Document And Entity Information
Document And Entity Information - shares | 9 Months Ended | |
Sep. 30, 2019 | Nov. 01, 2019 | |
Document Information [Line Items] | ||
Entity Central Index Key | 0001047335 | |
Entity Registrant Name | NATIONAL HEALTHCARE CORP | |
Amendment Flag | false | |
Current Fiscal Year End Date | --12-31 | |
Document Fiscal Period Focus | Q3 | |
Document Fiscal Year Focus | 2019 | |
Document Type | 10-Q | |
Document Quarterly Report | true | |
Document Period End Date | Sep. 30, 2019 | |
Document Transition Report | false | |
Entity File Number | 001-13489 | |
Entity Incorporation, State or Country Code | DE | |
Entity Tax Identification Number | 52-2057472 | |
Entity Address, Address Line One | 100 E. Vine Street | |
Entity Address, City or Town | Murfreesboro | |
Entity Address, State or Province | TN | |
Entity Address, Postal Zip Code | 37130 | |
City Area Code | 615 | |
Local Phone Number | 890–2020 | |
Entity Current Reporting Status | Yes | |
Entity Interactive Data Current | Yes | |
Entity Filer Category | Large Accelerated Filer | |
Entity Small Business | false | |
Entity Emerging Growth Company | false | |
Entity Shell Company | false | |
Entity Common Stock, Shares Outstanding | 15,318,890 | |
Title of 12(b) Security | Common, $0.01 par value | |
Trading Symbol | NHC | |
Security Exchange Name | NYSEAMER |
Interim Condensed Consolidated
Interim Condensed Consolidated Statements of Operations (Unaudited) - USD ($) | 3 Months Ended | 9 Months Ended | ||||||
Sep. 30, 2019 | Jun. 30, 2019 | Mar. 31, 2019 | Sep. 30, 2018 | Jun. 30, 2018 | Mar. 31, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Revenues: | ||||||||
Net patient revenues | $ 235,090,000 | $ 234,827,000 | $ 706,465,000 | $ 697,173,000 | ||||
Other revenues | 11,977,000 | 11,499,000 | 36,038,000 | 34,256,000 | ||||
Net operating revenues | 247,067,000 | 246,326,000 | 742,503,000 | 731,429,000 | ||||
Costs and expenses: | ||||||||
Salaries, wages and benefits | 152,175,000 | 149,188,000 | 441,441,000 | 434,749,000 | ||||
Other operating | 66,730,000 | 64,507,000 | 203,760,000 | 192,268,000 | ||||
Facility rent | 10,167,000 | 10,190,000 | 30,602,000 | 30,691,000 | ||||
Depreciation and amortization | 10,663,000 | 10,437,000 | 31,515,000 | 31,176,000 | ||||
Interest | 764,000 | 1,170,000 | 2,644,000 | 3,663,000 | ||||
Total costs and expenses | 240,499,000 | 235,492,000 | 709,962,000 | 692,547,000 | ||||
Income from operations | 6,568,000 | 10,834,000 | 32,541,000 | 38,882,000 | ||||
Other income: | ||||||||
Non–operating income | 6,663,000 | 8,467,000 | 20,936,000 | 11,056,000 | ||||
Unrealized gains on marketable equity securities | 9,312,000 | 3,486,000 | 16,096,000 | 417,000 | ||||
Income before income taxes | 22,543,000 | 22,787,000 | 69,573,000 | 50,355,000 | ||||
Income tax provision | (3,167,000) | (1,700,000) | (15,284,000) | (9,792,000) | ||||
Net income | 19,376,000 | 21,087,000 | 54,289,000 | 40,563,000 | ||||
Net loss attributable to noncontrolling interest | 85,000 | $ 29,000 | $ 38,000 | 55,000 | $ 86,000 | $ 108,000 | 152,000 | 249,000 |
Net income attributable to National HealthCare Corporation | $ 19,461,000 | $ 13,711,000 | $ 21,269,000 | $ 21,142,000 | $ 22,461,000 | $ (2,791,000) | $ 54,441,000 | $ 40,812,000 |
Earnings per share attributable to National HealthCare Corporation stockholders: | ||||||||
Basic (in dollars per share) | $ 1.27 | $ 1.39 | $ 3.57 | $ 2.68 | ||||
Diluted (in dollars per share) | $ 1.27 | $ 1.39 | $ 3.55 | $ 2.68 | ||||
Basic (in shares) | 15,275,709 | 15,225,654 | 15,267,250 | 15,221,217 | ||||
Diluted (in shares) | 15,373,617 | 15,242,086 | 15,350,308 | 15,230,692 | ||||
Dividends declared per common share (in dollars per share) | $ 0.52 | $ 0.50 | $ 1.54 | $ 1.48 |
Interim Condensed Consolidate_2
Interim Condensed Consolidated Statements of Comprehensive Income (Unaudited) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Net income | $ 19,376 | $ 21,087 | $ 54,289 | $ 40,563 |
Other comprehensive income (loss): | ||||
Unrealized gains (losses) on investments in restricted marketable debt securities | 855 | (180) | 7,049 | (3,772) |
Reclassification adjustment for realized (gains) losses on sale of securities | (117) | 7 | (117) | (18) |
Income tax benefit (expense) related to items of other comprehensive income | (155) | 36 | (1,456) | 795 |
Other comprehensive income (loss), net of tax | 583 | (137) | 5,476 | (2,995) |
Net loss attributable to noncontrolling interest | 85 | 55 | 152 | 249 |
Comprehensive income attributable to National HealthCare Corporation | $ 20,044 | $ 21,005 | $ 59,917 | $ 37,817 |
Interim Condensed Consolidate_3
Interim Condensed Consolidated Balance Sheets (Current Period Unaudited) - USD ($) | Sep. 30, 2019 | Dec. 31, 2018 |
Current Assets: | ||
Cash and cash equivalents | $ 59,261,000 | $ 43,247,000 |
Restricted cash and cash equivalents, current portion | 7,114,000 | 9,967,000 |
Marketable equity securities | 156,319,000 | 140,223,000 |
Restricted marketable debt securities, current portion | 21,222,000 | 18,676,000 |
Accounts receivable | 92,040,000 | 97,274,000 |
Inventories | 7,774,000 | 7,470,000 |
Prepaid expenses and other assets | 3,674,000 | 3,863,000 |
Notes receivable, current portion | 1,456,000 | 1,289,000 |
Federal income tax receivable | 2,330,000 | 0 |
Total current assets | 351,190,000 | 322,009,000 |
Property and Equipment: | ||
Property and equipment, at cost | 1,010,629,000 | 979,088,000 |
Accumulated depreciation and amortization | (471,025,000) | (444,438,000) |
Net property and equipment | 539,604,000 | 534,650,000 |
Other Assets: | ||
Restricted cash and cash equivalents, less current portion | 1,707,000 | 1,706,000 |
Restricted marketable securities, less current portion | 128,335,000 | 153,917,000 |
Deposits and other assets | 5,636,000 | 5,602,000 |
Operating lease right-of-use assets | 208,785,000 | 0 |
Goodwill | 20,995,000 | 20,995,000 |
Notes receivable, less current portion | 13,992,000 | 9,707,000 |
Investments in unconsolidated companies | 36,987,000 | 32,362,000 |
Total other assets | 416,437,000 | 224,289,000 |
Total assets | 1,307,231,000 | 1,080,948,000 |
Current Liabilities: | ||
Trade accounts payable | 18,693,000 | 19,759,000 |
Finance lease obligations, current portion | 4,104,000 | 3,924,000 |
Operating lease liabilities, current portion | 23,988,000 | 0 |
Accrued payroll | 59,497,000 | 67,618,000 |
Amounts due to third party payors | 15,911,000 | 16,108,000 |
Accrued risk reserves, current portion | 28,335,000 | 28,643,000 |
Other current liabilities | 22,594,000 | 14,249,000 |
Dividends payable | 7,966,000 | 7,623,000 |
Total current liabilities | 181,088,000 | 157,924,000 |
Long-term debt | 30,000,000 | 55,000,000 |
Finance lease obligations, less current portion | 16,028,000 | 19,128,000 |
Operating lease liabilities, less current portion | 184,797,000 | 0 |
Accrued risk reserves, less current portion | 69,944,000 | 67,381,000 |
Refundable entrance fees | 7,394,000 | 8,078,000 |
Obligation to provide future services | 2,172,000 | 2,172,000 |
Deferred income taxes | 26,193,000 | 18,550,000 |
Other noncurrent liabilities | 13,765,000 | 15,204,000 |
Deferred revenue | 3,819,000 | 3,054,000 |
Total liabilities | 535,200,000 | 346,491,000 |
Equity: | ||
Common stock, $.01 par value; 45,000,000 shares authorized; 15,318,790 and 15,255,002 shares, respectively, issued and outstanding | 153,000 | 153,000 |
Capital in excess of par value | 221,394,000 | 219,435,000 |
Retained earnings | 547,292,000 | 516,435,000 |
Accumulated other comprehensive income (loss) | 2,731,000 | (2,745,000) |
Total National HealthCare Corporation stockholders’ equity | 771,570,000 | 733,278,000 |
Noncontrolling interest | 461,000 | 1,179,000 |
Total equity | 772,031,000 | 734,457,000 |
Total liabilities and equity | $ 1,307,231,000 | $ 1,080,948,000 |
Interim Condensed Consolidate_4
Interim Condensed Consolidated Balance Sheets (Current Period Unaudited) (Parentheticals) - $ / shares | Sep. 30, 2019 | Dec. 31, 2018 |
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) | 15,318,790 | 15,255,002 |
Common stock, shares outstanding (in shares) | 15,318,790 | 15,255,002 |
Interim Condensed Consolidate_5
Interim Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) | 9 Months Ended | |
Sep. 30, 2019 | Sep. 30, 2018 | |
Cash Flows From Operating Activities: | ||
Net income | $ 54,289,000 | $ 40,563,000 |
Adjustments to reconcile net income to net cash provided by operating activities: | ||
Depreciation and amortization | 31,515,000 | 31,176,000 |
Equity in (earnings) losses of unconsolidated investments | (7,548,000) | 1,860,000 |
Distributions from unconsolidated investments | 3,884,000 | 3,830,000 |
Unrealized gains on marketable equity securities | (16,096,000) | (417,000) |
Gains on sale of restricted marketable debt securities | (117,000) | (18,000) |
Gain on acquisition of equity method investment | (1,975,000) | (2,050,000) |
Deferred income taxes | (6,187,000) | (1,067,000) |
Stock–based compensation | 1,448,000 | 1,538,000 |
Changes in operating assets and liabilities: | ||
Accounts receivable | 5,234,000 | 613,000 |
Income tax receivable | (2,330,000) | 3,262,000 |
Inventories | (304,000) | (437,000) |
Prepaid expenses and other assets | 169,000 | (1,336,000) |
Trade accounts payable | (1,066,000) | 3,319,000 |
Accrued payroll | (8,121,000) | (8,615,000) |
Amounts due to third party payors | (197,000) | 207,000 |
Accrued risk reserves | 2,241,000 | 2,668,000 |
Other current liabilities | 8,345,000 | 262,000 |
Other noncurrent liabilities | (1,439,000) | (1,092,000) |
Deferred revenue | 765,000 | 666,000 |
Net cash provided by operating activities | 74,884,000 | 77,066,000 |
Cash Flows From Investing Activities: | ||
Additions to property and equipment | (19,670,000) | (22,708,000) |
Acquisition of equity method investment | (15,589,000) | (527,000) |
(Investments in)/distributions from unconsolidated investments | (197,000) | 376,000 |
Investments in notes receivable | (5,462,000) | 0 |
Collections of notes receivable | 1,010,000 | 1,180,000 |
Purchases of restricted marketable debt securities | (11,187,000) | (9,950,000) |
Sales of restricted marketable debt securities | 41,272,000 | 4,539,000 |
Net cash used in investing activities | (9,823,000) | (27,090,000) |
Cash Flows From Financing Activities: | ||
Principal payments on debt | (25,000,000) | (25,000,000) |
Principal payments under finance lease obligations | (2,920,000) | (2,751,000) |
Dividends paid to common stockholders | (23,240,000) | (22,214,000) |
Distributions attributable to noncontrolling interest | (566,000) | 0 |
Issuance of common shares | 1,383,000 | 1,327,000 |
Repurchase of common shares | (872,000) | (867,000) |
Entrance fee refunds | (684,000) | (159,000) |
Net cash used in financing activities | (51,899,000) | (49,664,000) |
Net Increase in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents | 13,162,000 | 312,000 |
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period | 54,920,000 | 67,421,000 |
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period | 68,082,000 | 67,733,000 |
