National HealthCare (NHC) 10-Q 10 May 17 2017 Q1 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	3 Months Ended
	Mar. 31, 2017	May 08, 2017
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)		15,195,030
Document Type	10-Q
Document Period End Date	Mar. 31, 2017
Document Fiscal Year Focus	2,017
Document Fiscal Period Focus	Q1
Amendment Flag	false

Interim Condensed Consolidated

Interim Condensed Consolidated Statements of Income (Unaudited) - USD ($)	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Revenues:
Net patient revenues	$ 227,959,000	$ 218,106,000
Other revenues	11,284,000	11,482,000
Net operating revenues	239,243,000	229,588,000
Cost and Expenses:
Salaries, wages and benefits	138,055,000	130,020,000
Other operating	63,883,000	61,309,000
Facility rent	10,088,000	10,327,000
Depreciation and amortization	10,295,000	9,354,000
Interest	1,058,000	954,000
Total costs and expenses	223,379,000	211,964,000
Income Before Non–Operating Income	15,864,000	17,624,000
Non–Operating Income	4,768,000	4,773,000
Income Before Income Taxes	20,632,000	22,397,000
Income Tax Provision	(7,999,000)	(8,698,000)
Net Income	12,633,000	13,699,000
Add: Net loss attributable to noncontrolling interest	(95,000)
Net Income Attributable to National HealthCare Corporation	$ 12,728,000	$ 13,699,000
Earnings Per Share attributable to National HealthCare Corporation Stockholders:
Basic (in dollars per share)	$ 0.84	$ 0.92
Diluted (in dollars per share)	$ 0.84	$ 0.91
Weighted Average Common Shares Outstanding:
Basic (in shares)	15,173,491	14,916,905
Diluted (in shares)	15,212,133	15,135,446
Dividends declared to common stockholders per (in dollars per share)	$ 0.45	$ 0.40

Interim Condensed Consolidated3

Interim Condensed Consolidated Statements of Comprehensive Income (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Net income	$ 12,633	$ 13,699
Other Comprehensive Income (Loss):
Unrealized gains (losses) on investments in marketable securities	(941)	12,504
Reclassification adjustment for realized gains on sale of securities	(34)	(279)
Income tax (expense) benefit related to items of other comprehensive income	408	(4,667)
Other comprehensive income (loss), net of tax	(567)	7,558
Add: Comprehensive loss attributable to noncontrolling interest	(95)
Comprehensive Income Attributable to National HealthCare Corporation	$ 12,161	$ 21,257

Interim Condensed Consolidated4

Interim Condensed Consolidated Balance Sheets (Current Period Unaudited) - USD ($)	Mar. 31, 2017	Dec. 31, 2016
Current Assets:
Cash and cash equivalents	$ 47,096,000	$ 26,335,000
Restricted cash and cash equivalents	14,572,000	3,125,000
Marketable securities	136,341,000	138,013,000
Restricted marketable securities	10,979,000	22,773,000
Accounts receivable, less allowance for doubtful accounts of $6,663 and $5,743, respectively	83,339,000	82,531,000
Inventories	7,320,000	7,508,000
Prepaid expenses and other assets	3,928,000	2,648,000
Notes receivable, current portion	875,000	3,259,000
Federal income tax receivable		4,665,000
Total current assets	304,450,000	290,857,000
Property and Equipment:
Property and equipment, at cost	941,172,000	933,140,000
Accumulated depreciation and amortization	(383,777,000)	(373,516,000)
Net property and equipment	557,395,000	559,624,000
Other Assets:
Restricted cash and cash equivalents	2,141,000	2,129,000
Restricted marketable securities	141,860,000	160,931,000
Deposits and other assets	5,909,000	5,244,000
Goodwill	17,600,000	17,600,000
Notes receivable, less current portion	13,270,000	13,820,000
Investments in limited liability companies	36,351,000	37,242,000
Total other assets	217,131,000	236,966,000
Total assets	1,078,976,000	1,087,447,000
Current Liabilities:
Trade accounts payable	18,579,000	18,593,000
Capital lease obligations, current portion	3,533,000	3,481,000
Accrued payroll	41,976,000	65,912,000
Amounts due to third party payors	17,687,000	17,019,000
Accrued risk reserves, current portion	25,551,000	25,898,000
Other current liabilities	17,905,000	13,207,000
Dividends payable	6,831,000	6,818,000
Total current liabilities	132,062,000	150,928,000
Long–term debt	120,000,000	120,000,000
Long-term capital lease obligations, capital leases	25,845,000	26,748,000
Accrued risk reserves, less current portion	69,272,000	65,264,000
Refundable entrance fees	9,405,000	9,924,000
Obligation to provide future services	3,236,000	3,236,000
Deferred income taxes	20,007,000	22,072,000
Other noncurrent liabilities	16,830,000	16,302,000
Deferred revenue	5,594,000	3,362,000
Total liabilities	402,251,000	417,836,000
Stockholders’ Equity:
Common stock, $.01 par value; 30,000,000 shares authorized; 15,179,930 and 15,162,938 shares, respectively, issued and outstanding	152,000	152,000
Capital in excess of par value	212,366,000	211,457,000
Retained earnings	397,831,000	391,934,000
Accumulated other comprehensive income	65,501,000	66,068,000
Total National HealthCare Corporation stockholders’ equity	675,850,000	669,611,000
Noncontrolling interest	875,000
Total stockholders' equity	676,725,000	669,611,000
Total liabilities and stockholders’ equity	$ 1,078,976,000	$ 1,087,447,000

Interim Condensed Consolidated5

Interim Condensed Consolidated Balance Sheets (Current Period Unaudited) (Parentheticals) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, authorized (in shares)	30,000,000	30,000,000
Common stock, shares issued (in shares)	15,179,930	15,162,938
Common stock, shares outstanding (in shares)	15,179,930	15,162,938
Allowance for doubtful accounts	$ 6,663	$ 5,743

Interim Condensed Consolidated6

Interim Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Cash Flows From Operating Activities:
Net income	$ 12,633	$ 13,699
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	10,295	9,354
Provision for doubtful accounts receivable	1,883	1,885
Equity in earnings of unconsolidated investments	(1,526)	(1,505)
Distributions from unconsolidated investments	2,609	2,851
Gains on sale of restricted marketable securities	(34)	(279)
Deferred income taxes	(1,657)	1,477
Stock–based compensation	92	286
Changes in operating assets and liabilities, net of the effect of acquisitions:
Accounts receivable	(2,691)	478
Income tax receivable	4,665	3,203
Inventories	188	270
Prepaid expenses and other assets	(1,280)	(953)
Trade accounts payable	(14)	(2,237)
Accrued payroll	(23,936)	(14,624)
Amounts due to third party payors	668	944
Other current liabilities and accrued risk reserves	8,356	6,749
Other noncurrent liabilities	528	494
Deferred revenue	2,232	2,158
Net cash provided by operating activities	13,011	24,250
Cash Flows From Investing Activities:
Additions to property and equipment	(8,066)	(13,432)
Investments in unconsolidated companies	(176)	(904)
Investments in notes receivable		(1,844)
Collections of notes receivable	2,918	77
Purchase of restricted marketable securities	(2,291)	(11,079)
Sale of restricted marketable securities	33,887	15,573
Net cash provided by (used in) investing activities	26,272	(11,609)
Cash Flows From Financing Activities:
Tax expense from stock–based compensation		(1,186)
Principal payments under capital lease obligations	(851)	(801)
Dividends paid to common stockholders	(6,818)	(5,995)
Issuance of common shares	817	9,330
Equity attributable to noncontrolling interest	970
Entrance fee (refunds) deposits	(519)	206
Change in deposits	(662)	129
Net cash (used in) provided by financing activities	(7,063)	1,683
Net Increase in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents	32,220	14,324
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period	31,589	49,314
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period	63,809	63,638
Balance Sheet Classifications:
Total Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents	$ 31,589	$ 49,314

