National Health Investors (NHI) 10-Q 8 May 18 2018 Q1 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	3 Months Ended
	Mar. 31, 2018	May 04, 2018
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2018
Document Fiscal Year Focus	2,018
Document Fiscal Period Focus	Q1
Entity Registrant Name	NATIONAL HEALTH INVESTORS INC
Entity Central Index Key	877,860
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		41,532,154

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Assets
Land	$ 192,953	$ 191,623
Buildings and improvements	2,485,951	2,471,602
Construction in progress	4,781	2,678
Real estate properties, gross	2,683,685	2,665,903
Less accumulated depreciation	(397,538)	(380,202)
Real estate properties, net	2,286,147	2,285,701
Mortgage and other notes receivable, net	145,845	141,486
Cash and cash equivalents	3,230	3,063
Straight-line rent receivable	102,046	97,359
Other assets	22,160	18,212
Total Assets	2,559,428	2,545,821
Liabilities and Equity
Debt	1,160,226	1,145,497
Accounts payable and accrued expenses	16,514	17,476
Dividends Payable	41,532	39,456
Lease deposit liabilities	21,275	21,275
Total Liabilities	1,239,547	1,223,704
Commitments and Contingencies
Stockholders' Equity:
Common stock, $.01 par value; 60,000,000 shares authorized; 40,978,934 and 39,847,860 shares issued and outstanding, respectively	415	415
Capital in excess of par value	1,288,861	1,289,919
Cumulative net income in excess of dividends	29,270	32,605
Accumulated other comprehensive income	1,335	(822)
Total Stockholders' Equity	1,319,881	1,322,117
Total Liabilities and Equity	$ 2,559,428	$ 2,545,821

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Mar. 31, 2018	Dec. 31, 2017
Statement of Financial Position [Abstract]
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	60,000,000	60,000,000
Common stock, shares issued	41,532,154	41,532,154
Common stock, shares outstanding	41,532,154	41,532,154

Consolidated Statements Of Inco

Consolidated Statements Of Income - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Revenues:
Rental income	$ 69,253	$ 63,127
Interest income from mortgage and other notes	3,460	3,089
Investment income and other	33	162
Revenues	72,746	66,378
Expenses:
Depreciation	17,335	16,144
Interest, including amortization of debt discount and issuance costs	11,614	11,661
Legal	111	56
Franchise, excise and other taxes	346	267
General and administrative	4,170	4,108
Total operating expenses	33,576	32,236
Income before equity-method investee, TRS tax benefit, investment and other gains and noncontrolling interest	39,170	34,142
Loss on convertible note retirement	(738)	0
Investment and other gains	0	10,088
Net income	$ 38,432	$ 44,230
Weighted average common shares outstanding:
Basic	41,532,154	39,953,804
Diluted	41,576,876	40,108,762
Basic:
Net income per common share attributable to common stockholders	$ 0.93	$ 1.11
Diluted:
Net income per common share attributable to common stockholders	$ 0.92	$ 1.10

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Statement of Comprehensive Income [Abstract]
Net income	$ 38,432	$ 44,230
Other comprehensive income (loss):
Change in unrealized gains on securities	0	(26)
Reclassification for amounts recognized in investment and other gains	0	(10,038)
Increase (decrease) in fair value of cash flow hedge	(1,646)	(465)
Less: reclassification adjustment for amounts recognized in net income	276	789
Total other comprehensive income (loss)	1,922	(8,810)
Comprehensive income	$ 40,354	$ 35,420

Consolidated Statements Of Cash

Consolidated Statements Of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Cash flows from operating activities:
Net income	$ 38,432	$ 44,230
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	17,335	16,144
Amortization	1,069	1,337
Straight-line rental income	(5,962)	(5,755)
Non-cash interest income on construction loan	(436)	(271)
Gain on sale of real estate	0	(50)
Loss on modification and extinguishment of debt	738	0
Gain on sale of marketable securities	0	(10,038)
Share-based compensation	1,425	1,523
Amortization of commitment fees	(552)	(104)
Amortization of lease incentives	63	10
Change in operating assets and liabilities:
Other assets	(4,245)	(657)
Accounts payable and accrued expenses	641	2,306
Net cash provided by operating activities	48,508	48,675
Cash flows from investing activities:
Investment in mortgage and other notes receivable	(5,905)	(28,338)
Collection of mortgage and other notes receivable	2,535	12,109
Investment in real estate	(14,404)	(118,011)
Investment in real estate development	0	(3,842)
Investment in renovations of existing real estate	(1,812)	(994)
Proceeds from disposition of real estate properties	0	450
Proceeds from sales of marketable securities	0	18,182
Net cash used in investing activities	(19,586)	(120,444)
Cash flows from financing activities:
Proceeds from revolving credit facilities	56,000	112,000
Payments on revolving credit facilities	(15,000)	(83,000)
Payments on term loans	(285)	(196)
Value of shares withheld from options exercised for employee tax withholding	0	(116)
Proceeds from issuance of common shares, net	0	79,797
Deferred offering costs	(56)	0
Consideration provided in convertible bond repurchase	(29,958)	0
Dividends paid to stockholders	(39,456)	(35,863)
Net cash provided by (used in) financing activities	(28,755)	72,622
(Decrease) increase in cash and cash equivalents	167	853
Cash and cash equivalents, beginning of year	3,063	4,832
Cash and cash equivalents, end of year	3,230	5,685
Supplemental disclosure of cash flow information:
Interest Paid	9,904	9,164
Supplemental schedule of non-cash investing and financing activities:
Accounts payable related to investments in real estate	290	824
Tenant investment in leased asset	$ 1,275	$ 1,250

Consolidated Statement Of Equit

Consolidated Statement Of Equity - USD ($)	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Cumulative Dividends In Excess Of Net Income [Member]	Accumulated Other Comprehensive Income (Loss) [Member]
Increase (Decrease) in Stockholders' Equity [Roll Forward]
New Accounting Pronouncement or Change in Accounting Principle, Cumulative Effect of Change on Equity or Net Assets				$ (235,000)	$ 235,000
Balance, shares at Dec. 31, 2017	41,532,154	41,532,154
Balance, value at Dec. 31, 2017	$ 1,322,117,000	$ 415,000	$ 1,289,919,000	32,605,000	(822,000)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss) attributable to common stockholders	38,432,000			38,432,000	1,922,000
Comprehensive Income (Loss), Net of Tax, Attributable to Parent	40,354,000
Adjustments to Additional Paid in Capital, Equity Component of Convertible Debt, Subsequent Adjustments	(2,427,000)		(2,427,000)
Equity Issuance Costs	(56,000)		(56,000)
Share-based compensation	1,425,000		1,425,000
Dividends declared, $1.54 per share	(41,532,000)			(41,532,000)
Balance, value at Mar. 31, 2018	$ 1,319,881,000	$ 415,000	$ 1,288,861,000	$ 29,270,000	$ 1,335,000
Balance, shares at Mar. 31, 2018	41,532,154	41,532,154
Increase (Decrease) in Stockholders' Equity [Roll Forward]
New Accounting Pronouncement or Change in Accounting Principle, Cumulative Effect of Change on Equity or Net Assets	$ 235,000

Consolidated Statement Of Equi8

Consolidated Statement Of Equity Consolidated Statement of Equity (Parenthetical)	3 Months Ended
	Mar. 31, 2018$ / shares
Statement of Stockholders' Equity [Abstract]
Common Stock, Dividends, Per Share, Declared	$ 1

Significant Accounting Policies

Significant Accounting Policies	3 Months Ended
	Mar. 31, 2018
Accounting Policies [Abstract]
Significant Accounting Policies	SIGNIFICANT ACCOUNTING POLICIES We, the management of National Health Investors, Inc., (“NHI” or the “Company”) believe that the unaudited condensed consolidated financial statements of which these notes are an integral part include all normal, recurring adjustments that are necessary to fairly present the condensed consolidated financial position, results of operations and cash flows of NHI in all material respects. The Condensed Consolidated Balance Sheet at December 31, 2017 has been derived from the audited consolidated financial statements at that date. We assume that users of these condensed consolidated financial statements have read or have access to the audited December 31, 2017 consolidated financial statements and that the adequacy of additional disclosure needed for a fair presentation, except regarding material contingencies, may be determined in that context. Accordingly, footnotes and other disclosures which would substantially duplicate those contained in our most recent Annual Report on Form 10-K for the year ended December 31, 2017 have been omitted. This condensed consolidated financial information is not necessarily indicative of the results that may be expected for a full year for a variety of reasons including, but not limited to, acquisitions and dispositions, changes in interest rates, rents and the timing of debt and equity financings. For a better understanding of NHI and its condensed consolidated financial statements, we recommend reading these condensed consolidated financial statements in conjunction with the audited consolidated financial statements for the year ended December 31, 2017 , which are included in our 2017 Annual Report on Form 10-K filed with the U.S. Securities and Exchange Commission, a copy of which is available at our web site: www.nhireit.com . Principles of Consolidation - The accompanying condensed consolidated financial statements include our accounts and the accounts of our wholly-owned subsidiaries, joint ventures, partnerships and consolidated variable interest entities (“VIE”), if any. All intercompany transactions and balances have been eliminated in consolidation. Net income is reduced by the portion of net income attributable to noncontrolling interests, if any. A VIE is broadly defined as an entity with one or more of the following characteristics: (a) the total equity investment at risk is insufficient to finance the entity’s activities without additional subordinated financial support; (b) as a group, the holders of the equity investment at risk lack (i) the ability to make decisions about the entity’s activities through voting or similar rights, (ii) the obligation to absorb the expected losses of the entity, or (iii) the right to receive the expected residual returns of the entity; or (c) the equity investors have voting rights that are not proportional to their economic interests, and substantially all of the entity’s activities either involve, or are conducted on behalf of, an investor that has disproportionately few voting rights. We apply Financial Accounting Standards Board (“FASB”) guidance for our arrangements with VIEs which requires us to identify entities for which control is achieved through means other than voting rights and to determine which business enterprise is the primary beneficiary of the VIE. In accordance with FASB guidance, management must evaluate each of the Company’s contractual relationships which creates a variable interest in other entities. If the Company has a variable interest and the entity is a VIE, then management must determine whether the Company is the primary beneficiary of the VIE. If it is determined that the Company is the primary beneficiary, NHI consolidates the VIE. We identify the primary beneficiary of a VIE as the enterprise that has both: (i) the power to direct the activities of the VIE that most significantly impact the entity’s economic performance; and (ii) the obligation to absorb losses or the right to receive benefits of the VIE that could be significant to the entity. We perform this analysis on an ongoing basis. At March 31, 2018 , we held an interest in eight unconsolidated VIEs and, because we generally lack either directly or through related parties any material input in the activities that most significantly impact their economic performance, we have concluded that NHI is not the primary beneficiary. Accordingly, we account for our transactions with these entities and their subsidiaries at amortized cost. Our VIEs are summarized below by date of initial involvement. For further discussion of the nature of the relationships, including the sources of our exposure to these VIEs, see the notes to our condensed consolidated financial statements cross-referenced below. Date Name Source of Exposure Carrying Amount Maximum Exposure to Loss Note Reference 2012 Bickford Various 1 $ 33,528,000 $ 55,360,000 Notes 2, 3 2014 Senior Living Communities Notes and straight-line receivable $ 39,106,000 $ 53,377,000 Notes 2, 3 2014 Life Care Services affiliate Notes receivable $ 54,693,000 $ 59,754,000 Note 3 2015 East Lake Capital Mgmt. Straight-line receivable $ 3,531,000 $ 3,531,000 2016 The Ensign Group developer N/A $ — $ — Note 2 2016 Senior Living Management Notes and straight-line receivable $ 26,315,000 $ 26,315,000 Note 3 2017 Navion Senior Solutions Straight-line receivable $ 355,000 $ 355,000 2017 Evolve Senior Living Note receivable $ 9,913,000 $ 9,913,000 1 Notes, straight-line rent receivables, and unamortized lease incentives We are not obligated to provide support beyond our stated commitments to these tenants and borrowers whom we classify as VIEs, and accordingly our maximum exposure to loss as a result of these relationships is limited to the amount of our commitments, as shown above and discussed in the notes. When the above relationships involve leases, some additional exposure to economic loss is present. Generally, additional economic loss on a lease, if any, would be limited to that resulting from a short period of arrearage and non-payment of monthly rent before we are able to take effective remedial action, as well as costs incurred in transitioning the lease. The potential extent of such loss will be dependent upon individual facts and circumstances, cannot be quantified, and is therefore not included in the tabulation above. Typically, the only carrying amounts involving our leases are accumulated straight-line receivables. For VIE relationships listed above without a note reference, please refer to our most recent Annual Report on Form 10-K for the year ended December 31, 2017 . Use of Estimates - The preparation of financial statements in conformity with accounting principles generally accepted in the U.S. requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, 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. Earnings Per Share - The weighted average number of common shares outstanding during the reporting period is used to calculate basic earnings per common share. Diluted earnings per common share assumes the exercise of stock options using the treasury stock method, to the extent dilutive. Diluted earnings per share also incorporate the potential dilutive impact of our convertible senior notes. We apply the treasury stock method to our convertible debt instruments, the effect of which is that conversion will not be assumed for purposes of computing diluted earnings per share unless the average share price for the period exceeds the conversion price per share. Reclassifications - We have reclassified certain balances where necessary to conform the presentation of prior periods to the current period. These reclassifications had no effect on previously reported net income. New Accounting Pronouncements - For a review of recent accounting pronouncements pertinent to our operations and management’s judgment as to the impact that the eventual adoption of these pronouncements will have on our financial position and results of operations, see Note 11.

