National HealthCare (NHC) 10-Q 9 Aug 18 2018 Q2 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	6 Months Ended
	Jun. 30, 2018	Aug. 07, 2018
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	Large Accelerated Filer
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Well-known Seasoned Issuer	No
Entity Common Stock, Shares Outstanding (in shares)		15,225,654
Document Type	10-Q
Document Period End Date	Jun. 30, 2018
Document Fiscal Year Focus	2,018
Document Fiscal Period Focus	Q2
Amendment Flag	false

Interim Condensed Consolidated

Interim Condensed Consolidated Statements of Operations (Unaudited) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Revenues:
Other revenues	$ 11,488,000	$ 11,610,000	$ 22,757,000	$ 22,894,000
Net operating revenues	242,142,000	238,695,000	485,103,000	477,233,000
Costs and expenses:
Salaries, wages and benefits	145,466,000	142,684,000	285,561,000	280,739,000
Other operating	62,589,000	62,094,000	127,761,000	125,272,000
Facility rent	10,272,000	10,079,000	20,501,000	20,167,000
Depreciation and amortization	10,397,000	10,481,000	20,739,000	20,776,000
Interest	1,253,000	1,219,000	2,493,000	2,277,000
Total costs and expenses	229,977,000	226,557,000	457,055,000	449,231,000
Income from operations	12,165,000	12,138,000	28,048,000	28,002,000
Non–operating income	5,654,000	5,189,000	2,589,000	9,957,000
Unrealized gains (losses) on marketable equity securities	12,448,000		(3,069,000)
Income before income taxes	30,267,000	17,327,000	27,568,000	37,959,000
Income tax provision	(7,892,000)	(6,758,000)	(8,092,000)	(14,757,000)
Net income	22,375,000	10,569,000	19,476,000	23,202,000
Net loss attributable to noncontrolling interest	86,000	86,000	194,000	181,000
Net income attributable to National HealthCare Corporation	$ 22,461,000	$ 10,655,000	$ 19,670,000	$ 23,383,000
Earnings per share attributable to National HealthCare Corporation stockholders:
Basic (in dollars per share)	$ 1.48	$ 0.70	$ 1.29	$ 1.54
Diluted (in dollars per share)	$ 1.47	$ 0.70	$ 1.29	$ 1.54
Weighted average common shares outstanding:
Basic (in shares)	15,221,262	15,189,818	15,218,962	15,181,700
Diluted (in shares)	15,228,305	15,220,448	15,224,958	15,216,336
Dividends declared to common stockholders, per share (in dollars per share)	$ 0.50	$ 0.48	$ 0.98	$ 0.93
Net Patient Revenues [Member]
Revenues:
Revenues	$ 230,654,000	$ 227,085,000	$ 462,346,000	$ 454,339,000

Interim Condensed Consolidated3

Interim Condensed Consolidated Statements of Comprehensive Income (Unaudited) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Net income	$ 22,375	$ 10,569	$ 19,476	$ 23,202
Other comprehensive loss:
Unrealized gains (losses) on investments in restricted marketable securities	(794)	13,297	(3,592)	12,356
Reclassification adjustment for realized gains on sale of securities	(14)	(204)	(25)	(238)
Income tax benefit (expense) related to items of other comprehensive income	169	(5,054)	759	(4,646)
Other comprehensive income (loss), net of tax	(639)	8,039	(2,858)	7,472
Net loss attributable to noncontrolling interest	86	86	194	181
Comprehensive income attributable to National HealthCare Corporation	$ 21,822	$ 18,694	$ 16,812	$ 30,855

Interim Condensed Consolidated4

Interim Condensed Consolidated Balance Sheets (Current Period Unaudited) - USD ($)	Jun. 30, 2018	Dec. 31, 2017
Current Assets:
Cash and cash equivalents	$ 59,322,000	$ 59,118,000
Restricted cash and cash equivalents	7,629,000	6,397,000
Marketable equity securities	136,016,000	139,085,000
Restricted marketable debt securities	20,064,000	21,012,000
Accounts receivable, net	82,230,000	86,767,000
Inventories	7,306,000	7,153,000
Prepaid expenses and other assets	3,428,000	2,864,000
Notes receivable, current portion	1,499,000	1,450,000
Federal income tax receivable		5,465,000
Total current assets	317,494,000	329,311,000
Property and Equipment:
Property and equipment, at cost	974,049,000	958,748,000
Accumulated depreciation and amortization	(430,014,000)	(409,429,000)
Net property and equipment	544,035,000	549,319,000
Other Assets:
Restricted cash and cash equivalents	1,920,000	1,906,000
Restricted marketable securities	144,885,000	145,383,000
Deposits and other assets	5,849,000	4,867,000
Goodwill	17,600,000	17,600,000
Notes receivable, less current portion	10,952,000	11,801,000
Investments in limited liability companies	28,014,000	36,339,000
Total other assets	209,220,000	217,896,000
Total assets	1,070,749,000	1,096,526,000
Current Liabilities:
Trade accounts payable	16,166,000	15,978,000
Capital lease obligations, current portion	3,808,000	3,696,000
Accrued payroll	55,688,000	67,102,000
Amounts due to third party payors	17,218,000	17,389,000
Accrued risk reserves, current portion	27,693,000	27,409,000
Other current liabilities	14,808,000	16,194,000
Dividends payable	7,612,000	7,297,000
Total current liabilities	142,993,000	155,065,000
Long–term debt	85,000,000	100,000,000
Capital lease obligations, less current portion	21,120,000	23,052,000
Accrued risk reserves, less current portion	67,115,000	65,866,000
Refundable entrance fees	8,668,000	8,827,000
Obligation to provide future services	2,887,000	2,887,000
Deferred income taxes	15,240,000	18,376,000
Other noncurrent liabilities	16,335,000	15,795,000
Deferred revenue	4,621,000	3,226,000
Total liabilities	363,979,000	393,094,000
Equity:
Common stock, $.01 par value; 45,000,000 shares authorized; 15,225,654 and 15,212,133 shares, respectively, issued and outstanding	152,000	152,000
Capital in excess of par value	217,296,000	215,659,000
Retained earnings	492,377,000	419,423,000
Accumulated other comprehensive income (loss)	(3,555,000)	67,504,000
Total National HealthCare Corporation stockholders’ equity	706,270,000	702,738,000
Noncontrolling interest	500,000	694,000
Total equity	706,770,000	703,432,000
Total liabilities and equity	$ 1,070,749,000	$ 1,096,526,000

Interim Condensed Consolidated5

Interim Condensed Consolidated Balance Sheets (Current Period Unaudited) (Parentheticals) - $ / shares	Jun. 30, 2018	Dec. 31, 2017
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	45,000,000	45,000,000
Common stock, shares issued (in shares)	15,225,654	15,212,133
Common stock, shares outstanding (in shares)	15,225,654	15,212,133

Interim Condensed Consolidated6

Interim Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017
Cash Flows From Operating Activities:
Net income	$ 19,476,000	$ 23,202,000
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	20,739,000	20,776,000
Equity in (earnings) losses of unconsolidated investments	4,584,000	(3,380,000)
Distributions from unconsolidated investments	3,741,000	4,337,000
Unrealized losses on marketable equity securities	3,069,000
Gains on sale of restricted marketable securities	(25,000)	(238,000)
Deferred income taxes	(2,376,000)	(1,540,000)
Stock–based compensation	1,177,000	832,000
Changes in operating assets and liabilities:
Accounts receivable	4,537,000	2,891,000
Income tax receivable	5,465,000	2,218,000
Inventories	(153,000)	310,000
Prepaid expenses and other assets	(1,551,000)	(969,000)
Trade accounts payable	188,000	(3,855,000)
Accrued payroll	(11,414,000)	(12,601,000)
Amounts due to third party payors	(171,000)	931,000
Accrued risk reserves	1,538,000	3,379,000
Other current liabilities	(1,386,000)	1,440,000
Other noncurrent liabilities	540,000	1,048,000
Deferred revenue	1,395,000	1,524,000
Net cash provided by operating activities	49,373,000	40,305,000
Cash Flows From Investing Activities:
Additions to property and equipment	(15,456,000)	(16,681,000)
Investments in unconsolidated companies		(176,000)
Collections of notes receivable	800,000	3,651,000
Purchase of restricted marketable securities	(6,545,000)	(22,775,000)
Sale of restricted marketable securities	4,399,000	44,756,000
Net cash (used in) provided by investing activities	(16,802,000)	8,775,000
Cash Flows From Financing Activities:
Principal payments on debt	(15,000,000)
Principal payments under capital lease obligations	(1,820,000)	(1,715,000)
Dividends paid to common stockholders	(14,602,000)	(13,649,000)
Issuance of common shares	1,327,000	1,496,000
Repurchase of common shares	(867,000)
Equity attributable to noncontrolling interest		970,000
Entrance fee refunds	(159,000)	(757,000)
Change in deposits		(418,000)
Net cash used in financing activities	(31,121,000)	(14,073,000)
Net Increase in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents	1,450,000	35,007,000
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period	67,421,000	31,589,000
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period	68,871,000	66,596,000
Balance Sheet Classifications:
Total Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents	$ 67,421,000	$ 31,589,000