Balance Sheet Classifications: | ||
Total Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents | $ 54,920,000 | $ 67,421,000 |
Interim Condensed Consolidate_6
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, 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 | 0 | 0 | (2,791) | 0 | 0 | (2,791) |
Net loss attributable to noncontrolling interest | 0 | 0 | 0 | 0 | (108) | (108) |
Other comprehensive income (loss) | 0 | 0 | 0 | (2,219) | 0 | (2,219) |
Stock–based compensation | $ 0 | 428 | 0 | 0 | 0 | 428 |
Shares sold – options exercised (in shares) | 21,906 | |||||
Shares sold – options exercised | $ 0 | 1,067 | 0 | 0 | 0 | 1,067 |
Repurchase of common shares (in shares) | (14,506) | |||||
Repurchase of common shares | $ 0 | (867) | 0 | 0 | 0 | (867) |
Dividends declared to common stockholders | $ 0 | 0 | (7,305) | 0 | 0 | (7,305) |
Balance (in shares) at Mar. 31, 2018 | 15,219,533 | |||||
Balance at Mar. 31, 2018 | $ 152 | 216,287 | 477,528 | (2,916) | 586 | 691,637 |
Reclassification due to new accounting standards at Dec. 31, 2017 | $ 0 | 0 | 68,201 | (68,201) | 0 | 0 |
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 | 40,812 | |||||
Net loss attributable to noncontrolling interest | (249) | |||||
Other comprehensive income (loss) | (2,995) | |||||
Balance (in shares) at Sep. 30, 2018 | 15,225,654 | |||||
Balance at Sep. 30, 2018 | $ 152 | 217,657 | 505,906 | (3,692) | 1,195 | 721,218 |
Reclassification due to new accounting standards at Dec. 31, 2017 | $ 0 | 0 | 68,201 | (68,201) | 0 | 0 |
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 |
Shares sold – options exercised (in shares) | 68,291 | |||||
Balance (in shares) at Dec. 31, 2018 | 15,255,002 | |||||
Balance at Dec. 31, 2018 | $ 153 | 219,435 | 516,435 | (2,745) | 1,179 | $ 734,457 |
Reclassification due to new accounting standards at Dec. 31, 2017 | $ 0 | 0 | 68,201 | (68,201) | 0 | 0 |
Balance (in shares) at Mar. 31, 2018 | 15,219,533 | |||||
Balance at Mar. 31, 2018 | $ 152 | 216,287 | 477,528 | (2,916) | 586 | 691,637 |
Net income attributable to National HealthCare Corporation | 0 | 0 | 22,461 | 0 | 0 | 22,461 |
Net loss attributable to noncontrolling interest | 0 | 0 | 0 | 0 | (86) | (86) |
Other comprehensive income (loss) | 0 | 0 | 0 | (639) | 0 | (639) |
Stock–based compensation | $ 0 | 749 | 0 | 0 | 0 | 749 |
Shares sold – options exercised (in shares) | 6,121 | |||||
Shares sold – options exercised | $ 0 | 260 | 0 | 0 | 0 | 260 |
Dividends declared to common stockholders | $ 0 | 0 | (7,612) | 0 | 0 | (7,612) |
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 |
Net income attributable to National HealthCare Corporation | 0 | 0 | 21,142 | 0 | 0 | 21,142 |
Net loss attributable to noncontrolling interest | 0 | 0 | 0 | 0 | (55) | (55) |
Other comprehensive income (loss) | 0 | 0 | 0 | (137) | 0 | (137) |
Stock–based compensation | 0 | 361 | 0 | 0 | 0 | 361 |
Dividends declared to common stockholders | $ 0 | 0 | (7,613) | 0 | 0 | (7,613) |
Balance (in shares) at Sep. 30, 2018 | 15,225,654 | |||||
Balance at Sep. 30, 2018 | $ 152 | 217,657 | 505,906 | (3,692) | 1,195 | 721,218 |
Equity contributed by noncontrolling interest | 750 | 750 | ||||
Balance (in shares) at Dec. 31, 2018 | 15,255,002 | |||||
Balance at Dec. 31, 2018 | $ 153 | 219,435 | 516,435 | (2,745) | 1,179 | 734,457 |
Net income attributable to National HealthCare Corporation | 0 | 0 | 21,269 | 0 | 0 | 21,269 |
Net loss attributable to noncontrolling interest | 0 | 0 | 0 | 0 | (38) | (38) |
Other comprehensive income (loss) | 0 | 0 | 0 | 2,548 | 0 | 2,548 |
Stock–based compensation | $ 0 | 424 | 0 | 0 | 0 | 424 |
Shares sold – options exercised (in shares) | 59,384 | |||||
Shares sold – options exercised | $ 0 | 579 | 0 | 0 | 0 | 579 |
Repurchase of common shares (in shares) | (10,396) | |||||
Repurchase of common shares | $ 0 | (872) | 0 | 0 | 0 | (872) |
Dividends declared to common stockholders | $ 0 | 0 | (7,652) | 0 | 0 | (7,652) |
Balance (in shares) at Mar. 31, 2019 | 15,303,990 | |||||
Balance at Mar. 31, 2019 | $ 153 | 219,566 | 530,052 | (197) | 1,141 | 750,715 |
Balance (in shares) at Dec. 31, 2018 | 15,255,002 | |||||
Balance at Dec. 31, 2018 | $ 153 | 219,435 | 516,435 | (2,745) | 1,179 | 734,457 |
Net income attributable to National HealthCare Corporation | 54,441 | |||||
Net loss attributable to noncontrolling interest | (152) | |||||
Other comprehensive income (loss) | $ 5,476 | |||||
Shares sold – options exercised (in shares) | 332,852 | |||||
Balance (in shares) at Sep. 30, 2019 | 15,318,790 | |||||
Balance at Sep. 30, 2019 | $ 153 | 221,394 | 547,292 | 2,731 | 461 | $ 772,031 |
Balance (in shares) at Mar. 31, 2019 | 15,303,990 | |||||
Balance at Mar. 31, 2019 | $ 153 | 219,566 | 530,052 | (197) | 1,141 | 750,715 |
Net income attributable to National HealthCare Corporation | 0 | 0 | 13,711 | 0 | 0 | 13,711 |
Net loss attributable to noncontrolling interest | 0 | 0 | 0 | 0 | (29) | (29) |
Other comprehensive income (loss) | 0 | 0 | 0 | 2,345 | 0 | 2,345 |
Stock–based compensation | $ 0 | 684 | 0 | 0 | 0 | 684 |
Shares sold – options exercised (in shares) | 14,800 | |||||
Shares sold – options exercised | $ 0 | 804 | 0 | 0 | 0 | 804 |
Dividends declared to common stockholders | 0 | 0 | (7,966) | 0 | 0 | (7,966) |
Distributions attributable to noncontrolling interest | $ 0 | 0 | 0 | 0 | (17) | (17) |
Balance (in shares) at Jun. 30, 2019 | 15,318,790 | |||||
Balance at Jun. 30, 2019 | $ 153 | 221,054 | 535,797 | 2,148 | 1,095 | 760,247 |
Net income attributable to National HealthCare Corporation | 0 | 0 | 19,461 | 0 | 0 | 19,461 |
Net loss attributable to noncontrolling interest | 0 | 0 | 0 | 0 | (85) | (85) |
Other comprehensive income (loss) | 0 | 0 | 0 | 583 | 0 | 583 |
Stock–based compensation | 0 | 340 | 0 | 0 | 0 | 340 |
Dividends declared to common stockholders | 0 | 0 | (7,966) | 0 | 0 | (7,966) |
Distributions attributable to noncontrolling interest | $ 0 | 0 | 0 | 0 | (549) | (549) |
Balance (in shares) at Sep. 30, 2019 | 15,318,790 | |||||
Balance at Sep. 30, 2019 | $ 153 | $ 221,394 | $ 547,292 | $ 2,731 | $ 461 | $ 772,031 |
Interim Condensed Consolidate_7
Interim Condensed Consolidated Statements of Stockholders' Equity (Unaudited) (Parentheticals) - $ / shares | 3 Months Ended | |||||
Sep. 30, 2019 | Jun. 30, 2019 | Mar. 31, 2019 | Sep. 30, 2018 | Jun. 30, 2018 | Mar. 31, 2018 | |
Common Stock [Member] | ||||||
Dividends declared to common stockholders, per share (in dollars per share) | $ 0.52 | $ 0.52 | $ 0.50 | $ 0.50 | $ 0.50 | $ 0.48 |
Dividends declared to common stockholders, per share (in dollars per share) | $ 0.52 | $ 0.50 |
Note 1 - Description of Busines
Note 1 - Description of Business | 9 Months Ended |
Sep. 30, 2019 | |
Notes to Financial Statements | |
Organization, Consolidation and Presentation of Financial Statements Disclosure [Text Block] | Note 1 National HealthCare Corporation (“NHC” or the “Company”) is a leading provider of senior health care services. As of September 30, 2019, five one |
Note 2 - Summary of Significant
Note 2 - Summary of Significant Accounting Policies | 9 Months Ended |
Sep. 30, 2019 | |
Notes to Financial Statements | |
Significant Accounting Policies [Text Block] | Note 2 The listing below is not not December 31, 2018 December 31, 2018 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 that is attributable to NHC and the noncontrolling interest in its consolidated statements of operations. We assume that users of these interim financial statements have read or have access to the audited December 31, 2018 may not may Estimates and Assumptions The preparation of financial statements in conformity with U.S. GAAP 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 February 2016, No. 2016 02, 842 December 15, 2018, The Company adopted the standard as of January 1, 2019, not September 30, 2019, not On June 20, 2018, No. 2018 07, 718 No. 2018 07 January 1, 2019, No. 2018 07 not On August 28, 2018, No. 2018 13, 820 No. 2018 13 820. no 1 2 3 January 1, 2019, No. 2018 13 not not 3 Recent Accounting Guidance Not In June 2016, No. 2016 13, No. 2016 13 December 15, 2019, December 15, 2018. Net Patient Revenues and Accounts Receivable Net patient revenues are derived from services rendered to patients for skilled and intermediate nursing, rehabilitation therapy, assisted 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 recognizes revenue as its performance obligations are completed. Routine services are treated as a single performance obligation satisfied over time as services are rendered. These routine services represent a bundle of services that are not may not The Company determines the transaction price based on established billing rates reduced by contractual adjustments provided to third three nine September 30, 2019, three nine September 30, 2018, September 30, 2019, December 31, 2018, Other Revenues Other revenues include revenues from the provision of insurance services, management and accounting services to other long–term care providers, and rental income. Our insurance revenues consist of premiums that are generally paid in advance and then amortized into income over the policy period. We charge for management services based on a percentage of net revenues. We charge for accounting services based on a monthly fee or a fixed fee per bed of the healthcare facility under contract. We record other revenues as the performance obligations are satisfied based on the terms of our contractual arrangements. Segment Reporting In accordance with the provisions of ASC 280, two 1 one 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 $7,170,000 and $18,991,000 for the three nine September 30, 2019, three nine September 30, 2018, Property and Equipment Property and equipment are recorded at cost. Depreciation is provided by the straight-line method over the expected useful lives of the assets estimated as follows: buildings and improvements, 20-40 years and equipment and furniture, 3-15 years. Leasehold improvements are amortized over periods that do not Finance leases are recorded at cost. Finance leases are amortized in accordance with the provision codified within ASC Topic 842, 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. The Company has been, and continues to be, subject to claims and legal actions that arise in the ordinary course of business, including potential claims related to patient care and treatment. A significant increase in the number of these claims, or an increase in the amounts due as a result of these claims could have a material adverse effect on our consolidated financial position, results of operations and cash flows. It is also possible that future events could cause us to make significant adjustments or revisions to these reserve estimates and cause our reported net income to vary significantly from period to period. We 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 Non-refundable fees are included as a component of the transaction price and are amortized into revenue over the actuarily 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 September 30, 2019, December 31, 2018, 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 September 30, 2019, December 31, 2018, Other Noncurrent Liabilities Other noncurrent liabilities include reserves primarily related to various uncertain income tax positions. Deferred 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 variable interest entity (“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 |