Interim Condensed Consolidated7

Interim Condensed Consolidated Statements of Stockholders' Equity (Unaudited) - USD ($) $ in Thousands	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	AOCI Attributable to Parent [Member]	Noncontrolling Interest [Member]	Total
Balance (in shares) at Dec. 31, 2015	15,000,616
Balance at Dec. 31, 2015	$ 150	$ 209,469	$ 368,013	$ 53,364		$ 630,996
Net income attributable to National HealthCare Corporation			13,699			13,699
Other comprehensive income (loss)				7,558		7,558
Stock–based compensation		286				286
Tax benefit (expense) from exercise of stock options		(1,186)				(1,186)
Shares sold – options exercised (in shares)	263,523
Shares sold – options exercised	$ 3	9,327				9,330
Dividends declared to common stockholders			(6,105)			(6,105)
Balance (in shares) at Mar. 31, 2016	15,264,139
Balance at Mar. 31, 2016	$ 153	217,896	375,607	60,922		654,578
Net loss attributable to noncontrolling interest
Other comprehensive loss				7,558		7,558
Balance (in shares) at Dec. 31, 2015	15,000,616
Balance at Dec. 31, 2015	$ 150	209,469	368,013	53,364		$ 630,996
Shares sold – options exercised (in shares)						499,066
Balance (in shares) at Dec. 31, 2016	15,162,938
Balance at Dec. 31, 2016	$ 152	211,457	391,934	66,068		$ 669,611
Net income attributable to National HealthCare Corporation			12,728			12,728
Other comprehensive income (loss)				(567)		(567)
Stock–based compensation		92				$ 92
Shares sold – options exercised (in shares)	16,992					16,992
Shares sold – options exercised		817				$ 817
Dividends declared to common stockholders			(6,831)			(6,831)
Balance (in shares) at Mar. 31, 2017	15,179,930
Balance at Mar. 31, 2017	$ 152	212,366	$ 397,831	65,501	$ 875	676,725
Net loss attributable to noncontrolling interest					(95)	(95)
Equity contributed by noncontrolling interest					$ 970	970
Other comprehensive loss				$ (567)		$ (567)

Interim Condensed Consolidated8

Interim Condensed Consolidated Statements of Stockholders' Equity (Unaudited) (Parentheticals) - $ / shares	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Common Stock [Member]
Dividends declared to common stockholders per (in dollars per share)	$ 0.45	$ 0.40
Dividends declared to common stockholders per (in dollars per share)	$ 0.45	$ 0.40

Note 1 - Description of Busines

Note 1 - Description of Business	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Organization, Consolidation and Presentation of Financial Statements Disclosure [Text Block]	Note 1 – Description of Business National HealthCare Corporation (“NHC” or the “Company”) is a leading provider of senior health care services. As of March 31, 2017, 76 9,597 24 five 36 10

Note 2 - Summary of Significant

Note 2 - Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Significant Accounting Policies [Text Block]	Note 2 – Summary of Significant Accounting Policies The listing below is not intended to be a comprehensive list of all of our significant accounting policies. In many cases, the accounting treatment of a particular transaction is specifically dictated by generally accepted accounting principles, with limited need for management’s judgment in their application. There are also areas in which management’s judgment in selecting any available alternative would not produce a materially different result. See our audited December 31, 2016 December 31, 2016 Basis of Presentation The unaudited interim condensed consolidated financial statements to which these notes are attached include all normal, recurring adjustments which are necessary to fairly present the financial position, results of operations and cash flows of NHC. All significant intercompany transactions and balances have been eliminated in consolidation. The consolidated financial statements include the accounts of all entities controlled by NHC. The Company presents noncontrolling interest within the equity section of its consolidated balance sheets. The Company presents the amount of consolidated net income (loss) that is attributable to NHC and the noncontrolling interest in its consolidated statements of income. We assume that users of these interim financial statements have read or have access to the audited December 31, 2016 may may Estimates and Assumptions The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires us to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates and could cause our reported net income to vary significantly from period to period. Change in Accounting Principle Effective December 31, 2016, 2016–18, Statement of Cash Flows (Topic 230)—Restricted As described in the guidance for accounting changes under ASC Topic 250, three March 31, 2016 December 31, 2016: Consolidated Statement of Cash Flows ( in thousands Three Months Ended March 31, 2016 As Previously Reported Effect of Accounting Change As Adjusted Cash Flows from Operating Activities: Restricted cash and cash equivalents $ (6,519 ) $ 6,519 $ – Net cash provided by operating activities 17,731 6,519 24,250 Cash Flows from Investing Activities: Change in restricted cash and cash equivalents 3,170 (3,170 ) – Net cash used in investing activities (8,439 ) (3,170 ) (11,609 ) Net Increase in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents 10,975 3,349 14,324 Cash, Cash Equivalents, Restricted Cash, and Restricted Cash, Equivalents, Beginning of Period 38,208 11,106 49,314 Cash, Cash Equivalents, Restricted Cash, and Restricted Cash, Equivalents, End of Period $ 49,183 $ 14,455 $ 63,638 Recently Adopted Accounting Guidance In November 2016, 2016–18, 230)—Restricted December 15, 2017, December 31, 2016, Change in Accounting Principle 2016–18. In March 2016, 2016 09, 718): 2016 09 2016 09 December 15, 2016, January 1, 2017, 2016 09. $124,000 three March 31, 2017. Recent Accounting Guidance Not Yet Adopted 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 01 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 Revenue Recognition – Third Party Payors Approximately 65% may $17,687,000 $17,019,000 March 31, 2017 December 31, 2016, Revenue Recognition – Private P ay For private pay patients in skilled nursing or assisted living facilities, we bill room and board in advance with payment being due in the month the services are performed. Charges for ancillary, pharmacy, therapy and other services to private patients are billed in the month following the performance of services; however, all billings are recognized as revenue when the services are performed. Revenue Recognition – Subordination of Fees and Uncert ain Collections We provide management services to certain senior care facilities and to others we provide accounting and financial services. We generally charge 6% 7% third may We agree to subordinate our fees to the other expenses of a managed center because we believe we know how to improve the quality of patient services and finances of a senior healthcare center. We believe subordinating our fees demonstrates to the owner and employees of the managed center how confident we are of the impact we can have in making the center operations successful. We may may may may Segment Reporting In accordance with the provisions of ASC 280, first 2017 he Company now has two (1) (2) 5 Other Operating Expenses Other operating expenses include the costs of care and services that we provide to the residents of our facilities and the costs of maintaining our facilities. Our primary patient care costs include drugs, medical supplies, purchased professional services, food, and professional liability insurance and licensing fees. The primary facility costs include utilities and property insurance. 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 $8,965,000 $8,270,000 three March 31, 2017 2016, Property and Equipment Property and equipment are recorded at cost. Depreciation is provided by the straight-line method over the expected useful lives of the assets estimated as follows: buildings and improvements, 20 40 3 15 Capital leases are recorded at the lower of fair market value or the present value of future minimum lease payments. Capital leases are amortized in accordance with the provision codified within Accounting Standards Codification (“ASC”) Subtopic 840 30, Leases – Capital Leases 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. The accrued risk reserves include a liability for reported claims and estimates for incurred but unreported claims. Our policy is to engage an external, independent actuary to assist in estimating our exposure for claims obligations (for both asserted and unasserted claims). We reassess our accrued risk reserves on a quarterly basis. Professional liability remains an area of particular concern to us. The long term care industry has seen an increase in personal injury/wrongful death claims based on alleged negligence by skilled nursing facilities and their employees in providing care to residents. As of March 31, 2017, 60 2005 March 31, 2017. We are principally self-insured for incidents occurring in all centers owned or leased by us. The coverages include both primary policies and excess policies. In all years, settlements, if any, in excess of available insurance policy limits and our own reserves would be expensed by us. Continuing Care Contracts and Refundable Entrance Fee We have one Residents at this retirement center may 10% 90% 40% March 31, 2017 December 31, 2016 $9,405,000 $9,924,000, Obligation to Provide Future Services W e annually estimate the present value of the 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 cost of future services exceeds the related anticipated revenues, a liability is recorded (obligation to provide future services) with a corresponding charge to income. As of March 31, 2017 December 31, 2016, $ 3,236,000 Other Noncurrent Liabilities Other noncurrent liabilities include reserves primarily related to various uncertain income tax positions. D eferred Revenue Deferred revenue includes the deferred gain on the sale of assets to National Health Corporation (“National”) , the non-refundable portion (10%) Noncontrolling Interest The noncontrolling interest in a subsidiary is presented within total equity in the Company's consolidated balance sheets. The Company presents the noncontrolling interest and the amount of consolidated net income attributable to NHC in its interim condensed consolidated statements of income and net income per share is calculated based on net income attributable to NHC’s stockholders. The carrying amount of the noncontrolling interest is adjusted based on an allocation of subsidiary earnings based on ownership interest. Variable Interest Entities We have equity interests in unconsolidated limited liability companies that operate various post-acute and senior healthcare businesses. We analyze our investments in these limited liability companies to determine if the company is considered a VIE and would require consolidation. To the extent that we own interests in a VIE and we (i) are the sole entity that has the power to direct the activities of the VIE and (ii) have the obligation or rights to absorb the VIE's losses or receive its benefits, then we would be determined to be the primary beneficiary and would consolidate the VIE. To the extent we own interests in a VIE, then at each reporting period, we re-assess our conclusions as to which, if any, party within the VIE is considered the primary beneficiary. The Company's maximum exposure to losses in its investments in unconsolidated VIEs cannot be quantified and may may

Note 3 - Other Revenues

Note 3 - Other Revenues	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Other Revenues [Text Block]	N ote 3 – Other Revenues Other revenues are outlined in the table below. Revenues from management and accounting services include management and accounting fees provided to managed healthcare facilities and other health care centers. Revenues from rental income include health care real estate properties owned by us and leased to third Other revenues include the following: Three Months Ended March 31 (in thousands) 2017 2016 Rental Income $ 5,485 $ 5,570 Management and accounting services fees 3,859 3,749 Insurance services 1,559 1,924 Other 381 239 $ 11,284 $ 11,482 Management Fees from National We manage five three March 31, 2017, $936,000 three March 31, 2016, $969,000 Because the amount collectable cannot be reasonably determined when the management services are provided, and because we cannot estimate the timing or amount of expected future collections, the unpaid fees from the five may five may may may five Insurance Services For workers’ compensation insurance services, the premium revenues reflected in the interim condensed consolidated statements of income for the three March 31, 2017 $1,280,000. three March 31, 2016, $1,234,000. For professional liability insurance services, the premium revenues reflected in the interim condensed consolidated statements of income for the three March 31, 2017 $279,000. three March 31, 2016, $690,000.

