Document And Entity Information
Document And Entity Information - USD ($) $ in Millions | 12 Months Ended | ||
Dec. 31, 2016 | Feb. 09, 2017 | Jun. 30, 2016 | |
Document Information [Line Items] | |||
Entity Registrant Name | NATIONAL HEALTHCARE CORP | ||
Entity Central Index Key | 1,047,335 | ||
Trading Symbol | nhc | ||
Current Fiscal Year End Date | --12-31 | ||
Entity Filer Category | Accelerated Filer | ||
Entity Current Reporting Status | Yes | ||
Entity Voluntary Filers | No | ||
Entity Well-known Seasoned Issuer | No | ||
Entity Common Stock, Shares Outstanding (in shares) | 15,177,938 | ||
Entity Public Float | $ 505 | ||
Document Type | 10-K | ||
Document Period End Date | Dec. 31, 2016 | ||
Document Fiscal Year Focus | 2,016 | ||
Document Fiscal Period Focus | FY | ||
Amendment Flag | false |
Consolidated Statements of Inco
Consolidated Statements of Income - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 | |
Revenues: | |||
Net patient revenues | $ 880,724 | $ 864,846 | $ 829,287 |
Other revenues | 45,914 | 41,776 | 42,396 |
Net operating revenues | 926,638 | 906,622 | 871,683 |
Costs and Expenses: | |||
Salaries, wages and benefits | 548,007 | 532,735 | 510,249 |
Other operating | 233,833 | 227,072 | 217,143 |
Facility rent | 41,292 | 39,967 | 39,731 |
Depreciation and amortization | 39,023 | 37,114 | 34,384 |
Interest | 3,941 | 2,608 | 2,165 |
Total costs and expenses | 866,096 | 839,496 | 803,672 |
Income Before Non–Operating Income | 60,542 | 67,126 | 68,011 |
Non–Operating Income | 19,665 | 18,148 | 17,182 |
Income Before Income Taxes | 80,207 | 85,274 | 85,193 |
Income Tax Provision | (29,669) | (32,131) | (31,824) |
Net Income | 50,538 | 53,143 | 53,369 |
Dividends to Preferred Stockholders | (6,819) | (8,670) | |
Net Income Available to Common Stockholders | $ 50,538 | $ 46,324 | $ 44,699 |
Earnings Per Common Share: | |||
Basic Earnings Per Share (in dollars per share) | $ 3.34 | $ 3.34 | $ 3.24 |
Diluted Earnings Per Share (in dollars per share) | $ 3.32 | $ 3.20 | $ 3.14 |
Weighted Average Common Shares Outstanding: | |||
Basic (in shares) | 15,134,518 | 13,889,134 | 13,816,095 |
Diluted (in shares) | 15,206,997 | 14,491,433 | 14,222,133 |
Dividends Declared Per Common Share (in dollars per share) | $ 1.75 | $ 1.54 | $ 1.34 |
Consolidated Statements of Comp
Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 | |
Net Income | $ 50,538 | $ 53,143 | $ 53,369 |
Other Comprehensive Income (Loss): | |||
Unrealized gains (losses) on investments in marketable securities | 21,705 | (17,740) | 30,416 |
Reclassification adjustment for realized gains on sale of securities | (816) | (566) | (379) |
Income tax (expense) benefit related to items of other comprehensive income (loss) | (8,185) | 7,062 | (11,614) |
Other comprehensive income (loss), net of tax | 12,704 | (11,244) | 18,423 |
Comprehensive Income | $ 63,242 | $ 41,899 | $ 71,792 |
Consolidated Balance Sheets
Consolidated Balance Sheets - USD ($) $ in Thousands | Dec. 31, 2016 | Dec. 31, 2015 |
Current Assets: | ||
Cash and cash equivalents | $ 26,335 | $ 38,208 |
Restricted cash and cash equivalents | 3,125 | 8,793 |
Marketable securities | 138,013 | 116,168 |
Restricted marketable securities | 22,773 | 18,276 |
Accounts receivable, less allowance for doubtful accounts of $5,743 and $5,583, respectively | 82,531 | 84,095 |
Inventories | 7,508 | 7,568 |
Prepaid expenses and other assets | 2,648 | 2,171 |
Notes receivable, current portion | 3,259 | 460 |
Federal income tax receivable | 4,665 | 3,203 |
Total current assets | 290,857 | 278,942 |
Property and Equipment: | ||
Property and equipment, at cost | 933,140 | 875,287 |
Accumulated depreciation and amortization | (373,516) | (339,241) |
Net property and equipment | 559,624 | 536,046 |
Other Assets: | ||
Restricted cash and cash equivalents | 2,129 | 2,313 |
Restricted marketable securities | 160,931 | 151,590 |
Deposits and other assets | 5,244 | 8,451 |
Goodwill | 17,600 | 17,600 |
Notes receivable, less current portion | 13,820 | 12,704 |
Investments in limited liability companies | 37,242 | 37,683 |
Total other assets | 236,966 | 230,341 |
Total assets | 1,087,447 | 1,045,329 |
Current Liabilities: | ||
Trade accounts payable | 18,593 | 20,128 |
Capital lease obligations, current portion | 3,481 | 3,279 |
Accrued payroll | 65,912 | 65,338 |
Amounts due to third party payors | 17,019 | 16,654 |
Accrued risk reserves, current portion | 25,898 | 27,069 |
Other current liabilities | 13,207 | 12,192 |
Dividends payable | 6,818 | 5,996 |
Total current liabilities | 150,928 | 150,656 |
Long–term debt | 120,000 | 120,000 |
Long-term capital lease obligations, capital leases | 26,748 | 30,228 |
Accrued risk reserves, less current portion | 65,264 | 71,439 |
Refundable entrance fees | 9,924 | 9,865 |
Obligation to provide future services | 3,236 | 3,440 |
Deferred income taxes | 22,072 | 9,096 |
Other noncurrent liabilities | 16,302 | 16,294 |
Deferred revenue | 3,362 | 3,315 |
Stockholders' Equity: | ||
Common stock, $.01 par value; 30,000,000 shares authorized; 15,162,938 and 15,000,616 shares, respectively, issued and outstanding | 152 | 150 |
Capital in excess of par value | 211,457 | 209,469 |
Retained earnings | 391,934 | 368,013 |
Accumulated other comprehensive income | 66,068 | 53,364 |
Total stockholders’ equity | 669,611 | 630,996 |
Total liabilities and stockholders’ equity | $ 1,087,447 | $ 1,045,329 |
Consolidated Balance Sheets (Pa
Consolidated Balance Sheets (Parentheticals) - USD ($) $ in Thousands | Dec. 31, 2016 | Dec. 31, 2015 |
Allowance for doubtful accounts | $ 5,743 | $ 5,583 |
Common stock, par value (in dollars per share) | $ 0.01 | $ 0.01 |
Common stock, shares authorized (in shares) | 30,000,000 | 30,000,000 |
Common stock, shares issued (in shares) | 15,162,938 | 15,000,616 |
Common stock, shares outstanding (in shares) | 15,162,938 | 15,000,616 |
Consolidated Statements of Cash
Consolidated Statements of Cash Flows - USD ($) | 12 Months Ended | ||
Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 | |
Cash Flows From Operating Activities: | |||
Net Income | $ 50,538,000 | $ 53,143,000 | $ 53,369,000 |
Adjustments to reconcile net income to net cash provided by operating activities: | |||
Depreciation and amortization | 39,023,000 | 37,114,000 | 34,384,000 |
Provision for Doubtful Accounts | 5,967,000 | 6,583,000 | 6,228,000 |
Equity in earnings of unconsolidated investments | (6,636,000) | (5,845,000) | (6,675,000) |
Distributions from unconsolidated investments | 8,059,000 | 6,505,000 | 10,288,000 |
Gains on sale of marketable securities | (816,000) | (566,000) | (379,000) |
Deferred income taxes | 4,791,000 | (648,000) | (1,434,000) |
Stock–based compensation | 509,000 | 1,982,000 | 2,021,000 |
Changes in operating assets and liabilities, net of the effect of acquisitions: | |||
Accounts receivable | (4,403,000) | (11,835,000) | (5,215,000) |
Income tax receivable | (1,462,000) | 1,524,000 | (4,727,000) |
Inventories | 60,000 | (441,000) | 19,000 |
Prepaid expenses and other assets | (477,000) | 89,000 | (2,587,000) |
Trade accounts payable | (1,535,000) | 4,251,000 | 2,827,000 |
Accrued payroll | 574,000 | 5,479,000 | (3,603,000) |
Amounts due to third party payors | 365,000 | (6,277,000) | 1,312,000 |
Other current liabilities and accrued risk reserves | (3,526,000) | (7,455,000) | (5,652,000) |
Obligation to provide future services | (204,000) | (487,000) | 238,000 |
Other noncurrent liabilities | 8,000 | 283,000 | 1,486,000 |
Deferred revenue | 47,000 | (44,000) | 39,000 |
Net cash provided by operating activities | 90,882,000 | 83,355,000 | 81,939,000 |
Cash Flows From Investing Activities: | |||
Additions to property and equipment | (62,601,000) | (58,416,000) | (53,298,000) |
Investments in unconsolidated companies | (1,282,000) | (674,000) | (1,975,000) |
Acquisition of non–controlling interest | (768,000) | ||
Investments in notes receivable | (5,251,000) | (5,676,000) | (767,000) |
Collections of notes receivable | 1,636,000 | 4,948,000 | 3,156,000 |
Purchases of marketable securities | (48,620,000) | (60,540,000) | (62,165,000) |
Sale of marketable securities | 34,642,000 | 47,574,000 | 48,786,000 |
Net cash used in investing activities | (81,476,000) | (72,784,000) | (67,031,000) |
Cash Flows From Financing Activities: | |||
Borrowings under credit facility | 110,000,000 | ||
Redemption of preferred shareholders | (130,538,000) | ||
Principal payments under capital lease obligations | (3,278,000) | (3,089,000) | (2,436,000) |
Dividends paid to preferred stockholders | (8,986,000) | (8,670,000) | |
Dividends paid to common stockholders | (25,795,000) | (21,089,000) | (18,704,000) |
Issuance of common shares | 10,772,000 | 10,634,000 | 7,429,000 |
Repurchase of common shares | (8,195,000) | (6,995,000) | |
Tax (expense) benefit from exercise of stock options | (1,096,000) | 1,942,000 | 201,000 |
Debt issuance costs | (601,000) | ||
Entrance fee deposits (refunds) | 59,000 | (354,000) | (501,000) |
Change in deposits | 402,000 | 406,000 | (448,000) |
Net cash used in financing activities | (27,131,000) | (41,675,000) | (30,124,000) |
Net Decrease in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents | (17,725,000) | (31,104,000) | (15,216,000) |
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period | 49,314,000 | 80,418,000 | 95,634,000 |
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period | 31,589,000 | 49,314,000 | 80,418,000 |
Balance Sheet Classifications: | |||
Total Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents | 49,314,000 | 49,314,000 | 80,418,000 |
Supplemental Information: | |||
Cash payments for interest | 4,528,000 | 2,965,000 | 2,242,000 |
Cash payments for income taxes | 27,668,000 | 29,183,000 | 36,642,000 |
Non–cash financing and investing activities include: | |||
Buildings, personal property, and obligations recorded under capital lease agreements | $ 39,032,000 |
Consolidated Statements of Stoc
Consolidated Statements of Stockholders' Equity - USD ($) | Preferred Stock [Member] | Common Stock [Member] | Additional Paid-in Capital [Member] | Retained Earnings [Member] | AOCI Attributable to Parent [Member] | Total |
Balance (in shares) at Dec. 31, 2013 | 10,837,665 | 14,078,028 | ||||
Balance at Dec. 31, 2013 | $ 170,510,000 | $ 140,000 | $ 153,061,000 | $ 318,216,000 | $ 46,185,000 | $ 688,112,000 |
Net Income | 53,369,000 | 53,369,000 | ||||
Other comprehensive income (loss) | 18,423,000 | 18,423,000 | ||||
Stock–based compensation | 2,021,000 | 2,021,000 | ||||
Tax benefit (expense) from exercise of stock options | 201,000 | $ 201,000 | ||||
Shares sold – options exercised (in shares) | 157,590 | 157,590 | ||||
Shares sold – options exercised | $ 1,000 | 7,428,000 | $ 7,429,000 | |||
Repurchase of common shares (in shares) | (125,000) | |||||
Repurchase of common shares | $ (1,000) | (6,994,000) | (6,995,000) | |||
Shares issued in conversion of preferred stock to common stock (in shares) | (1,006) | 241 | ||||
Shares issued in conversion of preferred stock to common stock | $ (16,000) | 16,000 | ||||
Acquisition of noncontrolling interest | (768,000) | (768,000) | ||||
Dividends declared to preferred stockholders | (8,670,000) | (8,670,000) | ||||
Dividends declared to common stockholders | (18,974,000) | (18,974,000) | ||||
Balance (in shares) at Dec. 31, 2014 | 10,836,659 | 14,110,859 | ||||
Balance at Dec. 31, 2014 | $ 170,494,000 | $ 140,000 | 154,965,000 | 343,941,000 | 64,608,000 | 734,148,000 |
Net Income | 53,143,000 | 53,143,000 | ||||
Other comprehensive income (loss) | (11,244,000) | (11,244,000) | ||||
Stock–based compensation | 1,982,000 | 1,982,000 | ||||
Tax benefit (expense) from exercise of stock options | 1,942,000 | $ 1,942,000 | ||||
Shares sold – options exercised (in shares) | 273,000 | 389,498 | ||||
Shares sold – options exercised | $ 3,000 | 10,631,000 | $ 10,634,000 | |||
Shares issued in conversion of preferred stock to common stock (in shares) | (2,548,561) | 616,757 | ||||
Shares issued in conversion of preferred stock to common stock | $ (39,956,000) | $ 7,000 | 39,949,000 | |||
Dividends declared to preferred stockholders | (6,819,000) | (6,819,000) | ||||
Dividends declared to common stockholders | (22,252,000) | (22,252,000) | ||||
Balance (in shares) at Dec. 31, 2015 | 15,000,616 | |||||
Balance at Dec. 31, 2015 | $ 150,000 | 209,469,000 | 368,013,000 | 53,364,000 | 630,996,000 | |
Redemption of preferred stock (in shares) | (8,288,098) | |||||
Redemption of preferred stock | $ (130,538,000) | (130,538,000) | ||||
Net Income | 50,538,000 | 50,538,000 | ||||
Other comprehensive income (loss) | 12,704,000 | 12,704,000 | ||||
Stock–based compensation | 509,000 | 509,000 | ||||
Tax benefit (expense) from exercise of stock options | (1,096,000) | $ (1,096,000) | ||||
Shares sold – options exercised (in shares) | 292,322 | 499,066 | ||||
Shares sold – options exercised | $ 3,000 | 10,769,000 | $ 10,772,000 | |||
Repurchase of common shares (in shares) | (130,000) | |||||
Repurchase of common shares | $ (1,000) | (8,194,000) | (8,195,000) | |||
Dividends declared to preferred stockholders | ||||||
Dividends declared to common stockholders | (26,617,000) | (26,617,000) | ||||
Balance (in shares) at Dec. 31, 2016 | 15,162,938 | |||||
Balance at Dec. 31, 2016 | $ 152,000 | $ 211,457,000 | $ 391,934,000 | $ 66,068,000 | $ 669,611,000 |
Consolidated Statements of Sto8
Consolidated Statements of Stockholders' Equity (Parentheticals) - $ / shares | 12 Months Ended | ||
Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 | |
Preferred Stock [Member] | |||
Dividends declared to preferred stockholders per share (in dollars per share) | $ 0.64 | $ 0.80 | |
Common Stock [Member] | |||
Dividends declared to common stockholders per share (in dollars per share) | $ 1.75 | 1.54 | 1.34 |
Dividends declared to common stockholders per share (in dollars per share) | $ 1.75 | $ 1.54 | $ 1.34 |
Note 1 - Summary of Significant
Note 1 - Summary of Significant Accounting Policies | 12 Months Ended |
Dec. 31, 2016 | |
Notes to Financial Statements | |