Note 3 - Net Patient Revenues
Note 3 - Net Patient Revenues | 9 Months Ended |
Sep. 30, 2019 | |
Notes to Financial Statements | |
Revenue from Contract with Customer [Text Block] | Note 3 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 September 30 Nine Months Ended September 30 (in thousands) 2019 2018 2019 2018 Net patient revenues: Inpatient services $ 222,246 $ 220,099 $ 664,768 $ 652,066 Homecare 12,844 14,728 41,697 45,107 Total net patient revenue $ 235,090 $ 234,827 $ 706,465 $ 697,173 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 not no one 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 September 30 Nine Months Ended September 30 Source 2019 2018 2019 2018 Medicare 32 % 34 % 33 % 35 % Managed Care 12 % 12 % 12 % 12 % Medicaid 28 % 27 % 27 % 26 % Private Pay and Other 28 % 27 % 28 % 27 % Total 100 % 100 % 100 % 100 % 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 for each episode 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 center's 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 following 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. Settlements with third not no not September 30, 2019 December 31, 2018, |
Note 4 - Other Revenues
Note 4 - Other Revenues | 9 Months Ended |
Sep. 30, 2019 | |
Notes to Financial Statements | |
Other Revenues [Text Block] | Note 4 Other revenues are outlined in the table below. Revenues from insurance services include premiums for workers’ compensation and professional liability insurance policies that our wholly owned insurance subsidiaries have written for certain healthcare operators to which we provide management or accounting services. Revenues from management and accounting services include fees provided to manage and provide accounting services to other healthcare operators. Revenues from rental income include health care real estate properties owned by us and leased to third Three Months Ended September 30 Nine Months Ended September 30 (in thousands) 2019 2018 2019 2018 Rental income $ 5,678 $ 5,548 $ 16,963 $ 16,633 Management and accounting services fees 4,520 3,818 13,567 11,265 Insurance services 1,528 1,716 4,667 5,362 Other 251 417 841 996 Total other revenues $ 11,977 $ 11,499 $ 36,038 $ 34,256 Rental Income The Company leases real estate assets consisting of skilled nursing facilities and assisted living facilities to third four 7 The following table sets forth the undiscounted cash flows for future minimum lease payments receivable for leases in effect at September 30, 2019 ( in thousands 2020 $ 22,002 2021 22,774 2022 22,931 2023 22,774 2024 22,730 Thereafter 28,633 Total future minimum lease payments $ 141,844 Management Fees from National We manage five three nine September 30, 2019, three nine September 30, 2018, Insurance Services For workers’ compensation insurance services, the premium revenues reflected in the interim condensed consolidated statements of operations for the three nine September 30, 2019 three nine September 30, 2018, For professional liability insurance services, the premium revenues reflected in the interim condensed consolidated statements of operations for the three nine September 30, 2019 three nine September 30, 2018 |
Note 5 - Non-operating Income
Note 5 - Non-operating Income | 9 Months Ended |
Sep. 30, 2019 | |
Notes to Financial Statements | |
Other Nonoperating Income and Expense [Text Block] | Note 5 Non–operating income includes equity in earnings of unconsolidated investments, dividends and other realized gains and losses on sales of marketable securities, and interest income. Our most significant equity method investment is a 75.1% non–controlling ownership interest in Caris HealthCare L.P. (“Caris”), a business that specializes in hospice care services. For the nine September 30, 2018, first two Three Months Ended September 30 Nine Months Ended September 30 (in thousands) 2019 2018 2019 2018 Equity in earnings (losses) of unconsolidated investments $ 2,747 $ 2,724 $ 7,548 $ (1,860 ) Dividends and net realized gains on sales of securities 2,049 1,777 5,911 5,374 Interest income 1,867 1,916 5,502 5,492 Gain on acquisition of equity method investment - 2,050 1,975 2,050 Total non-operating income $ 6,663 $ 8,467 $ 20,936 $ 11,056 Gain on Acquisition of Equity Method Investments Effective June 1, 2019, 60 Upon acquiring the remaining ownership interest, the Company recorded and increased its previously held equity interest up to fair value as of the acquisition date. This remeasurement of our equity interest at fair value resulted in a gain of $1,975,000 during the second 2019. In July 2018, 14 third 2018. |
Note 6 - Business Segments
Note 6 - Business Segments | 9 Months Ended |
Sep. 30, 2019 | |
Notes to Financial Statements | |
Segment Reporting Disclosure [Text Block] | Note 6 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 September 30, 2019 Inpatient Services Homecare All Other Total Revenues: Net patient revenues $ 222,246 $ 12,844 $ - $ 235,090 Other revenues 199 - 11,778 11,977 Net operating revenues 222,445 12,844 11,778 247,067 Costs and expenses: Salaries, wages and benefits 133,949 8,630 9,596 152,175 Other operating 60,800 4,267 1,663 66,730 Rent 8,234 450 1,483 10,167 Depreciation and amortization 9,666 61 936 10,663 Interest 312 - 452 764 Total costs and expenses 212,961 13,408 14,130 240,499 Income (loss) from operations 9,484 (564 ) (2,352 ) 6,568 Non-operating income - - 6,663 6,663 Unrealized gains on marketable equity securities - - 9,312 9,312 Income (loss) before income taxes $ 9,484 $ (564 ) $ 13,623 $ 22,543 Three Months Ended September 30, 2018 Inpatient Services Homecare All Other Total Revenues: Net patient revenues $ 220,099 $ 14,728 $ - $ 234,827 Other revenues 136 - 11,363 11,499 Net operating revenues 220,235 14,728 11,363 246,326 Costs and expenses: Salaries, wages and benefits 131,418 8,367 9,403 149,188 Other operating 57,371 4,797 2,339 64,507 Rent 8,255 488 1,447 10,190 Depreciation and amortization 9,570 55 812 10,437 Interest 369 - 801 1,170 Total costs and expenses 206,983 13,707 14,802 235,492 Income (loss) from operations 13,252 1,021 (3,439 ) 10,834 Non-operating income - - 8,467 8,467 Unrealized gains on marketable equity securities - - 3,486 3,486 Income before income taxes $ 13,252 $ 1,021 $ 8,514 $ 22,787 Nine Months Ended September 30, 2019 Inpatient Services Homecare All Other Total Revenues: Net patient revenues $ 664,768 $ 41,697 $ - $ 706,465 Other revenues 672 - 35,366 36,038 Net operating revenues 665,440 41,697 35,366 742,503 Costs and expenses: Salaries, wages and benefits 390,770 25,136 25,535 441,441 Other operating 183,602 13,193 6,965 203,760 Rent 24,754 1,400 4,448 30,602 Depreciation and amortization 28,790 183 2,542 31,515 Interest 979 - 1,665 2,644 Total costs and expenses 628,895 39,912 41,155 709,962 Income (loss) from operations 36,545 1,785 (5,789 ) 32,541 Non-operating income - - 20,936 20,936 Unrealized gains on marketable equity securities - - 16,096 16,096 Income before income taxes $ 36,545 $ 1,785 $ 31,243 $ 69,573 Nine Months Ended September 30, 2018 Inpatient Services Homecare All Other Total Revenues: Net patient revenues $ 652,066 $ 45,107 $ - $ 697,173 Other revenues 588 - 33,668 34,256 Net operating revenues 652,654 45,107 33,668 731,429 Costs and expenses: Salaries, wages and benefits 382,913 25,009 26,827 434,749 Other operating 171,275 14,816 6,177 192,268 Rent 24,780 1,460 4,451 30,691 Depreciation and amortization 28,602 137 2,437 31,176 Interest 1,149 - 2,514 3,663 Total costs and expenses 608,719 41,422 42,406 692,547 Income (loss) from operations 43,935 3,685 (8,738 ) 38,882 Non-operating income - - 11,056 11,056 Unrealized gains on marketable equity securities - - 417 417 Income before income taxes $ 43,935 $ 3,685 $ 2,735 $ 50,355 |
Note 7 - Long-term Leases
Note 7 - Long-term Leases | 9 Months Ended |
Sep. 30, 2019 | |
Notes to Financial Statements | |
Leases of Lessee Disclosure [Text Block] | Note 7 The Company’s lease portfolio primarily consists of finance and operating real estate leases for certain skilled nursing facilities, assisted and independent living facilities, homecare offices, and pharmacy warehouses. The original terms of the leases typically range from two fiftee may not On January 1, 2019, one 12 not Operating lease right-of-use assets and liabilities are recorded at the present value of the lease payments over the lease term. The present values of the lease payments are discounted using the incremental borrowing rate associated with each lease. As most of our leases do not January 1, 2019. not Accounting Policy Elections The Company has elected the package of practical expedients offered in the transition guidance which allows management not not Operating Leases with NHI At September 30, 2019, seven three two first four third On January 1, 2007, 15–year three five December 2012, first three 2026. two 2007 In September 2013 second seven 2014 seven 13th Base rent expense under both NHI lease agreements totals $34,200,000 annually. Percentage rent under the leases is based on a quarterly calculation of revenue increases and is payable on a quarterly basis. Percentage rent expense under both leases was $965,000 and $928,000 for the three September 30, 2019 2018, nine September 30, 2019 2018, We have a right of first 180 Finance Leases Effective June 1, 2014, three three third ten two five 2014 Lease Classification At September 30, 2019, in thousands Right-of-Use Assets Balance Sheet Classification September 30, 2019 Finance lease assets Net property and equipment $ 17,143 Operating lease right-of-use assets Operating lease right-of-use assets 208,785 Total $ 225,928 Lease Liabilities Balance Sheet Classification September 30, 2019 Current: Finance lease liabilities Finance lease obligations, current portion $ 4,104 Operating lease liabilities Operating lease liabilities, current portion 23,988 Noncurrent: Finance lease liabilities Finance lease obligations, less current portion 16,028 Operating lease liabilities Operating lease liabilities, less current portion 184,797 Total $ 228,917 Weighted-average remaining lease terms and discount rates at September 30, 2019 Weighted-average remaining lease terms (in years) Finance 4.4 Operating 7.4 Weighted-average discount rate Finance 6.0 % Operating 6.0 % Lease Costs For the three nine September 30, 2019, (in thousands): Three Months Ended September 30, 2019 Nine Months Ended September 30, 2019 Finance lease costs: Depreciation of leased assets $ 962 $ 2,911 Interest of lease liabilities 319 1,001 Total finance lease costs 1,281 3,912 Operating lease costs: Operating lease costs 8,944 27,034 Variable lease costs 965 2,895 Short-term lease costs 258 673 Total operating lease costs 10,167 30,602 Total lease costs $ 11,448 $ 34,514 Minimum Lease Payments The following table summarizes the maturity of our finance and operating lease liabilities as of September 30, 2019 ( in thousands Finance Leases Operating Leases 2020 $ 5,200 $ 35,674 2021 5,200 35,326 2022 5,200 35,015 2023 5,200 34,489 2024 2,167 34,345 Thereafter - 82,711 Total minimum lease payments $ 22,967 $ 257,560 Less: amounts representing interest (2,835 ) (48,775 ) Present value of future minimum lease payments 20,132 208,785 Less: current portion (4,104 ) (23,988 ) Noncurrent lease liabilities $ 16,028 $ 184,797 Other Supplemental cash flow data for the nine September 30, 2019 (in thousands) Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 27,034 Operating cash flows for finance leases 1,001 Financing cash flows for finance leases 2,920 |