Real Estate

Real Estate	3 Months Ended
	Mar. 31, 2018
Real Estate [Abstract]
Real Estate Disclosure [Text Block]	REAL ESTATE As of March 31, 2018 , we owned 210 health care real estate properties located in 32 states and consisting of 136 senior housing communities (“SHO”), 69 skilled nursing facilities (“SNF”), 3 hospitals and 2 medical office buildings. Our senior housing communities include assisted living facilities, senior living campuses, independent living facilities, and entrance-fee communities. These investments (excluding our corporate office of $1,298,000 ) consisted of properties with an original cost of approximately $2,682,387,000 rented under triple-net leases to 27 lessees. Ensign On January 12, 2018, NHI acquired from a developer a 121 -bed skilled nursing facility in Waxahachie, Texas for a cash investment of $14,404,000 plus $1,275,000 contributed by the lessee, The Ensign Group (“Ensign”). The facility is included under our existing master lease with Ensign for the remaining lease term of 13 years plus renewal options. The initial lease rate is set at 8.2% subject to annual escalators based on prevailing inflation rates. The acquisition was accounted for as an asset purchase. With the acquisition of the Waxahachie property, NHI has a continuing commitment to purchase from the developer two new skilled nursing facilities in Texas for approximately $28,000,000 which are newly developed, leased to Legend Healthcare (“Legend”) and subleased to Ensign. The fixed-price nature of the commitment creates a variable interest for NHI in the developer, whom NHI considers to lack sufficient equity to finance its operations without recourse to additional subordinated debt. The presence of these conditions causes the developer to be considered a VIE. Major Tenants Bickford As of March 31, 2018 our Bickford Senior Living (“Bickford”) portfolio consists of leases with lease expiration dates as follows (in thousands) : Lease Expiration Sept / Oct 2019 June 2023 Sept 2027 May 2031 Total Number of Properties 10 13 4 20 47 2018 Annual Contractual Rent $ 9,264 $ 11,133 $ 1,515 $ 20,030 $ 41,942 Straight Line Rent Adjustment (617 ) 588 221 3,813 4,005 Total Revenues $ 8,647 $ 11,721 $ 1,736 $ 23,843 $ 45,947 Of our total revenues, $11,445,000 ( 16% ) and $9,373,000 ( 14% ) were recognized as rental income from Bickford for the three months ended March 31, 2018 and 2017 , including $1,169,000 and $910,000 in straight-line rent income, respectively. Senior Living Communities As of March 31, 2018 , we leased nine retirement communities totaling 1,970 units to Senior Living Communities, LLC (“Senior Living”). The 15 -year master lease, which began in December 2014, contains two 5 -year renewal options and provides for an annual escalator of 4% effective January 1, 2018 and 3% thereafter. Of our total revenues, $11,449,000 ( 16% ) and $11,431,000 ( 17% ) in rental income were derived from Senior Living for the three months ended March 31, 2018 and 2017 , respectively, including $1,359,000 and $1,746,000 in straight-line rent income. Holiday As of March 31, 2018 , we leased 25 independent living facilities to an affiliate of Holiday Retirement (“Holiday”). The 17 -year master lease, which began in December 2013, currently provides for a minimum escalator of 3.5% through the end of the lease term. Of our total revenues, $10,954,000 ( 15% ) and $10,954,000 ( 17% ) were derived from Holiday for the three months ended March 31, 2018 and 2017 , including $1,530,000 and $1,849,000 in straight-line rent income, respectively. Our tenant operates the facilities pursuant to a management agreement with a Holiday-affiliated manager. NHC As of March 31, 2018 , we leased 42 facilities under two master leases to National HealthCare Corporation (“NHC”), a publicly-held company and the lessee of our legacy properties. The facilities leased to NHC consist of 3 independent living facilities and 39 skilled nursing facilities ( 4 of which are subleased to other parties for whom the lease payments are guaranteed to us by NHC). These facilities are leased to NHC under the terms of an amended master lease agreement originally dated October 17, 1991 (“the 1991 lease”) which includes our 35 remaining legacy properties and a master lease agreement dated August 30, 2013 (“the 2013 lease”) which includes 7 skilled nursing facilities acquired from a third party. The 1991 lease has been amended to extend the lease expiration to December 31, 2026. There are two additional 5 -year renewal options, each at fair rental value of such leased property as negotiated between the parties and determined without including the value attributable to any improvements to the leased property voluntarily made by NHC at its expense. Under the terms of the 1991 lease, the base annual rental is $30,750,000 and rent escalates by 4% of the increase, if any, in each facility’s revenue over a 2007 base year. The 2013 lease provides for a base annual rental of $3,450,000 and has a lease expiration of August 2028. Under the terms of the 2013 lease, rent escalates 4% of the increase, if any, in each facility’s revenue over the 2014 base year. For both the 1991 lease and the 2013 lease, we refer to this additional rent component as “percentage rent.” During the last three years of the 2013 lease, NHC will have the option to purchase the facilities for $49,000,000 . The following table summarizes the percentage rent income from NHC ( in thousands ): Three Months Ended March 31, 2018 2017 Current year $ 853 $ 782 Prior year final certification 1 285 194 Total percentage rent income $ 1,138 $ 976 1 For purposes of the percentage rent calculation described in the master lease agreement, NHC’s annual revenue by facility for a given year is certified to NHI by March 31st of the following year. Of our total revenues, $9,674,000 ( 13% ) and $9,513,000 ( 14% ) were derived from NHC for the three months ended March 31, 2018 and 2017 , respectively. The chairman of our board of directors is also a director on NHC’s board of directors. As of March 31, 2018 , NHC owned 1,630,462 shares of our common stock. Tenant Non-Compliance In October 2017, we issued a letter of forbearance to one of our tenants for a default on our lease terms involving lease coverage and arrearages to certain vendors. Lease revenues from the tenant and its affiliates comprise less than 4% of our rental income, and the related straight-line rent receivable was approximately $3,773,000 at March 31, 2018 . The tenant has maintained its status as current on all rent payments to NHI, and we have made no rent concessions. We continue to work with the tenant to resolve their defaults. The defaults mentioned above typically give rise to considerations regarding the impairment or recoverability of the related assets, and we give additional attention to the nature of the default’s underlying causes. At this time, our assessment of likely undiscounted cash flows reveals no basis for an impairment charge on the underlying real estate.

Mortgage And Other Notes Receiv

Mortgage And Other Notes Receivable	3 Months Ended
	Mar. 31, 2018
Financing Receivable, Net [Abstract]
Mortgage Notes Receivable	MORTGAGE AND OTHER NOTES RECEIVABLE At March 31, 2018 , we had net investments in mortgage notes receivable with a carrying value of $102,536,000 , secured by real estate and UCC liens on the personal property of 10 facilities, and other notes receivable with a carrying value of $43,309,000 , guaranteed by significant parties to the notes or by cross-collateralization of properties with the same owner. No allowance for doubtful accounts was considered necessary at March 31, 2018 or December 31, 2017 . Bickford At March 31, 2018 , our construction loans to Bickford are summarized as follows: Commencement Rate Maturity Commitment Drawn Location July 2016 9% 5 years $ 14,000,000 $ (12,754,000 ) Illinois January 2017 9% 5 years 14,000,000 (5,672,000 ) Michigan January 2018 9% 5 years 14,000,000 (1,742,000 ) Virginia $ 42,000,000 $ (20,168,000 ) The promissory notes are secured by first mortgage liens on substantially all real and personal property as well as a pledge of any and all leases or agreements which may grant a right of use to the subject property. Usual and customary covenants extend to the agreements, including the borrower’s obligation for payment of insurance and taxes. NHI has a purchase option on the properties at stabilization, whereby annual rent will be set with a floor of 9.55% , based on NHI’s total investment, plus fixed annual escalators. On these and future loan development projects, Bickford as the borrower is entitled to up to $2,000,000 per project in incentive loan draws based upon the achievement of predetermined operational milestones, the funding of which will increase the principal amount, NHI's future purchase price under option and, upon exercise, eventual lease payment to NHI. Our loans to Bickford represent a variable interest as do our leases, which are considered analogous to financing arrangements. Bickford is structured to limit liability for potential claims for damages, is capitalized to achieve that purpose and is considered a VIE. Timber Ridge In February 2015, we entered into an agreement to lend up to $154,500,000 to LCS-Westminster Partnership III LLP (“LCS-WP”), an affiliate of Life Care Services (“LCS”). The loan agreement conveys a mortgage interest and facilitated the construction of Phase II of Timber Ridge at Talus (“Timber Ridge”), a Type-A Continuing Care Retirement Community in Issaquah, WA managed by LCS. Our loan to LCS-WP represents a variable interest. As an affiliate of a larger company, LCS-WP is structured to limit liability for potential damage claims, is capitalized to achieve that purpose and is considered a VIE. The loan took the form of two notes under a master credit agreement. The senior note (“Note A”) totals $60,000,000 at a 6.75% interest rate with 10 basis-point escalators after year three , and has a term of 10 years. We have funded $54,939,000 of Note A as of March 31, 2018 . Note A is interest-only and is locked to prepayment for three years. After year three in February 2018, the prepayment penalty starts at 5% and declines 1% per year. Note B was a construction loan for up to $94,500,000 at an annual interest rate of 8% and a five -year maturity and was fully drawn during 2016. We began receiving repayment with new resident entrance fees upon the opening of Phase II during the fourth quarter of 2016. The balance remaining on Note B at December 31, 2017 , of $1,953,000 was repaid during the first quarter of 2018, resulting in the recognition of $515,000 in unamortized commitment fees. NHI has an option to purchase the entire Timber Ridge property for the greater of fair market value or $115,000,000 during a window of 120 days that will contingently open in year five or upon earlier stabilization of the development, as defined in our agreements. Senior Living Communities In connection with the acquisition in December 2014 of the properties leased to Senior Living, we provided a $15,000,000 revolving line of credit, the maturity of which mirrors the 15 -year term of the master lease. Borrowings are used to finance construction projects within the Senior Living portfolio, including building additional units. Up to $5,000,000 of the facility may be used to meet general working capital needs. Amounts outstanding under the facility, $729,000 at March 31, 2018 , bear interest at an annual rate equal to the prevailing 10 -year U.S. Treasury rate, 2.74% at March 31, 2018 , plus 6% . NHI has two mezzanine loans totaling $14,000,000 to affiliates of Senior Living, whose purpose was to partially fund construction of a 186 -unit senior living campus on Daniel Island in South Carolina. The loans bear interest payable monthly at a 10% annual rate and mature in March 2021. The lending arrangement provides NHI with a purchase option on the development upon its meeting certain operational metrics. The community opened in the first quarter of 2018. The option is to remain open during the term of the loans, plus any extensions. Our loans to Senior Living and its subsidiaries represent a variable interest as does our lease, which is considered to be analogous to a financing arrangement. Senior Living is structured to limit liability for potential damage claims, is appropriately capitalized for that purpose and is considered a VIE. Senior Living Management On August 3, 2016, we entered into an agreement to furnish to our current tenant, Senior Living Management, Inc. (“SLM”), through its affiliates, loans of up to $24,500,000 to facilitate SLM’s acquisition of five senior housing facilities that it currently operates. The loans consist of two notes under a master credit agreement, include both a mortgage and a corporate loan, and bear interest at 8.25% with terms of five years, plus optional one and two -year extensions. NHI has a right of first refusal if SLM elects to sell the facilities. The loans were fully funded as of March 31, 2018 . Our loans to SLM represent a variable interest as do our leases, which are analogous to financing arrangements. SLM is structured to limit liability for potential damage claims, is capitalized for that purpose and is considered a VIE.

Other Assets

Other Assets	3 Months Ended
	Mar. 31, 2018
Other Assets [Abstract]
Other Assets Disclosure [Text Block]	OTHER ASSETS Other assets consist of the following ( in thousands ): March 31, December 31, Accounts receivable and other assets $ 8,963 $ 5,187 Regulatory escrows 8,208 8,208 Reserves for replacement, insurance and tax escrows 4,989 4,817 $ 22,160 $ 18,212 Reserves for replacement, insurance and tax escrows include amounts required to be held on deposit in accordance with regulatory agreements governing our Fannie Mae and HUD mortgages.