Significant Accounting Policies [Text Block] | Note 1 – Summary of Significant Accounting Policies Nature of Operations National HealthCare Corporation ("NHC" or "the Company") operates, manages or provides services to skilled nursing facilities, assisted living facilities, independent living facilities, and home health care programs located in 10 Principles of Consolidation and Basis of Presentation The consolidated financial statements which are prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) include our wholly owned and controlled subsidiaries and affiliates. Variable interest entities (“VIEs”) in which we have an interest have been consolidated when we have been identified as the primary beneficiary. Investments in ventures in which we have the ability to exercise significant influence but do not have control over are accounted for using the equity method. Equity method investments are initially recorded at cost and subsequently are adjusted for our share of the venture’s earnings or losses and cash distributions. Our most significant equity method investment is a 75.1% Use of Estimates The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. Change in Accounting Principle Effective December 31, 2016, 2016–18, Statement of Cash Flows (Topic 230)—Restricted As described in the guidance for accounting changes under ASC Topic 250, December 31, 2016: Consolidated Statements of Cash Flows ( in thousands Year Ended December 31, 2015 Year Ended December 1, 2014 As Previously Reported Effect of Accounting Change As Adjusted As Previously Reported Effect of Accounting Change As Adjusted Cash Flows from Operating Activities: Restricted cash and cash equivalents $ (9,392 ) $ 9,392 $ - $ (6,245 ) $ 6,245 $ - Net cash provided by operating activities 73,963 9,392 83,355 75,694 6,245 81,939 Cash Flows from Investing Activities: Change in restricted cash and cash equivalents 8,937 (8,937 ) - 9,523 (9,523 ) - Net cash used in investing activities (63,847 ) (8,937 ) (72,784 ) (57,508 ) (9,523 ) (67,031 ) Net Decrease in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents (31,559 ) 455 (31,104 ) (11,938 ) (3,278 ) (15,216 Cash, Cash Equivalents, Restricted Cash, and Restricted Cash, Equivalents, Beginning of Period 69,767 10,651 80,418 81,705 13,929 95,634 Cash, Cash Equivalents, Restricted Cash, and Restricted Cash, Equivalents, $ 38,208 $ 11,106 $ 49,314 $ 69,767 $ 10,651 $ 80,418 Net Patient Revenues and Accounts Receivable Revenues are derived from services rendered to patients for skilled and intermediate nursing, rehabilitation therapy, hospice, assisted living and retirement and home health care services. Revenues are recorded when services are provided based on established rates adjusted to amounts expected to be received under governmental programs and other third–party For private pay patients in skilled nursing, assisted living and independent living facilities, the Company bills for room and board charges, with the remittance being due on receipt of the statement and generally by the 10th We receive payments from the Medicare program under a prospective payment system ("PPS"). For skilled nursing services, Medicare pays a fixed fee per Medicare patient per day, based on the acuity level of the patient, to cover all post–hospital extended care routine service costs, ancillary costs and capital related costs. Medicaid program payments for long–term care services are generally based on fixed per diem rates subject to program cost ceilings. For homecare services, Medicare pays based on the acuity level of the patient and based on episodes of care. An episode of care is defined as a length of care up to 60 60% Laws and regulations governing the Medicare and Medicaid programs are complex and subject to interpretation. Noncompliance with such laws and regulations can be subject to regulatory actions including fines, penalties, and exclusion from the Medicare and Medicaid programs. We believe that we are in compliance with all applicable laws and regulations. Medicare and Medicaid program revenues, as well as certain Managed Care program revenues, are subject to audit and retroactive adjustment by government representatives or their agents. The Medicare PPS methodology requires that patients be assigned to Resource Utilization Groups ("RUGs") based on the acuity level of the patient to determine the amount paid to us for patient services. The assignment of patients to the various RUG categories is subject to post–payment review by Medicare intermediaries or their agents. In our opinion, adequate provision has been made for any adjustments that may $17,019,000 $16,654,000 December 31, 2016 2015, Other Revenues As discussed in Note 3 3, Certain management contracts, including, but not limited to contracts with National, subordinate the payment of management fees earned under those contracts to other expenditures of the long–term care center and to the availability of cash provided by the facility’s operations. Revenues from management services provided to the facilities that generate insufficient cash flow to pay the management fee, as prioritized under the contractual arrangement, are not recognized until such time as the amount of revenue earned is fixed or determinable and collectability is reasonably assured. This recognition policy could cause our reported revenues and net income from management services to vary significantly from period to period. We recognize rental income based on the terms of our operating leases. Under certain of our leases, we receive contingent rent, which is based on the increase in revenues of a lessee over a base year. We recognize contingent rent annually or monthly, as applicable, when, based on the actual revenue of the lessee, receipt of such income is assured. We identify leased real estate properties as nonperforming if a required payment is not received within 30 Provision for Doubtful Accounts We evaluate the collectability of our accounts receivable based on factors such as payor type, historical collection trends and aging categories. We review these factors and determine an estimated provision for doubtful accounts. Historically, bad debts have resulted primarily from uncollectible private balances or from uncollectible coinsurance and deductibles. Receivables that are deemed to be uncollectible are written off against the allowance. The allowance for doubtful accounts balance is assessed on a quarterly basis, with changes in estimated losses being recorded in the consolidated statements of income in the period first The Company includes provisions for doubtful accounts in operating expenses in its consolidated statements of income. The provisions for doubtful accounts were $5,967,000, $6,583,000, $6,228,000 2016, 2015 2014, Other Operating Expenses Other operating expenses include the costs of care and services that we provide to the residents of our facilities and the costs of maintaining our facilities. Our primary patient care costs include drugs, medical supplies, purchased professional services, food, professional insurance and licensing fees. The primary facility costs include utilities and property insurance. General and Administrative Costs With the Company being a healthcare provider, the majority of our expenses are "cost of revenue" items. Costs that could be classified as "general and administrative" by the Company would include its corporate office costs, which were $29.3 $34.5 $34.9 December 31, 2016, 2015, 2014, Cash and Cash Equivalents Cash equivalents include highly liquid investments with an original maturity of three Restricted Cash and Cash Equivalents and Restricted Marketable Securities Restricted cash and cash equivalents and restricted marketable securities primarily represent assets that are held by our wholly–owned limited purpose insurance companies for workers' compensation and professional liability claims. Investments in Marketable Securities and Restricted Marketable Securities Our investments in marketable securities and restricted marketable securities include available for sale securities, which are recorded at fair value. Unrealized gains and losses on available for sale securities that are deemed temporary are recorded as a separate component of stockholders’ equity. If any adjustment to fair value reflects a significant decline in the value of the security, we consider all available evidence to evaluate the extent to which the decline is "other than temporary". Credit losses are identified when we do not expect to receive cash flows sufficient to recover the amortized cost basis of a security. In the event of a credit loss, only the amount associated with the credit loss is recognized in earnings, with the amount of loss relating to other factors recorded as a separate component of stockholders’ equity. Inventories Inventories consist generally of food and supplies and are valued at the lower of cost or market, with cost determined on a first–in, first–out Mortgage and Other Notes Receivable In accordance with Accounting Standards Codification ("ASC") Topic 310, Receivables may Pro perty 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 3– 15 Expenditures for repairs and maintenance are charged to expense as incurred. Betterments, which significantly extend the useful life, are capitalized. We remove the costs and related allowances for accumulated depreciation or amortization from the accounts for properties sold or retired, and any resulting gains or losses are included in income. In accordance with ASC Topic 360, Property, Plant, and Equipment may Goodwill The Company accounts for goodwill under ASC Topic 350, Intangibles – Goodwill and Other first fourth Accrued Risk Reserves We are principally self–insured for risks related to employee health insurance and utilize wholly–owned limited purpose insurance companies for workers’ compensation and professional liability claims. Accrued risk reserves primarily represent the accrual for risks associated with employee health insurance, workers’ compensation and professional liability claims. The accrued risk reserves include a liability for unpaid reported claims and estimates for incurred but unreported claims. Our policy with respect to a significant portion of our workers’ compensation and professional and general liability claims is to use an actuary to assist management in estimating our exposure for claims obligation (for both asserted and unasserted claims). Our health insurance reserve is based on our known claims incurred and an estimate of incurred but unreported claims determined by our analysis of historical claims paid. We reassess our accrued risk reserves on a quarterly basis, with changes in estimated losses being recorded in the consolidated statements of income in the period first Other Current Liabilities Other current liabilities primarily represent accruals for current federal and state income taxes, real estate taxes and other current liabilities. Continuing Care Contracts and Refundable Entrance Fees We have one may 10% 90% 40% December 31, 2016 December 31, 2015 $9,924,000 $9,865,000, 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. At December 31, 2016 2015, $3,236,000 $3,440,000, Other Noncurrent Liabilities Other noncurrent liabilities include reserves primarily related to various uncertain income tax positions (see Note 12). Deferred Revenue Deferred revenue includes the deferred gain on the sale of assets to National (as discussed in Note 2) (10%) Income Taxes We utilize ASC Topic 740, Income Taxes 12 Also under ASC Topic 740, Income Taxes 50 Stock– Based Compensation Stock–based awards granted include stock options, restricted stock units, and stock purchased under our employee stock purchase plan. Stock–based compensation cost is measured at the grant date, based on the fair value of the awards, and is recognized as expense over the requisite service period only for those equity awards expected to vest. The fair value of the restricted stock units is determined based on the stock price on the date of grant. We estimated the fair value of stock options and stock purchased under our employee stock purchase plan using the Black–Scholes model. This model utilizes the estimated fair value of common stock and requires that, at the date of grant, we use the expected term of the grant, the expected volatility of the price of our common stock, risk–free interest rates and expected dividend yield of our common stock. The fair value is amortized on a straight–line basis over the requisite service periods of the awards. Concentration of Credit Risks Our credit risks primarily relate to cash and cash equivalents, restricted cash and cash equivalents, accounts receivable, marketable securities, restricted marketable securities and notes receivable. Cash and cash equivalents are primarily held in bank accounts and overnight investments. Restricted cash and cash equivalents is primarily invested in commercial paper and certificates of deposit with financial institutions and other interest bearing accounts. Accounts receivable consist primarily of amounts due from patients (funded through Medicare, Medicaid, other contractual programs and through private payors) and from other health care companies for management, accounting and other services. We perform continual credit evaluations of our clients and maintain allowances for doubtful accounts on these accounts receivable. Marketable securities and restricted marketable securities are held primarily in accounts with brokerage institutions. Notes receivable relate primarily to secured loans with health care facilities (recorded as notes receivable in the consolidated balance sheets) as discussed in Note 10. At any point in time we have funds in our operating accounts and restricted cash accounts that are with third may Our financial instruments, principally our notes receivable, are subject to the possibility of loss of the carrying values as a result of the failure of other parties to perform according to their contractual obligations. We obtain various collateral and other protective rights, and continually monitor these rights in order to reduce such possibilities of loss. We evaluate the need to provide reserves for potential losses on our financial instruments based on management's periodic review of the portfolio on an instrument by instrument basis. See Note 10 Comprehensive Income ASC Topic 220, Comprehensive Income, Segment Disclosures ASC Topic 280, Segment Reporting, 3 Recently Adopted Accounting Guidance In November 2016, 2016–18, 230)—Restricted December 15, 2017, December 31, 2016, 1 Change in Accounting Principle 2016–18. In November 2015, 2015–17, December 15, 2016. December 31, 2015. In April 2015, 2015–03, 835.30): 2015–03 August 2015, 2015–15 December 15, 2015. In February 2015, ASU No. 2015–02 may December 15, 2015. Recent Accounting Guidance Not Yet Adopted In March 2016, 2016–09, 718): 2016–09 2016–09 December 15, 2016. 2016–09, believe the final result will be a decrease to our income tax expense and an increase in net cash provided by operating activities. In February 2016, 2016–02, 842)." December 15, 2018, In January 2016, 2016–01, (Topic 825)”. 2016–01 2016–01 2016–01 December 15, 2017, 2016– 0 1 may 2016–01. In May 2014, 2014–09 five 1. 2. 3. 4. 5. For a public entity, this update is effective for annual reporting periods beginning after December 15, 2017, As we progress with our implementation efforts to adopt the New Revenue Standard, management continues to evaluate and refine its estimates of the anticipated impacts it will have on our revenue recognition policies, procedures, financial position, results of operations, cash flows, financial disclosures and control framework. Specifically, the Company is continuing to evaluate its population of revenue sources to determine the potential effects the New Revenue Standard will have on the amount or timing of certain industry-specific healthcare revenue sources, which at this time includes revenue recorded from our CCRC, settlements with third |
Note 2 - Relationship with Nati
Note 2 - Relationship with National Health Corporation | 12 Months Ended |
Dec. 31, 2016 | |
Notes to Financial Statements | |
Related Party Transactions Disclosure [Text Block] | Note 2 with National Health Corporation National Health Corporation ("National"), which is wholly–owned by the National Health Corporation Leveraged Employee Stock Ownership Plan ("ESOP"), was formed in 1986 may Management Contracts We currently manage five January 1, 2018. 3 Financing Activities During 1991, $10,000,000 0.85 2018. In conjunction with our management contract, we have entered into a line of credit arrangement whereby we may $2,000,000. December 31, 2016, not The maximum line of credit commitment amount of $2,000,000 1988. January 2018. Payroll and Related Services The personnel conducting our business, including our executive management team, are employees of National and may 1% December 31, 2016, 2015, 2014 $4,701,000, $4,542,000, $4,395,000, December 31, 2016, $1,775,000 $3,312,000 National ’ s Ownership of Our Stock At December 31, 2016, 1,084,763 7.2%) Consolidation Considerations 810, Consolidation (1) (2) (3) (1) may (2) 50% |
Note 3 - Other Revenues
Note 3 - Other Revenues | 12 Months Ended |
Dec. 31, 2016 | |
Notes to Financial Statements | |
Other Revenues [Text Block] | Note 3 Revenues third Year Ended December 31, 2016 2015 2014 (in thousands) Insurance services $ 7,195 $ 7,012 $ 7,215 Management and accounting service fees 15,953 14,586 15,184 Rental income 21,835 19,191 19,123 Other 931 987 874 $ 45,914 $ 41,776 $ 42,396 Insurance Services For workers’ compensation insurance services, the premium revenues reflected in the consolidated statements of income for the years ended December 31, 2016, 2015 2014 $4,508,000, $4,215,000, $4,434,000, For professional liability insurance services, the premium revenues reflected in the consolidated statements of income for the years ended December 31, 2016, 2015 2014 $2,687,000, $2,797,000, $2,781,000, Management Fees from National We have managed skilled nursing facilities for National since 1988, five 2 During 2016, 2015 2014, $3,777,000, $3,599,000, $3,544,000, $21,296,000 $21,345,000 December 31, 2016 2015, The unpaid fees from these five may five may may may Management Fees and Financial and Accounting Services for Other Healthcare Centers During 2016 2015, six five third December 31, 2016 2015, $2,172,000 $2,490,000 During 2016 2015, 20 Rental Income The health care properties currently owned and leased to third nine four January 1, 2016, eleven thirteen ten December 31, 2025. |