Note 4 - Non-operating Income

Note 4 - Non-operating Income	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Other Nonoperating Income and Expense [Text Block]	Note 4 Non–operating income is outlined in the table below. Non–operating income includes equity in earnings of unconsolidated investments, dividends and other realized gains and losses on marketable securities, and interest income. Our most significant equity method investment is a 75.1% Three Months Ended March 31 (in thousands) 2017 2016 Equity in earnings of unconsolidated investments $ 1,526 $ 1,505 Dividends and other net realized gains and losses on sales of securities 1,724 1,861 Interest income 1,518 1,407 $ 4,768 $ 4,773

Note 5 - Business Segments

Note 5 - Business Segments	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Segment Reporting Disclosure [Text Block]	Note 5 The Company has two (1) (2) The Company also reports an “all other” category that includes revenues from rental income, management and accounting services fees, insurance services, and costs of the corporate office. The Company has presented the financial information for the three March 31, 2016 1 Description of Business”. The Company’s CODM evaluates performance and allocates capital resources to each segment based on an operating model that is designed to improve the quality of patient care and profitability of the Company while enhancing long-term shareholder value. The CODM does not review assets by segment in his resource allocation and therefore, assets by segment are not disclosed below. The following table sets forth the Company’s unaudited interim condensed consolidated statements of income by business segment (in thousands Three Months Ended March 31, 2017 Inpatient Services Homecare All Other Total Revenues: Net patient revenues $ 212,302 $ 15,657 $ - $ 227,959 Other revenues 226 - 11,058 11,284 Net operating revenues 212,528 15,657 11,058 239,243 Costs and Expenses: Salaries, wages and benefits 118,248 8,781 11,026 138,055 Other Operating 58,530 4,293 1,060 63,883 Rent 8,167 489 1,432 10,088 Depreciation and Amortization 9,209 40 1,046 10,295 Interest 449 - 609 1,058 Total costs and expenses 194,603 13,603 15,173 223,379 Income (Loss) Before Non-Operating Income $ 17,925 $ 2,054 $ (4,115 ) $ 15,864 Non-Operating Income - - 4,768 4,768 Income Before Income Taxes $ 17,925 $ 2,054 $ 653 $ 20,632 Three Months Ended March 31, 2016 Inpatient Services Homecare All Other Total Revenues: Net patient revenues $ 202,083 $ 16,023 $ - $ 218,106 Other revenues 169 - 11,313 11,482 Net operating revenues 202,252 16,023 11,313 229,588 Costs and Expenses: Salaries, wages and benefits 110,564 9,157 10,299 130,020 Other Operating 55,607 4,218 1,484 61,309 Rent 8,360 487 1,480 10,327 Depreciation and Amortization 8,215 46 1,093 9,354 Interest 499 - 455 954 Total costs and expenses 183,245 13,908 14,811 211,964 Income (Loss) Before Non-Operating Income $ 19,007 $ 2,115 $ (3,498 ) $ 17,624 Non-Operating Income - - 4,773 4,773 Income Before Income Taxes $ 19,007 $ 2,115 $ 1,275 $ 22,397

Note 6 - Long-term Leases

Note 6 - Long-term Leases	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Leases of Lessee Disclosure [Text Block]	Note 6 Capital Leases Fixed assets recorded under the capital leases, which are included in property and equipment in the interim condensed consolidated balance sheets, are as follows: March 31, 2017 December 31, 2016 (in thousands) Buildings and personal property $ 39,032 $ 39,032 Accumulated amortization (12,101 ) (11,120 ) $ 26,931 $ 27,912 Operating Leases At March 31, 2017, 35 seven three two $34,200,000 4% $9,314,000 $9,480,000 three March 31, 2017 2016, Minimum Lease Payments The approximate future minimum lease payments required under all leases that have remaining non-cancelable lease terms at March 31, 2017 Operating Leases Capital Leases (in thousands) 2018 $ 34,200 $ 5,200 2019 34,200 5,200 2020 34,200 5,200 2021 34,200 5,200 2022 34,200 5,200 Thereafter 168,200 9,967 Total minimum lease payments $ 339,200 $ 35,967 Less: Amounts representing interest (6,589 ) Present value of minimum lease payments 29,378 Less: Current portion (3,533 ) Long-term capital lease obligations $ 25,845

Note 7 - Earnings Per Share

Note 7 - Earnings Per Share	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Earnings Per Share [Text Block]	Note 7 – Earnings per Share Basic net income per share is computed based on the weighted average number of common shares outstanding for each period presented. Diluted net income per share reflects the potential dilution that would have occurred if securities to issue common stock were exercised, converted, or resulted in the issuance of common stock that would have then shared in our earnings. The following table summarizes the earnings and the weighted average number of common shares used in the calculation of basic and diluted earnings per share. Three Months Ended March 31 (in thousands, except for share and per share amounts) 2017 2016 Basic: Weighted average common shares outstanding 15,173,491 14,916,905 Net income attributable to National HealthCare Corporation $ 12,728 $ 13,699 Earnings per common share, basic $ 0.84 $ 0.92 Diluted: Weighted average common shares outstanding 15,173,491 14,916,905 Dilutive effect of stock options 38,642 24,266 Dilutive effect of contingent issuable stock – 194,275 Weighted average common shares outstanding 15,212,133 15,135,446 Net income attributable to National HealthCare Corporation $ 12,728 $ 13,699 Earnings per common share, diluted $ 0.84 $ 0.91 In the above table, options to purchase 1,072,425 12,239 March 31, 2017 2016,

Note 8 - Investments in Marketa

Note 8 - Investments in Marketable Securities	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Investments in Debt and Marketable Equity Securities (and Certain Trading Assets) Disclosure [Text Block]	Note 8 – Inve stments in Marketable Securities Our investments in marketable securities are classified as available for sale securities. Realized gains and losses from securities sales are recognized in results of operations upon disposition of the securities using the specific identification method on a trade date basis. Refer to Note 8 Marketable securities and restricted marketable securities consist of the following: March 31, 2017 December 31, 2016 (in thousands) Amortized Cost Fair Value Amortized Cost Fair Value Investments available for sale: Marketable equity securities $ 30,176 $ 136,341 $ 30,176 $ 138,013 Restricted investments available for sale: Corporate debt securities 59,534 59,555 71,311 71,100 Commercial mortgage–backed securities 46,222 45,582 56,889 56,168 U.S. Treasury securities 21,707 21,248 25,748 25,181 State and municipal securities 26,945 26,454 32,020 31,255 $ 184,584 $ 289,180 $ 216,144 $ 321,717 Included in the available for sale marketable equity securities are the following (in thousands, except share amounts) : March 31, 2017 December 31, 2016 Shares Cost Fair Value Shares Cost Fair Value NHI Common Stock 1,630,642 $ 24,734 $ 118,434 1,630,642 $ 24,734 $ 120,945 The amortized cost and estimated fair value of debt securities classified as available for sale, by contractual maturity, are as follows: March 31, 2017 December 31, 2016 (in thousands) Cost Fair Value Cost Fair Value Maturities: Within 1 year $ 13,418 $ 13,450 $ 14,181 $ 14,216 1 to 5 years 66,671 66,517 79,827 79,502 6 to 10 years 74,319 72,872 91,211 89,269 Over 10 years – – 749 717 $ 154,408 $ 152,839 $ 185,968 $ 183,704 Gross unrealized gains related to available for sale securities are $107,010,000 $108,730,000 March 31, 2017 December 31, 2016, $2,414,000 $3,157,000 March 31, 2017 December 31, 2016, no three March 31, 2017 December 31, 2016. Proceeds from the sale of securities during the three March 31, 2017 2016 $33,887,000 $15,573,000, $34,000 $279,000 three March 31, 2017 2016,