Debt

Debt	3 Months Ended
	Mar. 31, 2018
Debt Instruments [Abstract]
Debt Disclosure	DEBT Debt consists of the following ( in thousands ): March 31, December 31, Convertible senior notes - unsecured (net of discount of $1,959 and $2,637) $ 118,041 $ 144,938 Revolving credit facility - unsecured 262,000 221,000 Bank term loan - unsecured 250,000 250,000 Private placement term loans - unsecured 400,000 400,000 HUD mortgage loans (net of discount of $1,381 and $1,402) 43,463 43,645 Fannie Mae term loans - secured, non-recourse 96,285 96,367 Unamortized loan costs (9,563 ) (10,453 ) $ 1,160,226 $ 1,145,497 Aggregate principal maturities of debt as of March 31, 2018 for each of the next five years and thereafter are as follows ( in thousands ): Twelve months ended March 31, 2018 $ 1,155 2019 1,196 2020 1,244 2021 121,291 2022 638,340 Thereafter 409,903 1,173,129 Less: discount (3,340 ) Less: unamortized loan costs (9,563 ) $ 1,160,226 As amended in August 2017, our unsecured $800,000,000 credit facility, originally scheduled to mature in June 2020, consolidated our three bank term loans into a single $250,000,000 term loan and provided for an extension of the maturity of the term loan and the $550,000,000 revolving credit facility to August 2022. The amended facility calls for floating interest on the term loan and revolver to be initially set at 30-day LIBOR plus 130 and 115 bps, respectively, based on current leverage metrics. Additional significant amendments to the facility included the refinement of the collateral pool, imposition of a 0% floor LIBOR base, movement from the payment of unused commitment fees to a facility fee of 20 basis points and the composition of creditors participating in our loan syndication. The employment of interest rate swaps to fix LIBOR on our bank term debt leaves only our revolving credit facility exposed to variable rate risk. Our swaps and the financial instruments to which they relate are described in the table below, under the caption “Interest Rate Swap Agreements.” At March 31, 2018 , we had $288,000,000 available to draw on the revolving portion of our credit facility. The unsecured credit facility agreement requires that we maintain certain financial ratios within limits set by our creditors. To date, these ratios, which are calculated quarterly, have been within the limits required by the credit facility agreements. Pinnacle Bank is a participating member of our banking group. A member of NHI’s board of directors and chairman of our audit committee is also the chairman of Pinnacle Financial Partners, Inc., the holding company for Pinnacle Bank. NHI’s local banking transactions are conducted primarily through Pinnacle Bank. Also in August 2017, we amended our private placement term loan agreements to largely conform those agreements with the amendment to our bank credit facility as noted above. The composition of these loans is summarized below (in thousands) : Amount Inception Maturity Fixed Rate $ 125,000 January 2015 January 2023 3.99% 50,000 November 2015 November 2023 3.99% 75,000 September 2016 September 2024 3.93% 50,000 November 2015 November 2025 4.33% 100,000 January 2015 January 2027 4.51% $ 400,000 In connection with our November 2017 acquisition of a facility in Tulsa, we assumed a Fannie Mae mortgage loan with remaining balance of $18,311,000 . The mortgage amortizes through 2025 when a balloon payment will be due, is subject to prepayment penalties until 2024, and bears interest at a nominal rate of 4.6% with a remaining balance of $18,201,000 at March 31, 2018 . In March 2015 we obtained $78,084,000 in Fannie Mae financing. The term debt financing consists of interest-only payments at an annual rate of 3.79% and a 10 -year maturity. The mortgages are non-recourse and secured by thirteen properties leased to Bickford. These notes together with the Fannie Mae debt assumed in connection with the 2017 Tulsa acquisition, mentioned above, are secured by facilities having a net book value of $141,189,000 at March 31, 2018 . In March 2014 we issued $200,000,000 of 3.25% senior unsecured convertible notes due April 2021 (the “Notes”) with interest payable April 1st and October 1st of each year. The Notes were convertible at an initial conversion rate of 13.93 shares of common stock per $1,000 principal amount, representing a conversion price of approximately $71.81 per share for a total of approximately 2,785,200 underlying shares. The conversion rate is subsequently adjusted upon each occurrence of certain events, as defined in the indenture governing the Notes, including the payment of dividends at a rate exceeding that prevailing in 2014. The conversion option was accounted for as an “optional net-share settlement conversion feature,” meaning that upon conversion, NHI’s conversion obligation may be satisfied, at our option, in cash, shares of common stock or a combination of cash and shares of common stock. Because we have the ability and intent to settle the convertible securities in cash upon exercise, we use the treasury stock method to account for potential dilution. The embedded conversion options (1) do not require net cash settlement, (2) are not conventionally convertible but can be classified in stockholders’ equity under Accounting Standards Codification (“ASC”) 815-40, and (3) are considered indexed to NHI’s own stock. Therefore, the conversion feature satisfies the conditions to qualify for an exception to the derivative liability rules, and the Notes are split into debt and equity components. The carrying value of the debt component was based upon the estimated fair value at the time of issuance of a similar debt instrument without the conversion feature and was approximately $192,238,000 at issuance. The difference between the contractual principal on the debt and the value allocated to the debt of $7,762,000 was recorded as the equity component and represented the estimated value of the conversion feature of the instrument. The excess of the contractual principal amount of the debt over the estimated fair value of the debt component, the original issue discount, is being amortized to interest expense using the effective interest method over the estimated term of the Notes. The effective interest rate used to amortize the debt discount and the liability component of the debt issue costs is approximately 3.9% based on our estimated non-convertible borrowing rate at the date the Notes were issued. The total cost of issuing the Notes was $6,063,000 , of which $275,000 was allocated to the equity component and $5,788,000 was allocated to the debt component and subject to amortization over the estimated term of the notes. We have undertaken targeted open-market repurchases of certain of the convertible notes, whose carrying amount at December 31, 2017, net of issue costs, discount and previous retirements was $144,938,000 . Payments of cash negotiated in the transactions were dependent on prevailing market conditions, our liquidity requirements, contractual restrictions, individual circumstances of the selling parties and other factors. The amount of notes repurchased and retired during the three months ended March 31, 2018 , net of unamortized original issue discount and associated issuance costs, was $26,821,000 . Recognition of losses on the note retirements for the three months ended March 31, 2018 , was $738,000 , calculated as the excess of cash paid over the carrying value of that portion of the notes accounted for as debt. For the retirement of that portion of the outlay allocated to the fair value of the conversion feature, $2,427,000 was charged to additional paid-in capital during the three months ended March 31, 2018 . The remaining unamortized balance of issuance costs at March 31, 2018 , was $1,300,000 . As of March 31, 2018 , the outstanding balance of our 3.25% senior unsecured convertible notes was $120,000,000 . As adjusted for terms of the indenture, the Notes are convertible at a rate of 14.28 shares of common stock per $1,000 principal amount, representing a conversion price of approximately $70.01 per share for a total of 1,714,100 remaining underlying shares. As of March 31, 2018 , the value of the convertible debt, computed as if the debt were immediately eligible for conversion, was exceeded by its face amount. For the three months ended March 31, 2018 , the effect of the conversion option on our per-share calculations is also anti-dilutive, since the conversion price exceeded our average stock price. If NHI’s current share price increases above the adjusted $70.01 conversion price, dilution will be attributable to the conversion feature. Our HUD mortgage loans are secured by ten Bickford-operated properties having a net book value of $52,156,000 at March 31, 2018 . Nine mortgage notes require monthly payments of principal and interest from 4.3% to 4.4% (inclusive of mortgage insurance premium) and mature in August and October 2049. One additional HUD mortgage loan assumed in 2014 requires monthly payments of principal and interest of 2.9% (inclusive of mortgage insurance premium) and matures in October 2047. The following table summarizes interest expense ( in thousands ): Three Months Ended March 31, 2018 2017 Interest expense on debt at contractual rates $ 10,527 $ 10,033 Losses reclassified from accumulated other comprehensive income into interest expense 276 789 Capitalized interest (24 ) (67 ) Amortization of debt issuance costs and debt discount 835 906 Total interest expense $ 11,614 $ 11,661 Interest Rate Swap Agreements Our existing interest rate swap agreements will collectively continue through June 2020 to hedge against fluctuations in variable interest rates applicable to our $250,000,000 bank term loan. With the amendment to our credit facility in August 2017, discussed above, the introduction to the bank term loan of a LIBOR floor not present in the hedges resulted in hedge inefficiency of $353,000 , which we credited to interest expense in 2017. To better reflect earnings, on January 1, 2018 we adopted ASU 2017-12 Derivatives and Hedging: Targeted Improvements to Accounting for Hedging Activities , as discussed in Note 11. Upon the adoption of the new standard, we reversed cumulative ineffectiveness, resulting in a retroactive net charge to retained earnings and a credit to accumulated other comprehensive income of $235,000 as of January 1, 2018 . During the next twelve months, approximately $775,000 of losses, which are included as a component of accumulated other comprehensive income, are projected to be reclassified into earnings. As of March 31, 2018 , we employ the following interest rate swap contracts to mitigate our interest rate risk on the $250,000,000 term loan ( dollars in thousands ): Date Entered Maturity Date Fixed Rate Rate Index Notional Amount Fair Value May 2012 April 2019 2.84% 1-month LIBOR $ 40,000 $ 266 June 2013 June 2020 3.41% 1-month LIBOR $ 80,000 $ 459 March 2014 June 2020 3.46% 1-month LIBOR $ 130,000 $ 607 If the fair value of the hedge is an asset, we include it in our Condensed Consolidated Balance Sheets among other assets, and, if a liability, as a component of accrued expenses. See Note 10 for fair value disclosures about our interest rate swap agreements. Net asset/(liability) balances for our hedges included as components of consolidated other comprehensive income on March 31, 2018 and December 31, 2017 were $1,332,000 and $(588,000) , respectively.

Commitments And Contingencies

Commitments And Contingencies	3 Months Ended
	Mar. 31, 2018
Commitments and Contingencies Disclosure [Abstract]
Commitments And Contingencies	COMMITMENTS AND CONTINGENCIES In the normal course of business, we enter into a variety of commitments, typical of which are those for the funding of revolving credit arrangements, construction and mezzanine loans to our operators to conduct expansions and acquisitions for their own account, and commitments for the funding of construction for expansion or renovation to our existing properties under lease. In our leasing operations we offer to our tenants and to sellers of newly-acquired properties a variety of inducements which originate contractually as contingencies but which may become commitments upon the satisfaction of the contingent event. Contingent payments earned will be included in the respective lease bases when funded. The tables below summarize our existing, known commitments and contingencies according to the nature of their impact on our leasehold or loan portfolios. Asset Class Type Total Funded Remaining Loan Commitments: Life Care Services Note A SHO Construction $ 60,000,000 $ (54,939,000 ) $ 5,061,000 Bickford Senior Living SHO Construction 42,000,000 (20,168,000 ) 21,832,000 Senior Living Communities SHO Revolving Credit 15,000,000 (729,000 ) 14,271,000 $ 117,000,000 $ (75,836,000 ) $ 41,164,000 See Note 3 for full details of our loan commitments. As provided above, loans funded do not include the effects of discounts or commitment fees. We expect to fully fund the Life Care Services Note A during 2018. Funding of the promissory note commitments to Bickford is expected to transpire monthly throughout 2018. Asset Class Type Total Funded Remaining Development Commitments: Legend/The Ensign Group SNF Purchase $ 56,000,000 $ (28,000,000 ) $ 28,000,000 East Lake/Watermark Retirement SHO Renovation 10,000,000 (5,900,000 ) 4,100,000 Santé Partners SHO Renovation 3,500,000 (2,621,000 ) 879,000 Bickford Senior Living SHO Renovation 2,400,000 (1,647,000 ) 753,000 East Lake Capital Management SHO Renovation 400,000 — 400,000 Senior Living Communities SHO Renovation 6,830,000 (1,424,000 ) 5,406,000 Discovery Senior Living SHO Renovation 500,000 — 500,000 Woodland Village SHO Renovation 7,450,000 (1,709,000 ) 5,741,000 Chancellor Health Care SHO Construction 650,000 (62,000 ) 588,000 Navion Senior Solutions SHO Construction 650,000 — 650,000 $ 88,380,000 $ (41,363,000 ) $ 47,017,000 As discussed in Note 2 and shown above, we remain obligated to purchase, from a developer, two new skilled nursing facilities in Texas for $28,000,000 which are leased to Legend and subleased to Ensign. Asset Class Type Total Funded Remaining Contingencies: Bickford Senior Living SHO Lease Inducement $ 10,000,000 $ (3,250,000 ) $ 6,750,000 Bickford Senior Living SHO Incentive Draws 6,000,000 (250,000 ) $ 5,750,000 East Lake Capital Management SHO Lease Inducement 8,000,000 — 8,000,000 Navion Senior Solutions SHO Lease Inducement 4,850,000 — 4,850,000 Prestige Care SHO Lease Inducement 1,000,000 — 1,000,000 The LaSalle Group SHO Lease Inducement 5,000,000 — 5,000,000 $ 34,850,000 $ (3,500,000 ) $ 31,350,000 Contingent payments related to the five Bickford development properties constructed in 2016 and 2017 include a licensure incentive of $250,000 per property and a three-tiered operator incentive schedule paying up to an additional $1,750,000 , based on the attainment of certain performance metrics. As funded, these payments are added to the lease base and amortized against rental income. For a discussion of incentive loan draws available to Bickford related to the development of its properties in Illinois, Michigan and Virginia, see Note 3. In connection with our July 2015 lease to East Lake of three senior housing properties, NHI has committed to certain lease inducement payments of $8,000,000 contingent on reaching and maintaining certain metrics. The inducements have been assessed as not probable of payment, and we have not recorded them on our balance sheets as of March 31, 2018. We are unaware of circumstances that would change our initial assessment as to the contingent lease incentives. Not included in the above table is a seller earnout of $750,000 , which is recorded on our condensed consolidated balance sheets within accounts payable and accrued expenses. Litigation Our facilities are subject to claims and suits in the ordinary course of business. Our lessees and borrowers have indemnified, and are obligated to continue to indemnify us, against all liabilities arising from the operation of the facilities, and are further obligated to indemnify us against environmental or title problems affecting the real estate underlying such facilities. While there may be lawsuits pending against certain of the owners and/or lessees of the facilities, management believes that the ultimate resolution of all such pending proceedings will have no material adverse effect on our financial condition, results of operations or cash flows.

Investment And Other Gains

Investment And Other Gains	3 Months Ended
	Mar. 31, 2018
Investment And Other Gains [Abstract]
Investment And Other Gains	INVESTMENT AND OTHER GAINS The following table summarizes our investment and other gains (in thousands) : Three Months Ended March 31, 2018 2017 Gains on sale of real estate $ — $ 50 Gains on sales of marketable securities — 10,038 $ — $ 10,088 In January and February 2017, we recognized gains of $10,038,000 on sales totaling $11,718,000 of marketable securities with a carrying value $11,745,000 and an adjusted cost of $1,680,000 at December 31, 2016. Total proceeds of $18,182,000 from marketable securities for 2017 included settlements occurring in 2017 of $6,464,000 that resulted from sales in December 2016.