Note 4 - Non-operating Income
Note 4 - Non-operating Income | 12 Months Ended |
Dec. 31, 2016 | |
Notes to Financial Statements | |
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 securities, interest income, and other miscellaneous non–operating income. Our most significant equity method investment is a 75.1% 16 Year Ended December 31, 2016 2015 2014 (in thousands) Equity in earnings of unconsolidated investments $ 6,636 $ 5,845 $ 6,675 Dividends and net realized gains on sales of securities 7,324 6,809 5,957 Interest income 5,705 5,494 4,550 $ 19,665 $ 18,148 $ 17,182 |
Note 5 - Long-term Leases
Note 5 - Long-term Leases | 12 Months Ended |
Dec. 31, 2016 | |
Notes to Financial Statements | |
Leases of Lessee Disclosure [Text Block] | Note 5 – Long–Term Leases Capital Leases Effective March 1, 2014, three three Two third ten two five–year $5,200,000 4% 2014 Fixed assets recorded under the capital leases, which are included in property and equipment in the consolidated balance sheets, are as follows: December 31, 2016 December 31, 2015 (in thousands) Buildings and personal property $ 39,032 $ 39,032 Accumulated amortization (11,120 ) (7,196 ) $ 27,912 $ 31,836 Operating Leases At December 31, 2016, 35 seven three two first four third On January 1, 2007, 15–year three five–year December 2012, first three five–year 2026. two five–year $30,750,000 4% 2007 In September 2013 second seven 15 $3,450,000 4% 2014 seven 13 th $49,000,000. Base rent expense under both NHI lease agreements totals $34,200,000. 2016, 2015, 2014 $3,720,000, $2,510,000, $2,334,000, Each lease with NHI is a "triple net lease" under which we are responsible for paying all taxes, utilities, insurance premium costs, repairs and other charges relating to the ownership of the facilities. We are obligated at our expense to maintain adequate insurance on the facilities' assets. We have a right of first 180 Minimum Lease Payments The approximate future minimum lease payments required under all leases that have remaining non–cancelable lease terms at December 31, 2016 Operating Leases Capital Leases (in thousands) 2017 $ 34,200 $ 5,200 2018 34,200 5,200 2019 34,200 5,200 2020 34,200 5,200 2021 34,200 5,200 Thereafter 176,750 11,267 Total minimum lease payments $ 347,750 $ 37,267 Less: Amounts representing interest (7,038 ) Present value of minimum lease payments 30,229 Less: Current portion (3,481 ) Long–term capital lease obligations $ 26,748 |
Note 6 - Earnings Per Share
Note 6 - Earnings Per Share | 12 Months Ended |
Dec. 31, 2016 | |
Notes to Financial Statements | |
Earnings Per Share [Text Block] | Note 6 Per Share The following table summarizes the earnings and the weighted average number of common shares used in the calculation of basic and diluted earnings per share. Year Ended December 31, 2016 2015 2014 (dollars in thousands, except share and per share amounts) Basic: Weighted average common shares outstanding 15,134,518 13,889,134 13,816,095 Net income $ 50,538 $ 53,143 $ 53,369 Dividends to preferred stockholders – 6,819 8,670 Net income available to common stockholders $ 50,538 $ 46,324 $ 44,699 Earnings per common share, basic $ 3.34 $ 3.34 $ 3.24 Diluted: Weighted average common shares outstanding 15,134,518 13,889,134 13,816,095 Dilutive effect of stock options 24,176 144,793 73,678 Dilutive effect of restricted stock – 1,183 3,691 Dilutive effect of contingent issuable stock 48,303 456,323 328,669 Assumed average common shares outstanding 15,206,997 14,491,433 14,222,133 Net income available to common stockholders $ 50,538 $ 46,324 $ 44,699 Earnings per common share, diluted $ 3.32 $ 3.20 $ 3.14 |
Note 7 - Investments in Marketa
Note 7 - Investments in Marketable Securities | 12 Months Ended |
Dec. 31, 2016 | |
Notes to Financial Statements | |
Investments in Debt and Marketable Equity Securities (and Certain Trading Assets) Disclosure [Text Block] | Note 7 in Marketable Securities Our investments in marketable securities include available for sale securities. Realized gains and losses from securities sales are determined on the specific identification of the securities. Marketable securities and restricted marketable securities consist of the following: December 31, 2016 December 31, 2015 (in thousands) Amortized Cost Fair Value Amortized Cost Fair Value Investments available for sale: Marketable equity securities $ 30,176 $ 138,013 $ 30,176 $ 116,168 Restricted investments available for sale: Corporate debt securities 71,311 71,100 71,960 71,143 Asset–backed securities 56,889 56,168 61,645 60,910 U.S. Treasury securities 25,748 25,181 21,123 21,033 State and municipal securities 32,020 31,255 16,446 16,780 $ 216,144 $ 321,717 $ 201,350 $ 286,034 Included in the available for sale marketable equity securities are the following (in thousands, except share amounts) December 31, 2016 December 31, 2015 Shares Cost Fair Value Shares Cost Fair Value NHI Common Stock 1,630,642 $ 24,734 $ 120,945 1,630,642 $ 24,734 $ 99,257 The amortized cost and estimated fair value of debt securities classified as available for sale, by contractual maturity, are as follows: December 31, 2016 December 31, 2015 (in thousands) Cost Fair Value Cost Fair Value Maturities: Within 1 year $ 14,181 $ 14,216 $ 23,291 $ 23,273 1 to 5 years 79,827 79,502 74,747 74,671 6 to 10 years 91,211 89,269 71,442 70,223 Over 10 years 749 717 1,694 1,699 $ 185,968 $ 183,704 $ 171,174 $ 169,866 Gross unrealized gains related to available for sale securities are $108,730,000 $86,921,000 December 31, 2016 2015, $3,157,000 $2,237,000 December 31, 2016 2015, no December 31, 2016 2015. Proceeds from the sale of investments in marketable securities during the years ended December 31, 2016, 2015 2014 $34,642,000, $47,574,000, $48,786,000, $816,000, $566,000, $379,000 December 31, 2016, 2015, 2014, |
Note 8 - Fair Value Measurement
Note 8 - Fair Value Measurements | 12 Months Ended |
Dec. 31, 2016 | |
Notes to Financial Statements | |
Fair Value Disclosures [Text Block] | Note 8 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 may Level 1 Level 2 Level 3 3 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 2 2 third We validated the prices provided by our broker by reviewing their pricing methods, obtaining market values from other pricing sources, analyzing pricing data in certain instances and confirming that the relevant markets are active. After completing our validation procedures, we did not adjust or override any fair value measurements provided by our broker as of December 31, 2016 2015. 1 2 2016 2015. Other The carrying amounts of cash and cash equivalents, restricted cash and cash equivalents, accounts receivable, and accounts payable approximate fair value due to their short–term nature. The estimated fair value of notes receivable approximates the carrying value based principally on their underlying interest rates and terms, maturities, collateral and credit status of the receivables. Our long–term debt approximates fair value due to variable interest rates. At December 31, 2016 2015, The following table summarizes fair value measurements by level at December 31, 2016 December 31, 2015 (in thousands) Fair Value Measurements Using December 31, 2016 Fair Value Quoted Prices in Active Markets For Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Cash and cash equivalents $ 26,335 $ 26,335 $ – $ – Restricted cash and cash equivalents 5,254 5,254 – – Marketable equity securities 138,013 138,013 – – Corporate debt securities 71,100 42,323 28,777 – Asset–backed securities 56,168 – 56,168 – U.S. Treasury securities 25,181 25,181 – – State and municipal securities 31,255 – 31,255 – Total financial assets $ 353,306 $ 237,106 $ 116,200 $ – Fair Value Measurements Using December 31, 2015 Fair Value Quoted Prices in Active Markets For Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Cash and cash equivalents $ 38,208 $ 38,208 $ – $ – Restricted cash and cash equivalents 11,106 11,106 – – Marketable equity securities 116,168 116,168 – – Corporate debt securities 71,143 32,683 38,460 – Asset–backed securities 60,910 – 60,910 – U.S. Treasury securities 21,033 21,033 – – State and municipal securities 16,780 – 16,780 – Total financial assets $ 335,348 $ 219,198 $ 116,150 $ – |
Note 9 - Property and Equipment
Note 9 - Property and Equipment | 12 Months Ended |
Dec. 31, 2016 | |
Notes to Financial Statements | |
Property, Plant and Equipment Disclosure [Text Block] | Note 9 and Equipment Property and equipment, at cost, consists of the following: December 31, 2016 2015 (in thousands) Land $ 59,812 $ 59,831 Leasehold improvements 108,661 103,445 Buildings and improvements 552,404 507,627 Furniture and equipment 158,558 150,357 Construction in progress 53,705 54,027 933,140 875,287 Less: Accumulated depreciation (373,516 ) (339,241 ) $ 559,624 $ 536,046 In January 2017, 112 December 31, 2016, $3,936,000. December 31, 2016, no The Company estimates the cost to complete construction in progress is approximately $7,292,000 December 31, 2016. |
Note 10 - Notes Receivable
Note 10 - Notes Receivable | 12 Months Ended |
Dec. 31, 2016 | |
Notes to Financial Statements | |
Loans, Notes, Trade and Other Receivables Disclosure [Text Block] | Note 10 Receivable At December 31, 2016 2015, $17,079,000 $13,164,000, first second 2% 8% 2018 2023. |
Note 11 - Long-term Debt
Note 11 - Long-term Debt | 12 Months Ended |
Dec. 31, 2016 | |
Notes to Financial Statements | |
Debt Disclosure [Text Block] | Note 1 1 Term Debt Long–term debt consists of the following (dollars in thousands) Interest Rate at December 31, Dec. 31, 2016 Maturities 2016 2015 Credit Facility, interest payable monthly Variable, 2.1% 2020 $ 110,000 $ 110,000 Unsecured term note payable to National, interest payable quarterly, principal payable at maturity Variable, 3.0% 2018 10,000 10,000 120,000 120,000 Less current portion – – $ 120,000 $ 120,000 $ 1 75,000,000 Credit Facility October 2015, $175 five (October 2020). 1.40% 0.40%. 1%, 1.00%. The Credit Agreement contains customary representations and financial 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 aggregate maturities of long–term debt for the five December 31, 2016 Long–Term Debt (in thousands) 2017 $ − 2018 10,000 2019 − 2020 110,000 2021 − Total $ 120,000 |
Note 12 - Income Taxes
Note 12 - Income Taxes | 12 Months Ended |
Dec. 31, 2016 | |
Notes to Financial Statements | |
Income Tax Disclosure [Text Block] | Note 12 The provision for income taxes is comprised of the following components: Year Ended December 31, 2016 2015 2014 (in thousands) Current Tax Provision Federal $ 24,012 $ 29,322 $ 30,235 State 661 3,568 3,095 24,673 32,890 33,330 Deferred Tax Provision Federal 4,208 (532 ) (1,172 ) State 788 (227 ) (334 ) 4,996 (759 ) (1,506 ) Income Tax Provision $ 29,669 $ 32,131 $ 31,824 The deferred tax assets and liabilities, consisting of temporary differences tax effected at the respective income tax rates, are as follows: December 31, 2016 2015 (in thousands) Deferred tax assets: Allowance for doubtful accounts receivable $ 2,077 $ 2,055 Accrued risk reserves 2,277 2,648 Accrued expenses 8,907 8,420 Financial reporting depreciation in excess of tax depreciation 8,642 9,142 Stock based compensation 387 3,511 Non-refundable entrance fees 211 163 Refundable entrance fees 1,923 1,830 Obligation to provide future services 1,262 1,342 Deferred revenue 3,942 4,258 Total deferred tax assets $ 29,628 $ 33,369 Deferred tax liabilities: Unrealized gains on marketable securities $ (41,264 ) $ (33,079 ) Deferred gain on sale of assets (net) (3,135 ) (3,135 ) Book basis in excess of tax basis of intangible assets (1,481 ) (945 ) Book basis in excess of tax basis of securities (2,416 ) (2,344 ) Long–term investments (3,404 ) (2,962 ) Total deferred tax liabilities $ (51,700 ) $ (42,465 ) Net deferred tax liability $ (22,072 ) $ (9,096 ) A reconciliation of income tax expense and the amount computed by applying the statutory federal income tax rate to income before income taxes is as follows: Year Ended December 31, 2016 2015 2014 (in thousands) Tax provision at federal statutory rate $ 28,072 $ 29,846 $ 29,818 Increase (decrease) in income taxes resulting from: State, net of federal benefit 1,783 1,767 2,207 Nondeductible expenses 156 351 363 Insurance expense 27 6 27 Other, net 283 (372 ) 439 Unrecognized tax benefits 716 2,674 512 Expiration of statute of limitations (1,368 ) (2,141 ) (1,542 ) 1,597 2,285 2,006 Effective income tax expense $ 29,669 $ 32,131 $ 31,824 The exercise of non–qualified stock options results in state and federal income tax benefits to the Company related to the difference between the market price at the date of exercise and the option exercise price. During 2016, 2015 2014, $(1,096,000), $1,942,000, $201,000, 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 may 740 Income Taxes Also under ASC Topic 740, 50 In accordance with current guidance, the Company has established a liability for unrecognized tax benefits, which are differences between a tax position taken or expected to be taken in a tax return and the benefit recognized and measured. Generally a liability is created for an unrecognized tax benefit because it represents a company’s potential future obligation to a taxing authority for a tax position that was not recognized per above. A reconciliation of the beginning and ending amount of unrecognized tax benefits is as follows (in thousands): Deferred Tax Asset Liability For Unrecognized Tax Benefits Liability For Interest and Penalties Liability Total Balance, January 1, 2014 $ 8,598 $ 12,453 $ 2,072 $ 14,525 Additions based on tax positions related to the current year − 2,008 216 2,224 Additions for tax positions of prior years 2,032 1,218 706 1,924 Reductions for statute of limitation expirations (1,523 ) (2,059 ) (603 ) (2,662 ) Balance, December 31, 2014 9,107 13,620 2,391 16,011 Additions based on tax positions related to the current year − 1,595 308 1,903 Additions for tax positions of prior years 490 498 1,298 1,796 Reductions for statute of limitation expirations (1,779 ) (2,551 ) (865 ) (3,416 ) Balance, December 31, 2015 7,818 13,162 3,132 16,294 Additions based on tax positions related to the current year 1,249 1,249 - 1,249 Additions for tax positions of prior years 481 718 934 1,652 Reductions for statute of limitation expirations (1,525 ) (2,164 ) (729 ) (2,893 ) Balance, December 31, 2016 $ 8,023 $ 12,965 $ 3,337 $ 16,302 During the year ended December 31, 2016, $2,164,000 $729,000 $1,368,000. Unrecognized tax benefits of $5,616,000, December 31, 2016, twelve December 31, 2016, $2,345,000. During the year ended December 31, 2015, $2,551,000 $865,000 $2,141,000. During the year ended December 31, 2014, $2,059,000 $603,000 $1,542,000. Interest and penalties expense related to U.S. federal and state income tax returns are included within income tax expense. Interest and penalties expense was $205,000, $740,000, $319,000 December 31, 2016, 2015, 2014, The Company is no longer subject to U.S. federal and state examinations by tax authorities for years before 2013 |
Note 13 - Stock Repurchase Prog
Note 13 - Stock Repurchase Program | 12 Months Ended |
Dec. 31, 2016 | |
Notes to Financial Statements | |
Treasury Stock [Text Block] | Note 1 3 Repurchase Program In May 2015, $25 August 5, 2016, 130,000 $8,195,000. August 31, 2016. August 2016, $25 September 1, 2016 August 31, 2017. No Under previously approved repurchase plans, the Company repurchased 125,000 August 11, 2014 $6,995,000. Under the common stock repurchase program, the Company may may may |
Note 14 - Stock-based Compensat
Note 14 - Stock-based Compensation | 12 Months Ended |
Dec. 31, 2016 | |
Notes to Financial Statements | |
