National HealthCare (NHC) 10-Q 5 Aug 21 2021 Q2 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	6 Months Ended
	Jun. 30, 2021	Aug. 02, 2021
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	Q2
Document Fiscal Year Focus	2021
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2021
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
Title of 12(b) Security	Common, $0.01 par value
Trading Symbol	NHC
Security Exchange Name	NYSEAMER
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		15,423,240

Interim Condensed Consolidated

Interim Condensed Consolidated Statements of Operations (Unaudited) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Revenues:
Net patient revenues	$ 236,976,000	$ 225,671,000	$ 453,831,000	$ 469,766,000
Other revenues	11,056,000	11,323,000	22,425,000	23,352,000
Government stimulus income	15,126,000	24,648,000	37,875,000	24,648,000
Net operating revenues and grant income	263,158,000	261,642,000	514,131,000	517,766,000
Costs and expenses:
Salaries, wages, and benefits	156,804,000	156,914,000	301,934,000	304,383,000
Other operating	72,043,000	70,861,000	142,196,000	142,529,000
Facility rent	10,170,000	10,320,000	20,233,000	20,652,000
Depreciation and amortization	10,131,000	10,545,000	20,292,000	20,983,000
Interest	215,000	453,000	459,000	865,000
Total costs and expenses	249,363,000	249,093,000	485,114,000	489,412,000
Income from operations	13,795,000	12,549,000	29,017,000	28,354,000
Other income/(losses):
Non–operating income	5,586,000	5,954,000	11,846,000	12,392,000
Gains on acquisitions of equity method investments	95,202,000	0	95,202,000	1,708,000
Unrealized (losses)/gains on marketable equity securities	(6,489,000)	20,053,000	570,000	(40,339,000)
Income before income taxes	108,094,000	38,556,000	136,635,000	2,115,000
Income tax provision	(2,764,000)	(10,034,000)	(9,997,000)	(409,000)
Net income	105,330,000	28,522,000	126,638,000	1,706,000
Net income attributable to noncontrolling interest	(447,000)	(198,000)	(488,000)	(234,000)
Net income attributable to National HealthCare Corporation	$ 104,883,000	$ 28,324,000	$ 126,150,000	$ 1,472,000
Earnings per share attributable to National HealthCare Corporation stockholders:
Basic (in dollars per share)	$ 6.83	$ 1.85	$ 8.22	$ 0.10
Diluted (in dollars per share)	$ 6.80	$ 1.84	$ 8.19	$ 0.10
Basic (in shares)	15,349,162	15,307,105	15,338,400	15,300,941
Diluted (in shares)	15,419,012	15,372,430	15,404,634	15,367,464
Dividends declared to common stockholders, per share (in dollars per share)	$ 0.52	$ 0.52	$ 1.04	$ 1.04

Interim Condensed Consolidate_2

Interim Condensed Consolidated Statements of Comprehensive Income/(Loss) (Unaudited) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Net income	$ 105,330	$ 28,522	$ 126,638	$ 1,706
Other comprehensive income:
Unrealized gains/(losses) on investments in marketable debt securities	407	4,796	(2,033)	2,251
Reclassification adjustment for realized gains on sales of marketable debt securities	(212)	(11)	(212)	(13)
Income tax (expense)/benefit related to items of other comprehensive income	(42)	(1,005)	476	(470)
Other comprehensive income/(loss), net of tax	153	3,780	(1,769)	1,768
Net income attributable to noncontrolling interest	(447)	(198)	(488)	(234)
Comprehensive income attributable to National HealthCare Corporation	$ 105,036	$ 32,104	$ 124,381	$ 3,240

Interim Condensed Consolidate_3

Interim Condensed Consolidated Balance Sheets (Current Period Unaudited) - USD ($)	Jun. 30, 2021	Dec. 31, 2020
Current Assets:
Cash and cash equivalents	$ 134,692,000	$ 147,093,000
Restricted cash and cash equivalents, current portion	14,093,000	9,673,000
Marketable equity securities	128,666,000	128,590,000
Marketable debt securities	33,651,000	47,762,000
Restricted marketable equity securities	25,174,000	4,680,000
Restricted marketable debt securities, current portion	16,839,000	16,601,000
Accounts receivable	97,811,000	89,670,000
Inventories	7,939,000	8,781,000
Prepaid expenses and other assets	6,160,000	2,977,000
Notes receivable, current portion	882,000	928,000
Total current assets	465,907,000	456,755,000
Property and Equipment:
Property and equipment, at cost	1,050,009,000	1,030,426,000
Accumulated depreciation and amortization	(530,392,000)	(510,108,000)
Net property and equipment	519,617,000	520,318,000
Other Assets:
Restricted cash and cash equivalents, less current portion	1,802,000	1,736,000
Restricted marketable debt securities, less current portion	115,856,000	125,472,000
Deposits and other assets	4,681,000	4,580,000
Operating lease right-of-use assets	168,572,000	179,055,000
Goodwill	168,295,000	21,341,000
Intangible assets	7,038,000	0
Notes receivable, less current portion	3,734,000	12,093,000
Investments in unconsolidated companies	1,867,000	40,782,000
Total other assets	471,845,000	385,059,000
Total assets	1,457,369,000	1,362,132,000
Current Liabilities:
Trade accounts payable	22,246,000	21,112,000
Finance lease obligations, current portion	4,557,000	4,423,000
Operating lease liabilities, current portion	26,873,000	25,451,000
Accrued payroll	93,264,000	86,183,000
Amounts due to third party payors	16,931,000	16,454,000
Accrued risk reserves, current portion	30,932,000	30,953,000
Other current liabilities	19,639,000	21,344,000
Provider relief funds	10,429,000	16,068,000
Contract liabilities	40,121,000	51,253,000
Dividends payable	8,020,000	7,987,000
Total current liabilities	273,012,000	281,228,000
Finance lease obligations, less current portion	8,228,000	10,540,000
Operating lease liabilities, less current portion	141,699,000	153,604,000
Accrued risk reserves, less current portion	70,918,000	68,584,000
Refundable entrance fees	7,461,000	7,462,000
Deferred income taxes	13,463,000	14,079,000
Other noncurrent liabilities	29,336,000	28,375,000
Total liabilities	544,117,000	563,872,000
Equity:
Common stock, $.01 par value; 45,000,000 shares authorized; 15,423,240 and 15,369,745 shares, respectively, issued and outstanding	154,000	153,000
Capital in excess of par value	230,248,000	226,943,000
Retained earnings	673,151,000	563,024,000
Accumulated other comprehensive income	3,288,000	5,057,000
Total National HealthCare Corporation stockholders’ equity	906,841,000	795,177,000
Noncontrolling interest	6,411,000	3,083,000
Total equity	913,252,000	798,260,000
Total liabilities and equity	$ 1,457,369,000	$ 1,362,132,000

Interim Condensed Consolidate_4

Interim Condensed Consolidated Balance Sheets (Current Period Unaudited) (Parentheticals) - $ / shares	Jun. 30, 2021	Dec. 31, 2020
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)	15,423,240	15,369,745
Common stock, shares outstanding (in shares)	15,423,240	15,369,745

Interim Condensed Consolidate_5

Interim Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)	6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020
Cash Flows From Operating Activities:
Net income	$ 126,638,000	$ 1,706,000
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	20,292,000	20,983,000
Equity in earnings of unconsolidated investments	(5,306,000)	(5,429,000)
Distributions from unconsolidated investments	6,314,000	6,901,000
Unrealized (gains)/losses on marketable equity securities	(570,000)	40,339,000
Gains on sale of marketable debt securities	(212,000)	(13,000)
Gains on acquisitions of equity method investments	(95,202,000)	(1,708,000)
Deferred income taxes	140,000	11,529,000
Stock–based compensation	1,179,000	1,289,000
Changes in operating assets and liabilities:
Accounts receivable	2,402,000	8,350,000
Inventories	842,000	332,000
Prepaid expenses and other assets	(2,278,000)	2,238,000
Trade accounts payable	(2,325,000)	(1,241,000)
Accrued payroll	3,858,000	(1,320,000)
Amounts due to third party payors	(15,000)	2,570,000
Accrued risk reserves	2,313,000	8,860,000
Provider relief funds	(5,639,000)	19,294,000
Contract liabilities	(11,132,000)	50,992,000
Other current liabilities	(1,800,000)	11,979,000
Other noncurrent liabilities	903,000	134,000
Net cash provided by operating activities	40,122,000	154,727,000
Cash Flows From Investing Activities:
Purchases of property and equipment	(13,143,000)	(12,517,000)
Acquisitions of equity method investments, net of cash acquired	(28,713,000)	(6,648,000)
Investments in unconsolidated companies	0	(185,000)
Investments in notes receivable	0	(425,000)
Collections of notes receivable	8,405,000	1,139,000
Purchases of marketable securities	(43,483,000)	(19,754,000)
Proceeds from sale of marketable securities	44,939,000	19,823,000
Net cash used in investing activities	(31,995,000)	(18,567,000)
Cash Flows From Financing Activities:
Borrowings under credit facility	0	40,000,000
Repayments under credit facility	0	(50,000,000)
Principal payments under finance lease obligations	(2,178,000)	(2,052,000)
Dividends paid to common stockholders	(15,990,000)	(15,948,000)
Noncontrolling interest contributions	0	525,000
Issuance of common shares	2,405,000	949,000
Repurchase of common shares	(278,000)	(53,000)
Entrance fee (refunds) deposits	(1,000)	188,000
Net cash used in financing activities	(16,042,000)	(26,391,000)
Net (Decrease)/Increase in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents	(7,915,000)	109,769,000
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period	158,502,000	61,010,000
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period	150,587,000	170,779,000
Balance Sheet Classifications:
Cash and cash equivalents	134,692,000	149,471,000
Restricted Cash and Cash Equivalents	15,895,000	21,308,000
Total Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents	$ 150,587,000	$ 170,779,000