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, 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			23,383			23,383
Net loss attributable to noncontrolling interest					(181)	(181)
Equity contributed by noncontrolling interest					970	970
Other comprehensive income (loss)				7,472		7,472
Stock–based compensation		832				832
Shares sold – options exercised (in shares)	32,092
Shares sold – options exercised		1,496				1,496
Dividends declared to common stockholders			(14,125)			(14,125)
Balance (in shares) at Jun. 30, 2017	15,195,030
Balance at Jun. 30, 2017	$ 152	213,785	401,192	73,540	789	689,458
Balance (in shares) at Dec. 31, 2016	15,162,938
Balance at Dec. 31, 2016	$ 152	211,457	391,934	66,068		$ 669,611
Shares sold – options exercised (in shares)						48,995
Balance (in shares) at Dec. 31, 2017	15,212,133
Balance at Dec. 31, 2017	$ 152	215,659	419,423	67,504	694	$ 703,432
Net income attributable to National HealthCare Corporation			19,670			19,670
Net loss attributable to noncontrolling interest					(194)	(194)
Other comprehensive income (loss)				(2,858)		(2,858)
Stock–based compensation		1,177				$ 1,177
Shares sold – options exercised (in shares)	28,027					33,526
Shares sold – options exercised		1,327				$ 1,327
Dividends declared to common stockholders			(14,917)			(14,917)
Repurchase of common shares (in shares)	(14,506)
Repurchase of common shares		(867)				(867)
Balance (in shares) at Jun. 30, 2018	15,225,654
Balance at Jun. 30, 2018	$ 152	217,296	492,377	(3,555)	500	706,770
Reclassification due to new accounting standards			$ 68,201	$ (68,201)

Interim Condensed Consolidated8

Interim Condensed Consolidated Statements of Stockholders' Equity (Unaudited) (Parentheticals) - $ / shares	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017
Common Stock [Member]
Dividends declared to common stockholders, per share (in dollars per share)	$ 0.98	$ 0.93
Dividends declared to common stockholders, per share (in dollars per share)	$ 0.98	$ 0.93

Note 1 - Description of Busines

Note 1 - Description of Business	6 Months Ended
	Jun. 30, 2018
Notes to Financial Statements
Organization, Consolidation and Presentation of Financial Statements Disclosure [Text Block]	Note 1 – Description of Business National HealthCare Corporation June 30, 2018, 76 9,629 24 five 36 10

Note 2 - Summary of Significant

Note 2 - Summary of Significant Accounting Policies	6 Months Ended
	Jun. 30, 2018
Notes to Financial Statements
Significant Accounting Policies [Text Block]	Note 2 – Summary of Significant Accounting Policies The listing below is not not December 31, 2017 December 31, 2017 www.nhccare.com Basis of Presentation The unaudited interim condensed consolidated financial statements to which these notes are attached include all normal, recurring adjustments which are necessary to fairly present the financial position, results of operations and cash flows of NHC. All significant intercompany transactions and balances have been eliminated in consolidation. 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 operations. We assume that users of these interim condensed consolidated financial statements have read or have access to the audited December 31, 2017 may not 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. Recently Adopted Accounting Guidance In May 2014, No. 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, On January 1, 2018, No. 2014 09 No. 2014 09. not No. 2014 09 no three six June 30, 2017 January 1, 2018: Consolidated Statements of Operations ( in thousands Three Months Ended June 30, 2017 As Previously Reported Effect of Accounting Change As Adjusted Net patient revenues $ 227,847 $ (762 ) $ 227,085 Net operating revenues 239,457 (762 ) 238,695 Other operating expenses 62,856 (762 ) 62,094 Total costs and expenses 227,319 (762 ) 226,557 Net income $ 10,569 $ - $ 10,569 Six Months Ended June 30, 2017 As Previously Reported Effect of Accounting Change As Adjusted Net patient revenues $ 455,806 $ (1,467 ) $ 454,339 Net operating revenues 478,700 (1,467 ) 477,233 Other operating expenses 126,739 (1,467 ) 125,272 Total costs and expenses 450,698 (1,467 ) 449,231 Net income $ 23,202 $ - $ 23,202 In January 2016, No. 2016–01, 825 No. 2016–01 No. 2016–01 January 1, 2018, No. 2016 01 No. 2016 01 $68,073,000 three six June 30, 2018, $12,448,000 $3,069,000, No. 2016 01 In August 2016, No. 2016 15, No. 2016 15 eight 1 2 January 1, 2018, No. 2016 15 not In May 2017, No. 2017 09, 718 No. 2017 09 718. January 1, 2018, No. 2017 09 not In February 2018, No. 2018 02, No. 2018 02 2017 January 1, 2018, No. 2018 02. $128,000, Recent Accounting Guidance Not In February 2016, No. 2016 02, 842 December 15, 2018, In June 2016, No. 2016 13, No. 2016 13 December 15, 2019, December 15, 2018. Segment Reporting In accordance with the provisions of ASC 280, two 1 2 6 Other Operating Expenses Other operating expenses include the costs of care and services that we provide to the residents of our facilities and the costs of maintaining our facilities. Our primary patient care costs include drugs, medical supplies, purchased professional services, food, and professional liability insurance and licensing fees. The primary facility costs include utilities and property insurance. 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, excluding stock-based compensation, which were $6,573,000 $13,250,000 three six June 30, 2018, $6,390,000 $15,262,000 three six June 30, 2017, 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 not 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 June 30, 2018, 63 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 may 10% 90% 40% Non-refundable fees are included as a component of the transaction price and are amortized into revenue over the actuarially determined remaining life of the resident, which is the expected period of occupancy by the resident. We pay the refundable portion of our entry fees to residents when they relocate from our community and the apartment is re-occupied. Refundable entrance fees are not June 30, 2018 December 31, 2017 $8,668,000 $8,827,000, Obligation to Provide Future Services We 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 June 30, 2018, December 31, 2017, $2,887,000. 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% not Noncontrolling Interest The noncontrolling interest in a subsidiary is presented within total equity in the Company's interim condensed 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 operations. The Company’s earnings 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 not Prior Period Classifications Certain amounts in prior periods have been reclassified to conform with current period presentation.

Note 3 - Net Patient Revenues

Note 3 - Net Patient Revenues	6 Months Ended
	Jun. 30, 2018
Notes to Financial Statements
Revenue from Contract with Customer [Text Block]	Note 3 – Net Patient Revenue s Net patient revenues are derived from services rendered to patients for skilled and intermediate nursing, rehabilitation therapy, assisted living and independent living, and home health care services. Net patient revenue is reported at the amount that reflects the consideration to which the Company expects to be entitled in exchange for providing patient services. These amounts are due from patients, governmental programs, and other third The Company disaggregates revenue from contracts with customers by service type and by payor. Revenue by Service Type The Company’s net patient services can generally be classified into the following two 1 2 Three Months Ended June 30 Six Months Ended June 30 (in thousands) 2018 2017 2018 2017 Net patient revenues: Inpatient services $ 215,617 $ 211,057 $ 431,968 $ 422,497 Homecare 15,037 16,028 30,378 31,842 Total net patient revenue $ 230,654 $ 227,085 $ 462,346 $ 454,339 The Company recognizes revenue as its performance obligations are completed. The performance obligations are satisfied over time as the patient simultaneously receives and consumes the benefits of the healthcare services provided. For inpatient services, revenue is recognized on a daily basis as each day represents a separate contract and performance obligation. For homecare, revenue is recognized when services are provided based on the number of days of service rendered in the episode or on a per-visit basis. Typically, patients and third As our performance obligations relate to contracts with a duration of one 606 10 50 14 not no As the period between the time of service and time of payment is typically one 606 10 32 18 not Revenue by Payor Certain groups of patients receive funds to pay the cost of their care from a common source. The following table sets forth sources of net patient revenues for the periods indicated: Three Months Ended June 30 Six Months Ended June 30 Source 2018 2017 2018 2017 Medicare 35 % 35 % 36 % 35 % Managed Care 12 % 13 % 12 % 13 % Medicaid 26 % 26 % 26 % 26 % Private Pay and Other 27 % 26 % 26 % 26 % Total 100 % 100 % 100 % 100 % The Company determines the transaction price based on established billing rates reduced by contractual adjustments provided to third $1,064,000 $2,023,000 three six June 30, 2018, $1,055,000 $2,233,000 three six June 30, 2017, Medicare covers skilled nursing services for beneficiaries who require nursing care and/or rehabilitation services following a hospitalization of at least three 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% not Medicaid is operated by individual states with the financial participation of the federal government. The states in which we operate currently use prospective cost–based reimbursement systems. Under cost–based reimbursement systems, the skilled nursing facility is reimbursed for the reasonable direct and indirect allowable costs it incurred in a base year in providing routine resident care services as defined by the program. Private pay, managed care, and other payment sources include commercial insurance, individual patient funds, managed care plans and the Veterans Administration. Private paying patients, private insurance carriers and the Veterans Administration generally pay based on the healthcare facilities charges or specifically negotiated contracts. 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 Certain managed care payors for homecare services pay on a per-visit basis. This non-episodic based revenue is recorded on an accrual basis based upon the date of services at amounts equal to its established or estimated per-visit rates. Third Party Payors 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. Settlements with third not no not $17,218,000 $17,389,000 June 30, 2018 December 31, 2017,

Note 4 - Other Revenues

Note 4 - Other Revenues	6 Months Ended
	Jun. 30, 2018
Notes to Financial Statements
Other Revenues [Text Block]	N ote 4 – Other Revenues Revenues from rental income include health care real estate properties owned by us and leased to third third third Other revenues include the following: Three Months Ended June 30 Six Months Ended June 30 (in thousands) 2018 2017 2018 2017 Rental income $ 5,553 $ 5,515 $ 11,086 $ 11,001 Management and accounting services fees 3,738 3,752 7,446 7,611 Insurance services 1,955 2,087 3,646 3,644 Other 242 256 579 638 Total other revenues $ 11,488 $ 11,610 $ 22,757 $ 22,894 Management Fees from National We manage five three six June 30, 2018, $1,038,000 $2,053,000 three six June 30, 2017, $989,000 $1,925,000 Insurance Services For workers’ compensation insurance services, the premium revenues reflected in the interim condensed consolidated statements of operations for the three six June 30, 2018 $1,282,000 $2,300,000, three six June 30, 2017, $1,409,000 $2,688,000. For professional liability insurance services, the premium revenues reflected in the interim condensed consolidated statements of operations for the three six June 30, 2018 $673,000 $1,346,000, three six June 30, 2017 $678,000 $956,000,