Disclosure of Compensation Related Costs, Share-based Payments [Text Block] | Note 1 4 NHC recognizes stock–based compensation for all stock options and restricted stock granted over the requisite service period using the fair value for these grants as estimated at the date of grant either using the Black–Scholes pricing model for stock options or the quoted market price for restricted stock. The 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 may 100% may ten 100% In May 2010, 2010 1,200,000 May 2015, 1,200,000 2,575,000 December 31, 2016, 1,661,243 Additionally, we have an employee stock purchase plan that allows employees to purchase our shares of stock through payroll deductions. The plan allows employees to terminate participation at any time. Compensation expense is recognized only for the awards that ultimately vest. Stock–based compensation totaled $509,000, $1,982,000, $2,021,000, December 31, 2016, 2015, 2014, $5,680,000, $5,263,000, $697,000 December 31, 2016, 2015, 2014, $7,431,000, $5,447,000, $855,000 December 31, 2016, 2015 2014, At December 31, 2016, Stock Options The Company is required to estimate the fair value of stock–based awards on the date of grant. The fair value of each option award is estimated using the Black–Scholes option valuation model with the weighted average assumptions indicated in the following table. Each grant is valued as a single award with an expected term based upon expected employment and termination behavior. Compensation cost is recognized over the requisite service period in a manner consistent with the option vesting provisions. The straight–line attribution method requires that compensation expense is recognized at least equal to the portion of the grant–date fair value that is vested at that date. The expected volatility is derived using weekly historical data for periods immediately preceding the date of grant. The risk–free interest rate is the approximate yield on the United States Treasury Strips having a life equal to the expected option life on the date of grant. The expected life is an estimate of the number of years an option will be held before it is exercised. The following table summarizes the assumptions used to value the options granted in the periods shown. Year Ended December 31, 2016 2015 2014 Risk–free interest rate 0.89 % 0.71 % 0.52 % Expected volatility 15.8 % 16.5 % 17.3 % Expected life, in years 2.2 2.2 2.2 Expected dividend yield 3.09 % 2.73 % 2.68 % The following table summarizes option activity: Number of Shares Weighted Average Exercise Price Aggregate Intrinsic Value Options outstanding at January 1, 2014 1,074,552 $ 46.44 $ − Options granted 57,716 53.10 − Options exercised (157,590 ) 45.97 − Options cancelled (20,000 ) 46.69 − Options outstanding at December 31, 2014 954,678 46.92 − Options granted 56,210 61.47 − Options exercised (389,498 ) 47.06 − Options cancelled – – − Options outstanding at December 31, 2015 621,390 48.15 − Options granted 56,291 62.54 − Options exercised (499,066 ) 47.16 − Options cancelled (656 ) 46.69 − Options outstanding at December 31, 2016 177,959 $ 55.48 $ 3,615,000 Options exercisable at December 31, 2016 177,959 $ 55.48 $ 3,615,000 Options Outstanding December 31, 2016 Exercise Prices Weighted Average Exercise Price Weighted Average Remaining Contractual Life in Years 90,000 $44.80 – $52.93 $ 49.07 1.5 87,959 $61.25 – $62.78 62.03 3.9 177,959 $ 55.48 2.7 |
Note 15 - Contingencies and Gua
Note 15 - Contingencies and Guarantees | 12 Months Ended |
Dec. 31, 2016 | |
Notes to Financial Statements | |
Commitments and Contingencies Disclosure [Text Block] | Note 1 5 antees 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 $91,162,000 $98,508,000 December 31, 2016 2015, 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 assist management in estimating 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 twelve $1,000,000 General and Professional Liability Insurance and Lawsuits The health care industry has experienced significant increases in both the number of personal injury/wrongful death claims and in the severity of awards based upon alleged negligence by skilled nursing facilities and their employees in providing care to residents. As of December 31, 2016, 43 Insurance coverage for all years includes both primary policies and excess policies. The primary coverage is in the amount of $1.0 $3.0 2016, $9.0 third There is certain additional litigation incidental to our business, none of which, based upon information available to date, would be material to our financial position, results of operations, or cash flows. In addition, the long–term care industry is continuously subject to scrutiny by governmental regulators, which could result in litigation or claims related to regulatory compliance matters. Civil Investigative Demand On December 19, 2013, On October 7, 2014, The Company is cooperating fully with these requests. We are unable to evaluate the outcome of this investigation at this time. It is possible that this investigation could lead to a claim that could have a material adverse effect on our consolidated financial position, results of operations and cash flows. Caris HealthCare, L.P. Investigation On December 9, 2014, qui tam 75.1% A qui tam May 22, 2014, United States of America, State of Tennessee, and State of Virginia ex rel. Barbara Hinkle v. Caris Healthcare, L.P. 3:14–cv–212 On June 16, 2016, qui tam June 20, 2016, October 11, 2016, June 2013 December 2013 forty–five June 2013. qui tam Caris denies the allegations in the United States' complaint and intends to defend itself vigorously. Given the early stage of this action, we are unable to assess the probable outcome or potential liability, if any, arising from this action. It is possible that this claim could have a material adverse effect on our consolidated financial position, results of operations and cash flows. South Carolina Medicaid Audits The South Carolina Office of State Auditor (“State Auditor”) conducted Medicaid cost report audits for eleven September 30, 2013 September 30, 2014. During 2015, $6.8 December 31, 2016, $1,374,000 Governmental Regulations Laws and regulations governing the Medicare, Medicaid and other federal healthcare programs are complex and subject to interpretation. Management believes that it is in compliance with all applicable laws and regulations in all material respects. However, compliance with such laws and regulations can be subject to future government review and interpretation as well as significant regulatory action including fines, penalties, and exclusions from the Medicare, Medicaid and other federal healthcare programs. Debt Guarantees At December 31, 2016, |
Note 16 - Equity Method Investm
Note 16 - Equity Method Investment in Caris HealthCare, L.P. | 12 Months Ended |
Dec. 31, 2016 | |
Notes to Financial Statements | |
Cost and Equity Method Investments Disclosure [Text Block] | Note 1 6 – Equity Method Investment in Caris HealthCare, L.P. As of December 31, 2016, 75.1% $34,717,000 $35,771,000 December 31, 2016 2015, December 31, 2016, 2015, 2014 December 31, 2016 2015 2014 ( in thousands) Current assets $ 21,973 $ 23,213 $ 20,922 Noncurrent assets 10,896 11,091 11,540 Liabilities 8,082 7,970 7,305 Partners’ capital 24,787 26,334 25,157 Revenue 52,105 50,464 51,441 Expenses 42,928 40,875 40,908 Net income 9,177 9,589 10,533 Consolidation Consideration s Due to our ownership percentage in Caris, we have considered whether Caris should be consolidated by NHC under the guidance provided in ASC Topic 810, Consolidation (1) (2) (3) (1) (2) (3) |
Note 17 - Variable Interest Ent
Note 17 - Variable Interest Entity | 12 Months Ended |
Dec. 31, 2016 | |
Notes to Financial Statements | |
Variable Interest Entity [Text Block] | Note 1 7 – Variable Interest Entity Accounting guidance requires that a variable interest entity (“VIE”), according to the provisions of ASC Topic 810, Consolidation December 31, 2016, one Springfield, Missouri L ease In December 2010, 120–bed ten five five third 120–bed third $4,500,000, December 31, 2016 2015, $4,500,000 third $4,500,000 |
Note 18 - Redemption of the Ser
Note 18 - Redemption of the Series A Convertible Preferred Stock | 12 Months Ended |
Dec. 31, 2016 | |
Notes to Financial Statements | |
Preferred Stock [Text Block] | N ote 18 Series A Convertible Preferred Stock In October 2007, $170,555,000 $15.75. $0.80 In November 2015, $15.75 . There were 8,288,098 $130,538,000. $110,000,000. In lieu of redemption, the holders of the Preferred Stock could have converted any or all of their shares into shares of the Company's common stock. The holders electing to convert their Preferred Shares received 0.24204 2,548 , 561 616 , 757 2015 |
Note 19 - Series B Junior Parti
Note 19 - Series B Junior Participating Preferred Stock | 12 Months Ended |
Dec. 31, 2016 | |
Notes to Financial Statements | |
Stockholder Rights Plan Disclosure [Text Block] | Note 19 – Series B Junior Participating Preferred Stock On August 2, 2007, one August 2, 2007. one one–ten $0.01 $250 August 2, 2007, may No |
Note 20 - Selected Quarterly Fi
Note 20 - Selected Quarterly Financial Data | 12 Months Ended |
Dec. 31, 2016 | |
Notes to Financial Statements | |
Quarterly Financial Information [Text Block] | Note 20 Quarterly Financial Data (unaudited, in thousands, except per share amounts) The following table sets forth selected quarterly financial data for the two 2016 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Net Operating Revenues $ 229,588 $ 227,768 $ 231,281 $ 238,001 Income Before Non–Operating Income 17,624 14,641 10,590 17,687 Non–Operating Income 4,773 4,925 5,091 4,876 Net Income 13,699 11,866 11,110 13,863 Net Income Available to Common Stockholders 13,699 11,866 11,110 13,863 Basic Earnings Per Share .92 .78 .73 .92 Diluted Earnings Per Share .91 .78 .73 .91 2015 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Net Operating Revenues $ 222,407 $ 224,902 $ 225,386 $ 233,927 Income Before Non–Operating Income 17,436 15,706 13,761 20,223 Non–Operating Income 4,222 4,130 4,550 5,246 Net Income 13,242 12,358 12,567 14,976 Preferred Dividends 2,168 2,167 2,152 332 Net Income Available to Common Stockholders 11,074 10,191 10,415 14,644 Basic Earnings Per Share .80 .74 .75 1.03 Diluted Earnings Per Share .77 .71 .72 .99 |
Schedule II - Valuation and Qua
Schedule II - Valuation and Qualifying Accounts | 12 Months Ended |
Dec. 31, 2016 | |
Notes to Financial Statements | |
Schedule of Valuation and Qualifying Accounts Disclosure [Text Block] | NATIONAL HEALTHCARE CORPORATION SCHEDULE II – VALUATION AND QUALIFYING ACCOUNTS FOR THE YEARS ENDED DECEMBER 31, 2016, 2015 2014 (in thousands) Column A Column B Column C Column D Column E Additions Description Balance– Beginning of Period Charged to Costs and Expenses Charged to other Accounts Deductions Balance– End of Period For the year ended December 31, 2014 Allowance for doubtful accounts $ 4,972 $ 6,228 $ − $ 5,462 (1) $ 5,738 Accrued risk reserves $ 110,557 $ 61,557 $ − $ 65,896 $ 106,218 For the year ended December 31, 2015 Allowance for doubtful accounts $ 5,738 $ 6,583 $ − $ 6,738 (1) $ 5,583 Accrued risk reserves $ 106,218 $ 69,392 $ − $ 77,102 $ 98,508 For the year ended December 31, 2016 Allowance for doubtful accounts $ 5,583 $ 5,967 $ − $ 5,807 (1) $ 5,743 Accrued risk reserves $ 98,508 $ 63,596 $ − $ 70,942 $ 91,162 (1) All other financial statement schedules are not required under the related instructions or are inapplicable and therefore have been omitted. (3) (a) Reference is made to the Exhibit Index, which is found within this Form 10–K |
Significant Accounting Policies
Significant Accounting Policies (Policies) | 12 Months Ended |
Dec. 31, 2016 | |
Accounting Policies [Abstract] | |
Basis of Accounting, Policy [Policy Text Block] | Principles of Consolidation and Basis of Presentation The consolidated financial statements which are prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) include our wholly owned and controlled subsidiaries and affiliates. Variable interest entities (“VIEs”) in which we have an interest have been consolidated when we have been identified as the primary beneficiary. Investments in ventures in which we have the ability to exercise significant influence but do not have control over are accounted for using the equity method. Equity method investments are initially recorded at cost and subsequently are adjusted for our share of the venture’s earnings or losses and cash distributions. Our most significant equity method investment is a 75.1% |
Use of Estimates, Policy [Policy Text Block] | Use of Estimates The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. |
Change in Accounting Principle, Policy [Policy Text Block] | Change in Accounting Principle Effective December 31, 2016, 2016–18, Statement of Cash Flows (Topic 230)—Restricted As described in the guidance for accounting changes under ASC Topic 250, December 31, 2016: Consolidated Statements of Cash Flows ( in thousands Year Ended December 31, 2015 Year Ended December 1, 2014 As Previously Reported Effect of Accounting Change As Adjusted As Previously Reported Effect of Accounting Change As Adjusted Cash Flows from Operating Activities: Restricted cash and cash equivalents $ (9,392 ) $ 9,392 $ - $ (6,245 ) $ 6,245 $ - Net cash provided by operating activities 73,963 9,392 83,355 75,694 6,245 81,939 Cash Flows from Investing Activities: Change in restricted cash and cash equivalents 8,937 (8,937 ) - 9,523 (9,523 ) - Net cash used in investing activities (63,847 ) (8,937 ) (72,784 ) (57,508 ) (9,523 ) (67,031 ) Net Decrease in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents (31,559 ) 455 (31,104 ) (11,938 ) (3,278 ) (15,216 Cash, Cash Equivalents, Restricted Cash, and Restricted Cash, Equivalents, Beginning of Period 69,767 10,651 80,418 81,705 13,929 95,634 Cash, Cash Equivalents, Restricted Cash, and Restricted Cash, Equivalents, $ 38,208 $ 11,106 $ 49,314 $ 69,767 $ 10,651 $ 80,418 |
Revenue Recognition, Policy [Policy Text Block] | Net Patient Revenues and Accounts Receivable Revenues are derived from services rendered to patients for skilled and intermediate nursing, rehabilitation therapy, hospice, assisted living and retirement and home health care services. Revenues are recorded when services are provided based on established rates adjusted to amounts expected to be received under governmental programs and other third–party For private pay patients in skilled nursing, assisted living and independent living facilities, the Company bills for room and board charges, with the remittance being due on receipt of the statement and generally by the 10th We receive payments from the Medicare program under a prospective payment system ("PPS"). For skilled nursing services, Medicare pays a fixed fee per Medicare patient per day, based on the acuity level of the patient, to cover all post–hospital extended care routine service costs, ancillary costs and capital related costs. Medicaid program payments for long–term care services are generally based on fixed per diem rates subject to program cost ceilings. For homecare services, Medicare pays based on the acuity level of the patient and based on episodes of care. An episode of care is defined as a length of care up to 60 60% Laws and regulations governing the Medicare and Medicaid programs are complex and subject to interpretation. Noncompliance with such laws and regulations can be subject to regulatory actions including fines, penalties, and exclusion from the Medicare and Medicaid programs. We believe that we are in compliance with all applicable laws and regulations. Medicare and Medicaid program revenues, as well as certain Managed Care program revenues, are subject to audit and retroactive adjustment by government representatives or their agents. The Medicare PPS methodology requires that patients be assigned to Resource Utilization Groups ("RUGs") based on the acuity level of the patient to determine the amount paid to us for patient services. The assignment of patients to the various RUG categories is subject to post–payment review by Medicare intermediaries or their agents. In our opinion, adequate provision has been made for any adjustments that may $17,019,000 $16,654,000 December 31, 2016 2015, |