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, 2019	15,332,206
Balance at Dec. 31, 2019	$ 153	$ 222,787	$ 553,093	$ 2,560	$ 476	$ 779,069
Net income			(26,852)		36	(26,816)
Other comprehensive income (loss)				(2,012)		(2,012)
Stock–based compensation		466				466
Shares sold – options exercised (in shares)	15,006
Shares sold – options exercised	$ 0	400				400
Repurchase of common shares (in shares)	(611)
Repurchase of common shares		(53)				(53)
Dividends declared to common stockholders ($0.52 per share)			(7,980)			(7,980)
Contributions attributable to noncontrolling interest					281	281
Net income (loss)			(26,852)		36	(26,816)
Balance (in shares) at Mar. 31, 2020	15,346,601
Balance at Mar. 31, 2020	$ 153	223,600	518,261	548	793	743,355
Balance (in shares) at Dec. 31, 2019	15,332,206
Balance at Dec. 31, 2019	$ 153	222,787	553,093	2,560	476	779,069
Net income						1,706
Other comprehensive income (loss)						1,768
Net income (loss)						1,706
Balance (in shares) at Jun. 30, 2020	15,357,488
Balance at Jun. 30, 2020	$ 153	224,972	538,599	4,328	1,235	769,287
Balance (in shares) at Dec. 31, 2019	15,332,206
Balance at Dec. 31, 2019	$ 153	222,787	553,093	2,560	476	$ 779,069
Shares sold – options exercised (in shares)						43,630
Balance (in shares) at Dec. 31, 2020	15,369,745
Balance at Dec. 31, 2020	$ 153	226,943	563,024	5,057	3,083	$ 798,260
Balance (in shares) at Mar. 31, 2020	15,346,601
Balance at Mar. 31, 2020	$ 153	223,600	518,261	548	793	743,355
Net income			28,324		198	28,522
Other comprehensive income (loss)				3,780		3,780
Stock–based compensation		823				823
Shares sold – options exercised (in shares)	11,073
Shares sold – options exercised		549				549
Repurchase of common shares (in shares)	(186)
Dividends declared to common stockholders ($0.52 per share)			(7,986)			(7,986)
Contributions attributable to noncontrolling interest					244	244
Net income (loss)			28,324		198	28,522
Balance (in shares) at Jun. 30, 2020	15,357,488
Balance at Jun. 30, 2020	$ 153	224,972	538,599	4,328	1,235	769,287
Balance (in shares) at Dec. 31, 2020	15,369,745
Balance at Dec. 31, 2020	$ 153	226,943	563,024	5,057	3,083	798,260
Net income			21,267		41	21,308
Other comprehensive income (loss)				(1,922)		(1,922)
Stock–based compensation		496				496
Shares sold – options exercised (in shares)	24,331
Shares sold – options exercised	$ 1	326				327
Repurchase of common shares (in shares)	(3,936)
Repurchase of common shares		(278)				(278)
Dividends declared to common stockholders ($0.52 per share)			(8,003)			(8,003)
Net income (loss)			21,267		41	21,308
Balance (in shares) at Mar. 31, 2021	15,390,140
Balance at Mar. 31, 2021	$ 154	227,487	576,288	3,135	3,124	810,188
Balance (in shares) at Dec. 31, 2020	15,369,745
Balance at Dec. 31, 2020	$ 153	226,943	563,024	5,057	3,083	798,260
Net income						126,638
Other comprehensive income (loss)						$ (1,769)
Shares sold – options exercised (in shares)						148,900
Net income (loss)						$ 126,638
Balance (in shares) at Jun. 30, 2021	15,423,240
Balance at Jun. 30, 2021	$ 154	230,248	673,151	3,288	6,411	913,252
Balance (in shares) at Mar. 31, 2021	15,390,140
Balance at Mar. 31, 2021	$ 154	227,487	576,288	3,135	3,124	810,188
Net income			104,883		447	105,330
Other comprehensive income (loss)				153		153
Stock–based compensation		683				683
Shares sold – options exercised (in shares)	33,100
Shares sold – options exercised		2,078				2,078
Dividends declared to common stockholders ($0.52 per share)			(8,020)			(8,020)
Contributions attributable to noncontrolling interest					2,840	2,840
Net income (loss)			104,883		447	105,330
Balance (in shares) at Jun. 30, 2021	15,423,240
Balance at Jun. 30, 2021	$ 154	$ 230,248	$ 673,151	$ 3,288	$ 6,411	$ 913,252

Interim Condensed Consolidate_7

Interim Condensed Consolidated Statements of Stockholders' Equity (Unaudited) (Parentheticals) - $ / shares	3 Months Ended				6 Months Ended
	Jun. 30, 2021	Mar. 31, 2021	Jun. 30, 2020	Mar. 31, 2020	Jun. 30, 2021	Jun. 30, 2020
Dividends declared to common stockholders, per share (in dollars per share)	$ 0.52	$ 0.52	$ 0.52	$ 0.52	$ 1.04	$ 1.04

Note 1 - Description of Busines

Note 1 - Description of Business	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Organization, Consolidation and Presentation of Financial Statements Disclosure [Text Block]	Note 1 Description of Business National HealthCare Corporation June 30, 2021, five one

Note 2 - Summary of Significant

Note 2 - Summary of Significant Accounting Policies	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Significant Accounting Policies [Text Block]	Note 2 Summary of Significant Accounting Policies The listing below is not not December 31, 2020 December 31, 2020 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, 2020 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, including but not 19” Net Patient Revenues and Accounts Receivable Net patient revenues are derived from services rendered to patients for skilled and intermediate nursing, rehabilitation therapy, assisted living and independent living, home health care services, and hospice 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 not The Company determines the transaction price based on established billing rates reduced by contractual adjustments provided to third three six June 30, 2021. three six June 30, 2020, June 30, 2021, December 31, 2020, 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 center under contract. We record other revenues as the performance obligations are satisfied based on the terms of our contractual arrangements. We recognize rental income based on the terms of our operating leases. Under certain of our leases, we receive variable rent, which is based on the increase in revenues of a lessee over a base year. We recognize variable rent annually or monthly, as applicable, when, based on the actual revenue of the lessee is earned. Government Grants In the absence of specific guidance to account for government grants under U.S. GAAP, we have concluded to account for government grants in accordance with International Accounting Standard (“IAS”) 20, Accounting for Government Grants and Disclosure of Government Assistance Segment Reporting In accordance with the provisions of Accounting Standards Codification ("ASC") 280, Segment Reporting two 1 one 2 8 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 $4,885,000 and $10,254,000 for the three six June 30, 2021. three six June 30, 2020, Long-Term Leases 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 and hospice offices, and pharmacy warehouses. The original terms of the leases typically range from two fifteen may not The Company records right-of-use assets and liabilities on the interim condensed consolidated balance sheets for non-cancelable real estate operating leases with original or remaining lease terms in excess of one 12 not 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 value of the lease payments are discounted using the incremental borrowing rate associated with each lease. The variable components of the lease payment that fluctuate with the operations of a health facility are not 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 842, Leases Business Combinations We account for acquisitions using the acquisition method of accounting in accordance with ASC 805, Business Combinations. Goodwill and Other Intangible Assets Goodwill represents the excess of purchase price over the fair value of identifiable net assets acquired in business combinations. Goodwill is not first fourth not The Company’s indefinite-lived intangible assets consist of trade names and certificates of need and licenses. The Company reviews indefinite-lived intangible assets for impairment on an annual basis or more frequently if events or changes in circumstances indicate that the carrying amount of the intangible asset may not 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 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 June 30, 2021, December 31, 2020, We also 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 with a corresponding charge to income. As of June 30, 2021, December 31, 2020, $2,177,000 Other Noncurrent Liabilities Other noncurrent liabilities include reserves primarily related to various uncertain income tax positions, deferred revenue, and obligations to provide future services to our CCRC residents. Deferred revenue includes the deferred gain on the sale of assets to National Health Corporation (“National”) and the non-refundable portion ( 10% 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 the subsidiary earnings, contributions, and distributions. 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) have the power to direct the activities of the VIE and (ii) have the obligation or rights to absorb the VIE's losses or receive its benefits, then we would be determined to be the primary beneficiary and would consolidate the VIE. To the extent we own interests in a VIE, then at each reporting period, we re-assess our conclusions as to which, if any, party within the VIE is considered the primary beneficiary. The Company's maximum exposure to losses in its investments in unconsolidated VIEs cannot be quantified and may may not Prior Period Classification Certain amounts in prior periods have been reclassified to conform with current period presentation.

Note 3 - Coronavirus Pandemic

Note 3 - Coronavirus Pandemic	6 Months Ended
	Jun. 30, 2021
COVID 19 [Member]
Notes to Financial Statements
Unusual or Infrequent Items, or Both, Disclosure [Text Block]	Note 3 Coronavirus Pandemic In early March 2020, 19, March 2020 19 $178 Public Health and Social Services Emergency Fund 19. The Provider Relief Fund grants come with terms and condition certifications in which all providers are required to submit documents to ensure the funds will be used for healthcare-related expenses or lost revenue attributable to COVID- 19. three June 30, 2021 2020, six June 30, 2021 2020, As of June 30, 2021, not 19 Additionally, as part of the CARES Act, the legislation included an expansion of the Medicare Accelerated and Advance Payment Program. The expanded Medicare Accelerated and Advance Payment Program is a streamlined version of existing policy that allows the Medicare Administrative Contractors (“MAC’s”) to issue up to three one first eleven twenty-five six fifty not twenty-nine four second 2021. June 30, 2021, The CARES Act temporarily suspended Medicare sequestration beginning May 1, 2020 December 31, 2020. 2 December 27, 2020, 2021 2.0% June 30, 2021. April 14, 2021, December 31, 2021. The CARES Act also temporarily permitted employers to defer the deposit and payment of the employer’s portion of the social security taxes ( 6.2% March 27, 2020 December 31, 2020. two December 31, 2021, December 31, 2022. June 30, 2021, June 30, 2021, We have also received supplemental Medicaid payments from many of the states in which we operate to help mitigate the incremental costs resulting from the COVID- 19 three June 30, 2021 2020, six June 30, 2021 2020,

Note 4 - Acquisition of Caris H

Note 4 - Acquisition of Caris HealthCare, L.P.	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Business Combination Disclosure [Text Block]	Note 4 Acquisition of Caris HealthCare, L.P. On June 11, 2021, Prior to the June 11, 2021 The Company utilized widely accepted income-based, market-based, and cost-based valuation approaches to perform the preliminary purchase price allocation and to determine the fair value of the previously held equity method investment. The Company has performed a preliminary valuation analysis of the fair market value of Caris’ assets to be acquired and liabilities to be assumed. The final valuation of the assets acquired and liabilities assumed was not June 30, 2021, in thousands Amount Cash and cash equivalents $ 15,515 Restricted cash and cash equivalents 58 Accounts receivable 10,544 Prepaid expenses and other assets 1,006 Property and equipment 3,608 Operating lease – right-of-use assets 1,600 Intangible assets 7,038 Total assets acquired 39,369 Trade accounts payable 3,459 Accrued payroll 3,223 Other current liabilities 587 Operating lease liabilities 1,600 Other noncurrent liabilities 58 Total liabilities assumed 8,927 Net identifiable assets acquired 30,442 Goodwill 146,954 Total estimated fair value of Caris $ 177,396 The indefinite-lived intangible assets acquired include the trade name of Caris and the certificates of need and licenses. The goodwill is recorded in the homecare and hospice segment and is attributed to the workforce acquired and reputation of the business as part of the transaction. We expect approximately 35% - 40% of the goodwill to be deductible for income tax purposes. For the second 2021, The following table contains unaudited pro forma interim condensed consolidated statements of operations information for the three six June 30, 2021 2020, January 1, 2020. may (in thousands) Three Months Ended June 30 Six Months Ended June 30 2021 2020 2021 2020 Net patient revenues $ 249,733 $ 241,670 $ 481,802 $ 501,726 Total costs and expenses 258,754 261,573 506,320 514,274 Income from operations 17,161 16,068 35,782 35,452 Non-operating income 3,162 3,453 6,975 7,315 Income before income taxes 13,834 39,574 43,327 4,136 Net income attributable to NHC $ 10,378 $ 29,077 $ 32,350 $ 2,968

