares - Options Granted	58,090	59,472
Weighted Average Exercise Price - Options Granted	$53.11	$47.95
Number of Shares - Options Exercised	-145,074	-21,522
Weighted Average Exercise Price - Options Exercised	$45.32	$45.63
Number of Shares, Cancelled	-20,000	-98,000
Weighted Average Exercise Price, Cancelled	$46.69	$51.11
Number of Shares - Options Outstanding	967,568	1,074,552
Weighted Average Exercise Price - Options Outstanding	$47.01	$46.44
Aggregate Intrinsic Value - Options Outstanding	$8,227,000	'
Options exercisable at September 30, 2014	158,573	'
Options exercisable at September 30, 2014	$48.06	'
Options exercisable at September 30, 2014	$1,182,000	'

Note_13_StockBased_Compensatio5

Note 13 - Stock-Based Compensation (Details) - Options Outstanding (USD $)	3 Months Ended	9 Months Ended
	Sep. 30, 2014	Sep. 30, 2014
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]	'	'
Options Outstanding (in Shares)	967,568	967,568
Weighted Average Exercise Price	$47.01	$47.01
Weighted Average Remaining Contractual Life in Years	'1 year 255 days	'
Exercise Price Range 1 [Member]	'	'
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]	'	'
Options Outstanding (in Shares)	909,678	909,678
Lower Exercise Prices	'	$44.80
Upper Exercise Prices	'	$47.45
Weighted Average Exercise Price	$46.62	$46.62
Weighted Average Remaining Contractual Life in Years	'1 year 219 days	'
Exercise Price Range 2 [Member]	'	'
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]	'	'
Options Outstanding (in Shares)	57,890	57,890
Lower Exercise Prices	'	$52.93
Upper Exercise Prices	'	$53.72
Weighted Average Exercise Price	$53.11	$53.11
Weighted Average Remaining Contractual Life in Years	'3 years 255 days	'

Note_13_StockBased_Compensatio6

Note 13 - Stock-Based Compensation (Details) - Summary of Restricted Stock Activity (Restricted Stock [Member], USD $)	9 Months Ended	12 Months Ended
	Sep. 30, 2014	Dec. 31, 2013
Restricted Stock [Member]	'	'
Note 13 - Stock-Based Compensation (Details) - Summary of Restricted Stock Activity [Line Items]	'	'
Non-vested restricted shares at January 1, 2013	12,000	18,000
Non-vested restricted shares at January 1, 2013	$34.46	$34.46
Number of Shares, Vested	6,000	6,000
Weighted Average Grant Date Fair Value, Vested	$34.46	$34.46
Number of Shares	6,000	12,000
Weighted Average Grant Date Fair Value	$34.46	$34.46
Aggregate Intrinsic Value	$126,000	'

Note_14_Income_Taxes_Details

Note 14 - Income Taxes (Details) (USD $)	3 Months Ended		9 Months Ended
	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Note 14 - Income Taxes (Details) [Line Items]	'	'	'	'
Income Tax Expense (Benefit)	$5,844,000	$10,559,000	$22,028,000	$28,659,000
Effective Income Tax Rate Reconciliation, Percent	31.30%	34.70%	36.40%	37.40%
Unrecognized Tax Benefits, Period Increase (Decrease)	16,000	54,000	-290,000	-260,000
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations	-1,542,000	-1,605,000	-1,542,000	-1,605,000
Income Tax Benefit as a Percentage of Income	8.30%	5.30%	2.50%	2.10%
Unrecognized Tax Benefits	13,534,000	'	13,534,000	'
Unrecognized Tax Benefits, Income Tax Penalties and Interest Accrued	2,096,000	'	2,096,000	'
Unrecognized Tax Benefits that Would Impact Effective Tax Rate	4,839,000	'	4,839,000	'
Scenario, Forecast [Member] | Permanent Differences [Member]	'	'	'	'
Note 14 - Income Taxes (Details) [Line Items]	'	'	'	'
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations	'	'	1,065,000	'
Scenario, Forecast [Member] | Temporary Difference [Member]	'	'	'	'
Note 14 - Income Taxes (Details) [Line Items]	'	'	'	'
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations	'	'	1,520,000	'
Scenario, Forecast [Member] | Liability For Interest And Penalties [Member]	'	'	'	'
Note 14 - Income Taxes (Details) [Line Items]	'	'	'	'
Unrecognized Tax Benefits, Period Increase (Decrease)	'	'	585,000	'
Scenario, Forecast [Member]	'	'	'	'
Note 14 - Income Taxes (Details) [Line Items]	'	'	'	'
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations	'	'	2,585,000	'
Permanent Differences [Member]	'	'	'	'
Note 14 - Income Taxes (Details) [Line Items]	'	'	'	'
Unrecognized Tax Benefits, Period Increase (Decrease)	-460,000	-410,000	-557,000	-490,000
Unrecognized Tax Benefits	4,839,000	'	4,839,000	'
Unrecognized Tax Benefits, Income Tax Penalties and Interest Accrued	1,858,000	'	1,858,000	'
Deferred Tax Assets [Member]	'	'	'	'
Note 14 - Income Taxes (Details) [Line Items]	'	'	'	'
Unrecognized Tax Benefits	$8,695,000	'	$8,695,000	'

Note_15_Guarantees_and_Conting1

Note 15 - Guarantees and Contingencies (Details) (USD $)	9 Months Ended	36 Months Ended		45 Months Ended
	Sep. 30, 2014	Dec. 31, 2010	Dec. 31, 2007	Sep. 30, 2014	Dec. 31, 2013
Note 15 - Guarantees and Contingencies (Details) [Line Items]	'	'	'	'	'
Self Insurance Reserve	$112,836,000	'	'	$112,836,000	$110,557,000
Direct Business Coverage Statutory Limits	1,000,000	'	'	'	'
Malpractice Loss Contingency, Number of Claims	38	'	'	38	'
Annual Excess Coverage	'	9,000,000	7,500,000	4,000,000	'
Coverage Amount per Incident [Member]	'	'	'	'	'
Note 15 - Guarantees and Contingencies (Details) [Line Items]	'	'	'	'	'
Primary Insurance Coverage Amount Per Incident	1,000,000	'	'	'	'
Coverage Amount per Location [Member]	'	'	'	'	'
Note 15 - Guarantees and Contingencies (Details) [Line Items]	'	'	'	'	'
Primary Insurance Coverage Amount Per Location	$3,000,000	'	'	'	'