Note 9 - Fair Value Measurement

Note 9 - Fair Value Measurements	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Fair Value Disclosures [Text Block]	Note 9 – Fair Value Measurements The accounting standard for fair value measurements provides a framework for measuring fair value and requires expanded disclosures regarding fair value measurements. Fair value is defined as the price that would be received for an asset or the exit price that would be paid to transfer a liability in the principal or most advantageous market in an orderly transaction between market participants on the measurement date. This accounting standard establishes a fair value hierarchy, which requires an entity to maximize the use of observable inputs, where available. The following summarizes the three 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 March 31, 2017. 1 2 three March 31, 2017. Other The carrying amounts of cash and cash equivalents, restricted cash and cash equivalents, accounts receivable, and accounts payable approximate fair value due to their short–term nature. The estimated fair value of notes receivable approximates the carrying value based principally on their underlying interest rates and terms, maturities, collateral and credit status of the receivables. Our long–term debt approximates fair value due to variable interest rates, but fair value is also determined using Level 2 March 31, 2017, The following table summarizes fair value measurements by level at March 31, 2017 December 31, 2016 (in thousands) Fair Value Measurements Using March 31, 2017 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 $ 47,096 $ 47,096 $ – $ – Restricted cash and cash equivalents 16,713 16,713 – – Marketable equity securities 136,341 136,341 – – Corporate debt securities 59,555 40,788 18,767 – Mortgage–backed securities 45,582 – 45,582 – U.S. Treasury securities 21,248 21,248 – – State and municipal securities 26,454 – 26,454 – Total financial assets $ 352,989 $ 262,186 $ 90,803 $ – 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 – Mortgage-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 $ –

Note 10 - Long-term Debt

Note 10 - Long-term Debt	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Debt Disclosure [Text Block]	Note 10 – Long – Term Debt Long–term debt consists of the following: Weighted Average Interest Rate Maturities March 31, 2017 December 31, 2016 Variable (dollars in thousands) Revolving Credit Facility, interest payable monthly 2.3 % 2020 $ 110,000 $ 110,000 Unsecured term note payable to National, interest payable quarterly, principal payable at maturity 3.4 % 2018 10,000 10,000 120,000 120,000 Less current portion – – $ 120,000 $ 120,000 The $10 January 1, 2018. $175 $175,000,000 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.

Note 11 - Stock Repurchase Prog

Note 11 - Stock Repurchase Program	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Treasury Stock [Text Block]	Note 11 - Stock Repurchase Program August 2016, $25 September 1, 2016 August 31, 2017. No

Note 12 - Stock-based Compensat

Note 12 - Stock-based Compensation	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Disclosure of Compensation Related Costs, Share-based Payments [Text Block]	Note 12 – Stock–Based Compensation NHC recognizes stock–based compensation expense for all stock options and restricted stock granted over the requisite service period using the fair value for these grants as estimated at the date of grant either using the Black–Scholes pricing model for stock options or the quoted market price for restricted stock. The 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 may ten In May 2015, 2010 2010 1,200,000 2,575,000 three March 31, 2017 9,925 1,062,500 March 31, 2017, 621,244 2010 Compensation expense is recognized only for the awards that ultimately vest. Stock–based compensation totaled $92,000 $286,000 three March 31, 2017 2016, At March 31, 2017, $8,382,000 five Stock Options The following table summarizes the significant assumptions used to value the options granted for the three March 31, 2017 December 31, 2016. 2017 2016 Risk–free interest rate 2.11 % 0.89 % Expected volatility 16.6 % 15.8 % Expected life, in years 5.0 2.2 Expected dividend yield 3.11 % 3.09 % The following table summarizes our outstanding stock options for the three March 31, 2017 December 31, 2016. Number of Shares Weighted Average Exercise Price Aggregate Intrinsic Value Options outstanding at January 1, 2016 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 – Options granted 1,072,425 72.96 – Options exercised (16,992 ) 48.08 – Options cancelled – – – Options outstanding at March 31, 2017 1,233,392 $ 70.78 $ 2,421,000 Options exercisable at March 31, 2017 160,967 $ 56.26 $ 2,421,000 Options Outstanding March 31, 2017 Exercise Prices Weighted Average Exercise Price Weighted Average Remaining Contractual Life in Years 75,000 $44.80 - $52.93 $ 49.66 1.4 1,158,392 $61.25 - $75.45 72.15 4.8 1,233,392 $ 70.78 4.6

Note 13 - Income Taxes

Note 13 - Income Taxes	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Income Tax Disclosure [Text Block]	Note 13 – Income Taxes The income tax provision for the three March 31, 2017 $7,999,000 38.8%). three March 31, 2017 $175,000 $49,000, $124,000 three March 31, 2016 $8,698,000 38.8%). three March 31, 2016 $175,000 $86,000 Interest and penalties expense related to U.S. federal and state income tax returns are included within income tax expense. The Company is no longer subject to U.S. federal and state examinations by tax authorities for years before 2013

Note 14 - Contingencies and Gua

Note 14 - Contingencies and Guarantees	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Commitments and Contingencies Disclosure [Text Block]	Note 14 – Contingencies and Commitments 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 $94,823,000 $91,162,000 March 31, 2017 December 31, 2016, 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 consider the professional services of independent actuaries to assist us 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 Lawsuits and Insurance The senior care industry has experienced increases in both the number of personal injury/wrongful death claims and in the severity of awards based upon alleged negligence by nursing facilities and their employees in providing care to residents. As of March 31, 2017, 60 Insurance coverage for both periods includes both primary policies and excess policies. The primary coverage is in the amount of $1.0 $3.0 2016 2017, $ 9.0 third 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. Financing Commitments In conjunction with our management contract with National, we have entered into a line of credit arrangement whereby we may $2,000,000. March 31, 2017, not 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.

Note 15 - Subsequent Event

Note 15 - Subsequent Event	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Subsequent Events [Text Block]	Note 15 – Subsequent Event On May 9, 2017, 15,000,000 30,000,000 45,000,000 $0.01. The Company has no current plan, commitment, arrangement, understanding or agreement regarding the issuance of the additional shares of common stock. The additional shares of common stock will be available for issuance by the Board of Directors for various corporate purposes, including but not limited to, stock splits, stock dividends, grants under employee stock plans, financings, potential strategic transactions, including mergers, acquisitions, strategic partnerships, joint ventures, divestitures, and business combinations, as well as other general corporate transactions.