Note 8 - Earnings Per Share
Note 8 - Earnings Per Share | 9 Months Ended |
Sep. 30, 2019 | |
Notes to Financial Statements | |
Earnings Per Share [Text Block] | Note 8 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 September 30 Nine Months Ended September 30 2019 2018 2019 2018 Basic: Weighted average common shares outstanding 15,275,709 15,225,654 15,267,250 15,221,217 Net income attributable to National HealthCare Corporation $ 19,461 $ 21,142 $ 54,441 $ 40,812 Earnings per common share, basic $ 1.27 $ 1.39 $ 3.57 $ 2.68 Diluted: Weighted average common shares outstanding 15,275,709 15,225,654 15,267,250 15,221,217 Effects of dilutive instruments 97,908 16,432 83,058 9,475 Weighted average common shares outstanding 15,373,617 15,242,086 15,350,308 15,230,692 Net income attributable to National HealthCare Corporation $ 19,461 $ 21,142 $ 54,441 $ 40,812 Earnings per common share, diluted $ 1.27 $ 1.39 $ 3.55 $ 2.68 In the above table, options to purchase 1,048,275 shares of our common stock have been excluded for the nine September 30, 2018 |
Note 9 - Investments in Marketa
Note 9 - Investments in Marketable Securities | 9 Months Ended |
Sep. 30, 2019 | |
Notes to Financial Statements | |
Investments in Debt and Marketable Equity Securities (and Certain Trading Assets) Disclosure [Text Block] | Note 9 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 Marketable securities and restricted marketable securities consist of the following (in thousands) September 30, 2019 December 31, 2018 Amortized Cost Fair Value Amortized Cost Fair Value Investments available for sale: Marketable equity securities $ 30,176 $ 156,319 $ 30,176 $ 140,223 Restricted investments available for sale: Corporate debt securities 62,584 64,683 69,439 67,632 Asset-based securities 57,451 58,454 62,772 62,068 U.S. Treasury securities 13,088 13,211 22,038 21,457 State and municipal securities 12,976 13,209 21,818 21,436 $ 176,275 $ 305,876 $ 206,243 $ 312,816 Included in the marketable equity securities are the following (in thousands, except share amounts): September 30, 2019 December 31, 2018 Shares Cost Fair Value Shares Cost Fair Value NHI Common Stock 1,630,642 $ 24,734 $ 134,349 1,630,642 $ 24,734 $ 123,179 The amortized cost and estimated fair value of debt securities classified as available for sale, by contractual maturity, are as follows (in thousands) September 30, 2019 December 31, 2018 Cost Fair Value Cost Fair Value Maturities: Within 1 year $ 11,139 $ 11,153 $ 11,448 $ 11,401 1 to 5 years 90,140 92,120 98,487 97,430 6 to 10 years 44,820 46,284 64,932 62,527 Over 10 years - - 1,200 1,235 $ 146,099 $ 149,557 $ 176,067 $ 172,593 Gross unrealized gains related to marketable equity securities are $126,149,000 and $110,081,000 as of September 30, 2019 December 31, 2018, September 30, 2019 December 31, 2018, three nine September 30, 2019, three nine September 30, 2018, Gross unrealized gains related to available for sale debt securities are $3,568,000 and $335,000 as of September 30, 2019 December 31, 2018, September 30, 2019 December 31, 2018, For the marketable securities in gross unrealized loss positions, (a) it is more likely than not not nine September 30, 2019 December 31, 2018. Proceeds from the sale of available for sale debt securities during the nine September 30, 2019 2018 nine September 30, 2019 2018, nine September 30, 2019 2018, |
Note 10 - Fair Value Measuremen
Note 10 - Fair Value Measurements | 9 Months Ended |
Sep. 30, 2019 | |
Notes to Financial Statements | |
Fair Value Disclosures [Text Block] | Note 10 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 September 30, 2019 December 31, 2018 (in thousands) Fair Value Measurements Using September 30, 2019 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 $ 59,261 $ 59,261 $ – $ – Restricted cash and cash equivalents 8,821 8,821 – – Marketable equity securities 156,319 156,319 – – Corporate debt securities 64,683 48,941 15,742 – Mortgage–backed securities 58,454 – 58,454 – U.S. Treasury securities 13,211 13,211 – – State and municipal securities 13,209 – 13,209 – Total financial assets $ 373,958 $ 286,553 $ 87,405 $ – Fair Value Measurements Using December 31, 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 $ 43,247 $ 43,247 $ – $ – Restricted cash and cash equivalents 11,673 11,673 – – Marketable equity securities 140,223 140,223 – – Corporate debt securities 67,632 47,921 19,711 – Asset - backed securities 62,068 – 62,068 – U.S. Treasury securities 21,457 21,457 – – State and municipal securities 21,436 – 21,436 – Total financial assets $ 367,736 $ 264,521 $ 103,215 $ – |
Note 11 - Long-term Debt
Note 11 - Long-term Debt | 9 Months Ended |
Sep. 30, 2019 | |
Notes to Financial Statements | |
Debt Disclosure [Text Block] | Note 11 Long–term debt consists of the following: Weighted Average Interest Rate Maturity September 30, 2019 December 31, 2018 Variable (dollars in thousands) Credit facility, interest payable monthly 3.5% 2020 $ 30,000 $ 55,000 Less current portion – – Total long-term debt $ 30,000 $ 55,000 During the third 2019, October 2020. |
Note 12 - Stock Repurchase Prog
Note 12 - Stock Repurchase Program | 9 Months Ended |
Sep. 30, 2019 | |
Notes to Financial Statements | |
Treasury Stock [Text Block] | Note 12 In August 2019, August 31, 2018, |
Note 13 - Stock-based Compensat
Note 13 - Stock-based Compensation | 9 Months Ended |
Sep. 30, 2019 | |
Notes to Financial Statements | |
Share-based Payment Arrangement [Text Block] | Note 13 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 $340,000 and $361,000 for the three September 30, 2019 2018, nine September 30, 2019 2018, At September 30, 2019, three Stock Options The following table summarizes the significant assumptions used to value the options granted for the nine September 30, 2019 December 31, 2018. September 30, 2019 December 31, 2018 Risk–free interest rate 2.30% 2.46% Expected volatility 17.4% 16.1% Expected life, in years 2.3 3.0 Expected dividend yield 2.73% 3.29% The following table summarizes our outstanding stock options for the nine September 30, 2019 December 31, 2018. Number of Shares Weighted Average Exercise Price Aggregate Intrinsic Value Options outstanding at January 1, 2018 1,239,407 $ 71.19 $ – Options granted 110,265 61.39 – Options exercised (68,291 ) 54.31 – Options cancelled (118,000 ) 72.11 – Options outstanding at December 31, 2018 1,163,381 71.16 – Options granted 53,628 77.89 – Options exercised (332,852 ) 71.56 – Options cancelled (85,000 ) 72.94 -- Options outstanding at September 30, 2019 799,157 $ 71.25 $ 8,468,000 Options exercisable at September 30, 2019 209,029 $ 68.05 $ 2,885,000 Options Outstanding September 30, 2019 Exercise Prices Weighted Average Exercise Price Weighted Average Remaining Contractual Life in Years 144,968 60.73 - 62.78 61.81 2.3 654,189 72.94 - 77.92 73.35 2.6 799,157 71.25 2.5 |
Note 14 - Income Taxes
Note 14 - Income Taxes | 9 Months Ended |
Sep. 30, 2019 | |
Notes to Financial Statements | |
Income Tax Disclosure [Text Block] | Note 14 The income tax provision for the three September 30, 2019 three September 30, 3019 1 2 2018 three September 30, 2018 three September 30, 2018 1 2 3 2017 The income tax provision for the nine September 30, 2019 nine September 30, 2019 2018 nine September 30, 2018 nine September 30, 2018 nine nine September 30, 2018 1 2 3 2017 Interest and penalties expense related to U.S. federal and state income tax returns are included within income tax expense. The Company is no |
Note 15 - Contingencies and Com
Note 15 - Contingencies and Commitments | 9 Months Ended |
Sep. 30, 2019 | |
Notes to Financial Statements | |
Commitments and Contingencies Disclosure [Text Block] | Note 15 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 and 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 $98,279,000 and $96,024,000 at September 30, 2019 December 31, 2018, 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 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. The Company has been, and continues to be, subject to claims and legal actions that arise in the ordinary course of business, including potential claims related to patient care and treatment. The defense of these lawsuits may Insurance coverage for both periods includes both primary policies and excess policies. The primary coverage is in the amount of $1.0 million per incident, $3.0 million per location with an annual primary policy aggregate limit that is adjusted on an annual basis. For 2018 2019, third Financing Commitments In conjunction with our management contract with National, we have entered into a line of credit arrangement whereby we may September 30, 2019, no Nutritional Support Services, L.P., Qui Tam Litigation On June 19, 2018, 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 following 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) | 9 Months Ended |
Sep. 30, 2019 | |
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 that is attributable to NHC and the noncontrolling interest in its consolidated statements of operations. We assume that users of these interim financial statements have read or have access to the audited December 31, 2018 may not may |
Use of Estimates, Policy [Policy Text Block] | Estimates and Assumptions The preparation of financial statements in conformity with U.S. GAAP 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 February 2016, No. 2016 02, 842 December 15, 2018, The Company adopted the standard as of January 1, 2019, not September 30, 2019, not On June 20, 2018, No. 2018 07, 718 No. 2018 07 January 1, 2019, No. 2018 07 not On August 28, 2018, No. 2018 13, 820 No. 2018 13 820. no 1 2 3 January 1, 2019, No. 2018 13 not not 3 Recent Accounting Guidance Not In June 2016, No. 2016 13, No. 2016 13 December 15, 2019, December 15, 2018. |
Revenue [Policy Text Block] | Net Patient Revenues and Accounts Receivable Net patient revenues are derived from services rendered to patients for skilled and intermediate nursing, rehabilitation therapy, assisted 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 recognizes revenue as its performance obligations are completed. Routine services are treated as a single performance obligation satisfied over time as services are rendered. These routine services represent a bundle of services that are not may not The Company determines the transaction price based on established billing rates reduced by contractual adjustments provided to third three nine September 30, 2019, three nine September 30, 2018, September 30, 2019, December 31, 2018, |