Note 5 - Net Patient Revenues

Note 5 - Net Patient Revenues	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Revenue from Contract with Customer [Text Block]	Note 5 Net Patient Revenues 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 (in thousands) Three Months Ended June 30 Six Months Ended June 30 2021 2020 2021 2020 Net patient revenues: Inpatient services $ 218,860 $ 214,387 $ 422,103 $ 445,374 Homecare and hospice services 18,116 11,284 31,728 24,392 Total net patient revenue $ 236,976 $ 225,671 $ 453,831 $ 469,766 For inpatient and hospice 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 period of care 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 June 30 Six Months Ended June 30 Source 2021 2020 2021 2020 Medicare 34 % 32 % 34 % 33 % Managed Care 12 % 10 % 13 % 11 % Medicaid 29 % 32 % 29 % 30 % Private Pay and Other 25 % 26 % 24 % 26 % 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 three 19 For homecare services, Medicare pays based on the acuity level of the patient and based on periods of care. A period of care is defined as a length of care up to 30 Certain managed care payors for homecare services pay on a per-visit basis. This revenue is recorded on an accrual basis based upon the date of services at amounts equal to its established or estimated per-visit rates. For hospice services, Medicare pays a daily rate to cover the hospice’s costs for providing services included in the patient care plan. Medicare makes daily payments based on 1 4 Our hospice service revenue is subject to certain limitations on payments from Medicare. We are subject to an inpatient cap limit and an overall Medicare payment cap for each provider number. We monitor these caps on a provider-by-provider basis and estimate amounts due back to Medicare if we estimate a cap has been exceeded. If applicable, we record these cap adjustments as a reduction to revenue. 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 Contract Liabilities Included in the Company’s interim condensed consolidated balance sheets are contract liabilities, which represent payments the Company receives in advance of services provided. As of June 30, 2021 December 31, 2020, second 2021. A summary of the contract liabilities are follows ( in thousands Balance at December 31, 2020 $ 51,253 Payments received - Payments recouped (11,132 ) Balance at June 30, 2021 $ 40,121 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 June 30, 2021 December 31, 2020,

Note 6 - Other Revenues

Note 6 - Other Revenues	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Other Revenues [Text Block]	Note 6 Other Revenues Other revenues are outlined in the table below. Revenues from rental income include health care real estate properties owned by us and leased to third (in thousands) Three Months Ended June 30 Six Months Ended June 30 2021 2020 2021 2020 Rental income $ 5,514 $ 5,646 $ 11,161 $ 11,325 Management and accounting services fees 4,136 4,121 8,460 8,600 Insurance services 1,277 1,398 2,541 2,780 Other 129 158 263 647 Total other revenues $ 11,056 $ 11,323 $ 22,425 $ 23,352 Rental Income The Company leases real estate assets consisting of skilled nursing facilities and assisted living facilities to third four 9 (in thousands) Three Months Ended June 30 Six Months Ended June 30 2021 2020 2021 2020 Operating lease payments $ 5,303 $ 5,505 $ 10,809 $ 11,008 Variable lease payments 211 141 352 317 Total rental income $ 5,514 $ 5,646 $ 11,161 $ 11,325 Management Fees from National Health Corporation We manage five three six June 30, 2021, three six June 30, 2020, Insurance Services For workers’ compensation insurance services, the premium revenues reflected in the interim condensed consolidated statements of operations for the three six June 30, 2021 three six June 30, 2020 For professional liability insurance services, the premium revenues reflected in the interim condensed consolidated statements of operations for the three six June 30, 2021 three six June 30, 2020

Note 7 - Non-operating Income

Note 7 - Non-operating Income	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Other Nonoperating Income and Expense [Text Block]	Note 7 Non Operating Income 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 (in thousands) Three Months Ended June 30 Six Months Ended June 30 2021 2020 2021 2020 Equity in earnings of unconsolidated investments $ 2,395 $ 2,618 $ 5,306 $ 5,429 Dividends and net realized gains on sales of securities 1,915 1,891 3,877 3,913 Interest income 1,276 1,445 2,663 3,050 Total non-operating income $ 5,586 $ 5,954 $ 11,846 $ 12,392 Caris HealthCare, L.P. On June 11, 2021, 4 Prior to the June 11, 2021 no

Note 8 - Business Segments

Note 8 - Business Segments	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Segment Reporting Disclosure [Text Block]	Note 8 Business Segments The Company has two reportable operating segments: ( 1 2 The Company also reports an “all other” category that includes revenues from rental income, management and accounting services fees, insurance services, and costs of the corporate office. For additional information on these reportable segments see Note 2 Summary of Significant Accounting Policies. The Company’s CODM evaluates performance and allocates capital resources to each segment based on an operating model that is designed to improve the quality of patient care and profitability of the Company while enhancing long-term shareholder value. The CODM does not not The following table sets forth the Company’s unaudited interim condensed consolidated statements of operations by business segment (in thousands Three Months Ended June 30, 2021 Inpatient Homecare and Hospice All Other Total Revenues: Net patient revenues $ 218,860 $ 18,116 $ - $ 236,976 Other revenues 97 - 10,959 11,056 Government stimulus income 15,126 - - 15,126 Net operating revenues and grant income 234,083 18,116 10,959 263,158 Costs and expenses: Salaries, wages, and benefits 128,573 10,482 17,749 156,804 Other operating 65,129 3,991 2,923 72,043 Rent 8,278 454 1,438 10,170 Depreciation and amortization 9,227 94 810 10,131 Interest 215 - - 215 Total costs and expenses 211,422 15,021 22,920 249,363 Income (loss) from operations 22,661 3,095 (11,961 ) 13,795 Non-operating income - - 5,586 5,586 Gain on acquisition of equity method investment - - 95,202 95,202 Unrealized losses on marketable equity securities - - (6,489 ) (6,489 ) Income before income taxes $ 22,661 $ 3,095 $ 82,338 $ 108,094 Three Months Ended June 30, 2020 Inpatient Homecare and Hospice All Other Total Revenues and grant income: Net patient revenues $ 214,387 $ 11,284 $ - $ 225,671 Other revenues 127 - 11,196 11,323 Government stimulus income 22,622 2,026 - 24,648 Net operating revenues and grant income 237,136 13,310 11,196 261,642 Costs and expenses: Salaries, wages, and benefits 136,380 7,963 12,571 156,914 Other operating 63,999 4,342 2,520 70,861 Rent 8,380 446 1,494 10,320 Depreciation and amortization 9,626 106 813 10,545 Interest 366 - 87 453 Total costs and expenses 218,751 12,857 17,485 249,093 Income (loss) from operations 18,385 453 (6,289 ) 12,549 Non-operating income - - 5,954 5,954 Unrealized gains on marketable equity securities - - 20,053 20,053 Income before income taxes $ 18,385 $ 453 $ 19,718 $ 38,556 Six Months Ended June 30, 2021 Inpatient Homecare and Hospice All Other Total Revenues and grant income: Net patient revenues $ 422,103 $ 31,728 $ - $ 453,831 Other revenues 195 - 22,230 22,425 Government stimulus income 37,875 - - 37,875 Net operating revenues and grant income 460,173 31,728 22,230 514,131 Costs and expenses: Salaries, wages, and benefits 257,383 18,890 25,661 301,934 Other operating 129,938 6,934 5,324 142,196 Rent 16,472 884 2,877 20,233 Depreciation and amortization 18,490 181 1,621 20,292 Interest 459 - - 459 Total costs and expenses 422,742 26,889 35,483 485,114 Income (loss) from operations 37,431 4,839 (13,253 ) 29,017 Non-operating income - - 11,846 11,846 Gain on acquisition of equity method investment - - 95,202 95,202 Unrealized gains on marketable equity securities - - 570 570 Income before income taxes $ 37,431 $ 4,839 $ 94,365 $ 136,635 Six Months Ended June 30, 2020 Inpatient Homecare and Hospice All Other Total Revenues and grant income: Net patient revenues $ 445,374 $ 24,392 $ - $ 469,766 Other revenues 561 - 22,791 23,352 Government stimulus income 22,622 2,026 - 24,648 Net operating revenues and grant income 468,557 26,418 22,791 517,766 Costs and expenses: Salaries, wages, and benefits 271,595 16,279 16,509 304,383 Other operating 129,104 8,161 5,264 142,529 Rent 16,757 903 2,992 20,652 Depreciation and amortization 19,197 160 1,626 20,983 Interest 748 - 117 865 Total costs and expenses 437,401 25,503 26,508 489,412 Income (loss) from operations 31,156 915 (3,717 ) 28,354 Non-operating income - - 12,392 12,392 Gain on acquisition of equity method investment - - 1,708 1,708 Unrealized losses on marketable equity securities - - (40,339 ) (40,339 ) Income (loss) before income taxes $ 31,156 $ 915 $ (29,956 ) $ 2,115

Note 9 - Long-term Leases

Note 9 - Long-term Leases	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Leases of Lessee Disclosure [Text Block]	Note 9 Long-Term Leases Operating Leases At June 30, 2021, seven three two first four third three six June 30, 2021. three six June 30, 2020. Finance Leases At June 30, 2021, three three third ten two five 2014 Minimum Lease Payments The following table summarizes the maturity of our finance and operating lease liabilities as of June 30, 2021 ( in thousands Finance Leases Operating Leases 2022 $ 5,200 $ 36,047 2023 5,200 35,418 2024 3,467 34,918 2025 - 34,549 2026 - 34,343 Thereafter - 22,857 Total minimum lease payments 13,867 198,132 Less: amounts representing interest (1,082 ) (29,560 ) Present value of future minimum lease payments 12,785 168,572 Less: current portion (4,557 ) (26,873 ) Noncurrent lease liabilities $ 8,228 $ 141,699

Note 10 - Earnings Per Share

Note 10 - Earnings Per Share	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Earnings Per Share [Text Block]	Note 10 Earnings per Share Basic net income per share is computed based on the weighted average number of common shares outstanding for each period presented. Diluted net income per share reflects the potential dilution that would have occurred if securities to issue common stock were exercised, converted, or resulted in the issuance of common stock that would have then shared in our earnings. The following table summarizes the earnings and the weighted average number of common shares used in the calculation of basic and diluted earnings per share (in thousands, except for share and per share amounts) Three Months Ended June 30 Six Months Ended June 30 2021 2020 2021 2020 Basic: Weighted average common shares outstanding 15,349,162 15,307,105 15,338,400 15,300,941 Net income attributable to National HealthCare Corporation $ 104,883 $ 28,324 $ 126,150 $ 1,472 Earnings per common share, basic $ 6.83 $ 1.85 $ 8.22 $ 0.10 Diluted: Weighted average common shares outstanding 15,349,162 15,307,105 15,338,400 15,300,941 Effects of dilutive instruments 69,850 65,325 66,234 66,523 Weighted average common shares outstanding 15,419,012 15,372,430 15,404,634 15,367,464 Net income attributable to National HealthCare Corporation $ 104,883 $ 28,324 $ 126,150 $ 1,472 Earnings per common share, diluted $ 6.80 $ 1.84 $ 8.19 $ 0.10 In the above table, options to purchase 631,905 and 698,421 shares of our common stock have been excluded for the six June 31, 2021 2020,