Significant Accounting Policies

Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2017
Accounting Policies [Abstract]
Basis of Accounting, Policy [Policy Text Block]	Basis of Presentation The unaudited interim condensed consolidated financial statements to which these notes are attached include all normal, recurring adjustments which are necessary to fairly present the financial position, results of operations and cash flows of NHC. All significant intercompany transactions and balances have been eliminated in consolidation. The consolidated financial statements include the accounts of all entities controlled by NHC. The Company presents noncontrolling interest within the equity section of its consolidated balance sheets. The Company presents the amount of consolidated net income (loss) that is attributable to NHC and the noncontrolling interest in its consolidated statements of income. We assume that users of these interim financial statements have read or have access to the audited December 31, 2016 may may
Use of Estimates, Policy [Policy Text Block]	Estimates and Assumptions The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires us to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates and could cause our reported net income to vary significantly from period to period.
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, three March 31, 2016 December 31, 2016: Consolidated Statement of Cash Flows ( in thousands Three Months Ended March 31, 2016 As Previously Reported Effect of Accounting Change As Adjusted Cash Flows from Operating Activities: Restricted cash and cash equivalents $ (6,519 ) $ 6,519 $ – Net cash provided by operating activities 17,731 6,519 24,250 Cash Flows from Investing Activities: Change in restricted cash and cash equivalents 3,170 (3,170 ) – Net cash used in investing activities (8,439 ) (3,170 ) (11,609 ) Net Increase in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents 10,975 3,349 14,324 Cash, Cash Equivalents, Restricted Cash, and Restricted Cash, Equivalents, Beginning of Period 38,208 11,106 49,314 Cash, Cash Equivalents, Restricted Cash, and Restricted Cash, Equivalents, End of Period $ 49,183 $ 14,455 $ 63,638
New Accounting Pronouncements, Policy [Policy Text Block]	Recently Adopted Accounting Guidance In November 2016, 2016–18, 230)—Restricted December 15, 2017, December 31, 2016, Change in Accounting Principle 2016–18. In March 2016, 2016 09, 718): 2016 09 2016 09 December 15, 2016, January 1, 2017, 2016 09. $124,000 three March 31, 2017. Recent Accounting Guidance Not Yet Adopted 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 01 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
Contractual Adjustments and Third Party Settlements, Policy [Policy Text Block]	Revenue Recognition – Third Party Payors Approximately 65% may $17,687,000 $17,019,000 March 31, 2017 December 31, 2016,
Revenue Recognition for Alternative Revenue Programs, Policy [Policy Text Block]	Revenue Recognition – Private P ay For private pay patients in skilled nursing or assisted living facilities, we bill room and board in advance with payment being due in the month the services are performed. Charges for ancillary, pharmacy, therapy and other services to private patients are billed in the month following the performance of services; however, all billings are recognized as revenue when the services are performed.
Premiums Receivable, Allowance for Doubtful Accounts, Estimation Methodology, Policy [Policy Text Block]	Revenue Recognition – Subordination of Fees and Uncert ain Collections We provide management services to certain senior care facilities and to others we provide accounting and financial services. We generally charge 6% 7% third may We agree to subordinate our fees to the other expenses of a managed center because we believe we know how to improve the quality of patient services and finances of a senior healthcare center. We believe subordinating our fees demonstrates to the owner and employees of the managed center how confident we are of the impact we can have in making the center operations successful. We may may may may
Segment Reporting, Policy [Policy Text Block]	Segment Reporting In accordance with the provisions of ASC 280, first 2017 he Company now has two (1) (2) 5
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, and professional liability 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 $8,965,000 $8,270,000 three March 31, 2017 2016,
Property, Plant and Equipment, Policy [Policy Text Block]	Property and Equipment Property and equipment are recorded at cost. Depreciation is provided by the straight-line method over the expected useful lives of the assets estimated as follows: buildings and improvements, 20 40 3 15 Capital leases are recorded at the lower of fair market value or the present value of future minimum lease payments. Capital leases are amortized in accordance with the provision codified within Accounting Standards Codification (“ASC”) Subtopic 840 30, Leases – Capital Leases
Liability Reserve Estimate, Policy [Policy Text Block]	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. The accrued risk reserves include a liability for reported claims and estimates for incurred but unreported claims. Our policy is to engage an external, independent actuary to assist in estimating our exposure for claims obligations (for both asserted and unasserted claims). We reassess our accrued risk reserves on a quarterly basis. Professional liability remains an area of particular concern to us. The long term care industry has seen an increase in personal injury/wrongful death claims based on alleged negligence by skilled nursing facilities and their employees in providing care to residents. As of March 31, 2017, 60 2005 March 31, 2017. We are principally self-insured for incidents occurring in all centers owned or leased by us. The coverages include both primary policies and excess policies. In all years, settlements, if any, in excess of available insurance policy limits and our own reserves would be expensed by us.
Continuing Care Retirement Communities, Advance Fees, Policy [Policy Text Block]	Continuing Care Contracts and Refundable Entrance Fee We have one Residents at this retirement center may 10% 90% 40% March 31, 2017 December 31, 2016 $9,405,000 $9,924,000, Obligation to Provide Future Services W e annually estimate the present value of the 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 cost of future services exceeds the related anticipated revenues, a liability is recorded (obligation to provide future services) with a corresponding charge to income. As of March 31, 2017 December 31, 2016, $3,236,000.
Other Noncurrent Liabilities [Policy Text Block]	Other Noncurrent Liabilities Other noncurrent liabilities include reserves primarily related to various uncertain income tax positions.
Revenue Recognition, Deferred Revenue [Policy Text Block]	D eferred Revenue Deferred revenue includes the deferred gain on the sale of assets to National Health Corporation (“National”) , the non-refundable portion (10%)
Noncontrolling Interest, Policy [Policy Text Block]	Noncontrolling Interest The noncontrolling interest in a subsidiary is presented within total equity in the Company's consolidated balance sheets. The Company presents the noncontrolling interest and the amount of consolidated net income attributable to NHC in its interim condensed consolidated statements of income and net income per share is calculated based on net income attributable to NHC’s stockholders. The carrying amount of the noncontrolling interest is adjusted based on an allocation of subsidiary earnings based on ownership interest.
Consolidation, Variable Interest Entity, Policy [Policy Text Block]	Variable Interest Entities We have equity interests in unconsolidated limited liability companies that operate various post-acute and senior healthcare businesses. We analyze our investments in these limited liability companies to determine if the company is considered a VIE and would require consolidation. To the extent that we own interests in a VIE and we (i) are the sole entity that has the power to direct the activities of the VIE and (ii) have the obligation or rights to absorb the VIE's losses or receive its benefits, then we would be determined to be the primary beneficiary and would consolidate the VIE. To the extent we own interests in a VIE, then at each reporting period, we re-assess our conclusions as to which, if any, party within the VIE is considered the primary beneficiary. The Company's maximum exposure to losses in its investments in unconsolidated VIEs cannot be quantified and may may

Note 2 - Summary of Significa25

Note 2 - Summary of Significant Accounting Policies (Tables)	3 Months Ended
	Mar. 31, 2017
Notes Tables
New Accounting Pronouncement, Early Adoption [Table Text Block]	Three Months Ended March 31, 2016 As Previously Reported Effect of Accounting Change As Adjusted Cash Flows from Operating Activities: Restricted cash and cash equivalents $ (6,519 ) $ 6,519 $ – Net cash provided by operating activities 17,731 6,519 24,250 Cash Flows from Investing Activities: Change in restricted cash and cash equivalents 3,170 (3,170 ) – Net cash used in investing activities (8,439 ) (3,170 ) (11,609 ) Net Increase in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents 10,975 3,349 14,324 Cash, Cash Equivalents, Restricted Cash, and Restricted Cash, Equivalents, Beginning of Period 38,208 11,106 49,314 Cash, Cash Equivalents, Restricted Cash, and Restricted Cash, Equivalents, End of Period $ 49,183 $ 14,455 $ 63,638

Note 3 - Other Revenues (Tables

Note 3 - Other Revenues (Tables)	3 Months Ended
	Mar. 31, 2017
Notes Tables
Schedule of Other Revenues [Table Text Block]	Three Months Ended March 31 (in thousands) 2017 2016 Rental Income $ 5,485 $ 5,570 Management and accounting services fees 3,859 3,749 Insurance services 1,559 1,924 Other 381 239 $ 11,284 $ 11,482

Note 4 - Non-operating Income (

Note 4 - Non-operating Income (Tables)	3 Months Ended
	Mar. 31, 2017
Notes Tables
Schedule of Other Nonoperating Income, by Component [Table Text Block]	Three Months Ended March 31 (in thousands) 2017 2016 Equity in earnings of unconsolidated investments $ 1,526 $ 1,505 Dividends and other net realized gains and losses on sales of securities 1,724 1,861 Interest income 1,518 1,407 $ 4,768 $ 4,773

Note 5 - Business Segments (Tab

Note 5 - Business Segments (Tables)	3 Months Ended
	Mar. 31, 2017
Notes Tables
Schedule of Segment Reporting Information, by Segment [Table Text Block]	Three Months Ended March 31, 2017 Inpatient Services Homecare All Other Total Revenues: Net patient revenues $ 212,302 $ 15,657 $ - $ 227,959 Other revenues 226 - 11,058 11,284 Net operating revenues 212,528 15,657 11,058 239,243 Costs and Expenses: Salaries, wages and benefits 118,248 8,781 11,026 138,055 Other Operating 58,530 4,293 1,060 63,883 Rent 8,167 489 1,432 10,088 Depreciation and Amortization 9,209 40 1,046 10,295 Interest 449 - 609 1,058 Total costs and expenses 194,603 13,603 15,173 223,379 Income (Loss) Before Non-Operating Income $ 17,925 $ 2,054 $ (4,115 ) $ 15,864 Non-Operating Income - - 4,768 4,768 Income Before Income Taxes $ 17,925 $ 2,054 $ 653 $ 20,632 Three Months Ended March 31, 2016 Inpatient Services Homecare All Other Total Revenues: Net patient revenues $ 202,083 $ 16,023 $ - $ 218,106 Other revenues 169 - 11,313 11,482 Net operating revenues 202,252 16,023 11,313 229,588 Costs and Expenses: Salaries, wages and benefits 110,564 9,157 10,299 130,020 Other Operating 55,607 4,218 1,484 61,309 Rent 8,360 487 1,480 10,327 Depreciation and Amortization 8,215 46 1,093 9,354 Interest 499 - 455 954 Total costs and expenses 183,245 13,908 14,811 211,964 Income (Loss) Before Non-Operating Income $ 19,007 $ 2,115 $ (3,498 ) $ 17,624 Non-Operating Income - - 4,773 4,773 Income Before Income Taxes $ 19,007 $ 2,115 $ 1,275 $ 22,397

Note 6 - Long-term Leases (Tabl

Note 6 - Long-term Leases (Tables)	3 Months Ended
	Mar. 31, 2017
Notes Tables
Schedule of Capital Leased Assets [Table Text Block]	March 31, 2017 December 31, 2016 (in thousands) Buildings and personal property $ 39,032 $ 39,032 Accumulated amortization (12,101 ) (11,120 ) $ 26,931 $ 27,912
Schedule of Future Minimum Lease Payments for Capital Leases [Table Text Block]	Operating Leases Capital Leases (in thousands) 2018 $ 34,200 $ 5,200 2019 34,200 5,200 2020 34,200 5,200 2021 34,200 5,200 2022 34,200 5,200 Thereafter 168,200 9,967 Total minimum lease payments $ 339,200 $ 35,967 Less: Amounts representing interest (6,589 ) Present value of minimum lease payments 29,378 Less: Current portion (3,533 ) Long-term capital lease obligations $ 25,845