Note 5 - Non-operating Income

Note 5 - Non-operating Income	6 Months Ended
	Jun. 30, 2018
Notes to Financial Statements
Other Nonoperating Income and Expense [Text Block]	N ote 5 – Non – Operating Income Non–operating income includes equity in earnings (losses) of unconsolidated investments, dividends and other realized gains and losses on marketable securities, interest income, and unrealized losses on our equity marketable securities. Our most significant equity method investment is a 75.1% three six June 30, 2018, $136,000 $8,364,000, 15 Contingencies and Commitments Three Months Ended June 30 Six Months Ended June 30 (in thousands) 2018 2017 2018 2017 Equity in earnings (losses) of unconsolidated investments $ 2,001 $ 1,854 $ (4,584 ) $ 3,380 Dividends and net realized gains on sales of securities 1,795 1,899 3,597 3,623 Interest income 1,858 1,436 3,576 2,954 Total non-operating income $ 5,654 $ 5,189 $ 2,589 $ 9,957

Note 6 - Business Segments

Note 6 - Business Segments	6 Months Ended
	Jun. 30, 2018
Notes to Financial Statements
Segment Reporting Disclosure [Text Block]	Note 6 – Business Segments 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. For additional information on these reportable segments see Note 2 Summary of Significant Accounting Policies. 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 not The following table sets forth the Company’s unaudited interim condensed consolidated statements of operations by business segment (in thousands Three Months Ended June 30, 2018 Inpatient Services Homecare All Other Total Revenues: Net patient revenues $ 215,617 $ 15,037 $ - $ 230,654 Other revenues 181 - 11,307 11,488 Net operating revenues 215,798 15,037 11,307 242,142 Costs and expenses: Salaries, wages and benefits 128,115 8,611 8,740 145,466 Other operating 56,069 4,740 1,780 62,589 Rent 8,267 485 1,520 10,272 Depreciation and amortization 9,571 44 782 10,397 Interest 383 - 870 1,253 Total costs and expenses 202,405 13,880 13,692 229,977 Income (loss) from operations 13,393 1,157 (2,385 ) 12,165 Non-operating income - - 5,654 5,654 Unrealized gains on marketable equity securities - - 12,448 12,448 Income before income taxes $ 13,393 $ 1,157 $ 15,717 $ 30,267 Three Months Ended June 30, 2017 (As adjusted) Inpatient Services Homecare All Other Total Revenues: Net patient revenues $ 211,057 $ 16,028 $ - $ 227,085 Other revenues 225 - 11,385 11,610 Net operating revenues 211,282 16,028 11,385 238,695 Costs and expenses: Salaries, wages and benefits 125,614 8,615 8,455 142,684 Other operating 55,227 5,058 1,809 62,094 Rent 8,257 499 1,323 10,079 Depreciation and amortization 9,396 39 1,046 10,481 Interest 436 - 783 1,219 Total costs and expenses 198,930 14,211 13,416 226,557 Income (loss) from operations 12,352 1,817 (2,031 ) 12,138 Non-operating income - - 5,189 5,189 Income before income taxes $ 12,352 $ 1,817 $ 3,158 $ 17,327 Six Months Ended June 30, 2018 Inpatient Services Homecare All Other Total Revenues: Net patient revenues $ 431,968 $ 30,378 $ - $ 462,346 Other revenues 451 - 22,306 22,757 Net operating revenues 432,419 30,378 22,306 485,103 Costs and expenses: Salaries, wages and benefits 251,495 16,642 17,424 285,561 Other operating 113,904 10,019 3,838 127,761 Rent 16,524 973 3,004 20,501 Depreciation and amortization 19,032 82 1,625 20,739 Interest 780 - 1,713 2,493 Total costs and expenses 401,735 27,716 27,604 457,055 Income (loss) from operations 30,684 2,662 (5,298 ) 28,048 Non-operating income - - 2,589 2,589 Unrealized losses on marketable equity securities - - (3,069 ) (3,069 ) Income (loss) before income taxes $ 30,684 $ 2,662 $ (5,778 ) $ 27,568 Six Months Ended June 30, 2017 (As adjusted) Inpatient Services Homecare All Other Total Revenues: Net patient revenues $ 422,497 $ 31,842 $ - $ 454,339 Other revenues 451 - 22,443 22,894 Net operating revenues 422,948 31,842 22,443 477,233 Costs and expenses: Salaries, wages and benefits 245,238 16,442 19,059 280,739 Other operating 111,392 10,193 3,687 125,272 Rent 16,424 987 2,756 20,167 Depreciation and amortization 18,605 80 2,091 20,776 Interest 886 - 1,391 2,277 Total costs and expenses 392,545 27,702 28,984 449,231 Income (loss) from operations 30,403 4,140 (6,541 ) 28,002 Non-operating income - - 9,957 9,957 Income before income taxes $ 30,403 $ 4,140 $ 3,416 $ 37,959

Note 7 - Long-term Leases

Note 7 - Long-term Leases	6 Months Ended
	Jun. 30, 2018
Notes to Financial Statements
Leases of Lessee Disclosure [Text Block]	Note 7 – Long-Term Leases 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: June 30, 2018 December 31, 2017 (in thousands) Buildings and personal property $ 39,032 $ 39,032 Accumulated amortization (17,008 ) (15,045 ) $ 22,024 $ 23,987 Operating Leases The Company leases from National Health Investors, Inc. (“NHI”) the real property of 35 seven three two $34,200,000 4% $9,478,000 $9,314,000 three June 30, 2018 2017, $18,956,000 $18,628,000 six June 30, 2018 2017, Minimum Lease Payments The approximate future minimum lease payments required under all leases that have remaining non-cancelable lease terms at June 30, 2018 Operating Leases Capital Leases (in thousands) 2019 $ 34,200 $ 5,200 2020 34,200 5,200 2021 34,200 5,200 2022 34,200 5,200 2023 34,200 5,200 Thereafter 125,450 3,467 Total minimum lease payments $ 296,450 $ 29,467 Less: Amounts representing interest (4,539 ) Present value of minimum lease payments 24,928 Less: Current portion (3,808 ) Long-term capital lease obligations $ 21,120

Note 8 - Earnings Per Share

Note 8 - Earnings Per Share	6 Months Ended
	Jun. 30, 2018
Notes to Financial Statements
Earnings Per Share [Text Block]	Note 8 – 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 (in thousands, except for share and per share amounts) : Three Months Ended June 30 Six Months Ended June 30 2018 2017 2018 2017 Basic: Weighted average common shares outstanding 15,221,262 15,189,818 15,218,962 15,181,700 Net income attributable to National HealthCare Corporation $ 22,461 $ 10,655 $ 19,670 $ 23,383 Earnings per common share, basic $ 1.48 $ 0.70 $ 1.29 $ 1.54 Diluted: Weighted average common shares outstanding 15,221,262 15,189,818 15,218,962 15,181,700 Dilutive effect of stock options 7,043 30,630 5,996 34,636 Weighted average common shares outstanding 15,228,305 15,220,448 15,224,958 15,216,336 Net income attributable to National HealthCare Corporation $ 22,461 $ 10,655 $ 19,670 $ 23,383 Earnings per common share, diluted $ 1.47 $ 0.70 $ 1.29 $ 1.54 In the above table, options to purchase 1,137,015 1,124,689 six June 30, 2018 2017,

Note 9 - Investments in Marketa

Note 9 - Investments in Marketable Securities	6 Months Ended
	Jun. 30, 2018
Notes to Financial Statements
Investments in Debt and Marketable Equity Securities (and Certain Trading Assets) Disclosure [Text Block]	Note 9 – Inve stments in Marketable Securities Our investments in marketable equity securities are carried at fair value with the changes in unrealized gains and losses recognized in our results of operations at each measurement date. Our investments in marketable debt securities are classified as available for sale securities and carried at fair value with the unrealized gains and losses recognized through accumulated other comprehensive income at each measurement date. 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 10 Fair Value Measurements Marketable securities and restricted marketable securities consist of the following (in thousands) June 30, 2018 December 31, 2017 Amortized Cost Fair Value Amortized Cost Fair Value Non-restricted investments: Marketable equity securities $ 30,176 $ 136,016 $ 30,176 $ 139,085 Restricted investments: Corporate debt securities 68,796 66,949 65,107 65,461 Commercial mortgage–backed securities 54,802 53,586 54,030 53,544 U.S. Treasury securities 21,516 20,676 21,685 21,172 State and municipal securities 24,334 23,738 26,455 26,218 $ 199,624 $ 300,965 $ 197,453 $ 305,480 Included in the marketable equity securities are the following (in thousands, except share amounts) : June 30, 2018 December 31, 2017 Shares Cost Fair Value Shares Cost Fair Value NHI Common Stock 1,630,642 $ 24,734 $ 120,146 1,630,642 $ 24,734 $ 122,918 The amortized cost and estimated fair value of the marketable debt securities classified as available for sale, by contractual maturity, are as follows (in thousands) June 30, 2018 December 31, 2017 Cost Fair Value Cost Fair Value Maturities: Within 1 year $ 18,660 $ 18,627 $ 18,492 $ 18,499 1 to 5 years 80,101 78,615 70,331 70,157 6 to 10 years 68,842 65,862 77,657 76,943 Over 10 years 1,845 1,845 797 796 $ 169,448 $ 164,949 $ 167,277 $ 166,395 Gross unrealized gains related to marketable equity securities are $105,851,000 $108,933,000 June 30, 2018 December 31, 2017, $11,000 $24,000 June 30, 2018 December 31, 2017, three six June 30, 2018, $12,448,000 $3,069,000, Gross unrealized gains related to available for sale marketable debt securities are $110,000 $823,000 June 30, 2018 December 31, 2017, $4,609,000 $1,705,000 June 30, 2018 December 31, 2017, For the marketable securities in gross unrealized loss positions, (a) it is more likely than not not no six June 30, 2018 December 31, 2017. Proceeds from the sale of available for sale marketable debt securities during the six June 30, 2018 2017 $4,399,000 $44,756,000, $25,000 $238,000 six June 30, 2018 2017, No six June 30, 2018 2017,