Share-Based Compensation

Share-Based Compensation	3 Months Ended
	Mar. 31, 2018
Deferred Compensation Arrangements [Abstract]
Share-Based Compensation	-BASED COMPENSATION We recognize stock-based compensation for all stock options granted over the requisite service period using the fair value of these grants as estimated at the date of grant using the Black-Scholes pricing model, and all restricted stock granted over the requisite service period using the market value of our publicly-traded common stock on the date of grant. Stock-Based Compensation Plans The Compensation Committee of the Board of Directors (“the Committee”) has the authority to select the participants to be granted options; to designate whether the option granted is an incentive stock option (“ISO”), a non-qualified option, or a stock appreciation right; to establish the number of shares of common stock that may be issued upon exercise of the option; to establish the vesting provision for any award; and to establish the term any award may be outstanding. The exercise price of any ISO’s granted will not be less than 100% of the fair market value of the shares of common stock on the date granted, and the term of an ISO may not be more than ten years. The exercise price of any non-qualified options granted will not be less than 100% of the fair market value of the shares of common stock on the date granted unless so determined by the Committee. In May 2012, our stockholders approved the 2012 Stock Incentive Plan (“the 2012 Plan”) pursuant to which 1,500,000 shares of our common stock were made available to grant as stock-based payments to employees, officers, directors or consultants. Through a vote of our shareholders on May 7, 2015, we increased the maximum number of shares under the plan from 1,500,000 shares to 3,000,000 shares; increased the automatic annual grant to non-employee directors from 15,000 shares to 20,000 shares; and limited the Company’s ability to re-issue shares under the Plan. Through a second amendment approved on May 4, 2018, our shareholders voted to increase the maximum number of shares under the plan to 3,500,000 and to increase the automatic annual grant to non-employee directors to 25,000 . The individual restricted stock and option grant awards vest over periods up to five years. The term of the options under the 2012 Plan is up to ten years from the date of grant. As of March 31, 2018 , there were 391,668 shares available for future grants under the 2012 Plan. In May 2005, our stockholders approved the NHI 2005 Stock Option Plan (“the 2005 Plan”) pursuant to which 1,500,000 shares of our common stock were made available to grant as stock-based payments to employees, officers, directors or consultants. The 2005 Plan has expired and no additional shares may be granted under the 2005 Plan. The individual restricted stock and option grant awards vest over periods up to ten years. The term of the options outstanding under the 2005 Plan is up to ten years from the date of grant. Compensation expense is recognized only for the awards that ultimately vest. Accordingly, forfeitures that were not expected will result in the reversal of previously recorded compensation expense. The compensation expense reported for the three months ended March 31, 2018 and 2017 was $1,425,000 and $1,523,000 , respectively, and is included in general and administrative expense in the Condensed Consolidated Statements of Income. At March 31, 2018 , we had, net of expected forfeitures, $1,707,000 of unrecognized compensation cost related to unvested stock options which is expected to be expensed over the following periods: 2018 - $1,105,000 , 2019 - $542,000 and 2020 - $60,000 . The weighted average fair value per share of options granted during the three months ended March 31, 2018 and 2017 was $4.49 and $5.75 , respectively. The fair value of each grant is estimated on the date of grant using the Black-Scholes option-pricing model with the following weighted average assumptions: 2018 2017 Dividend yield 6.5% 5.3% Expected volatility 19.4% 19.8% Expected lives 3.3 years 2.9 years Risk-free interest rate 2.39% 1.49% The following table summarizes our outstanding stock options: Three Months Ended March 31, 2018 2017 Options outstanding January 1, 859,182 541,679 Options granted under 2012 Plan 560,000 485,000 Options exercised under 2012 Plan — (25,833 ) Options forfeited under 2012 Plan (15,000 ) (6,668 ) Options exercised under 2005 Plan — (15,000 ) Options outstanding, March 31, 1,404,182 979,178 Exercisable at March 31, 949,160 585,827

Earnings and Dividends Per Shar

Earnings and Dividends Per Share	3 Months Ended
	Mar. 31, 2018
Earnings Per Share [Abstract]
Earnings Per Share	EARNINGS AND DIVIDENDS PER COMMON SHARE The weighted average number of common shares outstanding during the reporting period is used to calculate basic earnings per common share. Diluted earnings per common share assume the exercise of stock options and the conversion of our convertible debt using the treasury stock method, to the extent dilutive. If our average stock price for the period increases over the conversion price of our convertible debt, the conversion feature will be considered dilutive. The following table summarizes the average number of common shares and the net income used in the calculation of basic and diluted earnings per common share (in thousands, except share and per share amounts): Three Months Ended March 31, 2018 2017 Net income $ 38,432 $ 44,230 BASIC: Weighted average common shares outstanding 41,532,154 39,953,804 DILUTED: Weighted average common shares outstanding 41,532,154 39,953,804 Stock options 44,722 56,910 Convertible subordinated debentures — 98,048 Average dilutive common shares outstanding 41,576,876 40,108,762 Net income per common share - basic $ .93 $ 1.11 Net income per common share - diluted $ .92 $ 1.10 Incremental shares excluded since anti-dilutive: Net share effect of stock options and convertible debt with an exercise or conversion price in excess of the average market price for our common shares 118,639 19,851 Regular dividends declared per common share $ 1.00 $ .95

Fair Value Of Financial Instrum

Fair Value Of Financial Instruments	3 Months Ended
	Mar. 31, 2018
Fair Value Of Financial Instruments [Abstract]
Fair Value Disclosures [Text Block]	FAIR VALUE OF FINANCIAL INSTRUMENTS Our financial assets and liabilities measured at fair value (based on the hierarchy of the three levels of inputs described in Note 1 to the consolidated financial statements contained in our most recent Annual Report on Form 10-K) on a recurring basis have included marketable securities, derivative financial instruments and contingent consideration arrangements. Derivative financial instruments include our interest rate swap agreements. Contingent consideration arrangements relate to certain provisions of recent real estate purchase agreements involving business combinations. Derivative financial instruments . Derivative financial instruments are valued in the market using discounted cash flow techniques. These techniques incorporate Level 1 and Level 2 inputs. The market inputs are utilized in the discounted cash flow calculation considering the instrument’s term, notional amount, discount rate and credit risk. Significant inputs to the derivative valuation model for interest rate swaps are observable in active markets and are classified as Level 2 in the hierarchy. Contingent consideration. Contingent consideration arrangements are classified as Level 3 and are valued using unobservable inputs about the nature of the contingent arrangement and the counter-party to the arrangement, as well as our assumptions about the probability of full settlement of the contingency. Assets and liabilities measured at fair value on a recurring basis are as follows (in thousands) : Fair Value Measurement Balance Sheet Classification March 31, December 31, Level 2 Interest rate swap asset Other assets $ 1,332 $ 159 Interest rate swap liability Accounts payable and accrued expenses $ — $ 747 Carrying values and fair values of financial instruments that are not carried at fair value at March 31, 2018 and December 31, 2017 in the Condensed Consolidated Balance Sheets are as follows ( in thousands ): Carrying Amount Fair Value Measurement 2018 2017 2018 2017 Level 2 Variable rate debt $ 506,991 $ 465,642 $ 512,000 $ 471,000 Fixed rate debt $ 653,235 $ 679,855 $ 642,700 $ 679,385 Level 3 Mortgage and other notes receivable $ 145,845 $ 141,486 $ 142,962 $ 140,049 Fixed rate debt. Fixed rate debt is classified as Level 2 and its value is based on quoted prices for similar instruments or calculated utilizing model derived valuations in which significant inputs are observable in active markets. Mortgage and other notes receivable. The fair value of mortgage and other notes receivable is based on credit risk and discount rates that are not observable in the marketplace and therefore represents a Level 3 measurement. Carrying amounts of cash and cash equivalents, accounts receivable and accounts payable approximate fair value due to their short-term nature. The fair value of our borrowings under our revolving credit facility and other variable rate debt are reasonably estimated at their notional amounts at March 31, 2018 and December 31, 2017 , due to the predominance of floating interest rates, which generally reflect market conditions.

Recent Accounting Pronouncement

Recent Accounting Pronouncements Recent Accounting Pronouncements	3 Months Ended
	Mar. 31, 2018
Recent Accounting Pronouncements [Abstract]
New Accounting Pronouncements and Changes in Accounting Principles [Text Block]	RECENT ACCOUNTING PRONOUNCEMENTS In May 2014 the Financial Accounting Standards Board (“FASB”) issued ASU 2014-09, Revenue from Contracts with Customers . ASU 2014-09 provides a principles-based approach for a broad range of revenue generating transactions, including the sale of real estate, which will generally require more estimates, judgment and disclosures than under current guidance. In August 2015 the FASB issued ASU 2015-14, which defers the effective date of ASU 2014-09. ASU 2014-09 is now effective for public entities for annual periods beginning after December 15, 2017, including interim periods therein. The Company adopted this standard using the modified retrospective method on January 1, 2018. The ASU provides for revenues from leases to continue to follow the guidance in Topics 840 and 842 (when adopted) and provides for loans to follow established guidance in Topic 310. Because this ASU specifically excludes these areas of our operations from its scope, there was no impact to our accounting for lease revenue and interest income resulting from the ASU. Additionally, the other significant types of contracts in which we periodically engage, sales of real estate to customers, typically never remain executory across points in time. Because all performance obligations from these contracts can therefore be expected to continue to fall within a single period, the timing of our revenue recognition from future sales of real estate is not expected to be affected by the ASU. A number of practical expedients are available in applying the recognition and measurement principles within the standard, including those permitting the aggregation of contract revenues and costs with components of interest income or amortization expense whose period of aggregation, within parameters, is not considered to be of significant duration for separate treatment. We realized no significant revenues in 2017 or 2018 within the scope of ASU 2014-09, and, accordingly, adoption of the ASU did not have a material impact on the timing and measurement of the Company’s income. In February 2016 the FASB issued ASU 2016-02, Leases, which has been codified under Topic 842. Public companies will be required to apply ASU 2016-02 for all accounting periods beginning after December 15, 2018. Early adoption is permitted. All leases with lease terms greater than one year are subject to ASU 2016-02, including leases in place as of the adoption date. The principal difference between Topic 842 and previous guidance is that, for lessees, lease assets and lease liabilities arising from operating leases will be recognized in the balance sheet. While, the accounting applied by a lessor is largely unchanged from that applied under previous GAAP, significant changes to lessor accounting have been made to align i) certain lessor and lessee accounting guidance, and ii) key aspects of the lessor accounting model with the revenue recognition guidance in Topic 606, Revenue from Contracts with Customers , which we adopted January 1, 2018. Under Topic 842 provisions promulgated to conform with Topic 606, the presence of a lessee purchase option can result in recording as a financing a transaction that would otherwise meet the requirements for lease accounting under previous guidance. As a result, NHI may explore different structures to continue to apply lease accounting rather than record a financing similar to a long-term note. The accounting treatment for sale-leaseback transactions will mirror the current guidance for lessees which may result in a financing transaction. Upon adoption the Company anticipates grossing up rental income for property taxes and insurance, currently paid by tenants. The Company will continue to evaluate the impact of Topic 842 on our consolidated financial statements. Consistent with present standards, upon the adoption of ASU 2016-02, NHI will continue to account for lease revenue on a straight-line basis for most leases. Also consistent with NHI’s current practice, under ASU 2016-02 only initial direct costs that are incremental to the lessor will be capitalized. We have made significant progress in evaluating the extent to which adopting the provisions of ASU 2016-02 in 2019 will affect NHI. In June 2016 the FASB issued ASU 2016-13, Financial Instruments - Credit Losses . ASU 2016-13 will require more timely recognition of credit losses associated with financial assets. While current GAAP includes multiple credit impairment objectives for instruments, the previous objectives generally delayed recognition of the full amount of credit losses until the loss was probable of occurring. The amendments in ASU 2016-13, whose scope is asset-based and not restricted to financial institutions, eliminate the probable initial recognition threshold in current GAAP and, instead, reflect an entity’s current estimate of all expected credit losses. Previously, when credit losses were measured under GAAP, we generally only considered past events and current conditions in measuring the incurred loss. The amendments in ASU 2016-13 broaden the information that we must consider in developing our expected credit loss estimate for assets measured either collectively or individually. The use of forecasted information incorporates more timely information in the estimate of expected credit loss that will be more useful to users of the financial statements. ASU 2016-13 is effective for public entities for fiscal years beginning after December 15, 2019, including interim periods within those fiscal years. Because we are likely to continue to invest in loans and generate receivables, adoption of ASU 2016-13 in 2020 will have some effect on our accounting for these investments, though the nature of those effects will depend on the composition of our loan portfolio at that time; accordingly, we are in the initial stages of evaluating the extent of the effects, if any, that adopting the provisions of ASU 2016-13 in 2020 will have on NHI. In November 2016 the FASB issued ASU 2016-18, Restricted Cash . ASU 2016-18 will require that a statement of cash flows explain the change during the period in the total of cash, cash equivalents, and amounts generally described as restricted cash or restricted cash equivalents, generally by requiring the inclusion of restricted cash and restricted cash equivalents with cash and cash equivalents when reconciling the beginning-of-period and end-of-period total amounts shown on the statement of cash flows. The amendments in this ASU do not provide a definition of restricted cash or restricted cash equivalents. ASU 2016-18 is effective for public entities for fiscal years beginning after December 15, 2017, including interim periods. The adoption of ASU 2016-18 did not have a material effect on our consolidated financial statements. In January 2017 the FASB issued ASU 2017-01, Clarifying the Definition of a Business . ASU 2017-01 narrowed the definition of a business in evaluating whether transactions should be accounted for as acquisitions (or disposals) of assets or businesses. Under the current implementation guidance in Topic 805, there are three elements of a business-inputs, processes, and outputs. Currently the definition of outputs contributes to broad interpretations of the definition of a business. Additionally, the standard provides that when substantially all of the fair value of the gross assets acquired is concentrated in a single identifiable asset or group of similar identifiable assets, the set is not a business. For purposes of this test, land and buildings can be combined along with the intangible assets for any in-place leases. For most of NHI’s acquisitions of investment property, this screen would be met and, therefore, not meet the definition of a business. ASU 2017-01 became effective for public entities for fiscal years beginning after December 15, 2017, including interim periods. Early application of this standard is generally allowed for acquisitions acquired after the standard was issued but before the acquisition has been reflected in financial statements. We adopted the provisions of ASU 2017-01 in the first quarter of 2017. The adoption of ASU 2017-01 did not have a material effect on our consolidated financial statements. Our acquisitions in 2018 and 2017 were accounted for as asset purchases. In August 2017 the FASB issued ASU 2017-12, Derivatives and Hedging: Targeted Improvements to Accounting for Hedging Activities , which is available for early adoption in any interim period after issuance of the update, or alternatively requires adoption for fiscal years beginning after December 15, 2018. The purpose of this updated guidance is to better align a company’s financial reporting for hedging activities with the economic objectives of those activities. On January 1, 2018, we adopted ASU 2017-12 Derivatives and Hedging: Targeted Improvements to Accounting for Hedging Activities , among whose provisions is a change in the timing and income statement line item for ineffectiveness related to cash flow hedges. The transition method is a modified retrospective approach that will require the Company to recognize the cumulative effect of initially applying the ASU as an adjustment to accumulated other comprehensive income with a corresponding adjustment to the opening balance of retained earnings as of the beginning of the fiscal year that we adopt the update. The primary provision in the ASU requiring an adjustment to our beginning consolidated retained earnings is the change in timing and income statement line item for ineffectiveness related to cash flow hedges. As a result of the transition guidance provided in the ASU, as of January 1, 2018, cumulative ineffectiveness as adjusted for any prior off-market cashflow hedges was reclassified out of beginning retained earnings and into accumulated other comprehensive income. With the adoption of the ASU, the Company has achieved a better alignment of the Company’s financial reporting for hedging activities with the economic objectives of those activities.