Revenue Recognition for Alternative Revenue Programs, Policy [Policy Text Block] | Other Revenues Other revenues include revenues from the provision of insurance services, management and accounting services to other long–term care providers, and rental income. Our insurance revenues consist of premiums that are generally paid in advance and then amortized into income over the policy period. We charge for management services based on a percentage of net revenues. We charge for accounting services based on a monthly fee or a fixed fee per bed of the healthcare facility under contract. We record other revenues as the performance obligations are satisfied based on the terms of our contractual arrangements. |
Segment Reporting, Policy [Policy Text Block] | Segment Reporting In accordance with the provisions of ASC 280, two 1 one 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 $7,170,000 and $18,991,000 for the three nine September 30, 2019, three nine September 30, 2018, |
Property, Plant and Equipment, Policy [Policy Text Block] | Property and Equipment Property and equipment are recorded at cost. Depreciation is provided by the straight-line method over the expected useful lives of the assets estimated as follows: buildings and improvements, 20-40 years and equipment and furniture, 3-15 years. Leasehold improvements are amortized over periods that do not Finance leases are recorded at cost. Finance leases are amortized in accordance with the provision codified within ASC Topic 842, 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. The Company has been, and continues to be, subject to claims and legal actions that arise in the ordinary course of business, including potential claims related to patient care and treatment. A significant increase in the number of these claims, or an increase in the amounts due as a result of these claims could have a material adverse effect on our consolidated financial position, results of operations and cash flows. It is also possible that future events could cause us to make significant adjustments or revisions to these reserve estimates and cause our reported net income to vary significantly from period to period. We 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, Policy [Policy Text Block] | Continuing Care Contracts and Refundable Entrance Fee We have one may Non-refundable fees are included as a component of the transaction price and are amortized into revenue over the actuarily 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 September 30, 2019, December 31, 2018, 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 September 30, 2019, December 31, 2018, |
Other Noncurrent Liabilities [Policy Text Block] | Other Noncurrent Liabilities Other noncurrent liabilities include reserves primarily related to various uncertain income tax positions. |
Revenue from Contract with Customer [Policy Text Block] | Deferred 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 variable interest entity (“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 |
Note 3 - Net Patient Revenues (
Note 3 - Net Patient Revenues (Tables) | 9 Months Ended |
Sep. 30, 2019 | |
Notes Tables | |
Disaggregation of Revenue [Table Text Block] | Three Months Ended September 30 Nine Months Ended September 30 (in thousands) 2019 2018 2019 2018 Net patient revenues: Inpatient services $ 222,246 $ 220,099 $ 664,768 $ 652,066 Homecare 12,844 14,728 41,697 45,107 Total net patient revenue $ 235,090 $ 234,827 $ 706,465 $ 697,173 Three Months Ended September 30 Nine Months Ended September 30 Source 2019 2018 2019 2018 Medicare 32 % 34 % 33 % 35 % Managed Care 12 % 12 % 12 % 12 % Medicaid 28 % 27 % 27 % 26 % Private Pay and Other 28 % 27 % 28 % 27 % Total 100 % 100 % 100 % 100 % |
Note 4 - Other Revenues (Tables
Note 4 - Other Revenues (Tables) | 9 Months Ended |
Sep. 30, 2019 | |
Notes Tables | |
Schedule of Other Revenues [Table Text Block] | Three Months Ended September 30 Nine Months Ended September 30 (in thousands) 2019 2018 2019 2018 Rental income $ 5,678 $ 5,548 $ 16,963 $ 16,633 Management and accounting services fees 4,520 3,818 13,567 11,265 Insurance services 1,528 1,716 4,667 5,362 Other 251 417 841 996 Total other revenues $ 11,977 $ 11,499 $ 36,038 $ 34,256 |
Lessor, Operating Lease, Payments to be Received, Maturity [Table Text Block] | 2020 $ 22,002 2021 22,774 2022 22,931 2023 22,774 2024 22,730 Thereafter 28,633 Total future minimum lease payments $ 141,844 |
Note 5 - Non-operating Income (
Note 5 - Non-operating Income (Tables) | 9 Months Ended |
Sep. 30, 2019 | |
Notes Tables | |
Schedule of Other Nonoperating Income, by Component [Table Text Block] | Three Months Ended September 30 Nine Months Ended September 30 (in thousands) 2019 2018 2019 2018 Equity in earnings (losses) of unconsolidated investments $ 2,747 $ 2,724 $ 7,548 $ (1,860 ) Dividends and net realized gains on sales of securities 2,049 1,777 5,911 5,374 Interest income 1,867 1,916 5,502 5,492 Gain on acquisition of equity method investment - 2,050 1,975 2,050 Total non-operating income $ 6,663 $ 8,467 $ 20,936 $ 11,056 |
Note 6 - Business Segments (Tab
Note 6 - Business Segments (Tables) | 9 Months Ended |
Sep. 30, 2019 | |
Notes Tables | |
Schedule of Segment Reporting Information, by Segment [Table Text Block] | Three Months Ended September 30, 2019 Inpatient Services Homecare All Other Total Revenues: Net patient revenues $ 222,246 $ 12,844 $ - $ 235,090 Other revenues 199 - 11,778 11,977 Net operating revenues 222,445 12,844 11,778 247,067 Costs and expenses: Salaries, wages and benefits 133,949 8,630 9,596 152,175 Other operating 60,800 4,267 1,663 66,730 Rent 8,234 450 1,483 10,167 Depreciation and amortization 9,666 61 936 10,663 Interest 312 - 452 764 Total costs and expenses 212,961 13,408 14,130 240,499 Income (loss) from operations 9,484 (564 ) (2,352 ) 6,568 Non-operating income - - 6,663 6,663 Unrealized gains on marketable equity securities - - 9,312 9,312 Income (loss) before income taxes $ 9,484 $ (564 ) $ 13,623 $ 22,543 Three Months Ended September 30, 2018 Inpatient Services Homecare All Other Total Revenues: Net patient revenues $ 220,099 $ 14,728 $ - $ 234,827 Other revenues 136 - 11,363 11,499 Net operating revenues 220,235 14,728 11,363 246,326 Costs and expenses: Salaries, wages and benefits 131,418 8,367 9,403 149,188 Other operating 57,371 4,797 2,339 64,507 Rent 8,255 488 1,447 10,190 Depreciation and amortization 9,570 55 812 10,437 Interest 369 - 801 1,170 Total costs and expenses 206,983 13,707 14,802 235,492 Income (loss) from operations 13,252 1,021 (3,439 ) 10,834 Non-operating income - - 8,467 8,467 Unrealized gains on marketable equity securities - - 3,486 3,486 Income before income taxes $ 13,252 $ 1,021 $ 8,514 $ 22,787 Nine Months Ended September 30, 2019 Inpatient Services Homecare All Other Total Revenues: Net patient revenues $ 664,768 $ 41,697 $ - $ 706,465 Other revenues 672 - 35,366 36,038 Net operating revenues 665,440 41,697 35,366 742,503 Costs and expenses: Salaries, wages and benefits 390,770 25,136 25,535 441,441 Other operating 183,602 13,193 6,965 203,760 Rent 24,754 1,400 4,448 30,602 Depreciation and amortization 28,790 183 2,542 31,515 Interest 979 - 1,665 2,644 Total costs and expenses 628,895 39,912 41,155 709,962 Income (loss) from operations 36,545 1,785 (5,789 ) 32,541 Non-operating income - - 20,936 20,936 Unrealized gains on marketable equity securities - - 16,096 16,096 Income before income taxes $ 36,545 $ 1,785 $ 31,243 $ 69,573 Nine Months Ended September 30, 2018 Inpatient Services Homecare All Other Total Revenues: Net patient revenues $ 652,066 $ 45,107 $ - $ 697,173 Other revenues 588 - 33,668 34,256 Net operating revenues 652,654 45,107 33,668 731,429 Costs and expenses: Salaries, wages and benefits 382,913 25,009 26,827 434,749 Other operating 171,275 14,816 6,177 192,268 Rent 24,780 1,460 4,451 30,691 Depreciation and amortization 28,602 137 2,437 31,176 Interest 1,149 - 2,514 3,663 Total costs and expenses 608,719 41,422 42,406 692,547 Income (loss) from operations 43,935 3,685 (8,738 ) 38,882 Non-operating income - - 11,056 11,056 Unrealized gains on marketable equity securities - - 417 417 Income before income taxes $ 43,935 $ 3,685 $ 2,735 $ 50,355 |
Note 7 - Long-term Leases (Tabl
Note 7 - Long-term Leases (Tables) | 9 Months Ended |
Sep. 30, 2019 | |
Notes Tables | |
Lease, Balance Sheet Classification [Table Text Block] | Right-of-Use Assets Balance Sheet Classification September 30, 2019 Finance lease assets Net property and equipment $ 17,143 Operating lease right-of-use assets Operating lease right-of-use assets 208,785 Total $ 225,928 Lease Liabilities Balance Sheet Classification September 30, 2019 Current: Finance lease liabilities Finance lease obligations, current portion $ 4,104 Operating lease liabilities Operating lease liabilities, current portion 23,988 Noncurrent: Finance lease liabilities Finance lease obligations, less current portion 16,028 Operating lease liabilities Operating lease liabilities, less current portion 184,797 Total $ 228,917 |
Lease, Cost [Table Text Block] | Weighted-average remaining lease terms (in years) Finance 4.4 Operating 7.4 Weighted-average discount rate Finance 6.0 % Operating 6.0 % Three Months Ended September 30, 2019 Nine Months Ended September 30, 2019 Finance lease costs: Depreciation of leased assets $ 962 $ 2,911 Interest of lease liabilities 319 1,001 Total finance lease costs 1,281 3,912 Operating lease costs: Operating lease costs 8,944 27,034 Variable lease costs 965 2,895 Short-term lease costs 258 673 Total operating lease costs 10,167 30,602 Total lease costs $ 11,448 $ 34,514 |
Lessee, Lease, Liability, Maturity [Table Text Block] | Finance Leases Operating Leases 2020 $ 5,200 $ 35,674 2021 5,200 35,326 2022 5,200 35,015 2023 5,200 34,489 2024 2,167 34,345 Thereafter - 82,711 Total minimum lease payments $ 22,967 $ 257,560 Less: amounts representing interest (2,835 ) (48,775 ) Present value of future minimum lease payments 20,132 208,785 Less: current portion (4,104 ) (23,988 ) Noncurrent lease liabilities $ 16,028 $ 184,797 |
Lease, Cash Flow Information [Table Text Block] | Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 27,034 Operating cash flows for finance leases 1,001 Financing cash flows for finance leases 2,920 |
Note 8 - Earnings Per Share (Ta
Note 8 - Earnings Per Share (Tables) | 9 Months Ended |
Sep. 30, 2019 | |
Notes Tables | |