Note 10 - Fair Value Measuremen

Note 10 - Fair Value Measurements	6 Months Ended
	Jun. 30, 2018
Notes to Financial Statements
Fair Value Disclosures [Text Block]	Note 10 – 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 not Level 3 no 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. The following table summarizes fair value measurements by level at June 30, 2018 December 31, 2017 (in thousands) Fair Value Measurements Using June 30, 2018 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 $ 59,322 $ 59,322 $ – $ – Restricted cash and cash equivalents 9,549 9,549 – – Marketable equity securities 136,016 136,016 – – Corporate debt securities 66,949 43,803 23,146 – Mortgage–backed securities 53,586 – 53,586 – U.S. Treasury securities 20,676 20,676 – – State and municipal securities 23,738 – 23,738 – Total financial assets $ 369,836 $ 269,366 $ 100,470 $ – Fair Value Measurements Using December 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 $ 59,118 $ 59,118 $ – $ – Restricted cash and cash equivalents 8,303 8,303 – – Marketable equity securities 139,085 139,085 – – Corporate debt securities 65,461 43,073 22,388 – Mortgage-backed securities 53,544 – 53,544 – U.S. Treasury securities 21,172 21,172 – – State and municipal securities 26,218 – 26,218 – Total financial assets $ 372,901 $ 270,751 $ 102,150 $ –

Note 11 - Long-term Debt

Note 11 - Long-term Debt	6 Months Ended
	Jun. 30, 2018
Notes to Financial Statements
Debt Disclosure [Text Block]	Note 1 1 – Long – Term Debt Long–term debt consists of the following: Weighted Average Interest Rate Maturities June 30, 2018 December 31, 2017 Variable (dollars in thousands) Credit Facility, interest payable monthly 3.5% 2020 $ 75,000 $ 90,000 Unsecured term note payable to National, interest payable quarterly, principal payable at maturity 4.3% 2028 10,000 10,000 85,000 100,000 Less current portion – – $ 85,000 $ 100,000 $1 50 ,000,000 During the second 2018, $175 $150 five October 2020). 1.40% 0.40%.

Note 12 - Stock Repurchase Prog

Note 12 - Stock Repurchase Program	6 Months Ended
	Jun. 30, 2018
Notes to Financial Statements
Treasury Stock [Text Block]	Note 1 2 - Stock Repurchase Program In August 2017, $25 six June 30, 2018, 14,506 $867,000.

Note 13 - Stock-based Compensat

Note 13 - Stock-based Compensation	6 Months Ended
	Jun. 30, 2018
Notes to Financial Statements
Disclosure of Compensation Related Costs, Share-based Payments [Text Block]	Note 1 3 – S tock – Based Compensation NHC recognizes stock–based compensation expense for all stock options granted over the requisite service period using the fair value at the date of grant using the Black–Scholes pricing model. Stock–based compensation totaled $749,000 $740,000 three June 30, 2018 2017, $1,177,000 $832,000 six June 30, 2018 2017, At June 30, 2018, $6,329,000 four Stock Options The following table summarizes the significant assumptions used to value the options granted for the six June 30, 2018 December 31, 2017. 2018 2017 Risk–free interest rate 2.46 % 2.08 % Expected volatility 16.1 % 16.6 % Expected life, in years 3.0 4.8 Expected dividend yield 3.29 % 3.10 % The following table summarizes our outstanding stock options for the six June 30, 2018 December 31, 2017. Number of Shares Weighted Average Exercise Price Aggregate Intrinsic Value Options outstanding at January 1, 2017 177,959 $ 55.48 $ – Options granted 1,125,443 72.96 – Options exercised (48,995 ) 51.25 – Options cancelled (15,000 ) 72.94 – Options outstanding at December 31, 2017 1,239,407 71.19 – Options granted 111,240 61.40 – Options exercised (33,526 ) 51.25 – Options cancelled (20,000 ) 72.94 – Options outstanding at June 30, 2018 1,297,121 $ 70.84 $ 2,167,000 Options vested at June 30, 2018 210,881 $ 63.35 $ 1,613,000 Options Outstanding June 30, 2018 Exercise Prices Weighted Average Exercise Price Weighted Average Remaining Contractual Life in Years 218,846 $52.93 - $62.78 $ 59.77 2.9 1,078,275 $72.94 72.94 3.7 1,297,121 $ 70.84 3.6

Note 14 - Income Taxes

Note 14 - Income Taxes	6 Months Ended
	Jun. 30, 2018
Notes to Financial Statements
Income Tax Disclosure [Text Block]	Note 1 4 – Income Taxes The income tax provision for the three June 30, 2018 $7,892,000 26.1% three June 30, 2017 $6,758,000 39.0% three June 30, 2017 $146,200 $84,000 $123,000 The income tax provision for the six June 30, 2018 $8,092,000 29.4% six June 30, 2018 $881,000 3.2% six six June 30, 2018 $3,069,000 2018, not six June 30, 2017 $14,757,000 38.9% six June 30, 2017 $321,000 $133,400 $244,000 On December 22, 2017, 2017 "2017 No. 118 118" 2017 December 31, 2017, $8,488,000, June 30, 2018. 2018. Interest and penalties expense related to U.S. federal and state income tax returns are included within income tax expense. The Company is no 2014

Note 15 - Contingencies and Com

Note 15 - Contingencies and Commitments	6 Months Ended
	Jun. 30, 2018
Notes to Financial Statements
Commitments and Contingencies Disclosure [Text Block]	Note 1 5 – 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 $94,808,000 $93,275,000 June 30, 2018 December 31, 2017, 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 customers. Policies are written for a duration of 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 June 30, 2018, 63 Insurance coverage for both periods includes both primary policies and excess policies. The primary coverage is in the amount of $1.0 $3.0 2017 2018, $9.0 third 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. June 30, 2018, not Caris HealthCare, L.P. Investigation and Related Litigation 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. No. 3:14–cv–212 On June 16, 2016, qui tam June 20, 2016, October 11, 2016, June 2013 December 2013 April 2010 June 2013. On March 9, 2018, 90 June 25, 2018, $8.5 April 1, 2010, December 31, 2013. June 28, 2018, Nutritional Support Services, L.P., Qui Tam Litigation On June 19, 2018, U.S. ex rel. McClain v. Nutritional Support Services, L.P., No. 6:17 2608 not April 16, 2018, 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.

Significant Accounting Policies

Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2018
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 operations. We assume that users of these interim condensed consolidated financial statements have read or have access to the audited December 31, 2017 may not 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.
New Accounting Pronouncements, Policy [Policy Text Block]	Recently Adopted Accounting Guidance In May 2014, No. 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, On January 1, 2018, No. 2014 09 No. 2014 09. not No. 2014 09 no three six June 30, 2017 January 1, 2018: Consolidated Statements of Operations ( in thousands Three Months Ended June 30, 2017 As Previously Reported Effect of Accounting Change As Adjusted Net patient revenues $ 227,847 $ (762 ) $ 227,085 Net operating revenues 239,457 (762 ) 238,695 Other operating expenses 62,856 (762 ) 62,094 Total costs and expenses 227,319 (762 ) 226,557 Net income $ 10,569 $ - $ 10,569 Six Months Ended June 30, 2017 As Previously Reported Effect of Accounting Change As Adjusted Net patient revenues $ 455,806 $ (1,467 ) $ 454,339 Net operating revenues 478,700 (1,467 ) 477,233 Other operating expenses 126,739 (1,467 ) 125,272 Total costs and expenses 450,698 (1,467 ) 449,231 Net income $ 23,202 $ - $ 23,202 In January 2016, No. 2016–01, 825 No. 2016–01 No. 2016–01 January 1, 2018, No. 2016 01 No. 2016 01 $68,073,000 three six June 30, 2018, $12,448,000 $3,069,000, No. 2016 01 In August 2016, No. 2016 15, No. 2016 15 eight 1 2 January 1, 2018, No. 2016 15 not In May 2017, No. 2017 09, 718 No. 2017 09 718. January 1, 2018, No. 2017 09 not In February 2018, No. 2018 02, No. 2018 02 2017 January 1, 2018, No. 2018 02. $128,000, Recent Accounting Guidance Not In February 2016, No. 2016 02, 842 December 15, 2018, In June 2016, No. 2016 13, No. 2016 13 December 15, 2019, December 15, 2018.
Segment Reporting, Policy [Policy Text Block]	Segment Reporting In accordance with the provisions of ASC 280, two 1 2 6
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, excluding stock-based compensation, which were $6,573,000 $13,250,000 three six June 30, 2018, $6,390,000 $15,262,000 three six June 30, 2017,
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 not 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 June 30, 2018, 63 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 may 10% 90% 40% Non-refundable fees are included as a component of the transaction price and are amortized into revenue over the actuarially determined remaining life of the resident, which is the expected period of occupancy by the resident. We pay the refundable portion of our entry fees to residents when they relocate from our community and the apartment is re-occupied. Refundable entrance fees are not June 30, 2018 December 31, 2017 $8,668,000 $8,827,000,
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% not
Noncontrolling Interest, Policy [Policy Text Block]	Noncontrolling Interest The noncontrolling interest in a subsidiary is presented within total equity in the Company's interim condensed 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 operations. The Company’s earnings 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 not
Reclassification, Policy [Policy Text Block]	Prior Period Classifications Certain amounts in prior periods have been reclassified to conform with current period presentation.