Revenue Recognition for Alternative Revenue Programs, Policy [Policy Text Block] | Other Revenues As discussed in Note 3 3, Certain management contracts, including, but not limited to contracts with National, subordinate the payment of management fees earned under those contracts to other expenditures of the long–term care center and to the availability of cash provided by the facility’s operations. Revenues from management services provided to the facilities that generate insufficient cash flow to pay the management fee, as prioritized under the contractual arrangement, are not recognized until such time as the amount of revenue earned is fixed or determinable and collectability is reasonably assured. This recognition policy could cause our reported revenues and net income from management services to vary significantly from period to period. We recognize rental income based on the terms of our operating leases. Under certain of our leases, we receive contingent rent, which is based on the increase in revenues of a lessee over a base year. We recognize contingent rent annually or monthly, as applicable, when, based on the actual revenue of the lessee, receipt of such income is assured. We identify leased real estate properties as nonperforming if a required payment is not received within 30 |
Premiums Receivable, Allowance for Doubtful Accounts, Estimation Methodology, Policy [Policy Text Block] | Provision for Doubtful Accounts We evaluate the collectability of our accounts receivable based on factors such as payor type, historical collection trends and aging categories. We review these factors and determine an estimated provision for doubtful accounts. Historically, bad debts have resulted primarily from uncollectible private balances or from uncollectible coinsurance and deductibles. Receivables that are deemed to be uncollectible are written off against the allowance. The allowance for doubtful accounts balance is assessed on a quarterly basis, with changes in estimated losses being recorded in the consolidated statements of income in the period first The Company includes provisions for doubtful accounts in operating expenses in its consolidated statements of income. The provisions for doubtful accounts were $5,967,000, $6,583,000, $6,228,000 2016, 2015 2014, |
Other Operating Expenses Policy [Policy Text Block] | Other Operating Expenses Other operating expenses include the costs of care and services that we provide to the residents of our facilities and the costs of maintaining our facilities. Our primary patient care costs include drugs, medical supplies, purchased professional services, food, professional insurance and licensing fees. The primary facility costs include utilities and property insurance. |
Selling, General and Administrative Expenses, Policy [Policy Text Block] | General and Administrative Costs With the Company being a healthcare provider, the majority of our expenses are "cost of revenue" items. Costs that could be classified as "general and administrative" by the Company would include its corporate office costs, which were $29.3 $34.5 $34.9 December 31, 2016, 2015, 2014, |
Cash and Cash Equivalents, Policy [Policy Text Block] | Cash and Cash Equivalents Cash equivalents include highly liquid investments with an original maturity of three |
Cash and Restricted Cash and Cash Equivalents and Restricted Marketable Securities [Policy Text Block] | Restricted Cash and Cash Equivalents and Restricted Marketable Securities Restricted cash and cash equivalents and restricted marketable securities primarily represent assets that are held by our wholly–owned limited purpose insurance companies for workers' compensation and professional liability claims. |
Marketable Securities, Policy [Policy Text Block] | Investments in Marketable Securities and Restricted Marketable Securities Our investments in marketable securities and restricted marketable securities include available for sale securities, which are recorded at fair value. Unrealized gains and losses on available for sale securities that are deemed temporary are recorded as a separate component of stockholders’ equity. If any adjustment to fair value reflects a significant decline in the value of the security, we consider all available evidence to evaluate the extent to which the decline is "other than temporary". Credit losses are identified when we do not expect to receive cash flows sufficient to recover the amortized cost basis of a security. In the event of a credit loss, only the amount associated with the credit loss is recognized in earnings, with the amount of loss relating to other factors recorded as a separate component of stockholders’ equity. |
Inventory, Policy [Policy Text Block] | Inventories Inventories consist generally of food and supplies and are valued at the lower of cost or market, with cost determined on a first–in, first–out |
Finance, Loans and Leases Receivable, Policy [Policy Text Block] | Mortgage and Other Notes Receivable In accordance with Accounting Standards Codification ("ASC") Topic 310, Receivables may |
Property, Plant and Equipment, Policy [Policy Text Block] | Pro perty 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 3– 15 Expenditures for repairs and maintenance are charged to expense as incurred. Betterments, which significantly extend the useful life, are capitalized. We remove the costs and related allowances for accumulated depreciation or amortization from the accounts for properties sold or retired, and any resulting gains or losses are included in income. In accordance with ASC Topic 360, Property, Plant, and Equipment may |
Goodwill and Intangible Assets, Goodwill, Policy [Policy Text Block] | Goodwill The Company accounts for goodwill under ASC Topic 350, Intangibles – Goodwill and Other first fourth |
Liability Reserve Estimate, Policy [Policy Text Block] | Accrued Risk Reserves We are principally self–insured for risks related to employee health insurance and utilize wholly–owned limited purpose insurance companies for workers’ compensation and professional liability claims. Accrued risk reserves primarily represent the accrual for risks associated with employee health insurance, workers’ compensation and professional liability claims. The accrued risk reserves include a liability for unpaid reported claims and estimates for incurred but unreported claims. Our policy with respect to a significant portion of our workers’ compensation and professional and general liability claims is to use an actuary to assist management in estimating our exposure for claims obligation (for both asserted and unasserted claims). Our health insurance reserve is based on our known claims incurred and an estimate of incurred but unreported claims determined by our analysis of historical claims paid. We reassess our accrued risk reserves on a quarterly basis, with changes in estimated losses being recorded in the consolidated statements of income in the period first |
Other Current Liabilities [Policy Text Block] | Other Current Liabilities Other current liabilities primarily represent accruals for current federal and state income taxes, real estate taxes and other current liabilities. |
Continuing Care Retirement Communities, Advance Fees, Policy [Policy Text Block] | Continuing Care Contracts and Refundable Entrance Fees We have one may 10% 90% 40% December 31, 2016 December 31, 2015 $9,924,000 $9,865,000, 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. At December 31, 2016 2015, $3,236,000 $3,440,000, |
Income Tax Uncertainties, Policy [Policy Text Block] | Other Noncurrent Liabilities Other noncurrent liabilities include reserves primarily related to various uncertain income tax positions (see Note 12). |
Revenue Recognition, Deferred Revenue [Policy Text Block] | Deferred Revenue Deferred revenue includes the deferred gain on the sale of assets to National (as discussed in Note 2) (10%) |
Income Tax, Policy [Policy Text Block] | Income Taxes We utilize ASC Topic 740, Income Taxes 12 Also under ASC Topic 740, Income Taxes 50 |
Share-based Compensation, Option and Incentive Plans Policy [Policy Text Block] | Stock– Based Compensation Stock–based awards granted include stock options, restricted stock units, and stock purchased under our employee stock purchase plan. Stock–based compensation cost is measured at the grant date, based on the fair value of the awards, and is recognized as expense over the requisite service period only for those equity awards expected to vest. The fair value of the restricted stock units is determined based on the stock price on the date of grant. We estimated the fair value of stock options and stock purchased under our employee stock purchase plan using the Black–Scholes model. This model utilizes the estimated fair value of common stock and requires that, at the date of grant, we use the expected term of the grant, the expected volatility of the price of our common stock, risk–free interest rates and expected dividend yield of our common stock. The fair value is amortized on a straight–line basis over the requisite service periods of the awards. |
Concentration Risk, Credit Risk, Policy [Policy Text Block] | Concentration of Credit Risks Our credit risks primarily relate to cash and cash equivalents, restricted cash and cash equivalents, accounts receivable, marketable securities, restricted marketable securities and notes receivable. Cash and cash equivalents are primarily held in bank accounts and overnight investments. Restricted cash and cash equivalents is primarily invested in commercial paper and certificates of deposit with financial institutions and other interest bearing accounts. Accounts receivable consist primarily of amounts due from patients (funded through Medicare, Medicaid, other contractual programs and through private payors) and from other health care companies for management, accounting and other services. We perform continual credit evaluations of our clients and maintain allowances for doubtful accounts on these accounts receivable. Marketable securities and restricted marketable securities are held primarily in accounts with brokerage institutions. Notes receivable relate primarily to secured loans with health care facilities (recorded as notes receivable in the consolidated balance sheets) as discussed in Note 10. At any point in time we have funds in our operating accounts and restricted cash accounts that are with third may Our financial instruments, principally our notes receivable, are subject to the possibility of loss of the carrying values as a result of the failure of other parties to perform according to their contractual obligations. We obtain various collateral and other protective rights, and continually monitor these rights in order to reduce such possibilities of loss. We evaluate the need to provide reserves for potential losses on our financial instruments based on management's periodic review of the portfolio on an instrument by instrument basis. See Note 10 |
Comprehensive Income, Policy [Policy Text Block] | Comprehensive Income ASC Topic 220, Comprehensive Income, |
Segment Reporting, Policy [Policy Text Block] | Segment Disclosures ASC Topic 280, Segment Reporting, 3 |
New Accounting Pronouncements, Policy [Policy Text Block] | Recently Adopted Accounting Guidance In November 2016, 2016–18, 230)—Restricted December 15, 2017, December 31, 2016, 1 Change in Accounting Principle 2016–18. In November 2015, 2015–17, December 15, 2016. December 31, 2015. In April 2015, 2015–03, 835.30): 2015–03 August 2015, 2015–15 December 15, 2015. In February 2015, ASU No. 2015–02 may December 15, 2015. Recent Accounting Guidance Not Yet Adopted In March 2016, 2016–09, 718): 2016–09 2016–09 December 15, 2016. 2016–09, believe the final result will be a decrease to our income tax expense and an increase in net cash provided by operating activities. In February 2016, 2016–02, 842)." December 15, 2018, In January 2016, 2016–01, (Topic 825)”. 2016–01 2016–01 2016–01 December 15, 2017, 2016– 0 1 may 2016–01. In May 2014, 2014–09 five 1. 2. 3. 4. 5. For a public entity, this update is effective for annual reporting periods beginning after December 15, 2017, As we progress with our implementation efforts to adopt the New Revenue Standard, management continues to evaluate and refine its estimates of the anticipated impacts it will have on our revenue recognition policies, procedures, financial position, results of operations, cash flows, financial disclosures and control framework. Specifically, the Company is continuing to evaluate its population of revenue sources to determine the potential effects the New Revenue Standard will have on the amount or timing of certain industry-specific healthcare revenue sources, which at this time includes revenue recorded from our CCRC, settlements with third |
Note 1 - Summary of Significa31
Note 1 - Summary of Significant Accounting Policies (Tables) | 12 Months Ended |
Dec. 31, 2016 | |
Notes Tables | |
New Accounting Pronouncement, Early Adoption [Table Text Block] | Year Ended December 31, 2015 Year Ended December 1, 2014 As Previously Reported Effect of Accounting Change As Adjusted As Previously Reported Effect of Accounting Change As Adjusted Cash Flows from Operating Activities: Restricted cash and cash equivalents $ (9,392 ) $ 9,392 $ - $ (6,245 ) $ 6,245 $ - Net cash provided by operating activities 73,963 9,392 83,355 75,694 6,245 81,939 Cash Flows from Investing Activities: Change in restricted cash and cash equivalents 8,937 (8,937 ) - 9,523 (9,523 ) - Net cash used in investing activities (63,847 ) (8,937 ) (72,784 ) (57,508 ) (9,523 ) (67,031 ) Net Decrease in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents (31,559 ) 455 (31,104 ) (11,938 ) (3,278 ) (15,216 Cash, Cash Equivalents, Restricted Cash, and Restricted Cash, Equivalents, Beginning of Period 69,767 10,651 80,418 81,705 13,929 95,634 Cash, Cash Equivalents, Restricted Cash, and Restricted Cash, Equivalents, $ 38,208 $ 11,106 $ 49,314 $ 69,767 $ 10,651 $ 80,418 |
Note 3 - Other Revenues (Tables
Note 3 - Other Revenues (Tables) | 12 Months Ended |
Dec. 31, 2016 | |
Notes Tables | |
Schedule of Other Revenues [Table Text Block] | Year Ended December 31, 2016 2015 2014 (in thousands) Insurance services $ 7,195 $ 7,012 $ 7,215 Management and accounting service fees 15,953 14,586 15,184 Rental income 21,835 19,191 19,123 Other 931 987 874 $ 45,914 $ 41,776 $ 42,396 |
Note 4 - Non-operating Income (
Note 4 - Non-operating Income (Tables) | 12 Months Ended |
Dec. 31, 2016 | |
Notes Tables | |
Schedule of Other Nonoperating Income, by Component [Table Text Block] | Year Ended December 31, 2016 2015 2014 (in thousands) Equity in earnings of unconsolidated investments $ 6,636 $ 5,845 $ 6,675 Dividends and net realized gains on sales of securities 7,324 6,809 5,957 Interest income 5,705 5,494 4,550 $ 19,665 $ 18,148 $ 17,182 |
Note 5 - Long-term Leases (Tabl
Note 5 - Long-term Leases (Tables) | 12 Months Ended |
Dec. 31, 2016 | |
Notes Tables | |
Schedule of Capital Leased Assets [Table Text Block] | December 31, 2016 December 31, 2015 (in thousands) Buildings and personal property $ 39,032 $ 39,032 Accumulated amortization (11,120 ) (7,196 ) $ 27,912 $ 31,836 |
Schedule of Future Minimum Lease Payments for Capital Leases [Table Text Block] | Operating Leases Capital Leases (in thousands) 2017 $ 34,200 $ 5,200 2018 34,200 5,200 2019 34,200 5,200 2020 34,200 5,200 2021 34,200 5,200 Thereafter 176,750 11,267 Total minimum lease payments $ 347,750 $ 37,267 Less: Amounts representing interest (7,038 ) Present value of minimum lease payments 30,229 Less: Current portion (3,481 ) Long–term capital lease obligations $ 26,748 |
Note 6 - Earnings Per Share (Ta
Note 6 - Earnings Per Share (Tables) | 12 Months Ended |
Dec. 31, 2016 | |
Notes Tables | |
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block] | Year Ended December 31, 2016 2015 2014 (dollars in thousands, except share and per share amounts) Basic: Weighted average common shares outstanding 15,134,518 13,889,134 13,816,095 Net income $ 50,538 $ 53,143 $ 53,369 Dividends to preferred stockholders – 6,819 8,670 Net income available to common stockholders $ 50,538 $ 46,324 $ 44,699 Earnings per common share, basic $ 3.34 $ 3.34 $ 3.24 Diluted: Weighted average common shares outstanding 15,134,518 13,889,134 13,816,095 Dilutive effect of stock options 24,176 144,793 73,678 Dilutive effect of restricted stock – 1,183 3,691 Dilutive effect of contingent issuable stock 48,303 456,323 328,669 Assumed average common shares outstanding 15,206,997 14,491,433 14,222,133 Net income available to common stockholders $ 50,538 $ 46,324 $ 44,699 Earnings per common share, diluted $ 3.32 $ 3.20 $ 3.14 |
Note 7 - Investments in Marke36
Note 7 - Investments in Marketable Securities (Tables) | 12 Months Ended |
Dec. 31, 2016 | |
Notes Tables | |