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block] | Three Months Ended September 30 Nine Months Ended September 30 2019 2018 2019 2018 Basic: Weighted average common shares outstanding 15,275,709 15,225,654 15,267,250 15,221,217 Net income attributable to National HealthCare Corporation $ 19,461 $ 21,142 $ 54,441 $ 40,812 Earnings per common share, basic $ 1.27 $ 1.39 $ 3.57 $ 2.68 Diluted: Weighted average common shares outstanding 15,275,709 15,225,654 15,267,250 15,221,217 Effects of dilutive instruments 97,908 16,432 83,058 9,475 Weighted average common shares outstanding 15,373,617 15,242,086 15,350,308 15,230,692 Net income attributable to National HealthCare Corporation $ 19,461 $ 21,142 $ 54,441 $ 40,812 Earnings per common share, diluted $ 1.27 $ 1.39 $ 3.55 $ 2.68 |
Note 9 - Investments in Marke_2
Note 9 - Investments in Marketable Securities (Tables) | 9 Months Ended |
Sep. 30, 2019 | |
Notes Tables | |
Available-for-sale Securities [Table Text Block] | September 30, 2019 December 31, 2018 Amortized Cost Fair Value Amortized Cost Fair Value Investments available for sale: Marketable equity securities $ 30,176 $ 156,319 $ 30,176 $ 140,223 Restricted investments available for sale: Corporate debt securities 62,584 64,683 69,439 67,632 Asset-based securities 57,451 58,454 62,772 62,068 U.S. Treasury securities 13,088 13,211 22,038 21,457 State and municipal securities 12,976 13,209 21,818 21,436 $ 176,275 $ 305,876 $ 206,243 $ 312,816 |
Schedule of Available-for-sale Securities Reconciliation [Table Text Block] | September 30, 2019 December 31, 2018 Shares Cost Fair Value Shares Cost Fair Value NHI Common Stock 1,630,642 $ 24,734 $ 134,349 1,630,642 $ 24,734 $ 123,179 |
Investments Classified by Contractual Maturity Date [Table Text Block] | September 30, 2019 December 31, 2018 Cost Fair Value Cost Fair Value Maturities: Within 1 year $ 11,139 $ 11,153 $ 11,448 $ 11,401 1 to 5 years 90,140 92,120 98,487 97,430 6 to 10 years 44,820 46,284 64,932 62,527 Over 10 years - - 1,200 1,235 $ 146,099 $ 149,557 $ 176,067 $ 172,593 |
Note 10 - Fair Value Measurem_2
Note 10 - Fair Value Measurements (Tables) | 9 Months Ended |
Sep. 30, 2019 | |
Notes Tables | |
Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis [Table Text Block] | Fair Value Measurements Using September 30, 2019 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 $ 59,261 $ 59,261 $ – $ – Restricted cash and cash equivalents 8,821 8,821 – – Marketable equity securities 156,319 156,319 – – Corporate debt securities 64,683 48,941 15,742 – Mortgage–backed securities 58,454 – 58,454 – U.S. Treasury securities 13,211 13,211 – – State and municipal securities 13,209 – 13,209 – Total financial assets $ 373,958 $ 286,553 $ 87,405 $ – Fair Value Measurements Using December 31, 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 $ 43,247 $ 43,247 $ – $ – Restricted cash and cash equivalents 11,673 11,673 – – Marketable equity securities 140,223 140,223 – – Corporate debt securities 67,632 47,921 19,711 – Asset - backed securities 62,068 – 62,068 – U.S. Treasury securities 21,457 21,457 – – State and municipal securities 21,436 – 21,436 – Total financial assets $ 367,736 $ 264,521 $ 103,215 $ – |
Note 11 - Long-term Debt (Table
Note 11 - Long-term Debt (Tables) | 9 Months Ended |
Sep. 30, 2019 | |
Notes Tables | |
Schedule of Debt [Table Text Block] | Weighted Average Interest Rate Maturity September 30, 2019 December 31, 2018 Variable (dollars in thousands) Credit facility, interest payable monthly 3.5% 2020 $ 30,000 $ 55,000 Less current portion – – Total long-term debt $ 30,000 $ 55,000 |
Note 13 - Stock-based Compens_2
Note 13 - Stock-based Compensation (Tables) | 9 Months Ended |
Sep. 30, 2019 | |
Notes Tables | |
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions [Table Text Block] | September 30, 2019 December 31, 2018 Risk–free interest rate 2.30% 2.46% Expected volatility 17.4% 16.1% Expected life, in years 2.3 3.0 Expected dividend yield 2.73% 3.29% |
Share-based Payment Arrangement, Option, Activity [Table Text Block] | Number of Shares Weighted Average Exercise Price Aggregate Intrinsic Value Options outstanding at January 1, 2018 1,239,407 $ 71.19 $ – Options granted 110,265 61.39 – Options exercised (68,291 ) 54.31 – Options cancelled (118,000 ) 72.11 – Options outstanding at December 31, 2018 1,163,381 71.16 – Options granted 53,628 77.89 – Options exercised (332,852 ) 71.56 – Options cancelled (85,000 ) 72.94 -- Options outstanding at September 30, 2019 799,157 $ 71.25 $ 8,468,000 Options exercisable at September 30, 2019 209,029 $ 68.05 $ 2,885,000 |
Share-based Payment Arrangement, Option, Exercise Price Range [Table Text Block] | Options Outstanding September 30, 2019 Exercise Prices Weighted Average Exercise Price Weighted Average Remaining Contractual Life in Years 144,968 60.73 - 62.78 61.81 2.3 654,189 72.94 - 77.92 73.35 2.6 799,157 71.25 2.5 |
Note 1 - Description of Busin_2
Note 1 - Description of Business (Details Textual) | Sep. 30, 2019 |
Number of Skilled Nursing Centers | 75 |
Number of Beds | 9,510 |
Number of Assisted Living Facilities | 26 |
Number of Independent Living Facilities | 5 |
Number of Geriatric Psychiatric Hospitals | 1 |
Number of Homecare Programs | 36 |
Number of States in which Entity Operates | 10 |
Note 2 - Summary of Significa_2
Note 2 - Summary of Significant Accounting Policies (Details Textual) | 3 Months Ended | 9 Months Ended | |||
Sep. 30, 2019USD ($) | Sep. 30, 2018USD ($) | Sep. 30, 2019USD ($) | Sep. 30, 2018USD ($) | Dec. 31, 2018USD ($) | |
Accounts Receivable, Credit Loss Expense (Reversal) | $ 827,000 | $ 1,098,000 | $ 2,866,000 | $ 3,121,000 | |
Accounts Receivable, Allowance for Credit Loss, Ending Balance | 5,727,000 | $ 5,727,000 | $ 4,610,000 | ||
Number of Reportable Segments | 2 | ||||
General and Administrative Expense, Total | 7,170,000 | $ 7,805,000 | $ 18,991,000 | $ 21,056,000 | |
Contract with Customer, Refund Liability, Total | 7,394,000 | 7,394,000 | 8,078,000 | ||
Continuing Care Retirement Communities, Refund Obligation | $ 2,172,000 | $ 2,172,000 | $ 2,172,000 | ||
Refundable Advance Fees [Member] | |||||
Nonrefundable Resident Entry Fee Percentage | 10.00% | ||||
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 |
Note 3 - Net Patient Revenues_2
Note 3 - Net Patient Revenues (Details Textual) - USD ($) | Sep. 30, 2019 | Dec. 31, 2018 |
Accounts Receivable, Allowance for Credit Loss, Ending Balance | $ 5,727,000 | $ 4,610,000 |
Medicare and Medicaid [Member] | ||
Accounts Receivable, Allowance for Credit Loss, Ending Balance | $ 15,911,000 | $ 16,108,000 |
Note 3 - Net Patient Revenues -
Note 3 - Net Patient Revenues - Revenue Disaggregation (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Net patient revenues | $ 235,090 | $ 234,827 | $ 706,465 | $ 697,173 |
Revenue, concentration percentage | 100.00% | 100.00% | 100.00% | 100.00% |
Medicare [Member] | ||||
Revenue, concentration percentage | 32.00% | 34.00% | 33.00% | 35.00% |
Inpatient Services [Member] | ||||
Net patient revenues | $ 222,246 | $ 220,099 | $ 664,768 | $ 652,066 |
Managed Care [Member] | ||||
Revenue, concentration percentage | 12.00% | 12.00% | 12.00% | 12.00% |
Homecare [Member] | ||||
Net patient revenues | $ 12,844 | $ 14,728 | $ 41,697 | $ 45,107 |
Medicaid [Member] | ||||
Revenue, concentration percentage | 28.00% | 27.00% | 27.00% | 26.00% |
Private Pay and Other [Member] | ||||
Revenue, concentration percentage | 28.00% | 27.00% | 28.00% | 27.00% |
Note 4 - Other Revenues (Detail
Note 4 - Other Revenues (Details Textual) | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2019USD ($) | Sep. 30, 2018USD ($) | Sep. 30, 2019USD ($) | Sep. 30, 2018USD ($) | |
Number of Assisted Living Facilities | 26 | 26 | ||
Number of Skilled Nursing Centers | 75 | 75 | ||
Insurance Services Revenue, Total | $ 1,528,000 | $ 1,716,000 | $ 4,667,000 | $ 5,362,000 |
Workers Compensation Revenue [Member] | ||||
Insurance Services Revenue, Total | 866,000 | 1,043,000 | 2,656,000 | 3,342,000 |
Professional Liability Insurance [Member] | ||||
Insurance Services Revenue, Total | $ 662,000 | 673,000 | $ 2,011,000 | 2,020,000 |
National [Member] | ||||
Number of Skilled Nursing Centers | 5 | 5 | ||
Property Management Fee Revenue | $ 1,543,000 | $ 1,087,000 | $ 4,748,000 | $ 3,140,000 |
Florida 1 [Member] | ||||
Number of Assisted Living Facilities | 4 | 4 |
Note 4 - Other Revenues - Summa
Note 4 - Other Revenues - Summary of Other Revenues (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Rental income | $ 5,678 | $ 5,548 | $ 16,963 | $ 16,633 |
Management and accounting services fees | 4,520 | 3,818 | 13,567 | 11,265 |
Insurance services | 1,528 | 1,716 | 4,667 | 5,362 |
Other | 251 | 417 | 841 | 996 |
Total other revenues | $ 11,977 | $ 11,499 | $ 36,038 | $ 34,256 |
Note 4 - Other Revenues - Minim
Note 4 - Other Revenues - Minimum Lease Payments Receivable (Details) $ in Thousands | Sep. 30, 2019USD ($) |
2020 | $ 22,002 |
2021 | 22,774 |
2022 | 22,931 |
2023 | 22,774 |
2024 | 22,730 |
Thereafter | 28,633 |
Total future minimum lease payments | $ 141,844 |
Note 5 - Non-operating Income_2
Note 5 - Non-operating Income (Details Textual) - USD ($) | 3 Months Ended | 9 Months Ended | |||
Sep. 30, 2019 | Jun. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Gain (Loss) on Acquisition of Equity Method Investment | $ 0 | $ 2,050,000 | $ 1,975,000 | $ 2,050,000 | |
Nonoperating Income (Expense) [Member] | |||||
Gain (Loss) on Acquisition of Equity Method Investment | $ 1,975,000 | $ 2,050,000 | |||
Caris [Member] | |||||
Equity Method Investment, Ownership Percentage | 75.10% | 75.10% | |||
Loss Contingency, Damages Paid, Value | $ 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 | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Equity in earnings (losses) of unconsolidated investments | $ 2,747 | $ 2,724 | $ 7,548 | $ (1,860) |
Dividends and net realized gains on sales of securities | 2,049 | 1,777 | 5,911 | 5,374 |
Interest income | 1,867 | 1,916 | 5,502 | 5,492 |
Gain on acquisition of equity method investment | 0 | 2,050 | 1,975 | 2,050 |
Total non-operating income | $ 6,663 | $ 8,467 | $ 20,936 | $ 11,056 |
Note 6 - Business Segments (Det
Note 6 - Business Segments (Details Textual) | 9 Months Ended |
Sep. 30, 2019 | |
Number of Operating Segments | 2 |
Note 6 - Business Segments - Su
Note 6 - Business Segments - Summary of Financial Information by Reporting Segment (Details) - USD ($) | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Revenues: | ||||
Net patient revenues | $ 235,090,000 | $ 234,827,000 | $ 706,465,000 | $ 697,173,000 |
Other revenues | 11,977,000 | 11,499,000 | 36,038,000 | 34,256,000 |
Net operating revenues | 247,067,000 | 246,326,000 | 742,503,000 | 731,429,000 |
Costs and expenses: | ||||
Salaries, wages and benefits | 152,175,000 | 149,188,000 | 441,441,000 | 434,749,000 |
Other operating | 66,730,000 | 64,507,000 | 203,760,000 | 192,268,000 |
Rent | 10,167,000 | 10,190,000 | 30,602,000 | 30,691,000 |
Depreciation and amortization | 10,663,000 | 10,437,000 | 31,515,000 | 31,176,000 |
Interest | 764,000 | 1,170,000 | 2,644,000 | 3,663,000 |
Total costs and expenses | 240,499,000 | 235,492,000 | 709,962,000 | 692,547,000 |
Income (loss) from operations | 6,568,000 | 10,834,000 | 32,541,000 | 38,882,000 |