Subsequent Events Subsequent Ev

Subsequent Events Subsequent Events	3 Months Ended
	Mar. 31, 2018
Subsequent Events [Abstract]
Subsequent Events [Text Block]	NOTE 12. SUBSEQUENT EVENT Bickford On April 30, 2018, we acquired an assisted living/memory-care portfolio comprised of five facilities totaling 320 units in Ohio and Pennsylvania. The purchase price was $69,750,000 , inclusive of $500,000 in closing costs and $1,750,000 in specified capital improvements, which will be added to the lease base upon funding. We included this portfolio in a new master lease with Bickford which provides for a lease rate of 6.85% , with annual fixed escalators over a term of 15 years plus renewal options, subject to a fair market value rent reset feature available to NHI between years three and five. We accounted for the acquisition as an asset purchase.

Significant Accounting Polici21

Significant Accounting Policies (Policy)	3 Months Ended
	Mar. 31, 2018
Policy Text Block [Abstract]
Consolidation, Policy	Principles of Consolidation - The accompanying condensed consolidated financial statements include our accounts and the accounts of our wholly-owned subsidiaries, joint ventures, partnerships and consolidated variable interest entities (“VIE”), if any. All intercompany transactions and balances have been eliminated in consolidation. Net income is reduced by the portion of net income attributable to noncontrolling interests, if any. A VIE is broadly defined as an entity with one or more of the following characteristics: (a) the total equity investment at risk is insufficient to finance the entity’s activities without additional subordinated financial support; (b) as a group, the holders of the equity investment at risk lack (i) the ability to make decisions about the entity’s activities through voting or similar rights, (ii) the obligation to absorb the expected losses of the entity, or (iii) the right to receive the expected residual returns of the entity; or (c) the equity investors have voting rights that are not proportional to their economic interests, and substantially all of the entity’s activities either involve, or are conducted on behalf of, an investor that has disproportionately few voting rights. We apply Financial Accounting Standards Board (“FASB”) guidance for our arrangements with VIEs which requires us to identify entities for which control is achieved through means other than voting rights and to determine which business enterprise is the primary beneficiary of the VIE. In accordance with FASB guidance, management must evaluate each of the Company’s contractual relationships which creates a variable interest in other entities. If the Company has a variable interest and the entity is a VIE, then management must determine whether the Company is the primary beneficiary of the VIE. If it is determined that the Company is the primary beneficiary, NHI consolidates the VIE. We identify the primary beneficiary of a VIE as the enterprise that has both: (i) the power to direct the activities of the VIE that most significantly impact the entity’s economic performance; and (ii) the obligation to absorb losses or the right to receive benefits of the VIE that could be significant to the entity. We perform this analysis on an ongoing basis. At March 31, 2018 , we held an interest in eight unconsolidated VIEs and, because we generally lack either directly or through related parties any material input in the activities that most significantly impact their economic performance, we have concluded that NHI is not the primary beneficiary. Accordingly, we account for our transactions with these entities and their subsidiaries at amortized cost. Our VIEs are summarized below by date of initial involvement. For further discussion of the nature of the relationships, including the sources of our exposure to these VIEs, see the notes to our condensed consolidated financial statements cross-referenced below. Date Name Source of Exposure Carrying Amount Maximum Exposure to Loss Note Reference 2012 Bickford Various 1 $ 33,528,000 $ 55,360,000 Notes 2, 3 2014 Senior Living Communities Notes and straight-line receivable $ 39,106,000 $ 53,377,000 Notes 2, 3 2014 Life Care Services affiliate Notes receivable $ 54,693,000 $ 59,754,000 Note 3 2015 East Lake Capital Mgmt. Straight-line receivable $ 3,531,000 $ 3,531,000 2016 The Ensign Group developer N/A $ — $ — Note 2 2016 Senior Living Management Notes and straight-line receivable $ 26,315,000 $ 26,315,000 Note 3 2017 Navion Senior Solutions Straight-line receivable $ 355,000 $ 355,000 2017 Evolve Senior Living Note receivable $ 9,913,000 $ 9,913,000 1 Notes, straight-line rent receivables, and unamortized lease incentives We are not obligated to provide support beyond our stated commitments to these tenants and borrowers whom we classify as VIEs, and accordingly our maximum exposure to loss as a result of these relationships is limited to the amount of our commitments, as shown above and discussed in the notes. When the above relationships involve leases, some additional exposure to economic loss is present. Generally, additional economic loss on a lease, if any, would be limited to that resulting from a short period of arrearage and non-payment of monthly rent before we are able to take effective remedial action, as well as costs incurred in transitioning the lease. The potential extent of such loss will be dependent upon individual facts and circumstances, cannot be quantified, and is therefore not included in the tabulation above. Typically, the only carrying amounts involving our leases are accumulated straight-line receivables. For VIE relationships listed above without a note reference, please refer to our most recent Annual Report on Form 10-K for the year ended December 31, 2017 .
Reclassification, Policy	Reclassifications - We have reclassified certain balances where necessary to conform the presentation of prior periods to the current period. These reclassifications had no effect on previously reported net income.
Use of Estimates, Policy	Use of Estimates - The preparation of financial statements in conformity with accounting principles generally accepted in the U.S. requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, 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
Earnings Per Share, Policy	Earnings Per Share - The weighted average number of common shares outstanding during the reporting period is used to calculate basic earnings per common share. Diluted earnings per common share assumes the exercise of stock options using the treasury stock method, to the extent dilutive. Diluted earnings per share also incorporate the potential dilutive impact of our convertible senior notes. We apply the treasury stock method to our convertible debt instruments, the effect of which is that conversion will not be assumed for purposes of computing diluted earnings per share unless the average share price for the period exceeds the conversion price per share
New Accounting Pronouncements, Policy	New Accounting Pronouncements - For a review of recent accounting pronouncements pertinent to our operations and management’s judgment as to the impact that the eventual adoption of these pronouncements will have on our financial position and results of operations, see Note 11.

Significant Accounting Polici22

Significant Accounting Policies Significant Accounting Policies (Schedule of Variable Interest Entities) (Tables)	3 Months Ended
	Mar. 31, 2018
Variable Interest Entity, Not Primary Beneficiary, Disclosures [Abstract]
Schedule of Variable Interest Entities [Table Text Block]	Date Name Source of Exposure Carrying Amount Maximum Exposure to Loss Note Reference 2012 Bickford Various 1 $ 33,528,000 $ 55,360,000 Notes 2, 3 2014 Senior Living Communities Notes and straight-line receivable $ 39,106,000 $ 53,377,000 Notes 2, 3 2014 Life Care Services affiliate Notes receivable $ 54,693,000 $ 59,754,000 Note 3 2015 East Lake Capital Mgmt. Straight-line receivable $ 3,531,000 $ 3,531,000 2016 The Ensign Group developer N/A $ — $ — Note 2 2016 Senior Living Management Notes and straight-line receivable $ 26,315,000 $ 26,315,000 Note 3 2017 Navion Senior Solutions Straight-line receivable $ 355,000 $ 355,000 2017 Evolve Senior Living Note receivable $ 9,913,000 $ 9,913,000

Real Estate (Tables)

Real Estate (Tables)	3 Months Ended
	Mar. 31, 2018
Real Estate [Abstract]
Schedule of Bickford Leases [Table Text Block]	As of March 31, 2018 our Bickford Senior Living (“Bickford”) portfolio consists of leases with lease expiration dates as follows (in thousands) : Lease Expiration Sept / Oct 2019 June 2023 Sept 2027 May 2031 Total Number of Properties 10 13 4 20 47 2018 Annual Contractual Rent $ 9,264 $ 11,133 $ 1,515 $ 20,030 $ 41,942 Straight Line Rent Adjustment (617 ) 588 221 3,813 4,005 Total Revenues $ 8,647 $ 11,721 $ 1,736 $ 23,843 $ 45,947
Summary of NHC Percentage Rent [Table Text Block]	The following table summarizes the percentage rent income from NHC ( in thousands ): Three Months Ended March 31, 2018 2017 Current year $ 853 $ 782 Prior year final certification 1 285 194 Total percentage rent income $ 1,138 $ 976 1 For purposes of the percentage rent calculation described in the master lease agreement, NHC’s annual revenue by facility for a given year is certified to NHI by March 31st of the following year.

Mortgage And Other Notes Rece24

Mortgage And Other Notes Receivable Mortgage and Other Notes Receivable (Schedule of Bickford Construction Loans) (Tables)	3 Months Ended
	Mar. 31, 2018
Bickford Senior Living [Member]
Schedule of Accounts, Notes, Loans and Financing Receivable [Table Text Block]	At March 31, 2018 , our construction loans to Bickford are summarized as follows: Commencement Rate Maturity Commitment Drawn Location July 2016 9% 5 years $ 14,000,000 $ (12,754,000 ) Illinois January 2017 9% 5 years 14,000,000 (5,672,000 ) Michigan January 2018 9% 5 years 14,000,000 (1,742,000 ) Virginia $ 42,000,000 $ (20,168,000 )

Other Assets (Tables)

Other Assets (Tables)	3 Months Ended
	Mar. 31, 2018
Other Assets [Abstract]
Schedule of Other Assets [Table Text Block]	Other assets consist of the following ( in thousands ): March 31, December 31, Accounts receivable and other assets $ 8,963 $ 5,187 Regulatory escrows 8,208 8,208 Reserves for replacement, insurance and tax escrows 4,989 4,817 $ 22,160 $ 18,212

Debt (Tables)

Debt (Tables)	3 Months Ended
	Mar. 31, 2018
Debt Instruments [Abstract]
Schedule of Debt	Debt consists of the following ( in thousands ): March 31, December 31, Convertible senior notes - unsecured (net of discount of $1,959 and $2,637) $ 118,041 $ 144,938 Revolving credit facility - unsecured 262,000 221,000 Bank term loan - unsecured 250,000 250,000 Private placement term loans - unsecured 400,000 400,000 HUD mortgage loans (net of discount of $1,381 and $1,402) 43,463 43,645 Fannie Mae term loans - secured, non-recourse 96,285 96,367 Unamortized loan costs (9,563 ) (10,453 ) $ 1,160,226 $ 1,145,497
Schedule of Maturities of Long-term Debt	Aggregate principal maturities of debt as of March 31, 2018 for each of the next five years and thereafter are as follows ( in thousands ): Twelve months ended March 31, 2018 $ 1,155 2019 1,196 2020 1,244 2021 121,291 2022 638,340 Thereafter 409,903 1,173,129 Less: discount (3,340 ) Less: unamortized loan costs (9,563 ) $ 1,160,226
Schedule of Unsecured Term Loans	loans is summarized below (in thousands) : Amount Inception Maturity Fixed Rate $ 125,000 January 2015 January 2023 3.99% 50,000 November 2015 November 2023 3.99% 75,000 September 2016 September 2024 3.93% 50,000 November 2015 November 2025 4.33% 100,000 January 2015 January 2027 4.51% $ 400,000
Schedule of Interest Expense	The following table summarizes interest expense ( in thousands ): Three Months Ended March 31, 2018 2017 Interest expense on debt at contractual rates $ 10,527 $ 10,033 Losses reclassified from accumulated other comprehensive income into interest expense 276 789 Capitalized interest (24 ) (67 ) Amortization of debt issuance costs and debt discount 835 906 Total interest expense $ 11,614 $ 11,661
Schedule of Interest Rate Derivatives	Date Entered Maturity Date Fixed Rate Rate Index Notional Amount Fair Value May 2012 April 2019 2.84% 1-month LIBOR $ 40,000 $ 266 June 2013 June 2020 3.41% 1-month LIBOR $ 80,000 $ 459 March 2014 June 2020 3.46% 1-month LIBOR $ 130,000 $ 607

Commitments And Contingencies C

Commitments And Contingencies Commitments and Contingencies (Tables)	3 Months Ended
	Mar. 31, 2018
Commitments and Contingencies Disclosure [Abstract]
Schedule of Loan Commitments [Table Text Block]	Asset Class Type Total Funded Remaining Loan Commitments: Life Care Services Note A SHO Construction $ 60,000,000 $ (54,939,000 ) $ 5,061,000 Bickford Senior Living SHO Construction 42,000,000 (20,168,000 ) 21,832,000 Senior Living Communities SHO Revolving Credit 15,000,000 (729,000 ) 14,271,000 $ 117,000,000 $ (75,836,000 ) $ 41,164,000
Schedule of Lease Commitments [Table Text Block]	Asset Class Type Total Funded Remaining Development Commitments: Legend/The Ensign Group SNF Purchase $ 56,000,000 $ (28,000,000 ) $ 28,000,000 East Lake/Watermark Retirement SHO Renovation 10,000,000 (5,900,000 ) 4,100,000 Santé Partners SHO Renovation 3,500,000 (2,621,000 ) 879,000 Bickford Senior Living SHO Renovation 2,400,000 (1,647,000 ) 753,000 East Lake Capital Management SHO Renovation 400,000 — 400,000 Senior Living Communities SHO Renovation 6,830,000 (1,424,000 ) 5,406,000 Discovery Senior Living SHO Renovation 500,000 — 500,000 Woodland Village SHO Renovation 7,450,000 (1,709,000 ) 5,741,000 Chancellor Health Care SHO Construction 650,000 (62,000 ) 588,000 Navion Senior Solutions SHO Construction 650,000 — 650,000 $ 88,380,000 $ (41,363,000 ) $ 47,017,000
Schedule of Loss Contingencies [Table Text Block]	Asset Class Type Total Funded Remaining Contingencies: Bickford Senior Living SHO Lease Inducement $ 10,000,000 $ (3,250,000 ) $ 6,750,000 Bickford Senior Living SHO Incentive Draws 6,000,000 (250,000 ) $ 5,750,000 East Lake Capital Management SHO Lease Inducement 8,000,000 — 8,000,000 Navion Senior Solutions SHO Lease Inducement 4,850,000 — 4,850,000 Prestige Care SHO Lease Inducement 1,000,000 — 1,000,000 The LaSalle Group SHO Lease Inducement 5,000,000 — 5,000,000 $ 34,850,000 $ (3,500,000 ) $ 31,350,000