Available-for-sale Securities [Table Text Block] | December 31, 2016 December 31, 2015 (in thousands) Amortized Cost Fair Value Amortized Cost Fair Value Investments available for sale: Marketable equity securities $ 30,176 $ 138,013 $ 30,176 $ 116,168 Restricted investments available for sale: Corporate debt securities 71,311 71,100 71,960 71,143 Asset–backed securities 56,889 56,168 61,645 60,910 U.S. Treasury securities 25,748 25,181 21,123 21,033 State and municipal securities 32,020 31,255 16,446 16,780 $ 216,144 $ 321,717 $ 201,350 $ 286,034 |
Schedule of Available-for-sale Securities Reconciliation [Table Text Block] | December 31, 2016 December 31, 2015 Shares Cost Fair Value Shares Cost Fair Value NHI Common Stock 1,630,642 $ 24,734 $ 120,945 1,630,642 $ 24,734 $ 99,257 |
Investments Classified by Contractual Maturity Date [Table Text Block] | December 31, 2016 December 31, 2015 (in thousands) Cost Fair Value Cost Fair Value Maturities: Within 1 year $ 14,181 $ 14,216 $ 23,291 $ 23,273 1 to 5 years 79,827 79,502 74,747 74,671 6 to 10 years 91,211 89,269 71,442 70,223 Over 10 years 749 717 1,694 1,699 $ 185,968 $ 183,704 $ 171,174 $ 169,866 |
Note 8 - Fair Value Measureme37
Note 8 - Fair Value Measurements (Tables) | 12 Months Ended |
Dec. 31, 2016 | |
Notes Tables | |
Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis [Table Text Block] | Fair Value Measurements Using December 31, 2016 Fair Value Quoted Prices in Active Markets For Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Cash and cash equivalents $ 26,335 $ 26,335 $ – $ – Restricted cash and cash equivalents 5,254 5,254 – – Marketable equity securities 138,013 138,013 – – Corporate debt securities 71,100 42,323 28,777 – Asset–backed securities 56,168 – 56,168 – U.S. Treasury securities 25,181 25,181 – – State and municipal securities 31,255 – 31,255 – Total financial assets $ 353,306 $ 237,106 $ 116,200 $ – Fair Value Measurements Using December 31, 2015 Fair Value Quoted Prices in Active Markets For Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Cash and cash equivalents $ 38,208 $ 38,208 $ – $ – Restricted cash and cash equivalents 11,106 11,106 – – Marketable equity securities 116,168 116,168 – – Corporate debt securities 71,143 32,683 38,460 – Asset–backed securities 60,910 – 60,910 – U.S. Treasury securities 21,033 21,033 – – State and municipal securities 16,780 – 16,780 – Total financial assets $ 335,348 $ 219,198 $ 116,150 $ – |
Note 9 - Property and Equipme38
Note 9 - Property and Equipment (Tables) | 12 Months Ended |
Dec. 31, 2016 | |
Notes Tables | |
Property, Plant and Equipment [Table Text Block] | December 31, 2016 2015 (in thousands) Land $ 59,812 $ 59,831 Leasehold improvements 108,661 103,445 Buildings and improvements 552,404 507,627 Furniture and equipment 158,558 150,357 Construction in progress 53,705 54,027 933,140 875,287 Less: Accumulated depreciation (373,516 ) (339,241 ) $ 559,624 $ 536,046 |
Note 11 - Long-term Debt (Table
Note 11 - Long-term Debt (Tables) | 12 Months Ended |
Dec. 31, 2016 | |
Notes Tables | |
Schedule of Debt [Table Text Block] | Interest Rate at December 31, Dec. 31, 2016 Maturities 2016 2015 Credit Facility, interest payable monthly Variable, 2.1% 2020 $ 110,000 $ 110,000 Unsecured term note payable to National, interest payable quarterly, principal payable at maturity Variable, 3.0% 2018 10,000 10,000 120,000 120,000 Less current portion – – $ 120,000 $ 120,000 |
Schedule of Maturities of Long-term Debt [Table Text Block] | Long–Term Debt (in thousands) 2017 $ − 2018 10,000 2019 − 2020 110,000 2021 − Total $ 120,000 |
Note 12 - Income Taxes (Tables)
Note 12 - Income Taxes (Tables) | 12 Months Ended |
Dec. 31, 2016 | |
Notes Tables | |
Schedule of Components of Income Tax Expense (Benefit) [Table Text Block] | Year Ended December 31, 2016 2015 2014 (in thousands) Current Tax Provision Federal $ 24,012 $ 29,322 $ 30,235 State 661 3,568 3,095 24,673 32,890 33,330 Deferred Tax Provision Federal 4,208 (532 ) (1,172 ) State 788 (227 ) (334 ) 4,996 (759 ) (1,506 ) Income Tax Provision $ 29,669 $ 32,131 $ 31,824 |
Schedule of Deferred Tax Assets and Liabilities [Table Text Block] | December 31, 2016 2015 (in thousands) Deferred tax assets: Allowance for doubtful accounts receivable $ 2,077 $ 2,055 Accrued risk reserves 2,277 2,648 Accrued expenses 8,907 8,420 Financial reporting depreciation in excess of tax depreciation 8,642 9,142 Stock based compensation 387 3,511 Non-refundable entrance fees 211 163 Refundable entrance fees 1,923 1,830 Obligation to provide future services 1,262 1,342 Deferred revenue 3,942 4,258 Total deferred tax assets $ 29,628 $ 33,369 Deferred tax liabilities: Unrealized gains on marketable securities $ (41,264 ) $ (33,079 ) Deferred gain on sale of assets (net) (3,135 ) (3,135 ) Book basis in excess of tax basis of intangible assets (1,481 ) (945 ) Book basis in excess of tax basis of securities (2,416 ) (2,344 ) Long–term investments (3,404 ) (2,962 ) Total deferred tax liabilities $ (51,700 ) $ (42,465 ) Net deferred tax liability $ (22,072 ) $ (9,096 ) |
Schedule of Effective Income Tax Rate Reconciliation [Table Text Block] | Year Ended December 31, 2016 2015 2014 (in thousands) Tax provision at federal statutory rate $ 28,072 $ 29,846 $ 29,818 Increase (decrease) in income taxes resulting from: State, net of federal benefit 1,783 1,767 2,207 Nondeductible expenses 156 351 363 Insurance expense 27 6 27 Other, net 283 (372 ) 439 Unrecognized tax benefits 716 2,674 512 Expiration of statute of limitations (1,368 ) (2,141 ) (1,542 ) 1,597 2,285 2,006 Effective income tax expense $ 29,669 $ 32,131 $ 31,824 |
Schedule of Unrecognized Tax Benefits Roll Forward [Table Text Block] | Deferred Tax Asset Liability For Unrecognized Tax Benefits Liability For Interest and Penalties Liability Total Balance, January 1, 2014 $ 8,598 $ 12,453 $ 2,072 $ 14,525 Additions based on tax positions related to the current year − 2,008 216 2,224 Additions for tax positions of prior years 2,032 1,218 706 1,924 Reductions for statute of limitation expirations (1,523 ) (2,059 ) (603 ) (2,662 ) Balance, December 31, 2014 9,107 13,620 2,391 16,011 Additions based on tax positions related to the current year − 1,595 308 1,903 Additions for tax positions of prior years 490 498 1,298 1,796 Reductions for statute of limitation expirations (1,779 ) (2,551 ) (865 ) (3,416 ) Balance, December 31, 2015 7,818 13,162 3,132 16,294 Additions based on tax positions related to the current year 1,249 1,249 - 1,249 Additions for tax positions of prior years 481 718 934 1,652 Reductions for statute of limitation expirations (1,525 ) (2,164 ) (729 ) (2,893 ) Balance, December 31, 2016 $ 8,023 $ 12,965 $ 3,337 $ 16,302 |
Note 14 - Stock-based Compens41
Note 14 - Stock-based Compensation (Tables) | 12 Months Ended |
Dec. 31, 2016 | |
Notes Tables | |
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions [Table Text Block] | Year Ended December 31, 2016 2015 2014 Risk–free interest rate 0.89 % 0.71 % 0.52 % Expected volatility 15.8 % 16.5 % 17.3 % Expected life, in years 2.2 2.2 2.2 Expected dividend yield 3.09 % 2.73 % 2.68 % |
Schedule of Share-based Compensation, Stock Options, Activity [Table Text Block] | Number of Shares Weighted Average Exercise Price Aggregate Intrinsic Value Options outstanding at January 1, 2014 1,074,552 $ 46.44 $ − Options granted 57,716 53.10 − Options exercised (157,590 ) 45.97 − Options cancelled (20,000 ) 46.69 − Options outstanding at December 31, 2014 954,678 46.92 − Options granted 56,210 61.47 − Options exercised (389,498 ) 47.06 − Options cancelled – – − Options outstanding at December 31, 2015 621,390 48.15 − Options granted 56,291 62.54 − Options exercised (499,066 ) 47.16 − Options cancelled (656 ) 46.69 − Options outstanding at December 31, 2016 177,959 $ 55.48 $ 3,615,000 Options exercisable at December 31, 2016 177,959 $ 55.48 $ 3,615,000 |
Schedule of Share-based Compensation, Shares Authorized under Stock Option Plans, by Exercise Price Range [Table Text Block] | Options Outstanding December 31, 2016 Exercise Prices Weighted Average Exercise Price Weighted Average Remaining Contractual Life in Years 90,000 $44.80 – $52.93 $ 49.07 1.5 87,959 $61.25 – $62.78 62.03 3.9 177,959 $ 55.48 2.7 |
Note 16 - Equity Method Inves42
Note 16 - Equity Method Investment in Caris HealthCare, L.P. (Tables) | 12 Months Ended |
Dec. 31, 2016 | |
Notes Tables | |
Equity Method Investments [Table Text Block] | December 31, 2016 2015 2014 ( in thousands) Current assets $ 21,973 $ 23,213 $ 20,922 Noncurrent assets 10,896 11,091 11,540 Liabilities 8,082 7,970 7,305 Partners’ capital 24,787 26,334 25,157 Revenue 52,105 50,464 51,441 Expenses 42,928 40,875 40,908 Net income 9,177 9,589 10,533 |
Note 20 - Selected Quarterly 43
Note 20 - Selected Quarterly Financial Data (Tables) | 12 Months Ended |
Dec. 31, 2016 | |
Notes Tables | |
Quarterly Financial Information [Table Text Block] | 2016 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Net Operating Revenues $ 229,588 $ 227,768 $ 231,281 $ 238,001 Income Before Non–Operating Income 17,624 14,641 10,590 17,687 Non–Operating Income 4,773 4,925 5,091 4,876 Net Income 13,699 11,866 11,110 13,863 Net Income Available to Common Stockholders 13,699 11,866 11,110 13,863 Basic Earnings Per Share .92 .78 .73 .92 Diluted Earnings Per Share .91 .78 .73 .91 2015 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Net Operating Revenues $ 222,407 $ 224,902 $ 225,386 $ 233,927 Income Before Non–Operating Income 17,436 15,706 13,761 20,223 Non–Operating Income 4,222 4,130 4,550 5,246 Net Income 13,242 12,358 12,567 14,976 Preferred Dividends 2,168 2,167 2,152 332 Net Income Available to Common Stockholders 11,074 10,191 10,415 14,644 Basic Earnings Per Share .80 .74 .75 1.03 Diluted Earnings Per Share .77 .71 .72 .99 |
Schedule II - Valuation and Q44
Schedule II - Valuation and Qualifying Accounts (Tables) | 12 Months Ended |
Dec. 31, 2016 | |
Notes Tables | |
Summary of Valuation Allowance [Table Text Block] | Column A Column B Column C Column D Column E Additions Description Balance– Beginning of Period Charged to Costs and Expenses Charged to other Accounts Deductions Balance– End of Period For the year ended December 31, 2014 Allowance for doubtful accounts $ 4,972 $ 6,228 $ − $ 5,462 (1) $ 5,738 Accrued risk reserves $ 110,557 $ 61,557 $ − $ 65,896 $ 106,218 For the year ended December 31, 2015 Allowance for doubtful accounts $ 5,738 $ 6,583 $ − $ 6,738 (1) $ 5,583 Accrued risk reserves $ 106,218 $ 69,392 $ − $ 77,102 $ 98,508 For the year ended December 31, 2016 Allowance for doubtful accounts $ 5,583 $ 5,967 $ − $ 5,807 (1) $ 5,743 Accrued risk reserves $ 98,508 $ 63,596 $ − $ 70,942 $ 91,162 |
Note 1 - Summary of Significa45
Note 1 - Summary of Significant Accounting Policies (Details Textual) - USD ($) | 12 Months Ended | ||
Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 | |
Number of States in which Entity Operates | 10 | ||
Homecare Services Anticipated Payment Deferred Revenue Percentage | 60.00% | ||
Provision for Doubtful Accounts | $ 5,967,000 | $ 6,583,000 | $ 6,228,000 |
General and Administrative Expense | 29,300,000 | 34,500,000 | $ 34,900,000 |
Continuing Care Retirement Communities Advance Fees, Obligation for Future Services, Amount | $ 3,236,000 | 3,440,000 | |
Refundable Advance Fees [Member] | |||
Nonrefundable Resident Entry Fee Percentage | 10.00% | ||
Customer Refundable Fees | $ 9,924,000 | 9,865,000 | |
Original Entry Fee [Member] | |||
Refundable Resident Entry Fee Percentage | 90.00% | ||
Appreciation [Member] | |||
Appreciation of Apartment Over Original Residents Entry Fee Percentage | 40.00% | ||
Building and Building Improvements [Member] | Minimum [Member] | |||
Property, Plant and Equipment, Useful Life | 20 years | ||
Building and Building Improvements [Member] | Maximum [Member] | |||
Property, Plant and Equipment, Useful Life | 40 years | ||
Equipment and Furniture [Member] | Minimum [Member] | |||
Property, Plant and Equipment, Useful Life | 3 years | ||
Equipment and Furniture [Member] | Maximum [Member] | |||
Property, Plant and Equipment, Useful Life | 15 years | ||
Medicare and Medicaid [Member] | |||
Allowance for Doubtful Accounts Receivable | $ 17,019,000 | $ 16,654,000 | |
Caris [Member] | |||
Equity Method Investment, Ownership Percentage | 75.10% |
Note 1 - Summary of Significa46
Note 1 - Summary of Significant Accounting Policies - Effect of the Accounting Change on the Statements of Cash Flows (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 | |
Net cash provided by operating activities | $ 90,882 | $ 83,355 | $ 81,939 |
Net cash used in investing activities | (81,476) | (72,784) | (67,031) |
Net Decrease in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents | (17,725) | (31,104) | (15,216) |
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period | 49,314 | 80,418 | 95,634 |
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period | 31,589 | 49,314 | 80,418 |
New Accounting Pronouncement, Early Adoption, Effect [Member] | |||
Restricted cash and cash equivalents | |||
Net cash provided by operating activities | 83,355 | 81,939 | |
Change in restricted cash and cash equivalents | |||
Net cash used in investing activities | (72,784) | (67,031) | |
Net Decrease in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents | (31,104) | (15,216) | |
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period | 49,314 | 80,418 | 95,634 |
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period | 49,314 | 80,418 | |
New Accounting Pronouncement, Early Adoption, Effect [Member] | Scenario, Previously Reported [Member] | |||
Restricted cash and cash equivalents | (9,392) | (6,245) | |
Net cash provided by operating activities | 73,963 | 75,694 | |
Change in restricted cash and cash equivalents | 8,937 | 9,523 | |
Net cash used in investing activities | (63,847) | (57,508) | |
Net Decrease in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents | (31,559) | (11,938) | |
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period | 38,208 | 69,767 | 81,705 |
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period | 38,208 | 69,767 | |
New Accounting Pronouncement, Early Adoption, Effect [Member] | Restatement Adjustment [Member] | |||
Restricted cash and cash equivalents | 9,392 | 6,245 | |
Net cash provided by operating activities | 9,392 | 6,245 | |
Change in restricted cash and cash equivalents | (8,937) | (9,523) | |
Net cash used in investing activities | (8,937) | (9,523) | |
Net Decrease in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents | 455 | (3,278) | |
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period | $ 11,106 | 10,651 | 13,929 |
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period | $ 11,106 | $ 10,651 |
Note 2 - Relationship with Na47
Note 2 - Relationship with National Health Corporation (Details Textual) - USD ($) | 12 Months Ended | ||
Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 | |
National [Member] | |||
Line of Credit Facility, Maximum Borrowing Capacity | $ 2,000,000 | ||
Payroll and Related Services Administrative Fee Percentage | 1.00% | ||
Payment for Administrative Fees | $ 4,701,000 | $ 4,542,000 | $ 4,395,000 |
Employee-related Receivables | 1,775,000 | ||
Employee-related Liabilities | $ 3,312,000 | ||
National [Member] | Common Stock [Member] | |||
Shares, Outstanding | 1,084,763 | ||
Equity Owned by Related Parties | 7.20% | ||
Loans Payable [Member] | National [Member] | |||
Notes Payable, Related Parties | $ 10,000,000 | ||
Debt Instrument, Basis Spread on Variable Rate | 0.85% | ||
Line of Credit [Member] | National Health Care [Member] | |||
Line of Credit Facility, Maximum Borrowing Capacity | $ 2,000,000 | ||
Long-term Line of Credit | $ 0 | ||
National [Member] | |||
Number of Skilled Nursing Centers | 5 |
Note 3 - Other Revenues (Detail
Note 3 - Other Revenues (Details Textual) | 1 Months Ended | 12 Months Ended | ||
Dec. 31, 2010 | Dec. 31, 2016USD ($) | Dec. 31, 2015USD ($) | Dec. 31, 2014USD ($) | |
Unbilled Receivables, Current | $ 21,296,000 | $ 21,345,000 | ||
Lessee Leasing Arrangements, Operating Leases, Term of Contract | 10 years | 10 years | ||
Accounting and Financial Services Provided [Member] | ||||
Number of Healthcare Facilities | 20 | 20 | ||
National [Member] | ||||