Non-operating income (loss) | 6,663,000 | 8,467,000 | 20,936,000 | 11,056,000 |
Unrealized gains on marketable equity securities | 9,312,000 | 3,486,000 | 16,096,000 | 417,000 |
Income (loss) before income taxes | 22,543,000 | 22,787,000 | 69,573,000 | 50,355,000 |
Inpatient Services Segment [Member] | ||||
Revenues: | ||||
Net patient revenues | 222,246,000 | 220,099,000 | 664,768,000 | 652,066,000 |
Other revenues | 199,000 | 136,000 | 672,000 | 588,000 |
Net operating revenues | 222,445,000 | 220,235,000 | 665,440,000 | 652,654,000 |
Costs and expenses: | ||||
Salaries, wages and benefits | 133,949,000 | 131,418,000 | 390,770,000 | 382,913,000 |
Other operating | 60,800,000 | 57,371,000 | 183,602,000 | 171,275,000 |
Rent | 8,234,000 | 8,255,000 | 24,754,000 | 24,780,000 |
Depreciation and amortization | 9,666,000 | 9,570,000 | 28,790,000 | 28,602,000 |
Interest | 312,000 | 369,000 | 979,000 | 1,149,000 |
Total costs and expenses | 212,961,000 | 206,983,000 | 628,895,000 | 608,719,000 |
Income (loss) from operations | 9,484,000 | 13,252,000 | 36,545,000 | 43,935,000 |
Non-operating income (loss) | 0 | 0 | 0 | 0 |
Unrealized gains on marketable equity securities | 0 | 0 | 0 | 0 |
Income (loss) before income taxes | 9,484,000 | 13,252,000 | 36,545,000 | 43,935,000 |
Homecare Services Segment [Member] | ||||
Revenues: | ||||
Net patient revenues | 12,844,000 | 14,728,000 | 41,697,000 | 45,107,000 |
Other revenues | 0 | 0 | 0 | 0 |
Net operating revenues | 12,844,000 | 14,728,000 | 41,697,000 | 45,107,000 |
Costs and expenses: | ||||
Salaries, wages and benefits | 8,630,000 | 8,367,000 | 25,136,000 | 25,009,000 |
Other operating | 4,267,000 | 4,797,000 | 13,193,000 | 14,816,000 |
Rent | 450,000 | 488,000 | 1,400,000 | 1,460,000 |
Depreciation and amortization | 61,000 | 55,000 | 183,000 | 137,000 |
Interest | 0 | 0 | 0 | 0 |
Total costs and expenses | 13,408,000 | 13,707,000 | 39,912,000 | 41,422,000 |
Income (loss) from operations | (564,000) | 1,021,000 | 1,785,000 | 3,685,000 |
Non-operating income (loss) | 0 | 0 | 0 | 0 |
Unrealized gains on marketable equity securities | 0 | 0 | 0 | 0 |
Income (loss) before income taxes | (564,000) | 1,021,000 | 1,785,000 | 3,685,000 |
Other Segments [Member] | ||||
Revenues: | ||||
Net patient revenues | 0 | 0 | 0 | 0 |
Other revenues | 11,778,000 | 11,363,000 | 35,366,000 | 33,668,000 |
Net operating revenues | 11,778,000 | 11,363,000 | 35,366,000 | 33,668,000 |
Costs and expenses: | ||||
Salaries, wages and benefits | 9,596,000 | 9,403,000 | 25,535,000 | 26,827,000 |
Other operating | 1,663,000 | 2,339,000 | 6,965,000 | 6,177,000 |
Rent | 1,483,000 | 1,447,000 | 4,448,000 | 4,451,000 |
Depreciation and amortization | 936,000 | 812,000 | 2,542,000 | 2,437,000 |
Interest | 452,000 | 801,000 | 1,665,000 | 2,514,000 |
Total costs and expenses | 14,130,000 | 14,802,000 | 41,155,000 | 42,406,000 |
Income (loss) from operations | (2,352,000) | (3,439,000) | (5,789,000) | (8,738,000) |
Non-operating income (loss) | 6,663,000 | 8,467,000 | 20,936,000 | 11,056,000 |
Unrealized gains on marketable equity securities | 9,312,000 | 3,486,000 | 16,096,000 | 417,000 |
Income (loss) before income taxes | $ 13,623,000 | $ 8,514,000 | $ 31,243,000 | $ 2,735,000 |
Note 7 - Long-term Leases (Deta
Note 7 - Long-term Leases (Details Textual) | Jun. 01, 2014USD ($) | Mar. 01, 2014 | Jan. 01, 2007USD ($) | Sep. 30, 2013USD ($) | Sep. 30, 2019USD ($) | Sep. 30, 2018USD ($) | Sep. 30, 2019USD ($) | Sep. 30, 2018USD ($) |
Number of Skilled Nursing Centers | 75 | 75 | ||||||
Number of Facilities Under Capitalized Lease | 3 | |||||||
Number of Capitalized Lease Agreements | 3 | |||||||
Capital Leases, Future Minimum Payments, Net Minimum Payments, Total | $ 5,200,000 | |||||||
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 | ||||||
Lease One With NHI [Member] | ||||||||
Lessee, Operating Lease, Term of Contract | 15 years | |||||||
Number of Skilled Nursing Facilities Subleased | 4 | 4 | ||||||
Number of Additional Lease Options | 3 | |||||||
Term of Additional Lease Option | 5 years | |||||||
Operating Leases, Rent Expense, Minimum Rentals | $ 30,750,000 | |||||||
Operating Lease Additional Percentage Rent Percentage | 4.00% | |||||||
Lease Two with NHI [Member] | ||||||||
Lessee, Operating Lease, Term of Contract | 15 years | |||||||
Operating Leases, Rent Expense, Minimum Rentals | $ 3,450,000 | $ 34,200,000 | ||||||
Operating Lease Additional Percentage Rent Percentage | 4.00% | |||||||
Number of Skilled Nursing Centers | 7 | |||||||
Facility Purchase Price | $ 49,000,000 | |||||||
Both NHI Lease Agreements [Member] | ||||||||
Operating Leases Percentage Rent Expense | $ 965,000 | $ 928,000 | $ 2,895,000 | $ 2,784,000 | ||||
Capital Lease [Member] | ||||||||
Number of Additional Lease Options | 2 | |||||||
Term of Additional Lease Option | 5 years | |||||||
Initial Lease Term | 10 years | |||||||
Capital Lease Additional Percentage Rent Percentage | 4.00% | |||||||
Minimum [Member] | ||||||||
Lessee, Operating Lease, Term of Contract | 2 years | 2 years | ||||||
Maximum [Member] | ||||||||
Lessee, Operating Lease, Term of Contract | 15 years | 15 years |
Note 7 - Long-term Leases - Bal
Note 7 - Long-term Leases - Balance Sheet Classification (Details) - USD ($) $ in Thousands | Sep. 30, 2019 | Dec. 31, 2018 |
Finance lease assets | $ 17,143 | |
Operating lease right-of-use assets | 208,785 | $ 0 |
Total | 225,928 | |
Finance lease liabilities | 4,104 | 3,924 |
Operating lease liabilities | 23,988 | 0 |
Noncurrent lease liabilities, finance leases | 16,028 | 19,128 |
Noncurrent lease liabilities, operating leases | 184,797 | $ 0 |
Total | $ 228,917 |
Note 7 - Long-term Leases - Lea
Note 7 - Long-term Leases - Lease Information and Expense (Details) $ in Thousands | 3 Months Ended | 9 Months Ended |
Sep. 30, 2019USD ($) | Sep. 30, 2019USD ($) | |
Finance (Year) | 4 years 4 months 24 days | 4 years 4 months 24 days |
Operating (Year) | 7 years 4 months 24 days | 7 years 4 months 24 days |
Finance | 6.00% | 6.00% |
Operating | 6.00% | 6.00% |
Depreciation of leased assets | $ 962 | $ 2,911 |
Interest of lease liabilities | 319 | 1,001 |
Total finance lease costs | 1,281 | 3,912 |
Operating lease costs | 8,944 | 27,034 |
Variable lease costs | 965 | 2,895 |
Short-term lease costs | 258 | 673 |
Total operating lease costs | 10,167 | 30,602 |
Total lease costs | $ 11,448 | $ 34,514 |
Note 7 - Long-term Leases - Mat
Note 7 - Long-term Leases - Maturity of Lease Liabilities (Details) - USD ($) $ in Thousands | Sep. 30, 2019 | Dec. 31, 2018 |
2020, finance leases | $ 5,200 | |
2020, operating leases | 35,674 | |
2021, finance leases | 5,200 | |
2021, operating leases | 35,326 | |
2022, finance leases | 5,200 | |
2022, operating leases | 35,015 | |
2023, finance leases | 5,200 | |
2023, operating leases | 34,489 | |
2024, finance leases | 2,167 | |
2024, operating leases | 34,345 | |
Thereafter, finance leases | 0 | |
Thereafter, operating leases | 82,711 | |
Total minimum lease payments, finance leases | 22,967 | |
Total minimum lease payments, operating leases | 257,560 | |
Less: amounts representing interest, finance leases | (2,835) | |
Less: amounts representing interest, operating leases | (48,775) | |
Present value of future minimum lease payments, finance leases | 20,132 | |
Present value of future minimum lease payments, operating leases | 208,785 | |
Less: current portion, finance leases | (4,104) | $ (3,924) |
Less: current portion, operating leases | (23,988) | 0 |
Noncurrent lease liabilities, finance leases | 16,028 | 19,128 |
Noncurrent lease liabilities, operating leases | $ 184,797 | $ 0 |
Note 7 - Long-term Leases - Cas
Note 7 - Long-term Leases - Cash Flow Information (Details) - USD ($) $ in Thousands | 9 Months Ended | |
Sep. 30, 2019 | Sep. 30, 2018 | |
Operating cash flows for operating leases | $ 27,034 | |
Operating cash flows for finance leases | 1,001 | |
Financing cash flows for finance leases | $ 2,920 | $ 2,751 |
Note 8 - Earnings Per Share (De
Note 8 - Earnings Per Share (Details Textual) | 9 Months Ended |
Sep. 30, 2018shares | |
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount | 1,048,275 |
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 | 9 Months Ended | ||||||
Sep. 30, 2019 | Jun. 30, 2019 | Mar. 31, 2019 | Sep. 30, 2018 | Jun. 30, 2018 | Mar. 31, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Basic: | ||||||||
Weighted average common shares outstanding (in shares) | 15,275,709 | 15,225,654 | 15,267,250 | 15,221,217 | ||||
Net income attributable to National HealthCare Corporation | $ 19,461 | $ 13,711 | $ 21,269 | $ 21,142 | $ 22,461 | $ (2,791) | $ 54,441 | $ 40,812 |
Earnings per common share, basic (in dollars per share) | $ 1.27 | $ 1.39 | $ 3.57 | $ 2.68 | ||||
Diluted: | ||||||||
Weighted average common shares outstanding (in shares) | 15,275,709 | 15,225,654 | 15,267,250 | 15,221,217 | ||||
Effects of dilutive instruments (in shares) | 97,908 | 16,432 | 83,058 | 9,475 | ||||
Weighted average common shares outstanding (in shares) | 15,373,617 | 15,242,086 | 15,350,308 | 15,230,692 | ||||
Net income attributable to National HealthCare Corporation | $ 19,461 | $ 13,711 | $ 21,269 | $ 21,142 | $ 22,461 | $ (2,791) | $ 54,441 | $ 40,812 |
Earnings per common share, diluted (in dollars per share) | $ 1.27 | $ 1.39 | $ 3.55 | $ 2.68 |
Note 9 - Investments in Marke_3
Note 9 - Investments in Marketable Securities (Details Textual) - USD ($) | 3 Months Ended | 9 Months Ended | 12 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | Dec. 31, 2018 | |
Equity Securities Fv Ni Gross Unrealized Gain | $ 126,149,000 | $ 126,149,000 | $ 110,081,000 | ||
Equity Securities Fv Ni Gross Unrealized Loss | 6,000 | 6,000 | 34,000 | ||
Equity Securities, FV-NI, Unrealized Gain (Loss), Total | 9,312,000 | $ 3,486,000 | 16,096,000 | $ 417,000 | |
Debt Securities, Available-for-sale, Accumulated Gross Unrealized Gain, before Tax | 3,568,000 | 3,568,000 | 335,000 | ||
Debt Securities, Available-for-sale, Accumulated Gross Unrealized Loss, before Tax | $ 110,000 | 110,000 | 3,809,000 | ||
Other than Temporary Impairment Losses, Investments, Available-for-sale Securities, Total | 0 | $ 0 | |||
Proceeds from Sale of Debt Securities, Available-for-sale | 41,272,000 | 4,539,000 | |||
Realized Investment Gains (Losses), Total | 117,000 | 18,000 | |||
Proceeds from Sale and Maturity of Marketable Securities, Total | $ 0 | $ 0 |
Note 9 - Investments in Marke_4
Note 9 - Investments in Marketable Securities - Marketable Securities and Restricted Marketable Securities (Details) - USD ($) $ in Thousands | Sep. 30, 2019 | Dec. 31, 2018 |
Restricted investments available for sale, amortized cost | $ 146,099 | $ 176,067 |
Restricted investments available for sale, fair value | 149,557 | 172,593 |
Investments available for sale, amortized cost | 176,275 | 206,243 |
Investments available for sale, fair value | 305,876 | 312,816 |
Equity Securities [Member] | ||
Unrestricted investments available for sale, amortized cost | 30,176 | 30,176 |
Unrestricted investments available for sale, fair value | 156,319 | 140,223 |