Note 7 - Earnings Per Share (Ta

Note 7 - Earnings Per Share (Tables)	3 Months Ended
	Mar. 31, 2017
Notes Tables
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	Three Months Ended March 31 (in thousands, except for share and per share amounts) 2017 2016 Basic: Weighted average common shares outstanding 15,173,491 14,916,905 Net income attributable to National HealthCare Corporation $ 12,728 $ 13,699 Earnings per common share, basic $ 0.84 $ 0.92 Diluted: Weighted average common shares outstanding 15,173,491 14,916,905 Dilutive effect of stock options 38,642 24,266 Dilutive effect of contingent issuable stock – 194,275 Weighted average common shares outstanding 15,212,133 15,135,446 Net income attributable to National HealthCare Corporation $ 12,728 $ 13,699 Earnings per common share, diluted $ 0.84 $ 0.91

Note 8 - Investments in Marke31

Note 8 - Investments in Marketable Securities (Tables)	3 Months Ended
	Mar. 31, 2017
Notes Tables
Available-for-sale Securities [Table Text Block]	March 31, 2017 December 31, 2016 (in thousands) Amortized Cost Fair Value Amortized Cost Fair Value Investments available for sale: Marketable equity securities $ 30,176 $ 136,341 $ 30,176 $ 138,013 Restricted investments available for sale: Corporate debt securities 59,534 59,555 71,311 71,100 Commercial mortgage–backed securities 46,222 45,582 56,889 56,168 U.S. Treasury securities 21,707 21,248 25,748 25,181 State and municipal securities 26,945 26,454 32,020 31,255 $ 184,584 $ 289,180 $ 216,144 $ 321,717
Schedule of Available-for-sale Securities Reconciliation [Table Text Block]	March 31, 2017 December 31, 2016 Shares Cost Fair Value Shares Cost Fair Value NHI Common Stock 1,630,642 $ 24,734 $ 118,434 1,630,642 $ 24,734 $ 120,945
Investments Classified by Contractual Maturity Date [Table Text Block]	March 31, 2017 December 31, 2016 (in thousands) Cost Fair Value Cost Fair Value Maturities: Within 1 year $ 13,418 $ 13,450 $ 14,181 $ 14,216 1 to 5 years 66,671 66,517 79,827 79,502 6 to 10 years 74,319 72,872 91,211 89,269 Over 10 years – – 749 717 $ 154,408 $ 152,839 $ 185,968 $ 183,704

Note 9 - Fair Value Measureme32

Note 9 - Fair Value Measurements (Tables)	3 Months Ended
	Mar. 31, 2017
Notes Tables
Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis [Table Text Block]	Fair Value Measurements Using March 31, 2017 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 $ 47,096 $ 47,096 $ – $ – Restricted cash and cash equivalents 16,713 16,713 – – Marketable equity securities 136,341 136,341 – – Corporate debt securities 59,555 40,788 18,767 – Mortgage–backed securities 45,582 – 45,582 – U.S. Treasury securities 21,248 21,248 – – State and municipal securities 26,454 – 26,454 – Total financial assets $ 352,989 $ 262,186 $ 90,803 $ – 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 – Mortgage-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 $ –

Note 10 - Long-term Debt (Table

Note 10 - Long-term Debt (Tables)	3 Months Ended
	Mar. 31, 2017
Notes Tables
Schedule of Debt [Table Text Block]	Weighted Average Interest Rate Maturities March 31, 2017 December 31, 2016 Variable (dollars in thousands) Revolving Credit Facility, interest payable monthly 2.3 % 2020 $ 110,000 $ 110,000 Unsecured term note payable to National, interest payable quarterly, principal payable at maturity 3.4 % 2018 10,000 10,000 120,000 120,000 Less current portion – – $ 120,000 $ 120,000

Note 12 - Stock-based Compens34

Note 12 - Stock-based Compensation (Tables)	3 Months Ended
	Mar. 31, 2017
Notes Tables
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions [Table Text Block]	2017 2016 Risk–free interest rate 2.11 % 0.89 % Expected volatility 16.6 % 15.8 % Expected life, in years 5.0 2.2 Expected dividend yield 3.11 % 3.09 %
Share-based Compensation, Stock Options, Activity [Table Text Block]	Number of Shares Weighted Average Exercise Price Aggregate Intrinsic Value Options outstanding at January 1, 2016 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 – Options granted 1,072,425 72.96 – Options exercised (16,992 ) 48.08 – Options cancelled – – – Options outstanding at March 31, 2017 1,233,392 $ 70.78 $ 2,421,000 Options exercisable at March 31, 2017 160,967 $ 56.26 $ 2,421,000
Schedule of Share-based Compensation, Shares Authorized under Stock Option Plans, by Exercise Price Range [Table Text Block]	Options Outstanding March 31, 2017 Exercise Prices Weighted Average Exercise Price Weighted Average Remaining Contractual Life in Years 75,000 $44.80 - $52.93 $ 49.66 1.4 1,158,392 $61.25 - $75.45 72.15 4.8 1,233,392 $ 70.78 4.6

Note 1 - Description of Busin35

Note 1 - Description of Business (Details Textual)	Mar. 31, 2017
Number of Skilled Nursing Centers	76
Number of Beds	9,597
Number of Assisted Living Facilities	24
Number of Independent Living Facilities	5
Number of Homecare Programs	36
Number of States in which Entity Operates	10

Note 2 - Summary of Significa36

Note 2 - Summary of Significant Accounting Policies (Details Textual)	3 Months Ended
	Mar. 31, 2017USD ($)	Mar. 31, 2016USD ($)	Dec. 31, 2016USD ($)
Income Tax Expense (Benefit)	$ 7,999,000	$ 8,698,000
Number of Reportable Segments	2
Continuing Care Retirement Communities Advance Fees, Obligation for Future Services, Amount	$ 3,236,000		$ 3,236,000
Number of Operating Segments	2
Appreciation [Member]
Malpractice Loss Contingency, Number of Claims	60
Appreciation of Apartment Over Original Residents Entry Fee Percentage	40.00%
Refundable Advance Fees [Member]
Nonrefundable Resident Entry Fee Percentage	10.00%
Customer Refundable Fees	$ 9,405,000		9,924,000
Original Entry Fee [Member]
Refundable Resident Entry Fee Percentage	90.00%
Corporate Office Costs [Member]
General and Administrative Expense	$ 8,965,000	$ 8,270,000
Minimum [Member]
Management Services Fees	6.00%
Minimum [Member] | Building and Building Improvements [Member]
Property, Plant and Equipment, Useful Life	20 years
Minimum [Member] | Equipment and Furniture [Member]
Property, Plant and Equipment, Useful Life	3 years
Maximum [Member]
Management Services Fees	7.00%
Maximum [Member] | Building and Building Improvements [Member]
Property, Plant and Equipment, Useful Life	40 years
Maximum [Member] | Equipment and Furniture [Member]
Property, Plant and Equipment, Useful Life	15 years
Medicare and Medicaid [Member]
Allowance for Doubtful Accounts Receivable	$ 17,687,000		$ 17,019,000
Percent of Revenues Derived from Medicare, Medicaid and Other Government Programs [Member]
Concentration Risk, Percentage	65.00%
Accounting Standards Update 2016-09 [Member]
Income Tax Expense (Benefit)	$ (124,000)

Note 2 - Summary of Significa37

Note 2 - Summary of Significant Accounting Policies - Effect of the Accounting Change on the Statements of Cash Flows (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Net cash provided by operating activities	$ 13,011	$ 24,250
Net cash used in investing activities	26,272	(11,609)
Net Increase in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents	32,220	14,324
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period	31,589	49,314
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period	$ 63,809	63,638
New Accounting Pronouncement, Early Adoption, Effect [Member]
Restricted cash and cash equivalents
Net cash provided by operating activities		24,250
Change in restricted cash and cash equivalents
Net cash used in investing activities		(11,609)
Net Increase in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents		14,324
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period		49,314
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period		63,638
New Accounting Pronouncement, Early Adoption, Effect [Member] | Scenario, Previously Reported [Member]
Restricted cash and cash equivalents		(6,519)
Net cash provided by operating activities		17,731
Change in restricted cash and cash equivalents		3,170
Net cash used in investing activities		(8,439)
Net Increase in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents		10,975
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period		38,208
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period		49,183
New Accounting Pronouncement, Early Adoption, Effect [Member] | Restatement Adjustment [Member]
Restricted cash and cash equivalents		6,519
Net cash provided by operating activities		6,519
Change in restricted cash and cash equivalents		(3,170)
Net cash used in investing activities		(3,170)
Net Increase in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents		3,349
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period		11,106
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period		$ 14,455