Note 11 - Investments in Market

Note 11 - Investments in Marketable Securities	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Investments in Debt and Marketable Equity Securities (and Certain Trading Assets) Disclosure [Text Block]	Note 11 Investments in Marketable Securities Our investments in marketable equity securities are carried at fair value with the changes in unrealized gains and losses recognized in our results of operations at each measurement date. Our investments in marketable debt securities are classified as available for sale securities and carried at fair value with the unrealized gains and losses recognized through accumulated other comprehensive income at each measurement date. Any credit related decline in fair market values of our available for sale debt securities are recorded in our results of operations through an allowance for credit losses. 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 12 Marketable securities consist of the following (in thousands) June 30, 2021 December 31, 2020 Amortized Cost Fair Value Amortized Cost Fair Value Investments available for sale: Marketable equity securities $ 30,176 $ 128,666 $ 30,176 $ 128,590 Corporate debt securities 20,009 19,930 25,812 25,778 Asset-backed securities 2,476 2,464 2,485 2,480 U.S. Treasury securities 11,298 11,257 19,519 19,504 Restricted investments available for sale: Marketable equity securities 24,783 25,174 4,783 4,680 Corporate debt securities 63,046 66,398 61,709 66,247 Asset-based securities 33,587 34,436 40,655 41,769 U.S. Treasury securities 22,234 22,015 20,760 21,159 State and municipal securities 9,543 9,846 12,497 12,898 $ 217,152 $ 320,186 $ 218,396 323,105 Included in the marketable equity securities are the following (in thousands, except share amounts): June 30, 2021 December 31, 2020 Shares Cost Fair Value Shares Cost Fair Value NHI Common Stock 1,630,642 $ 24,734 $ 109,335 1,630,642 $ 24,734 $ 112,792 The amortized cost and estimated fair value of debt securities classified as available for sale, by contractual maturity, are as follows (in thousands) June 30, 2021 December 31, 2020 Cost Fair Value Cost Fair Value Maturities: Within 1 year $ 41,415 $ 41,582 $ 49,694 $ 49,863 1 to 5 years 85,438 88,232 99,143 103,002 6 to 10 years 35,340 36,532 34,326 36,685 Over 10 years - - 274 285 $ 162,193 $ 166,346 $ 183,437 $ 189,835 Gross unrealized gains related to marketable equity securities are $99,232,000 and $98,445,000 as of June 30, 2021 December 31, 2020, June 30, 2021 December 31, 2020, three six June 30, 2021, three six June 30, 2020, Gross unrealized gains related to available for sale marketable debt securities are $4,806,000 and $6,759,000 as of June 30, 2021 December 31, 2020, June 30, 2021 December 31, 2020, The Company has not three six June 30, 2021 2020. For the marketable securities in gross unrealized loss positions, (a) it is more likely than not not Proceeds from the sale of available for sale marketable debt securities during the six June 30, 2021 2020 six June 30, 2021 2020, No six June 30, 2021 2020,

Note 12 - Fair Value Measuremen

Note 12 - Fair Value Measurements	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Fair Value Disclosures [Text Block]	Note 12 Fair Value Measurements The accounting standard for fair value measurements provides a framework for measuring fair value and requires expanded disclosures regarding fair value measurements. Fair value is defined as the price that would be received for an asset or the exit price that would be paid to transfer a liability in the principal or most advantageous market in an orderly transaction between market participants on the measurement date. This accounting standard establishes a fair value hierarchy, which requires an entity to maximize the use of observable inputs, where available. The following summarizes the three may Level 1 Level 2 not Level 3 no 3 A financial instrument’s level within the fair value hierarchy is based on the lowest level of input that is significant to the fair value measurement. The following table summarizes fair value measurements by level at June 30, 2021 December 31, 2020 (in thousands) Fair Value Measurements Using June 30, 2021 Fair Value Quoted Prices Active For Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Cash and cash equivalents $ 134,692 $ 134,692 $ – $ – Restricted cash and cash equivalents 15,895 15,895 – – Marketable equity securities 153,840 153,840 – – Corporate debt securities 86,328 46,850 39,478 – Mortgage–backed securities 36,900 - 36,900 – U.S. Treasury securities 33,272 33,272 – – State and municipal securities 9,846 - 9,846 – Total financial assets $ 470,773 $ 384,549 $ 86,224 $ – Fair Value Measurements Using December 31, 2020 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 $ 147,093 $ 147,093 $ – $ – Restricted cash and cash equivalents 11,409 11,409 – – Marketable equity securities 133,270 133,270 – – Corporate debt securities 92,025 56,772 35,253 – Asset–backed securities 44,249 – 44,249 – U.S. Treasury securities 40,663 40,663 – – State and municipal securities 12,898 – 12,898 – Total financial assets $ 481,607 $ 389,207 $ 92,400 $ –

Note 13 - Goodwill and Other In

Note 13 - Goodwill and Other Intangible Assets	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Goodwill and Intangible Assets Disclosure [Text Block]	Note 13 Goodwill and Other Intangible Assets At June 30, 2021, 19" three June 30, 2021 19. not may See Note 4 Acquisition of Caris HealthCare, L.P. 2021. June 30, 2021, in thousands Inpatient Services Homecare and Hospice All Other Total January 1, 2021 $ 3,741 $ 17,600 $ – $ 21,341 Additions – 146,954 – 146,954 June 30, 2021 $ 3,741 $ 164,554 $ – $ 168,295 As part of the Caris acquisition, we also recorded indefinite-lived intangible assets that consisted of the trade name ($4,340,000) and certificates of need and licenses ($2,698,000).

Note 14 - Stock Repurchase Prog

Note 14 - Stock Repurchase Program	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Treasury Stock [Text Block]	Note 14 During the six June 30, 2021,

Note 15 - Stock-based Compensat

Note 15 - Stock-based Compensation	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Share-based Payment Arrangement [Text Block]	Note 15 Stock Based Compensation NHC recognizes stock–based compensation expense for all stock options granted over the requisite service period using the fair value at the date of grant using the Black–Scholes pricing model. Stock–based compensation totaled $683,000 and $823,000 for the three June 30, 2021 2020, six June 30, 2021 2020, At June 30, 2021, one Stock Options The following table summarizes the significant assumptions used to value the options granted for the six June 30, 2021 December 31, 2020. June 30, 2021 December 31, Risk–free interest rate 0.21 % 0.87 % Expected volatility 35.1 % 20.1 % Expected life, in years 2.2 2.2 Expected dividend yield 3.01 % 2.91 % The following table summarizes our outstanding stock options for the six June 30, 2021 December 31, 2020. Number of Shares Weighted Average Exercise Price Aggregate Intrinsic Value Options outstanding at January 1, 2020 809,529 $ 71.24 $ – Options granted 104,057 73.98 – Options exercised (43,630 ) 63.37 – Options cancelled (3,000 ) 72.94 – Options outstanding at December 31, 2020 866,956 72.11 – Options granted 56,829 70.73 – Options exercised (148,900 ) 68.41 – Options cancelled (6,000 ) 72.94 – Options outstanding at June 30, 2021 768,885 $ 72.72 $ 648,212 Options exercisable at June 30, 2021 222,686 $ 69.84 $ 580,540 Options Outstanding June 30, 2021 Exercise Prices Weighted Average Exercise Price Weighted Average Remaining Contractual Life in Years 103,809 60.73 - 67.28 63.66 2.9 665,076 71.64 - 84.30 74.14 1.1 768,885 72.72 1.3

Note 16 - Income Taxes

Note 16 - Income Taxes	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Income Tax Disclosure [Text Block]	Note 16 Income Taxes The Company's income tax provision as a percentage of our income before income taxes was 2.6% and 26.0% for the three June 30, 2021 2020, The Company's income tax provision as a percentage of our income before income taxes was 7.3% and 19.4% for the six June 30, 2021 2020, Typically, these percentages vary from the U.S. federal statutory income tax rate of 21% three six June 30, 2021, Our quarterly income tax provision, and our estimate of our annual effective income tax rate, is subject to variation due to several factors, including volatility based on the amount of pre-tax income or loss. The Company is no 2017

Note 17 - Contingencies and Com

Note 17 - Contingencies and Commitments	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Commitments and Contingencies Disclosure [Text Block]	Note 17 Contingencies and Commitments Accrued Risk Reserves We are self–insured for risks related to health insurance and have wholly–owned limited purpose insurance companies that insure risks related to workers’ compensation and general and professional liability insurance claims both for our owned 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 $101,850,000 and $99,537,000 at June 30, 2021 December 31, 2020, 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 Insurance and Lawsuits The senior care industry has experienced significant increases in both the number of personal injury/wrongful death claims and in the severity of awards based upon alleged negligence by skilled nursing facilities and their employees in providing care to residents. 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 third There is certain additional litigation incidental to our business, none Qui Tam Litigation United States of America, ex rel. Jennifer Cook and Sally Gaither v. Integrated Behavioral Health, Inc., NHC HealthCare/Moulton, LLC, et al. , Case No. 2:20 00877 qui tam June 22, 2020. March 1, 2021. 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. There have been several enacted and proposed federal and state relief measures as a result of COVID- 19 not

Significant Accounting Policies

Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2021
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, 2020 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, including but not 19”
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 living and independent living, home health care services, and hospice 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 not The Company determines the transaction price based on established billing rates reduced by contractual adjustments provided to third three six June 30, 2021. three six June 30, 2020, June 30, 2021, December 31, 2020,
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 center under contract. We record other revenues as the performance obligations are satisfied based on the terms of our contractual arrangements. We recognize rental income based on the terms of our operating leases. Under certain of our leases, we receive variable rent, which is based on the increase in revenues of a lessee over a base year. We recognize variable rent annually or monthly, as applicable, when, based on the actual revenue of the lessee is earned.
Government Grants, policy [Policy Text Block]	Government Grants In the absence of specific guidance to account for government grants under U.S. GAAP, we have concluded to account for government grants in accordance with International Accounting Standard (“IAS”) 20, Accounting for Government Grants and Disclosure of Government Assistance
Segment Reporting, Policy [Policy Text Block]	Segment Reporting In accordance with the provisions of Accounting Standards Codification ("ASC") 280, Segment Reporting two 1 one 2 8
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 $4,885,000 and $10,254,000 for the three six June 30, 2021. three six June 30, 2020,
Lessee, Leases [Policy Text Block]	Long-Term Leases 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 and hospice offices, and pharmacy warehouses. The original terms of the leases typically range from two fifteen may not The Company records right-of-use assets and liabilities on the interim condensed consolidated balance sheets for non-cancelable real estate operating leases with original or remaining lease terms in excess of one 12 not 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 value of the lease payments are discounted using the incremental borrowing rate associated with each lease. The variable components of the lease payment that fluctuate with the operations of a health facility are not
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 842, Leases
Business Combinations Policy [Policy Text Block]	Business Combinations We account for acquisitions using the acquisition method of accounting in accordance with ASC 805, Business Combinations.
Goodwill and Intangible Assets, Policy [Policy Text Block]	Goodwill and Other Intangible Assets Goodwill represents the excess of purchase price over the fair value of identifiable net assets acquired in business combinations. Goodwill is not first fourth not The Company’s indefinite-lived intangible assets consist of trade names and certificates of need and licenses. The Company reviews indefinite-lived intangible assets for impairment on an annual basis or more frequently if events or changes in circumstances indicate that the carrying amount of the intangible asset may not
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 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 June 30, 2021, December 31, 2020, We also 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 with a corresponding charge to income. As of June 30, 2021, December 31, 2020, $2,177,000
Income Tax Uncertainties, Policy [Policy Text Block]	Other Noncurrent Liabilities Other noncurrent liabilities include reserves primarily related to various uncertain income tax positions, deferred revenue, and obligations to provide future services to our CCRC residents. Deferred revenue includes the deferred gain on the sale of assets to National Health Corporation (“National”) and the non-refundable portion ( 10%
Noncontrolling Interest, Policy [Policy Text Block]	Noncontrolling Interest The noncontrolling interest in a subsidiary is presented within total equity in the Company's 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 the subsidiary earnings, contributions, and distributions.
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) have the power to direct the activities of the VIE and (ii) have the obligation or rights to absorb the VIE's losses or receive its benefits, then we would be determined to be the primary beneficiary and would consolidate the VIE. To the extent we own interests in a VIE, then at each reporting period, we re-assess our conclusions as to which, if any, party within the VIE is considered the primary beneficiary. The Company's maximum exposure to losses in its investments in unconsolidated VIEs cannot be quantified and may may not
Reclassification, Comparability Adjustment [Policy Text Block]	Prior Period Classification Certain amounts in prior periods have been reclassified to conform with current period presentation.