Corporate Debt Securities [Member] | ||
Restricted investments available for sale, amortized cost | 62,584 | 69,439 |
Restricted investments available for sale, fair value | 64,683 | 67,632 |
Collateralized Mortgage Backed Securities [Member] | ||
Restricted investments available for sale, amortized cost | 57,451 | 62,772 |
Restricted investments available for sale, fair value | 58,454 | 62,068 |
US Government Corporations and Agencies Securities [Member] | ||
Restricted investments available for sale, amortized cost | 13,088 | 22,038 |
Restricted investments available for sale, fair value | 13,211 | 21,457 |
US States and Political Subdivisions Debt Securities [Member] | ||
Restricted investments available for sale, amortized cost | 12,976 | 21,818 |
Restricted investments available for sale, fair value | $ 13,209 | $ 21,436 |
Note 9 - Investments in Marke_5
Note 9 - Investments in Marketable Securities - Available for Sale Marketable Equity Securities (Details) - NHI Common Stock [Member] - USD ($) $ in Thousands | Sep. 30, 2019 | Dec. 31, 2018 |
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 | $ 134,349 | $ 123,179 |
Note 9 - Investments in Marke_6
Note 9 - Investments in Marketable Securities - Amortized Cost and Estimated Fair Value of Debt Securities as Available for Sale (Details) - USD ($) $ in Thousands | Sep. 30, 2019 | Dec. 31, 2018 |
Within 1 year, cost | $ 11,139 | $ 11,448 |
Within 1 year, fair value | 11,153 | 11,401 |
1 to 5 years, cost | 90,140 | 98,487 |
1 to 5 years, fair value | 92,120 | 97,430 |
6 to 10 years, cost | 44,820 | 64,932 |
6 to 10 years, fair value | 46,284 | 62,527 |
Over 10 years, cost | 0 | 1,200 |
Over 10 years, fair value | 0 | 1,235 |
Cost | 146,099 | 176,067 |
Fair Value | $ 149,557 | $ 172,593 |
Note 10 - Fair Value Measurem_3
Note 10 - Fair Value Measurements - Summary of Fair Value Measurements by Level (Details) - USD ($) $ in Thousands | Sep. 30, 2019 | Dec. 31, 2018 | Sep. 30, 2018 |
Restricted cash and cash equivalents | $ 8,821 | $ 12,134 | |
Available-for-sale securities | 149,557 | $ 172,593 | |
Corporate Debt Securities [Member] | |||
Available-for-sale securities | 64,683 | 67,632 | |
Collateralized Mortgage Backed Securities [Member] | |||
Available-for-sale securities | 58,454 | 62,068 | |
US States and Political Subdivisions Debt Securities [Member] | |||
Available-for-sale securities | 13,209 | 21,436 | |
Fair Value, Recurring [Member] | |||
Cash and cash equivalents | 59,261 | 43,247 | |
Restricted cash and cash equivalents | 8,821 | 11,673 | |
Total financial assets | 373,958 | 367,736 | |
Fair Value, Recurring [Member] | Equity Securities [Member] | |||
Available-for-sale securities | 156,319 | 140,223 | |
Fair Value, Recurring [Member] | Corporate Debt Securities [Member] | |||
Available-for-sale securities | 64,683 | 67,632 | |
Fair Value, Recurring [Member] | Collateralized Mortgage Backed Securities [Member] | |||
Available-for-sale securities | 58,454 | ||
Fair Value, Recurring [Member] | Asset-backed Securities [Member] | |||
Available-for-sale securities | 62,068 | ||
Fair Value, Recurring [Member] | US Treasury Securities [Member] | |||
Available-for-sale securities | 13,211 | 21,457 | |
Fair Value, Recurring [Member] | US States and Political Subdivisions Debt Securities [Member] | |||
Available-for-sale securities | 13,209 | 21,436 | |
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | |||
Cash and cash equivalents | 59,261 | 43,247 | |
Restricted cash and cash equivalents | 8,821 | 11,673 | |
Total financial assets | 286,553 | 264,521 | |
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | Equity Securities [Member] | |||
Available-for-sale securities | 156,319 | 140,223 | |
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | Corporate Debt Securities [Member] | |||
Available-for-sale securities | 48,941 | 47,921 | |
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | Collateralized Mortgage Backed Securities [Member] | |||
Available-for-sale securities | 0 | ||
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | Asset-backed Securities [Member] | |||
Available-for-sale securities | 0 | ||
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | US Treasury Securities [Member] | |||
Available-for-sale securities | 13,211 | 21,457 | |
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | US States and Political Subdivisions Debt Securities [Member] | |||
Available-for-sale securities | 0 | 0 | |
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | |||
Cash and cash equivalents | 0 | 0 | |
Restricted cash and cash equivalents | 0 | 0 | |
Total financial assets | 87,405 | 103,215 | |
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | Equity Securities [Member] | |||
Available-for-sale securities | 0 | 0 | |
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | Corporate Debt Securities [Member] | |||
Available-for-sale securities | 15,742 | 19,711 | |
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | Collateralized Mortgage Backed Securities [Member] | |||
Available-for-sale securities | 58,454 | ||
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | Asset-backed Securities [Member] | |||
Available-for-sale securities | 62,068 | ||
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | US Treasury Securities [Member] | |||
Available-for-sale securities | 0 | 0 | |
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | US States and Political Subdivisions Debt Securities [Member] | |||
Available-for-sale securities | $ 13,209 | $ 21,436 |
Note 11 - Long-term Debt (Detai
Note 11 - Long-term Debt (Details Textual) - Bank of America [Member] - USD ($) | 1 Months Ended | |
Oct. 31, 2015 | Sep. 30, 2019 | |
Line of Credit Facility, Maximum Borrowing Capacity | $ 110,000,000 | $ 60,000,000 |
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 Thousands | 9 Months Ended | |
Sep. 30, 2019 | Dec. 31, 2018 | |
Long-term debt | $ 30,000 | $ 55,000 |
Less current portion | 0 | 0 |
Total long-term debt | $ 30,000 | 55,000 |
Line of Credit [Member] | ||
Long-term debt, weighted average interest rate | 3.50% | |
Long-term debt, maturities | 2020 | |
Long-term debt | $ 30,000 | $ 55,000 |
Note 12 - Stock Repurchase Pr_2
Note 12 - Stock Repurchase Program (Details Textual) - Common Stock [Member] - USD ($) | 1 Months Ended | 12 Months Ended | |
Sep. 30, 2019 | Aug. 31, 2018 | Aug. 31, 2019 | |
Share Repurchase Program 2019 [Member] | |||
Stock Repurchase Program, Authorized Amount | $ 25,000,000 | ||
Stock Repurchased and Retired During Period, Shares | 0 | ||
Share Repurchase Program 2017 [Member] | |||
Stock Repurchased and Retired During Period, Shares | 10,396 | ||
Stock Repurchased and Retired During Period, Value | $ 872,000 |
Note 13 - Stock-based Compens_3
Note 13 - Stock-based Compensation (Details Textual) - USD ($) | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Share-based Payment Arrangement, Expense | $ 340,000 | $ 361,000 | $ 1,448,000 | $ 1,538,000 |
Share-based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount, Total | $ 3,981,000 | $ 3,981,000 | ||
Share-based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition | 3 years |
Note 13 - Stock-based Compens_4
Note 13 - Stock-based Compensation - Summary of Assumptions Used to Value Options Granted (Details) | 9 Months Ended | 12 Months Ended |
Sep. 30, 2019 | Dec. 31, 2018 | |
Risk–free interest rate | 2.30% | 2.46% |
Expected volatility | 17.40% | 16.10% |
Expected life (Year) | 2 years 3 months 18 days | 3 years |
Expected dividend yield | 2.73% | 3.29% |
Note 13 - Stock-based Compens_5
Note 13 - Stock-based Compensation - Summary of Options Outstanding (Details) - USD ($) | 9 Months Ended | 12 Months Ended |
Sep. 30, 2019 | Dec. 31, 2018 | |
Options outstanding, shares (in shares) | 1,163,381 | 1,239,407 |
Options outstanding, weighted average exercise price (in dollars per share) | $ 71.16 | $ 71.19 |
Options granted, shares (in shares) | 53,628 | 110,265 |
Options granted, weighted average exercise price (in dollars per share) | $ 77.89 | $ 61.39 |
Options exercised, shares (in shares) | (332,852) | (68,291) |
Options exercised, weighted average exercise price (in dollars per share) | $ 71.56 | $ 54.31 |
Options cancelled, shares (in shares) | (85,000) | (118,000) |
Options cancelled, weighted average exercise price (in dollars per share) | $ 72.94 | $ 72.11 |
Options outstanding, shares (in shares) | 799,157 | 1,163,381 |
Options outstanding, weighted average exercise price (in dollars per share) | $ 71.25 | $ 71.16 |
Options outstanding, aggregate intrinsic value | $ 8,468,000 | |
Options exercisable, shares (in shares) | 209,029 | |
Options exercisable, weighted average exercise price (in dollars per share) | $ 68.05 | |
Options exercisable, aggregate intrinsic value | $ 2,885,000 |
Note 13 - Stock-based Compens_6
Note 13 - Stock-based Compensation - Options Outstanding by Exercise Price Range (Details) | 9 Months Ended |
Sep. 30, 2019$ / shares | |
Weighted average exercise price (in dollars per share) | $ 71.25 |
Weighted average remaining contractual life (Year) | 2 years 6 months |
Exercise Price Range 1 [Member] | |
Exercise prices, lower range (in dollars per share) | $ 60.73 |
Exercise prices, upper range (in dollars per share) | 62.78 |
Weighted average exercise price (in dollars per share) | $ 61.81 |
Weighted average remaining contractual life (Year) | 2 years 3 months 18 days |
Exercise Price Range 2 [Member] | |
Exercise prices, lower range (in dollars per share) | $ 72.94 |
Exercise prices, upper range (in dollars per share) | 77.92 |
Weighted average exercise price (in dollars per share) | $ 73.35 |
Weighted average remaining contractual life (Year) | 2 years 7 months 6 days |
Note 14 - Income Taxes (Details
Note 14 - Income Taxes (Details Textual) - USD ($) | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Income Tax Expense (Benefit), Total | $ 3,167,000 | $ 1,700,000 | $ 15,284,000 | $ 9,792,000 |
Effective Income Tax Rate Reconciliation, Percent, Total | 14.00% | 7.50% | 22.00% | 19.50% |
Effective Income Tax Rate Reconciliation, Expiration of Statute of Limitations, Amount | $ 2,064,000 | $ 2,222,000 | $ 2,064,000 | $ 2,222,000 |
Effective Income Tax Rate Reconciliation, Return to Provision, Amount | $ 793,000 | 1,434,000 | $ 793,000 | 1,434,000 |
Effective Income Tax Rate Reconciliation, Gain on Acquisition of Equity Method Investment, Amount, Total | $ 547,000 | 547,000 | ||
Effective Income Tax Rate Reconciliation, Nondeductible Expense, Amount, Total | $ 945,000 | |||
Effective Income Tax Rate Reconciliation, Nondeductible Expense, Percent, Total | 1.90% | |||
Open Tax Year | 2016 |
Note 15 - Contingencies and C_2
Note 15 - Contingencies and Commitments (Details Textual) - USD ($) | 9 Months Ended | 12 Months Ended |
Sep. 30, 2019 | Dec. 31, 2018 | |
Self Insurance Reserve | $ 98,279,000 | $ 96,024,000 |
Direct Business Coverage Statutory Limits | 1,000,000 | |
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 |
National [Member] | ||
Line of Credit Facility, Maximum Borrowing Capacity | 2,000,000 | |
Long-term Line of Credit, Total | $ 0 |