Note 2 - Summary of Significa25

Note 2 - Summary of Significant Accounting Policies (Tables)	6 Months Ended
	Jun. 30, 2018
Notes Tables
Schedule of Prospective Adoption of New Accounting Pronouncements [Table Text Block]	Three Months Ended June 30, 2017 As Previously Reported Effect of Accounting Change As Adjusted Net patient revenues $ 227,847 $ (762 ) $ 227,085 Net operating revenues 239,457 (762 ) 238,695 Other operating expenses 62,856 (762 ) 62,094 Total costs and expenses 227,319 (762 ) 226,557 Net income $ 10,569 $ - $ 10,569 Six Months Ended June 30, 2017 As Previously Reported Effect of Accounting Change As Adjusted Net patient revenues $ 455,806 $ (1,467 ) $ 454,339 Net operating revenues 478,700 (1,467 ) 477,233 Other operating expenses 126,739 (1,467 ) 125,272 Total costs and expenses 450,698 (1,467 ) 449,231 Net income $ 23,202 $ - $ 23,202

Note 3 - Net Patient Revenues (

Note 3 - Net Patient Revenues (Tables)	6 Months Ended
	Jun. 30, 2018
Notes Tables
Disaggregation of Revenue [Table Text Block]	Three Months Ended June 30 Six Months Ended June 30 (in thousands) 2018 2017 2018 2017 Net patient revenues: Inpatient services $ 215,617 $ 211,057 $ 431,968 $ 422,497 Homecare 15,037 16,028 30,378 31,842 Total net patient revenue $ 230,654 $ 227,085 $ 462,346 $ 454,339 Three Months Ended June 30 Six Months Ended June 30 Source 2018 2017 2018 2017 Medicare 35 % 35 % 36 % 35 % Managed Care 12 % 13 % 12 % 13 % Medicaid 26 % 26 % 26 % 26 % Private Pay and Other 27 % 26 % 26 % 26 % Total 100 % 100 % 100 % 100 %

Note 4 - Other Revenues (Tables

Note 4 - Other Revenues (Tables)	6 Months Ended
	Jun. 30, 2018
Notes Tables
Schedule of Other Revenues [Table Text Block]	Three Months Ended June 30 Six Months Ended June 30 (in thousands) 2018 2017 2018 2017 Rental income $ 5,553 $ 5,515 $ 11,086 $ 11,001 Management and accounting services fees 3,738 3,752 7,446 7,611 Insurance services 1,955 2,087 3,646 3,644 Other 242 256 579 638 Total other revenues $ 11,488 $ 11,610 $ 22,757 $ 22,894

Note 5 - Non-operating Income (

Note 5 - Non-operating Income (Tables)	6 Months Ended
	Jun. 30, 2018
Notes Tables
Schedule of Other Nonoperating Income, by Component [Table Text Block]	Three Months Ended June 30 Six Months Ended June 30 (in thousands) 2018 2017 2018 2017 Equity in earnings (losses) of unconsolidated investments $ 2,001 $ 1,854 $ (4,584 ) $ 3,380 Dividends and net realized gains on sales of securities 1,795 1,899 3,597 3,623 Interest income 1,858 1,436 3,576 2,954 Total non-operating income $ 5,654 $ 5,189 $ 2,589 $ 9,957

Note 6 - Business Segments (Tab

Note 6 - Business Segments (Tables)	6 Months Ended
	Jun. 30, 2018
Notes Tables
Schedule of Segment Reporting Information, by Segment [Table Text Block]	Three Months Ended June 30, 2018 Inpatient Services Homecare All Other Total Revenues: Net patient revenues $ 215,617 $ 15,037 $ - $ 230,654 Other revenues 181 - 11,307 11,488 Net operating revenues 215,798 15,037 11,307 242,142 Costs and expenses: Salaries, wages and benefits 128,115 8,611 8,740 145,466 Other operating 56,069 4,740 1,780 62,589 Rent 8,267 485 1,520 10,272 Depreciation and amortization 9,571 44 782 10,397 Interest 383 - 870 1,253 Total costs and expenses 202,405 13,880 13,692 229,977 Income (loss) from operations 13,393 1,157 (2,385 ) 12,165 Non-operating income - - 5,654 5,654 Unrealized gains on marketable equity securities - - 12,448 12,448 Income before income taxes $ 13,393 $ 1,157 $ 15,717 $ 30,267 Three Months Ended June 30, 2017 (As adjusted) Inpatient Services Homecare All Other Total Revenues: Net patient revenues $ 211,057 $ 16,028 $ - $ 227,085 Other revenues 225 - 11,385 11,610 Net operating revenues 211,282 16,028 11,385 238,695 Costs and expenses: Salaries, wages and benefits 125,614 8,615 8,455 142,684 Other operating 55,227 5,058 1,809 62,094 Rent 8,257 499 1,323 10,079 Depreciation and amortization 9,396 39 1,046 10,481 Interest 436 - 783 1,219 Total costs and expenses 198,930 14,211 13,416 226,557 Income (loss) from operations 12,352 1,817 (2,031 ) 12,138 Non-operating income - - 5,189 5,189 Income before income taxes $ 12,352 $ 1,817 $ 3,158 $ 17,327 Six Months Ended June 30, 2018 Inpatient Services Homecare All Other Total Revenues: Net patient revenues $ 431,968 $ 30,378 $ - $ 462,346 Other revenues 451 - 22,306 22,757 Net operating revenues 432,419 30,378 22,306 485,103 Costs and expenses: Salaries, wages and benefits 251,495 16,642 17,424 285,561 Other operating 113,904 10,019 3,838 127,761 Rent 16,524 973 3,004 20,501 Depreciation and amortization 19,032 82 1,625 20,739 Interest 780 - 1,713 2,493 Total costs and expenses 401,735 27,716 27,604 457,055 Income (loss) from operations 30,684 2,662 (5,298 ) 28,048 Non-operating income - - 2,589 2,589 Unrealized losses on marketable equity securities - - (3,069 ) (3,069 ) Income (loss) before income taxes $ 30,684 $ 2,662 $ (5,778 ) $ 27,568 Six Months Ended June 30, 2017 (As adjusted) Inpatient Services Homecare All Other Total Revenues: Net patient revenues $ 422,497 $ 31,842 $ - $ 454,339 Other revenues 451 - 22,443 22,894 Net operating revenues 422,948 31,842 22,443 477,233 Costs and expenses: Salaries, wages and benefits 245,238 16,442 19,059 280,739 Other operating 111,392 10,193 3,687 125,272 Rent 16,424 987 2,756 20,167 Depreciation and amortization 18,605 80 2,091 20,776 Interest 886 - 1,391 2,277 Total costs and expenses 392,545 27,702 28,984 449,231 Income (loss) from operations 30,403 4,140 (6,541 ) 28,002 Non-operating income - - 9,957 9,957 Income before income taxes $ 30,403 $ 4,140 $ 3,416 $ 37,959

Note 7 - Long-term Leases (Tabl

Note 7 - Long-term Leases (Tables)	6 Months Ended
	Jun. 30, 2018
Notes Tables
Schedule of Capital Leased Assets [Table Text Block]	June 30, 2018 December 31, 2017 (in thousands) Buildings and personal property $ 39,032 $ 39,032 Accumulated amortization (17,008 ) (15,045 ) $ 22,024 $ 23,987
Schedule of Future Minimum Lease Payments for Capital Leases [Table Text Block]	Operating Leases Capital Leases (in thousands) 2019 $ 34,200 $ 5,200 2020 34,200 5,200 2021 34,200 5,200 2022 34,200 5,200 2023 34,200 5,200 Thereafter 125,450 3,467 Total minimum lease payments $ 296,450 $ 29,467 Less: Amounts representing interest (4,539 ) Present value of minimum lease payments 24,928 Less: Current portion (3,808 ) Long-term capital lease obligations $ 21,120

Note 8 - Earnings Per Share (Ta

Note 8 - Earnings Per Share (Tables)	6 Months Ended
	Jun. 30, 2018
Notes Tables
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	Three Months Ended June 30 Six Months Ended June 30 2018 2017 2018 2017 Basic: Weighted average common shares outstanding 15,221,262 15,189,818 15,218,962 15,181,700 Net income attributable to National HealthCare Corporation $ 22,461 $ 10,655 $ 19,670 $ 23,383 Earnings per common share, basic $ 1.48 $ 0.70 $ 1.29 $ 1.54 Diluted: Weighted average common shares outstanding 15,221,262 15,189,818 15,218,962 15,181,700 Dilutive effect of stock options 7,043 30,630 5,996 34,636 Weighted average common shares outstanding 15,228,305 15,220,448 15,224,958 15,216,336 Net income attributable to National HealthCare Corporation $ 22,461 $ 10,655 $ 19,670 $ 23,383 Earnings per common share, diluted $ 1.47 $ 0.70 $ 1.29 $ 1.54