Note 4 - Acquisition of Caris_2

Note 4 - Acquisition of Caris HealthCare, L.P. (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Schedule of Business Acquisitions, by Acquisition [Table Text Block]	Amount Cash and cash equivalents $ 15,515 Restricted cash and cash equivalents 58 Accounts receivable 10,544 Prepaid expenses and other assets 1,006 Property and equipment 3,608 Operating lease – right-of-use assets 1,600 Intangible assets 7,038 Total assets acquired 39,369 Trade accounts payable 3,459 Accrued payroll 3,223 Other current liabilities 587 Operating lease liabilities 1,600 Other noncurrent liabilities 58 Total liabilities assumed 8,927 Net identifiable assets acquired 30,442 Goodwill 146,954 Total estimated fair value of Caris $ 177,396
Business Acquisition, Pro Forma Information [Table Text Block]	Three Months Ended June 30 Six Months Ended June 30 2021 2020 2021 2020 Net patient revenues $ 249,733 $ 241,670 $ 481,802 $ 501,726 Total costs and expenses 258,754 261,573 506,320 514,274 Income from operations 17,161 16,068 35,782 35,452 Non-operating income 3,162 3,453 6,975 7,315 Income before income taxes 13,834 39,574 43,327 4,136 Net income attributable to NHC $ 10,378 $ 29,077 $ 32,350 $ 2,968

Note 5 - Net Patient Revenues (

Note 5 - Net Patient Revenues (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Disaggregation of Revenue [Table Text Block]	Three Months Ended June 30 Six Months Ended June 30 2021 2020 2021 2020 Net patient revenues: Inpatient services $ 218,860 $ 214,387 $ 422,103 $ 445,374 Homecare and hospice services 18,116 11,284 31,728 24,392 Total net patient revenue $ 236,976 $ 225,671 $ 453,831 $ 469,766 Three Months Ended June 30 Six Months Ended June 30 Source 2021 2020 2021 2020 Medicare 34 % 32 % 34 % 33 % Managed Care 12 % 10 % 13 % 11 % Medicaid 29 % 32 % 29 % 30 % Private Pay and Other 25 % 26 % 24 % 26 % Total 100 % 100 % 100 % 100 %
Contract with Customer, Contract Asset, Contract Liability, and Receivable [Table Text Block]	Balance at December 31, 2020 $ 51,253 Payments received - Payments recouped (11,132 ) Balance at June 30, 2021 $ 40,121

Note 6 - Other Revenues (Tables

Note 6 - Other Revenues (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Schedule of Other Revenues [Table Text Block]	Three Months Ended June 30 Six Months Ended June 30 2021 2020 2021 2020 Rental income $ 5,514 $ 5,646 $ 11,161 $ 11,325 Management and accounting services fees 4,136 4,121 8,460 8,600 Insurance services 1,277 1,398 2,541 2,780 Other 129 158 263 647 Total other revenues $ 11,056 $ 11,323 $ 22,425 $ 23,352
Operating Lease, Lease Income [Table Text Block]	Three Months Ended June 30 Six Months Ended June 30 2021 2020 2021 2020 Operating lease payments $ 5,303 $ 5,505 $ 10,809 $ 11,008 Variable lease payments 211 141 352 317 Total rental income $ 5,514 $ 5,646 $ 11,161 $ 11,325

Note 7 - Non-operating Income (

Note 7 - Non-operating Income (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Schedule of Other Nonoperating Income, by Component [Table Text Block]	Three Months Ended June 30 Six Months Ended June 30 2021 2020 2021 2020 Equity in earnings of unconsolidated investments $ 2,395 $ 2,618 $ 5,306 $ 5,429 Dividends and net realized gains on sales of securities 1,915 1,891 3,877 3,913 Interest income 1,276 1,445 2,663 3,050 Total non-operating income $ 5,586 $ 5,954 $ 11,846 $ 12,392

Note 8 - Business Segments (Tab

Note 8 - Business Segments (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Schedule of Segment Reporting Information, by Segment [Table Text Block]	Three Months Ended June 30, 2021 Inpatient Homecare and Hospice All Other Total Revenues: Net patient revenues $ 218,860 $ 18,116 $ - $ 236,976 Other revenues 97 - 10,959 11,056 Government stimulus income 15,126 - - 15,126 Net operating revenues and grant income 234,083 18,116 10,959 263,158 Costs and expenses: Salaries, wages, and benefits 128,573 10,482 17,749 156,804 Other operating 65,129 3,991 2,923 72,043 Rent 8,278 454 1,438 10,170 Depreciation and amortization 9,227 94 810 10,131 Interest 215 - - 215 Total costs and expenses 211,422 15,021 22,920 249,363 Income (loss) from operations 22,661 3,095 (11,961 ) 13,795 Non-operating income - - 5,586 5,586 Gain on acquisition of equity method investment - - 95,202 95,202 Unrealized losses on marketable equity securities - - (6,489 ) (6,489 ) Income before income taxes $ 22,661 $ 3,095 $ 82,338 $ 108,094 Three Months Ended June 30, 2020 Inpatient Homecare and Hospice All Other Total Revenues and grant income: Net patient revenues $ 214,387 $ 11,284 $ - $ 225,671 Other revenues 127 - 11,196 11,323 Government stimulus income 22,622 2,026 - 24,648 Net operating revenues and grant income 237,136 13,310 11,196 261,642 Costs and expenses: Salaries, wages, and benefits 136,380 7,963 12,571 156,914 Other operating 63,999 4,342 2,520 70,861 Rent 8,380 446 1,494 10,320 Depreciation and amortization 9,626 106 813 10,545 Interest 366 - 87 453 Total costs and expenses 218,751 12,857 17,485 249,093 Income (loss) from operations 18,385 453 (6,289 ) 12,549 Non-operating income - - 5,954 5,954 Unrealized gains on marketable equity securities - - 20,053 20,053 Income before income taxes $ 18,385 $ 453 $ 19,718 $ 38,556 Six Months Ended June 30, 2021 Inpatient Homecare and Hospice All Other Total Revenues and grant income: Net patient revenues $ 422,103 $ 31,728 $ - $ 453,831 Other revenues 195 - 22,230 22,425 Government stimulus income 37,875 - - 37,875 Net operating revenues and grant income 460,173 31,728 22,230 514,131 Costs and expenses: Salaries, wages, and benefits 257,383 18,890 25,661 301,934 Other operating 129,938 6,934 5,324 142,196 Rent 16,472 884 2,877 20,233 Depreciation and amortization 18,490 181 1,621 20,292 Interest 459 - - 459 Total costs and expenses 422,742 26,889 35,483 485,114 Income (loss) from operations 37,431 4,839 (13,253 ) 29,017 Non-operating income - - 11,846 11,846 Gain on acquisition of equity method investment - - 95,202 95,202 Unrealized gains on marketable equity securities - - 570 570 Income before income taxes $ 37,431 $ 4,839 $ 94,365 $ 136,635 Six Months Ended June 30, 2020 Inpatient Homecare and Hospice All Other Total Revenues and grant income: Net patient revenues $ 445,374 $ 24,392 $ - $ 469,766 Other revenues 561 - 22,791 23,352 Government stimulus income 22,622 2,026 - 24,648 Net operating revenues and grant income 468,557 26,418 22,791 517,766 Costs and expenses: Salaries, wages, and benefits 271,595 16,279 16,509 304,383 Other operating 129,104 8,161 5,264 142,529 Rent 16,757 903 2,992 20,652 Depreciation and amortization 19,197 160 1,626 20,983 Interest 748 - 117 865 Total costs and expenses 437,401 25,503 26,508 489,412 Income (loss) from operations 31,156 915 (3,717 ) 28,354 Non-operating income - - 12,392 12,392 Gain on acquisition of equity method investment - - 1,708 1,708 Unrealized losses on marketable equity securities - - (40,339 ) (40,339 ) Income (loss) before income taxes $ 31,156 $ 915 $ (29,956 ) $ 2,115

Note 9 - Long-term Leases (Tabl

Note 9 - Long-term Leases (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Lessee, Lease, Liability, Maturity [Table Text Block]	Finance Leases Operating Leases 2022 $ 5,200 $ 36,047 2023 5,200 35,418 2024 3,467 34,918 2025 - 34,549 2026 - 34,343 Thereafter - 22,857 Total minimum lease payments 13,867 198,132 Less: amounts representing interest (1,082 ) (29,560 ) Present value of future minimum lease payments 12,785 168,572 Less: current portion (4,557 ) (26,873 ) Noncurrent lease liabilities $ 8,228 $ 141,699

Note 10 - Earnings Per Share (T

Note 10 - Earnings Per Share (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	Three Months Ended June 30 Six Months Ended June 30 2021 2020 2021 2020 Basic: Weighted average common shares outstanding 15,349,162 15,307,105 15,338,400 15,300,941 Net income attributable to National HealthCare Corporation $ 104,883 $ 28,324 $ 126,150 $ 1,472 Earnings per common share, basic $ 6.83 $ 1.85 $ 8.22 $ 0.10 Diluted: Weighted average common shares outstanding 15,349,162 15,307,105 15,338,400 15,300,941 Effects of dilutive instruments 69,850 65,325 66,234 66,523 Weighted average common shares outstanding 15,419,012 15,372,430 15,404,634 15,367,464 Net income attributable to National HealthCare Corporation $ 104,883 $ 28,324 $ 126,150 $ 1,472 Earnings per common share, diluted $ 6.80 $ 1.84 $ 8.19 $ 0.10

Note 11 - Investments in Mark_2

Note 11 - Investments in Marketable Securities (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Available-for-sale Securities [Table Text Block]	June 30, 2021 December 31, 2020 Amortized Cost Fair Value Amortized Cost Fair Value Investments available for sale: Marketable equity securities $ 30,176 $ 128,666 $ 30,176 $ 128,590 Corporate debt securities 20,009 19,930 25,812 25,778 Asset-backed securities 2,476 2,464 2,485 2,480 U.S. Treasury securities 11,298 11,257 19,519 19,504 Restricted investments available for sale: Marketable equity securities 24,783 25,174 4,783 4,680 Corporate debt securities 63,046 66,398 61,709 66,247 Asset-based securities 33,587 34,436 40,655 41,769 U.S. Treasury securities 22,234 22,015 20,760 21,159 State and municipal securities 9,543 9,846 12,497 12,898 $ 217,152 $ 320,186 $ 218,396 323,105
Schedule of Available-for-sale Securities Reconciliation [Table Text Block]	June 30, 2021 December 31, 2020 Shares Cost Fair Value Shares Cost Fair Value NHI Common Stock 1,630,642 $ 24,734 $ 109,335 1,630,642 $ 24,734 $ 112,792
Investments Classified by Contractual Maturity Date [Table Text Block]	June 30, 2021 December 31, 2020 Cost Fair Value Cost Fair Value Maturities: Within 1 year $ 41,415 $ 41,582 $ 49,694 $ 49,863 1 to 5 years 85,438 88,232 99,143 103,002 6 to 10 years 35,340 36,532 34,326 36,685 Over 10 years - - 274 285 $ 162,193 $ 166,346 $ 183,437 $ 189,835