Number of Skilled Nursing Centers | 5 | |||
Management Fees Revenue | $ 3,777,000 | $ 3,599,000 | $ 3,544,000 | |
Other Nursing Centers [Member] | ||||
Management Fees Revenue | $ 2,172,000 | 2,490,000 | ||
Number of Healthcare Facilities | 6 | |||
Owned and Leased to Third Party Operators [Member] | ||||
Number of Skilled Nursing Centers | 9 | |||
Number of Assisted Living Facilities | 4 | |||
Number of New Triple Net Lease Agreements Entered Into During the Period | 11 | |||
Number of Health Care Properties Owned and Leased to Third Party Operators | 13 | |||
Workers Compensation Premium Revenue [Member] | ||||
Health Care Organization, Premium Revenue | $ 4,508,000 | 4,215,000 | 4,434,000 | |
Professional Liability Insurance [Member] | ||||
Health Care Organization, Premium Revenue | $ 2,687,000 | $ 2,797,000 | $ 2,781,000 |
Note 3 - Other Revenues - Summa
Note 3 - Other Revenues - Summary of Other Revenues (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 | |
Other Revenues | $ 45,914 | $ 41,776 | $ 42,396 |
Other Income [Member] | |||
Other Revenues | 931 | 987 | 874 |
Insurance Services [Member] | |||
Other Revenues | 7,195 | 7,012 | 7,215 |
Management and Accounting Services Fees [Member] | |||
Other Revenues | 15,953 | 14,586 | 15,184 |
Rental Income [Member] | |||
Other Revenues | $ 21,835 | $ 19,191 | $ 19,123 |
Note 4 - Non-operating Income50
Note 4 - Non-operating Income (Details Textual) | Dec. 31, 2016 |
Caris [Member] | |
Equity Method Investment, Ownership Percentage | 75.10% |
Note 4 - Non-operating Income -
Note 4 - Non-operating Income - Schedule of Non-operating Income (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 | |
Equity in earnings of unconsolidated investments | $ 6,636 | $ 5,845 | $ 6,675 |
Dividends and net realized gains on sales of securities | 7,324 | 6,809 | 5,957 |
Interest income | 5,705 | 5,494 | 4,550 |
Other non-operating income | $ 19,665 | $ 18,148 | $ 17,182 |
Note 5 - Long-term Leases (Deta
Note 5 - Long-term Leases (Details Textual) | Mar. 01, 2014USD ($) | Jan. 01, 2007USD ($) | Sep. 30, 2013USD ($) | Dec. 31, 2010 | Dec. 31, 2016USD ($) | Dec. 31, 2015USD ($) | Dec. 31, 2014USD ($) |
Number of Facilities Under Capitalized Lease | 3 | ||||||
Number of Capitalized Lease Agreements | 3 | ||||||
Initial Lease Term | 10 years | ||||||
Number of Additional Lease Options | 2 | 5 | |||||
Term of Additional Lease Option | 5 years | ||||||
Capital Leases, Future Minimum Payments, Net Minimum Payments | $ 5,200,000 | ||||||
Lessee Leasing Arrangements, Operating Leases, Term of Contract | 10 years | 10 years | |||||
Capital Lease [Member] | |||||||
Capital Lease Additional Percentage Rent Percentage | 4.00% | ||||||
Capital Lease [Member] | Skilled Nursing Facility [Member] | |||||||
Number of Facilities Under Capitalized Lease | 2 | ||||||
Two Leases with NHI [Member] | |||||||
Number of Skilled Nursing Centers Leased from NHI | 35 | ||||||
Number of Assisted Living Centers Leased from NHI | 7 | ||||||
Number of Independent Living Centers Leased from NHI | 3 | ||||||
Number of Lease Agreements with NHI | 2 | ||||||
Operating Leases, Rent Expense, Minimum Rentals | $ 34,200,000 | ||||||
Lease One With NHI [Member] | |||||||
Number of Additional Lease Options | 3 | ||||||
Term of Additional Lease Option | 5 years | ||||||
Number of Skilled Nursing Facilities Subleased | 4 | ||||||
Lessee Leasing Arrangements, Operating Leases, Term of Contract | 15 years | ||||||
Operating Leases, Rent Expense, Minimum Rentals | $ 30,750,000 | ||||||
Operating Lease Additional Percentage Rent Percentage | 4.00% | ||||||
Lease Two with NHI [Member] | |||||||
Lessee Leasing Arrangements, Operating Leases, Term of Contract | 15 years | ||||||
Operating Leases, Rent Expense, Minimum Rentals | $ 3,450,000 | ||||||
Operating Lease Additional Percentage Rent Percentage | 4.00% | ||||||
Number of Skilled Nursing Centers | 7 | ||||||
Facility Purchase Price | $ 49,000,000 | ||||||
Both NHI Lease Agreements [Member] | |||||||
Operating Leases Percentage Rent Expense | $ 3,720,000 | $ 2,510,000 | $ 2,334,000 |
Note 5 - Long-term Leases - Fix
Note 5 - Long-term Leases - Fixed Assets Recorded Under Capital Leases (Details) - Buildings and Personal Property [Member] - USD ($) $ in Thousands | Dec. 31, 2016 | Dec. 31, 2015 |
Buildings and personal property | $ 39,032 | $ 39,032 |
Accumulated amortization | (11,120) | (7,196) |
Total capital leases | $ 27,912 | $ 31,836 |
Note 5 - Long-term Leases - Fut
Note 5 - Long-term Leases - Future Minimum Lease Payments (Details) - USD ($) $ in Thousands | Dec. 31, 2016 | Dec. 31, 2015 |
2017, operating leases | $ 34,200 | |
2017, capital leases | 5,200 | |
2018, operating leases | 34,200 | |
2018, capital leases | 5,200 | |
2019, operating leases | 34,200 | |
2019, capital leases | 5,200 | |
2020, operating leases | 34,200 | |
2020, capital leases | 5,200 | |
2021, operating leases | 34,200 | |
2021, capital leases | 5,200 | |
Thereafter, operating leases | 176,750 | |
Thereafter, capital leases | 11,267 | |
Total minimum lease payments, operating leases | 347,750 | |
Total minimum lease payments, capital leases | 37,267 | |
Less: Amounts representing interest, capital leases | (7,038) | |
Present value of minimum lease payments, capital leases | 30,229 | |
Less: Current portion, capital leases | (3,481) | $ (3,279) |
Long-term capital lease obligations, capital leases | $ 26,748 | $ 30,228 |
Note 6 - Earnings Per Share - S
Note 6 - Earnings Per Share - Summary of Earnings and Weighted Average Number of Common Shares Used in Calculation of Basic and Diluted Earnings Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands | 3 Months Ended | 12 Months Ended | |||||||||
Dec. 31, 2016 | Sep. 30, 2016 | Jun. 30, 2016 | Mar. 31, 2016 | Dec. 31, 2015 | Sep. 30, 2015 | Jun. 30, 2015 | Mar. 31, 2015 | Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 | |
Weighted average common shares outstanding (in shares) | 15,134,518 | 13,889,134 | 13,816,095 | ||||||||
Net Income | $ 13,863 | $ 11,110 | $ 11,866 | $ 13,699 | $ 14,976 | $ 12,567 | $ 12,358 | $ 13,242 | $ 50,538 | $ 53,143 | $ 53,369 |
Dividends to preferred stockholders | 6,819 | 8,670 | |||||||||
Net income available to common stockholders | $ 13,863 | $ 11,110 | $ 11,866 | $ 13,699 | $ 14,644 | $ 10,415 | $ 10,191 | $ 11,074 | $ 50,538 | $ 46,324 | $ 44,699 |
Earnings per common share, basic (in dollars per share) | $ 0.92 | $ 0.73 | $ 0.78 | $ 0.92 | $ 1.03 | $ 0.75 | $ 0.74 | $ 0.80 | $ 3.34 | $ 3.34 | $ 3.24 |
Dilutive effect of contingent issuable stock (in shares) | 48,303 | 456,323 | 328,669 | ||||||||
Assumed average common shares outstanding (in shares) | 15,206,997 | 14,491,433 | 14,222,133 | ||||||||
Earnings per common share, diluted (in dollars per share) | $ 0.91 | $ 0.73 | $ 0.78 | $ 0.91 | $ 0.99 | $ 0.72 | $ 0.71 | $ 0.77 | $ 3.32 | $ 3.20 | $ 3.14 |
Employee Stock Option [Member] | |||||||||||
Dilutive effect share-based awards (in shares) | 24,176 | 144,793 | 73,678 | ||||||||
Restricted Stock [Member] | |||||||||||
Dilutive effect share-based awards (in shares) | 1,183 | 3,691 |
Note 7 - Investments in Marke56
Note 7 - Investments in Marketable Securities (Details Textual) - USD ($) | 12 Months Ended | ||
Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 | |
Available-for-sale Securities, Accumulated Gross Unrealized Gain, before Tax | $ 108,730,000 | $ 86,921,000 | |
Available-for-sale Securities, Accumulated Gross Unrealized Loss, before Tax | 3,157,000 | 2,237,000 | |
Proceeds from Sale and Maturity of Marketable Securities | 34,642,000 | 47,574,000 | $ 48,786,000 |
Realized Investment Gains (Losses) | 816,000 | 566,000 | $ 379,000 |
Other than Temporary Impairment Losses, Investments, Available-for-sale Securities | $ 0 | $ 0 |
Note 7 - Investments in Marke57
Note 7 - Investments in Marketable Securities - Marketable Securities and Restricted Marketable Securities (Details) - USD ($) $ in Thousands | Dec. 31, 2016 | Dec. 31, 2015 |
Restricted investments available for sale, amortized cost | $ 185,968 | $ 171,174 |
Investments available for sale, amortized cost | 216,144 | 201,350 |
Available-for-sale securities | 321,717 | 286,034 |
Equity Securities [Member] | ||
Unrestricted investments available for sale, amortized cost | 30,176 | 30,176 |
Unrestricted investments available for sale, fair value | 138,013 | 116,168 |
Corporate Debt Securities [Member] | ||
Restricted investments available for sale, amortized cost | 71,311 | 71,960 |
Restricted investments available for sale, fair value | 71,100 | 71,143 |
Asset-backed Securities [Member] | ||
Restricted investments available for sale, amortized cost | 56,889 | 61,645 |
Restricted investments available for sale, fair value | 56,168 | 60,910 |
US Government Corporations and Agencies Securities [Member] | ||
Restricted investments available for sale, amortized cost | 25,748 | 21,123 |
Restricted investments available for sale, fair value | 25,181 | 21,033 |
US States and Political Subdivisions Debt Securities [Member] | ||
Restricted investments available for sale, amortized cost | 32,020 | 16,446 |
Restricted investments available for sale, fair value | $ 31,255 | $ 16,780 |
Note 7 - Investments in Marke58
Note 7 - Investments in Marketable Securities - Available for Sale Marketable Equity Securities (Details) - NHI Common Stock [Member] - USD ($) $ in Thousands | Dec. 31, 2016 | Dec. 31, 2015 |
NHI Common Stock, Shares (in shares) | 1,630,642 | 1,630,642 |
NHI Common Stock, Cost | $ 24,734 | $ 24,734 |
NHI Common Stock, Fair Value | $ 120,945 | $ 99,257 |
Note 7 - Amortized Cost and Est
Note 7 - Amortized Cost and Estimated Fair Value of Debt Securities as Available for Sale (Details) - USD ($) $ in Thousands | Dec. 31, 2016 | Dec. 31, 2015 |
Within 1 year, cost | $ 14,181 | $ 23,291 |
Within 1 year, fair value | 14,216 | 23,273 |
1 to 5 years, cost | 79,827 | 74,747 |
1 to 5 years, fair value | 79,502 | 74,671 |
6 to 10 years, cost | 91,211 | 71,442 |
6 to 10 years, fair value | 89,269 | 70,223 |
Over 10 years, cost | 749 | 1,694 |
Over 10 years, fair value | 717 | 1,699 |
Cost | 185,968 | 171,174 |
Fair Value | $ 183,704 | $ 169,866 |
Note 8 - Fair Value Measureme60
Note 8 - Fair Value Measurements - Summary of Fair Value Measurements by Level (Details) - USD ($) $ in Thousands | Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 |
Restricted cash and cash equivalents | $ 5,254 | $ 11,106 | $ 10,651 |
Available-for-sale securities | 321,717 | 286,034 | |
Fair Value, Measurements, Recurring [Member] | |||
Cash and cash equivalents | 26,335 | 38,208 | |
Restricted cash and cash equivalents | 5,254 | 11,106 | |
Total financial assets | 353,306 | 335,348 | |
Fair Value, Measurements, Recurring [Member] | Equity Securities [Member] | |||
Available-for-sale securities | 138,013 | 116,168 | |
Fair Value, Measurements, Recurring [Member] | Corporate Debt Securities [Member] | |||
Available-for-sale securities | 71,100 | 71,143 | |
Fair Value, Measurements, Recurring [Member] | Asset-backed Securities [Member] | |||
Available-for-sale securities | 56,168 | 60,910 | |
Fair Value, Measurements, Recurring [Member] | US Treasury Securities [Member] | |||
Available-for-sale securities | 25,181 | 21,033 | |
Fair Value, Measurements, Recurring [Member] | US States and Political Subdivisions Debt Securities [Member] | |||
Available-for-sale securities | 31,255 | 16,780 | |
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | |||
Cash and cash equivalents | 26,335 | 38,208 | |
Restricted cash and cash equivalents | 5,254 | 11,106 | |
Total financial assets | 237,106 | 219,198 | |
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | Equity Securities [Member] | |||
Available-for-sale securities | 138,013 | 116,168 | |
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | Corporate Debt Securities [Member] | |||
Available-for-sale securities | 42,323 | 32,683 | |
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | Asset-backed Securities [Member] | |||
Available-for-sale securities | |||
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | US Treasury Securities [Member] | |||
Available-for-sale securities | 25,181 | 21,033 | |
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | US States and Political Subdivisions Debt Securities [Member] | |||
Available-for-sale securities | |||
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | |||
Cash and cash equivalents | |||
Restricted cash and cash equivalents | |||
Total financial assets | 116,200 | 116,150 | |
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | Equity Securities [Member] | |||
Available-for-sale securities | |||
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | Corporate Debt Securities [Member] | |||
Available-for-sale securities | 28,777 | 38,460 | |
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | Asset-backed Securities [Member] | |||
Available-for-sale securities | 56,168 | 60,910 | |
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | US Treasury Securities [Member] | |||
Available-for-sale securities | |||
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | US States and Political Subdivisions Debt Securities [Member] | |||
Available-for-sale securities | $ 31,255 | $ 16,780 |
Note 9 - Property and Equipme61
Note 9 - Property and Equipment (Details Textual) | 12 Months Ended | |||
Dec. 31, 2016USD ($) | Jan. 31, 2017 | Dec. 31, 2015USD ($) | Dec. 31, 2010 | |
Number of Patient Beds in Facility | 120 | |||
Property, Plant and Equipment, Net | $ 559,624,000 | $ 536,046,000 | ||
Cost to Complete Construction in Progress | 7,292,000 | |||
Healthcare Facility at NHC Hillview Location [Member] | ||||
Property, Plant and Equipment, Net | 3,936,000 | |||
Gain (Loss) on Disposition of Property Plant Equipment, Excluding Oil and Gas Property and Timber Property | $ 0 | |||
Subsequent Event [Member] | Skilled Nursing Facility in Columbia, Tennessee [Member] | ||||
Number of Patient Beds in Facility | 112 |
Note 9 - Property and Equipme62
Note 9 - Property and Equipment - Property and Equipment, at Cost (Details) - USD ($) $ in Thousands | Dec. 31, 2016 | Dec. 31, 2015 |
Land | $ 59,812 | $ 59,831 |
Leasehold improvements | 108,661 | 103,445 |
Buildings and improvements | 552,404 | 507,627 |
Furniture and equipment | 158,558 | 150,357 |
Construction in progress | 53,705 | 54,027 |
933,140 | 875,287 | |
Less: Accumulated depreciation | (373,516) | (339,241) |
Property, Plant and Equipment, Net | $ 559,624 | $ 536,046 |
Note 10 - Notes Receivable (Det
Note 10 - Notes Receivable (Details Textual) - USD ($) | Dec. 31, 2016 | Dec. 31, 2015 |
Financing Receivable, Gross | $ 17,079,000 | $ 13,164,000 |
Prime Rate [Member] | Minimum [Member] | ||
Loans Receivable, Basis Spread on Variable Rate | 2.00% | |
Prime Rate [Member] | Maximum [Member] | ||
Loans Receivable, Basis Spread on Variable Rate | 8.00% |
Note 11 - Long-term Debt (Detai
Note 11 - Long-term Debt (Details Textual) - Bank of America [Member] $ in Millions | 1 Months Ended |
Oct. 31, 2015USD ($) | |
Line of Credit Facility, Maximum Borrowing Capacity | $ 175 |
Debt Instrument, Term | 5 years |
London Interbank Offered Rate (LIBOR) [Member] | |
Debt Instrument, Basis Spread on Variable Rate | 1.40% |
Debt Instrument, Basis Spread on Base Rate | 1.00% |
Base Rate [Member] | |
Debt Instrument, Basis Spread on Variable Rate | 0.40% |
Federal Funds Effective Swap Rate [Member] | |
Debt Instrument, Basis Spread on Base Rate | 0.50% |
Note 11 - Long-term Debt - Sche
Note 11 - Long-term Debt - Schedule of Debt (Details) - USD ($) $ in Millions | 12 Months Ended | |
Dec. 31, 2016 | Dec. 31, 2015 | |
Long-term debt | $ 120 | $ 120 |
Long-term debt, noncurrent | $ 120 | 120 |
Unsecured Term Note Payable [Member] | ||
Long-term debt, interest rate | 3.00% | |
Long-term debt maturity | 2,018 | |
Long-term debt | $ 10 | 10 |
Revolving Credit Facility [Member] | ||
Long-term debt, interest rate | 2.10% | |
Long-term debt maturity | 2,020 | |
Long-term debt | $ 110 | $ 110 |
Note 11 - Long-term Debt - Aggr
Note 11 - Long-term Debt - Aggregate Maturities of Long-term Debt (Details) - USD ($) $ in Millions | Dec. 31, 2016 | Dec. 31, 2015 |
2,017 | ||
2,018 | 10 | |
2,019 | ||
2,020 | 110 | |
2,021 | ||
Total | $ 120 | $ 120 |
Note 12 - Income Taxes (Details