Investment And Other Gains (Tab

Investment And Other Gains (Tables)	3 Months Ended
	Mar. 31, 2018
Investment And Other Gains [Abstract]
Schedule of Investment And Other Gains	The following table summarizes our investment and other gains (in thousands) : Three Months Ended March 31, 2018 2017 Gains on sale of real estate $ — $ 50 Gains on sales of marketable securities — 10,038 $ — $ 10,088

Share-Based Compensation (Table

Share-Based Compensation (Tables)	3 Months Ended
	Mar. 31, 2018
Deferred Compensation Arrangements [Abstract]
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions [Table Text Block]	The fair value of each grant is estimated on the date of grant using the Black-Scholes option-pricing model with the following weighted average assumptions: 2018 2017 Dividend yield 6.5% 5.3% Expected volatility 19.4% 19.8% Expected lives 3.3 years 2.9 years Risk-free interest rate 2.39% 1.49%
Schedule of Stock Option Activity	The following table summarizes our outstanding stock options: Three Months Ended March 31, 2018 2017 Options outstanding January 1, 859,182 541,679 Options granted under 2012 Plan 560,000 485,000 Options exercised under 2012 Plan — (25,833 ) Options forfeited under 2012 Plan (15,000 ) (6,668 ) Options exercised under 2005 Plan — (15,000 ) Options outstanding, March 31, 1,404,182 979,178 Exercisable at March 31, 949,160 585,827

Earnings and Dividends Per Sh30

Earnings and Dividends Per Share (Tables)	3 Months Ended
	Mar. 31, 2018
Earnings Per Share [Abstract]
Schedule of Earnings Per Share, Basic and Diluted	The following table summarizes the average number of common shares and the net income used in the calculation of basic and diluted earnings per common share (in thousands, except share and per share amounts): Three Months Ended March 31, 2018 2017 Net income $ 38,432 $ 44,230 BASIC: Weighted average common shares outstanding 41,532,154 39,953,804 DILUTED: Weighted average common shares outstanding 41,532,154 39,953,804 Stock options 44,722 56,910 Convertible subordinated debentures — 98,048 Average dilutive common shares outstanding 41,576,876 40,108,762 Net income per common share - basic $ .93 $ 1.11 Net income per common share - diluted $ .92 $ 1.10 Incremental shares excluded since anti-dilutive: Net share effect of stock options and convertible debt with an exercise or conversion price in excess of the average market price for our common shares 118,639 19,851 Regular dividends declared per common share $ 1.00 $ .95

Fair Value Of Financial Instr31

Fair Value Of Financial Instruments Fair Value Of Financial Instruments (Tables)	3 Months Ended
	Mar. 31, 2018
Fair Value Of Financial Instruments [Abstract]
Schedule of Assets and Liabilities Measured on Recurring Basis	Assets and liabilities measured at fair value on a recurring basis are as follows (in thousands) : Fair Value Measurement Balance Sheet Classification March 31, December 31, Level 2 Interest rate swap asset Other assets $ 1,332 $ 159 Interest rate swap liability Accounts payable and accrued expenses $ — $ 747
Fair Value Measurements, Nonrecurring [Table Text Block]	Carrying values and fair values of financial instruments that are not carried at fair value at March 31, 2018 and December 31, 2017 in the Condensed Consolidated Balance Sheets are as follows ( in thousands ): Carrying Amount Fair Value Measurement 2018 2017 2018 2017 Level 2 Variable rate debt $ 506,991 $ 465,642 $ 512,000 $ 471,000 Fixed rate debt $ 653,235 $ 679,855 $ 642,700 $ 679,385 Level 3 Mortgage and other notes receivable $ 145,845 $ 141,486 $ 142,962 $ 140,049

Significant Accounting Polici32

Significant Accounting Policies Significant Accounting Policies (Details)	Mar. 31, 2018
Accounting Policies [Abstract]
Variable Interest Entity Number Of Entities Not Primary Beneficiary	8

Significant Accounting Polici33

Significant Accounting Policies Significant Accounting Policies (Schedule of Variable Interest Entities) (Details) $ in Thousands	Dec. 31, 2017USD ($)
Ensign Group [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	$ 0
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	0
Straight-Line Rent Receivable [Member] | Bickford / Sycamore [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	33,528
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	55,360
Straight-Line Rent Receivable [Member] | Senior Living Communities [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	39,106
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	53,377
Straight-Line Rent Receivable [Member] | East Lake Capital [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	3,531
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	3,531
Straight-Line Rent Receivable [Member] | Senior Living Management [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	26,315
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	26,315
Straight-Line Rent Receivable [Member] | Ravn Senior Solutions [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	355
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	355
Straight-Line Rent Receivable [Member] | Evolve Senior Living [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	9,913
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	9,913
Notes Receivable [Member] | Life Care Services [Member]
Variable Interest Entity [Line Items]
Variable Interest Entity, Nonconsolidated, Carrying Amount, Assets	54,693
Variable Interest Entity, Reporting Entity Involvement, Maximum Loss Exposure, Amount	$ 59,754

Real Estate Real Estate (Schedu

Real Estate Real Estate (Schedule of Bickford Leases) (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2018USD ($)properties	Dec. 31, 2017properties
Number of Properties | properties		210
Bickford Senior Living [Member]
Number of Properties | properties	47
2017 Contractual Rent	$ 41,942
Straight Line Rent Adjustment	4,005
Total Revenues	$ 45,947
Bickford Senior Living [Member] | September 2027 [Member]
Number of Properties | properties	4
2017 Contractual Rent	$ 1,515
Straight Line Rent Adjustment	221
Total Revenues	$ 1,736
Bickford Senior Living [Member] | Sept / Oct 2019 [Member]
Number of Properties | properties	10
2017 Contractual Rent	$ 9,264
Straight Line Rent Adjustment	(617)
Total Revenues	$ 8,647
Bickford Senior Living [Member] | June 2023 [Member]
Number of Properties | properties	13
2017 Contractual Rent	$ 11,133
Straight Line Rent Adjustment	588
Total Revenues	$ 11,721
Bickford Senior Living [Member] | May 2031 [Member]
Number of Properties | properties	20
2017 Contractual Rent	$ 20,030
Straight Line Rent Adjustment	3,813
Total Revenues	$ 23,843

Real Estate (Summary of NHC Per

Real Estate (Summary of NHC Percentage Rent) (Details) - National Healthcare Corporation [Member] - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Total percentage rent	$ 1,138	$ 976
Current year [Member]
Total percentage rent	853	782
Prior year final certification [Member]
Total percentage rent	$ 285	$ 194

Real Estate (Narrative) (Detail

Real Estate (Narrative) (Details)	1 Months Ended	3 Months Ended
	Jan. 31, 2018USD ($)	Mar. 31, 2018USD ($)propertiesbeds_or_unitsrenewalOptionsMaster_Leasesshares	Mar. 31, 2017USD ($)	Jan. 12, 2018beds_or_units	Dec. 31, 2017USD ($)properties	Sep. 30, 2017USD ($)
Number of Real Estate Properties | properties					210
Number of States in which Entity Operates					32
Nonportfolio Assets, Original Cost					$ 1,298,000
Real Estate Investment Property, Portfolio Assets						$ 2,682,387,000
Number of Lessees					27
Payments to Acquire Real Estate		$ 14,404,000	$ 118,011,000
Lessee Payment To Acquire Purchase Option		1,275,000	1,250,000
Operating Leases, Income Statement, Lease Revenue		69,253,000	63,127,000
Deferred Rent Receivables, Net		102,046,000			$ 97,359,000
Straight Line Rent		5,962,000	5,755,000
Real Estate Properties, Commitment To Purchase, Amount		$ 47,017,000
Holiday Acquisition Holdings [Member]
Number of Real Estate Properties | properties		25
Lessor, Operating Lease, Term of Contract		17 years
Lease Escalator Rate, After Lease Year 3		3.50%
Operating Leases, Income Statement, Lease Revenue		$ 10,954,000	$ 10,954,000
Percentage of Continuing Revenue		15.00%	17.00%
Straight Line Rent		$ 1,530,000	$ 1,849,000
National Healthcare Corporation [Member]
Number of Real Estate Properties | properties		42
Number of Master Leases | Master_Leases		2
Operating Leases, Income Statement, Lease Revenue		$ 9,674,000	$ 9,513,000
Percentage of Continuing Revenue		13.00%	14.00%
Lessor Equity Shares Owned, Significant Lessee | shares		1,630,462
National Healthcare Corporation [Member] | NHC - 1991 Lease [Member]
Number of Real Estate Properties | properties		35
Number Of Additional Lease Renewal Options | renewalOptions		2
Lease Renewal Period In Years		5 years
Percentage Rent Rate		0.04
Minimum Annual Lease Income		$ 30,750,000
National Healthcare Corporation [Member] | NHC - 2013 Lease [Member]
Number Of Real Estate Properties Acquired | properties		7
Percentage Rent Rate		0.04
Minimum Annual Lease Income		$ 3,450,000
Purchase Option Amount		$ 49,000,000
Bickford Senior Living [Member]
Number of Real Estate Properties | properties		47
Operating Leases, Income Statement, Lease Revenue		$ 11,445,000	$ 9,373,000
Percentage of Continuing Revenue		16.00%	14.00%
Straight Line Rent		$ 1,169,000	$ 910,000
Minimum Annual Lease Income		$ 41,942,000
Senior Living Communities [Member]
Number of Real Estate Properties | properties		9
Number of Units in Real Estate Property		1,970
Lessor, Operating Lease, Term of Contract		15 years
Lease Escalator Rate Lease Year 2 to Lease Year 4		4.00%
Lease Escalator Rate after Lease Year 4		3.00%
Operating Leases, Income Statement, Lease Revenue		$ 11,449,000	$ 11,431,000
Percentage of Continuing Revenue		16.00%	17.00%
Straight Line Rent		$ 1,359,000	$ 1,746,000
Number Of Additional Lease Renewal Options		2
Lease Renewal Period In Years		5 years
Ensign Group [Member]
Real Estate Properties, Commitment To Purchase | properties		2
Default Tenant [Member]
Percentage of Continuing Revenue		4.00%
Deferred Rent Receivables, Net		$ 3,773,000
Senior Housing Community [Member]
Number of Real Estate Properties | properties					136
Skilled Nursing Facility [Member]
Number of Real Estate Properties | properties					69
Skilled Nursing Facility [Member] | National Healthcare Corporation [Member]
Number of Real Estate Properties | properties		39
Skilled Nursing Facility [Member] | National Healthcare Corporation [Member] | Subleased Facilities [Member]
Number of Real Estate Properties | properties		4
Hospital [Member]
Number of Real Estate Properties | properties					3
Medical Office Building [Member]
Number of Real Estate Properties | properties					2
Independent Living Facility [Member] | National Healthcare Corporation [Member]
Number of Real Estate Properties | properties		3
Ensign Waxahachie Purchase [Member]
Number of Units in Real Estate Property | beds_or_units				121
Payments to Acquire Real Estate	$ 14,404,000
Lessee Payment To Acquire Purchase Option	$ 1,275,000
Lessor, Operating Lease, Term of Contract	13 years
Initial lease rate				8.20%

Mortgage And Other Notes Rece37

Mortgage And Other Notes Receivable (Details)	3 Months Ended
	Mar. 31, 2018USD ($)propertiesbeds_or_units	Mar. 31, 2017USD ($)	Dec. 31, 2017USD ($)properties
Mortgage and other notes receivable, net	$ 145,845,000		$ 141,486,000
Amortization of Deferred Loan Origination Fees, Net	$ 552,000	$ 104,000
Number of health care properties related to mortgage notes receivables | properties	10
Allowance for Doubtful Accounts Receivable	$ 0		$ 0
Loans and Leases Receivable, Commitments, Fixed Rates	117,000,000
Number of Real Estate Properties | properties			210
Secured By Real Estate [Member]
Mortgage and other notes receivable, net	102,536,000
Not Secured By Real Estate [Member]
Mortgage and other notes receivable, net	43,309,000
Life Care Services [Member]
Mortgage and other notes receivable, net	54,939,000
Loans and Leases Receivable, Commitments, Fixed Rates	60,000,000
Notes Receivable, Total Borrowings, Master Credit Agreement	$ 154,500,000
Notes Receivable, Number Of Loans, Master Credit Agreement	2
Purchase Option, Amount, Minimum	$ 115,000,000
Purchase Option, Period, Months	120 days
Purchase Option, Open Period, Begin, Note Year	5 years
Senior Living Communities [Member]
Loans Receivable, Description of Variable Rate Basis, Reference Rate Maturity	10 years
Loans Receivable, Description of Variable Rate Basis	0.0274
Number of Units in Real Estate Property	1,970
Loans and Lease Receivable, Maximum Revolving Amount	$ 15,000,000
Lessor, Operating Lease, Term of Contract	15 years
Revolving Note Receivable, Maximum Amount Available for Working Capital Purposes	$ 5,000,000
Revolving Note Receivable, Amount Outstanding	$ 729,000
Loans Receivable, Basis Spread on Variable Rate	6.00%
Number of Term Loans	2
Loans and Leases Receivable, Commitments, Fixed Rates	$ 14,000,000
Number of Real Estate Properties | properties	9
Bickford Note Investment [Member]
Initial lease rate	9.55%
Contingent Incentive Payments	$ 2,000,000
Mortgage and other notes receivable, net	20,168,000
Loans and Leases Receivable, Commitments, Fixed Rates	42,000,000
Senior Living Management [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	$ 24,500,000
Notes Receivable, Number Of Loans, Master Credit Agreement	2
Loan Term	5 years
Notes Receivable, Interest Rate, Master Credit Agreement	8.25%
Number of Real Estate Properties | properties	5
Notes Receivable, Maturity, Optional Extension, Years	1 year
Note Receivable, Maturity, Second Optional Extension, Years	2 years
Note A [Member] | Life Care Services [Member]
Mortgage and other notes receivable, net	$ 54,939,000
Notes Receivable, Total Borrowings, Master Credit Agreement	$ 60,000,000
Note Receivable, First Note Year For Rate Escalator	3 years
Loan Term	10 years
Note Receivable, Prepayment, Disallowance Period	3 years
Note Receivable, Prepayment Penalty, Rate	5.00%
Note Receivable, Prepayment Penalty, Rate Decrease	1.00%
Notes Receivable, Interest Rate, Master Credit Agreement	6.75%
Loans And Leases Receivable, Commitment, Fixed Rates, Escalator, Basis Points	10
Note A [Member] | Senior Living Communities [Member]
Note Receivable Interest Rate	10.00%
Note B [Member] | Life Care Services [Member]
Mortgage and other notes receivable, net	$ 1,953,000
Amortization of Deferred Loan Origination Fees, Net	515,000
Notes Receivable, Total Borrowings, Master Credit Agreement	$ 94,500,000
Loan Term	5 years
Notes Receivable, Interest Rate, Master Credit Agreement	8.00%