Note 9 - Investments in Marke32

Note 9 - Investments in Marketable Securities (Tables)	6 Months Ended
	Jun. 30, 2018
Notes Tables
Available-for-sale Securities [Table Text Block]	June 30, 2018 December 31, 2017 Amortized Cost Fair Value Amortized Cost Fair Value Non-restricted investments: Marketable equity securities $ 30,176 $ 136,016 $ 30,176 $ 139,085 Restricted investments: Corporate debt securities 68,796 66,949 65,107 65,461 Commercial mortgage–backed securities 54,802 53,586 54,030 53,544 U.S. Treasury securities 21,516 20,676 21,685 21,172 State and municipal securities 24,334 23,738 26,455 26,218 $ 199,624 $ 300,965 $ 197,453 $ 305,480
Schedule of Available-for-sale Securities Reconciliation [Table Text Block]	June 30, 2018 December 31, 2017 Shares Cost Fair Value Shares Cost Fair Value NHI Common Stock 1,630,642 $ 24,734 $ 120,146 1,630,642 $ 24,734 $ 122,918
Investments Classified by Contractual Maturity Date [Table Text Block]	June 30, 2018 December 31, 2017 Cost Fair Value Cost Fair Value Maturities: Within 1 year $ 18,660 $ 18,627 $ 18,492 $ 18,499 1 to 5 years 80,101 78,615 70,331 70,157 6 to 10 years 68,842 65,862 77,657 76,943 Over 10 years 1,845 1,845 797 796 $ 169,448 $ 164,949 $ 167,277 $ 166,395

Note 10 - Fair Value Measurem33

Note 10 - Fair Value Measurements (Tables)	6 Months Ended
	Jun. 30, 2018
Notes Tables
Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis [Table Text Block]	Fair Value Measurements Using June 30, 2018 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 $ 59,322 $ 59,322 $ – $ – Restricted cash and cash equivalents 9,549 9,549 – – Marketable equity securities 136,016 136,016 – – Corporate debt securities 66,949 43,803 23,146 – Mortgage–backed securities 53,586 – 53,586 – U.S. Treasury securities 20,676 20,676 – – State and municipal securities 23,738 – 23,738 – Total financial assets $ 369,836 $ 269,366 $ 100,470 $ – Fair Value Measurements Using December 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 $ 59,118 $ 59,118 $ – $ – Restricted cash and cash equivalents 8,303 8,303 – – Marketable equity securities 139,085 139,085 – – Corporate debt securities 65,461 43,073 22,388 – Mortgage-backed securities 53,544 – 53,544 – U.S. Treasury securities 21,172 21,172 – – State and municipal securities 26,218 – 26,218 – Total financial assets $ 372,901 $ 270,751 $ 102,150 $ –

Note 11 - Long-term Debt (Table

Note 11 - Long-term Debt (Tables)	6 Months Ended
	Jun. 30, 2018
Notes Tables
Schedule of Debt [Table Text Block]	Weighted Average Interest Rate Maturities June 30, 2018 December 31, 2017 Variable (dollars in thousands) Credit Facility, interest payable monthly 3.5% 2020 $ 75,000 $ 90,000 Unsecured term note payable to National, interest payable quarterly, principal payable at maturity 4.3% 2028 10,000 10,000 85,000 100,000 Less current portion – – $ 85,000 $ 100,000

Note 13 - Stock-based Compens35

Note 13 - Stock-based Compensation (Tables)	6 Months Ended
	Jun. 30, 2018
Notes Tables
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions [Table Text Block]	2018 2017 Risk–free interest rate 2.46 % 2.08 % Expected volatility 16.1 % 16.6 % Expected life, in years 3.0 4.8 Expected dividend yield 3.29 % 3.10 %
Share-based Compensation, Stock Options, Activity [Table Text Block]	Number of Shares Weighted Average Exercise Price Aggregate Intrinsic Value Options outstanding at January 1, 2017 177,959 $ 55.48 $ – Options granted 1,125,443 72.96 – Options exercised (48,995 ) 51.25 – Options cancelled (15,000 ) 72.94 – Options outstanding at December 31, 2017 1,239,407 71.19 – Options granted 111,240 61.40 – Options exercised (33,526 ) 51.25 – Options cancelled (20,000 ) 72.94 – Options outstanding at June 30, 2018 1,297,121 $ 70.84 $ 2,167,000 Options vested at June 30, 2018 210,881 $ 63.35 $ 1,613,000
Schedule of Share-based Compensation, Shares Authorized under Stock Option Plans, by Exercise Price Range [Table Text Block]	Options Outstanding June 30, 2018 Exercise Prices Weighted Average Exercise Price Weighted Average Remaining Contractual Life in Years 218,846 $52.93 - $62.78 $ 59.77 2.9 1,078,275 $72.94 72.94 3.7 1,297,121 $ 70.84 3.6

Note 1 - Description of Busin36

Note 1 - Description of Business (Details Textual)	Jun. 30, 2018
Number of Skilled Nursing Centers	76
Number of Beds	9,629
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 Significa37

Note 2 - Summary of Significant Accounting Policies (Details Textual)	3 Months Ended		6 Months Ended
	Jun. 30, 2018USD ($)	Jun. 30, 2017USD ($)	Jun. 30, 2018USD ($)	Jun. 30, 2017USD ($)	Mar. 31, 2018	Dec. 31, 2017USD ($)
Equity Securities, FV-NI, Unrealized Gain (Loss), Total	$ 12,448,000		$ (3,069,000)
Number of Reportable Segments			2
Malpractice Loss Contingency, Number of Claims	63		63		63
Customer Refundable Fees	$ 8,668,000		$ 8,668,000			$ 8,827,000
Continuing Care Retirement Communities, Refund Obligation	2,887,000		$ 2,887,000			2,887,000
Refundable Advance Fees [Member]
Nonrefundable Resident Entry Fee Percentage			10.00%
Customer Refundable Fees	8,668,000		$ 8,668,000			$ 8,827,000
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
Corporate Office Costs [Member]
General and Administrative Expense, Total	$ 6,573,000	$ 6,390,000	$ 13,250,000	$ 15,262,000
Accounting Standards Update 2016-01 [Member]
Reclassification of Net Unrealized Gains From AOCI To Retained Earnings			68,073,000
Accounting Standards Update 2018-02 [Member]
Reclassification of Stranded Tax Effects From AOCI to Retained Earnings			$ 128,000

Note 2 - Summary of Significa38

Note 2 - Summary of Significant Accounting Policies - Effect of Accounting Change (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Net operating revenues	$ 242,142	$ 238,695	$ 485,103	$ 477,233
Other operating expenses	62,589	62,094	127,761	125,272
Total costs and expenses	229,977	226,557	457,055	449,231
Net income	22,375	10,569	19,476	23,202
Previously Reported [Member]
Net operating revenues		239,457		478,700
Other operating expenses		62,856		126,739
Total costs and expenses		227,319		450,698
Net income		10,569		23,202
Restatement Adjustment [Member]
Net operating revenues		(762)		(1,467)
Other operating expenses		(762)		(1,467)
Total costs and expenses		(762)		(1,467)
Net income
Net Patient Revenues [Member]
Revenues	$ 230,654	227,085	$ 462,346	454,339
Net Patient Revenues [Member] | Previously Reported [Member]
Revenues		227,847		455,806
Net Patient Revenues [Member] | Restatement Adjustment [Member]
Revenues		$ (762)		$ (1,467)

Note 3 - Net Patient Revenues39

Note 3 - Net Patient Revenues (Details Textual) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017	Dec. 31, 2017
Provision for Doubtful Accounts	$ 1,064,000	$ 1,055,000	$ 2,023,000	$ 2,233,000
Medicare and Medicaid [Member]
Allowance for Doubtful Accounts Receivable, Ending Balance	$ 17,218,000		$ 17,218,000		$ 17,389,000

Note 3 - Net Patient Revenues -

Note 3 - Net Patient Revenues - Revenue Dissagregation (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Revenue, concentration percentage	100.00%	100.00%	100.00%	100.00%
Net Patient Revenues [Member]
Net patient revenues	$ 230,654	$ 227,085	$ 462,346	$ 454,339
Medicare [Member]
Revenue, concentration percentage	35.00%	35.00%	36.00%	35.00%
Inpatient Services [Member] | Net Patient Revenues [Member]
Net patient revenues	$ 215,617	$ 211,057	$ 431,968	$ 422,497
Managed Care [Member]
Revenue, concentration percentage	12.00%	13.00%	12.00%	13.00%
Homecare [Member] | Net Patient Revenues [Member]
Net patient revenues	$ 15,037	$ 16,028	$ 30,378	$ 31,842
Medicaid [Member]
Revenue, concentration percentage	26.00%	26.00%	26.00%	26.00%
Private Pay and Other [Member]
Revenue, concentration percentage	27.00%	26.00%	26.00%	26.00%

Note 4 - Other Revenues (Detail

Note 4 - Other Revenues (Details Textual)	3 Months Ended		6 Months Ended
	Jun. 30, 2018USD ($)	Jun. 30, 2017USD ($)	Jun. 30, 2018USD ($)	Jun. 30, 2017USD ($)
Number of Skilled Nursing Centers	76		76
Insurance Services Revenue, Total	$ 1,955,000	$ 2,087,000	$ 3,646,000	$ 3,644,000
Workers Compensation Revenue [Member]
Insurance Services Revenue, Total	1,282,000	1,409,000	2,300,000	2,688,000
Professional Liability Insurance [Member]
Insurance Services Revenue, Total	$ 673,000	678,000	$ 1,346,000	956,000
National [Member]
Number of Skilled Nursing Centers	5		5
Property Management Fee Revenue	$ 1,038,000	$ 989,000	$ 2,053,000	$ 1,925,000

Note 4 - Other Revenues - Summa

Note 4 - Other Revenues - Summary of Other Revenues (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Rental income	$ 5,553	$ 5,515	$ 11,086	$ 11,001
Management and accounting services fees	3,738	3,752	7,446	7,611
Insurance services	1,955	2,087	3,646	3,644
Other	242	256	579	638
Total other revenues	$ 11,488	$ 11,610	$ 22,757	$ 22,894

Note 5 - Non-operating Income43

Note 5 - Non-operating Income (Details Textual) - Caris [Member] - USD ($)	3 Months Ended	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2018	Mar. 31, 2018
Equity Method Investment, Ownership Percentage	75.10%	75.10%	75.10%
Loss Contingency, Damages Paid, Value	$ 136,000	$ 8,364,000