Note 12 - Fair Value Measurem_2

Note 12 - Fair Value Measurements (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis [Table Text Block]	Fair Value Measurements Using June 30, 2021 Fair Value Quoted Prices Active For Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Cash and cash equivalents $ 134,692 $ 134,692 $ – $ – Restricted cash and cash equivalents 15,895 15,895 – – Marketable equity securities 153,840 153,840 – – Corporate debt securities 86,328 46,850 39,478 – Mortgage–backed securities 36,900 - 36,900 – U.S. Treasury securities 33,272 33,272 – – State and municipal securities 9,846 - 9,846 – Total financial assets $ 470,773 $ 384,549 $ 86,224 $ – Fair Value Measurements Using December 31, 2020 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 $ 147,093 $ 147,093 $ – $ – Restricted cash and cash equivalents 11,409 11,409 – – Marketable equity securities 133,270 133,270 – – Corporate debt securities 92,025 56,772 35,253 – Asset–backed securities 44,249 – 44,249 – U.S. Treasury securities 40,663 40,663 – – State and municipal securities 12,898 – 12,898 – Total financial assets $ 481,607 $ 389,207 $ 92,400 $ –

Note 13 - Goodwill and Other _2

Note 13 - Goodwill and Other Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Schedule of Goodwill [Table Text Block]	Inpatient Services Homecare and Hospice All Other Total January 1, 2021 $ 3,741 $ 17,600 $ – $ 21,341 Additions – 146,954 – 146,954 June 30, 2021 $ 3,741 $ 164,554 $ – $ 168,295

Note 15 - Stock-based Compens_2

Note 15 - Stock-based Compensation (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions [Table Text Block]	June 30, 2021 December 31, Risk–free interest rate 0.21 % 0.87 % Expected volatility 35.1 % 20.1 % Expected life, in years 2.2 2.2 Expected dividend yield 3.01 % 2.91 %
Share-based Payment Arrangement, Option, Activity [Table Text Block]	Number of Shares Weighted Average Exercise Price Aggregate Intrinsic Value Options outstanding at January 1, 2020 809,529 $ 71.24 $ – Options granted 104,057 73.98 – Options exercised (43,630 ) 63.37 – Options cancelled (3,000 ) 72.94 – Options outstanding at December 31, 2020 866,956 72.11 – Options granted 56,829 70.73 – Options exercised (148,900 ) 68.41 – Options cancelled (6,000 ) 72.94 – Options outstanding at June 30, 2021 768,885 $ 72.72 $ 648,212 Options exercisable at June 30, 2021 222,686 $ 69.84 $ 580,540
Share-based Payment Arrangement, Option, Exercise Price Range [Table Text Block]	Options Outstanding June 30, 2021 Exercise Prices Weighted Average Exercise Price Weighted Average Remaining Contractual Life in Years 103,809 60.73 - 67.28 63.66 2.9 665,076 71.64 - 84.30 74.14 1.1 768,885 72.72 1.3

Note 1 - Description of Busin_2

Note 1 - Description of Business (Details Textual)	Jun. 30, 2021
Number of Skilled Nursing Centers	75
Number of Beds	9,473
Number of Assisted Living Facilities	24
Number of Independent Living Facilities	5
Number of Geriatric Psychiatric Hospitals	1
Number of Homecare Programs	35
Number of Hospice Agencies	28
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			6 Months Ended
	Jun. 30, 2021USD ($)	Mar. 31, 2021	Jun. 30, 2020USD ($)	Jun. 30, 2021USD ($)	Jun. 30, 2020USD ($)	Dec. 31, 2020USD ($)
Accounts Receivable, Credit Loss Expense (Reversal)	$ 1,102,000		$ 1,245,000	$ 2,021,000	$ 2,075,000
Accounts Receivable, Allowance for Credit Loss, Ending Balance	6,841,000			6,841,000		$ 5,672,000
Number of Reportable Segments		2
General and Administrative Expense, Total	4,885,000		$ 4,892,000	10,254,000	$ 10,390,000
Contract with Customer, Refund Liability, Total	7,461,000			7,461,000		7,462,000
Continuing Care Retirement Communities, Refund Obligation	$ 2,177,000			$ 2,177,000		$ 2,177,000
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%
Minimum [Member]
Lessee, Operating Lease, Term of Contract (Year)	2 years			2 years
Minimum [Member] | Building and Building Improvements [Member]
Property, Plant and Equipment, Useful Life (Year)				20 years
Minimum [Member] | Equipment and Furniture [Member]
Property, Plant and Equipment, Useful Life (Year)				3 years
Maximum [Member]
Lessee, Operating Lease, Term of Contract (Year)	15 years			15 years
Maximum [Member] | Building and Building Improvements [Member]
Property, Plant and Equipment, Useful Life (Year)				40 years
Maximum [Member] | Equipment and Furniture [Member]
Property, Plant and Equipment, Useful Life (Year)				15 years

Note 3 - Coronavirus Pandemic (

Note 3 - Coronavirus Pandemic (Details Textual) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020	Dec. 31, 2020
Government Assistance Stimulus Income CARES Act	$ 15,126,000	$ 24,648,000	$ 37,875,000	$ 24,648,000
Provider Relief Funds	10,429,000		10,429,000		$ 16,068,000
Proceeds from Medicare Accelerated and Advance Payment Program			51,253,000
Contract with Customer, Liability, Current	40,121,000		40,121,000		$ 51,253,000
Proceeds from Government Assistance Medicare Accelerated and Advance Payment Program			0
Revenue from Contract with Customer, Including Assessed Tax	236,976,000	225,671,000	453,831,000	469,766,000
Supplemental Medicaid Payments [Member]
Revenue from Contract with Customer, Including Assessed Tax	$ 7,094,000	$ 3,858,000	11,049,000	$ 5,532,000
Medicare Accelerated and Advance Payment Program [Member]
Proceeds from Government Assistance Medicare Accelerated and Advance Payment Program			$ 21,153,000

Note 4 - Acquisition of Caris_3

Note 4 - Acquisition of Caris HealthCare, L.P. (Details Textual)	Jun. 11, 2021USD ($)	Jun. 30, 2021USD ($)	Jun. 30, 2021USD ($)	Jun. 30, 2020USD ($)	Jun. 30, 2021USD ($)	Jun. 30, 2020USD ($)
Business Combination, Step Acquisition, Equity Interest in Acquiree, Remeasurement Gain			$ 95,202,000	$ 0	$ 95,202,000	$ 1,708,000
Caris [Member]
Number of Patients Per Day in All Locations	1,200
Number of Locations in which Entity Operates	28
Acquisition of Caris [Member]
Business Acquisition, Percentage of Voting Interests Acquired	24.90%
Payments to Acquire Businesses, Net of Cash Acquired, Total	$ 28,713,000
Business Combination, Step Acquisition, Equity Interest in Acquiree, Percentage	75.10%
Business Combination, Step Acquisition, Equity Interest in Acquiree, Fair Value	$ 133,100,000
Business Combination, Step Acquisition, Equity Interest in Acquiree, Remeasurement Gain	$ 95,200,000
Business Combination, Pro Forma Information, Revenue of Acquiree since Acquisition Date, Actual		$ 3,712,000
Business Combination, Pro Forma Information, Earnings or Loss of Acquiree since Acquisition Date, Actual		$ 982,000
Acquisition of Caris [Member] | Minimum [Member]
Business Combination, Percentage of Goodwill Expected to Be Deductible for Income Tax Purposes	35.00%
Acquisition of Caris [Member] | Maximum [Member]
Business Combination, Percentage of Goodwill Expected to Be Deductible for Income Tax Purposes	40.00%

Note 4 - Acquisition of Caris_4

Note 4 - Acquisition of Caris HealthCare, L.P. - Allocation of Assets and Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Jun. 11, 2021	Dec. 31, 2020
Goodwill	$ 168,295		$ 21,341
Acquisition of Caris [Member]
Cash and cash equivalents		$ 15,515
Restricted cash and cash equivalents		58
Accounts receivable		10,544
Prepaid expenses and other assets		1,006
Property and equipment		3,608
Operating lease – right-of-use assets		1,600
Intangible assets		7,038
Total assets acquired		39,369
Trade accounts payable		3,459
Accrued payroll		3,223
Other current liabilities		587
Operating lease liabilities		1,600
Other noncurrent liabilities		58
Total liabilities assumed		8,927
Net identifiable assets acquired		30,442
Goodwill		146,954
Total estimated fair value of Caris		$ 177,396

Note 4 - Acquisition of Caris_5

Note 4 - Acquisition of Caris HealthCare, L.P. - Pro Forma Financial Information (Details) - Acquisition of Caris [Member] - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Net patient revenues	$ 249,733	$ 241,670	$ 481,802	$ 501,726
Total costs and expenses	258,754	261,573	506,320	514,274
Income from operations	17,161	16,068	35,782	35,452
Non-operating income	3,162	3,453	6,975	7,315
Income before income taxes	13,834	39,574	43,327	4,136
Net income attributable to NHC	$ 10,378	$ 29,077	$ 32,350	$ 2,968

Note 5 - Net Patient Revenues_2

Note 5 - Net Patient Revenues (Details Textual) - USD ($)	Jun. 30, 2021	Dec. 31, 2020
Contract with Customer, Liability, Current	$ 40,121,000	$ 51,253,000
Accounts Receivable, Allowance for Credit Loss, Ending Balance	6,841,000	5,672,000
Medicare and Medicaid [Member]
Accounts Receivable, Allowance for Credit Loss, Ending Balance	$ 16,931,000	$ 16,454,000

Note 5 - Net Patient Revenues -

Note 5 - Net Patient Revenues - Revenue Disaggregation (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Net patient revenues	$ 236,976	$ 225,671	$ 453,831	$ 469,766
Revenue, concentration percentage	100.00%	100.00%	100.00%	100.00%
Medicare [Member]
Revenue, concentration percentage	34.00%	32.00%	34.00%	33.00%
Inpatient Services [Member]
Net patient revenues	$ 218,860	$ 214,387	$ 422,103	$ 445,374
Managed Care [Member]
Revenue, concentration percentage	12.00%	10.00%	13.00%	11.00%
Homecare and Hospice [Member]
Net patient revenues	$ 18,116	$ 11,284	$ 31,728	$ 24,392
Medicaid [Member]
Revenue, concentration percentage	29.00%	32.00%	29.00%	30.00%
Private Pay and Other [Member]
Revenue, concentration percentage	25.00%	26.00%	24.00%	26.00%

Note 5 - Net Patient Revenues_3

Note 5 - Net Patient Revenues - Contract Liabilities (Details)	6 Months Ended
	Jun. 30, 2021USD ($)
Balance	$ 51,253,000
Payments received	0
Payments recouped	(11,132,000)
Balance	$ 40,121,000