Mortgage And Other Notes Rece38

Mortgage And Other Notes Receivable Mortgage and Other Notes Receivable (Schedule of Bickford Construction Loans) (Details) - USD ($)	3 Months Ended
	Mar. 31, 2018	Dec. 31, 2017
Loans and Leases Receivable, Commitments, Fixed Rates	$ 117,000,000
Loans and Leases Receivable, Net Amount	(145,845,000)	$ (141,486,000)
Bickford Note Investment [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	42,000,000
Loans and Leases Receivable, Net Amount	$ (20,168,000)
July 2016 [Member] | Bickford Note Investment [Member]
Note Receivable Interest Rate	9.00%
Loan Term	5 years
Loans and Leases Receivable, Commitments, Fixed Rates	$ 14,000,000
Loans and Leases Receivable, Net Amount	$ (12,754,000)
January 2017 [Member] | Bickford Note Investment [Member]
Note Receivable Interest Rate	9.00%
Loan Term	5 years
Loans and Leases Receivable, Commitments, Fixed Rates	$ 14,000,000
Loans and Leases Receivable, Net Amount	$ (5,672,000)
January 2018 [Member] | Bickford Note Investment [Member]
Note Receivable Interest Rate	9.00%
Loan Term	5 years
Loans and Leases Receivable, Commitments, Fixed Rates	$ 14,000,000
Loans and Leases Receivable, Net Amount	$ (1,742,000)

Other Assets (Schedule of Other

Other Assets (Schedule of Other Assets) (Details) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Equity Method Investments And Other Assets [Abstract]
Accounts receivable and other assets	$ 8,963	$ 5,187
Regulatory deposits	8,208	8,208
Reserves for replacement, insurance and tax escrows	4,989	4,817
Other Assets	$ 22,160	$ 18,212

Debt (Schedule of Debt) (Detail

Debt (Schedule of Debt) (Details) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017
Debt Instrument [Line Items]
Revolving credit facility - unsecured	$ 262,000	$ 221,000
Convertible Debt	118,041	144,938
Debt Instrument, Unamortized Discount (Premium) and Debt Issuance Costs, Net	9,563
Unamortized Debt Issuance Expense		(10,453)
Debt, Long-term and Short-term, Combined Amount	1,160,226	1,145,497
Bank Term Loans [Member]
Debt Instrument [Line Items]
Bank term loans - unsecured	250,000	250,000
Debt Instrument, Name, HUD Mortgages [Member]
Debt Instrument [Line Items]
Secured Debt	43,463	43,645
Private Placement Term Loans [Member]
Debt Instrument [Line Items]
Bank term loans - unsecured	400,000	400,000	$ 400,000
Debt Instrument, Name, Fannie Mae Term Loans [Member]
Debt Instrument [Line Items]
Secured Debt	$ 96,285	$ 96,367

Debt Debt (Schedule of Debt) (C

Debt Debt (Schedule of Debt) (Captions) (Details) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Debt Instrument, Unamortized Discount	$ 3,340
Debt Instrument, Name, Q3 2014 HUD Mortgages [Member]
Debt Instrument [Line Items]
Debt Instrument, Unamortized Discount	1,381	$ 1,402
Debt Instrument, Name, Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Debt Instrument, Unamortized Discount	$ 1,959	$ 2,637

Debt Debt (Schedule of Maturiti

Debt Debt (Schedule of Maturities of Long-term Debt) (Details) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Schedule of Maturities of Long-term Debt [Abstract]
Long-term Debt, Maturities, Repayments of Principal in Next Rolling Twelve Months	$ 1,155
Long-term Debt, Maturities, Repayments of Principal in Rolling Year Two	1,196
2,020	1,244
Long-term Debt, Maturities, Repayments of Principal in Rolling Year Four	121,291
Long-term Debt, Maturities, Repayments of Principal in Rolling Year Five	638,340
Long-term Debt, Maturities, Repayments of Principal in Rolling after Year Five	409,903
Long-term Debt, Gross	1,173,129
Debt Instrument, Unamortized Discount	(3,340)
Less: unamortized loan costs	(9,563)
Unamortized Debt Issuance Expense		$ 10,453
Debt, Long-term and Short-term, Combined Amount	$ 1,160,226	$ 1,145,497

Debt Debt (Schedule of Unsecure

Debt Debt (Schedule of Unsecured Term Loans) (Details) - Private Placement [Member] - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017
Unsecured Debt	$ 400,000	$ 400,000	$ 400,000
January 2023 [Member]
Unsecured Debt		$ 125,000
Debt Instrument, Interest Rate, Stated Percentage		3.99%
November 2023 [Member]
Unsecured Debt		$ 50,000
Debt Instrument, Interest Rate, Stated Percentage		3.99%
September 2024 [Member]
Unsecured Debt		$ 75,000
Debt Instrument, Interest Rate, Stated Percentage		3.93%
November 2025 [Member]
Unsecured Debt		$ 50,000
Debt Instrument, Interest Rate, Stated Percentage		4.33%
January 2027 [Member]
Unsecured Debt		$ 100,000
Debt Instrument, Interest Rate, Stated Percentage		4.51%

Debt (Schedule of Interest Expe

Debt (Schedule of Interest Expense) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Schedule of Interest Expense [Abstract]
Interest expense	$ 10,527	$ 10,033
Interest Costs Capitalized Adjustment	(24)	(67)
Gain (Loss) on Extinguishment of Debt	738	0
Amortization of debt issuance costs, debt discount and premium	276	789
Write off of Deferred Debt Issuance Cost	835	906
Total interest expense	$ 11,614	$ 11,661

Debt (Schedule of Interest Rate

Debt (Schedule of Interest Rate Derivatives) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Dec. 31, 2017
Interest Rate Swap, Date Entered, May 2012 [Member]
Derivative [Line Items]
Derivative, Inception Date	May 31, 2012
Derivative, Maturity Date	Apr. 30, 2019
Derivative, Fixed Interest Rate	2.84%
Debt Instrument, Description of Variable Rate Basis	1-month LIBOR
Derivative, Notional Amount	$ 40,000
Interest Rate Swap, Date Entered, June 2013 [Member]
Derivative [Line Items]
Derivative, Inception Date	Jun. 30, 2013
Derivative, Maturity Date	Jun. 30, 2020
Derivative, Fixed Interest Rate	3.41%
Debt Instrument, Description of Variable Rate Basis	1-month LIBOR
Derivative, Notional Amount	$ 80,000
Interest Rate Cash Flow Hedge Liability at Fair Value	$ 459
Interest Rate Swap, Date Entered, March 2014 [Member]
Derivative [Line Items]
Derivative, Inception Date	Mar. 31, 2014
Derivative, Maturity Date	Jun. 30, 2020
Derivative, Fixed Interest Rate	3.46%
Debt Instrument, Description of Variable Rate Basis	1-month LIBOR
Derivative, Notional Amount	$ 130,000
Interest Rate Cash Flow Hedge Liability at Fair Value	607
Fair Value, Inputs, Level 2 [Member]
Derivative [Line Items]
Cash Flow Hedge Derivative Instrument Assets at Fair Value	1,332	$ 159
Fair Value, Inputs, Level 2 [Member] | Interest Rate Swap, Date Entered, May 2012 [Member]
Derivative [Line Items]
Cash Flow Hedge Derivative Instrument Assets at Fair Value	$ 266

Debt (Narrative) (Details)

Debt (Narrative) (Details)	3 Months Ended		12 Months Ended
	Mar. 31, 2018USD ($)propertiesshares	Mar. 31, 2017USD ($)shares	Dec. 31, 2017USD ($)propertiessharesnumber_of_loans$ / shares	Mar. 31, 2014USD ($)
Loss on Cash Flow Hedge Ineffectiveness	$ (353,000)
New Accounting Pronouncement or Change in Accounting Principle, Cumulative Effect of Change on Equity or Net Assets	235,000
Interest Rate Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months, Net	775,000
Noncash or Part Noncash Acquisition, Value of Liabilities Assumed	290,000	$ 824,000
Line of Credit Facility, Maximum Borrowing Capacity	800,000,000
Debt Instrument, Convertible, Conversion Ratio			14.28
Debt Instrument, Convertible, Conversion Price | $ / shares			$ 70.01
Debt Instrument, Convertible, Carrying Amount of Equity Component	$ 192,238,000			$ 7,762,000
Debt Instrument, Convertible, Number of Equity Instruments | shares			1,714,100
Incremental Common Shares Attributable to Dilutive Effect of Conversion of Debt Securities | shares	0	98,048
Convertible Debt	$ 118,041,000		$ 144,938,000
Debt Instrument, Interest Rate, Effective Percentage			3.90%
Unamortized Debt Issuance Expense			$ 10,453,000
Gain (Loss) on Extinguishment of Debt	$ (738,000)	$ 0
Debt Instrument, Variable Rate Basis, Minimum	0.00%
Line of Credit Facility, Unused Capacity, Commitment Fee Percentage	2000.00%
Credit Facility, Current Revolving Borrowing Capacity	$ 550,000,000
Number of Real Estate Properties | properties			210
Cash Flow Hedge Derivative Instrument Liabilities at Fair Value			$ (588,000)
Bank Term Loans [Member]
Term Loans, Outstanding Balance	$ 250,000,000
Debt Instrument, Basis Spread on Variable Rate	13000.00%
Debt Instrument, Name, Convertible Senior Notes [Member]
Debt Instrument, Interest Rate, Stated Percentage			3.25%
Debt Instrument, Face Amount			$ 120,000,000
Convertible Debt Instrument, Conversion Ratio, Principal Amount, Basis	$ 1,000
Payments of Debt Issuance Costs			6,063,000
Unamortized Debt Issuance Expense			1,300,000
Payment for Debt Extinguishment or Debt Prepayment Cost	$ 144,938,000		26,821,000
Gain (Loss) on Extinguishment of Debt			738,000
Adjustments to Additional Paid in Capital, Convertible Debt with Conversion Feature			2,427,000
At Inception [Member]
Proceeds from convertible senior notes			$ 200,000,000
Debt Instrument, Convertible, Conversion Ratio			13.93
Debt Instrument, Convertible, Conversion Price | $ / shares			$ 71.81
Debt Instrument, Convertible, Number of Equity Instruments | shares			2,785,200
Debt Instrument, Name, Revolving Credit Facility [Member]
Debt Instrument, Basis Spread on Variable Rate	11500.00%
Unused balance of the unsecured revolving credit facility	$ 288,000,000
FNMA Berkadia Note [Member]
Long-term Debt, Percentage Bearing Fixed Interest, Percentage Rate			4.60%
Debt Instrument, Name, Fannie Mae Term Loans [Member]
Debt Instrument, Term			10 years
Mortgage Loans on Real Estate, Face Amount of Mortgages			$ 78,084,000
Debt Instrument, Interest Rate, Stated Percentage			3.79%
Number of Real Estate Properties			13
Net Book Value of Real Estate Pledged Toward Mortgage			$ 141,189,000
Debt Instrument, Name, HUD Mortgages [Member]
Number of Real Estate Properties | properties			10
Net Book Value of Real Estate Pledged Toward Mortgage			$ 52,156,000
Debt Instrument, Name, HUD Mortgages [Member] | Minimum [Member]
Mortgage Loans on Real Estate, Interest Rate			4.30%
Debt Instrument, Name, HUD Mortgages [Member] | Maximum [Member]
Mortgage Loans on Real Estate, Interest Rate			4.40%
Debt Instrument, HUD Mortgages, 2049 Maturity [Member]
Mortgage Loans on Real Estate, Number of Loans | number_of_loans			9
Debt Instrument, HUD Mortgages, 2047 Maturity [Member]
Mortgage Loans on Real Estate, Number of Loans | number_of_loans			1
Allocated to Debt [Member] | Debt Instrument, Name, Convertible Senior Notes [Member]
Payments of Debt Issuance Costs			$ 5,788,000
Allocated to Equity [Member] | Debt Instrument, Name, Convertible Senior Notes [Member]
Payments of Debt Issuance Costs			$ 275,000
Bickford Senior Living [Member]
Number of Real Estate Properties | properties	47
Middletown, OH [Member] | Bickford Senior Living [Member]
Noncash or Part Noncash Acquisition, Noncash Financial or Equity Instrument Consideration, Rate			2.90%
Fair Value, Inputs, Level 2 [Member]
Cash Flow Hedge Derivative Instrument Assets at Fair Value	$ 1,332,000		$ 159,000
Cash Flow Hedge Derivative Instrument Liabilities at Fair Value	$ 0		(747,000)
Real Estate Acquisition [Member] | Discovery Senior Living [Member]
Noncash or Part Noncash Acquisition, Debt Assumed			18,311,000
Independent Living Facility [Member] | Tulsa, OK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation, Amount of Encumbrances			$ 18,201,000