Note 5 - Non-operating Income -

Note 5 - Non-operating Income - Summary of Non-operating Income (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Equity in earnings (losses) of unconsolidated investments	$ 2,001	$ 1,854	$ (4,584)	$ 3,380
Dividends and net realized gains on sales of securities	1,795	1,899	3,597	3,623
Interest income	1,858	1,436	3,576	2,954
Total non-operating income	$ 5,654	$ 5,189	$ 2,589	$ 9,957

Note 6 - Business Segments (Det

Note 6 - Business Segments (Details Textual)	6 Months Ended
	Jun. 30, 2018
Number of Operating Segments	2
Number of Reportable Segments	2

Note 6 - Business Segments - Su

Note 6 - Business Segments - Summary of Financial Information by Reporting Segment (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Revenues:
Other revenues	$ 11,488,000	$ 11,610,000	$ 22,757,000	$ 22,894,000
Net operating revenues	242,142,000	238,695,000	485,103,000	477,233,000
Costs and expenses:
Salaries, wages and benefits	145,466,000	142,684,000	285,561,000	280,739,000
Other operating	62,589,000	62,094,000	127,761,000	125,272,000
Rent	10,272,000	10,079,000	20,501,000	20,167,000
Depreciation and amortization	10,397,000	10,481,000	20,739,000	20,776,000
Interest	1,253,000	1,219,000	2,493,000	2,277,000
Total costs and expenses	229,977,000	226,557,000	457,055,000	449,231,000
Income (loss) from operations	12,165,000	12,138,000	28,048,000	28,002,000
Non-operating income	5,654,000	5,189,000	2,589,000	9,957,000
Unrealized gains on marketable equity securities	12,448,000		(3,069,000)
Income before income taxes	30,267,000	17,327,000	27,568,000	37,959,000
Net Patient Revenues [Member]
Revenues:
Net patient revenues	230,654,000	227,085,000	462,346,000	454,339,000
Inpatient Services Segment [Member]
Revenues:
Other revenues	181,000	225,000	451,000	451,000
Net operating revenues	215,798,000	211,282,000	432,419,000	422,948,000
Costs and expenses:
Salaries, wages and benefits	128,115,000	125,614,000	251,495,000	245,238,000
Other operating	56,069,000	55,227,000	113,904,000	111,392,000
Rent	8,267,000	8,257,000	16,524,000	16,424,000
Depreciation and amortization	9,571,000	9,396,000	19,032,000	18,605,000
Interest	383,000	436,000	780,000	886,000
Total costs and expenses	202,405,000	198,930,000	401,735,000	392,545,000
Income (loss) from operations	13,393,000	12,352,000	30,684,000	30,403,000
Non-operating income
Unrealized gains on marketable equity securities
Income before income taxes	13,393,000	12,352,000	30,684,000	30,403,000
Inpatient Services Segment [Member] | Net Patient Revenues [Member]
Revenues:
Net patient revenues	215,617,000	211,057,000	431,968,000	422,497,000
Homecare Services Segment [Member]
Revenues:
Other revenues
Net operating revenues	15,037,000	16,028,000	30,378,000	31,842,000
Costs and expenses:
Salaries, wages and benefits	8,611,000	8,615,000	16,642,000	16,442,000
Other operating	4,740,000	5,058,000	10,019,000	10,193,000
Rent	485,000	499,000	973,000	987,000
Depreciation and amortization	44,000	39,000	82,000	80,000
Interest
Total costs and expenses	13,880,000	14,211,000	27,716,000	27,702,000
Income (loss) from operations	1,157,000	1,817,000	2,662,000	4,140,000
Non-operating income
Unrealized gains on marketable equity securities
Income before income taxes	1,157,000	1,817,000	2,662,000	4,140,000
Homecare Services Segment [Member] | Net Patient Revenues [Member]
Revenues:
Net patient revenues	15,037,000	16,028,000	30,378,000	31,842,000
Other Segments [Member]
Revenues:
Other revenues	11,307,000	11,385,000	22,306,000	22,443,000
Net operating revenues	11,307,000	11,385,000	22,306,000	22,443,000
Costs and expenses:
Salaries, wages and benefits	8,740,000	8,455,000	17,424,000	19,059,000
Other operating	1,780,000	1,809,000	3,838,000	3,687,000
Rent	1,520,000	1,323,000	3,004,000	2,756,000
Depreciation and amortization	782,000	1,046,000	1,625,000	2,091,000
Interest	870,000	783,000	1,713,000	1,391,000
Total costs and expenses	13,692,000	13,416,000	27,604,000	28,984,000
Income (loss) from operations	(2,385,000)	(2,031,000)	(5,298,000)	(6,541,000)
Non-operating income	5,654,000	5,189,000	2,589,000	9,957,000
Unrealized gains on marketable equity securities	12,448,000		(3,069,000)
Income before income taxes	15,717,000	3,158,000	(5,778,000)	3,416,000
Other Segments [Member] | Net Patient Revenues [Member]
Revenues:
Net patient revenues

Note 7 - Long-term Leases (Deta

Note 7 - Long-term Leases (Details Textual)	3 Months Ended		6 Months Ended
	Jun. 30, 2018USD ($)	Jun. 30, 2017USD ($)	Jun. 30, 2018USD ($)	Jun. 30, 2017USD ($)
Two Leases with NHI [Member]
Number of Skilled Nursing Centers Leased from NHI	35		35
Number of Assisted Living Centers Leased from NHI	7		7
Number of Independent Living Centers Leased from NHI	3		3
Number of Lease Agreements with NHI	2		2
Operating Leases, Rent Expense, Minimum Rentals			$ 34,200,000
Operating Lease Additional Percentage Rent Percentage			4.00%
Both NHI Lease Agreements [Member]
Operating Leases Percentage Rent Expense	$ 9,478,000	$ 9,314,000	$ 18,956,000	$ 18,628,000

Note 7 - Long-term Leases - Fix

Note 7 - Long-term Leases - Fixed Assets Recorded Under Capital Leases (Details) - Buildings and Personal Property [Member] - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Buildings and personal property	$ 39,032	$ 39,032
Accumulated amortization	(17,008)	(15,045)
Total capital leases	$ 22,024	$ 23,987

Note 7 - Long-term Leases - Fut

Note 7 - Long-term Leases - Future Minimum Lease Payments (Details) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
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
2023, operating leases	34,200
2023, capital leases	5,200
Thereafter, operating leases	125,450
Thereafter, capital leases	3,467
Total minimum lease payments, operating leases	296,450
Total minimum lease payments, capital leases	29,467
Less: Amounts representing interest, capital leases	(4,539)
Present value of minimum lease payments, capital leases	24,928
Less: Current portion, capital leases	(3,808)	$ (3,696)
Long-term capital lease obligations, capital leases	$ 21,120	$ 23,052

Note 8 - Earnings Per Share (De

Note 8 - Earnings Per Share (Details Textual) - shares	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017
Employee Stock Option [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	1,137,015	1,124,689

Note 8 - Earnings Per Share - S

Note 8 - 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		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Basic:
Weighted average common shares outstanding (in shares)	15,221,262	15,189,818	15,218,962	15,181,700
Net income attributable to National HealthCare Corporation	$ 22,461	$ 10,655	$ 19,670	$ 23,383
Earnings per common share, basic (in dollars per share)	$ 1.48	$ 0.70	$ 1.29	$ 1.54
Diluted:
Weighted average common shares outstanding (in shares)	15,221,262	15,189,818	15,218,962	15,181,700
Weighted average common shares outstanding (in shares)	15,228,305	15,220,448	15,224,958	15,216,336
Net income attributable to National HealthCare Corporation	$ 22,461	$ 10,655	$ 19,670	$ 23,383
Earnings per common share, diluted (in dollars per share)	$ 1.47	$ 0.70	$ 1.29	$ 1.54
Employee Stock Option [Member]
Diluted:
Dilutive effect of share-based awards (in shares)	7,043	30,630	5,996	34,636

Note 9 - Investments in Marke52

Note 9 - Investments in Marketable Securities (Details Textual) - USD ($)	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017	Dec. 31, 2017
Equity Securities Fv Ni Gross Unrealized Gain	$ 105,851,000		$ 105,851,000		$ 108,933,000
Equity Securities Fv Ni Gross Unrealized Loss	11,000		11,000		24,000
Equity Securities, FV-NI, Unrealized Gain (Loss), Total	12,448,000		(3,069,000)
Debt Securities, Available-for-sale, Accumulated Gross Unrealized Gain, before Tax	110,000		110,000		823,000
Debt Securities, Available-for-sale, Accumulated Gross Unrealized Loss, before Tax	$ 4,609,000		4,609,000		1,705,000
Other than Temporary Impairment Losses, Investments, Available-for-sale Securities, Total			0		$ 0
Proceeds from Sale of Debt Securities, Available-for-sale			4,399,000	44,756,000
Realized Investment Gains (Losses), Total			25,000	238,000
Proceeds from Sale and Maturity of Marketable Securities, Total			$ 0	$ 0

Note 9 - Investments in Marke53

Note 9 - Investments in Marketable Securities - Marketable Securities and Restricted Marketable Securities (Details) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Restricted investments available for sale, amortized cost	$ 169,448	$ 167,277
Restricted investments available for sale, fair value	164,949	166,395
Investments available for sale, amortized cost	199,624	197,453
Investments available for sale, fair value	300,965	305,480
Equity Securities [Member]
Unrestricted investments available for sale, amortized cost	30,176	30,176
Unrestricted investments available for sale, fair value	136,016	139,085
Corporate Debt Securities [Member]
Restricted investments available for sale, amortized cost	68,796	65,107
Restricted investments available for sale, fair value	66,949	65,461
Collateralized Mortgage Backed Securities [Member]
Restricted investments available for sale, amortized cost	54,802	54,030
Restricted investments available for sale, fair value	53,586	53,544
US Government Corporations and Agencies Securities [Member]
Restricted investments available for sale, amortized cost	21,516	21,685
Restricted investments available for sale, fair value	20,676	21,172
US States and Political Subdivisions Debt Securities [Member]
Restricted investments available for sale, amortized cost	24,334	26,455
Restricted investments available for sale, fair value	$ 23,738	$ 26,218