Note 6 - Other Revenues (Detail

Note 6 - Other Revenues (Details Textual)	3 Months Ended		6 Months Ended
	Jun. 30, 2021USD ($)	Jun. 30, 2020USD ($)	Jun. 30, 2021USD ($)	Jun. 30, 2020USD ($)
Number of Skilled Nursing Centers	75		75
Insurance Services Revenue, Total	$ 1,277,000	$ 1,398,000	$ 2,541,000	$ 2,780,000
Workers Compensation Revenue [Member]
Insurance Services Revenue, Total	766,000	883,000	1,518,000	1,662,000
Professional Liability Insurance [Member]
Insurance Services Revenue, Total	$ 511,000	515,000	$ 1,023,000	1,118,000
National [Member]
Number of Skilled Nursing Centers	5		5
Property Management Fee Revenue	$ 940,000	$ 941,000	$ 1,837,000	$ 2,478,000
FLORIDA
Number of Skilled Nursing Centers	4		4

Note 6 - Other Revenues - Summa

Note 6 - Other Revenues - Summary of Other Revenues (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Rental income	$ 5,514	$ 5,646	$ 11,161	$ 11,325
Management and accounting services fees	4,136	4,121	8,460	8,600
Insurance services	1,277	1,398	2,541	2,780
Other	129	158	263	647
Total other revenues	$ 11,056	$ 11,323	$ 22,425	$ 23,352

Note 6 - Other Revenues - Renta

Note 6 - Other Revenues - Rental Income (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Operating lease payments	$ 5,303	$ 5,505	$ 10,809	$ 11,008
Variable lease payments	211	141	352	317
Total rental income	$ 5,514	$ 5,646	$ 11,161	$ 11,325

Note 7 - Non-operating Income_2

Note 7 - Non-operating Income (Details Textual) - Acquisition of Caris [Member]	Jun. 11, 2021
Business Acquisition, Percentage of Voting Interests Acquired	24.90%
Business Combination, Step Acquisition, Equity Interest in Acquiree, Percentage	75.10%

Note 7 - Non-operating Income -

Note 7 - Non-operating Income - Summary of Non-operating Income (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Equity in earnings of unconsolidated investments	$ 2,395	$ 2,618	$ 5,306	$ 5,429
Dividends and net realized gains on sales of securities	1,915	1,891	3,877	3,913
Interest income	1,276	1,445	2,663	3,050
Total non-operating income	$ 5,586	$ 5,954	$ 11,846	$ 12,392

Note 8 - Business Segments (Det

Note 8 - Business Segments (Details Textual)	6 Months Ended
	Jun. 30, 2021
Number of Operating Segments	2

Note 8 - Business Segments - Su

Note 8 - Business Segments - Summary of Financial Information by Reporting Segment (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Revenues:
Revenue from Contract with Customer, Including Assessed Tax	$ 236,976,000	$ 225,671,000	$ 453,831,000	$ 469,766,000
Other revenues	11,056,000	11,323,000	22,425,000	23,352,000
Government Assistance Stimulus Income CARES Act	15,126,000	24,648,000	37,875,000	24,648,000
Net operating revenues and grant income	263,158,000	261,642,000	514,131,000	517,766,000
Costs and expenses:
Salaries, wages, and benefits	156,804,000	156,914,000	301,934,000	304,383,000
Other operating	72,043,000	70,861,000	142,196,000	142,529,000
Rent	10,170,000	10,320,000	20,233,000	20,652,000
Depreciation and amortization	10,131,000	10,545,000	20,292,000	20,983,000
Interest	215,000	453,000	459,000	865,000
Total costs and expenses	249,363,000	249,093,000	485,114,000	489,412,000
Income (loss) from operations	13,795,000	12,549,000	29,017,000	28,354,000
Non-operating income (loss)	5,586,000	5,954,000	11,846,000	12,392,000
Business Combination, Step Acquisition, Equity Interest in Acquiree, Remeasurement Gain	95,202,000	0	95,202,000	1,708,000
Equity Securities, FV-NI, Unrealized Gain (Loss), Total	(6,489,000)	20,053,000	570,000	(40,339,000)
Income before income taxes	108,094,000	38,556,000	136,635,000	2,115,000
Inpatient Services Segment [Member]
Revenues:
Revenue from Contract with Customer, Including Assessed Tax	218,860,000	214,387,000	422,103,000	445,374,000
Other revenues	97,000	127,000	195,000	561,000
Government Assistance Stimulus Income CARES Act	15,126,000	22,622,000	37,875,000	22,622,000
Net operating revenues and grant income	234,083,000	237,136,000	460,173,000	468,557,000
Costs and expenses:
Salaries, wages, and benefits	128,573,000	136,380,000	257,383,000	271,595,000
Other operating	65,129,000	63,999,000	129,938,000	129,104,000
Rent	8,278,000	8,380,000	16,472,000	16,757,000
Depreciation and amortization	9,227,000	9,626,000	18,490,000	19,197,000
Interest	215,000	366,000	459,000	748,000
Total costs and expenses	211,422,000	218,751,000	422,742,000	437,401,000
Income (loss) from operations	22,661,000	18,385,000	37,431,000	31,156,000
Non-operating income (loss)	0	0	0	0
Business Combination, Step Acquisition, Equity Interest in Acquiree, Remeasurement Gain	0		0	0
Equity Securities, FV-NI, Unrealized Gain (Loss), Total	0	0	0	0
Income before income taxes	22,661,000	18,385,000	37,431,000	31,156,000
Homecare and Hospice Segment [Member]
Revenues:
Revenue from Contract with Customer, Including Assessed Tax	18,116,000	11,284,000	31,728,000	24,392,000
Other revenues	0	0	0	0
Government Assistance Stimulus Income CARES Act	0	2,026,000	0	2,026,000
Net operating revenues and grant income	18,116,000	13,310,000	31,728,000	26,418,000
Costs and expenses:
Salaries, wages, and benefits	10,482,000	7,963,000	18,890,000	16,279,000
Other operating	3,991,000	4,342,000	6,934,000	8,161,000
Rent	454,000	446,000	884,000	903,000
Depreciation and amortization	94,000	106,000	181,000	160,000
Interest	0	0	0	0
Total costs and expenses	15,021,000	12,857,000	26,889,000	25,503,000
Income (loss) from operations	3,095,000	453,000	4,839,000	915,000
Non-operating income (loss)	0	0	0	0
Business Combination, Step Acquisition, Equity Interest in Acquiree, Remeasurement Gain	0		0	0
Equity Securities, FV-NI, Unrealized Gain (Loss), Total	0	0	0	0
Income before income taxes	3,095,000	453,000	4,839,000	915,000
Other Segments [Member]
Revenues:
Revenue from Contract with Customer, Including Assessed Tax	0	0	0	0
Other revenues	10,959,000	11,196,000	22,230,000	22,791,000
Government Assistance Stimulus Income CARES Act	0	0	0	0
Net operating revenues and grant income	10,959,000	11,196,000	22,230,000	22,791,000
Costs and expenses:
Salaries, wages, and benefits	17,749,000	12,571,000	25,661,000	16,509,000
Other operating	2,923,000	2,520,000	5,324,000	5,264,000
Rent	1,438,000	1,494,000	2,877,000	2,992,000
Depreciation and amortization	810,000	813,000	1,621,000	1,626,000
Interest	0	87,000	0	117,000
Total costs and expenses	22,920,000	17,485,000	35,483,000	26,508,000
Income (loss) from operations	(11,961,000)	(6,289,000)	(13,253,000)	(3,717,000)
Non-operating income (loss)	5,586,000	5,954,000	11,846,000	12,392,000
Business Combination, Step Acquisition, Equity Interest in Acquiree, Remeasurement Gain	95,202,000		95,202,000	1,708,000
Equity Securities, FV-NI, Unrealized Gain (Loss), Total	(6,489,000)	20,053,000	570,000	(40,339,000)
Income before income taxes	$ 82,338,000	$ 19,718,000	$ 94,365,000	$ (29,956,000)

Note 9 - Long-term Leases (Deta

Note 9 - Long-term Leases (Details Textual)	3 Months Ended		6 Months Ended
	Jun. 30, 2021USD ($)	Jun. 30, 2020USD ($)	Jun. 30, 2021USD ($)	Jun. 30, 2020USD ($)	Mar. 31, 2021
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
Lessee, Lease, Annual Base Rent			$ 34,200,000
Lessee, Operating Lease Additional Percentage Rent Percentage			4.00%
Operating Lease, Expense	$ 9,492,000	$ 9,655,000	$ 18,903,000	$ 19,310,000
Lease One With NHI [Member]
Number of Skilled Nursing Facilities Subleased					4
Senior Healthcare Facilities [Member]
Number of Facilities under Finance Leases	3		3
Number of Finance Lease Agreements	3		3
Lessee, Finance Lease, Term of Contract (Year)	10 years		10 years
Number of Additional Lease Options	2		2
Lessee, Finance Lease, Annual Base Rent Expense			$ 5,200,000
Lessee, Finance Lease Additional Percentage Rent Percentage			4.00%
Lessee, Finance Lease, Renewal Term (Year)	5 years		5 years

Note 9 - Long-term Leases - Mat

Note 9 - Long-term Leases - Maturity of Lease Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
2022, finance leases	$ 5,200
2022, operating leases	36,047
2023, finance leases	5,200
2023, operating leases	35,418
2024, finance leases	3,467
2024, operating leases	34,918
2025, finance leases	0
2025, operating leases	34,549
2026, finance leases	0
2026, operating leases	34,343
Thereafter, finance leases	0
Thereafter, operating leases	22,857
Total minimum lease payments, finance leases	13,867
Total minimum lease payments, operating leases	198,132
Less: amounts representing interest, finance leases	(1,082)
Less: amounts representing interest, operating leases	(29,560)
Present value of future minimum lease payments, finance leases	12,785
Present value of future minimum lease payments, operating leases	168,572
Less: current portion, finance leases	(4,557)	$ (4,423)
Less: current portion, operating leases	(26,873)	(25,451)
Noncurrent lease liabilities, finance leases	8,228	10,540
Noncurrent lease liabilities, operating leases	$ 141,699	$ 153,604

Note 10 - Earnings Per Share (D

Note 10 - Earnings Per Share (Details Textual) - shares	6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020
Share-based Payment Arrangement, Option [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount (in shares)	631,905	698,421

Note 10 - Earnings Per Share -

Note 10 - Earnings Per Share - Summary of Earnings and Weighted Average Number of Common Shares Used in Calculation of Basic and Diluted Earnings Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Basic:
Weighted average common shares outstanding (in shares)	15,349,162	15,307,105	15,338,400	15,300,941
Net income attributable to National HealthCare Corporation	$ 104,883	$ 28,324	$ 126,150	$ 1,472
Earnings per common share, basic (in dollars per share)	$ 6.83	$ 1.85	$ 8.22	$ 0.10
Diluted:
Weighted average common shares outstanding (in shares)	15,349,162	15,307,105	15,338,400	15,300,941
Effects of dilutive instruments (in shares)	69,850	65,325	66,234	66,523
Weighted average common shares outstanding (in shares)	15,419,012	15,372,430	15,404,634	15,367,464
Net income attributable to National HealthCare Corporation	$ 104,883	$ 28,324	$ 126,150	$ 1,472
Earnings per common share, diluted (in dollars per share)	$ 6.80	$ 1.84	$ 8.19	$ 0.10
Share-based Payment Arrangement, Option [Member]
Basic:
Weighted average common shares outstanding (in shares)	15,349,162	15,307,105	15,338,400	15,300,941
Diluted:
Weighted average common shares outstanding (in shares)	15,349,162	15,307,105	15,338,400	15,300,941