Note 3 - Other Revenues (Detail

Note 3 - Other Revenues (Details Textual)	3 Months Ended
	Mar. 31, 2017USD ($)	Mar. 31, 2016USD ($)	Dec. 31, 2016
Number of Skilled Nursing Centers	76
Workers Compensation Premium Revenue [Member]
Health Care Organization, Premium Revenue	$ 1,280,000	$ 1,234,000
Professional Liability Insurance [Member]
Health Care Organization, Premium Revenue	279,000	690,000
National [Member]
Number of Skilled Nursing Centers			5
Management Fees Revenue	$ 936,000	$ 969,000

Note 3 - Other Revenues - Summa

Note 3 - Other Revenues - Summary of Other Revenues (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Other Revenues	$ 11,284	$ 11,482
Other Income [Member]
Other Revenues	381	239
Rental Income [Member]
Other Revenues	5,485	5,570
Management and Accounting Services Fees [Member]
Other Revenues	3,859	3,749
Insurance Services [Member]
Other Revenues	$ 1,559	$ 1,924

Note 4 - Non-operating Income40

Note 4 - Non-operating Income (Details Textual)	Mar. 31, 2017	Dec. 09, 2014
Caris [Member]
Equity Method Investment, Ownership Percentage	75.10%	75.10%

Note 4 - Non-operating Income -

Note 4 - Non-operating Income - Schedule of Non-operating Income (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Equity in earnings of unconsolidated investments	$ 1,526	$ 1,505
Dividends and other net realized gains and losses on sales of securities	1,724	1,861
Interest income	1,518	1,407
Other non-operating income	$ 4,768	$ 4,773

Note 5 - Business Segments (Det

Note 5 - Business Segments (Details Textual)	3 Months Ended
	Mar. 31, 2017
Number of Reportable Segments	2
Number of Operating Segments	2

Note 5 - Business Segments - Su

Note 5 - Business Segments - Summary of Financial Information by Reporting Segment (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Revenues:
Net patient revenues	$ 227,959	$ 218,106
Other revenues	11,284	11,482
Net operating revenues	239,243	229,588
Cost and Expenses:
Salaries, wages and benefits	138,055	130,020
Other operating	63,883	61,309
Operating Leases, Rent Expense	10,088	10,327
Depreciation and amortization	10,295	9,354
Interest	1,058	954
Total costs and expenses	223,379	211,964
Income (Loss) Before Non-Operating Income	15,864	17,624
Non–Operating Income	4,768	4,773
Income Before Income Taxes	20,632	22,397
Inpatient Services Segment [Member]
Revenues:
Net patient revenues	212,302	202,083
Other revenues	226	169
Net operating revenues	212,528	202,252
Cost and Expenses:
Salaries, wages and benefits	118,248	110,564
Other operating	58,530	55,607
Operating Leases, Rent Expense	8,167	8,360
Depreciation and amortization	9,209	8,215
Interest	449	499
Total costs and expenses	194,603	183,245
Income (Loss) Before Non-Operating Income	17,925	19,007
Non–Operating Income
Income Before Income Taxes	17,925	19,007
Homecare Services Segment [Member]
Revenues:
Net patient revenues	15,657	16,023
Other revenues
Net operating revenues	15,657	16,023
Cost and Expenses:
Salaries, wages and benefits	8,781	9,157
Other operating	4,293	4,218
Operating Leases, Rent Expense	489	487
Depreciation and amortization	40	46
Interest
Total costs and expenses	13,603	13,908
Income (Loss) Before Non-Operating Income	2,054	2,115
Non–Operating Income
Income Before Income Taxes	2,054	2,115
Other Segments [Member]
Revenues:
Net patient revenues
Other revenues	11,058	11,313
Net operating revenues	11,058	11,313
Cost and Expenses:
Salaries, wages and benefits	11,026	10,299
Other operating	1,060	1,484
Operating Leases, Rent Expense	1,432	1,480
Depreciation and amortization	1,046	1,093
Interest	609	455
Total costs and expenses	15,173	14,811
Income (Loss) Before Non-Operating Income	(4,115)	(3,498)
Non–Operating Income	4,768	4,773
Income Before Income Taxes	$ 653	$ 1,275

Note 6 - Long-term Leases (Deta

Note 6 - Long-term Leases (Details Textual)	3 Months Ended
	Mar. 31, 2017USD ($)	Mar. 31, 2016USD ($)
Operating Leases, Rent Expense	$ 10,088,000	$ 10,327,000
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
Operating Lease Additional Percentage Rent Percentage	4.00%
Operating Leases, Rent Expense	$ 9,314,000	$ 9,480,000

Note 6 - Long-term Leases - Fix

Note 6 - Long-term Leases - Fixed Assets Recorded Under Capital Leases (Details) - Buildings and Personal Property [Member] - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Buildings and personal property	$ 39,032	$ 39,032
Accumulated amortization	(12,101)	(11,120)
Total capital leases	$ 26,931	$ 27,912

Note 6 - Long-term Leases - Fut

Note 6 - Long-term Leases - Future Minimum Lease Payments (Details) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
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
2022, operating leases	34,200
2022, capital leases	5,200
Thereafter, operating leases	168,200
Thereafter, capital leases	9,967
Total minimum lease payments, operating leases	339,200
Total minimum lease payments, capital leases	35,967
Less: Amounts representing interest, capital leases	(6,589)
Present value of minimum lease payments, capital leases	29,378
Less: Current portion, capital leases	(3,533)	$ (3,481)
Long-term capital lease obligations, capital leases	$ 25,845	$ 26,748

Note 7 - Earnings Per Share (De

Note 7 - Earnings Per Share (Details Textual) - shares	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Employee Stock Option [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	1,072,425	12,239

Note 7 - Earnings Per Share - S

Note 7 - 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
	Mar. 31, 2017	Mar. 31, 2016
Basic (in shares)	15,173,491	14,916,905
Net income attributable to National HealthCare Corporation	$ 12,728	$ 13,699
Earnings per common share, basic (in dollars per share)	$ 0.84	$ 0.92
Dilutive effect of contingent issuable stock (in shares)		194,275
Diluted (in shares)	15,212,133	15,135,446
Earnings per common share, diluted (in dollars per share)	$ 0.84	$ 0.91
Employee Stock Option [Member]
Dilutive effect share-based awards (in shares)	38,642	24,266

Note 8 - Investments in Marke49

Note 8 - Investments in Marketable Securities (Details Textual) - USD ($)	3 Months Ended		12 Months Ended
	Mar. 31, 2017	Mar. 31, 2016	Dec. 31, 2016
Available-for-sale Securities, Accumulated Gross Unrealized Gain, before Tax	$ 107,010,000		$ 108,730,000
Available-for-sale Securities, Accumulated Gross Unrealized Loss, before Tax	2,414,000		3,157,000
Proceeds from Sale and Maturity of Marketable Securities	33,887,000	$ 15,573,000
Realized Investment Gains (Losses)	34,000	$ 279,000
Other than Temporary Impairment Losses, Investments, Available-for-sale Securities	$ 0		$ 0

Note 8 - Investments in Marke50

Note 8 - Investments in Marketable Securities - Marketable Securities and Restricted Marketable Securities (Details) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Restricted investments available for sale, amortized cost	$ 154,408	$ 185,968
Investments available for sale, amortized cost	184,584	216,144
Available-for-sale securities	289,180	321,717
Equity Securities [Member]
Unrestricted investments available for sale, amortized cost	30,176	30,176
Unrestricted investments available for sale, fair value	136,341	138,013
Corporate Debt Securities [Member]
Restricted investments available for sale, amortized cost	59,534	71,311
Restricted investments available for sale, fair value	59,555	71,100
Commercial Mortgage Backed Securities [Member]
Restricted investments available for sale, amortized cost	46,222	56,889
Restricted investments available for sale, fair value	45,582	56,168
US Government Corporations and Agencies Securities [Member]
Restricted investments available for sale, amortized cost	21,707	25,748
Restricted investments available for sale, fair value	21,248	25,181
US States and Political Subdivisions Debt Securities [Member]
Restricted investments available for sale, amortized cost	26,945	32,020
Restricted investments available for sale, fair value	$ 26,454	$ 31,255

Note 8 - Investments in Marke51

Note 8 - Investments in Marketable Securities - Available for Sale Marketable Equity Securities (Details) - NHI Common Stock [Member] - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
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	$ 118,434	$ 120,945

Note 8 - Investments in Marke52

Note 8 - Investments in Marketable Securities - Amortized Cost and Estimated Fair Value of Debt Securities as Available for Sale (Details) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Within 1 year, cost	$ 13,418	$ 14,181
Within 1 year, fair value	13,450	14,216
1 to 5 years, cost	66,671	79,827
1 to 5 years, fair value	66,517	79,502
6 to 10 years, cost	74,319	91,211
6 to 10 years, fair value	72,872	89,269
Over 10 years, cost		749
Over 10 years, fair value		717
Cost	154,408	185,968
Fair Value	$ 152,839	$ 183,704