Note 9 - Investments in Marke54

Note 9 - Investments in Marketable Securities - Available for Sale Marketable Equity Securities (Details) - NHI Common Stock [Member] - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
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	$ 120,146	$ 122,918

Note 9 - Investments in Marke55

Note 9 - Investments in Marketable Securities - Amortized Cost and Estimated Fair Value of Debt Securities as Available for Sale (Details) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Within 1 year, cost	$ 18,660	$ 18,492
Within 1 year, fair value	18,627	18,499
1 to 5 years, cost	80,101	70,331
1 to 5 years, fair value	78,615	70,157
6 to 10 years, cost	68,842	77,657
6 to 10 years, fair value	65,862	76,943
Over 10 years, cost	1,845	797
Over 10 years, fair value	1,845	796
Cost	169,448	167,277
Fair Value	$ 164,949	$ 166,395

Note 10 - Fair Value Measurem56

Note 10 - Fair Value Measurements - Summary of Fair Value Measurements by Level (Details) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017	Jun. 30, 2017
Restricted cash and cash equivalents	$ 9,549		$ 5,748
Available-for-sale securities	164,949	$ 166,395
Corporate Debt Securities [Member]
Available-for-sale securities	66,949	65,461
Collateralized Mortgage Backed Securities [Member]
Available-for-sale securities	53,586	53,544
US States and Political Subdivisions Debt Securities [Member]
Available-for-sale securities	23,738	26,218
Fair Value, Measurements, Recurring [Member]
Cash and cash equivalents	59,322	59,118
Restricted cash and cash equivalents	9,549	8,303
Total financial assets	369,836	372,901
Fair Value, Measurements, Recurring [Member] | Equity Securities [Member]
Available-for-sale securities	136,016	139,085
Fair Value, Measurements, Recurring [Member] | Corporate Debt Securities [Member]
Available-for-sale securities	66,949	65,461
Fair Value, Measurements, Recurring [Member] | Collateralized Mortgage Backed Securities [Member]
Available-for-sale securities	53,586	53,544
Fair Value, Measurements, Recurring [Member] | US Treasury Securities [Member]
Available-for-sale securities	20,676	21,172
Fair Value, Measurements, Recurring [Member] | US States and Political Subdivisions Debt Securities [Member]
Available-for-sale securities	23,738	26,218
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member]
Cash and cash equivalents	59,322	59,118
Restricted cash and cash equivalents	9,549	8,303
Total financial assets	269,366	270,751
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | Equity Securities [Member]
Available-for-sale securities	136,016	139,085
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | Corporate Debt Securities [Member]
Available-for-sale securities	43,803	43,073
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | Collateralized 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	20,676	21,172
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	100,470	102,150
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	23,146	22,388
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | Collateralized Mortgage Backed Securities [Member]
Available-for-sale securities	53,586	53,544
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	$ 23,738	$ 26,218

Note 11 - Long-term Debt (Detai

Note 11 - Long-term Debt (Details Textual) - Bank of America [Member] - USD ($) $ in Millions	6 Months Ended
	Jun. 30, 2018	Mar. 31, 2018
Line of Credit Facility, Maximum Borrowing Capacity	$ 150	$ 175
Debt Instrument, Term	5 years
London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument, Basis Spread on Variable Rate	1.40%
Base Rate [Member]
Debt Instrument, Basis Spread on Variable Rate	0.40%

Note 11 - Long-term Debt - Summ

Note 11 - Long-term Debt - Summary of Long-term Debt (Details) - USD ($) $ in Millions	6 Months Ended
	Jun. 30, 2018	Dec. 31, 2017
Long-term debt	$ 85	$ 100
Less current portion
Long-term debt, noncurrent	$ 85	100
Line of Credit [Member]
Long-term debt, weighted average interest rate	3.50%
Long-term debt, maturities	2,020
Long-term debt	$ 75	90
Unsecured Term Note Payable [Member]
Long-term debt, weighted average interest rate	4.30%
Long-term debt, maturities	2,028
Long-term debt	$ 10	$ 10

Note 12 - Stock Repurchase Pr59

Note 12 - Stock Repurchase Program (Details Textual) - Common Stock [Member] - USD ($)	6 Months Ended
	Jun. 30, 2018	Aug. 31, 2017
Stock Repurchase Program, Authorized Amount		$ 25,000,000
Stock Repurchased and Retired During Period, Shares	14,506
Stock Repurchased and Retired During Period, Value	$ 867,000

Note 13 - Stock-based Compens60

Note 13 - Stock-based Compensation (Details Textual) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Allocated Share-based Compensation Expense, Total	$ 749,000	$ 740,000	$ 1,177,000	$ 832,000
Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized, Total	$ 6,329,000		$ 6,329,000
Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized, Period for Recognition			4 years

Note 13 - Stock-based Compens61

Note 13 - Stock-based Compensation - Summary of Assumptions Used to Value Options Granted (Details)	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017
Risk–free interest rate	2.46%	2.08%
Expected volatility	16.10%	16.60%
Expected life (Year)	3 years	4 years 292 days
Expected dividend yield	3.29%	3.10%

Note 13 - Stock-based Compens62

Note 13 - Stock-based Compensation - Summary of Options Outstanding (Details) - USD ($)	6 Months Ended	12 Months Ended
	Jun. 30, 2018	Dec. 31, 2017
Options outstanding, shares (in shares)	1,239,407	177,959
Options outstanding, weighted average exercise price (in dollars per share)	$ 71.19	$ 55.48
Options granted, shares (in shares)	111,240	1,125,443
Options granted, weighted average exercise price (in dollars per share)	$ 61.40	$ 72.96
Options exercised, shares (in shares)	(33,526)	(48,995)
Options exercised, weighted average exercise price (in dollars per share)	$ 51.25	$ 51.25
Options cancelled, shares (in shares)	(20,000)	(15,000)
Options cancelled, weighted average exercise price (in dollars per share)	$ 72.94	$ 72.94
Options outstanding, shares (in shares)	1,297,121	1,239,407
Options outstanding, weighted average exercise price (in dollars per share)	$ 70.84	$ 71.19
Options outstanding, aggregate intrinsic value	$ 2,167,000
Options vested, shares (in shares)	210,881
Options vested, weighted average exercise price (in dollars per share)	$ 63.35
Options vested, aggregate intrinsic value	$ 1,613,000

Note 13 - Stock-based Compens63

Note 13 - Stock-based Compensation - Options Outstanding by Exercise Price Range (Details)	6 Months Ended
	Jun. 30, 2018$ / sharesshares
Options outstanding (in shares) | shares	1,297,121
Weighted average exercise price (in dollars per share)	$ 70.84
Weighted average remaining contractual life in years (Year)	3 years 219 days
Exercise Price Range 1 [Member]
Options outstanding (in shares) | shares	218,846
Exercise price, lower range (in dollars per share)	$ 52.93
Exercise price, upper range (in dollars per share)	62.78
Weighted average exercise price (in dollars per share)	$ 59.77
Weighted average remaining contractual life in years (Year)	2 years 328 days
Exercise Price Range 2 [Member]
Options outstanding (in shares) | shares	1,078,275
Weighted average exercise price (in dollars per share)	$ 72.94
Weighted average remaining contractual life in years (Year)	3 years 255 days

Note 14 - Income Taxes (Details

Note 14 - Income Taxes (Details Textual) - USD ($)	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017	Dec. 31, 2017
Income Tax Expense (Benefit), Total	$ 7,892,000	$ 6,758,000	$ 8,092,000	$ 14,757,000
Effective Income Tax Rate Reconciliation, Percent, Total	26.10%	39.00%	29.40%	38.90%
Effective Income Tax Rate Reconciliation, Tax Contingency, Amount, Total		$ 146,200		$ 321,000
Effective Income Tax Rate Reconciliation, Nondeductible Expense, Amount, Total		84,000	$ 881,000	133,400
Effective Income Tax Rate Reconciliation, Exercise of Stock Options, Amount		123,000		244,000
Effective Income Tax Rate Reconciliation, Nondeductible Expense, Percent, Total			3.20%
Equity Securities, FV-NI, Unrealized Gain (Loss), Total	$ 12,448,000		$ (3,069,000)
Income Tax Expense (Benefit), Continuing Operations, Adjustment of Deferred Tax (Asset) Liability					$ (8,488,000)
Earliest Tax Year [Member]
Open Tax Year			2,014

Note 15 - Contingencies and C65

Note 15 - Contingencies and Commitments (Details Textual) - USD ($)	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Mar. 31, 2018	Dec. 31, 2017
Self Insurance Reserve	$ 94,808,000			$ 93,275,000
Direct Business Coverage Statutory Limits	$ 1,000,000
Malpractice Loss Contingency, Number of Claims	63		63
Primary Insurance Coverage, Amount Per Incident	$ 1,000,000
Primary Insurance Coverage, Amount Per Location	3,000,000
Annual Excess Coverage	9,000,000	$ 9,000,000
Qui Tam [Member] | Caris [Member]
Loss Contingency Accrual, Ending Balance	$ 8,500,000
Caris [Member]
Equity Method Investment, Ownership Percentage	75.10%		75.10%
Line of Credit [Member] | National Health Care [Member]
Line of Credit Facility, Maximum Borrowing Capacity	$ 2,000,000
Long-term Line of Credit, Total	$ 0