Note 11 - Investments in Mark_3

Note 11 - Investments in Marketable Securities (Details Textual) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020	Dec. 31, 2020
Equity Securities Fv Ni Gross Unrealized Gain	$ 99,232,000		$ 99,232,000		$ 98,445,000
Equity Securities Fv Ni Gross Unrealized Loss	351,000		351,000		134,000
Equity Securities, FV-NI, Unrealized Gain (Loss), Total	(6,489,000)	$ 20,053,000	570,000	$ (40,339,000)
Debt Securities, Available-for-sale, Accumulated Gross Unrealized Gain, before Tax	4,806,000		4,806,000		6,759,000
Debt Securities, Available-for-sale, Accumulated Gross Unrealized Loss, before Tax	653,000		653,000		$ 361,000
Other-than-temporary Impairment Loss, Debt Securities, Available-for-sale, Total	$ 0	$ 0	0	0
Proceeds from Sale and Maturity of Marketable Securities, Total			44,939,000	19,823,000
Debt Securities, Realized Gain (Loss), Total			212,000	13,000
Equity Securities, FV-NI, Realized Gain (Loss), Total			$ 0	$ 0

Note 11 - Investments in Mark_4

Note 11 - Investments in Marketable Securities - Marketable Securities and Restricted Marketable Securities (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Marketable equity securities	$ 128,666	$ 128,590
Unrestricted investments available for sale, debt, amortized cost	162,193	183,437
Unrestricted investments available for sale, debt, fair value	166,346	189,835
Restricted marketable equity securities	25,174	4,680
Investments available for sale, amortized cost	217,152	218,396
Marketable Securities, Total	320,186	323,105
Equity Securities [Member]
Unrestricted investments available for sale, equity, amortized cost	30,176	30,176
Marketable equity securities	128,666	128,590
Restricted investments available for sale, equity, amortized cost	24,783	4,783
Restricted marketable equity securities	25,174	4,680
Corporate Debt Securities [Member]
Unrestricted investments available for sale, debt, amortized cost	20,009	25,812
Unrestricted investments available for sale, debt, fair value	19,930	25,778
Restricted investments available for sale, debt, amortized cost	63,046	61,709
Restricted investments available for sale, debt, fair value	66,398	66,247
Asset-backed Securities [Member]
Unrestricted investments available for sale, debt, amortized cost	2,476	2,485
Unrestricted investments available for sale, debt, fair value	2,464	2,480
Restricted investments available for sale, debt, amortized cost	33,587	40,655
Restricted investments available for sale, debt, fair value	34,436	41,769
US Government Corporations and Agencies Securities [Member]
Unrestricted investments available for sale, debt, amortized cost	11,298	19,519
Unrestricted investments available for sale, debt, fair value	11,257	19,504
Restricted investments available for sale, debt, amortized cost	22,234	20,760
Restricted investments available for sale, debt, fair value	22,015	21,159
US States and Political Subdivisions Debt Securities [Member]
Restricted investments available for sale, debt, amortized cost	9,543	12,497
Restricted investments available for sale, debt, fair value	$ 9,846	$ 12,898

Note 11 - Investments in Mark_5

Note 11 - Investments in Marketable Securities - Available for Sale Marketable Equity Securities (Details) - NHI Common Stock [Member] - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
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	$ 109,335	$ 112,792

Note 11 - Investments in Mark_6

Note 11 - Investments in Marketable Securities - Amortized Cost and Estimated Fair Value of Debt Securities as Available for Sale (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Within 1 year, cost	$ 41,415	$ 49,694
Within 1 year, fair value	41,582	49,863
1 to 5 years, cost	85,438	99,143
1 to 5 years, fair value	88,232	103,002
6 to 10 years, cost	35,340	34,326
6 to 10 years, fair value	36,532	36,685
Over 10 years, cost	0	274
Over 10 years, fair value	0	285
Cost	162,193	183,437
Fair Value	$ 166,346	$ 189,835

Note 12 - Fair Value Measurem_3

Note 12 - Fair Value Measurements - Summary of Fair Value Measurements by Level (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020	Jun. 30, 2020
Restricted cash and cash equivalents	$ 15,895		$ 21,308
Available-for-sale securities	166,346	$ 189,835
Corporate Debt Securities [Member]
Available-for-sale securities	19,930	25,778
Asset-backed Securities [Member]
Available-for-sale securities	2,464	2,480
Fair Value, Recurring [Member]
Cash and cash equivalents	134,692	147,093
Restricted cash and cash equivalents	15,895	11,409
Marketable equity securities	153,840	133,270
Total financial assets	470,773	481,607
Fair Value, Recurring [Member] | Corporate Debt Securities [Member]
Available-for-sale securities	86,328	92,025
Fair Value, Recurring [Member] | Collateralized Mortgage Backed Securities [Member]
Available-for-sale securities	36,900
Fair Value, Recurring [Member] | Asset-backed Securities [Member]
Available-for-sale securities		44,249
Fair Value, Recurring [Member] | US Treasury Securities [Member]
Available-for-sale securities	33,272	40,663
Fair Value, Recurring [Member] | US States and Political Subdivisions Debt Securities [Member]
Available-for-sale securities	9,846	12,898
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 1 [Member]
Cash and cash equivalents	134,692	147,093
Restricted cash and cash equivalents	15,895	11,409
Marketable equity securities	153,840	133,270
Total financial assets	384,549	389,207
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | Corporate Debt Securities [Member]
Available-for-sale securities	46,850	56,772
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	33,272	40,663
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
Marketable equity securities	0	0
Total financial assets	86,224	92,400
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | Corporate Debt Securities [Member]
Available-for-sale securities	39,478	35,253
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | Collateralized Mortgage Backed Securities [Member]
Available-for-sale securities	36,900
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | Asset-backed Securities [Member]
Available-for-sale securities		44,249
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	$ 9,846	$ 12,898

Note 13 - Goodwill and Other _3

Note 13 - Goodwill and Other Intangible Assets (Details Textual) - USD ($)	Jun. 11, 2021	Jun. 30, 2021
Goodwill, Impairment Loss		$ 0
Acquisition of Caris [Member] | Trade Names [Member]
Indefinite-lived Intangible Assets Acquired	$ 4,340,000
Acquisition of Caris [Member] | Certificates of Need and Licenses [Member]
Indefinite-lived Intangible Assets Acquired	$ 2,698,000

Note 13 - Goodwill and Other _4

Note 13 - Goodwill and Other Intangible Assets - Activity Related to Goodwill By Segment (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2021USD ($)
Goodwill, beginning balance	$ 21,341
Additions	146,954
Goodwill, ending balance	168,295
Inpatient Services Segment [Member]
Goodwill, beginning balance	3,741
Additions	0
Goodwill, ending balance	3,741
Homecare and Hospice Segment [Member]
Goodwill, beginning balance	17,600
Additions	146,954
Goodwill, ending balance	$ 164,554

Note 14 - Stock Repurchase Pr_2

Note 14 - Stock Repurchase Program (Details Textual) - Common Stock [Member]	6 Months Ended
	Jun. 30, 2021USD ($)shares
Stock Repurchased and Retired During Period, Shares (in shares) | shares	3,936
Stock Repurchased and Retired During Period, Value | $	$ 278,000

Note 15 - Stock-based Compens_3

Note 15 - Stock-based Compensation (Details Textual) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Share-based Payment Arrangement, Expense	$ 683,000	$ 823,000	$ 1,179,000	$ 1,289,000
Share-based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount, Total	$ 2,494,000		$ 2,494,000
Share-based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition (Year)			1 year

Note 15 - Stock-based Compens_4

Note 15 - Stock-based Compensation - Summary of Assumptions Used to Value Options Granted (Details)	6 Months Ended	12 Months Ended
	Jun. 30, 2021	Dec. 31, 2020
Risk–free interest rate	0.21%	0.87%
Expected volatility	35.10%	20.10%
Expected life (Year)	2 years 2 months 12 days	2 years 2 months 12 days
Expected dividend yield	3.01%	2.91%

Note 15 - Stock-based Compens_5

Note 15 - Stock-based Compensation - Summary of Options Outstanding (Details)	6 Months Ended	12 Months Ended
	Jun. 30, 2021USD ($)$ / sharesshares	Dec. 31, 2020$ / sharesshares
Options outstanding, shares (in shares) | shares	866,956	809,529
Options outstanding, weighted average exercise price (in dollars per share) | $ / shares	$ 72.11	$ 71.24
Options granted, shares (in shares) | shares	56,829	104,057
Options granted, weighted average exercise price (in dollars per share) | $ / shares	$ 70.73	$ 73.98
Options exercised, shares (in shares) | shares	(148,900)	(43,630)
Options exercised, weighted average exercise price (in dollars per share) | $ / shares	$ 68.41	$ 63.37
Options cancelled, shares (in shares) | shares	(6,000)	(3,000)
Options cancelled, weighted average exercise price (in dollars per share) | $ / shares	$ 72.94	$ 72.94
Options outstanding, shares (in shares) | shares	768,885	866,956
Options outstanding, weighted average exercise price (in dollars per share) | $ / shares	$ 72.72	$ 72.11
Options outstanding, aggregate intrinsic value | $	$ 648,212
Options exercisable, shares (in shares) | shares	222,686
Options exercisable, weighted average exercise price (in dollars per share) | $ / shares	$ 69.84
Options exercisable, aggregate intrinsic value | $	$ 580,540

Note 15 - Stock-based Compens_6

Note 15 - Stock-based Compensation - Options Outstanding by Exercise Price Range (Details)	6 Months Ended
	Jun. 30, 2021$ / sharesshares
Options outstanding (in shares) | shares	768,885
Weighted average exercise price (in dollars per share)	$ 72.72
Weighted average remaining contractual life (Year)	1 year 3 months 18 days
Exercise Price Range 1 [Member]
Options outstanding (in shares) | shares	103,809
Exercise price, lower range (in dollars per share)	$ 60.73
Exercise price, upper range (in dollars per share)	67.28
Weighted average exercise price (in dollars per share)	$ 63.66
Weighted average remaining contractual life (Year)	2 years 10 months 24 days
Exercise Price Range 2 [Member]
Options outstanding (in shares) | shares	665,076
Exercise price, lower range (in dollars per share)	$ 71.64
Exercise price, upper range (in dollars per share)	84.30
Weighted average exercise price (in dollars per share)	$ 74.14
Weighted average remaining contractual life (Year)	1 year 1 month 6 days

Note 16 - Income Taxes (Details

Note 16 - Income Taxes (Details Textual)	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Effective Income Tax Rate Reconciliation, Percent, Total	2.60%	26.00%	7.30%	19.40%

Note 17 - Contingencies and C_2

Note 17 - Contingencies and Commitments (Details Textual) - USD ($)	Jun. 30, 2021	Dec. 31, 2020
Self Insurance Reserve	$ 101,850,000	$ 99,537,000