Note 9 - Fair Value Measureme53

Note 9 - Fair Value Measurements - Summary of Fair Value Measurements by Level (Details) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016	Mar. 31, 2016
Restricted Cash and Cash Equivalents	$ 16,713		$ 14,455
Available-for-sale securities	289,180	$ 321,717
Fair Value, Measurements, Recurring [Member]
Cash and cash equivalents	47,096	26,335
Restricted Cash and Cash Equivalents	16,713	5,254
Total financial assets	352,989	353,306
Fair Value, Measurements, Recurring [Member] | Equity Securities [Member]
Available-for-sale securities	136,341	138,013
Fair Value, Measurements, Recurring [Member] | Corporate Debt Securities [Member]
Available-for-sale securities	59,555	71,100
Fair Value, Measurements, Recurring [Member] | Commercial Mortgage Backed Securities [Member]
Available-for-sale securities	45,582	56,168
Fair Value, Measurements, Recurring [Member] | US Treasury Securities [Member]
Available-for-sale securities	21,248	25,181
Fair Value, Measurements, Recurring [Member] | US States and Political Subdivisions Debt Securities [Member]
Available-for-sale securities	26,454	31,255
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member]
Cash and cash equivalents	47,096	26,335
Restricted Cash and Cash Equivalents	16,713	5,254
Total financial assets	262,186	237,106
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | Equity Securities [Member]
Available-for-sale securities	136,341	138,013
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | Corporate Debt Securities [Member]
Available-for-sale securities	40,788	42,323
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | Commercial Mortgage 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	21,248	25,181
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	90,803	116,200
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	18,767	28,777
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | Commercial Mortgage Backed Securities [Member]
Available-for-sale securities	45,582	56,168
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	$ 26,454	$ 31,255

Note 10 - Long-term Debt (Detai

Note 10 - Long-term Debt (Details Textual) - USD ($) $ in Millions	1 Months Ended
	Oct. 31, 2015	Mar. 31, 2017	Dec. 31, 2016
Long-term Debt		$ 120	$ 120
Bank of America [Member]
Line of Credit Facility, Maximum Borrowing Capacity	$ 175
Debt Instrument, Term	5 years
Bank of America [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument, Basis Spread on Variable Rate	1.40%
Debt Instrument, Basis Spread on Base Rate	1.00%
Bank of America [Member] | Base Rate [Member]
Debt Instrument, Basis Spread on Variable Rate	0.40%
Bank of America [Member] | Federal Funds Effective Swap Rate [Member]
Debt Instrument, Basis Spread on Base Rate	0.50%
Unsecured Term Note Payable [Member]
Long-term Debt		$ 10	$ 10

Note 10 - Long-term Debt - Sche

Note 10 - Long-term Debt - Schedule of Debt (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2017	Dec. 31, 2016
Long-term debt	$ 120	$ 120
Long-term debt, noncurrent	$ 120	120
Unsecured Term Note Payable [Member]
Long-term debt, interest rate	3.40%
Long-term debt maturity	2,018
Long-term debt	$ 10	10
Revolving Credit Facility [Member]
Long-term debt, interest rate	2.30%
Long-term debt maturity	2,020
Long-term debt	$ 110	$ 110

Note 11 - Stock Repurchase Pr56

Note 11 - Stock Repurchase Program (Details Textual) - Common Stock [Member] - USD ($) shares in Thousands, $ in Millions	7 Months Ended
	Mar. 31, 2017	Aug. 31, 2016
Stock Repurchase Program, Authorized Amount		$ 25
Stock Repurchased and Retired During Period, Shares	0

Note 12 - Stock-based Compens57

Note 12 - Stock-based Compensation (Details Textual) - USD ($)	3 Months Ended		12 Months Ended
	Mar. 31, 2017	Mar. 31, 2016	Dec. 31, 2016	May 31, 2015	May 30, 2015
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Gross	1,072,425		56,291
Allocated Share-based Compensation Expense	$ 92,000	$ 286,000
Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized	$ 8,382,000
Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized, Period for Recognition	5 years
2010 Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Authorized				2,575,000	1,200,000
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Gross	1,062,500
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Available for Grant	621,244
Employee Stock Purchase Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Gross	9,925
Incentive Stock Option [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Expiration Period	10 years

Note 12 - Stock-based Compens58

Note 12 - Stock-based Compensation - Summary of Assumptions Used to Value Options Granted (Details)	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Risk–free interest rate	2.11%	0.89%
Expected volatility	16.60%	15.80%
Expected life, in years (Year)	5 years	2 years 73 days
Expected dividend yield	3.11%	3.09%

Note 12 - Stock-based Compens59

Note 12 - Stock-based Compensation - Summary of Outstanding Stock Options (Details) - USD ($)	3 Months Ended	12 Months Ended
	Mar. 31, 2017	Dec. 31, 2016
Options outstanding, shares (in shares)	177,959	621,390
Options outstanding, weighted average exercise price (in dollars per share)	$ 55.48	$ 48.15
Number of Shares - Options Granted (in shares)	1,072,425	56,291
Weighted Average Exercise Price - Options Granted (in dollars per share)	$ 72.96	$ 62.54
Number of Shares - Options Exercised (in shares)	(16,992)	(499,066)
Weighted Average Exercise Price - Options Exercised (in dollars per share)	$ 48.08	$ 47.16
Number of Shares - Options cancelled (in shares)		(656)
Weighted Average Exercise Price - Options cancelled (in dollars per share)		$ 46.69
Options outstanding, shares (in shares)	1,233,392	177,959
Options outstanding, weighted average exercise price (in dollars per share)	$ 70.78	$ 55.48
Options outstanding, aggregate intrinsic value	$ 2,421,000
Options exercisable (in shares)	160,967
Options exercisable, weighted average exercise price (in dollars per share)	$ 56.26
Options exercisable, aggregate intrinsic value	$ 2,421,000

Note 12 - Stock-based Compens60

Note 12 - Stock-based Compensation - Options Outstanding (Details)	3 Months Ended
	Mar. 31, 2017$ / sharesshares
Options outstanding (in shares) | shares	1,233,392
Weighted average exercise price (in dollars per share)	$ 70.78
Weighted average remaining contractual life in years (Year)	4 years 219 days
Exercise Price Range 1 [Member]
Options outstanding (in shares) | shares	75,000
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)	$ 49.66
Weighted average remaining contractual life in years (Year)	1 year 146 days
Exercise Price Range 2 [Member]
Options outstanding (in shares) | shares	1,158,392
Exercise prices, lower range limit (in dollars per share)	$ 61.25
Exercise prices, upper range limit (in dollars per share)	75.45
Weighted average exercise price (in dollars per share)	$ 72.15
Weighted average remaining contractual life in years (Year)	4 years 292 days

Note 13 - Income Taxes (Details

Note 13 - Income Taxes (Details Textual) - USD ($)	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Income Tax Expense (Benefit)	$ 7,999,000	$ 8,698,000
Effective Income Tax Rate Reconciliation, Percent	38.80%	38.80%
Effective Income Tax Rate Reconciliation, Tax Contingency, Amount	$ 175,000	$ 175,000
Effective Income Tax Rate Reconciliation, Nondeductible Expense, Amount	49,000	$ 86,000
Effective Income Tax Rate Reconciliation, Exercise of Stock Options, Amount	$ 124,000
Earliest Tax Year [Member]
Open Tax Year		2,013

Note 14 - Contingencies and G62

Note 14 - Contingencies and Guarantees (Details Textual) - USD ($)	3 Months Ended	12 Months Ended
	Mar. 31, 2017	Dec. 31, 2016	Dec. 09, 2014
Self Insurance Reserve	$ 94,823,000	$ 91,162,000
Direct Business Coverage Statutory Limits	1,000,000
Annual Excess Coverage	9,000,000	$ 9,000,000
Line of Credit [Member] | National Health Care [Member]
Line of Credit Facility, Maximum Borrowing Capacity	2,000,000
Long-term Line of Credit	$ 0
Caris [Member]
Equity Method Investment, Ownership Percentage	75.10%		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 15 - Subsequent Event (Det

Note 15 - Subsequent Event (Details Textual) - $ / shares	May 09, 2017	May 08, 2017	Mar. 31, 2017	Dec. 31, 2016
Common Stock, Shares Authorized			30,000,000	30,000,000
Common Stock, Par or Stated Value Per Share			$ 0.01	$ 0.01
Subsequent Event [Member]
Common Stock, Increase, Shares Authorized	15,000,000
Common Stock, Shares Authorized	45,000,000	30,000,000
Common Stock, Par or Stated Value Per Share	$ 0.01