Note 12 - Income Taxes (Details Textual) - USD ($) | 12 Months Ended | |||
Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 | Dec. 31, 2013 | |
Adjustment to Additional Paid in Capital, Income Tax Effect from Share-based Compensation, Net | $ (1,096,000) | $ 1,942,000 | $ 201,000 | |
Unrecognized Tax Benefits, Period Increase (Decrease) | (2,164,000) | (2,551,000) | (2,059,000) | |
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations | 1,368,000 | 2,141,000 | 1,542,000 | |
Effective Income Tax Rate Reconciliation, Benefit Resulting from Expiration of Applicable Statute Limitations, Amount | 1,368,000 | 2,141,000 | 1,542,000 | |
Significant Change in Unrecognized Tax Benefits is Reasonably Possible, Amount of Unrecorded Benefit | 2,345,000 | |||
Income Tax Examination, Penalties and Interest Expense | $ 205,000 | 740,000 | 319,000 | |
Earliest Tax Year [Member] | ||||
Open Tax Year | 2,013 | |||
Liability for Interest and Penalties [Member] | ||||
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations | $ 729,000 | 865,000 | 603,000 | |
Unrecognized Tax Benefits | 3,337,000 | $ 3,132,000 | $ 2,391,000 | $ 2,072,000 |
Permanent Differences [Member] | ||||
Unrecognized Tax Benefits | $ 5,616,000 |
Note 12 - Income Taxes - Provis
Note 12 - Income Taxes - Provision for Income Taxes (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 | |
Federal | $ 24,012 | $ 29,322 | $ 30,235 |
State | 661 | 3,568 | 3,095 |
24,673 | 32,890 | 33,330 | |
Federal | 4,208 | (532) | (1,172) |
State | 788 | (227) | (334) |
4,996 | (759) | (1,506) | |
Effective income tax expense | $ 29,669 | $ 32,131 | $ 31,824 |
Note 12 - Income Taxes - Deferr
Note 12 - Income Taxes - Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Thousands | Dec. 31, 2016 | Dec. 31, 2015 |
Deferred tax assets: | ||
Allowance for doubtful accounts receivable | $ 2,077 | $ 2,055 |
Accrued risk reserves | 2,277 | 2,648 |
Accrued expenses | 8,907 | 8,420 |
Financial reporting depreciation in excess of tax depreciation | 8,642 | 9,142 |
Stock based compensation | 387 | 3,511 |
Obligation to provide future services | 1,262 | 1,342 |
Deferred revenue | 3,942 | 4,258 |
Total deferred tax assets | 29,628 | 33,369 |
Deferred tax liabilities: | ||
Unrealized gains on marketable securities | (41,264) | (33,079) |
Deferred gain on sale of assets (net) | (3,135) | (3,135) |
Book basis in excess of tax basis of intangible assets | (1,481) | (945) |
Book basis in excess of tax basis of securities | (2,416) | (2,344) |
Long–term investments | (3,404) | (2,962) |
Total deferred tax liabilities | (51,700) | (42,465) |
Net deferred tax liability | (22,072) | (9,096) |
Nonrefundable Entrance Fees [Member] | ||
Deferred tax assets: | ||
Entrance fees | 211 | 163 |
Refundable Entrance Fees [Member] | ||
Deferred tax assets: | ||
Entrance fees | $ 1,923 | $ 1,830 |
Note 12 - Income Taxes - Reconc
Note 12 - Income Taxes - Reconciliation of Income Tax Expense (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 | |
Tax provision at federal statutory rate | $ 28,072 | $ 29,846 | $ 29,818 |
State, net of federal benefit | 1,783 | 1,767 | 2,207 |
Nondeductible expenses | 156 | 351 | 363 |
Insurance expense | 27 | 6 | 27 |
Other, net | 283 | (372) | 439 |
Unrecognized tax benefits | 716 | 2,674 | 512 |
Expiration of statute of limitations | (1,368) | (2,141) | (1,542) |
1,597 | 2,285 | 2,006 | |
Effective income tax expense | $ 29,669 | $ 32,131 | $ 31,824 |
Note 12 - Income Taxes - Reco71
Note 12 - Income Taxes - Reconciliation of Unrecognized Tax Benefits (Details) - USD ($) | 12 Months Ended | ||
Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 | |
Reductions for statute of limitation expirations | $ (1,368,000) | $ (2,141,000) | $ (1,542,000) |
Deferred Tax Assets [Member] | |||
Balance | 7,818,000 | 9,107,000 | 8,598,000 |
Additions based on tax positions related to the current year | 1,249,000 | ||
Additions for tax positions of prior years | 481,000 | 490,000 | 2,032,000 |
Reductions for statute of limitation expirations | (1,525,000) | (1,779,000) | (1,523,000) |
Balance | 8,023,000 | 7,818,000 | 9,107,000 |
Liability for Unrecognized Tax Benefits [Member] | |||
Balance | 13,162,000 | 13,620,000 | 12,453,000 |
Additions based on tax positions related to the current year | 1,249,000 | 1,595,000 | 2,008,000 |
Additions for tax positions of prior years | 718,000 | 498,000 | 1,218,000 |
Reductions for statute of limitation expirations | (2,164,000) | (2,551,000) | (2,059,000) |
Balance | 12,965,000 | 13,162,000 | 13,620,000 |
Liability for Interest and Penalties [Member] | |||
Balance | 3,132,000 | 2,391,000 | 2,072,000 |
Additions based on tax positions related to the current year | 308,000 | 216,000 | |
Additions for tax positions of prior years | 934,000 | 1,298,000 | 706,000 |
Reductions for statute of limitation expirations | (729,000) | (865,000) | (603,000) |
Balance | 3,337,000 | 3,132,000 | 2,391,000 |
Total Liability [Member] | |||
Balance | 16,294,000 | 16,011,000 | 14,525,000 |
Additions based on tax positions related to the current year | 1,249,000 | 1,903,000 | 2,224,000 |
Additions for tax positions of prior years | 1,652,000 | 1,796,000 | 1,924,000 |
Reductions for statute of limitation expirations | (2,893,000) | (3,416,000) | (2,662,000) |
Balance | $ 16,302,000 | $ 16,294,000 | $ 16,011,000 |
Note 13 - Stock Repurchase Pr72
Note 13 - Stock Repurchase Program (Details Textual) - Common Stock [Member] - USD ($) | Aug. 05, 2016 | Aug. 11, 2014 | Dec. 31, 2016 | Aug. 31, 2016 | May 07, 2015 |
Stock Repurchase Program, Authorized Amount | $ 25,000,000 | $ 25,000,000 | |||
Stock Repurchased and Retired During Period, Shares | 130,000 | 0 | |||
Stock Repurchased and Retired During Period, Value | $ 8,195,000 | ||||
Stock Repurchased During Period, Shares | 125,000 | ||||
Stock Repurchased During Period, Value | $ 6,995,000 |
Note 14 - Stock-based Compens73
Note 14 - Stock-based Compensation (Details Textual) - USD ($) | 12 Months Ended | ||||
Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 | May 31, 2010 | May 30, 2010 | |
Allocated Share-based Compensation Expense | $ 509,000 | $ 1,982,000 | $ 2,021,000 | ||
Employee Service Share-based Compensation, Tax Benefit from Compensation Expense | 5,680,000 | 5,263,000 | 697,000 | ||
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period, Intrinsic Value | 7,431,000 | $ 5,447,000 | $ 855,000 | ||
Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized | $ 0 | ||||
2010 Plan [Member] | |||||
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Available for Grant | 1,200,000 | ||||
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Authorized | 1,200,000 | ||||
Employee Stock Purchase Plan [Member] | |||||
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Available for Grant | 1,661,243 | ||||
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Authorized | 2,575,000 | ||||
Incentive Stock Option [Member] | Maximum [Member] | |||||
Share-based Compensation Arrangement by Share-based Payment Award, Expiration Period | 10 years |
Note 14 - Stock-based Compens74
Note 14 - Stock-based Compensation - Summary of Assumptions Used to Value Options Granted (Details) | 12 Months Ended | ||
Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 | |
Risk–free interest rate | 0.89% | 0.71% | 0.52% |
Expected volatility | 15.80% | 16.50% | 17.30% |
Expected life, in years (Year) | 2 years 73 days | 2 years 73 days | 2 years 73 days |
Expected dividend yield | 3.09% | 2.73% | 2.68% |
Note 14 - Stock-based Compens75
Note 14 - Stock-based Compensation - Summary of Outstanding Stock Options (Details) - USD ($) | 12 Months Ended | |||
Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 | Dec. 31, 2016 | |
Options outstanding, shares (in shares) | 621,390 | 954,678 | 1,074,552 | |
Options outstanding, weighted average exercise price (in dollars per share) | $ 48.15 | $ 46.92 | $ 46.44 | |
Number of Shares - Options Granted (in shares) | 56,291 | 56,210 | 57,716 | |
Weighted Average Exercise Price - Options Granted (in dollars per share) | $ 62.54 | $ 61.47 | $ 53.10 | |
Number of Shares - Options Exercised (in shares) | (499,066) | (389,498) | (157,590) | |
Weighted Average Exercise Price - Options Exercised (in dollars per share) | $ 47.16 | $ 47.06 | $ 45.97 | |
Number of Shares - Options cancelled (in shares) | (656) | (20,000) | ||
Weighted Average Exercise Price - Options cancelled (in dollars per share) | $ 46.69 | $ 46.69 | ||
Options outstanding, shares (in shares) | 177,959 | 621,390 | 954,678 | |
Options outstanding, weighted average exercise price (in dollars per share) | $ 55.48 | $ 48.15 | $ 46.92 | |
Options outstanding, shares (in shares) | 621,390 | 954,678 | 1,074,552 | 177,959 |
Options outstanding, weighted average exercise price (in dollars per share) | $ 48.15 | $ 46.92 | $ 46.44 | $ 55.48 |
Options outstanding | $ 3,615,000 | |||
Options exercisable (in shares) | 177,959 | |||
Options exercisable, weighted average exercise price (in dollars per share) | $ 55.48 | |||
Options exercisable, aggregate intrinsic value | $ 3,615,000 |
Note 14 - Stock-based Compens76
Note 14 - Stock-based Compensation - Options Outstanding (Details) | 12 Months Ended |
Dec. 31, 2016$ / sharesshares | |
Options outstanding (in shares) | shares | 177,959 |
Weighted average exercise price (in dollars per share) | $ 55.48 |
Weighted average remaining contractual life in years (Year) | 2 years 255 days |
Exercise Price Range 1 [Member] | |
Options outstanding (in shares) | shares | 90,000 |
Exercise prices, lower range limit (in dollars per share) | $ 44.80 |
Exercise prices, upper range limit (in dollars per share) | 52.93 |
Weighted average exercise price (in dollars per share) | $ 49.07 |
Weighted average remaining contractual life in years (Year) | 1 year 182 days |
Exercise Price Range 2 [Member] | |
Options outstanding (in shares) | shares | 87,959 |
Exercise prices, lower range limit (in dollars per share) | $ 61.25 |
Exercise prices, upper range limit (in dollars per share) | 62.78 |
Weighted average exercise price (in dollars per share) | $ 62.03 |
Weighted average remaining contractual life in years (Year) | 3 years 328 days |
Note 15 - Contingencies and G77
Note 15 - Contingencies and Guarantees (Details Textual) | 12 Months Ended | |
Dec. 31, 2016USD ($) | Dec. 31, 2015USD ($) | |
Self Insurance Reserve | $ 91,162,000 | $ 98,508,000 |
Direct Business Coverage Statutory Limits | $ 1,000,000 | |
Malpractice Loss Contingency, Number of Claims | 43 | |
Annual Excess Coverage | $ 9,000,000 | |
Number of Nursing Facilities under Medicaid Cost Report Audits | 11 | |
South Carolina Department of Health and Human Services [Member] | ||
Payments for Legal Settlements | $ 6,800,000 | |
Revenue for Settlement of Audit Periods and Withdrawal of Appeals Process | $ 1,374,000 | |
Caris [Member] | ||
Equity Method Investment, Ownership Percentage | 75.10% | |
Coverage Amount Per Incident [Member] | ||
Primary Insurance Coverage Amount Per Incident | $ 1,000,000 | |
Primary Insurance Coverage, Amount Per Location | $ 3,000,000 |
Note 16 - Equity Method Inves78
Note 16 - Equity Method Investment in Caris HealthCare, L.P. (Details Textual) - Caris [Member] - USD ($) | Dec. 31, 2016 | Dec. 31, 2015 |
Equity Method Investment, Ownership Percentage | 75.10% | |
Equity Method Investments | $ 34,717,000 | $ 35,771,000 |
Note 16 - Equity Method Inves79
Note 16 - Equity Method Investment in Caris HealthCare, L.P. - Summary of Financial Information of Caris (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 | |
Current assets | $ 21,973 | $ 23,213 | $ 20,922 |
Noncurrent assets | 10,896 | 11,091 | 11,540 |
Liabilities | 8,082 | 7,970 | 7,305 |
Partners’ capital | 24,787 | 26,334 | 25,157 |
Revenue | 52,105 | 50,464 | 51,441 |
Expenses | 42,928 | 40,875 | 40,908 |
Net income | $ 9,177 | $ 9,589 | $ 10,533 |
Note 17 - Variable Interest E80
Note 17 - Variable Interest Entity (Details Textual) | 1 Months Ended | 12 Months Ended | ||
Dec. 31, 2010USD ($) | Dec. 31, 2016USD ($) | Dec. 31, 2015USD ($) | Mar. 01, 2014 | |
Number of Variable Interest Entities | 1 | |||
Number of Patient Beds in Facility | 120 | |||
Lessee Leasing Arrangements, Operating Leases, Term of Contract | 10 years | 10 years | ||
Number of Additional Lease Options | 5 | 2 | ||
Lessee Leasing Arrangements, Operating Leases, Renewal Term | 5 years | |||
Notes, Loans and Financing Receivable, Gross, Current | $ 4,500,000 | |||
Increase (Decrease) in Notes Payable, Current | $ 4,500,000 | $ 4,500,000 | ||
Land and Land Improvements | $ 4,500,000 |
Note 18 - Redemption of the S81
Note 18 - Redemption of the Series A Convertible Preferred Stock (Details Textual) - USD ($) | Nov. 03, 2015 | Oct. 31, 2007 | Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 |
Stock Redeemed or Called During Period, Value | $ 130,538,000 | ||||
Proceeds from Lines of Credit | $ 110,000,000 | ||||
Conversion of Stock, Shares Issued | 616,757 | ||||
Series A Convertible Preferred Stock [Member] | |||||
Preferred Stock, Value, Issued | $ 170,555,000 | ||||
Preferred Stock, Liquidation Preference Per Share | $ 15.75 | ||||
Preferred Stock, Dividend Rate, Per-Dollar-Amount | $ 0.80 | ||||
Preferred Stock, Redemption Price Per Share | $ 15.75 | ||||
Stock Redeemed or Called During Period, Shares | 8,288,098 | ||||
Stock Redeemed or Called During Period, Value | $ 130,538,000 | ||||
Proceeds from Lines of Credit | $ 110,000,000 | ||||
Convertible Preferred Stock, Shares Issued upon Conversion | 0.24204 | ||||
Conversion of Stock, Shares Converted | 2,548,561 |
Note 19 - Series B Junior Par82
Note 19 - Series B Junior Participating Preferred Stock (Details Textual) - $ / shares | 113 Months Ended | |
Dec. 31, 2016 | Aug. 02, 2007 | |
Dividend Distribution Rights | 1 | |
Series B Junior Participating Preferred Stock [Member] | ||
Preferred Stock, Par or Stated Value Per Share | $ 0.01 | |
Preferred Stock, Redemption Price Per Share | $ 250 | |
Stock Issued During Period, Shares, Stockholder Rights Plan | 0 |
Note 20 - Selected Quarterly 83
Note 20 - Selected Quarterly Financial Data - Selected Quarterly Financial Data (Details) - USD ($) $ / shares in Units, $ in Thousands | 3 Months Ended | 12 Months Ended | |||||||||
Dec. 31, 2016 | Sep. 30, 2016 | Jun. 30, 2016 | Mar. 31, 2016 | Dec. 31, 2015 | Sep. 30, 2015 | Jun. 30, 2015 | Mar. 31, 2015 | Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 | |
Net Operating Revenues | $ 238,001 | $ 231,281 | $ 227,768 | $ 229,588 | $ 233,927 | $ 225,386 | $ 224,902 | $ 222,407 | $ 926,638 | $ 906,622 | $ 871,683 |
Income Before Non–Operating Income | 17,687 | 10,590 | 14,641 | 17,624 | 20,223 | 13,761 | 15,706 | 17,436 | 60,542 | 67,126 | 68,011 |
Non–Operating Income | 4,876 | 5,091 | 4,925 | 4,773 | 5,246 | 4,550 | 4,130 | 4,222 | |||
Net Income | 13,863 | 11,110 | 11,866 | 13,699 | 14,976 | 12,567 | 12,358 | 13,242 | 50,538 | 53,143 | 53,369 |
Net Income Available to Common Stockholders | $ 13,863 | $ 11,110 | $ 11,866 | $ 13,699 | $ 14,644 | $ 10,415 | $ 10,191 | $ 11,074 | $ 50,538 | $ 46,324 | $ 44,699 |
Basic Earnings Per Share (in dollars per share) | $ 0.92 | $ 0.73 | $ 0.78 | $ 0.92 | $ 1.03 | $ 0.75 | $ 0.74 | $ 0.80 | $ 3.34 | $ 3.34 | $ 3.24 |
Diluted Earnings Per Share (in dollars per share) | $ 0.91 | $ 0.73 | $ 0.78 | $ 0.91 | $ 0.99 | $ 0.72 | $ 0.71 | $ 0.77 | $ 3.32 | $ 3.20 | $ 3.14 |
Preferred Dividends | $ 332 | $ 2,152 | $ 2,167 | $ 2,168 | $ 6,819 | $ 8,670 |
Schedule II - Valuation and Q84
Schedule II - Valuation and Qualifying Accounts - Summary of Valuation and Qualifying Accounts (Details) - USD ($) $ in Thousands | 12 Months Ended | |||
Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 | ||
Allowance for Doubtful Accounts [Member] | ||||
Beginning Balance | $ 5,583 | $ 5,738 | $ 4,972 | |
Charged to Costs and Expenses | 5,967 | 6,583 | 6,228 | |
Charged to other Accounts | ||||
Deductions | [1] | 5,807 | 6,738 | 5,462 |
Allowance for doubtful accounts | 5,743 | 5,583 | 5,738 | |
Accrued Risk Reserves [Member] | ||||
Beginning Balance | 98,508 | 106,218 | 110,557 | |
Charged to Costs and Expenses | 63,596 | 69,392 | 61,557 | |
Charged to other Accounts | ||||
Deductions | 70,942 | 77,102 | 65,896 | |
Allowance for doubtful accounts | $ 91,162 | $ 98,508 | $ 106,218 | |
[1] | Amounts written off, net of recoveries |