Commitments And Contingencies (

Commitments And Contingencies (Details)	3 Months Ended
	Mar. 31, 2018USD ($)properties	Dec. 31, 2017properties
Real Estate Properties, Commitment To Purchase, Amount	$ 47,017,000
Number of Real Estate Properties | properties		210
Ensign Group [Member]
Real Estate Properties, Commitment To Purchase | properties	2
Capital Addition Purchase Commitments [Member] | Ensign Group [Member]
Real Estate Properties, Commitment To Purchase, Amount	$ 28,000,000
Maximum Contingent Amount [Member] | East Lake Capital [Member]
Lease Incentive Commitment Assessed As Not Probable	$ 8,000,000
East Lake Mgmt, Acquisition [Member]
Number of Real Estate Properties | properties	3
Payments to acquire real estate, seller earnout, contingent, not probable	$ 750,000
Bickford Development Properties [Member]
Developer Incentive Payments	250,000,000
Incentive to Lessee	$ 1,750,000,000
Number Of Development Projects Active | properties	5

Commitments And Contingencies48

Commitments And Contingencies Commitments and Contingencies (Schedule of Loan Commitments) (Details) - USD ($)	3 Months Ended
	Mar. 31, 2018	Dec. 31, 2017
Loans and Leases Receivable, Commitments, Fixed Rates	$ 117,000,000
Loans and Leases Receivable, Net Amount	(145,845,000)	$ (141,486,000)
Notes Receivable Funding Commitment	41,164,000
Life Care Services [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	60,000,000
Loans and Leases Receivable, Net Amount	(54,939,000)
Notes Receivable Funding Commitment	5,061,000
Bickford Senior Living [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	42,000,000
Loans and Leases Receivable, Net Amount	(20,168,000)
Notes Receivable Funding Commitment	21,832,000
Senior Living Communities [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	14,000,000
Revolving Credit Facility [Member] | Senior Living Communities [Member]
Loans and Leases Receivable, Commitments, Fixed Rates	15,000,000
Loans and Leases Receivable, Net Amount	(729,000)
Notes Receivable Funding Commitment	14,271,000
Notes Receivable Remain Unfunded [Member]
Loans and Leases Receivable, Net Amount	$ (75,836,000)

Commitments And Contingencies49

Commitments And Contingencies Commitments and Contingencies (Schedule of Lease Commitments) (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2018USD ($)
Maximum Commitment For All Active Development Projects	$ 88,380
Real Estate Properties, Commitment To Purchase, Amount	47,017
Construction and Development Costs	(41,363)
Capital Addition Purchase Commitments [Member] | Ensign Group [Member]
Maximum Commitment For All Active Development Projects	56,000
Real Estate Properties, Commitment To Purchase, Amount	28,000
Construction and Development Costs	(28,000)
Development Commitment [Member] | Chancellor Healthcare [Member]
Maximum Commitment For All Active Development Projects	650
Construction and Development Costs	(62)
Remaining Unfunded Development Commitment	588
Development Commitment [Member] | Navion Senior Solutions [Member]
Maximum Commitment For All Active Development Projects	650
Construction and Development Costs	0
Remaining Unfunded Development Commitment	650
Capital Improvement Commitment [Member] | Bickford Senior Living [Member]
Maximum Commitment For All Active Development Projects	2,400
Construction and Development Costs	(1,647)
Remaining Unfunded Development Commitment	753
Capital Improvement Commitment [Member] | East Lake Capital [Member]
Maximum Commitment For All Active Development Projects	400
Construction and Development Costs	0
Remaining Unfunded Development Commitment	400
Capital Improvement Commitment [Member] | Senior Living Communities [Member]
Maximum Commitment For All Active Development Projects	6,830
Construction and Development Costs	(1,424)
Remaining Unfunded Development Commitment	5,406
Capital Improvement Commitment [Member] | Discovery Senior Living [Member]
Maximum Commitment For All Active Development Projects	500
Construction and Development Costs	0
Remaining Unfunded Development Commitment	500
Capital Improvement Commitment [Member] | East Lake / Watermark Retirement [Member]
Maximum Commitment For All Active Development Projects	10,000
Construction and Development Costs	(5,900)
Remaining Unfunded Development Commitment	4,100
Capital Improvement Commitment [Member] | Sante Partners Commitment [Member]
Maximum Commitment For All Active Development Projects	3,500
Construction and Development Costs	(2,621)
Remaining Unfunded Development Commitment	879
Capital Improvement Commitment [Member] | Village Concepts [Member]
Maximum Commitment For All Active Development Projects	7,450
Construction and Development Costs	(1,709)
Remaining Unfunded Development Commitment	$ 5,741

Commitments And Contingencies50

Commitments And Contingencies Commitments and Contingencies (Schedule of Loss Contingencies) (Details)	3 Months Ended
	Mar. 31, 2018USD ($)
Contingent Funding Commitment	$ 34,850,000
Contingent Funding Commitment, Remaining Unfunded Amount	31,350,000
Contingent Amount Funded [Member]
Contingent Funding Commitment, Amount Funded	(3,500,000)
Bickford / Sycamore [Member]
Contingent Funding Commitment, Amount Funded	(250,000)
Contingent Funding Commitment, Remaining Unfunded Amount	5,750,000
Bickford / Sycamore [Member] | Lease Agreements [Member]
Contingent Funding Commitment	10,000,000
Contingent Funding Commitment, Amount Funded	(3,250,000)
Contingent Funding Commitment, Remaining Unfunded Amount	6,750,000
Bickford / Sycamore [Member] | Notes Receivable [Member]
Contingent Funding Commitment	6,000,000
East Lake Capital [Member]
Contingent Funding Commitment	8,000,000
Contingent Funding Commitment, Remaining Unfunded Amount	8,000,000
East Lake Capital [Member] | Maximum Contingent Amount [Member]
Lease Incentive Commitment Assessed As Not Probable	8,000,000
East Lake Capital [Member] | Contingent Amount Funded [Member]
Contingent Funding Commitment, Amount Funded	0
Ravn Senior Solutions [Member]
Contingent Funding Commitment	4,850,000
Contingent Funding Commitment, Remaining Unfunded Amount	4,850,000
Ravn Senior Solutions [Member] | Contingent Amount Funded [Member]
Contingent Funding Commitment, Amount Funded	0
Prestige Senior Living [Member]
Contingent Funding Commitment	1,000,000
Contingent Funding Commitment, Remaining Unfunded Amount	1,000,000
Prestige Senior Living [Member] | Contingent Amount Funded [Member]
Contingent Funding Commitment, Amount Funded	0
The Lasalle Group [Member]
Contingent Funding Commitment	5,000,000
Contingent Funding Commitment, Remaining Unfunded Amount	5,000,000
The Lasalle Group [Member] | Contingent Amount Funded [Member]
Contingent Funding Commitment, Amount Funded	$ 0

Investment And Other Gains (Sch

Investment And Other Gains (Schedule of Investment And Other Gains) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Investment And Other Gains [Abstract]
Gain on sale of real estate	$ 0	$ 50
Gains on sales of marketable securities	0	10,038
Investment and other gains	$ 0	$ 10,088

Investment And Other Gains Inve

Investment And Other Gains Investment And Other Gains (Details) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2018	Mar. 31, 2017	Dec. 31, 2017	Dec. 31, 2016
Marketable Securities, Realized Gain (Loss)	$ 0	$ 10,038
Proceeds from sales of marketable securities	$ 0	18,182	$ 18,182
2017 Sales Transaction [Member]
Proceeds from sales of marketable securities		$ 11,718
Marketable securities				$ 11,745
Available-for-sale Securities, Amortized Cost Basis				$ 1,680
2016 Sales Transaction [Member]
Proceeds from sales of marketable securities			$ 6,464

Share-Based Compensation Share-

Share-Based Compensation Share-Based Compensation (Schedule of Stock Option Valuation Assumptions) (Details)	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Schedule of Stock Option Valuation Assumptions [Abstract]
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Dividend Rate	6.50%	5.30%
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Volatility Rate	19.40%	19.80%
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Term	3 years 3 months 14 days	2 years 11 months 2 days
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Risk Free Interest Rate	2.39%	1.49%

Share-Based Compensation (Sched

Share-Based Compensation (Schedule Of Stock Option Activity) (Details) - shares	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Options outstanding, January 1	859,182	541,679
Options outstanding, March 31	1,404,182	979,178
Options exercisable, March 31	949,160	585,827
2012 Plan [Member]
Options granted	560,000	485,000
Options exercised	0	(25,833)
Options forfeited	(15,000)	(6,668)
2005 Plan [Member]
Options exercised	0	(15,000)

Share-Based Compensation (Narra

Share-Based Compensation (Narrative) (Details) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2018USD ($)$ / sharesshares	Mar. 31, 2017USD ($)$ / shares	May 04, 2018shares	May 07, 2015shares	May 31, 2012shares	May 31, 2005shares
Nonemployee director annual stock grants	25,000
Stock or Unit Option Plan Expense | $	$ 1,425	$ 1,523
Unrecognized compensation cost | $	$ 1,707
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Weighted Average Grant Date Fair Value | $ / shares	$ 4.49	$ 5.75
2012 Plan [Member]
Shares available for grants	391,668			3,000,000	1,500,000
Stock Option Plan, Award Vesting Period	5 years
Common stock on date granted term period, years	10
Prior To Shareholder Approval of Increase [Member]
Nonemployee director annual stock grants	15,000
Prior To Shareholder Approval of Second Amendment [Member]
Nonemployee director annual stock grants	20,000
2005 Plan [Member]
Shares available for grants						1,500,000
Stock Option Plan, Award Vesting Period	10 years
Common stock on date granted term period, years	10
Expected To Be Recognized During 2015 [Member]
Unrecognized compensation cost | $	$ 1,105
Expected To Be Recognized During 2016 [Member]
Unrecognized compensation cost | $	542
Expected To Be Recognized During 2017 [Member]
Unrecognized compensation cost | $	$ 60
Subsequent Event [Member] | 2012 Plan [Member]
Shares available for grants			3,500,000

Earnings and Dividends Per Sh56

Earnings and Dividends Per Share (Summary Of Calculation Of Basic And Diluted Earnings Per Share) (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Earnings Per Share [Abstract]
Net income (loss) attributable to common stockholders	$ 38,432	$ 44,230
BASIC:
Weighted Average Number of Shares Outstanding, Basic	41,532,154	39,953,804
DILUTED:
Weighted average common shares outstanding, diluted	41,532,154	39,953,804
Stock options, diluted	44,722	56,910
Incremental Common Shares Attributable to Dilutive Effect of Conversion of Debt Securities	0	98,048
Average dilutive common shares outstanding	41,576,876	40,108,762
Income (Loss) from Continuing Operations, Per Diluted Share	$ 0.92	$ 1.10
Incremental shares excluded since anti-dilutive:
Stock options with an exercise price in excess of the market price for our common shares	118,639	19,851
Common Stock, Dividends, Per Share, Declared	$ 1
Common Stock Dividends, Per Share, Declared, Regular	$ 1	$ 0.95

Fair Value Of Financial Instr57

Fair Value Of Financial Instruments (Schedule Of Assets And Liabilities Measured On A Recurring Basis) (Details) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Cash Flow Hedge Derivative Instrument Liabilities at Fair Value		$ 588
Fair Value, Inputs, Level 2 [Member]
Cash Flow Hedge Derivative Instrument Assets at Fair Value	$ 1,332	159
Cash Flow Hedge Derivative Instrument Liabilities at Fair Value	$ 0	$ 747

Fair Value of Financial Instr58

Fair Value of Financial Instruments (Fair Value Measurements, Nonrecurring) (Details) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Loans and Leases Receivable, Net Amount	$ 145,845	$ 141,486
Reported Value Measurement [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Loans and Leases Receivable, Net Amount	145,845	141,486
Reported Value Measurement [Member] | Variable Interest Rate Debt [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt Instrument, Fair Value Disclosure	506,991	465,642
Reported Value Measurement [Member] | Fixed Interest Rate Debt [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt Instrument, Fair Value Disclosure	653,235	679,855
Estimate of Fair Value Measurement [Member] | Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Loans and Leases Receivable, Net Amount	142,962	140,049
Estimate of Fair Value Measurement [Member] | Variable Interest Rate Debt [Member] | Fair Value, Inputs, Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt Instrument, Fair Value Disclosure	512,000	471,000
Estimate of Fair Value Measurement [Member] | Fixed Interest Rate Debt [Member] | Fair Value, Inputs, Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt Instrument, Fair Value Disclosure	$ 642,700	$ 679,385

Subsequent Events Subsequent 59

Subsequent Events Subsequent Events (Narrative) (Details)	1 Months Ended	3 Months Ended
	Apr. 29, 2018USD ($)	Mar. 31, 2018USD ($)properties	Mar. 31, 2017USD ($)	Apr. 30, 2018USD ($)propertiesbeds_or_units	Dec. 31, 2017properties
Subsequent Event [Line Items]
Number of Real Estate Properties | properties					210
Payments to Acquire Real Estate		$ 14,404,000	$ 118,011,000
Bickford Senior Living [Member]
Subsequent Event [Line Items]
Number of Real Estate Properties | properties		47
Bickford Senior Living [Member] | Subsequent Event [Member]
Subsequent Event [Line Items]
Number of Real Estate Properties | properties				5
Payments to Acquire Real Estate	$ 69,750,000
Initial lease rate				6.85%
Lessor, Operating Lease, Term of Contract	15 years
Number of Units in Real Estate Property | beds_or_units				320
Asset Purchase Transaction Costs	$ 500,000
Capital Improvements Commitment				$ 1,750,000